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Background: cytokines that regulate the bone turnover (TNFα, IL-6, etc.) may influence the pathogenesis of skeleton disorders, such as osteoporosis, by stimulating the bone reabsorption and the recruitment and differentiation of osteoclast precursors. Since H. pylori (HP) infection may increase the systemic levels of inflammatory cytokines, we investigated on the possibility that HP infection may affect bone metabolism in a group of male patients with osteoporosis. Material and Methods: we examined 55 male patients with osteoporosis for serum antibodies to HP and the CagA protein (by ELISA tests), and determined the most important biochemical and instrumental parameters of the disease. Proportions were compared in univariate analysis by the chi² tests with the Yates correction, or the Fisher's exact test. P values < 0.05 were considered significant. Results: the mean age of patients was 65 years (range 55-82 years); 37 patients (67.2%) were seropositive for H. pylori infection, and 18 patients (32.7%) were seronegative; 19 infected patients (51.3%) were CagA-positive. No significant difference was found between HP[sup +] and HP[sup -] patients in height, weight, calcium intake, sex hormone and 25 OH vitamin D levels, and femoral BMD. The following parameters showed a trend for difference: IGF-I (ng/ml) (145 ± 102 in HP[sup -] vs. 118 ± 40 in HP[sup +] patients, P = 0.15), serum calcium levels (mg/dl) (9.24 ± 0.37 in HP[sup -] vs. 9.06 ± 0.36 in HP[sup +] patients, P = 0.09) and urinary crosslaps (a marker of bone reabsorption) (µg/mmol) (233.46 ± 130 in HP[sup -] vs. 290.1 ± 108 in HP[sup +] patients, P = 0.14). These differences were even more pronounced in CagA-positive patients, respect to the CagA-negative ones. Discussion: these results suggest that the chronic low inflammatory response stimulated by HP infection may increase the bone turnover, and, in a long run, exacerbate the clinical expression... [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to assess the early effects of zoledronic acid (ZOL) and oral ibandronate (IBA) on the bone resorption marker s-CTX (serum C-telopeptide of collagen type I) and the bone formation marker B-ALP (bone-alkaline phosphatase) in patients with bone metastases from non-small cell lung cancer (NSCLC)., Methods: Fifty-five patients with at least one site of bone metastasis secondary to NSCLC were randomly assigned to receive intravenous ZOL 4 mg every 4 weeks, or oral IBA 50 mg/day., Results: At 1 month of treatment, s-CTX was reduced by 54.8% (95% CI 40.4-59.8%) in the ZOL group (26 evaluable patients) compared with 38.2% (95% CI 29.8-48.7%) in the oral IBA group (27 evaluable patients) (p = 0.03). At 3 months, s-CTX was reduced by 72.6% (95% CI 58.6-71.3%) in the ZOL group, compared with 66.4% (95% CI 54.3-79.5%) in the oral IBA group (p = 0.22). Both bisphosphonates similarly decreased the bone marker B-ALP at 1 month (ZOL 24.7%, 95% CI 3.6-39.5%, and IBA 24.2%, 95% CI 2.8-43.4%) and 3 months (ZOL 28.6%, 95% CI +2.8-43.3%, and IBA 24.2%, 95% CI 3.2-47.4%). Both bisphosphonates were well tolerated., Conclusion: Considering the changes in bone markers, ZOL and oral IBA show comparable efficacy in patients with NSCLC and bone metastases.

Background: The authors investigated the incidence of and risk factors for osteonecrosis of the jaw (ONJ) in patients with metastases to the bone who received the bisphosphonate agent zoledronic acid (ZOL) and chemotherapy combined with the antiangiogenic agent bevacizumab (BEV)., Methods: The authors evaluated 59 participants (34 with breast cancer and 25 with nonsmall-cell lung cancer). All of the participants received 4 milligrams of ZOL via intravenous (IV) infusion every four weeks and 15 mg per kilogram of BEV every three weeks. They conducted a dental examination in participants at baseline and every three months until the patients died or were lost to follow-up. If needed, participants received periodontal disease treatment and underwent tooth extraction before they started receiving ZOL and BEV., Results: The median time the participants received ZOL therapy was 18.8 months (range, 3.1-28.9 months); 36 participants (61.0 percent) received ZOL therapy for more than one year. The median time participants received BEV therapy was 16.7 months (range, 2.8-29.6 months). None of the participants required dentoalveolar surgery while undergoing cancer treatment. After a median follow-up period of 19.7 months, none of the participants developed bisphosphonate-related ONJ., Conclusions and Clinical Implications: ZOL combined with BEV did not predispose to ONJ participants with cancer that had metastasized to the bone who underwent a baseline dental examination and preventive dental measures. The study results must be considered in the context of the study's protocols and the follow-up period.

Background. The aim of this paper was to evaluate the activity and tolerability of docetaxel (D) and bevacizumab (Bev) in patients with metastatic castrate-resistant prostate cancer (CRPC) previously exposed to D. Methods. Treatment consisted of D 30 mg/m(2) i.v. for four consecutive weekly administrations followed by a 2-week rest interval, in addition to Bev 5 mg/kg i.v. every 2 weeks. Results. Forty-three patients were enrolled: a PSA response was observed in 27 patients (62.7%, 95% CI: 0.41 to 0.91), and a palliative response was achieved in 31 patients (72.1%, 95%CI: 0.48 to 1.02). After a median followup of 11.3 months, only five patients had died. The regimen was generally well tolerated. Conclusion. Weekly D + biweekly Bev seems to be an effective and well-tolerated treatment option for patients with metastatic CRPC previously exposed to D-based chemotherapy.

The primary objective of this study was to determine the activity and safety profile of biweekly oxaliplatin combined with continuous oral capecitabine in the first-line treatment of metastatic colorectal cancer. A secondary endpoint was to investigate the correlation between thymidylate synthase and thymidine phosphorylase (TP) expression in metastatic tissues and tumor response. Forty-one patients received oral capecitabine 1331 mg/m every day combined with intravenous oxaliplatin 85 mg/m every 2 weeks. The overall response rate was 58.5% [95% confidence interval (CI): 43.3-73.6%], the median progression-free survival 9.4 months (95% CI: 7.7-11.2 months) and the median survival 22.3 months (95% CI: 16.1-27.5 months). There were no grade 4 toxicities, and grade 3 toxicity was also uncommon. High TP expression in metastatic tissue was significantly associated with response to treatment (P=0.019), and also with a trend towards a better median progression-free survival and overall survival compared with patients expressing low TP (P=0.056; P=0.073). This study suggests that biweekly oxaliplatin and continuous oral capecitabine is an active and well-tolerated chemotherapy regimen in the first-line treatment of metastatic colorectal cancer. Moreover, these findings add to a growing body of evidence that patients with high levels of intratumoral TP expression are the ideal candidates for capecitabine-based chemotherapy.

Objective: Many studies have examined genetic factors associated with either development or severity of primary osteoarthritis (OA). Analyses of the frequencies of HLA antigens in various OA populations have yielded conflicting results; an increased frequency of HLA-A1, B8, and DR4 alleles has been suggested. We investigated the interrelationship between HLA antigens and primary OA., Methods: We analyzed the frequency of HLA-A, B, C, DR, and DQ antigens in 95 patients (82 women, 13 men) with primary OA of the hands compared to 200 controls matched for age, sex, and ethnicity. Class I and Class II HLA antigens were evaluated using conventional serologic typing., Results: No statistically significant difference in the distribution of HLA-A1 and B8 antigens was observed in patients with OA compared to controls. By contrast, HLA-B35, B40, DQ1, and CW4 antigens were overrepresented in the OA patients. Haplotype analysis showed an association of B35-DQ1, B40-DQ1, and DR2-DQ1 with increased OA risk., Conclusion: Our results suggest a role of the HLA system in the etiopathogenesis of primary OA of the hand.