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Chia-Chi Chu, Hirofumi HagaCampbelltown Hospital, Campbelltown, Sydney, NSW, AustraliaBackground: Osteoporosis is a debilitating disease that contributes to 1.5 million fractures per annum among women in the USA. The aim of this systemic review study was to determine the effects of oral bisphosphonates in preventing osteoporotic fractures in postmenopausal women.Methods: A literature search was performed of the MEDLINE®, Embase, and CENTRAL databases. Three types of oral bisphosphonates were identified for the study: alendronate, risedronate, and ibandronate. The chief outcome measure was the incidence of fractures in postmenopausal women.Results: Five randomized controlled studies were included in the meta-analysis. A total of 9,941 patients received oral bisphosphonate, while 5,956 patients received a placebo. The overall risk ratio for all fracture events was 0.73 (confidence interval: 0.66–0.81) There was no significant increased risk for upper gastrointestinal side effects in patients taking bisphosphonates (odds ratio: 1.00; confidence interval: 0.92–1.08).Conclusion: Oral bisphosphonates are associated with a statistically significant reduction in fracture risk in postmenopausal women. Adverse effects were similar for both placebo and oral bisphosphonates.Keywords: osteoporosis, fractures, alendronate, risedronate, ibandronate, fracture risk

Cytokeratin 5 (CK5) is a marker for pulmonary squamous cell carcinoma; however, CK5 is sometimes present in pulmonary adenocarcinoma (ADC), and there is insufficient information regarding the clinicopathological features of CK5‐positive ADC. We aimed to explore the clinicopathological characteristics of CK5‐positive ADC using immunohistochemistry. We prepared the following two cohorts: a resected cohort containing 220 resected tumours for primarily studying the detailed morphological characteristics, and a tissue microarray (TMA) cohort containing 337 samples for investigating the associations of CK5 expression with other protein expressions, genetic and prognostic findings. CK5‐positive ADC was defined to have ≥ 10% tumour cells and presence of CK5‐positive tumour cells in the resected and TMA cohorts, respectively. CK5‐positive ADCs were identified in 91 (16.3%) patients in the combined cohort. CK5‐positive ADCs had male predominance (P = 0.012), smoking history (P = 0.001), higher stage (P < 0.001), histological high‐grade components (P < 0.001), vascular invasion (P < 0.001), mucinous differentiation (P < 0.001), spread through airspaces (P < 0.001), EGFR wild‐type (P < 0.001), KRAS mutations (P < 0.001), ALK rearrangement (P < 0.001) and ROS1 rearrangement (P = 0.002). In the resected cohort, more than half the CK5‐positive ADCs (19 cases, 65.5%) showed mucinous differentiation; the remaining cases harboured high‐grade components. In the TMA cohort, CK5‐positive ADCs correlated with TTF‐1 negativity (P = 0.002) and MUC5B, MUC5AC and HNF4alpha positivity (P < 0.001, 0.048, < 0.001). Further, CK5‐positive ADCs had significantly lower disease‐free and overall survival rates than CK5‐negative ADCs (P < 0.001 for each). Additionally, multivariate analysis revealed that CK5 expression was an independent poor prognostic factor. CK5‐positive ADCs showed aggressive clinical behaviour, with high‐grade morphology and mucinous differentiation. [ABSTRACT FROM AUTHOR]

Cores from Northwind Ridge, a high-standing continental fragment in the Chukchi borderland of the oceanic Amerasia basin, Arctic Ocean, contain representatives of every Phanerozoic system except the Silurian and Devonian systems. Cambrian and Ordovician shallow-water marine carbonates in Northwind Ridge are similar to basement rocks beneath the Sverdrup basin of the Canadian Arctic Archipelago. Upper Mississippian(?) to Permian shelf carbonate and spicularite and Triassic turbidite and shelf lutite resemble coeval strata in the Sverdrup basin and the western Arctic Alaska basin (Hanna trough). These resemblances indicate that Triassic and older strata in southern Northwind Ridge were attached to both Arctic Canada and Arctic Alaska prior to the rifting that created the Amerasia basin. Late Jurassic marine lutite in Northwind Ridge was structurally isolated from coeval strata in the Sverdrup and Arctic Alaska basins by rift shoulders and grabens, and is interpreted to be a riftogenic deposit. This lutite may be the oldest deposit in the Canada basin. A cap of late Cenomanian or Turonian rhyodacite air-fall ash that lacks terrigenous material shows that Northwind Ridge was structurally isolated from the adjacent continental margins by earliest Late Cretaceous time. Closing Amerasia basin by con joining seafloor magnetic anomalies beneath the Canada basin or by uniting the pre-Jurassic strata of Northwind Ridge with kindred sections in the Sverdrup basin and Hanna trough yield similar tectonic reconstructions. Together with the orientation and age of rift-margin structures, these data suggest that (1) prior to opening of the Amerasia basin, both northern Alaska and the continental ridges of the Chukchi borderland were part of North America, (2) the extension that created the Amerasia basin formed rift-margin grabens beginning in Early Jurassic time and new oceanic crust probably beginning in Late Jurassic or early Neocomian time. Reconstruction of the Amerasia basin on the basis of the stratigraphy of Northwind Ridge and sea-floor magnetic anomalies in the Canada basin accounts in a general way for the major crustal elements of the Amerasia basin, including the highstanding ridges of the Chukchi borderland, and supports S. W. Carey's hypothesis that the Amerasia basin is the product of anticlockwise rotational rifting of Arctic Alaska from North America.