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Fulltext Metastatic cervical carcinoma presenting as psoas abscess and osteoblastic and lytic bony metastases

George J, Lai FM

Singapore Med J, 1995 Apr;36(2):224-7.
PMID: 7676275

A 60-year-old Chinese lady presented with a left flank mass and weight loss. Plain films showed a sclerotic L1 vertebral body, osteopenic L2 and L3 vertebral bodies and loss of left psoas outline. However initially unrevealed history of previous carcinoma of the cervix caused confusion as to the aetiology of a sclerotic vertebral body associated with an left flank collection. Psoas abscess with adjacent bony osteomyelitis was initially suspected. The left flank mass turned out to be an infected necrotic large metastatic lymph node compressing the lower pole of the left kidney. The sclerotic and osteopenic vertebral bodies represented an unusual presentation of bony cervical carcinoma metastases.

Matched MeSH terms: Bone Diseases, Metabolic/diagnosis
Fulltext Calcium intake, vitamin D and bone health status of post-menopausal Chinese women in Kuala Lumpur

Chee, W.S.S., Chong, P.N., Chuah, K.A., Karupaiah, T ., Norlaila Mustafa, Seri Suniza, S., et al.

Malays J Nutr, 2010;16(2):233-242.
MyJurnal

Bone health status was investigated in 178 free-living Chinese post-menopausal women in Kuala Lumpur. Body mass index (BMI), body composition (using whole body DXA), calcium intake and serum 25-OH vitamin D status were measured along with biochemical markers of bone turnover, that is, pro-collagen Type 1 N-terminal peptide (P1NP), osteocalcin (OC) and C-telopeptide ß cross
link of Type 1 collagen (CTX- β). Bone mineral density (BMD) was measured using DXA (Hologic, USA) at the lumbar spine, femoral neck and total hip. Results showed that osteopenia was present in 50% of the subjects at the spine and 57.9% at the femoral neck. Osteoporosis was diagnosed in 10% of the subjects at both the femoral neck and spine. A total of 29.3% of the subjects had high
levels of CTX- ß. Mean serum level of 25-OH vitamin D was 60.4+15.6 nmol/L and 50.6% of the subjects had hypovitaminosis D (defined as

Matched MeSH terms: Bone Diseases, Metabolic
Fulltext Relationship of Calcium Intake and Lifestyle Factors to Bone Health Status among Postmenopausal Women

Malays J Nutr, 2000;6(1):-.
MyJurnal

This study aims to determine the relationship between calcium intake and lifestyle factors with bone health status among 56 postmenopausal women in the Evergreen Senior Citizens Club, Petaling Jaya. Purposive sampling technique was used for sample selection. Bone mineral density (BMD) of the femur proximal and lumbar L2-L4 was measured based on the Dual Energy X-ray Absorptionmetry (DEXA) technique at KVOTC Clinic, Subang Jaya. The interview sessions were conducted using a questionnaire followed by anthropometric measurements. The results revealed that the average age of the respondents was 64.0 years old. The average weight and height of the respondents were 53.68 kg and 1.55 meters, respectively. Overall, the average body mass index (BMI) of the respondents was quite satisfactory (22.4 kg/mÂ²) with only 17.9% of them categorized as overweight (>25 kg/mÂ²). The average total calcium intake was 807.31 mg and about 76.2% was contributed by food intake. About 83.9% of the respondents met the recommended calcium intake according to the Malaysian RDA. The average BMD of the lumbar, neck, wards and trochanter was 9.983 Â± 0.178 g/cmÂ², 0.745 Â± 0.126 g/cmÂ², 0.604 Â± 0.150 g/cmÂ² and 0.674 Â± 0.127 g/cmÂ², respectively. About 32.1% of the respondents were categorized as osteoporotic at the femoral wards, while 10.7% respectively was at the lumbar L2-L4 and femoral neck. Half of the respondents had osteopenia at the femoral neck (53.6%) and wards (50.0%) and at the lumbar L2-L4 (53.6%). Pearson correlation test showed significant negative correlations between age and BMD in the neck (r = -0.419, p

Matched MeSH terms: Bone Diseases, Metabolic
Fulltext The Effects of Chemical Castration with Degarelix on Bone Turnover: Densitometric and Biomechanics Bone Properties of Male Rats

Jayusman PA, Mohamed IN, Shuid AN

Int J Endocrinol Metab, 2018 Jul;16(3):e64038.
PMID: 30197659 DOI: 10.5812/ijem.64038

Background: Gonadotropin releasing hormone (GnRH) antagonists may cause chemical castration in males by suppressing the pituitary-gonadal axis, hence reducing testosterone level. There are limited data on the effects of degarelix, a newer series of potent and long acting GnRH antagonist on bone.
Objectives: The current study aimed at determining the effects of degarelix on bone turnover, bone densitometry, and bone mechanical strength in male rats.
Methods: Eighteen male Sprague-Dawley rats were randomly divided into sham (SHAM), orchidectomized (ORX), and degarelix-induced (DGX) groups. Chemical castration was performed by subcutaneous degarelix injection (2 mg/kg) at the scapular region. The rats were scanned for baseline bone mineral area (BMA), bone mineral content (BMC), and bone mineral density (BMD) using dual-energy x-ray absorptiometry (DXA). Following six weeks of experimental period, BMA, BMC, and BMD were measured again with DXA and blood was collected for testosterone and bone biomarkers (osteocalcin and C-terminal of type I collagen crosslink (CTX-1)) measurements. The rats were euthanized and femora were dissected for bone biomechanical strength analysis.
Results: Bilateral orchidectomy and degarelix administration significantly lowered serum testosterone level, decreased whole body BMC, femoral BMA, femoral BMC, and femoral BMD (P < 0.05) compared with the SHAM group. However, no significant changes were observed in bone biochemical markers and bone mechanical strength in all experimental groups.
Conclusions: In conclusion, degarelix administration had comparable effects on bone as bilateral orchidectomy. Administration of degarelix provides an alternative method of inducing testosterone deficient-osteopenia in male rats without need for removing the testes.

Matched MeSH terms: Bone Diseases, Metabolic
Bone resorption marker status of pre and postmenopausal Malay women in Kelantan and its corresponding risk factors

Hermizi Hapidin, Hawa Mahmood, Sakinah Harith

Sains Malaysiana, 2013;42:1191-1200.

Menopause is the most prevalent cause of accelerated bone loss in women. Biochemical markers of bone resorption can be used clinically to predict future bone loss. This study aimed to determine the level of bone resorption markers in healthy pre and postmenopausal Malay women and determine their association with the risk. A total of 150 healthy women were recruited for this study (51 pre and 99 postmenopausal subjects). Data on socioeconomic, lifestyle habit and clinical were gained by personal interview. Fasting serum was collected to measure both C-telopeptide (CTx) and N-telopeptide (NTx) of type 1 collagen. Both markers were highly correlated with each other (r=0.568, p<0.001). Both intra- and inter-assay coefficient of variations (CV) of NTx were higher than those of CTx (8% and 12% vs 6% and 5%). The mean CTx values of pre and postmenopausal subjects were comparable with the expected values (0.2833 (0.1769) ng/mL and 0.4323 (1.851) ng/mL compared with 0.287 and 0.438 ng/mL, respectively). The NTx value for premenopausal subjects were higher than the expected values (15.2 (8.10) compared to 12.6 (3.20) nM BCE). The median was 19.929 nM BCE. The mean CTx and NTx levels of postmenopausal subjects were significantly lower than premenopausal subjects (p<0.05). The risk factors for bone resorption in this population were duration of menopause, marital status, body mass index (BMI), physical activity and education level. In conclusion, postmenopausal women showed a higher bone resorption, indicating higher bone loss. Increasing education and physical activity intervention might be effective to ensure better health in Malaysian older population.

Matched MeSH terms: Bone Diseases, Metabolic
Fulltext Combined virgin coconut oil and tocotrienol-rich fraction protects against bone loss in osteoporotic rat model

Malik MMA, Othman F, Hussan F, Shuid AN, Saad QM

Vet World, 2019 Dec;12(12):2052-2060.
PMID: 32095059 DOI: 10.14202/vetworld.2019.2052-2060

Background and Aim: Both virgin coconut oil (VCO) and tocotrienol-rich fraction (TRF) are rich in antioxidants and may protect the bone against bone loss induced by ovariectomy and high-fat diet. The study aimed to determine the protective effects of combined therapy of VCO and TRF on osteoporosis in ovariectomized (OVX) rat fed with high-fat diet.
Materials and Methods: Thirty-six female Sprague-Dawley rats were divided into six groups: Sham-operated (SHAM), OVX control, OVX and given Premarin at 64.5 µg/kg (OVX+E2), OVX and given VCO at 4.29 ml/kg (OVX+V), OVX and given TRF at 30 mg/kg (OVX+T), and OVX and given a combination of VCO at 4.29 ml/kg and TRF at 30 mg/kg (OVX+VT). Following 24 weeks of treatments, blood and femora samples were taken for analyses.
Results: There were no significant differences in serum osteocalcin levels between the groups (p>0.05), while serum C-terminal telopeptide of Type I collagen levels of the OVX+VT group were significantly lower than the other groups (p<0.05). The dynamic bone histomorphometry analysis of the femur showed that the double-labeled surface/bone surface (dLS/BS), mineral apposition rate, and bone formation rate/BS of the OVX+E2, OVX+T, and OVX+VT groups were significantly higher than the rest of the groups (p<0.05).
Conclusion: A combination of VCO and TRF has the potential as a therapeutic agent to restore bone loss induced by ovariectomy and high-fat diet.

Matched MeSH terms: Bone Diseases, Metabolic
Fulltext Avoiding diagnostic pitfalls in mimics of neoplasia: the importance of a comprehensive diagnostic approach

Samsudin EZ, Kamarul T, Mansor A

Singapore Med J, 2015 May;56(5):e92-5.
PMID: 26034328 DOI: 10.11622/smedj.2015082

Any medical diagnosis should take a multimodal approach, especially those involving tumour-like conditions, as entities that mimic neoplasms have overlapping features and may present detrimental outcomes if they are underdiagnosed. These case reports present diagnostic pitfalls resulting from overdependence on a single diagnostic parameter for three musculoskeletal neoplasm mimics: brown tumour (BT) that was mistaken for giant cell tumour (GCT), methicillin-resistant Staphylococcus aureus osteomyelitis mistaken for osteosarcoma and a pseudoaneurysm mistaken for a soft tissue sarcoma. Literature reviews revealed five reports of BT simulating GCT, four reports of osteomyelitis mimicking osteosarcoma and five reports of a pseudoaneurysm imitating a soft tissue sarcoma. Our findings highlight the therapeutic dilemmas that arise with musculoskeletal mimics, as well as the importance of thorough investigation to distinguish mimickers from true neoplasms.

Matched MeSH terms: Bone Diseases, Metabolic/diagnosis