Occurrence of bisphosphonate-associated osteonecrosis of the jaws in individuals with rheumatoid arthritis - a systematic review.

BACKGROUND: To access the occurrence of bisphosphonate-associated osteonecrosis of the jaw (BAONJ) in individuals with rheumatoid arthritis (RA). MATERIAL AND METHODS: Observational studies that evaluated the occurrence of BAONJ in individuals with RA (BAONJ-RA) were considered for inclusion. Electronic searches were performed up to December 2022 in six databases and in the grey literature. The study selection, data extraction, and quality assessment of the included studies according to the Joanna Briggs Institute Critical Appraisal Checklists was performed. The certainty of evidence was evaluated using the GRADE approach. RESULTS: Five studies were included three cohort and two cross-sectional. The sample size of subjects with RA ranged from 16 to 3201. Together, the studies presented 36 cases of BAONJ-RA. Prevalence of BAONJ-RA ranged from 0.094% to 56.25%. The incidence ranged from 0.4% to 2.21. Women between the 6th and 8th decade of life were the most affected. Alendronate (n=5) and zoledronic acid (n=9), orally and intravenously, respectively, were the most used bisphosphonates. The duration of bisphosphonates use ranged from 2.7 to 8 years. The certainty of evidence was very low. CONCLUSIONS: The occurrence of BAONJ-RA is low. However, the certainty of the evidence was very low for this outcome.

A high body mass index is not a worse prognostic factor for endometrial carcinoma in a predominantly obese population

AIM: We investigate if body mass index (BMI, kg × m(2)) is related to clinical-pathological characteristics in primary tumor and disease outcome in endometrial cancer. BACKGROUND: Endometrial cancer incidence is increasing in industrialized countries. High BMI is associated with worse prognosis for many diseases.INTRODUCTION: Endometrial carcinoma is the most common gynecological malignancy in industrialized countries and the incidence has been increasing over the last few decades associated with obesity, however, it is not clear if a high BMI is associated with poor prognosis. PATIENTS AND METHODS: In total, 147 women primarily treated for endometrial carcinoma at the Instituto Nacional de Cancerología during 2000-2005 were studied. Body mass index was available for all patients and related to comprehensive clinical and histopathological data. RESULTS: High BMI was related to endometrioid histology and low/intermediate grade, and overweight/obese women had the same survival as the normal/underweight women. In survival analysis adjusting for age, histological subtype and grade, BMI showed no independent prognostic impact. CONCLUSION: High BMI was significantly associated with markers of non-aggressive disease and women with high BMI had the same survival time in univariate analysis (AU)