Multicentric Giant Cell Tumor of Bone.

The typical presentation of giant cell tumor of bone is a solitary lesion involving the meta-epiphyseal region of the long bones. The presence of more than one distinct giant cell tumor in the same patient is rare. This study reports on 7 patients with multicentric giant cell tumor of bone. Clinical and radiologic features were reviewed to evaluate the behavior of multicentric giant cell tumor of bone. Immunohistochemistry and genetic analysis for the H3F3A gene were performed to confirm the diagnosis. The knee was most frequently involved, and most of the lesions were in an ipsilateral extremity. All of the patients received surgical management with curettage or resection. The overall median follow-up was 194 months (interquartile range, 41-336 months). Five of 7 patients had local recurrence (71%), but considering the number of surgically treated lesions, the risk of local recurrence was 33% (5 local recurrences among 15 treated lesions). No lung metastases occurred. Multicentric giant cell tumor of bone tends to exhibit the same aggressive clinical behavior as solitary giant cell tumor of bone. Patients should be monitored for the occurrence of other lesions, especially in the ipsilateral extremity. [Orthopedics. 2023;46(6):e376-e380.].

Association between Inflammatory Markers and Local Recurrence in Patients with Giant Cell Tumor of Bone: A Preliminary Result.

Giant cell tumor of bone (GCTB) has a high local recurrence rate of approximately 20%. Systemic inflammatory markers, such as neutrophil-lymphocyte ratio (NLR), modified Glasgow prognostic score (mGPS), prognostic nutritional index (PNI), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), hemoglobin (Hb), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH), have been reported as prognostic markers in patients with malignant tumors. This study aimed to investigate the correlation between these markers and the local recurrence rate of GCTB. In total, 103 patients with GCTB who underwent surgery at the authors' institutions between 1993 and 2021 were included. Thirty patients experienced local recurrence. Univariate and multivariate analysis showed that tumor site, preoperative and postoperative denosumab treatment, and surgery were significantly associated with local recurrence-free survival. LDH was associated with local recurrence-free survival on univariate analysis only. NLR, mGPS, PNI, LMR, and PLR score did not correlate with the local recurrence rate. In conclusion, NLR, mGPS, PNI, LMR, PLR score, Hb, ALP, and LDH levels are not correlated with the local recurrence rate of GCTB. However, due to the small number of patients included in this study, this result should be re-evaluated in a multicenter study with a larger sample size.

Use of a national reporting system for occupational injuries in Costa Rica.

Occupational injury surveillance in developing countries may be hindered by the lack of health data infrastructure as well the large numbers of informal-sector workers. The goal of this study was to elucidate the scope of occupational injury in the Monteverde district of Costa Rica using data collected through the national workers social security system. A list of occupational injuries occurring in the district reported to the National Insurance Institute (INS) central office between 1998 and 2002 was taken to the regional INS office, and the original injury reports for the cases were pulled. Specific data on the injuries were collected. There were 184 injuries reported during the five year period. Occupations with the highest number of injuries included production, building and grounds maintenance, and agricultural/forestry/fishing. Descriptive data showed that prevention efforts in this rural region should target food manufacturing, hotels, and construction.

Validación del inventario de depresión para niños (IDN) en Costa Rica / Validation of the inventary of depression for children (IDN) in Costa Rica

Dada la creciente importancia de los problemas depresivos y suicidios en niños y adolescentes, asi como su relación con otros problemas conductuales y académicos, se hace necesario explorar más este fenómeno. El objetivo del presente estudio es validar para Costa Rica el inventario de depresión para niños y adolescentes. El instrumento se aplicó a 727 estudiantes de 8 a 19 años y a 97 adolescentes previamente diagnosticados como depresivos. Los resultados evidenciaron altos índices de confiabilidad interna y temporal. Lo que demuestra la homogeneidad del cuestionario y su consistencia en el tiempo. También se encontró que aproximadamente cada uno de diez estudiantes presentaba sufucientes síntomas depresivos para ameritar un mayor estudio y posiblemente un tratamiento específico. Se recomienda realizar una exploración más profunda al respecto, así como despertar mayor interés sobre el tema y ofrecer capacitación a padres y educadores