Value of Cellular Components and Focal Dedifferentiation to Predict the Risk of Metastasis in a Benign-Appearing Extra-Meningeal Solitary Fibrous Tumor: An Original Series from a Tertiary Sarcoma Center.

Histology has not been accepted as a valid predictor of the biological behavior of extra-meningeal solitary fibrous tumors (SFTs). Based on the lack of a histologic grading system, a risk stratification model is accepted by the WHO to predict the risk of metastasis; however, the model shows some limitations to predict the aggressive behavior of a low-risk/benign-appearing tumor. We conducted a retrospective study based on medical records of 51 primary extra-meningeal SFT patients treated surgically with a median follow-up of 60 months. Tumor size (p = 0.001), mitotic activity (p = 0.003), and cellular variants (p = 0.001) were statistically associated with the development of distant metastases. In cox regression analysis for metastasis outcome, a one-centimeter increment in tumor size enhanced the expected metastasis hazard by 21% during the follow-up time (HR = 1.21, CI 95% (1.08-1.35)), and each increase in the number of mitotic figures escalated the expected hazard of metastasis by 20% (HR = 1.2, CI 95% (1.06-1.34)). Recurrent SFTs presented with higher mitotic activity and increased the likelihood of distant metastasis (p = 0.003, HR = 12.68, CI 95% (2.31-69.5)). All SFTs with focal dedifferentiation developed metastases during follow-up. Our findings also revealed that assembling risk models based on a diagnostic biopsy underestimated the probability of developing metastasis in extra-meningeal SFTs.

Comparison of Bone Density of Distal Radius With Hip and Spine Using DXA.

Osteoporosis diagnosis is usually based on examination of the hip bone and vertebrae density; however, the radius bone has gained attention recently in terms of feasibility and accessibility as it is done by portable devices with proper precision. This study aims to compare hip and spine density with radius, knowing whether radius may be an appropriate alternative for osteoporosis diagnosis. 120 females who were referred to one Densitometry Center checked their skeletal status using a hologic unit for densitometry of spine, femoral neck, and one-third radius. The patients were divided into three groups of healthy, osteopenic and osteoporotic based on WHO's protocol. Concordance analysis was done to investigate the degree of similarity of diagnosis. In the study, there were 40, 41, and 39 individuals with normal, osteopenic, and osteoporotic bone densities, respectively which obtained from hip bone or vertebrae using the T-score criterion T-score of radius bone density has a direct linear relationship with these result. Osteoporosis diagnosis can be made based on radius densitometry.

Population attributable fraction of modifiable risk factors for Alzheimer disease: A systematic review of systematic reviews.

BACKGROUND: Alzheimer's disease (AD) is the most common type of dementia. Demonstrating the modifiable risk factors of AD can help to plan for prevention of this disease. The aim of the current review was to characterize modifiable cardiovascular risk factors of AD using existing data and determine their contribution in AD development in Iran and the world. METHODS: The systematic search was done in Medline, Scopus, and Cochrane databases from inception to May 2014 to find systematic reviews or meta-analyses about association between AD and cardiovascular modifiable risk factors included diabetes, hypertension (HTN), physical inactivity, smoking, hypercholesterolemia, and overweight and obesity. The population attributable fraction (PAF) was calculated for these risk factors in Iran and the world. RESULTS: Of 2651 articles, 11 were eligible for data extraction after assessing relevancy and quality. Diabetes mellitus (DM) type 2, smoking, physical inactivity, overweight and obesity were significantly associated with increased risk of AD. Physical inactivity with 22.0% and smoking with 15.7% had the highest PAF for AD in Iran and the world, respectively. CONCLUSION: Our findings demonstrated that modifiable cardiovascular risk factors could increase the risk of AD. Moreover, about one-third of AD cases were attributed to five modifiable risk factors.