Impact of an osteoporosis specialized unit on bone health in breast cancer survivals treated with aromatase inhibitors / Impacto de una unidad de osteoporosis en la salud ósea de pacientes con cáncer de mama en tratamiento con inhibidores de la aromatasa

Objective: Considering the increased fracture risk in early breast cancer patients treated with aromatase inhibitors (AI), we assessed the impact of a preventive intervention conducted by a specialized osteoporosis unit on bone health at AI treatment start. Material and methods: Retrospective cohort of postmenopausal women who started treatment with AI after breast cancer surgical/chemotherapy treatment and were referred to the osteoporosis unit for a comprehensive assessment of bone health. Bone densitometry and fracture screening by plain X-ray were performed at the baseline visit and once a year for 5 years. Results: The final record included 130 patients. At AI treatment start, 49% had at least one high-risk factor for fractures, 55% had osteopenia, and 39% osteoporosis. Based on the baseline assessment, 79% of patients initiated treatment with bisphosphonates, 88% with calcium, and 79% with vitamin D. After a median of 65 (50-77) months, 4% developed osteopenia or osteoporosis, and 14% improved their densitometric diagnosis. Fifteen fractures were recorded in 11 (8.5%) patients, all of them receiving preventive treatment (10 with bisphosphonates). During the follow-up period, patients with one or more high-risk factors for fracture showed a greater frequency of fractures (15% vs. 3%) and experienced the first fracture earlier than those without high-risk factors (mean of 99 and 102 months, respectively; P=0.023). Conclusions: The preventive intervention of a specialized unit at the start of AI treatment in breast cancer survivors allows the identification of patients with high fracture risk and may contribute to preventing bone events in these patients

Objetivo: Evaluar el impacto de la intervención preventiva de una unidad de osteoporosis en supervivientes de cáncer de mama que inician un tratamiento con inhibidores de la aromatasa (IA). Material y métodos: Estudio retrospectivo en mujeres posmenopáusicas con cáncer de mama precoz que iniciaron un tratamiento con IA tras la cirugía y/o quimioterapia, derivadas a la unidad de osteoporosis para una evaluación de la salud ósea, incluyendo densitometrías óseas y búsqueda sistemática de fracturas mediante Rx al inicio del tratamiento y anualmente durante 5 años. Resultados: Se incluyeron 130 pacientes. Al inicio del tratamiento con IA el 49% tenía al menos un factor de riesgo alto para fracturas, el 55% osteopenia y el 39% osteoporosis. Tras la evaluación inicial, el 79% de las pacientes inició un tratamiento con bifosfonatos, el 88% con calcio y el 79% con vitamina D. Tras una mediana de 65 (50-77) meses, el 4% desarrolló osteopenia u osteoporosis y el 14% mejoró el diagnóstico densitométrico. Se registraron 15 fracturas en 11 (8,5%) pacientes, todas ellas en tratamiento preventivo. Durante el seguimiento, las pacientes con ≥1 factores de riesgo altos registraron una mayor frecuencia de fracturas (15 vs. 3%) y un menor tiempo hasta la primera fractura (media de 99 vs. 102 meses; p=0,023). Conclusiones: La intervención preventiva de una unidad de osteoporosis al inicio del tratamiento con IA en supervivientes de cáncer de mama permite identificar pacientes con un elevado riesgo de fracturas y puede contribuir a la prevención de eventos óseos en estas pacientes

Impact of an osteoporosis specialized unit on bone health in breast cancer survivals treated with aromatase inhibitors.

OBJECTIVE: Considering the increased fracture risk in early breast cancer patients treated with aromatase inhibitors (AI), we assessed the impact of a preventive intervention conducted by a specialized osteoporosis unit on bone health at AI treatment start. MATERIAL AND METHODS: Retrospective cohort of postmenopausal women who started treatment with AI after breast cancer surgical/chemotherapy treatment and were referred to the osteoporosis unit for a comprehensive assessment of bone health. Bone densitometry and fracture screening by plain X-ray were performed at the baseline visit and once a year for 5 years. RESULTS: The final record included 130 patients. At AI treatment start, 49% had at least one high-risk factor for fractures, 55% had osteopenia, and 39% osteoporosis. Based on the baseline assessment, 79% of patients initiated treatment with bisphosphonates, 88% with calcium, and 79% with vitamin D. After a median of 65 (50-77) months, 4% developed osteopenia or osteoporosis, and 14% improved their densitometric diagnosis. Fifteen fractures were recorded in 11 (8.5%) patients, all of them receiving preventive treatment (10 with bisphosphonates). During the follow-up period, patients with one or more high-risk factors for fracture showed a greater frequency of fractures (15% vs. 3%) and experienced the first fracture earlier than those without high-risk factors (mean of 99 and 102 months, respectively; P=0.023). CONCLUSIONS: The preventive intervention of a specialized unit at the start of AI treatment in breast cancer survivors allows the identification of patients with high fracture risk and may contribute to preventing bone events in these patients.

Sonographically guided percutaneous needle lavage in calcific tendinitis of the shoulder: short- and long-term results.

OBJECTIVE: The purpose of our study was to evaluate the short- and long-term effectiveness of sonographically guided percutaneous needle aspiration and lavage in calcific tendinitis of the shoulder and to study the progress of calcifications and symptoms in the first year after treatment. MATERIALS AND METHODS: Symptoms and radiologic findings after percutaneous aspiration of calcific tendinitis were prospectively evaluated in the short and the long term using a shoulder pain and disability index, evaluation of shoulder motion, and a survey of the self-perception by the patients regarding the progress of their disease. RESULTS: Sixty-seven consecutive shoulders were treated. A significant improvement was seen in shoulder motion, pain, and disability in the short term and in the long term (p < 0.0001). One year after treatment, 91% of shoulders had substantially or completely improved, 64% had perfect motion, and calcifications on radiography had resolved completely or nearly completely in 89%. A transitory recurrence was observed approximately 15 weeks after treatment in 44.3% of shoulders that improved. CONCLUSION: Percutaneous needle aspiration and lavage is effective in the short term and in the long term in calcific tendinitis of the shoulder, with results similar to or better than those published for other techniques, and it is only slightly invasive and painful. Progress after treatment may include a transitory period of recurrence of the pain.

Obstrucción intestinal en una mujer previamente sana / Intestinal occlusion in a previously healthy woman

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