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CABA, Argentina

The aim of this review is to discuss recent findings in the physiopathology and treatment of osteoporotic lesions present in almost all patients with MM. The efficacy of bisphosphonates is well known, so we summarize the current treatment schedules according to the most recent consensus. Pamidronate and Zoledronate are equally effective and universally accepted. They should be administered intravenously on a monthly basis for two years. Oral clodronate is accepted in Europe but not in USA. Even if bisphosphonates provide a better quality of life, they do not increase survival. Because osteonecrosis of the jaw has been repeatedly reported after high doses of bisphosphonates, we discuss the necessary precautions to prevent this condition emphasizing frequent dental care and examinations. Copyright © 2011 por la Sociedad Argentina de Endocrinología y Metabolismo. Source


Drnovsek M.L.,Htal. Ramos Mejia | Ercolano M.,Htal. Ramos Mejia | Rubin Z.,Htal. de Clinicas
Revista Argentina de Endocrinologia y Metabolismo | Year: 2011

Breast cancer is one of the most frequent tumors in women. More than 70% of these patients develop endocrine-responsive disease with estrogen receptor-positive, progesterone receptor-positive tumors or both. In the last decade, breast cancer mortality has decreased by 6-8%. This could be due to early screening and to adjuvant treatment with chemotherapy as well as hormonal treatment, either with estrogen blockage or ovary ablation. Estrogen depletion implies an increase in bone resorption, bone mass decrease and growth of the osteoporotic fractures The introduction of aromatase inhibitors offers promissory results in the early-stage breast cancer treatment. However, many clinical trials have demonstrated that estrogen deprivation induced by aromatase inhibitors seriously affects bone health. A systematic evaluation of these patients, including bone mass measurement, assessment of mineral metabolism and determination of risk factors for osteoporosis would be necessary to introduce prevention and/or treatment measures. Bisphosphonates may be useful since they increase bone mass and reduce bone remodeling, although their usefulness in reducing the fracture rate has not been demonstrated in this group of patients. Copyright © 2011 por la Sociedad Argentina de Endocrinología y Metabolismo. Source


Bertini K.,Htal. Militar Central | Drnovsek M.L.,Htal. Ramos Mejia | Echin M.,Htal. Rivadavia | Ercolano M.,Htal. Ramos Mejia | And 2 more authors.
Revista Argentina de Endocrinologia y Metabolismo | Year: 2013

Osteoimmunology is a research field that deals with the study of the interaction between the immune system and bone tissue. Enough evidence demonstrates that they share regulatory mechanisms. This interaction occurs through direct contact between the cells of both systems and by the action of immune regulatory mediators, cytokines and growth factors. The aim of this review is to provide an overview of the interaction between bone and immune cells and the role they play in the mutual development and function. A greater knowledge of the interaction of these two systems will allow a better understanding of the role of immunology in the pathogenesis of bone mass loss. Copyright ® 2013 por la Sociedad Argentina de Endocrinología y Metabolismo. Source


Bertini K.,Htal. Militar Central | Drnovsek M.,Htal. Ramos Mejia | Echin M.,Htal. Rivadavia | Ercolano M.,Htal. Ramos Mejia | And 2 more authors.
Revista Argentina de Endocrinologia y Metabolismo | Year: 2014

The objective of this communication is to review the immune mechanisms involved in the pathogenesis of bone damage in some autoimmune diseases. As they are numerous (autoimmune polyendocrinopathy , celiac disease, Crohn's disease, ulcerative colitis, HIV, rheumatic diseases, bronchial asthma, pernicious anemia, periodontitis, etc.), we selected only four: Rheumatoid Arthritis, because of its typical bone lesions; post-menopause, because the immune components are not so often described; HIV, because of the current longer survival time with higher possibilities of bone lesions, and Periodontitis, in order to have an overview of dental aspects of this pathology. In many cases, knowledge of these mechanisms has contributed to the development of specific drugs that have led to therapeutic success and an improved quality of life. Copyright ® 2014 por la Sociedad Argentina de Endocrinología y Metabolismo Source


Drnovsek M.,Htal. Ramos Mejia | Echin M.,Htal. Rivadavia | Ercolano M.,Htal. Ramos Mejia | Rubin Z.,Htal. de Clinicas
Revista Argentina de Endocrinologia y Metabolismo | Year: 2011

Osteoporosis and bone fractures are frequently overlooked complications of androgen deprivation therapy in men with non-metastatic prostate cancer. Several therapies commonly used in the treatment of prostate cancers, particularly in androgen deprivation therapy for prostate cancer, are associated with significant bone loss and with an increase in fracture risk. The use of bisphosphonates seems to attenuate bone loss, although the long-term impact remains unclear because of insufficient follow-up. Several agents, such as denosumab and toremifene, have shown to be promising in reducing fracture risk in these patients. Adjuvant endocrine therapy with androgen deprivation can be considered a risk factor for the development of osteopenia, osteoporosis, and bone fracture, which can be mitigated by appropriate bisphosphonate therapy. Clear identification of risk factors for osteoporosis in individual patients could help in decision-making about whether to initiate treatment with bisphosphonates in patients under androgen deprivation therapy. Patients need to be educated about this risk and other measures to avoid this complication, including lifestyle modifications that may benefit their general and bone health. Copyright © 2011 por la Sociedad Argentina de Endocrinología y Metabolismo. Source

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