“
“Bisphosphonates are widely prescribed and highly effective at limiting the bone loss that occurs In many disorders characterized by Increased Ofev osteoclast-mediated bone resorption, Including senile osteoporosis

In both men and women, glucocorticoid-associated osteoporosis, and malignancies metastatic to bone. Although they are generally well tolerated, potential adverse effects may limit bisphosphonate use In some patients. Optimal use of bisphosphonates for osteoporosis requires adequate calcium and vitamin D Intake before and during therapy. The World Health Organization fracture risk assessment algorithm Is currently available to determine absolute fracture risk in patients with low bone mass and Is a useful tool for clinicians In Identifying patients most likely to benefit from pharmacological Intervention to limit fracture risk. This fracture risk estimate may facilitate shared decision making, especially when patients are wary of the rare but serious adverse effects that have recently been described for this class of drugs. Mayo Clin Proc. 2009;84(7):632-638″
“Objectives: The aim of this study is to identify the prognostic factors predicting remission and subsequent disease relapse in patients with differentiated thyroid cancer (DTC)

greater than 60 years of age. Materials and Methods: The institute thyroid cancer database had 4370 patients with DTC, of which 447 (10%) were aged bigger than 60. However, 9 patients were excluded GSK461364 chemical structure due to follow-up less than 1 year. The prognostic factors check details in the remaining 438 patients were studied. Results: Among the 438 patients, 311 (71%) had only loco-regional disease (M-0) and 127 (29%) had distant metastases (M-1) at the time of initial presentation. The host factors predictive of distant metastases at presentation were female gender, primary tumor size ( bigger than 4 cm), follicular histology, and extra-thyroidal extension. Among M-0 patients, 195 (63%) achieved complete remission while only 12 (9%) M-1 patients did so. Average number of radioactive iodine (I-131) doses administered

to achieve complete remission was 2.3 (range, 1-6) and the mean cumulative dose was 3404 MBq (range, 925-46,250 MBq). In multivariate logistic regression among M-0 patients, follicular histology, nodal metastases, and surgical treatment lesser than total/near-total thyroidectomy and among M-1 patients, site of distant metastases (skeletal and multiple sites) were independent factors predicting non-remission. Among the patients (both M-0 and M-1) who achieved remission, factors associated with disease recurrence were primary tumor size ( bigger than 4 cm), nodal metastases, pulmonary metastases, and non-remission after first dose of radioactive iodine and were associated with greater chances of disease relapse.