The Journal of Osteoporosis and Mineral Metabolism (ROMM) was created at the end of 2009 and was presented at the Congress of the Spanish Society for Bone Research (SEIOMM) that year, held in Santander. We have participated from the beginning, both in its creation, start-up and later development, until today. It is the SEIOMM associates who should assess our management. For our part, we believe that a cycle has been completed and that the renewal of the management team is appropriate. For this reason and through this editorial, we say farewell, thanking all those who have trusted and collaborated with us: boards of directors, members of the editorial committee and associates, some who have submitted articles and others who have served as reviewers. A special thanks to our collaborators on a day-to-day basis: Jesús and Concha, publishers of Ibáñez y Plaza; Gabriel Plaza, responsible for the website; and David Shea, translator of the journal, with whom it has always been so easy to work, and who with professionalism and dedication have contributed enormously to make this journal where it is right now. Thank you all.Read More
Impact of dementia on the survival of patients with hip fracture after undergoing total and partial prosthesis
Hip fractures represent a general public health problem due to their high incidence and their impact on mortality and loss of quality of life . In the coming years, with the progressive aging of the population, its incidence is expected to increase, incurring a significant drain on resources . Crude mortality figures after a hip fracture are considered in most studies. An estimated 5% of patients die in-hospital and approximately 20% do so during the first year, depending on the series . However, hip fractures occur in elderly patients who have an associated comorbidity that also influences their survival . The highest mortality rates are reported mainly in the elderly, sick or disabled populations . A recent meta-analysis exploring the magnitude and duration of the excess risk of mortality after hip fracture found the highest risk in the first 3 months after the fracture, and mortality remained high even after 10 years . Excess risk increases with age and, at any age, is higher for men than for women .Read More
Osteoporosis is defined as a skeletal disease in which there is a decrease in bone strength that leads to an increased risk of fracture, usually due to mild trauma . Although any fracture can be observed in clinical practice, with the exception of the skull bones, the most prevalent is the vertebral one and the most serious that of the proximal extremity of the femur , given its significant morbidity and mortality . Genetic, anthropometric, nutritional and lifestyle factors [4,11] influence the appearance of fragility fractures or osteoporotic fractures, but also gynecological and obstetric factors . Among them, breastfeeding reportedly exerts an essential reproductive function in women and protects the mother from developing many diseases, such as cancer or diabetes [11-14].Read More
Effect of vitamin D supplementation on aromatase inhibitor-related musculoskeletal side effects for breast cancer: B-ABLE cohort
Survival for patients who suffer estrogen receptor positive (ER+) breast cancer has improved dramatically over the years due to the addition of adjuvant hormonal therapy, especially aromatase inhibitors (AI). Letrozole, anastrozole and exemestane are third generation AIs that massively reduce circulating estrogens in postmenopausal women. Although this effect is decisive for survival and the reduction of tumor relapse, it also leads to adverse events and quality of life problems, more prominently associated with the musculoskeletal system . Its use in women as adjunctive treatment for 2-5 years has been correlated with an increased risk of bone loss and fractures [2,3]. Furthermore, AI administration is associated with the appearance and/or increase of arthralgia –described as joint pain– with an estimated incidence of 55% in a previous study by our group . The high rate of arthralgias is of particular concern, since it is reportedly the most frequent reason for interrupting treatment [5,6]. Although practical guidelines have been developed to prevent and manage IA-related bone loss , effective treatment of arthralgia has yet to be addressed8.Read More
Humeral fragility fractures in a tertiary referral hospital. Clinical and epidemiological characteristics
The humeral fragility fracture is an important consequence of osteoporosis. It constitutes 5% of all osteoporotic fractures and is the third most frequent non-vertebral fracture in individuals over 60 years of age after hip fractures and those of the distal radius . Compared with the general population, patients with a proximal humeral fracture present a higher mortality rate in the first year, the risk being five times higher during the first month after the fracture .Read More
Calcium and vitamin D supplementation in the management of osteoporosis. What is the advisable dose of vitamin D?
Osteoporosis is the most common bone metabolism disease  and is characterized by a significant decrease in bone mineral density that is accompanied by alterations in the microarchitecture of the bone, which results in increased skeletal fragility and, consequently, an increase risk of fractures . Clearly related to aging, its prevalence, which in women between 50 and 59 years of age has been estimated at 4%, increases to 52% in women older than 80 years . Hip fracture in osteoporotic women produces an increase in mortality over the first two years post-fracture of between 12 and 20%, and more than 50% of survivors are not able to return to an independent life, many of them requiring long-term home help .Read More
Since its discovery, a century ago, we have advanced in the knowledge of what was erroneously called “vitamin” D. We now know that it is not a vitamin, but we continue to call it that out of custom and tacit consensus. In fact, it is an endocrine system, the vitamin D endocrine system (VDES), similar to that of other steroid hormones. Cholecalciferol or “vitamin” D3, is the threshold (physiological) nutrient of the system, synthesized from 7-dehydrocholesterol in the skin, by the action of ultraviolet B (UVB) solar radiation. This route represents about 80-90% of the contribution to the body, the rest is obtained from the diet (10-20%) . There is another isoform, of nutritional contribution, called ergocalciferol or “vitamin” D2 that is found in small quantities in foods of vegetable origin, yeasts and fungi, not commonly used in Spain [2,3].Read More
Maxillary metastasis due to pulmonary myofibroblastic tumor detected in study [18-F] FDG PET/CT
We present the case of a 62-year-old woman with a history of a fibrohistiocytic variant of a pulmonary inflammatory myofibroblastic tumor treated by a lobectomy of the right lower lobe and lymphadenectomy of the intrapulmonary area and pulmonary ligament, and a history of tooth extraction 11 due to a vestibular fistula torpid.
In a control [18-F] FDG PET/CT study, a solitary hypermetabolic lesion suggestive of malignancy was observed in the gingival area of the upper jaw (Figure1 A-C) and 3D reconstruction (Figure 2).
Given the suspicion of malignancy, a partial maxillectomy of teeth 13-23 was carried out with placement of an obturator prosthesis. Analysis confirmed the metastatic etiology by observing hypercellular areas with a fasciculate pattern and broader sarcomatoid areas. Immunohistochemical analysis showed strong ALK expression, higher FLI1 expression, and lower CD10 and TLE1 expression. At present, the patient remains asymptomatic.
We present a 44-year-old man with a history of multiple trauma in childhood and trauma to the left hip eight months before the consultation, who consulted for pain of short duration (5 days) in the left hip, presenting limited range of movement on physical examination in the extreme degrees of the left hip, without signs of local infection or laboratory abnormalities. The x-ray of the hips (Figure 1A) showed periosteal hyperostosis along the inner cortex of the left femur (white arrows), giving rise to a characteristic image of “molten wax dripping down the side of a candle”. (Figure 1B) Cortical thickening appeared as hypointense in all image sequences (white arrows), in addition to showing bone edema of the femoral head related to degenerative joint disease (black arrow). A bone gamma scan study was requested.Read More
To the editors,
We read with interest the position paper of the Spanish Society for Bone Research and Mineral Metabolism (SEIOMM) on COVID-19 and vitamin D, recently published in your journal . This document helps clarify the role of vitamin D in this infectious disease. One of its conclusions caught our attention. In the final section on the risk/benefit ratio of administering vitamin D, it stated that “it is considered that the administration of 10,000 IU/day of cholecalciferol or 4,000 IU/day of calcifediol is safe”. This assertion is bibliographically referenced with a review on the benefit-risk balance of vitamin D by Bischoff-Ferrari et al.  In this paper, an evaluation of the effectiveness and safety of several clinical trials in which cholecalciferol (vitamin D3) [mostly] or ergocalciferol (vitamin D2). In no case does the review collect clinical data generated from calcifediol supplementation, so including calcifediol in the phrase seems to us to generate some confusion.
Hypercalcemia is a very common water-electrolyte imbalance found in daily clinical practice. It is defined as the presence of a serum calcium concentration greater than 2 standard deviations from the mean laboratory value, which is usually 10.6 mg/dL .
From the pathophysiological point of view, high levels of calcium in the blood increase the difference in electrical potential between cell membranes, which increases the depolarization threshold. Clinically, hypercalcemia may present a very wide spectrum that can range from a certain muscle weakness to depression and even coma and death, and this depends on several factors such as the severity of hypercalcemia, the speed of its onset and other circumstances specific to the patient, such as age, comorbidity and medication received . Therefore, it is not surprising that two patients with the same high serum calcium values present completely different symptoms.
Hypercalcemia is a relatively common clinical problem and a frequent laboratory finding, both in hospital and out-of-hospital practice. Calcium ions play a critical role in many cellular functions. Parathyroid hormone (PTH) and vitamin D are the most important hormones for regulating calcium. The main sources of serum calcium are intestinal absorption, stimulated by active vitamin D metabolites, and bone resorption, usually stimulated by PTH. Therefore, hypercalcemia can be classified as PTH-dependent (due to increased secretion of PTH by the parathyroid glands) and independent of PTH. The latter cases are attributable to increased bone resorption and/or increased intestinal absorption of calcium, induced by factors other than PTH. Among them, PTH-related protein (PTHrP) and locally produced cytokines are factors that often cause hypercalcemia in cancer patients . Unregulated extrarenal synthesis of 1,25-dihydroxyvitamin D can also cause hypercalcemia, particularly in patients with chronic granulomatous disorders and in some patients with lymphoma .Read More
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