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Skeletal-related events among breast and prostate cancer patients: towards new treatment initiation in Malaysia's hospital setting

Ezat SW, Syed Junid SM, Noraziani K, Zafar A, Saperi S, Nur AM, et al.

Asian Pac J Cancer Prev, 2013;14(5):3357-62.
PMID: 23803129

The human skeleton is the most common organ to be affected by metastatic cancer and bone metastases are a major cause of cancer morbidity. The five most frequent cancers in Malaysia among males includes prostate whereas breast cancer is among those in females, both being associated with skeletal lesions. Bone metastases weaken bone structure, causing a range of symptoms and complications thus developing skeletal-related events (SRE). Patients with SRE may require palliative radiotherapy or surgery to bone for pain, having hypercalcaemia, pathologic fractures, and spinal cord compression. These complications contribute to a decline in patient health- related quality of life. The multidimensional assessment of health-related quality of life for those patients is important other than considering a beneficial treatment impact on patient survival, since the side effects of treatment and disease symptoms can significantly impact health-related quality of life. Cancer treatment could contribute to significant financial implications for the healthcare system. Therefore, it is essential to assess the health-related quality of life and treatment cost, among prostate and breast cancer patients in countries like Malaysia to rationalized cost-effective way for budget allocation or utilization of health care resources, hence helping in providing more personalized treatment for cancer patients.

Matched MeSH terms: Bone and Bones/pathology*
Fulltext Serum bone specific alkaline phosphatase and urinary deoxypyridinoline in postmenopausal osteoporosis

Nawawi HM, Yazid TN, Ismail NM, Mohamad AR, Nirwana SI, Khalid BA

Malays J Pathol, 2001 Dec;23(2):79-88.
PMID: 12166596

The objectives of this study were to: (i) evaluate the diagnostic sensitivity and specificity of the biochemical bone markers: serum total alkaline phosphatase (TALP), bone specific alkaline phosphatase (BSALP) and urinary deoxypyridinoline (Dpyr) in postmenopausal osteoporosis, (ii) compare the bone turnover of postmenopausal osteoporotic patients without and with hormone replacement therapy (HRT) against controls and (iii) identify the correlation between these bone markers and bone mineral density (BMD). We examined 42 postmenopausal women with BMD proven osteoporosis and 35 control subjects. Serum TALP, BSALP and urinary Dpyr were measured. All three biochemical bone markers showed comparable moderate diagnostic sensitivity but Dpyr had the highest diagnostic specificity. There were significantly higher serum TALP, BSALP and urinary Dpyr levels in non-HRT treated patients compared to controls (p<0.005, <0.0001 and <0.005 respectively). There were no significant differences in the levels of all three bone markers between HRT treated patients and control subjects. There was no significant correlation between TALP, BSALP or Dpyr and BMD in both controls and patients. In conclusion, the biochemical bone markers are not useful in diagnosis of postmenopausal osteoporosis but may have a role in monitoring progress and response to treatment. HRT treatment reduces bone turnover of postmenopausal osteoporosis.

Matched MeSH terms: Bone and Bones/enzymology*
Sciadonic acid attenuates high-fat diet-induced bone metabolism disorders in mice

Yao S, Lu H, Zhou T, Jiang Q, Jiang C, Hu W, et al.

Food Funct, 2024 Apr 22;15(8):4490-4502.
PMID: 38566566 DOI: 10.1039/d3fo04527g

High-fat diet (HFD) has been associated with certain negative bone-related outcomes, such as bone metabolism disruption and bone loss. Sciadonic acid (SC), one of the main nutritional and functional components of Torreya grandis seed oil, is a unique Δ5-unsaturated-polymethylene-interrupted fatty acid (Δ5-UPIFA) that has been claimed to counteract such disorders owing to some of its physiological effects. However, the role of SC in ameliorating bone metabolism disorders due to HFD remains unclear. In the present investigation, we observed that SC modulates the OPG/RANKL/RANK signaling pathway by modifying the lipid metabolic state and decreasing inflammation in mice. In turn, it could balance bone resorption and formation as well as calcium and phosphorus levels, enhance bone strength and bone mineral density (BMD), and improve its microstructure. In addition, SC could inhibit fat vacuoles in bone, reverse the phenomenon of reduced numbers and poor continuity of bone trabeculae, and promote orderly arrangement of collagen fibers and cartilage repair. This study provides some theoretical basis for SC as a dietary intervention agent to enhance bone nutrition.

Matched MeSH terms: Bone and Bones/drug effects; Bone and Bones/metabolism
Fulltext Safety and efficacy of tocotrienol supplementation for bone health in postmenopausal women: protocol for a dose-response double-blinded placebo-controlled randomised trial

Shen CL, Mo H, Yang S, Wang S, Felton CK, Tomison MD, et al.

BMJ Open, 2016 12 23;6(12):e012572.
PMID: 28011809 DOI: 10.1136/bmjopen-2016-012572

INTRODUCTION: Osteoporosis is a major health concern in postmenopausal women, and oxidative stress contributes to the development of bone loss. Cellular studies and ovariectomised rat model mimicking bone loss in postmenopausal women show the bone-protective effect of tocotrienols (TTs) with antioxidant capability. We aim to access the safety and efficacy of TT consumption for bone health in postmenopausal women.
METHODS AND ANALYSIS: In this 12-week randomised double-blinded placebo-controlled trial for the effects of dietary TT supplementation in postmenopausal women, postmenopausal women aged 45 years and older with at least 1 year after menopause and bone mineral density T-score at the spine and/or hip 2.5 or more below the reference values will be randomly assigned to 3 daily supplements: (1) placebo group receiving 860 mg olive oil, (2) low TT group receiving 430 mg of 70% pure TTs (containing 300 mg TT) and (3) high TT group receiving 860 mg of 70% pure TTs (600 mg TT). The primary outcome measure will be urinary N-terminal telopeptide. The secondary outcome measures will be serum bone-specific alkaline phosphatase, receptor activator of nuclear factor-κB ligand, osteoprotegerin, urinary 8-hydroxy-2'-deoxyguanosine and quality of life. At 0, 6 and 12 weeks, the following will be assessed: (1) primary and secondary outcome measures; (2) serum TT and tocopherol concentrations; (3) physical activity and food frequency questionnaires. Liver function will be monitored every 6 weeks for safety. 'Intent-to-treat' principle will be employed for data analysis. A model of repeated measurements with random effect error terms will be applied. Analysis of covariance, χ2 analysis and regression will be used for comparisons.
ETHICS AND DISSEMINATION: This study was approved by the Bioethics Committee of the Texas Tech University Health Sciences Center. The findings of this trial will be submitted to a peer-reviewed journal in the areas of bone or nutrition and international conferences.
TRIAL REGISTRATION NUMBER: NCT02058420; results.

Matched MeSH terms: Bone and Bones/metabolism*
Rothmund-Thomson syndrome in fraternal twins

Tong M

Pediatr Dermatol, 1995 Jun;12(2):134-7.
PMID: 7659639

Fraternal twins of Malay descent had the Rothmund-Thomson syndrome. This is a rare, autosomal recessive disorder characterized by photosensitivity, poikiloderma, short stature, skeletal defects, and juvenile cataracts. This is the first case report of the syndrome from southeast Asia.

Matched MeSH terms: Bone and Bones/abnormalities
Fulltext Role of medicinal plants and natural products on osteoporotic fracture healing

Abd Jalil MA, Shuid AN, Muhammad N

Evid Based Complement Alternat Med, 2012;2012:714512.
PMID: 22973405 DOI: 10.1155/2012/714512

Popularly known as "the silent disease" since early symptoms are usually absent, osteoporosis causes progressive bone loss, which renders the bones susceptible to fractures. Bone fracture healing is a complex process consisting of four overlapping phases-hematoma formation, inflammation, repair, and remodeling. The traditional use of natural products in bone fractures means that phytochemicals can be developed as potential therapy for reducing fracture healing period. Located closely near the equator, Malaysia has one of the world's largest rainforests, which are homes to exotic herbs and medicinal plants. Eurycoma longifolia (Tongkat Ali), Labisia pumila (Kacip Fatimah), and Piper sarmentosum (Kaduk) are some examples of the popular ethnic herbs, which have been used in the Malay traditional medicine. This paper focuses on the use of natural products for treating fracture as a result of osteoporosis and expediting its healing.

Matched MeSH terms: Bone and Bones
Fulltext Research trend in the processing and application of macroporous ceramic components

Dele-Afolabi, Temitope T., Azmah M.A. Hanim, Norkhairunnisa Mazlan, Shafreeza Sobri, Calin, Recep

The Pertanika Journal of Scholarly Research Reviews, 2017;3(3):83-92.
MyJurnal

Porous ceramic components with decently controlled porosity offers remarkable advantages in industrial and structural applications such as fluid filtration, thermal insulation and scaffolds for bone tissue engineering. In this review study of porous ceramic components, requisite processing techniques necessary for the development of porous ceramics with imbued microstructural model intended for a specific application. An appraisal of the fabrication was made with respect to their economic viability wherein cost effective methods having great potentials in decently controlling the pore network imbued within the host ceramic matrix was preferred over the capital intensive counterparts.

Matched MeSH terms: Bone and Bones
Fulltext Reply to The effect of vigorous physical activity and body composition on cortical bone mass in adolescence

Tan VP, Macdonald HM, McKay HA

J. Bone Miner. Res., 2015 Mar;30(3):585-6.
PMID: 25381875 DOI: 10.1002/jbmr.2399
Matched MeSH terms: Bone and Bones/physiology*
Remodelling of Humeral Fracture in a Child with Osteopetrosis Tarda following Conservative Management - A 7-year Follow-up: A Case Report

Erkus S, Turgut A, Kose O, Kalenderer O

Malays Orthop J, 2019 Jul;13(2):42-44.
PMID: 31467651 DOI: 10.5704/MOJ.1907.008

Osteopetrosis (OP) is a rare hereditary sclerosing bone dysplasia characterised by generalised hard and brittle bone secondary to defective osteoclastic function. Osteopetrotic bone is brittle, thus these subjects are prone to frequent fractures, particularly of the long bones. Due to defective osteoclastic function, remodeling is also defective in OP. This report is a case of humeral fracture in a 9 years old girl who was followed seven years. The fracture had remodeled totally similar to healthy bone at the final follow-up. Conservative treatment should be kept in mind in the management of fractures in children with OP, and fractures within acceptable angulations and/or translations should be treated conservatively without hesitation.

Matched MeSH terms: Bone and Bones
Fulltext Reheating of soy oil is detrimental to bone metabolism in oestrogen deficient rats

Ima-Nirwana S, Ahmad SN, Yee LJ, Loh HC, Yew SF, Norazlina M, et al.

Singapore Med J, 2007 Mar;48(3):200-6.
PMID: 17342287

The short-term and long- term effects of heated soy oil on bone metabolism in ovariectomised Sprague-Dawley rats were studied.

Matched MeSH terms: Bone and Bones/metabolism*
Recycled palm oil is better than soy oil in maintaining bone properties in a menopausal syndrome model of ovariectomized rat

Shuid AN, Chuan LH, Mohamed N, Jaarin K, Fong YS, Soelaiman IN

Asia Pac J Clin Nutr, 2007;16(3):393-402.
PMID: 17704019

Palm oil is shown to have antioxidant, anticancer and cholesterol lowering effects. It is resistant to oxidation when heated compared to other frying oils such as soy oil. When a frying oil is heated repeatedly, it forms toxic degradation products, such as aldehydes which when consumed, may be absorbed into the systemic circulation. We have studied the effects of taking soy or palm oil that were mixed with rat chow on the bone histomorphometric parameters of ovariectomised rats. Female Sprague-Dawley rats were divided into eight groups: (1) normal control group; (2) ovariectomised-control group; (3) ovariectomised and fresh soy oil; (4) ovariectomised and soy oil heated once; (5) ovariectomised and soy oil heated five times; (6) ovariectomised and fresh palm oil; (7) ovariectomised and palm oil heated once; (8) ovariectomised and palm oil heated five times. These oils were mixed with rat chow at weight ratio of 15:100 and were given to the rats daily for six months. Ovariectomy had caused negative effects on the bone histomorphometric parameters. Ingestion of both fresh and once-heated oils, were able to offer protections against the negative effects of ovariectomy, but these protections were lost when the oils were heated five times. Soy oil that was heated five times actually worsens the histomorphometric parameters of ovariectomised rats. Therefore, it may be better for postmenopausal who are at risk of osteoporosis to use palm oil as frying oil especially if they practice recycling of frying oils.

Matched MeSH terms: Bone and Bones/drug effects; Bone and Bones/metabolism
Recent development on porous calcium phosphate ceramics for biomedical application

Sopyan I

Med J Malaysia, 2008 Jul;63 Suppl A:14-5.
PMID: 19024961

Porous calcium phosphate ceramics have found enormous use in biomedical applications including bone tissue regeneration, cell proliferation, and drug delivery. In bone tissue engineering it has been applied as filling material for bone defects and augmentation, artificial bone graft material, and prosthesis revision surgery. Their high surface area leads to excellent osteoconductivity and resorbability providing fast bone ingrowths. Porous calcium phosphate can be produced by a variety of methods. This paper discusses briefly fundamental aspects of porous calcium phosphate for biomedical applications as well as various techniques used to prepare porous calcium phosphate.

Matched MeSH terms: Bone and Bones/physiology*
Radiobiological long-term accumulation of environmental alpha radioactivity in extracted human teeth and animal bones in Malaysia

Almayahi BA, Tajuddin AA, Jaafar MS

J Environ Radioact, 2014 Mar;129:140-7.
PMID: 24462923 DOI: 10.1016/j.jenvrad.2014.01.001

In this study, the radiobiological analysis of natural alpha emitters in extracted human teeth and animal bones from Malaysia was estimated. The microdistributions of alpha particles in tooth and bone samples were measured using CR-39 alpha-particle track detectors. The lowest and highest alpha emission rates in teeth in the Kedah and Perak states were 0.0080 ± 0.0005 mBq cm(-2) and 0.061 ± 0.008 mBq cm(-2), whereas those of bones in the Perlis and Kedah states were 0.0140 ± 0.0001 mBq cm(-2) and 0.7700 ± 0.0282 mBq cm(-2), respectively. The average alpha emission rate in male teeth was 0.0209 ± 0.0008 mBq cm(-2), whereas that of female teeth was 0.0199 ± 0.0010 mBq cm(-2). The alpha emission rate in teeth is higher in smokers (0.0228 ± 0.0008 mBq cm(-2)) than in non-smokers (0.0179 ± 0.0008 mBq cm(-2)). Such difference was found statistically significant (p < 0.01).

Matched MeSH terms: Bone and Bones/chemistry*
Fulltext Radio-opacity of commonly consumed bony fish in Kelantan, Malaysia

Irfan M, Ahmad Helmy AK, Wan Shah Jihan WD

Med J Malaysia, 2012 Oct;67(5):491-3.
PMID: 23770865

Fish is one of the major sources of protein among Malaysians. This has made incidents of fish bones lodged in the throat fairly common clinical problems. Plain radiograph, which is the first line of imaging in such cases, has been reported to have low sensitivity. Besides the location, the degree of radio-opacity of the bone is another important factor and is species dependent. This study was undertaken to determine the radio-opacity of bones from commonly consumed fish in Malaysia. A total of 15 types of fish were identified, six of them were opaque even when embedded and three were visualized in the simulated airway. In terms of radio-opacity, the commonly consumed fish in Malaysia possessed opaque bones and this fact can help doctors identify the location of the foreign body in the throat.

Matched MeSH terms: Bone and Bones
Fulltext Radial quantitative ultrasound and dual energy x-ray absorptiometry: intermethod agreement for bone status assessment in children

Chong KH, Poh BK, Jamil NA, Kamaruddin NA, Deurenberg P

Biomed Res Int, 2015;2015:232876.
PMID: 25922831 DOI: 10.1155/2015/232876

Aim. To validate a radial quantitative ultrasound (QUS) system with dual energy X-ray absorptiometry (DXA), a criterion technique in bone status assessment among children. Methods. Bone health was evaluated using a radial QUS system (Sunlight Omnisense 8000P) to measure the speed of sound (SOS) at one-third distal radius of the nondominant hand and DXA (Hologic QDR) was used to assess whole body bone mineral density (BMD). Results. Some 29.9% of the children were grossly misclassified according to quartiles of BMD and radial SOS. Poor agreement was observed between Z-scores of radial SOS and whole-body BMD (mean difference = 0.6 ± 0.9; 95% limits of agreement = -1.4 to 2.6). With a cut-off value of -1.0, radial SOS yielded satisfactory sensitivity (80%) and specificity (93%) for the detection of children with low BMD. Conclusion. The observed poor agreement in the present study suggests that radial QUS and DXA are not comparable and hence are not interchangeable in evaluating bone status of the children.

Matched MeSH terms: Bone and Bones/radiography*; Bone and Bones/ultrasonography*
Fulltext Quercetin as an Agent for Protecting the Bone: A Review of the Current Evidence

Wong SK, Chin KY, Ima-Nirwana S

Int J Mol Sci, 2020 Sep 03;21(17).
PMID: 32899435 DOI: 10.3390/ijms21176448

Quercetin is a flavonoid abundantly found in fruits and vegetables. It possesses a wide spectrum of biological activities, thus suggesting a role in disease prevention and health promotion. The present review aimed to uncover the bone-sparing effects of quercetin and its mechanism of action. Animal studies have found that the action of quercetin on bone is largely protective, with a small number of studies reporting negative outcomes. Quercetin was shown to inhibit RANKL-mediated osteoclastogenesis, osteoblast apoptosis, oxidative stress and inflammatory response while promoting osteogenesis, angiogenesis, antioxidant expression, adipocyte apoptosis and osteoclast apoptosis. The possible underlying mechanisms involved are regulation of Wnt, NF-κB, Nrf2, SMAD-dependent, and intrinsic and extrinsic apoptotic pathways. On the other hand, quercetin was shown to exert complex and competing actions on the MAPK signalling pathway to orchestrate bone metabolism, resulting in both stimulatory and inhibitory effects on bone in parallel. The overall interaction is believed to result in a positive effect on bone. Considering the important contributions of quercetin in regulating bone homeostasis, it may be considered an economical and promising agent for improving bone health. The documented preclinical findings await further validation from human clinical trials.

Matched MeSH terms: Bone and Bones/drug effects*
Fulltext Protective Effects of Selected Botanical Agents on Bone

Jolly JJ, Chin KY, Alias E, Chua KH, Soelaiman IN

Int J Environ Res Public Health, 2018 05 11;15(5).
PMID: 29751644 DOI: 10.3390/ijerph15050963

Osteoporosis is a serious health problem affecting more than 200 million elderly people worldwide. The early symptoms of this disease are hardly detectable. It causes progressive bone loss, which ultimately renders the patients susceptible to fractures. Osteoporosis must be prevented because the associated fragility fractures result in high morbidity, mortality, and healthcare costs. Many plants used in herbal medicine contain bioactive compounds possessing skeletal protective effects. This paper explores the anti-osteoporotic properties of selected herbal plants, including their actions on osteoblasts (bone forming cells), osteoclasts (bone resorbing cells), and bone remodelling. Some of the herbal plant families included in this review are Berberidaceae, Fabaceae, Arecaceae, Labiatae, Simaroubaceaea, and Myrsinaceae. Their active constituents, mechanisms of action, and pharmaceutical applications were discussed. The literature shows that very few herbal plants have undergone human clinical trials to evaluate their pharmacological effects on bone to date. Therefore, more intensive research should be performed on these plants to validate their anti-osteoporotic properties so that they can complement the currently available conventional drugs in the battle against osteoporosis.

Matched MeSH terms: Bone and Bones/drug effects*
Proliferation and osteogenic differentiation of mesenchymal stromal cells in a novel porous hydroxyapatite scaffold

Krishnamurithy G, Murali MR, Hamdi M, Abbas AA, Raghavendran HB, Kamarul T

Regen Med, 2015;10(5):579-90.
PMID: 26237702 DOI: 10.2217/rme.15.27

To compare the effect of bovine bone derived porous hydroxyapatite (BDHA) scaffold on proliferation and osteogenic differentiation of human bone marrow-derived mesenchymal stromal cells (hMSCs) compared with commercial hydroxyapatite (CHA) scaffold.

Matched MeSH terms: Bone and Bones/pathology
Fulltext Primary hyperparathyroidism with hungry bone syndrome - A Case Report

Norazmi, K., Khairul, A.J.

International Medical Journal Malaysia, 2007;6(2):1-7.
MyJurnal

Primary hyperparathyroidism with severe bone disease as a result of excessive parathyroid hormone ( PTH ) release and severe hypercalcaemia can lead to 'hungry bone syndrome' (HBS) post operatively. This is due to sudden cessation of PTH and drop in serum calcium. We reported a case a young man with primary hyperparathyriodism due to a single parathyroid adenoma with severe bone disease and post operatively developed hungry bone syndrome.

Matched MeSH terms: Bone and Bones
Fulltext Primary Ewing’s sarcoma of the lumbosacral spine: a case report

Zamzuri, Z., Mohd Adham, S.Y., Saufi, M.A., Azian, A.A., Fadhli, M.

International Medical Journal Malaysia, 2012;11(1):47-50.
MyJurnal

Ewing's sarcoma is a rare tumor first discovered by James Ewing in 1921. It is more common in bone or skeletal component compared to soft tissue or extraosseous Ewing's sarcoma. Among soft tissue Ewing’s, spinal cord involvement is rarer with only nine cases reported. We report a case of nine-year-old Malay girl who presented with low back pain for two months following a fall with progressive neurological deficits of bilateral lower limb. Magnetic resonance imaging was suggestive of a well-defined margin of intradural extramedullary tumor. With nerve sheath tumor in mind, surgical excision with laminectomy L2-S1 was performed. Intraoperative finding was an extradural mass from L3-L5 with extension to bilateral neuroforamen. Histopathology report defined a round cell tumour of Ewing’s sarcoma from the mass.

Matched MeSH terms: Bone and Bones

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