Intensified adjuvant chemotherapy had a positive impact on the DFS and OS of patients with high-risk extremity soft tissue sarcomas at a median follow-up of 59 months. Therefore, our data favor an intensified treatment in similar cases. Although cure is still difficult to achieve, a significant delay in death is worthwhile, also considering the short duration of treatment and the absence of toxic deaths.

Osteoporosis is a worldwide disease characterized by reduction of bone mass and alteration of bone architecture resulting in increased bone fragility and increased fracture risk. Causes of osteoporosis include increasing age, female sex, postmenopausal status, hypogonadism or premature ovarian failure, low body mass index, ethnic background, rheumatoid arthritis, low bone mineral density (BMD), vitamin D deficiency, low calcium intake, hyperkyphosis, current smoking, alcohol abuse, immobilization, and long-term use of certain medications. The diagnosis of osteoporosis is established by measurement of BMD of the hip and spine using dual energy X-ray absorptiometry. According to the World Health Organization criteria, osteoporosis is defined as a BMD that lies 2.5 standard deviation or more below the average value for young healthy women. Bone turnover biomarker detection may be useful in monitoring osteoporosis treatment and assessing fracture risk but not for diagnosis of osteoporosis. Management of osteoporosis consists of nonpharmacological interventions, which are recommended for all subjects, and pharmacological therapy in all postmenopausal women who have had an osteoporotic fracture or have BMD values consistent with osteoporosis.

Background: Rheumatoid arthritis is a systemic autoimmune disease, considered the most common inflammatory articular disease among the general population. However, not only the joints are affected; rheumatoid arthritis also has an extra-articular manifestation. As for many other chronic diseases, rheumatoid arthritis may be exacerbated by poorer lifestyle choices. In fact, recent studies emphasize the role of nutrition and physical activity in this disease. Aim: In the current paper, we aim to describe lifestyle modifications based on diet and physical activity and other recommendations that seem to improve the clinical management and the disease outcome of Rheumatoid arthritis. Results: A three-component lifestyle modification programme has been considered based on: (i) A low-fat low-sodium Mediterranean diet rich in fruits, vegetables, whole grains and nuts and poor in sugar-sweetened beverages, red and processed meat and trans fats, and the supplementation with omega-3 fatty acids, non-essential amino acids and probiotics, (ii) An appropriate physical activity programme based on an active daily lifestyle, aerobic exercise and resistance training and (iii) Adequate sleep hygiene and smoking reduction/cessation, that seems to have positive effects in terms of disease progression and related outcomes. Conclusion: Lifestyle modification programme should be considered as the basis of any treatment, (i.e., pharmacological treatment), in patients with rheumatoid arthritis.

disease is the most recent pandemic, since it has affected more than four and a half million people and caused more than 300,000 deaths. It is a very complex systemic disease in terms of pathogenesis, treatment, and prognosis. Pharmacological treatment may include antiviral and antimalarial drugs, antibiotics, monoclonal antibodies, corticosteroids as well as low-molecular-weight heparins to prevent the evolution of the disease from reaching the severe inflammatory phase that can lead to respiratory complications, multiple organ failure, disseminated intravascular coagulation (DIC), and finally death. Therefore, pending the development of the much sought-after vaccine, there needs to be a multidisciplinary approach to tackling this disease, and it is essential to use different medical treatments at the correct pathogenic moment. The aim of this article is to evaluate the rationale and reason behind the use of antirheumatic drugs, by expert point of view, in the various phases of the disease. Another important aspect in the management of the disease is to identify patients at high risk, both to change their lifestyle and to correct the state of their health through non-pharmacological measures for improving their immuno-balance. Our literature review reveals the important role and the therapeutic potential of antirheumatic agents in preventing the progression of the disease and aiding recovery from the disease. However, there is a lack of clinical evidence to support the use of these agents, indicating that further randomized controlled studies are required.

To investigate plasma concentrations of and Interleukin-10 (IL-10) in Lebanese knee osteoarthritis (KOA) patients and to examine the association between the diet-associated inflammation and increased risk for KOA. Methods: A total of 208 study participants were assigned to one of the 3 groups: Diagnosed Knee Osteoarthritis group (DKOA) (N ¼ 78); Undiagnosed Knee Osteoarthritis group (UKOA) (N ¼ 60) and controls matched on age, sex and sociodemographic characteristics (N ¼ 70). UKOA represents KOA features before they are altered by therapeutic intervention and lifestyle modifications that follow the diagnosis. Energy-adjusted dietary inflammatory index (E-DII™) scores were calculated using 2-day 24-hour recalls. IL-10 and IL-16 were measured using commercially available sandwich enzyme-linked immunosorbent assay kits. Results: The UKOA group and controls did not show any significant difference in plasma IL-16 levels (p ¼ 0.28), whereas significantly higher levels of IL-10 were observed in the UKOA group compared to controls (21 AE 41 vs 7.5 AE 12 pg/mL; p ¼ 0.01). The UKOA group had significantly higher IL-16 levels compared to the DKOA group (177 AE 215 vs 80 AE 57 pg/ml; p ¼ 0.001) and significantly higher IL-10 levels compared to the DKOA group (21 AE 41 vs 8 AE 14 pg/mL; p ¼ 0.02). Significantly higher levels of IL-16 were observed in the control group compared to the DKOA group (140 AE 161 vs 80 AE 57 pg/ml; p ¼ 0.009) whereas the DKOA group and controls did not show any significant difference in plasma IL-10 levels (p ¼ 0.82). Additionally, we found significantly higher E-DII scores in the UKOA group compared to controls (0.53 AE 1.028 vs 0.04 AE 1.580; p ¼ 0.04) and in the UKOA group compared to the DKOA group (0.53 AE 1.028 vs -0.37 AE 1.899; p ¼ 0.001). However, there was significant difference in E-DII scores between the DKOA group and controls (p ¼ 0.16). Conclusions: Our findings indicate an association between circulating levels of IL-10 and KOA in Lebanese population, and a potential role of pro-inflammatory diet in KOA pathology. We did not find an association between circulating levels of IL-16 and KOA.