BackgroundThe recurrence rate after aneurysmal bone cyst (ABC) treatment is quite high despite its benign nature. In ABC therapy, curettage is the treatment of choice; en bloc excision results in a lower recurrence rate, but more extensive reconstructive surgery is needed with associated morbidity. The aim of the present study was to compare the outcomes of the two treatment options.MethodsA retrospective analysis was performed on 26 patients treated for ABCs: 16 by curettage and 10 by en bloc excision. Each lesion was classified according to Enneking and patients were followed up for a mean time of 9.2 years. On follow-up, radiological examination and functional assessment (range of motion, muscle strength) were performed. Recurrence was defined as the presence of an osteolytic lesion, especially one with a tendency to grow.ResultsOn follow-up, the following symptoms were more prevalent in the en bloc excision group compared to the curettage group: pain (en bloc 20% versus curettage 6.25%), limb length differences (en bloc 20% versus curettage 12.5%), reduced range of motion (en bloc 20% versus curettage 6.25%) and muscle strength impairment (en bloc 50% versus curettage 31.2%); however, the differences were not statistically significant (P >0.05). In the curettage group, two cases of postoperative complications and two cases of recurrence were seen, while in the en bloc excision group one case of complications was noted.ConclusionsCurettage is a standard procedure in ABC management. En bloc excision is another option, albeit more technically demanding, that may be considered in recurrent lesions with extensive bone destruction or for cysts in an expendable location.

Purpose The aim of the study was to identify clinical, demographic and radiological factors predicting a positive response to steroid treatment in simple bone cysts (SBCs). Methods A retrospective study was conducted on 62 patients. The mean follow-up period was 9.2 years after the final steroid injection. Recurrences were defined according to Neer's scale as modified by Chang et al.. To identify predictive factors, the group of patients who positively responded to treatment (Neer stages I and II, n=39, 62.9 %, group 1) were compared with the group in which recurrences occurred (Nerr stages III and IV, n=23, 37.1 %, group 2). Results Recurrences were experienced by 37

New recommendations from the Global Initiative for Asthma (GINA) were released in a pocket guide form on April 12, 2019. These recommendations provide very important changes to the management of asthma, especially regarding the treatment of intermittent and mild asthma. Due to safety concerns, GINA experts no longer recommend treatment with a short‐acting β2 agonist alone. Henceforth, all adults and adolescents (but not yet children) with mild asthma should receive either symptom‐driven or daily low‐dose ICS. The main goal of this new approach is to reduce the risk of serious asthma exacerbations and asthma‐related deaths in the population of patients with mild asthma. Herein, the authors present the epidemiological and clinical data regarding the risks of excessive SABA use and the benefits of regular treatment with inhaled corticosteroids. The authors deliver a critical review on the evolution of the changes in the GINA experts’ standpoint and provide evidence‐based background for the new approach to asthma treatment. Moreover, the authors identify gaps and unmet needs still present in the current asthma management recommendations and discuss them thoroughly.

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