Author: Gianpiero Pescarmona
The rules are revisable and definitions too
Bisphosphonate related osteonecrosis of the jaw (BRONJ)
MRONJ follows nitrogen-containing bisphosphonates (NCB).
Metabolic effects of NCB :
Effect of NBPs on Mevalonate Pathway (http://flipper.diff.org/app/items/info/388)
The inhibition of farnesyl diphosphate synthase (FPP) leads to
an increase of uphill substrates (IPP)
a decrease of downhill substrates (cholesterol, CoQ10, farnesylPP and related metabolisms)
The decrease of CoQ10 slows the respiratory chain rate, reducing the intracellular ATP.
Results: Cases and controls did not differ for any study variable except for vascular congestion that was significantly associated with NBP use (multivariable OR = 0.24, exact 95% CI 0.10 to 0.57 for cases vs. controls, p = 0.0006).
heme synthesis http://flipper.diff.org/app/pathways/info/81
Epidermal Growth Factor Reverses the Inhibitory Effects of the Bisphosphonate, Zoledronic Acid, on Human Oral Keratinocytes and Human Vascular Endothelial Cells In Vitro via the Epidermal Growth Factor Receptor (EGFR)/Akt/Phosphoinositide 3-Kinase (PI3K) Signaling Pathway. 2019
Zoledronic acid treatment of HOKs and HUVECs had no significant effects on apoptosis (P>0.05), but significantly reduced expression levels of p-EGFR, p-Akt, p-PI3K, p-mTOR), and p-eNOS (P<0.05); EGF partially reversed these effects and increased the expression levels (P<0.05). CONCLUSIONS EGF partially reversed the effects of the bisphosphonate, zoledronic acid, on HOKs and HUVECs in vitro via the EGFR/Akt/PI3K signaling pathway. Further studies are required to determine the effects of EGF on MRONJ including bisphosphonate-related osteonecrosis of the jaw.
MANAGEMENT OF ENDOCRINE DISEASE: l-Thyroxine replacement therapy in the frail elderly: a challenge in clinical practice. (2017) https://doi.org/10.1530/EJE-17-0321
The prevalence of overt and subclinical hypothyroidism is as high as 20% and thyroid hormone prescription is common in the elderly, with a trend toward levothyroxine treatment of more marginal degrees of hypothyroidism.
Dr David Brownstein salt in diet