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A Practical Approach to Managing Patients With Myasthenia Gravis-Opinions and a Review of the Literature.

When the diagnosis of myasthenia gravis (MG) has been secured, the aim of management should be prompt symptom control and the induction of remission or minimal manifestations. Symptom control, with acetylcholinesterase inhibitors such as pyridostigmine, is commonly employed. This may be sufficient in mild disease. There is no single universally accepted treatment regimen. Corticosteroids are the mainstay of immunosuppressive treatment in patients with more than mild MG to induce remission. Immunosuppressive therapies, such as azathioprine are prescribed in addition to but sometimes instead of

Osteoprotective Roles of Green Tea Catechins.

Osteoporosis is the second most common disease only secondary to cardiovascular disease, with the risk of fracture increasing with age. Osteoporosis is caused by an imbalance between osteoblastogenesis and osteoclastogenesis processes. Osteoclastogenesis may be enhanced, osteoblastogenesis may be reduced, or both may be evident. Inflammation and high reactive oxygen enhance osteoclastogenesis while reducing osteoblastogenesis by inducing osteoblast apoptosis and suppressing osteoblastic proliferation and differentiation. Catechins, the main polyphenols found in green tea with potent anti-oxida

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… Vasomotor symptoms, muscle cramps, and venous thrombosis are adverse effects related to selective estrogen receptor modulators. Elevated urine or serum calcium, or higher serum uric acid or muscle cramps, are adverse effects related to parathyroid hormone receptor agonists [ 158 , 159 ]. …

Spinal cord infarction attributed to SARS-CoV-2, with post-acute sequelae of COVID-19: A case report.

BACKGROUND: While stroke and lower extremity venous thromboemboli have been commonly reported following acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spinal cord infarction or ischemia has been extremely rare. Findings of long coronavirus disease (COVID) in this select population have not been studied. CASE SUMMARY: We present the case of a 70-year-old female with sudden onset of trunk and lower extremity sensorimotor loss due to spinal cord infarction, attributed to acute infection with SARS-CoV-2. Diagnostic work up confirmed a T3 complete (ASIA impairme

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… Muscle spasms in the region of T3-8 were similarly intense, limiting the number of hours she could sit and forcing her to lie supine due to painful muscle cramping. Yet no spasms occurred below the area of the infarct. …

Mechanisms of Chemotherapy-Induced Peripheral Neuropathy.

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects caused by antineoplastic agents, with a prevalence from 19% to over 85%. Clinically, CIPN is a mostly sensory neuropathy that may be accompanied by motor and autonomic changes of varying intensity and duration. Due to its high prevalence among cancer patients, CIPN constitutes a major problem for both cancer patients and survivors as well as for their health care providers, especially because, at the moment, there is no single effective method of preventing CIPN; moreover, the possibilities of treating t

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… The symptoms of acute OIPN include cold-related paresthesias of the hands and feet, pharyngolaryngeal dysesthesias, jaw spasms, fasciculations and muscle cramps [ 33 ]. …

Assessment and monitoring of patients receiving chemotherapy for multiple myeloma: strategies to improve outcomes.

Improved understanding as to the biology of multiple myeloma (MM) and the bone marrow microenvironment has led to the development of new drugs to treat MM. This explosion of new and highly effective drugs has led to dramatic advances in the management of MM and underscores the need for supportive care. Impressive and deep response rates to chemotherapy, monoclonal antibodies, and small molecule drugs provide hope of a cure or prolonged remission for the majority of individuals. For most patients, long-term, continuous therapy is often required to suppress the malignant plasma cell clone, thus

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… Also, assessment and correction of blood electrolyte abnormalities is critical to prevent fatigue, muscle cramping, and potential electrocardiogram changes. Baseline and ongoing electrolyte monitoring should be employed on at least a monthly basis and include a complete metabolic panel + magnesium. …

Hypocalcemia in cancer patients: An exploratory study.

IntroductionCalcium has several physiological functions and when it registers abnormal serum levels those functions may be impacted with potentially severe consequences. There is much research on hypercalcemia in cancer patients, but there are no recent studies on the prevalence of hypocalcemia in those patients. However, there has been an evolution in oncology, namely, new drugs that may directly or indirectly result in hypocalcemia. The primary aim was to explore the association of hypocalcemia with the diverse types of cancer. The secondary aim was to study the influence that hypocalcemia m

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… However, the characteristic manifestations result in muscular irritability with tetany (which can be proven by the Chvostec and Trousseau signs), perioral numbness, distal paresthesias and muscle cramps. …

The Calcium Conundrum: Hypercalcemia of Unknown Etiology.

Hypercalcemia is a common clinical finding with a wide variety of clinical presentations and etiologies. The differential is broad and includes hyperparathyroidism, malignancy, medication adverse effects, endocrinopathies, and a variety of granulomatous diseases. We present the case of an 84-year-old woman with severe parathyroid hormone-independent hypercalcemia and elevated 1,25-OH Vitamin D. Non-necrotizing granulomas were identified on bone marrow biopsy. After an exhaustive workup for granulomatous disease, the patient was felt to have sarcoidosis isolated to the bone marrow and started o

Musculoskeletal Chronic Graft versus Host Disease-A Rare Complication to Allogeneic Hematopoietic Stem Cell Transplant: A Case-Based Report and Review of the Literature.

Musculoskeletal graft versus host disease (GVHD) is a rare manifestation of chronic GVHD (cGVHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Left untreated, the disease can cause extensive damage to muscle tissue and joints. We describe a 62-year-old male with musculoskeletal GVHD and generalized muscle pain and stiffness. In addition, we performed a systemic literature review based on published cases of musculoskeletal GVHD between 1983 and 2019. We identified 85 cases, 62% male and 38% female with an age of 4-69 years and median age of 39 years at diagnosis. The

Influence of Hemoglobin Level on Muscle and Physical Functions, Activities of Daily Living, and Quality of Life in Patients With Hematological Malignancies.

PurposePatients with hematological malignancies often present with reduced muscle and physical functions, which are caused by the disease or related treatment. Moreover, patients with hematological malignancies rapidly develop low hemoglobin levels, and this may affect muscle and physical functions. This study aimed to identify the influence of hemoglobin levels on muscle and physical functions in patients with hematological malignancies.MethodsUsing a cross-sectional study design, this study included 60 patients with hematological malignancies (mean age = 68.0 ± 10.2 years, women 56.7%) who w

Drug repurposing for breast cancer therapy: Old weapon for new battle.

Despite tremendous resources being invested in prevention and treatment, breast cancer remains a leading cause of cancer deaths in women globally. The available treatment modalities are very costly and produces severe side effects. Drug repurposing that relate to new uses for old drugs has emerged as a novel approach for drug development. Repositioning of old, clinically approved, off patent non-cancer drugs with known targets, into newer indication is like using old weapons for new battle. The advances in genomics, proteomics and information computational biology has facilitated the process o

New Approaches for the Treatment of Chronic Graft-Versus-Host Disease: Current Status and Future Directions.

Chronic graft-versus-host disease (cGvHD) is a severe complication of allogeneic hematopoietic stem cell transplantation that affects various organs leading to a reduced quality of life. The condition often requires enduring immunosuppressive therapy, which can also lead to the development of severe side effects. Several approaches including small molecule inhibitors, antibodies, cytokines, and cellular therapies are now being developed for the treatment of cGvHD, and some of these therapies have been or are currently tested in clinical trials. In this review, we discuss these emerging therapi

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… Imatinib was well tolerated in most patients but in 29% of them, adverse events (muscle cramps, nausea diarrhea, and fatigue) led to treatment discontinuation ( 100 ). …

Canadian perspectives in multiple myeloma on the use of steroids in clinical practice based on patient and healthcare provider interviews.

Corticosteroid (steroid) medications are associated with challenging adverse effects that can negatively impact patient quality of life. However, owing to a long legacy of effective use in treatment protocols, they remain a cornerstone of multiple myeloma (MM) care. We conducted a roundtable with Canadian healthcare providers (HCPs) with diverse healthcare backgrounds and involvement in MM care as well as with patients with MM. Our goal was to develop clear guidance for steroid management aimed at improving patient quality of life, taking into account patient perspective and experiences with m

Prevalence and risk factors of intra-dialytic hypotension: a 5 year retrospective report from a single Nigerian Centre.

IntroductionIntra-dialytic hypotension (IDH) is a common complication of haemodialysis that impacts negatively on the patient's quality of life and can induce serious cardiovascular events.MethodsRecords of all adults who had haemodialysis treatments from Jan 2012-Jan 2016 were reviewed. Socio-demographic data, health status of patient, aetiology of renal disease, clinical and biochemical parameters such as systolic and diastolic blood pressures (SBP and DBP), packed cell volume, were collated using Microsoft Excel.ResultsThe overall prevalence of intra-dialytic hypotension was 8.6%. Of all ha

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… The Kidney Disease Outcome Initiative (K/DOQI) defined IDH as a decrease in systolic blood pressure by > 20mmHg or a decrease in mean arterial pressure by 10mmHg, associated with symptoms that include abdominal discomfort, yawning, sighing, nausea, vomiting, muscle cramps, restlessness, dizziness, fainting …

Mechanisms, Mediators, and Moderators of the Effects of Exercise on Chemotherapy-Induced Peripheral Neuropathy.

Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse effect of neurotoxic antineoplastic agents commonly used to treat cancer. Patients with CIPN experience debilitating signs and symptoms, such as combinations of tingling, numbness, pain, and cramping in the hands and feet that inhibit their daily function. Among the limited prevention and treatment options for CIPN, exercise has emerged as a promising new intervention that has been investigated in approximately two dozen clinical trials to date. As additional studies test and suggest the efficacy of exercise in treating CIPN, it i

Abstracts - IANCON 2025

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The Persistence of Stigma and Other Challenges Experienced by Medical Cannabis Users: A Thematic Synthesis of Qualitative Studies.

BackgroundThe legislation, practices, and guidance shaping patient and professional access to medical cannabis (MC) for managing chronic pain and other conditions vary widely across jurisdictions. Despite promising evidence of effectiveness, challenges persist for those trying to access or prescribe MC. Little is known about how patients navigate these complex environments. We aimed to understand the evidence related to personal lived experiences associated with using MC for chronic pain and other conditions in negotiating these challenges.SummaryWe used a framework by Thomas and Harden for co

The impact of COVID-19 on patients with hematological malignancies: the mixed-method analysis of an Israeli national survey.

BackgroundThe COVID-19 pandemic required reevaluation of the therapeutic approach and added emotional stress for patients with hematological malignancies at high risk of contracting the virus. We aimed to evaluate how it affected such patients during the second lockdown in Israel.MethodsThis national survey included Hebrew-speaking patients with hematological malignancy. This included three tools with 28 items of sociodemographic and medical baseline characteristics, management of hematological disease, and evaluation of emotional coping during COVID-19 pandemic; the Hebrew version of the Pati

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… An earlier study, published before the COVID-19 pandemic, reinforced our data since both patients and their physicians listed fatigue, muscle cramps, swelling, personal worries, and uncertainty about health condition in the future, as the most important QOL issues in CML [ 20 ]. …

Воздействие транскутановой стимуляции нервы на сексуальную функцию женщин у пациентов с множественным склерозом: обзор скрипта.

Среди женщин с множественным склерозом (СМС) широко распространена сексуальная дисфункция (СФД), что приводит к значительным нарушениям качества жизни. Несмотря на различные имеющиеся методы лечения, в нынешних подходах зачастую не учитывается сложный, многофакторный характер ЛСД в этой группе населения. Транскутановая стимуляция берцового нерва (TTNS) недавно привлекла внимание как неинвазивная нейромодуляционная терапия, которая продемонстрировала потенциальные выгоды от нейрогенной дисфункции мочевого пузыря, при этом предварительные данные свидетельствуют о частичном улучшении сексуальной

Association of stiff-person syndrome with autoimmune endocrine diseases.

BackgroundStiff-person syndrome (SPS) and its subtype, stiff limb syndrome (SLS), are rare neurological disorders characterized by progressive muscular rigidity and spasms. Glutamic acid decarboxylase (GAD) is the enzyme that catalyzes the production of γ-aminobutyric acid (GABA), a major inhibitory neurotransmitter of the central nervous system. SPS is an autoimmune disease triggered by anti-glutamic acid decarboxylase antibody (anti-GAD Ab). Clinically, anti-GAD Ab is associated with SPS, type 1 diabetes mellitus (T1DM), and other autoimmune diseases.AimTo investigate the link of autoimmune

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… The rigidity is also accompanied by intermittent muscle cramps and painful spasms which are induced by external or internal stimuli (noises, touch, sudden movement, emotional upsets, and stress)[ 6 , 8 , 9 ]. Facial muscle involvement, although rare, gives rise to a mask-like appearance. …

Effects of Physical Exercise Intervention on Psychological and Physical Fitness in Lymphoma Patients.

Background and objectives: Lymphoma patients experience a psychological and physiological decline that could be reversed by exercise. However, little is known about the effects of the exercise on psychological and physical fitness variables. Therefore, the purpose of this longitudinal study was to assess self-efficacy, fatigue and physical fitness before and after an eight-week exercise intervention. Materials and Methods: Thirty-six participants (54.4 ± 19.1 years) performed a supervised exercise program (~60 min, 2d·wk-1). Each session included a combined progressive training of cardiorespir