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Exploring the impact of a decision support algorithm to improve clinicians' chemotherapy-induced peripheral neuropathy assessment and management practices: a two-phase, longitudinal study.

BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) negatively affects physical function and chemotherapy dosing, yet, clinicians infrequently document CIPN assessment and/or adhere to evidence-based CIPN management in practice. The primary aims of this two-phase, pre-posttest study were to explore the impact of a CIPN clinician decision support algorithm on clinicians' frequency of CIPN assessment documentation and adherence to evidence-based management. METHODS: One hundred sixty-two patients receiving neurotoxic chemotherapy (e.g., taxanes, platinums, or bortezomib) answered pati

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… For example, taxane-induced peripheral neuropathy symptoms (e.g., numbness or tingling) generally present in a stocking-glove distribution [ 3 ], acute oxaliplatin-induced peripheral neuropathy symptoms are characterized by brief cold-induced neuropathic pain and muscle cramps [ 4 ], while bortezomib-induced …

A systematic review of non-standard dosing of oral anticancer therapies.

BackgroundThe use of oral systemic anticancer therapies (SACT) has increased and led to improved cancer survival outcomes, particularly with the introduction of small molecule targeted agents and immunomodulators. Oral targeted SACT are, however, associated with toxicities, which might result in reduced quality of life and non-adherence. To reduce treatment-related toxicity, the practice of non-standard dosing is increasing; however guidance to govern this practice is limited. A systematic review was conducted to identify evidence of, and outcomes from, non-standard dosing of oral SACT in onco

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… . | Malaise, fatigue, diarrhoea, fluid retention and muscle cramps. | Nil Defina et al (2009) Italy [ 40 ] | To report tolerability and efficacy of alternate day dosing of lenalidomide | Prospective cohort study, sample = 6, indication: MDS | Lenalidomide 10 mg e.o.d (21/7 plus 7/7 break) Licensed starting …

Potential role of immunotherapy and targeted therapy in the treatment of cancer: A contemporary nursing practice.

Immunotherapy and targeted therapy have emerged as promising therapeutic options for cancer patients. Immunotherapies induce a host immune response that mediates long-lived tumor destruction, while targeted therapies suppress molecular mechanisms that are important for tumor maintenance and growth. In addition, cytotoxic agents and targeted therapies regulate immune responses, which increases the chances that these therapeutic approaches may be efficiently combined with immunotherapy to ameliorate clinical outcomes. Various studies have suggested that combinations of therapies that target diff

Polycythemia Vera: Barriers to and Strategies for Optimal Management.

Polycythemia vera (PV) is a subtype of myeloproliferative neoplasms characterized by impaired quality of life and severe complications. Despite the increasingly in-depth knowledge of this condition, it necessitates a multifaceted management approach to mitigate symptoms and prevent thrombotic and hemorrhagic events, ensuring prolonged survival. The therapeutic landscape has been revolutionized in recent years, where venesection and hydroxycarbamide associated with antiplatelet therapy have a central role and are now accompanied by other drugs, such as interferon and Janus kinase inhibitors. On

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… The risks associated, in this case, are related to the use of a larger venous catheter (with risk of bleeding and infections) or to the citrate used as an anticoagulant, which can reduce serum ionized calcium levels causing dizziness, paresthesia, twitching, muscle cramps, and tetany. 23 In summary, …

New and Emerging Biological Therapies for Myasthenia Gravis: A Focussed Review for Clinical Decision-Making.

Myasthenia gravis (MG) is a rare autoimmune disease characterised by exertion-induced muscle weakness that can lead to potentially life-threatening myasthenic crises. Detectable antibodies are directed against specific postsynaptic structures of the neuromuscular junction. MG is a chronic condition that can be improved through therapies, but to date, not cured. Standard treatment has been unchanged for decades and includes symptomatic treatment with acetylcholine-esterase inhibitors and disease-modifying treatment with steroids, steroid-sparing immunosuppressants and thymectomy. Overall, a rel

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… Further, hypertension, paraesthesia, gum sensitivity, altered taste, increased hair growth, headache, muscle cramps and diarrhoea have been reported. Tacrolimus is mainly used in Japan and China. It also induces a fast clinical response which can start as early as after 2 months. …

Traditional herbal medicine for the prevention of chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis with association rule analysis.

IntroductionThis systematic review and meta-analysis evaluated the preventive efficacy and safety of orally-administered traditional herbal medicine (THM) for the management of chemotherapy-induced peripheral neuropathy (CIPN) in patients with cancer.MethodsRandomized controlled trials (RCTs) evaluating the efficacy of orally-administered THM in the prevention of CIPN published up to 30 April 2024 were retrieved from nine databases. The primary outcome was the incidence of CIPN, and the secondary outcomes included changes in neuropathic pain intensity, nerve conduction study parameters, Karnof

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… CIPN, characterized by the presence of symptoms such as dysesthesia, numbness, pain, cold sensitivity, sensory loss, burning sensations, and motor dysfunction including muscle cramps and reduced muscle strength ( Richardson et al., 2006 ; Oh and Kim, 2018 ), is caused by damage to the peripheral motor …

Current and New Therapeutic Strategies for Relapsed and Refractory Multiple Myeloma: An Update.

Although survival of multiple myeloma patients has at least doubled during recent years, most patients eventually relapse, and treatment at this stage may be particularly complex. At the time of relapse, the use of alternative drugs to those given upfront is current practice. However, many new options are currently available for the treatment of relapsed multiple myeloma, including recently approved drugs, such as the second- and third-generation proteasome inhibitors carfilzomib and ixazomib, the immunomodulatory agent pomalidomide, the monoclonal antibodies daratumumab and elotuzumab and the

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… Peripheral neuropathy, rash, gastrointestinal complaints, and muscle cramps are rare described adverse events. Provided that thrombosis prophylaxis is given, thromboembolic events are also rare. …

Воспаление и воспаление болезней, маркеры и посредники: роль КПИ в некоторых воспламенительных заболеваниях

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Ionic Plasticity: Common Mechanistic Underpinnings of Pathology in Spinal Cord Injury and the Brain.

The neurotransmitter GABA is normally characterized as having an inhibitory effect on neural activity in the adult central nervous system (CNS), which quells over-excitation and limits neural plasticity. Spinal cord injury (SCI) can bring about a modification that weakens the inhibitory effect of GABA in the central gray caudal to injury. This change is linked to the downregulation of the potassium/chloride cotransporter (KCC2) and the consequent rise in intracellular Cl- in the postsynaptic neuron. As the intracellular concentration increases, the inward flow of Cl- through an ionotropic GABA

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… An example is provided by the neurodegenerative disease amyotrophic lateral sclerosis (ALS), which leads to muscle cramps, twitching, and stiffness. Mòdol et al., 2014 used a genetic model of ALS to examine whether these effects are related to a downregulation of KCC2. …

Inpatient Medicine

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A review of potential suggested drugs for coronavirus disease (COVID-19) treatment.

The latest pandemic, coronavirus disease-2019 (COVID-19), is associated with high prevalence and easy transmission, which is expanding globally with no conventional treatment or vaccine. The new virus revealed 79% and 50% genomic similarities with severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), respectively. Accordingly, since the disease resists testing and adopting new therapeutics, repositioning pre-existing drugs may present a fast and attractive strategy with known safety, characteristics, and dosage used. However, they

International Recommendations for Screening and Preventative Practices for Long-Term Survivors of Transplantation and Cellular Therapy: A 2023 Update.

As hematopoietic cell transplantation (HCT) and cellular therapy expand to new indications and international access improves, the number of HCTs performed annually continues to rise. Parallel improvements in HCT techniques and supportive care entails more patients surviving long term, creating further emphasis on survivorship needs. Survivors are at risk for developing late complications secondary to pretransplantation, peritransplantation, and post-transplantation exposures and other underlying risk factors. Guidelines for screening and preventive practices for HCT survivors were originally p

Does Regular Exercise Counter T Cell Immunosenescence Reducing the Risk of Developing Cancer and Promoting Successful Treatment of Malignancies?

Moderate intensity aerobic exercise training or regular physical activity is beneficial for immune function. For example, some evidence shows that individuals with an active lifestyle exhibit stronger immune responses to vaccination compared to those who are inactive. Encouragingly, poor vaccine responses, which are characteristic of an ageing immune system, can be improved by single or repeated bouts of exercise. In addition, exercise-induced lymphocytosis, and the subsequent lymphocytopenia, is thought to facilitate immune surveillance, whereby lymphocytes search tissues for antigens derived

Изменяющийся ландшафт терапии обслуживания в новой диагностированной миеломе: систематический обзор с сетевым мета-анализом европейской сети " Миелома " (ЕМН).

Мы провели всеобъемлющий обзор мета- и сетевого метаанализа исследований в области терапии. Леналидомид, протеиновые ингибиторы, а также CD38 антитела улучшили выживание без прогрессирования (PFS). Вместе с тем общее пособие по выживанию (ОС) появилось только при наличии линалидомида у пациентов, имеющих право на трансплантацию (ТЕ), в то время как CD38-directed Терапия показала тенденцию к улучшению ОС, не наблюдаемой с протеаозными ингибиторами. Сетевой метаанализ расценил режим против наблюдения: Daratumumumab-lenalidomide (DR) получил наибольшую пользу от PFS, за которым последовали карфил

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… Muscle cramps and thromboembolic events can occur, and thromboprophylaxis with aspirin or a direct oral anticoagulant is recommended [ 33 ]. …

Prevalence of symptomatic toxicities for novel therapies in adult oncology trials: a scoping review.

BackgroundPatients' self-report of their symptoms can provide important data for the evaluation of treatment benefit and tolerability of oncology drugs. Contemporary treatment approaches, including immunotherapy and molecular targeted therapies, have unique toxicities based on their novel mechanisms of action. This scoping review aimed to summarize evidence from existing reviews and clinical practice guidelines to examine the type and prevalence of toxicities including symptomatic adverse events (sympAEs) for adult cancer patients to inform clinical care and therapeutic trials.MethodsA systema

Expanding role of lenalidomide in hematologic malignancies.

Lenalidomide is an immunomodulatory agent that has been approved by the US Food and Drug Administration for treatment of multiple myeloma, deletion 5q myelodysplastic syndrome, and mantle cell lymphoma. In addition, it has clinical activity in lymphoproliferative disorders and acute myeloid leukemia. The mode of action includes immunomodulatory, anti-inflammatory, antiangiogenic, and antiproliferative mechanisms. The antitumor effect is a result of direct interference of key pathways in tumor cells and indirect modulation of the tumor microenvironment. There has been no recent collective revie

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… Other common toxicities include fatigue, asthenia, nausea, constipation, muscle cramp, anemia, diarrhea, and rash. …

The Role of Cullin-RING Ligases in Striated Muscle Development, Function, and Disease.

The well-orchestrated turnover of proteins in cross-striated muscles is one of the fundamental processes required for muscle cell function and survival. Dysfunction of the intricate protein degradation machinery is often associated with development of cardiac and skeletal muscle myopathies. Most muscle proteins are degraded by the ubiquitin-proteasome system (UPS). The UPS involves a number of enzymes, including E3-ligases, which tightly control which protein substrates are marked for degradation by the proteasome. Recent data reveal that E3-ligases of the cullin family play more diverse and c

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… One study [ 29 ] showed increased muscle cramps as an adverse event in treated patients, which led to the decision to no longer dose patients above 110 mg/m 2 . Pevonedistat treatment also resulted in sinus tachycardia in some individuals in this clinical trial [ 29 ]. …

High-Dose Vitamin C in Advanced-Stage Cancer Patients.

High-dose intravenously administered vitamin C (IVC) is widely used in cancer patients by complementary and alternative medicine practitioners. The most frequent indications for IVC therapy result from the belief in its effectiveness as a potent anti-cancer agent which additionally enhances chemosensitivity of cancer cells and reduces chemotherapy-related toxicities and fatigue intensity. In this narrative review, we decided to deal with this issue, trying to answer the question whether there is any scientific evidence supporting the rationale for application of high-dose IVC therapy in advanc

Targeting cancer stem cells in drug discovery: Current state and future perspectives.

In recent decades, cancer stem cells (CSCs) have been increasingly identified in many malignancies. CSC-related signaling pathways and their functions provide new strategies for treating cancer. The aberrant activation of related signaling pathways (e.g., Wnt, Notch, and Hedgehog pathways) has been linked to multiple types of malignant tumors, which makes these pathways attractive targets for cancer therapy. CSCs display many characteristic features, such as self-renewal, differentiation, high tumorigenicity, and drug resistance. Therefore, there is an urgent need to develop new therapeutic st

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… Treatment with patidegib results in fatigue, muscle cramps, and rash[ 150 ]. A phase I study demonstrated that BMS-833923 administered to patients with cancer was safe and well tolerated at all doses[ 151 ]. …

Emergency Care

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