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A multidisciplinary bone metastases clinic at Toronto Sunnybrook Regional Cancer Centre - A review of the experience from 1999 to 2005.

Our objective in this study was to review the experience of a one-stop multidisciplinary bone metastases clinic (BMC) that offers a coordinated multidisciplinary approach to the care of cancer patients with bone metastases in a tertiary cancer centre. Patients with symptomatic bone metastases were referred to BMC and assessed by a team of specialists in various disciplines - interventional radiology, orthopedic surgery, palliative medicine, and radiation oncology. At initial consultation, patient demographics, reasons for referral, and case disposition were recorded. From January 1999 to Febru

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… Thirty patients (46%) were classified to have a high risk of fracture at the spine because of mechanical instability (16/30), spinal cord compression (12/30), cauda equina syndrome or more than two nerve root deficits (2/30). …

Spinal brown tumors as a rare cause of spinal cord compression: Report of case series.

INTRODUCTION AND IMPORTANCE: Brown tumors (BTs) are rare benign osteolytic lesions that arise in the context of uncontrolled hyperparathyroidism. They mostly located in the large bone and rarely in the spine. Spine involvement can cause neurologic symptoms and rarely spinal cord compression. The aim of this study is to diagnose BTs of the spine in presence of spinal cord compression symptoms leading to appropriate treatment. CASE PRESENTATION: Retrospective study of 4 cases of Brown tumors revealed by spine cord compression and rapidly operated in our neurosurgery department between 2014 and

Neurofilament light chain in serum of cancer patients with acute neurological complications.

Aim: Neurofilament light chain (NfL) is a nonspecific sensitive biomarker of axonal damage.Methods: This case series identified cancer patients with neurological complications who had serum NfL measurements and paired these results to outcomes.Results: NfL serum levels were available in 15 patients with hematological malignancies or solid tumors. The neurological complications studied were immune effector cell-associated neurotoxicity syndrome, immune checkpoint inhibitor-related encephalopathy, anoxic brain injury, Guillain-Barre syndrome, hemophagocytic lymphohistiocytosis, transverse myelit

A randomized controlled trial to compare the efficacy of bisphosphonates in the management of painful bone metastasis.

IntroductionThe prospective interventional single-institution randomized control study was carried out to compare the pain relieving efficacy among different bisphosphonates at the cost of incidence of skeletal-related events (SRE).Materials and methodsDuring June 2008 and May 2011, 256 patients with painful bone metastasis in solid tumors with a pain score of at least 5 were randomized into three arms: zoledronic acid (4 mg, i.v.), ibandronate (6 mg, i.v.) and pamidronate (90 mg, i.v.). Radiation was given to all patients, either 800 cGy single fraction or 20 Gy in five fractions. The ANOVA t

Е-постеры.

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Multiple Myeloma: Cast Nephropathy, VTE, and Neurologic Complications.

Multiple myeloma accounts for approximately 1% of neoplastic diseases and 13% of hematologic cancers. Complications often associated with MM include neurologic and hematologic issues, infections, renal insufficiency, and bone involvement. It is crucial for advanced practice professionals caring for myeloma patients to assess patients accurately, be keenly aware of possible associated complications, and be familiar with appropriate interventions to prevent further injury. This article will provide an overview of MM-related renal insufficiency, with a focus on cast nephropathy, venous thromboemb

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… When the lumbar spine is involved, cauda equina syndrome can occur, with symptoms of low back and radicular pain and leg weakness (Gawler, 2004). Spinal cord compression is a medical emergency that requires an urgent MRI when it is suspected. …

Rare clinical experiences for surgical treatment of melanoma with osseous metastases in Taiwan.

BackgroundMalignant melanoma occurs infrequently in Taiwan. Once it has progressed into osseous metastases, the prognosis is poor. There are no reported clinical experiences of surgical management in this area.MethodsTo improve our understanding of the rare clinical experiences, we retrospectively investigated clinical characteristics, radiological findings, treatment modalities, survival outcomes and prognoses of 11 Taiwanese patients with osseous metastasis of melanoma treated surgically at two national medical centers, National Taiwan University Hospital and National Cheng Kung University H

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… For patients with neurological deficits such as paraplegia or cauda equina syndrome, the neurological decompression to relieve symptoms and recover functions should be considered as health permits. …

Leptomeningeal disease: current diagnostic and therapeutic strategies.

OBJECTIVES: We determined the efficacy of the use of a tension free prolene mesh to correct a grade III anterior vaginal wall prolapse recurrence. METHODS: Twelve women (mean age 65.6 years) with stress urinary incontinence (SUI) (4 type II and 1 type III) and bladder prolapse entered the study. After vaginal incision a pretailored polypropylene mesh was fixed to its four angles by absorbable sutures to the urethropelvic ligaments and pubocervical fascia anteriorly and to the cardinal ligaments and pubocervical fascia posteriorly. When present, a posterior descensus was corrected during the s

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… Common symptoms include cranial nerve deficits, radicular pain, headache, back pain, visual disturbances, diplopia, hearing loss, onset of psychiatric disorders, seizures, or cauda equina syndrome [ 1 , 5 , 17 – 19 ]. …

Short-term assessment of functional outcomes and quality of life after thoracic and lumbar spinal metastasis surgery.

BackgroundBecause of improvements in initial tumor identification and treatment, as well as longer life expectancies, more people are receiving diagnoses for spinal metastases.ObjectiveThe aim of this study was to assess early functional outcomes and quality of life (QOL) after surgical management of patients with spinal metastases.Patients and methodsIn this prospective cohort study, a total of 33 patients with thoracic and lumbar spine metastases who underwent surgical management between November 2021 and August 2023 were followed up for 1 year or until death. Oswestry Disability Index and t

Percutaneous pedicle screw fixation combined with percutaneous vertebroplasty for the treatment of thoracic and lumbar metastatic tumors.

BACKGROUND AND AIM: With the greatly prolonged survival of cancer patients, more and more patients develop bone metastasis, especially spinal metastasis. Therefore, it is very important to choose the best surgical plan for patients with spinal metastasis in different conditions. This paper aims to evaluate the clinical efficacy of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) for the treatment of thoracic and lumbar metastatic tumors. METHODS: Forty patients with thoracic and lumbar metastatic tumors were treated with PPSF combined with PVP and fol

Разнообразие по признаку пола 90-Day Послеоперационные осложнения у пациентов с анемической атропластикой.

Первичная анемия представляет собой фактор риска для неблагоприятных последствий после полной артропопластики (THA), что в непропорционально большой степени сказывается на женщинах и способствует заболеваемости. Хотя как анемия, так и пол независимо связаны с постоперационными осложнениями, лишь в немногих исследованиях анализировались результаты у анемических пациентов, стратифицированных по признаку пола. По сравнению с этим исследованием 90-day Коэффициент осложнений послеоперационного периода между анемическими пациентами мужского пола и анемическими пациентами женского пола, проходящими п

Global utilization of biportal spinal endoscopy: Case series on management of lumbar pathology in Soddo, Ethiopia.

INTRODUCTION: Biportal spinal endoscopy is a safe and cost-effective methodology for the management of lumbar pathology in rural underserved hospitals that have standard orthopaedic arthroscopic equipment, but lack access to microscopy. METHODS: This is a case series noting 1-year outcomes from 5 patients managed with biportal spinal endoscopy during an 11-day mission trip to Soddo, Ethiopia in November 2022. Surgical complications, postoperative assessments, and patient-reported outcomes (PROs) were retrospectively collected and analyzed. Surgical techniques and equipment utilized were share

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… She was admitted urgently for endoscopic decompression (single level ULBD) given concerns for subacute cauda equina syndrome. There were no complications. Fig. 5 Patient 3: Preoperative MRI. (A) Sagittal T2-weighted MRI showing vertebral body collapse, retropulsion, and stenosis at the L4 level. …

Risk factors for pulmonary cement embolism after percutaneous vertebroplasty and radiofrequency ablation for spinal metastases.

ObjectivePulmonary cement embolism is a rare but underestimated complication of vertebroplasty due to the relative lack of study and examination. This study aims to investigate the incidence of pulmonary cement embolism in patients with spinal metastasis who undergo PVP with RFA and to analyze the relative risk factors.MethodsA total of 47 patients were retrospectively included and classified into pulmonary cement embolism (PCE) group and non-pulmonary cement embolism (NPCE) group by comparing pre- and postoperative pulmonary CT scan images. The demographic and clinical information of the pati

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… Contraindications for the procedure included: i) clinical signs of spinal cord compression or cauda equina syndrome; ii) fractures with epidural involvement and contact with spinal cord or nerve roots; iii) the lesions close to the vital structures such as nerves, spinal cord, blood vessels; and iv) …

Efficacy of percutaneous vertebroplasty for the relief of osteoblastic spinal metastasis pain.

The aim of the present manuscript was to retrospectively evaluate the efficacy of fluoroscopy-guided percutaneous vertebroplasty (PVP) for the relief of osteoblastic spinal metastases pain. PVP was performed in 39 consecutive patients with 82 osteoblastic metastatic spinal vertebras. 19 vertebras had pathologic compressive fracture and the other 63 vertebras had no compressive fracture with obvious imaging abnormalities. The ages of the patients ranged from 40 to 77 years with a mean age of 58.5±9.0 years. Visual analog scale (VAS) and QLQ-BM22 score were used to evaluate pain and quality of l

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… Exclusion criteria included patients with: i) Clinical signs of spinal cord compression or cauda equina syndrome; ii) fractures with epidural involvement and contact with spinal cord or nerve roots; iii) complete vertebral destruction; iv) posterior arch involvement and v) local infection at the puncture …

Нейрогенная желудочно-кишечная, мочевая и сексуальная дисфункция при множественном склерозе: многодисциплинарная основа для клинической практики.

Нейрогенные желудочно-кишечные, мочевые и сексуальные симптомы широко распространены у людей с множественным склерозом и существенно ухудшают качество жизни, повседневное функционирование и психосоциальное благополучие. Несмотря на их частотность и клиническую актуальность, управление по-прежнему носит разрозненный характер по различным специальностям, тесная взаимосвязь между этими симптомами зачастую игнорируется, а у клинических работников отсутствует прагматическая основа, адаптированная к различным условиям здравоохранения. Этот обзор преобразует нынешние данные в прагматичную модель уход

Центральная нервная система Множественная миелома: обновление 2026 года.

Множественная миелома центральной нервной системы (CNS-MM) — редкая, но очень агрессивная дизракразия плазменных клеток с плохим прогнозом. КНС-ММ представляет собой отдельную клиническую структуру, характеризующуюся уникальными диагностическими проблемами и терапевтическими сопротивлениеми. Традиционная терапия исторически приводила к мрачным результатам, а медиана выживаемости за несколько месяцев. Современная диагностика основана на интеграции неврологических симптомов, усовершенствованной цитометрии потока CSF и изображений с высоким разрешением; однако единых диагностических критериев по-

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… Wang Y, Wang L, Zeng Y, Hong R, Zu C et al (2021) Successful BCMA CAR-T Therapy for Multiple Myeloma With Central Nervous System Involvement Manifesting as Cauda Equina Syndrome-A Wandering Road to Remission. Front Oncol 11:755584. 10.3389/fonc.2021.755584 61. …

Imaging of vertebral fractures.

Vertebral fracture is a common clinical problem. Osteoporosis is the leading cause of non-traumatic vertebral fracture. Often, vertebral fractures are not clinically suspected due to nonspecific presentation and are overlooked during routine interpretation of radiologic investigations. Moreover, once detected, many a times the radiologist fails to convey to the clinician in a meaningful way. Hence, vertebral fractures are a constant cause of morbidity and mortality. Presence of vertebral fracture increases the chance of fracture in another vertebra and also increases the risk of subsequent hip

Systematic review of the clinical effect of glucocorticoids on nonhematologic malignancy.

BackgroundGlucocorticoids are often used in the treatment of nonhematologic malignancy. This review summarizes the clinical evidence of the effect of glucocorticoid therapy on nonhematologic malignancy.MethodsA systematic review of clinical studies of glucocorticoid therapy in patients with nonhematologic malignancy was undertaken. Only studies having endpoints of tumor response or tumor control or survival were included. PubMed, EMBASE, the Cochrane Register/Databases, conference proceedings (ASCO, AACR, ASTRO/ASTR, ESMO, ECCO) and other resources were used. Data was extracted using a standar

Rapid Fire Presentations

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Accuracy and Reliability of Internet Resources for Information on Monoclonal Gammopathy of Undetermined Significance-What Information Is out There for Our Patients?

BACKGROUND: Online information gathering can increase patients' engagement in decision-making. The quality of online resources available for monoclonal gammopathy of undetermined significance (MGUS) was evaluated. METHODS: 900 websites from Google, Bing, Yahoo, and 150 YouTube videos were assessed. RESULTS: The websites did not differ regarding their search rank or between the search engines. The median time since last update was 24 months. The 86 unique websites showed a medium to poor general quality (JAMA score 3/4, only 8.1% websites with a valid HON certificate). The patient- (user-) fo

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… Cauda Equina Syndrome: Assessing the readability and quality of patient information on the Internet. Spine (Phila Pa 1976) Spine. 2014;39:E645–E649. doi: 10.1097/BRS.0000000000000282. 36. Reynolds M., Hoi A., Buchanan R.R.C. …