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A Multimodal Clinical Approach for the Treatment of Bone Metastases in Solid Tumors.

ContextBone metastasis (BM) is a frequent complication of cancer, representing the third most common site of secondary spread in solid cancers behind the lung and liver. Bone metastasis is found in up to 90% of prostate and breast cancer patients. They can cause significant complications, such as pathological fractures and paralysis of the spine, which decrease daily functioning and quality of life (QoL) and worsen prognosis. The growing life expectancy of cancer patients due to improvements in systemic therapies may further increase BM's eventuality and clinical burden in cancer patients.Evid

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… In this scenario, several studies have shown that morphine is most potent in suppressing the immune system, but fentanyl has moderate effects, and tramadol and buprenorphine show the least immune suppression ( 48 , 49 ). In terms of administration, the first option is the oral route. … Full Opioid Agonists and Tramadol: Pharmacological and Clinical Considerations. Anesth Pain Med. 2021;11(4):e119156. doi: 10.5812/aapm.119156. 50. Bouhassira D, Luporsi E, Krakowski I. Prevalence and incidence of chronic pain with or without neuropathic characteristics in patients with cancer. …

B12 as a Treatment for Peripheral Neuropathic Pain: A Systematic Review.

Neuropathic pain describes a range of unpleasant sensations caused by a lesion or disease of the somatosensory nervous system. The sensations caused by neuropathic pain are debilitating and improved treatment regimens are sought in order to improve the quality of life of patients. One proposed treatment for neuropathic pain is vitamin B12, which is thought to alleviate pain by a number of mechanisms including promoting myelination, increasing nerve regeneration and decreasing ectopic nerve firing. In this paper, the evidence for B12 as a drug treatment for neuropathic pain is reviewed. Twenty

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… Singh et al., 2013 [ 34 ] | RCT | Glossopharyngeal neuropathy | Standard medical therapy (combination of oral methylcobalamin, tramadol and gabapentin) versus standard medical therapy plus extraoral glossopharyngeal nerve block | Pain measured by numerical pain scale and brief pain inventory significantly … Glossopharyngeal Neuropathy Singh et al. examined 30 patients with glossopharyngeal neuropathy (GPN) and randomised them for treatment with either standard medical therapy (combination of methylcobalamin, tramadol and gabapentin) or standard medical therapy plus extraoral glossopharyngeal nerve block …

Severe toxicity with a generic formulation of zoledronic Acid: a case report.

Intravenous zoledronic acid (ZOL) is an integral component for the management of patients with bone metastases, but can be associated with transient flu-like symptoms, which generally occur only with the first infusion and are typically manageable with nonprescription analgesics. A 50-year-old woman with a bone metastasis secondary to breast cancer received radiation therapy, brand-name ZOL (Zometa(®)), and letrozole. During the first 3 cycles of Zometa (4 mg every 3-4 weeks), no acute adverse events were reported. For the next 2 cycles she was switched to generic ZOL and experienced severe to

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… As a result, the use of weak opioids such as tramadol (50 mg IV every 8 hours) in conjunction with paracetamol (500 mg every 8 hours) was necessary for pain control, and the patient had to be hospitalized for 2 to 3 days of evaluation and monitoring after each of the 2 generic ZOL infusions received. …

Adrenocortical Carcinoma: A Challenging Diagnosis.

Adrenocortical carcinoma (ACC) is a rare malignancy with aggressive behaviour and a poor prognosis. Patients can present with adrenal hormonal excess or with nonspecific symptoms driven by the presence of an abdominal mass or metastatic disease. Many are completely asymptomatic and diagnosed incidentally. ACC can cause considerable morbidity and mortality, mostly due to its ability to invade surrounding tissues, produce hormones, and spread to distant organs. The authors describe a case of a 62-year-old woman who presented with subacute dorso-lumbar pain. A computed tomography (CT) scan reveal

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… She described a localized pain with a mechanical pattern radiating to the left knee, to which painkillers (acetaminophen, tramadol, and non-steroidal anti-inflammatory drugs) only provided partial relief. …

Cancer of the prostate presenting with diffuse osteolytic metastatic bone lesions: a case report.

UnlabelledIntroductionProstate cancer is the second most common cancer in men and the fifth most common cancer worldwide. In the USA it is more common in African-American men than in Caucasian men. Prostate cancer frequently metastasizes to bone and the lesions appear osteoblastic on radiographs. Presentation with diffuse osteolytic bone lesions is rare. We describe an unusual presentation of metastatic prostate cancer with diffuse osteolytic bone lesions.Case presentationA 65-year-old Namibian man presented with anemia, thrombocytopenia and worsening back pains. In addition he had complaints

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… He was given adequate pain relief with 100mg of oral tramadol per eight hours. The patient declined to have bilateral orchidectomy the only form of androgen deprivation therapy available in the Namibian free health scheme. He continues to receive palliative care. …

Meperidine compared to morphine for rigors associated with monoclonal antibody-related infusion reactions.

IntroductionInfusion reactions, characterized by symptoms such as rigors, fever, and hypotension, are common adverse events that occur during monoclonal antibody (MAB) therapy. The treatment of rigors often involves opioids, most commonly meperidine, despite limited evidence supporting use in the setting of MAB infusions. This study aims to compare the efficacy and safety of intravenous (IV) meperidine and morphine is treatment of MAB-related rigors, filling a significant gap in the literature.MethodsThis was a single-center, retrospective cohort study which reviewed patients either inpatient

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… Control of shivering with clonidine, butorphanol, and tramadol under spinal anesthesia: a comparative study . Local Reg Anesth 2011 ; 4 : 29 – 34 . 22915890 10.2147/LRA.S15366 PMC3417970 3 Götz E Bogosyan S Müller E , et al. Treatment of postoperative shivering with nalbuphine . …

Carbon-Fiber-Reinforced PEEK Intramedullary Nails Defining the Niche.

BackgroundCarbon-fiber-reinforced Polyetheretherketone (CFR-PEEK) nails are gaining interest as they have biomechanical properties potentially capable of overcoming disadvantages of conventional metal nails.Case summaryThree cases are illustrated which required superior mechanical toughness, compatibility with radiotherapy, and postoperative advanced imaging.ConclusionCFR-PEEK nails seem to have a niche role in distinct groups of patients.

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… He is a nonsmoker and takes regular pamidronate, tramadol, and naproxen. In the past, he had sustained stress fractures to his humeri, femora, and tibiae bilaterally, which were managed with conventional nails and plates (Figures 1(a) , 1(d) , and 1(e) ). …

Refractory postherpetic neuralgia in a multiple myeloma patient with lenalidomide maintenance therapy: a case report.

Herpes zoster is not common in multiple myeloma (MM) patients treated with lenalidomide-based regimens. We report an MM patient in his late 60s who received lenalidomide as maintenance treatment and whose condition was complicated with refractory postherpetic neuralgia. The patient received antiviral treatment and analgesia immediately after the diagnosis of herpes zoster. Two months later, the patient received acupuncture, radiofrequency treatment, and even spinal cord stimulation, which failed to relieve the pain. Consequently, we performed high-resolution magnetic resonance imaging of the c

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… After obtaining consent for treatment from the patient, he received antiviral treatment (valaciclovir, 0.3 g, bid for 10 days) after the diagnosis of HZ and at the same time took pregabalin (150 mg, bid), tramadol sustained-release tablets (1 tablet, qd), paracetamol and oxycodone (1 tablet, twice a …

Распространение нетрофической боли в многоразовом склерозе - системном обзоре и мета-анализе с использованием алгоритма NeuPSIG.

Множественный склероз (MS) — нейродегенеративное расстройство, часто приводящее к нейропатической боли. Из-за нейродегенеративной природы диагноз нейропатической боли остается сложным. Была разработана система классификации, обеспечивающая обзор диагностической определенности (т.е. возможной, вероятной и определенной). Поскольку ни один из предыдущих обзоров не привел к этому, различия в диагностической определенности, возможно, повлияли на оценки распространенности. Чтобы прояснить этот вопрос, нынешний метаанализ был направлен на оценку распространенности возможной, вероятной и определенной

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… 23% a –26% b PMS 1.6% a –2.6% b BMS Khan et al. ( 2018 ) | Cross sectional | 73 (34%/66%) | 1.49 ± 1.82 | 7.72 ± 3.97 | 63% RRMS | — 26% SPMS 11% CIS Moisset et al. ( 2013 ) | Cross sectional | 673 (20/80) | 3.7 ± 0.1 | 14.5 ± 0.4 | 74% RRMS | Paracetamol (45%) NSAID (14%) SAID (1%) Nefopam (0.6%) Tramadol … Carbamazepine Lamotrigine other 20% SPMS 4% PPMS 3% CIS Truini et al. ( 2012 ) | Cross sectional | 302 (70%/30%) | 2.0 ± 2.3 | 8.0 ± 7.2 | 80% RRMS | — 3% PPMS 14% SPMS 3% CIS Vidović et al. ( 2014 ) | Cross sectional | 61 (28%/72%) | 5.5 (1.5–9) | — | 57% RRMS | 67% received pain medication Anticonvulsants Tramadol …

Консолидация, систематическая оценка и сопоставление руководящих рекомендаций в отношении лечения хронической боли: Протокол для составления карты рекомендаций в отношении цифрового хронического заболевания.

ВВЕДЕНИЕ: Хроническая боль 1 В 5 :: взрослые и дети во всем мире; однако управление попрежнему носит весьма различный характер, и, как правило, обеспечивается низкий уровень медицинского обслуживания. Несогласованность рекомендаций, содержащихся в руководящих принципах клинической практики в отношении лечения хронической боли, способствует неоптимальному лечению пациентов. Мы будем разрабатывать и распространять живую цифровую карту рекомендаций в отношении хронической боли (e-Chronic Bain RecMap) для выявления заслуживающих доверия рекомендаций в three высокоприоритетные области1) опиоиды,2)

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… n‐methylmorphine or n methylmorphine or nobligan or numorphan or oramorph or oxycodeinon or oxiconum or oxycone or oxycontin or palladone or pancodine or pethidine or phentanyl or prontofort or robidone or skenan or sublimaze or sulfentanyl or sulfentanil or sufenta or takadol or talwin or theocodin or tramadol … n‐methylmorphine or n methylmorphine or nobligan or numorphan or oramorph or oxycodeinon or oxiconum or oxycone or oxycontin or palladone or pancodine or pethidine or phentanyl or prontofort or robidone or skenan or sublimaze or sulfentanyl or sulfentanil or sufenta or takadol or talwin or theocodin or tramadol …

Palliative Care and the Management of Common Distressing Symptoms in Advanced Cancer: Pain, Breathlessness, Nausea and Vomiting, and Fatigue.

Good symptom management in oncology is associated with improved patient and family quality of life, greater treatment compliance, and may even offer survival advantages. With population growth and aging, the proportion of patients with multiple symptoms-both related and unrelated to their cancer-is anticipated to increase, supporting calls for a more routine and integrated approach to symptom management. This article presents a summary of the literature for the use of symptom assessment tools and reviews the management of four common and distressing symptoms commonly experienced by people with

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… Codeine phosphate and/or tramadol are commonly used, although this is supported by limited evidence. … Tramadol with or without paracetamol (acetaminophen) for cancer pain. Cochrane Database Syst Rev. 2017;5:CD012508. doi: 10.1002/14651858.CD012508.pub2. 57. Bandieri E, Romero M, Ripamonti CI, et al. Randomized trial of low-dose morphine versus weak opioids in moderate cancer pain. …

Managing treatment-related peripheral neuropathy in patients with multiple myeloma.

Peripheral neuropathy is one of the most important complications of multiple myeloma treatment. Neurological damage can be observed at the onset of the disease, due to the effect of monoclonal protein or radicular compression, but more often is treatment related. Vinca alkaloids in the past era, and more recently, thalidomide and bortezomib are mainly responsible. Degeneration of dorsal root ganglion is common, prevalently related to angiogenesis inhibition and cytokine modulation in the case of thalidomide and inhibition of the ubiquitin proteasome system in the case of bortezomib. Sensory ne

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… Tramadol can reduce chronic pain. 38 However, the recommendations from the British Committee for Standards in Haematology in MM are oral tramadol for mild–moderate pain; oral oxycodone or alternatively morphine for chronic moderate–severe pain; and SC opioid therapy (oxycodone or morphine injection …

Bilateral Knee Effusions Secondary to Zoledronic Acid Infusion.

Intravenous zoledronic acid is an established and generally well tolerated form of antiresorptive therapy for osteoporosis. Although mild arthralgias are a well-documented manifestation of the acute phase response to intravenous bisphosphonates, more severe musculoskeletal reactions manifesting as debilitating pain and joint effusions have been rarely documented in the current literature. In this case report, we discuss the case of a 55-year-old woman who developed severe painful bilateral knee effusions within 1 week of her first zoledronic acid infusion for osteoporosis. Prescribing physicia

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… . | Codeine phosphate, buprenorphine, and tramadol Kiyumi et al (2023) [ 8 ] | 62-year-old woman with osteoarthritis, osteoporosis, and peptic ulcer disease | Developed generalized myalgias, fevers, and bilateral knee and wrist pain and swelling within 12 hours of receiving first dose of IV zoledronic …

Management of Atlantoaxial Instability Due to a Pathological Fracture of the Axis.

Metastases to the upper cervical spine are uncommon, and subsequent instability is rare. We report the details of a patient with metastatic breast cancer to the axis manifesting as a pathologic fracture and C1/C2 instability. This was treated by preoperative reduction to appropriate alignment with use of crown halo traction, followed by posterior occipitocervical fusion and postoperative radiation therapy.

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… Postoperative Details The patient recovered well and was transitioned from intravenous pain medications to oral Tramadol. The patient was discharged with home physical therapy after clearance from physical and occupational therapy. …

Atypical Presentation of Systemic Amyloid Light Chain (AL) Amyloidosis.

Light chain (AL) amyloidosis is caused by a plasma cell clone that produces a dysfunctional, monoclonal light chain. This light chain misfolds and aggregates, resulting in catastrophic organ damage and eventual death. Due to the multiple organs affected by the disease, symptoms can be vague, such as lethargy, fatigue, weight loss, and peripheral edema. This case presentation follows a 66-year-old female patient who presented to our emergency department complaining of progressive shortness of breath (SOB). The patient denied any other associated symptoms and denied any past significant medical

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… Additionally, she was on tramadol 50 mg PO every six hours (Q6H) for back pain, alprazolam 0.5 mg PO daily pro re nata (PRN) or as needed for anxiety, and atorvastatin 40 mg PO daily. …

Prevalence of Chemotherapy-Induced Peripheral Neuropathy in Multiple Myeloma Patients and its Impact on Quality of Life: A Single Center Cross-Sectional Study.

Bortezomib is a pivotal drug for the management of multiple myeloma. However, bortezomib is a neurotoxic anticancer drug responsible for chemotherapy-induced peripheral neuropathy (CIPN). CIPN is associated with psychological distress and a decrease of health-related quality of life (HRQoL), but little is known regarding bortezomib-related CIPN. This single center, cross-sectional study assessed the prevalence and severity of sensory/motor CIPN, neuropathic pain and ongoing pain medications, anxiety, depression, and HRQoL, in multiple myeloma patients after the end of bortezomib treatment. Pap

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… Neuropathic pain ( N = 10) Analgesic treatment | 35 (52.2) | 23 (46.9) | 12 (66.7) | 27 (47.4) | 8 (80.0) Paracetamol | 26 (74.3) | 17 (73.9) | 9 (75.0) | 21 (77.8) | 5 (62.5) Aspirin | 5 (14.3) | 4 (17.4) | 1 (8.3) | 4 (14.8) | 1 (12.5) Morphine | 4 (11.4) | 3 (13.0) | 1 (8.3) | 3 (11.1) | 1 (12.5) Tramadol … + paracetamol | 3 (8.6) | 2 (8.7) | 1 (8.3) | 3 (11.1) | 0 (0) Pregabalin | 3 (8.6) | 2 (8.7) | 1 (8.3) | 3 (11.1) | 0 (0) Ibuprofen | 2 (5.7) | 2 (8.7) | 0 (0) | 2 (7.4) | 0 (0) Codeine + paracetamol | 2 (5.7) | 0 (0) | 2 (16.7) | 0 (0) | 2 (25.0) Tramadol | 2 (5.7) | 2 (8.7) | 0 (0) | 2 (7.4) | 0 …

The 4th Global Congress on Sickle Cell Disease Abstract Book 2022

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Onco-Hem Connectome-Network-Based Phenotyping of Polypharmacy and Drug-Drug Interactions in Onco-Hematological Inpatients.

We introduce the Onco-Hem Connectome (OHC), a patient similarity network (PSN) designed to organize real-world hemato-oncology inpatients by exploratory phenotypes with potential clinical utility. Background: Polypharmacy and drug-drug interactions (DDIs) are pervasive in hemato-oncology and vary with comorbidity and treatment intensity. Methods: We retrospectively analyzed a 2023 single-center cohort of 298 patients (1158 hospital episodes). Standardized feature vectors combined demographics, comorbidity (Charlson, Elixhauser), comorbidity polypharmacy score (CPS), aggregate DDI severity scor

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… The top over-represented drugs reflected supportive and regimen-adjacent care rather than a single signature protocol—acetaminophen and filgrastim ( Δ = +0.04 each), desloratadine (+0.02), tramadol (+0.01) and arginine/zoledronic acid/spironolactone (+0.01 each), alongside selective antineoplastic (obinutuzumab … For responsible management, Community 1 may be a reasonable target for order set optimization (e.g., zoledronic acid + calcium/vitamin D checks; filgrastim criteria; antibiotic de-escalation rules) and drug reconciliation to curb unnecessary adjacent treatments (e.g., routine tramadol) without compromising …

Anaesthesia as an influence in tumour progression.

PURPOSE: Tumour growth and the formation of metastases are essential elements in the progression of cancer. The centre of treatment is the surgical resection of primary solid tumours. But even if the tumour can be removed without microscopic residual cells, local recurrences and distant metastases occur and determine the patient's fate. During the operation, tumour cells are shed from the primary tumour and released into the circulation. These circulating tumour cells might play an important role in the formation of new tumour sites. Therefore, a functional innate and adaptive immune system is

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… For example, it was reduced by morphine and fentanyl, increased by tramadol and buprenorphine did not affect it. This was shown in vivo and in patients undergoing surgery [ 30 ]. … Opioids like fentanyl and morphine inhibit the natural killer cell cytotoxicity, whereas tramadol improves it. A direct induction of proliferative signalling pathways via the μ-receptor might influence tumour growth and survival. …

The effect of polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair) on oral microbial colonization and pain control compared with other rinsing solutions in patients with oral mucositis after allogeneic stem cells transplantation.

BackgroundGelclair is an oral lubricating gel used in the management of oral mucositis (OM). We evaluated its efficacy, tolerance and impact on oral cavity microbial colonization in patients with OM after allogeneic hematopoietic stem cells transplantation.Material/methodGelclair was administered in a group of 22 patients with active OM. A control group of 15 patients used other rinsing solutions (chlorhexidine, benzydamine, salvia). Tests with oral cavity swabs for microbiology analysis were performed once a week.ResultsThe characteristics of OM in both groups were comparable, and rinsing sol

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… The analgesic medication administered in the Gelclair group was: buprenorphine 35 ug/hour transdermal patch in 13/22 (59%), buprenorphine 52.5 ug/hour transdermal patch in 1/22 (4.5%) and tramadol 4.1 mg/hour I.V. in 1/22 (4.5%) patients. …