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Bone metastasis in colorectal cancer: Pathophysiology, prognostic factors, survival outcomes, and treatment strategies - A comprehensive review.

BackgroundColorectal cancer ranks as the third most prevalent cancer globally, with over 1.9 million new cases and 930,000 deaths in 2020. While the liver and lungs are the most common site of colorectal cancer metastases, bone metastasis is relatively rare but clinically significant. The rarity of bone metastasis in colorectal cancer, early diagnosis challenges, and the poorly understood mechanisms underlying bone metastasis have resulted in lesser research compared to other metastatic sites of colorectal cancer.ObjectiveThe goal of this review is to summarize pathophysiology, clinical presen

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… efficacy declined progressively, highlighting the need for further adjustments in pain management strategies for CRC patients with bone metastasis [ 42 ]. 3- Opioids and intrathecal neurolysis In a Japanese retrospective study, an increase in the use of opioids (oxycodone , fentanyl , morphine and tramadol …

Экспертный консенсус в отношении многодисциплинарного подхода к лечению множественных заболеваний костей, связанных с миеломой.

Этот консенсус по множественным болезням костей, связанным с миеломой, подчеркивает важность многодисциплинарного подхода, который охватывает гематологию, радиологию, ортопедию и дополнительные специальности для решения сложных проблем. МБД, широко распространенное и изнуряющее осложнение множественной миэломы, приводит к боли в костях, переломам и событиям, связанным со скелетом, что оказывает глубокое воздействие на качество жизни пациентов. Эти руководящие принципы обеспечивают тщательную основу для диагностики, лечения и постоянной оценки с уделением особого внимания раннему обнаружению и

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… Neuropathic pain, common in MBD, can be managed with first-line treatments, such as gabapentin (1200–1300 mg/day), pregabalin (300–600 mg/day), duloxetine (60–120 mg/day), venlafaxine (150–225 mg/day), and tricyclic antidepressants (25–150 mg/day). 58 If these are insufficient, weak opioids such as tramadol …

Mass Spectrometry-Based Proteomics: Analyses Related to Drug-Resistance and Disease Biomarkers.

Mass spectrometry-based proteomics is a key player in research efforts to characterize aberrant epigenetic alterations, including histone post-translational modifications and DNA methylation. Data generated by this approach complements and enrich datasets generated by genomic, epigenetic and transcriptomics approaches. These combined datasets can provide much-needed information on various mechanisms responsible for drug resistance, the discovery and validation of potential biomarkers for different diseases, the identification of signaling pathways, and genes and enzymes to be targeted by futur

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… Application of ion mobility spectrometry for the determination of tramadol in biological samples. J. Food Drug Anal. 2014;22:500–504. doi: 10.1016/j.jfda.2014.02.001. 40. Morrison K.A., Clowers B.H. Contemporary glycomic approaches using ion mobility–mass spectrometry. Curr. Opin. Chem. …

Long-Term Outcomes of Pituitary Gland Preservation in Pituitary Macroadenoma Apoplexy: Case Series and Review of the Literature.

Introduction  For patients presenting with neurological changes from pituitary tumor apoplexy, urgent surgical intervention is commonly performed for diagnosis, tumor resection, and optic apparatus decompression. Although identification and preservation of the pituitary gland during the time of surgery can be challenging, it may lead to improve endocrine outcomes. Methods  A retrospective case series of all patients with macroadenomas presenting with apoplexy at Loyola University Medical Center from 2016 to 2018 was studied. Demographic, radiographic, and intraoperative characteristics were co

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… Direct conversion from tramadol to tapentadol prolonged release for moderate to severe, chronic malignant tumour-related pain . Eur J Pain . 2016 ; 20 : 1513 – 1518 . doi: 10.1002/ejp.875 27062079 PMC5071659 39. …

Emergency Care

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Complication avoidance, rehabilitation, pain therapy and palliative care for patients with metastatic spine tumors: WFNS spine committee recommendations.

ObjectiveThis review aims to formulate the most current, evidence-based recommendations regarding complication avoidance, rehabilitation, pain therapy and palliative care for patients with metastatic spine tumors.MethodsA systematic literature search in PubMed and MEDLINE, and was performed from 2013 to 2023 using the search terms "complications" + "spine metastases", "spine metastases" + + "rehabilitation", "spine metastases" + "pain therapy" + "palliative care". Screening criteria resulted in 35, 15 and 56 studies respectively that were analyzed. Using the Delphi method and two rounds of vot

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… According to ECMO guidelines, for mild to moderate pain, weak opioids such as tramadol, dihydrocodeine and codeine can be given in combination with non-opioid analgesics. As an alternative to weak opioids, although not a part of WHO scheme, low doses of strong opioids could be an option [ 49 ]. …

Cancer, immune suppression and Coronavirus Disease-19 (COVID-19): Need to manage drug safety (French Society for Oncology Pharmacy [SFPO] guidelines).

The Coronavirus disease (COVID-19) pandemic is disrupting our health environment. As expected, studies highlighted the great susceptibility of cancer patients to COVID-19 and more severe complications, leading oncologists to deeply rethink patient cancer care. This review is dedicated to the optimization of care pathways and therapeutics in cancer patients during the pandemic and aims to discuss successive issues. First we focused on the international guidelines proposing adjustments and alternative options to cancer care in order to limit hospital admission and cytopenic treatment in cancer p

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… There is also a risk of lowering the epileptogenic threshold, as association to tramadol is strongly contraindicated, especially in at-risk patients (epilepsy, advanced age, brain tumor). …

Evaluation of the Enhanced Recovery After Surgery (ERAS) Guidance for Patients With Spinal Metastasis.

Surgery continues to remain the most effective treatment for spinal metastasis (SM). As the number of surgeries continues to grow, the need for consensus guidelines for optimal perioperative care is imperative. Enhanced recovery after surgery (ERAS) protocols were created for this purpose. The objective of this study is to review evidence-based ERAS guidelines for SM surgery. A group of multiple experienced spine surgeons was invited to participate in this study. This group identified 19 ERAS items for SM surgery. The principal literature search utilized MEDLINE, Embase, and Cochrane databases

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… With postoperative gabapentin 300 mg every 8 h, celecoxib 200 mg every 12 h, tramadol 200 mg every 12 h, and acetaminophen 1 g every 6 h. Patients received PCA and progressive transition to oral analgesics as needed. …

Radiotheranostics - Precision Medicine in Nuclear Medicine and Molecular Imaging.

'See what you treat and treat what you see, at a molecular level', could be the motto of theranostics. The concept implies diagnosis (imaging) and treatment of cells (usually cancer) using the same molecule, thus guaranteeing a targeted cytotoxic approach of the imaged tumor cells while sparing healthy tissues. As the brilliant late Sam Gambhir would say, the imaging agent acts like a 'molecular spy' and reveals where the tumoral cells are located and the extent of disease burden (diagnosis). For treatment, the same 'molecular spy' docks to the same tumor cells, this time delivering cytotoxic

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… diagnostic and treatment includes discontinuation of medication that interfere with norepinephrine transporters for at least five half-lives before and seven days after treatment (i.e., blood pressure medication such as combined alpha/beta blocker labetalol and calcium channel blockers, antidepressants, tramadol …

Lenalidomide, bortezomib and dexamethasone induction therapy for the treatment of newly diagnosed multiple myeloma: a practical review.

For patients with newly diagnosed multiple myeloma, survival outcomes continue to improve significantly: however, nearly all patients will relapse following induction treatment. Optimisation of induction therapy is essential to provide longer term disease control and the current standard of care for most patients incorporates an immunomodulatory agent and proteasome inhibitor, most commonly lenalidomide and bortezomib in combination with dexamethasone (RVD), with maintenance until progression. Historically there has been limited access to RVD as an induction strategy outside of the United Stat

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… In the case of poor response or major side‐effects to these agents, alternative options are opioids such as fentanyl, tramadol or buprenorphine, but also inhaled medical cannabis may be considered. 71 , 72 HOW DO I MANAGE IMMUNOMODULATORY IMIDE DRUG INDUCED BILE ACID MALABSORPTION AND DIARRHOEA? …

Е-постеры.

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Critical considerations in the administration of antineoplastic therapy for patients with malignant solid tumors undergoing hemodialysis.

Patients with chronic kidney disease exhibit a higher risk of developing malignancies, and among those with end-stage renal disease (ESRD) on dialysis, approximately 7% are diagnosed with new-onset tumors within five years. Patients with ESRD who are receiving antineoplastic treatment exhibit a significantly higher incidence and greater severity of adverse effects associated with antineoplastic agents compared to individuals with normal renal function. This complexity involves multiple factors, including the therapy options and dose adjustment of antineoplastic agents, drug-related toxicities,

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… Tramadol: understanding the risk of serotonin syndrome and seizures. Am J Med. (2018) 131:1382.e1–1382.e6. doi: 10.1016/j.amjmed.2018.04.025. PMID: 36. Pilleron S, Alqurini N, Ferlay J, Haase KR, Hannan M, Janssen-Heijnen M, et al. …

Practical management of disease-related manifestations and drug toxicities in patients with multiple myeloma.

Multiple myeloma (MM) is a very heterogeneous disease with multiple symptoms and clinical manifestations. MM affects mainly elderly patients and is difficult to manage in the presence of comorbidities, polypharmacy, frailty and adverse events of disease-targeted drugs. The rapid changes in MM treatment resulting from constant innovations in this area, together with the introduction of numerous new drugs with distinct mechanisms of action and toxicity profiles, have led to an increased complexity in the therapeutic decision-making and patient management processes. The prolonged exposure to nove

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… - Scores 5-6: weak opioids associated with non-opioids, such as tramadol (up to 400 mg/day, per os, SC, IM or IV) and paracetamol, may be used. - Scores 7-10: strong opioids are mandatory. …

Poster Presentation

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… Results: Drugs used were Tramadol (68% patients), Metoclopramide, Morphine, Xylocard (infusion), Haloperidol and Dexamethasone. NRS for pain and vomiting decreased by >70% in all patients at 30 minutes. …

Expert opinion on screening, diagnosis and management of diabetic peripheral neuropathy: a multidisciplinary approach.

The proposed expert opinion aimed to address the current knowledge on conceptual, clinical, and therapeutic aspects of diabetic peripheral neuropathy (DPN) and to provide a guidance document to assist clinicians for the best practice in DPN care. The participating experts consider the suspicion of the disease by clinicians as a key factor in early recognition and diagnosis, emphasizing an improved awareness of the disease by the first-admission or referring physicians. The proposed "screening and diagnostic" algorithm involves the consideration of DPN in a patient with prediabetes or diabetes

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… painful DPN. b IV form is marketed only in Germany, Eastern Europe and China Pharmacological treatment of painful DPN TCAs: Amitriptyline (25-150 mg/day), Imipramine 25-150 mg/day SNRIs: Duloxetine (0-120 mg/day) a GABA analogs: Pregabalin (300-600 mg/day) a , Gabapentin (300-3600 mg/day) Opiates: Tramadol …

A comprehensive review on pain: Model, target, therapy, and prospect (Review).

Pain serves as both a protective physiological response essential for species survival and a global health issue affecting human well‑being and societal development. The present review systematically summarized and analyzed the research progresses on pain through a multidimensional analytical framework encompassing animal models, molecular targets, therapeutic approaches and future prospects. In animal modeling, neuropathic pain paradigms have evolved from traditional mechanical compression to composite models that combine dynamic displacement and chemical stimulation. Cancer‑induced pain mode

Oral Presentation

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… Tramadol, Ondansetron, Hyoscine, Haloperidol and Ranitidine injections along with Lorazepam tablets (singly packed and labelled well) packed with a 23 gauge butterfly cannula, an alcohol swab and syringes in a seal proof package along with an anticipatory prescription, phone helpline number and video …

Consensus Recommendations for the Diagnosis and Management of X-Linked Hypophosphatemia in Belgium.

X-linked hypophosphatemia (XLH) is the most common genetic form of hypophosphatemic rickets and osteomalacia. In this disease, mutations in the PHEX gene lead to elevated levels of the hormone fibroblast growth factor 23 (FGF23), resulting in renal phosphate wasting and impaired skeletal and dental mineralization. Recently, international guidelines for the diagnosis and treatment of this condition have been published. However, more specific recommendations are needed to provide guidance at the national level, considering resource availability and health economic aspects. A national multidiscip

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… Tramadol and strong opioids may be required for more advanced, otherwise untreatable musculoskeletal problems. Glucocorticoids or colchicine are not recommended. …

Bone metastases in thyroid cancer.

Whereas preemptive screening for the presence of lymph node and lung metastases is standard-of-care in thyroid cancer patients, bone metastases are less well studied and are often neglected in thyroid cancer patient surveillance. Bone metastases in thyroid cancer are, however, independently associated with poor/worse prognosis with a median overall survival from detection of only 4 years despite an otherwise excellent prognosis for the vast majority of thyroid cancer patients. In this review we summarize the state of current knowledge as pertinent to bony metastatic disease in thyroid cancer,

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… Pure systemic analgesics include non-narcotic agents such as acetaminophen and oral narcotics (tramadol, codeine derivatives, and morphine derivatives – all of which have long and shorter acting preparations). …

Heart Failure in Older Patients: An Update.

Heart failure (HF) is a clinical syndrome with high incidence and prevalence and high morbidity and death rate, even in the short term, representing a serious public health issue, mainly in older people. It is a growing cause for hospital admission in this age group, being frequently associated with several comorbidities, further aggravating the disease's course. Moreover, older HF patients are usually affected by clinical conditions, like frailty, malnutrition, and cachexia, which significantly impact the overall management of HF and need to be properly identified and treated. Diagnosing and

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… Pain: NSAIDs are generally avoided in order to not worsen renal function [ 224 ]; anticonvulsants, antidepressants, and opioids (tramadol, oxycodone, hydromorphone, fentanyl) are preferred [ 223 ]. …