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Что делают физиотерапевты в борьбе с недержанием мочи у женщин в системе первичной медико-санитарной помощи?

Недержание мочесодержания, определяемое как недобровольная потеря мочи, широко распространено среди женщин и оказывает значительное воздействие на физическое, эмоциональное и социальное благополучие. Несмотря на широкое признание того, что обучение мускулам тазового пола является первым направлением деятельности для легкого и умеренного УИ, роль физиотерапевтов в лечении этого заболевания в рамках системы первичной медико-санитарной помощи (ПМС) по-прежнему недостаточно изучена. Учитывая центральную роль ПМО в системах здравоохранения и преобладание общих и многопрофессиональных групп в этой с

Exploring Barriers and Facilitators to Engagement of an Online Acceptance and Commitment Therapy Intervention for Cancer Survivors With Chronic Painful Chemotherapy-Induced Peripheral Neuropathy: Qualitative Interview Study.

BackgroundOnline self-management interventions for cancer survivors are increasingly being used, but engagement is often difficult for patients. Given the importance of engagement for intervention effectiveness, identifying patient-reported barriers and facilitators is essential.ObjectiveThe aim of this study was to qualitatively examine barriers and facilitators influencing engagement with an online self-management intervention, offered with or without guidance, for cancer survivors experiencing chronic painful chemotherapy-induced peripheral neuropathy (CIPN).MethodsPatients who took part in

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… Impact of a multimedia website with patient experiences of multiple sclerosis (PExMS) on immunotherapy decision-making: study protocol for a pilot randomised controlled trial in a mixed-methods design. Pilot Feasibility Stud. 2021 Jan 7;7(1):16. doi: 10.1186/s40814-020-00749-0. doi. Medline. 33. …

Резюме: 32 Второй Конгресс ЭСП и Международный конгресс XXXIII МПД.

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Targeting CD38 Across Autoimmune and Plasma Cell-Driven Immune-Mediated Diseases: Rationale, Clinical Evidence, and Emerging Therapeutic Landscape.

Autoimmune diseases remain a major cause of chronic morbidity despite substantial advances in targeted immunomodulatory therapies. In many autoantibody-mediated conditions, disease refractoriness and relapse are driven by long-lived plasma cells, which are largely resistant to conventional immunosuppression and upstream B cell-directed strategies. CD38, a surface molecule highly expressed on plasmablasts and plasma cells and functionally involved in immunometabolic regulation, has emerged as a promising therapeutic target to overcome this limitation. Clinical interest in anti-CD38 therapy has

The Health-Promoting Effects and the Mechanism of Intermittent Fasting.

Intermittent fasting (IF) is an eating pattern in which individuals go extended periods with little or no energy intake after consuming regular food in intervening periods. IF has several health-promoting effects. It can effectively reduce weight, fasting insulin levels, and blood glucose levels. It can also increase the antitumor activity of medicines and cause improvement in the case of neurological diseases, such as memory deficit, to achieve enhanced metabolic function and prolonged longevity. Additionally, IF activates several biological pathways to induce autophagy, encourages cell renew

Caregiver strain among patients of palliative care in Sri Lanka: validation of modified caregiver strain index - Sinhala version.

BackgroundCare givers of Palliated patients are at risk of adverse physical, psychosocial and emotional sequelae in varied nature. Efficient and valid assessment tools facilitate early detection to take corrective measures. The Modified Caregiver Strain Index (MCSI), composed of domains associated with caregiver strain is a simple and brief tool that can be used in both clinical and field settings. This study aimed to adapt and validate this in order to cater effective palliative care services in Sri Lanka.MethodsAfter cross-cultural adaptation, 200 primary caregivers in 3 teaching hospitals w

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… Factors associated with carer strain in carers of people with multiple sclerosis. Disabil Rehabil. 2001;23:768–76. doi: 10.1080/09638280110062158. 13. Thornton M, Travis SS. Analysis of the reliability of the modified caregiver strain index. …

Pathological Mechanisms of Bortezomib-Induced Peripheral Neuropathy.

Bortezomib, a first-generation proteasome inhibitor widely used in chemotherapy for hematologic malignancy, has effective anti-cancer activity but often causes severe peripheral neuropathy. Although bortezomib-induced peripheral neuropathy (BIPN) is a dose-limiting toxicity, there are no recommended therapeutics for its prevention or treatment. One of the most critical problems is a lack of knowledge about pathological mechanisms of BIPN. Here, we summarize the known mechanisms of BIPN based on preclinical evidence, including morphological abnormalities, involvement of non-neuronal cells, oxid

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… As fingolimod is now approved for multiple sclerosis, the results of these studies suggest that drug repositioning clinical trials should be advanced. …

Critical analysis of the prescription and evaluation of monoclonal antibodies approved in Germany for the outpatient setting from 2010-2021.

Monoclonal antibodies (mAbs) are increasingly being launched on the German market and account for a growing share of total drug costs every year. In 2021 alone, eleven monoclonal antibodies were among the 30 best-selling drugs, accounting for 9.91% of total drug costs. In contrast, a considerable additional benefit of the newly introduced monoclonal antibodies is not predominantly demonstrable. Therefore, our objective was to analyze the drug prescriptions and associated costs in comparison to the benefit assessment of the Federal Joint Committee (GBA). This paper analyzes 62 monoclonal antibo

Breast calcifications on mammography from systemic amyloidosis: A case report.

Calcifications on mammography from systemic disease at times meet diagnostic criteria for histologic sampling to exclude malignancy. We present a case of bilateral groups of new calcifications on mammography that yielded amyloidosis on core biopsy. Awareness of our patient's known diagnosis of systemic light chain amyloidosis (AL) prompted use of Congo red staining to confirm the histologic diagnosis. Knowledge of systemic diseases with possible manifestations on mammography can facilitate cogent and clinically relevant radiology-pathology correlation.

Killing me softly--future challenges in apoptosis research.

The induction of apoptosis, a highly regulated and clearly defined mode of cell dying, is a vital tenet of modern cancer therapy. In this review we focus on three aspects of apoptosis research which we believe are the most crucial and most exciting areas currently investigated and that will need to be better understood in order to enhance the efficacy of therapeutic measures. First, we discuss which target to select for cancer therapy and argue that not the cancer cell as such, but its interaction with the microenvironment is a more promising and genetically stable site of attack. Second, the

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… Firategrast for relapsing remitting multiple sclerosis: A phase 2 randomised double-blind placebo-controlled trial. Lancet Neurol. 2012;11:131–139. doi: 10.1016/S1474-4422(11)70299-X. 53. Tomlinson I.P., Novelli M.R., Bodmer W.F. The mutation rate and cancer. Proc. Natl. Acad. Sci. …

A distinct CAR-T cell phenotype mediates therapeutic response at limited doses.

Chimeric antigen receptor (CAR) T-cell therapies are typically administered at high doses to maximize durable clinical responses. However, manufacturing constraints can limit the production of sufficient cells to achieve the intended dose. Although some patients experience durable responses after receiving lower CAR-T cell doses, the mechanisms underlying efficacy at these limited cell numbers remain poorly understood. To address this, we performed deep phenotyping of anti-CD19 CAR-T cell products and their corresponding leukapheresis starting materials from a phase I/II dose-escalation trial.

Pharmacotherapy of Generalized Myasthenia Gravis with Special Emphasis on Newer Biologicals.

Myasthenia gravis (MG) is a chronic, fluctuating, antibody-mediated autoimmune disorder directed against the post-synaptic neuromuscular junctions of skeletal muscles, resulting in a wide spectrum of manifestations ranging from mild to potentially fatal. Given its unique natural course, designing an ideal trial design for MG has been wrought with difficulties and evidence in favour of several of the conventional agents is weak as per current standards. Despite this, acetylcholinesterases and corticosteroids have remained the cornerstones of treatment for several decades with intravenous immuno

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… Tolebrutinib, an oral BTKi, has already been found to be efficacious and well tolerated in multiple sclerosis in phase IIb trials and a phase III trial is currently recruiting patients with generalized MG [ 196 , 197 ]. …

Is COVID-19 Still a Threat? An Expert Opinion Review on the Continued Healthcare Burden in Immunocompromised Individuals.

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a profound global impact. The emergence of several variants during the pandemic has presented numerous challenges in preventing and managing this disease. The development of vaccines has played a pivotal role in controlling the pandemic, with a significant portion of the global population being vaccinated. This, along with the emergence of less virulent SARS-CoV-2 variants, has led to a reduction in the severity of COVID-19 outcomes for the overall population. Nevertheless, i

Precision in Action: The Role of Clustered Regularly Interspaced Short Palindromic Repeats/Cas in Gene Therapies.

Clustered Regularly Interspaced Short Palindromic Repeat (CRISPR)-associated enzyme-CAS holds great promise for treating many uncured human diseases and illnesses by precisely correcting harmful point mutations and disrupting disease-causing genes. The recent Food and Drug Association (FDA) approval of the first CRISPR-based gene therapy for sickle cell anemia marks the beginning of a new era in gene editing. However, delivering CRISPR specifically into diseased cells in vivo is a significant challenge and an area of intense research. The identification of new CRISPR/Cas variants, particularly

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… Multiple-Sclerosis Multiple Sclerosis (MS) is a chronic autoimmune disease that aggressively attacks an individual’s nervous system. This disease leads to progressive neurological deterioration. Emerging gene editing technologies, like CRISPR-Cas, offer relief for MS patients. …

Systemic adverse effects and toxicities associated with immunotherapy: A review.

Immunotherapy is rapidly evolving secondary to the advent of newer immunotherapeutic agents and increasing approval of the current agents by the United States Food and Drug Administration to treat a wide spectrum of cancers. Immunotherapeutic agents have gained immense popularity due to their tumor-specific action. Immunotherapy is slowly transforming into a separate therapeutic entity, and the fifth pillar of management for cancers alongside surgery, radiotherapy, chemotherapy, and targeted therapy. However, like any therapeutic entity it has its own adverse effects. With the increasing use o

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… These include inflammatory myopathies, myasthenia gravis, vasculitis, small fiber sensory type neuropathies, immune-mediated neuropathies, cranial mononeuropathies, aseptic meningitis, autoimmune encephalitis, and multiple sclerosis (both exacerbation and new onset CNS demyelinating disease)[ 44 ]. …

The role of interleukin-17 in inflammation-related cancers.

Emerging evidence indicates a correlation between inflammation and the development and progression of cancer. Among the various inflammatory signals, interleukin-17 (IL-17) family cytokines serve as a critical link between inflammation and cancer. IL-17 is a highly versatile pro-inflammatory cytokine that plays a pivotal role in host defense, tissue repair, the pathogenesis of inflammatory diseases, and cancer progression. During the early stages of tumorigenesis, IL-17 signaling directly promotes the proliferation of tumor cells. Conversely, IL-17 has been shown to exhibit antitumor immunity

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… In addition, IL-17 and its downstream signaling pathways have been implicated in several other pathologies, including multiple sclerosis (MS), systemic lupus erythematosus (SLE), and asthma ( 2 ). …

Advances in antisense oligonucleotide treatment for cancer.

RNA therapeutics, including antisense oligonucleotides (ASOs), have emerged as a promising class of drugs, with several already approved for clinical use. To date, most approved ASO-based RNA therapies target non-malignant disorders such as neurodegenerative diseases, and only a single therapy in this class has been approved for cancer. Notably, nearly half of existing RNA therapeutics act by modulating RNA splicing. Given the growing evidence implicating aberrant RNA splicing in cancer pathogenesis, the development of ASO-based therapeutics for oncologic indications is expected to accelerate.

Role of Protein Kinase CK2 in Aberrant Lipid Metabolism in Cancer.

Uncontrolled proliferation is a feature defining cancer and it is linked to the ability of cancer cells to effectively adapt their metabolic needs in response to a harsh tumor environment. Metabolic reprogramming is considered a hallmark of cancer and includes increased glucose uptake and processing, and increased glutamine utilization, but also the deregulation of lipid and cholesterol-associated signal transduction, as highlighted in recent years. In the first part of the review, we will i) provide an overview of the major types of lipids found in eukaryotic cells and their importance as med

Targeting the NLRP3 inflammasome in kidney disease: molecular mechanisms, pathogenic roles, and emerging small-molecule therapeutics.

Inflammatory responses represent a core pathological process driving the progression of both acute and chronic kidney diseases. As a key effector of the innate immune system, the NLRP3 inflammasome is widely activated in renal resident cellsand infiltrating immune cells, positioning it as a critical nexus linking metabolic dysregulation, cellular stress, and tissue injury. Accumulating preclinical and clinical evidence in recent years demonstrates that aberrant activation of the NLRP3 inflammasome directly promotes glomerular damage, tubulointerstitial inflammation, fibrosis, and vascular dysf

An expanding horizon of complex injectable products: development and regulatory considerations.

There has been a constant evolution in the pharmaceutical market concerning the new technologies imbibed in delivering drug substances for various indications. This is either market-driven or technology-driven to improve the overall therapeutic efficacy and patients' quality of life. The pharmaceutical industry has experienced rapid growth in the area of complex injectable products because of their effectiveness in the unmet market. These novel parenteral products, viz, the nanoparticles, liposomes, microspheres, suspensions, and emulsions, have proven their worth as "Safe and Effective" produ

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… . | Copaxone ® | Glatiramer acetate | Peptide | Solution Pre-filled syringe | 20 mg/mL, 40 mg/mL | Mannitol | Relapse from multiple sclerosis | S.C. | For subcutaneous injection only. 20 mg/mL (per day) 40 mg/mL (thrice per week) | Feb 12, 2002 | Teva Pharmaceuticals USA | [ 14 ] 2. | EpiPen ® | Epinephrine … Copaxone ® , glatiramer acetate injection, is marketed by Teva Pharmaceuticals Inc. for treatment of multiple sclerosis (MS via subcutaneous administration) [ 14 ]. Glatiramer acetate is a mixture of synthetic polypeptides having unique anti-inflammatory and immunomodulatory activities [ 62 ]. …