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The Complexities of Diagnosis with Co-Existing Gaucher Disease and Hemato-Oncology-A Case Report and Review of the Literature.

Hematological abnormalities are the most common early symptoms of Gaucher disease (GD), with an increased risk of hematopoietic system malignancies reported in patients with GD. GD may be associated with monoclonal and polyclonal gammopathies; however, the mechanism of association of GD with multiple myeloma (MM) remains uncertain. Enzyme replacement therapy (ERT) has been shown to improve patients' cytopenia and it seems to facilitate anti-myeloma therapy in patients with co-occurring GD and MM. Although it is necessary to demonstrate the deficiency of enzymatic activity, as well as using gen

American Society of Hematology 2026 guidelines on diagnosis of light chain amyloidosis.

BACKGROUND: Light chain (AL) amyloidosis is a rare disease caused by the misfolding of immunoglobulin light chains produced by a plasma cell dyscrasia. Patients can present with involvement of many organs, including the heart, kidneys, liver, nerves, and other sites, resulting in a high symptom burden. Timely and accurate diagnosis is important to prevent organ failure and improve patient survival. OBJECTIVE: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients and clinicians in the timely and effective diagnosis of AL amyloidosis. METH

Необычный Строук-Вроде Презентации Множественного Склероза в 27-летнем человеке.

Трубоактивный множественный склероз (TMS) является редким подтипом множественного склероза с различными клиническими представлениями, что часто приводит к задержкам с диагностикой и началом лечения. В ходе исследования она имеет большое (>2 см) демиелинирующее массово похожее повреждение и может сопровождаться кольцевым улучшением, опасным отёком и массовым эффектом. Мы сообщаем о случае с 27-летним мужчиной, у которого была правая слабость и онемение. Год назад он выступил с аналогичной презентацией без окончательного диагноза. Вычисленная томография (CT) мозга выявила многочисленные двусторо

Hematology and Immune-Related Disorders

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Multidisciplinary and Coordinated Management of Osteoporotic Vertebral Compression Fractures: Current State of the Art.

Osteoporotic vertebral compression fractures (OVCFs) present a significant health concern, affecting a substantial portion of the older adult population worldwide. This narrative review explores the prevalence, diagnostic challenges and management strategies for OVCFs. Despite the increasing incidence and impact on morbidity and mortality, existing clinical guidelines lack consistency and clear diagnostic and therapeutic recommendations. The review addresses key questions faced by physicians dealing with older adult patients experiencing acute back pain, offering insights into triage, radiolog

Multiple Myeloma (Part 2) - Update on The Approach to Bone Disease.

The increase in life expectancy of the world population has led to a concomitant increase in the prevalence of multiple myeloma (MM), a disease that usually affects the elderly population. Bone lesions are frequent in patients with this condition, demanding an early approach, from drug treatment, through radiotherapy to orthopedic surgery (prophylactic or therapeutic) with the objective of preventing or delaying the occurrence of fracture, or, when this event has already occurred, treat it through stabilization or replacement (lesions located in the appendicular skeleton) and/or promote stabil

Clinical Practice Guideline: Sudden Hearing Loss (Update).

OBJECTIVE: Sudden hearing loss is a frightening symptom that often prompts an urgent or emergent visit to a health care provider. It is frequently but not universally accompanied by tinnitus and/or vertigo. Sudden sensorineural hearing loss affects 5 to 27 per 100,000 people annually, with about 66,000 new cases per year in the United States. This guideline update provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with sudden hearing loss. It focuses on sudden sensorineural hearing loss in adult patients aged ≥18 years and primarily on

Цифровые симптомы, сообщающие о готовности к лечению до Даратумумаба: слепое перспективное исследование в Множественной миеломе.

Цели: Для пациентов с множественной миеломой (ММ) в настоящее время все большая часть лечения оказывается на дому. Хотя такая смена обеспечивает удобство и способствует непрерывному уходу, она также требует новых путей обеспечения безопасности пациентов вне больницы. Хотя пациенты, проходящие лечение на дому, как правило, являются клинически стабильными, каждая администрация по-прежнему нуждается в предварительной оценке безопасности, которая традиционно проводится по телефону. Мы стремились оценить, могут ли результаты, о которых сообщают пациенты в цифровой форме, заменить эти звонки для опр

Clinical Practice Guideline: Sudden Hearing Loss (Update) Executive Summary.

OBJECTIVE: Sudden hearing loss is a frightening symptom that often prompts an urgent or emergent visit to a health care provider. It is frequently, but not universally, accompanied by tinnitus and/or vertigo. Sudden sensorineural hearing loss affects 5 to 27 per 100,000 people annually, with about 66,000 new cases per year in the United States. This guideline update provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with sudden hearing loss. It focuses on sudden sensorineural hearing loss in adult patients aged 18 and over and primarily

BREAST

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Contemporary treatment with radiosurgery for spine metastasis and spinal cord compression in 2015.

With the progress of image-guided localization, body immobilization system, and computerized delivery of intensity-modulated radiation delivery, it became possible to perform spine radiosurgery. The next question is how to translate the high technology treatment to the clinical application. Clinical trials have been performed to demonstrate the feasibility of spine radiosurgery and efficacy of the treatment in the setting of spine metastasis, leading to the randomized trials by a cooperative group. Radiosurgery has also demonstrated its efficacy to decompress the spinal cord compression in sel

DNA Methylation Cancer Biomarkers: Translation to the Clinic.

Carcinogenesis is accompanied by widespread DNA methylation changes within the cell. These changes are characterized by a globally hypomethylated genome with focal hypermethylation of numerous 5'-cytosine-phosphate-guanine-3' (CpG) islands, often spanning gene promoters and first exons. Many of these epigenetic changes occur early in tumorigenesis and are highly pervasive across a tumor type. This allows DNA methylation cancer biomarkers to be suitable for early detection and also to have utility across a range of areas relevant to cancer detection and treatment. Such tests are also simple in

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… The problem of unnecessary procedures and patient psychological harm is very real in screening programs. …

Proposal for a preventive protocol for medication-related osteonecrosis of the jaw.

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse reaction experienced by some patients exposed to certain drugs (antiresorptives such as bisphosphonates or denosumab, and antiangiogenic drugs). From a review of the literature it appears that there is no uniform criterion when selecting preventive measures; these vary according to author. Likewise, the measures recommended are usually general, so that in few cases they result in specific actions to be applied depending on the different variables involved such as the type of drug used, the duration of its appli

Management of Tooth Extraction in Patients Taking Antiresorptive Drugs: An Evidence Mapping Review and Meta-Analysis.

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a well-known severe adverse reaction of antiresorptive, antiangiogenic or targeted therapies, and usually occurs after tooth extraction. This review is aimed at determining the efficacy of any intervention of tooth extraction to reduce the risk of MRONJ in patients taking antiresorptive drugs, and present the distribution of evidence in these clinical questions. METHODS: Primary studies and reviews were searched from nine databases (Medline, EMBase, Cochrane Library, Scopus, WOSCC, Inspec, KCI-KJD, SciELO and GIM) and two regi

Evaluation of Medication-Related Osteonecrosis of the Jaw (MRONJ) in Terms of Staging and Treatment Strategies by Dental Students at Different Educational Levels.

Background: The role of medication-related osteonecrosis of the jaw (MRONJ) as a dento-maxillo-facial pathology is becoming increasingly important due to its growing prevalence. The success of preventive and therapeutic measures relies mainly on the dentist's ability to correctly diagnose the disease. Methods: The aim of this study was to evaluate the skills of dental students of different educational levels in choosing the correct stage, diagnostics, and treatment option for MRONJ based on clinical and radiographic imaging (panoramic radiograph, CBCT). The study was designed as a cross-sectio

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… In particular, the lack of knowledge regarding the definition of MRONJ could lead to a misdiagnosis of exposed bone and unnecessary procedures. … Furthermore, the lack of knowledge may result in a late diagnosis and unnecessary procedures, increasing the risk of more severe complications. …

Impact of Pharmacist Interventions in a Portuguese Hospital: A Study Using the CLEO Multidimensional Tool.

(1) Background: Pharmacist interventions are key to optimizing medication therapy and improving patient outcomes. The CLEO multidimensional tool assesses the clinical, economic, and organizational impact of these interventions, though its use in Portuguese hospital settings is limited. This study explored the predicted impact of pharmacist interventions in the Oncology Department of a Portuguese hospital, using CLEO to quantify their potential contribution to patient care and healthcare system efficiency;(2) Methods: A retrospective observational study was conducted at the hospital's Oncology

Interventional Cardio-Oncology: Adding a New Dimension to the Cardio-Oncology Field.

The management of cardiovascular disease in patients with active cancer presents a unique challenge in interventional cardiology. Cancer patients often suffer from significant comorbidities such as thrombocytopenia and coagulopathic and/or hypercoagulable states, which complicates invasive evaluation and can specifically be associated with an increased risk for vascular access complications. Furthermore, anticancer therapies cause injury to the vascular endothelium as well as the myocardium. Meanwhile, improvements in diagnosis and treatment of various cancers have contributed to an increase i

Development and validation of a multiparametric MRI-based radiomics nomogram for the tripartite discrimination of primary benign, primary malignant, and metastatic lumbar spinal tumors.

ObjectiveTo develop and validate a multiparametric magnetic resonance imaging-based radiomics nomogram for the non-invasive preoperative differentiation of primary benign, primary malignant, and metastatic lumbar spinal tumors.MethodologyThis retrospective study enrolled 100 patients with pathologically confirmed lumbar tumors. Radiomics features were extracted from T1-weighted, T2-weighted, and fat-suppressed T2-weighted sequences. A radiomics signature was constructed using a two-step feature selection method comprising minimum redundancy maximum relevance and least absolute shrinkage and se

The Economic Value of Hybrid Single-photon Emission Computed Tomography With Computed Tomography Imaging in Pulmonary Embolism Diagnosis.

ObjectiveThe objective was to quantify the potential economic value of single-photon emission computed tomography (SPECT) with computed tomography (CT; SPECT/CT) versus CT pulmonary angiography (CTPA), ventilation-perfusion (V/Q) planar scintigraphy, and V/Q SPECT imaging modalities for diagnosing suspected pulmonary embolism (PE) patients in an emergency setting.MethodsAn Excel-based simulation model was developed to compare SPECT/CT versus the alternate scanning technologies from a payer's perspective. Clinical endpoints (diagnosis, treatment, complications, and mortality) and their correspo

Light Chain (AL) Amyloidosis: The Journey to Diagnosis.

BackgroundLight chain (AL) amyloidosis is a rare, complex disease associated with significant morbidity and mortality. Delays in diagnosis are common and may have detrimental consequences on patients' prognosis. Too little is known regarding the patient journey to diagnosis.ObjectiveThe objective of this study was to describe the patient-reported journey to a correct diagnosis for AL amyloidosis.MethodsUsing a mixed-methods approach, data were collected from clinician (n = 4) and patient (n = 10) interviews and a survey of community-based patients with AL amyloidosis (n = 341). Data were used

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… Unnecessary procedures and misdiagnoses not only delay treatment, but may negatively impact the patient-physician relationship and increase healthcare utilization and subsequent costs. …