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Повторное лечение миеломы: достижения, проблемы и будущие направления иммунотерапии.

Abstract Multiple mieloma (MM) — гематологическая злокачественность, которая создает серьезные проблемы с лечением из-за его неоднородности и склонности к рецидиву и прогрессированию. В последний раз two За несколько десятилетий терапевтический ландшафт MM радикально изменился, но болезнь остается в основном неизлечимой, и многие пациенты сталкиваются с сопротивлением лечению. В этом обзоре дается оценка текущего состояния методов лечения с использованием методов MM с уделением особого внимания ограничениям традиционной терапии и нарождающейся роли иммунной терапии в улучшении результатов лече

Цифровые биомаркеры и АИ для дистанционного мониторинга утомительного прогресса в области неврологических расстройств: подключение механизмов к клиническому применению.

Цифровые биомаркеры для мониторинга усталости в неврологических расстройствах представляют собой новаторский подход к преодолению разрыва между механистическим пониманием и клиническим применением. В настоящем перспективном документе рассматривается вопрос о том, каким образом меры, разработанные с помощью смартфонов и проанализированные с помощью искусственных методов интеллекта, могут трансформировать оценку усталости из субъективной, эпизодической отчетности в непрерывный, объективный мониторинг. Предлагаемые рамки для цифровой фенотификации на основе смартфонов содержат пассивные данные (о

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… Statistical validation should characterize psychometric properties, including test–retest reliability (ICC > 0.80 recommended), minimal clinically important differences, and sensitivity to interventions [ 65 ]. … Statistical validation should characterize psychometric properties, including test–retest reliability (ICC > 0.80 recommended), minimal clinically important differences, and sensitivity to interventions [ 45 ], while explicitly accounting for missing data patterns. 5.4. …

Application of deformity principles in the management of spinal neoplasms: A Primer.

BACKGROUND: With advances in surgical techniques, radiation, and systemic therapy, prognoses and quality of life have improved amongst patients with primary and metastatic vertebral column tumors. Sagittal deformity is known to have an adverse impact on patient quality of life but has been largely ignored in this study population. METHODS: A comprehensive literature review was conducted, focusing on articles germane to the study of spinal deformity in the context of oncologic disease. Articles included those focusing on bone health, the association of spinal deformity with oncologic spine dis

Charcot Arthropaticy of the Peelter with Ipsionteral Wrist и First Carpometakarpal Shiri Malformation I Type with Syringomyelia.

Артропатия плеча является редким проявлением нервно - суставной болезни и чаще всего ассоциируется с шприцомелией. Когда это происходит, оно часто приводит к постепенному совместному разрушению, но из-за минимальной боли оно приводит к задержкам в диагностике. Мы сообщаем о случае 54-летней женщины, представлявшей трехмесячную историю опухоли левого плеча, деформации и жесткого ограничения диапазона движения, связанного с ипсиосторонней деформацией запястья. У пациента была известная история неправильной формы Кьяри первого типа с шприцомелией. В ходе клинического обследования была выявлена за

Management of Multiple Myeloma in the Middle East: Unmet Needs, Challenges and Perspective.

Multiple myeloma (MM) is a prevalent hematological malignancy. Resource-constrained settings such as the Middle East are particularly burdened by the increasing trends in MM morbidity and mortality in addition to challenges in the management of MM. It thus becomes necessary to identify and address debatable areas of current practice and gaps in the management of MM in the Middle East. With a special focus on the Lebanese situation, the first-line treatment of the very elderly (> 80 years old) is discussed, in addition to the impact of relapse type (biochemical or clinical relapse) on maintenan

Hairy cell leukemia with isolated bone lesions.

Key clinical message18F-FDG PET/CT has clinical relevance in HCL at diagnosis and for the follow-up of patients treated, especially in case of atypical presentations such as bone involvements (which are probably underestimated) and poor bone marrow infiltration.AbstractBone lesions are rarely reported in Hairy Cell Leukemia (HCL). We report two BRAFV600E mutated HCL patients presented bone lesions at foreground, poor bone marrow involvement, and the important role 18F-FDG PET/CT played in their management. We discuss the crucial role that 18F-FDG PET/CT could play in HCL routine practice.

Clinical Efficacy of Microwave Ablation Combined with Percutaneous Osteoplasty in the Treatment of Flat Bone Metastases.

PurposeEvaluating the clinical efficacy and safety of microwave ablation combined with percutaneous osteoplasty (MWA + PO group) versus percutaneous osteoplasty (PO group) for the treatment of flat bone metastases.MethodsPatients with flat bone metastases and intractable pain who underwent PO and/or MWA from January 2016 to January 2023 in our hospital were included, with 36 cases in the MWA+PO group and 21 cases in the PO group. Changes in the visual analog scale (VAS), Oswestry Disability Index (ODI), and quality of life assessment scale(QOL) were evaluated regularly. Postoperative complicat

Truthfulness in patient-reported outcomes: factors affecting patients' responses and impact on data quality.

The use of patient-reported outcome (PRO) measures in research and clinical care has expanded dramatically, reflective of an increasing recognition of patient-centeredness as an important aspect of high-quality health care. Given this rapid expansion, ensuring that data collected using PRO measures is of high quality is crucial for their continued successful application. Because of the subjective nature of the outcomes assessed, there are many factors that may influence patients' responses and thus challenge the overall quality of the data. In this review, we discuss the multiple factors that

How I treat multiple myeloma in geriatric patients.

AbstractMultiple myeloma (MM) is primarily a disease of older patients. Until recently, geriatric aspects in the context of MM have been poorly investigated. Treatment outcomes for geriatric patients with MM are often compromised by comorbidities and an enhanced susceptibility to adverse events from therapy. Assessment of patient frailty has become more frequent and will be useful in the context of significant and continuous advances in therapy. The recent emergence of immunotherapy with CD38 monoclonal antibodies and upcoming immunooncology drugs, such as bispecific antibodies, will lead to a

Patterns of Glomerular Injury: Histopathological Classification and Clinical Correlation.

Glomerular diseases represent a diverse group of conditions that significantly contribute to chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide. Understanding the histopathological patterns of glomerular injury is essential for accurate diagnosis, prognosis, and targeted therapy. This comprehensive review explores the morphologic, immunopathologic, and clinical characteristics of major glomerular disorders, including minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, immunoglobulin A nephropathy, lupus nephritis, and others. Histological

Clinical Predictors of Non-Diabetic Kidney Disease in Patients with Diabetes: Insights from a Biopsy-Proven Cohort.

Background: Distinguishing diabetic nephropathy (DN) from non-diabetic kidney disease (NDKD) in patients with diabetes remains clinically challenging, particularly when renal biopsy is not routinely performed. We aimed to identify clinical predictors of biopsy-proven NDKD. Methods: We conducted a retrospective cohort study of patients with type 2 diabetes who underwent native kidney biopsy at a tertiary referral center. Patients were classified as DN alone, mixed DN with NDKD, or pure NDKD. Baseline clinical and laboratory variables were analyzed. Logistic regression models were used to identi

Насколько жарко для людей? Обзор эмпирических моделей восприятия, физиологических и функциональных пределов допуска тепла человека.

Насколько жарко для людей? Этот вопрос заключается в том, что физиологи-термологи часто задаются различными пользователями знаний в государственном и частном секторах, которые все больше осознают негативное воздействие глобального потепления на здоровье и качество жизни людей. Цель настоящего документа заключается в том, чтобы представить описательный обзор моделей, позволяющих количественно определить пределы допуска к тепловому воздействию человека во всех областях восприятия, физиологии и функциональных областях. Существует несколько моделей, в которых определены критические экологические п

Secondary fracture prevention in primary care: a narrative review.

The global burden of osteoporosis continues to rise with an ageing population. Untreated osteoporotic fractures not only heighten the risk of subsequent fractures but are associated with excess mortality. Although primary care guidelines consistently stress the importance of secondary fracture prevention, fewer than 20% of patients are appropriately treated for osteoporosis following an initial osteoporotic fracture. This worldwide phenomenon is known as the osteoporosis care gap. This literature review examines the barriers to secondary fracture prevention in primary care and evaluates the ef

Launch and Post-Launch Prices of Injectable Cancer Drugs in the US: Clinical Benefit, Innovation, Epidemiology, and Competition.

BackgroundRising cancer drug prices adversely affect patients' adherence and survival.ObjectiveWe aimed to identify and quantify factors associated with launch prices and post-launch price changes of injectable cancer drugs in the US from 2005 to 2023.Data and methodsAll anticancer drugs with US FDA approval between 2000 and 2022 were identified in the Drugs@FDA database. The sample was then restricted to cancer drugs covered under Medicare Part B (injectable drugs). Data characterizing each drug's clinical benefits, disease epidemiology, approved indications, competition, and price were obtai

Medication Risks and Their Association with Patient-Reported Outcomes in Inpatients with Cancer.

BackgroundWe aimed to assess medication risks and determine factors influencing the health-related quality of life (HRQOL) in cancer inpatients.MethodsA retrospective analysis was conducted to identify drug-related problems (DRPs) based on medication reviews, including patient-reported outcomes (PROs). Multiple linear regression analyses were performed to identify sociodemographic, disease-related, and drug therapy-related factors influencing changes from hospital admission to discharge in the scales of the EORTC QLQ-C30 questionnaire.ResultsA total of 162 inpatients with various hematological

Clinical relevance of extracellular vesicles in hematological neoplasms: from liquid biopsy to cell biopsy.

In the era of precision medicine, liquid biopsy is becoming increasingly important in oncology. It consists in the isolation and analysis of tumor-derived biomarkers, including extracellular vesicles (EVs), in body fluids. EVs are lipid bilayer-enclosed particles, heterogeneous in size and molecular composition, released from both normal and neoplastic cells. In tumor context, EVs are valuable carriers of cancer information; in fact, their amount, phenotype and molecular cargo, including proteins, lipids, metabolites and nucleic acids, mirror nature and origin of parental cells rendering EVs a

Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma.

The evolving paradigm of continuous therapy and maintenance treatment approaches in multiple myeloma (MM) offers prolonged disease control and improved outcomes compared to traditional fixed-duration approaches. Potential benefits of long-term strategies include sustained control of disease symptoms, as well as continued cytoreduction and clonal control, leading to unmeasurable residual disease and the possibility of transforming MM into a chronic or functionally curable condition. "Continuous therapy" commonly refers to administering a doublet or triplet regimen until disease progression, whe

From Pioneering Discoveries to Innovative Therapies: A Journey Through the History and Advancements of Nanoparticles in Breast Cancer Treatment.

Nanoparticle technology has revolutionized breast cancer treatment by offering innovative solutions addressing the gaps in traditional treatment methods. This paper aimed to comprehensively explore the historical journey and advancements of nanoparticles in breast cancer treatment, highlighting their transformative impact on modern medicine. The discussion traces the evolution of nanoparticle-based therapies from their early conceptualization to their current applications and future potential. We initially explored the historical context of breast cancer treatment, highlighting the limitations

Системный склероз-ассоциированный ILD: Понимание и ограничения ScleroID

Справочная информация/цель: Участие лёгких в системном склерозе (SSc), как правило, оценивается с использованием тестов легочных функций (PFT), CT с высоким разрешением (HRCT) и составных индексов. Результаты, о которых сообщают пациенты (ПРО), включая СклероИД, позволяют получить представление о качестве жизни, однако их связь с клиническими мерами и роль в общей оценке заболеваний остается неясной. Оценить корреляцию между показателями СклероИД и участием легких и активностью/повреждением заболеваний в группе пациентов SSC-ILD из крупного центра третичной медицинской помощи. Методы: Деятельн

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… The King’s Brief Interstitial Lung Disease (KBILD) questionnaire: An updated minimal clinically important difference. BMJ Open Respir. Res. 2019;6:e000363. doi: 10.1136/bmjresp-2018-000363. 18. …

Craniovertebral Junction Instability after Oncological Resection: A Narrative Review.

The craniovertebral junction (CVJ) is a complex transition area between the skull and cervical spine. Pathologies such as chordoma, chondrosarcoma and aneurysmal bone cysts may be encountered in this anatomical area and may predispose individuals to joint instability. An adequate clinical and radiological assessment is mandatory to predict any postoperative instability and the need for fixation. There is no common consensus on the need for, timing and setting of craniovertebral fixation techniques after a craniovertebral oncological surgery. The aim of the present review is to summarize the an