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The Korea National Disability Registration System.

The Korea National Disability Registration System (KNDRS) was established in 1989 to provide social welfare benefits based on predefined criteria for disability registration and an objective medical assessment using a disability grading system. Disability registration requires (1) a medical examination by a qualified specialist physician and (2) a medical advisory meeting to review the degree of disability. Medical institutions and specialists for the diagnosis of disabilities are legally stipulated, and medical records for a specified period are required to support the diagnosis. The number o

Venetoclax Induces Cardiotoxicity through Modulation of Oxidative-Stress-Mediated Cardiac Inflammation and Apoptosis via NF-κB and BCL-2 Pathway.

Cardiovascular damage induced by anticancer therapy has become the main health problem after tumor elimination. Venetoclax (VTX) is a promising novel agent that has been proven to have a high efficacy in multiple hematological diseases, especially acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL). Considering its mechanism of action, the possibility that VTX may cause cardiotoxicity cannot be ruled out. Therefore, this study was designed to investigate the toxic effect of VTX on the heart. Male Sprague-Dawley rats were randomly divided into three groups: control, low-dose VTX

Acute Kidney Injury in the Patient with Cancer.

Over the last three decades, advancements in the diagnosis, treatment, and supportive care of patients with cancer have significantly improved their overall survival. However, these advancements have also led to a higher rate of cancer-related complications. Acute kidney injury (AKI) and chronic kidney disease (CKD) are highly prevalent in patients with cancer, and they are associated with an increased risk of all-cause mortality. This bidirectional interplay between cancer and kidney, termed "the kidney-cancer connection" has become a very active area of research. This review aims to provide

Recognition of early mortality in multiple myeloma by a prediction matrix.

Early mortality (EM; death ≤ 6 months from diagnosis) has been reported in several newly diagnosed multiple myeloma (NDMM) trials. Before the era of novel agents, the incidence was 10%-14%. Causes of death included infections/pneumonia, renal failure, refractory disease, and cardiac events. Staging systems, such as the revised International Staging System (r-ISS), and prognostic factors including cytogenetics, lactate dehydrogenase levels, and myeloma-specific factors, are useful to assess overall prognosis; however, they cannot predict EM. We evaluated patients treated with novel agents in th

Risk of rehospitalization due to Clostridioides difficile infection among hospitalized patients with Clostridioides difficile: a cohort study.

BackgroundReducing rehospitalization has been a primary focus of hospitals and payors. Recurrence of Clostridioides difficile infection (CDI) is common and often results in rehospitalization. Factors that influence rehospitalization for CDI are not well understood.ObjectiveTo determine the risk factors that influence rehospitalization caused by CDI.DesignA retrospective cohort study from January 1, 2018, to December 31, 2018, of patients aged ≥18 who tested positive for C. difficile while hospitalized.SettingAcademic hospital.MethodsThe risk of rehospitalization was assessed across exposures d

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… Care and outcomes of patients newly hospitalized for heart failure in the community treated by cardiologists compared with other specialists. Circulation 2003;108:184–191. 11. Tsao S, Willard-Grace R, Wolf J, et al. …

Competing risk analysis of cardiovascular mortality in multiple myeloma survivors.

BackgroundThe survival of multiple myeloma (MM) patients has significantly improved, and several factors increase the risk of cardiovascular death (CVD) mortality in MM. This study aims to determine the prognostic significance of factors associated with long-term CVD risk in MM survivors.MethodsThe data of MM survivors whose survival time was longer than 36 months were retrieved from the Surveillance, Epidemiology, and End Result (SEER) database between 2000 and 2015. Cox proportional hazards regressions and competing risk survival analyses were utilized to assess the CVD-associated risk facto

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… For example, hypercalcemia, arteriovenous shunting, anemia, renal failure, hyperviscosity syndrome, and high-output cardiac failure were proven to be associated with a significantly increased risk of CVD and were always evaluated repeatedly by the hematologist/oncologist and cardiologists ( 8 , 18 , …

Incidence and management of adverse events in patients with relapsed and/or refractory multiple myeloma receiving single-agent carfilzomib.

Carfilzomib, a selective proteasome inhibitor approved in the USA in 2012, is a single agent for relapsed and refractory multiple myeloma. Carfilzomib is administered as a 2-10-minute infusion on days 1, 2, 8, 9, 15, and 16 of a 28-day cycle at a starting dose of 20 mg/m(2) for cycle 1 and a target dose of 27 mg/m(2) thereafter. In the pivotal Phase II study (PX-171-003-A1), carfilzomib 20/27 mg/m(2) provided durable responses in a heavily pretreated population with relapsed and refractory multiple myeloma (n=266), with an overall response rate of 22.9% and a median duration of response of 7.8

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… For prolonged episodes, referral to pulmonologists and/or cardiologists may be necessary based on the constellation of symptoms. Across the four studies, respiratory infections were reported in 18.8% of patients. …

A retrospective real-world study assessing diagnostic pattern of light-chain amyloidosis in Japan based on data from the medical data vision claims database.

BackgroundEarly diagnosis of primary or light chain (AL) amyloidosis is crucial for initiating appropriate therapeutic interventions. However, diagnosis is getting delayed (several months-to-years) in clinical practice.ObjectiveTo investigate the real-world patterns of clinical procedures until initial diagnosis of AL amyloidosis in Japan.DesignRetrospective longitudinal, observational cohort study.MethodsThis study included adults with AL amyloidosis using Medical Data Vision claims database (2003-2022). The primary endpoint was time from initial hospital visit until confirmed AL amyloidosis

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… AL amyloidosis for cardiologists: awareness, diagnosis, and future prospects: JACC: CardioOncology State-of-the-Art Review . …

Circulating Levels of Soluble α-Klotho and FGF23 in Childhood Cancer Survivors: Lack of Association with Nephro- and Cardiotoxicity-A Preliminary Study.

Background/Objectives: The survival rate among pediatric cancer patients has reached 80%; however, these childhood cancer survivors (CCSs) are at a heightened risk of developing chronic conditions in adulthood, particularly kidney and cardiovascular diseases. The aims of this study were to assess the serum α-Klotho and FGF23 levels in CCSs and to determine their association with nephro- and cardiotoxicity. Methods: This study evaluated a cohort of 66 CCSs who remained in continuous remission, with a mean follow-up of 8.41 ± 3.76 years. Results: The results of this study revealed that CCSs exhi

Модель "Прогнозное выживание" включает результаты, о которых сообщают пациенты, для пациентов, не имеющих права на трансплантацию, с несколькими миеломами.

Разработка перспективных инструментов, специально предназначенных для самих пациентов, представляет собой важный шаг в деле расширения возможностей пациентов участвовать в совместном принятии решений. Включение результатов, сообщаемых пациентами, может повысить точность этих перспективных инструментов. Мы провели ретроспективное демографическое исследование пациентов, имеющих право на трансплантацию (TIE), с множественным диагнозом миеломы (MM) в период с января 2007 и декабрь 2018. Была разработана многовариантная модель регрессии Кокса для прогнозирования риска смерти внутри 1-year период с

Indications for Sleeve Gastrectomy-Is It Worth Waiting for Comorbidities to Develop?

(1) Background and Objectives: Morbid obesity significantly increases the prevalence of comorbidities, such as heart disease, restrictive lung disease, stroke, diabetes mellitus and more. (2) Methods: Patients undergoing gastric sleeve surgery were divided into three groups with BMI between 30-34.9 kg/m2 (Group I), 35-39.9 kg/m2 (Group II), and over 40 kg/m2 (Group III). Preoperative examinations included cardiac ultrasound, respiratory function and laboratory tests, and preoperative comorbidities were also recorded. Following a one-year follow-up, we compared the rate of weight loss in the th

Protective Role of Enalapril in Anthracycline-Induced Cardiotoxicity: A Systematic Review.

BackgroundEvidence of the preventive and therapeutic effects of enalapril on cardiotoxicity caused by chemotherapy needs to be further confirmed and updated.MethodsWe performed a systematic review of studies from electronic databases that were searched from inception to January 29, 2019, and included relevant studies analyzing enalapril as a cardioprotective agent before or during the use of anthracyclines by oncology patients. Homogeneous results from different studies were pooled using RevMan 5.3 software. The Cochrane risk-of-bias tool was used to determine the quality of the studies.Result

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… Over the past decade, cardiologists have carried out multiple small clinical trials with drugs typically used for heart failure therapy, such as ACEIs, to provide either primary or secondary prevention for anthracycline-induced cardiotoxic effects ( Kaya et al., 2013 ). …

Risk Factors and Prevention of Cancer and CVDs: A Chicken and Egg Situation.

Cardiovascular diseases and cancer are the two primary causes of mortality worldwide. Although traditionally regarded as distinct pathologies, they share numerous pathophysiological mechanisms and risk factors, including chronic inflammation, insulin resistance, obesity, and metabolic dysregulation. Notably, several cancers have been identified as closely linked to cardiovascular diseases, including lung, breast, prostate, and colorectal cancers, as well as hematological malignancies, such as leukemia and lymphoma. Additionally, renal and pancreatic cancers exhibit a significant association wi

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… Conclusions The role of primary healthcare providers and cardiologists in cancer prevention should be expanded, emphasizing the importance of integrating oncological risk reduction strategies into routine CV care. … A multidisciplinary approach involving oncologists, cardiologists, and primary care physicians is essential to developing comprehensive prevention strategies addressing CV and cancer-related health concerns. …

Left Ventricular Hypertrophy: Etiology-Based Therapeutic Options.

Determining the etiologies of left ventricular hypertrophy (LVH) can be challenging due to the similarities of the different manifestations in clinical presentation and morphological features. Depending on the underlying cause, not only left ventricular mass but also left ventricular cavity size, or both, may increase. Patients with LVH remain asymptomatic for a few years, but disease progression will lead to the development of systolic or diastolic dysfunction and end-stage heart failure. As hypertrophied cardiac muscle disrupts normal conduction, LVH predisposes to arrhythmias. Distinguishin

Endoscopic and Histological Diagnosis of Gastrointestinal Amyloidosis: A Narrative Review.

Amyloidosis encompasses a diverse group of systemic and localised disorders defined by the extracellular accumulation of misfolded proteins, leading to progressive tissue damage and multiorgan dysfunction. Gastrointestinal (GI) involvement is common, yet diagnosis is frequently delayed because symptoms are non-specific and endoscopic findings are equivocal. Recent advances in endoscopic technique, biopsy site selection and advancements in processing of pathological specimens have substantially improved the diagnosis of this condition. Targeted gastrointestinal biopsy, performed during endoscop

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… Ultimately, the management of these patients necessitates a multidisciplinary approach between gastroenterologists, surgeons, pathologists, haematologists, cardiologists and radiologists. …

Долгосрочное воздействие COVID-19 на репродуктивное здоровье женщин и его связь с аутоиммунными заболеваниями, включая множественный склероз.

Озабоченность по поводу долгосрочного влияния COVID-19 на репродуктивное здоровье женщин растет, и появляющиеся исследования указывают на потенциальные связи с яичниковой дисфункцией, менструальными нарушениями, проблемами фертильности и неблагоприятными последствиями беременности. Регулирование послевирусной иммунной дисдукции связано как с развитием, так и с обострением аутоиммунных заболеваний, включая множественный склероз (МС). Длинный процесс COVID связан с иммунологической дисфункцией, гормональными дисфункциями и хроническим воспалением, что может усугублять аутоиммунные расстройства и

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… Long COVID’s involvement of multiple organ systems often compels patients to seek care from several specialists, including neurologists, rheumatologists, cardiologists, endocrinologists, and gynecologists, which may contribute to fragmented and uncoordinated management. …

Real-practice management and treatment of idiopathic multicentric Castleman disease with siltuximab: a collection of clinical experiences.

Castleman disease (CD) is a group of lymphoproliferative disorders that share common histopathological features yet have widely different aetiologies, clinical features and grades of severity as well as treatments and outcomes. Siltuximab is currently the only therapy approved by the FDA and EMA for idiopathic multicentric CD and is recommended as first-line therapy in treatment guidelines. Despite the extensive characterization of siltuximab treatment in clinical trials, available evidence from real-world practice is still scant. This collection of clinical experiences focuses on patients tre

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Clinical Outcomes and Treatment Strategies of Adult Transplant-Associated Thrombotic Microangiopathy: External Validation of Harmonizing Definitions and High-Risk Criteria.

Transplant-associated thrombotic microangiopathy (TA-TMA) is an endothelial dysfunction syndrome observed after allogeneic hematopoietic cell transplant (alloHCT). Our aim was to externally validate the impact of high-risk features on the clinical outcomes of adult patients meeting the updated TA-TMA harmonizing criteria. Between 2005 and 2022, 99 patients were diagnosed with TA-TMA at Mayo Clinic Rochester (incidence 6.2%) after a median of 137 days post alloHCT (IQR: 34-283 days). The development of TA-TMA was associated with an inferior overall survival posttransplant (HR: 3.8, 95% CI: 2.97

Risk of Atrial Fibrillation in Patients with Different Cancer Types in Taiwan.

Atrial fibrillation (AF) commonly occurs in approximately 2% of cancer patients, and the incidence of AF among cancer patients is greater than in the general population. This observational study presented the incidence risk of AF among cancer patients, including specific cancer types, using a population database. The Taiwan Cancer Registry was used to identify cancer patients between 2008 and 2017. The diagnosis of AF was based on the International Classification of Diseases codes (ICD-9-CM: 427.31 or ICD-10-CM: I48.0, I48.1, I48.2, and I48.91) in Taiwan national health insurance research data

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… Collaborative efforts between oncologists, cardiologists, and other healthcare providers are essential to optimize the management of these complex patients and improve their overall quality of care. …