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How I approach optimization of patients at risk of cardiac and pulmonary complications after CAR T-cell therapy.

Chimeric antigen receptor (CAR) T cells have transformed the care for patients with hematologic malignancies. Patients treated with CAR T cells may experience cardiovascular and pulmonary complications, which primarily occur in the setting of cytokine release syndrome. In addition, many patients considered for CAR T-cell therapy have preexisting cardiac and pulmonary comorbidities. Among patients with good functional status, these conditions should not prevent patients from being offered these lifesaving therapies. In this article, we use a case-based approach to discuss how we evaluate and op

Механистические понимания и достижения биконкретной T-клетки, использующей антителную терапию в мультимиеломе.

Множественная миелома (ММ) — клональная порча неизмеримо дифференцированных плазменных клеток, характеризующаяся инфильтрацией костного мозга и чрезмерным производством моноклонных иммуноглобулинов, что приводит к повреждению конечной формы, например остеолитических повреждений костей. Несмотря на значительный терапевтический прогресс, достигнутый с протеаозными ингибиторами, иммуномодуляционными препаратами и anti-CD38 Моноклональные антитела, множественная миелома остаются неизлечимыми, а результаты для трехклассных пациентов-восстановителей остаются мрачными, при этом медиана выживаемости н

Teclistamab Dosing Strategies in Relapsed/Refractory Myeloma: A Real-World Comparison of Weekly and Biweekly Versus Fixed Intervals.

Background/Objectives: Teclistamab is a bispecific antibody targeting BCMA and CD3, approved for relapsed/refractory multiple myeloma. It is administered continuously until progression or intolerance; however, prolonged use may increase infections and treatment burden. This study compares continuous versus fixed-duration teclistamab to determine whether treatment discontinuation after response is feasible without compromising outcomes. Methods: A multicenter retrospective study was conducted on adults with relapsed/refractory multiple myeloma treated with teclistamab between August 2022 and Ma

Application of cell-derived exosomes in the hematological malignancies therapy.

Exosomes are small membrane vesicles of endocytic origin that are produced by both tumor and normal cells and can be found in physiological fluids like plasma and cell culture supernatants. They include cytokines, growth factors, proteins, lipids, RNAs, and metabolites and are important intercellular communication controllers in several disorders. According to a vast amount of research, exosomes could support or inhibit tumor start and diffusion in a variety of solid and hematological malignancies by paracrine signaling. Exosomes are crucial therapeutic agents for a variety of illnesses, such

Evaluation and Management of Bacterial and Fungal Infections Occurring in Patients with a Hematological Malignancy: A 2011 Update

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Ось Гут-Брэйна и взаимодействие мозга с помощью микробиома с медицинской точки зрения.

Фон: кишечный микробиом непосредственно влияет на здоровье и активность мозга, что означает, что они тесно связаны между собой. Эта взаимосвязь предполагает наличие связи между микробными диспропорциями и болезнями, такими, как болезнь Альцгеймера, хотя здесь также играют свою роль и многочисленные другие факторы, способствующие этому, такие, как генетика. Кроме того, недавние исследования показали, что цереброспинальная жидкость содержит микробную дезоксирибонуклеиновую кислоту (ДНК), которая может быть истолкована как означающая наличие микробиома в мозгу. Вагустный нерв и центральная нервна

Neuropathic-like symptoms and central sensitization related signs and symptoms negatively affect the functional performance of patients with knee osteoarthritis - a cross-sectional study.

OBJECTIVE: This study aimed to compare the functional performance among participants with a neuropathic-like symptoms (NS) and central sensitization related signs and symptoms (CS), and their knee osteoarthritis (OA) counterparts. METHODS: A cross-sectional observational study was conducted with 125 participants with knee OA (94 females, mean age 63.1 ​± ​7.4 years). Participants completed a self-reported questionnaire with personal and clinical features and musculoskeletal pain characteristics, including NS (PainDETECT), CS (Central Sensitization Inventory, CSI), and conditioned pain modulat

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… Moreover, these patients demonstrated a lower rate of minimal clinically important difference for the WOMAC score after total knee arthroplasty than patients without CS [ 46 ]. … Minimal clinically important differences for patient-reported outcomes after TKA depend on central sensitization. JBJS. 2021;103:1374–1382. doi: 10.2106/JBJS.20.02138. 47. Gervais-Hupé J., Pollice J., Sadi J., Carlesso L.C. …

Является ли лекарственные средства на основе каннабиса полезным средством для нейрофической боли? Систематический обзор.

Нейропотическая боль - это хроническое расстройство, которое возникает из-за повреждения или неисправности нервов. Гиперчувствительность к стимуляторам, также известным как гиперальгезия, может вызвать у человека боль от неболезненных стимулов, называемых аллодинией. Лекарства на основе каннабиса (МД) могут обеспечить новые варианты лечения нейропатической боли. Был проведен обзор соответствующих исследований для оценки эффективности мер укрепления доверия в лечении нейропатической боли. С января проводились систематические обыски научной литературы 2003 по декабрь 2024 с использованием Web of

VEXAS Syndrome: A Comprehensive Review of Current Therapeutic Strategies and Emerging Treatments.

VEXAS syndrome is a recently identified autoinflammatory disorder resulting from somatic mutations in the UBA1 gene, leading to a complex spectrum of severe inflammatory and hematologic manifestations. The absence of established treatment guidelines and the variability in clinical presentation make its management particularly challenging. Current therapeutic approaches are often based on limited evidence, and their effectiveness remains inconsistent. This review seeks to consolidate the existing knowledge on therapeutic strategies for VEXAS syndrome, offering a critical evaluation of their eff

Role of T cells and cytokines in the pathogenesis of rheumatoid arthritis.

Rheumatoid arthritis (RA) is a long-term autoimmune disease. It causes persistent joint inflammation, aberrant tissue growth, and progressive joint deterioration. T cells have a key role in the onset of RA. They identify and trigger other immune cells, and produce inflammatory signals such as interleukin-6 (IL-6), interleukin-17 (IL-17), and tumor necrosis factor-α (TNF-α). Prolonged inflammation and tissue damage are caused by an imbalance between regulatory T cells (Tregs) and pro-inflammatory T helper 17 (Th17) cells. Additionally, the condition is exacerbated by uncontrolled cytokine netwo

Inpatient Medicine

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Physicians' Hierarchy of Tumor Biomarkers for Optimizing Chemotherapy in Breast Cancer Care.

BACKGROUND: Tumor biomarkers are regularly used to guide breast cancer treatment and clinical trial enrollment. However, there remains a lack of knowledge regarding physicians' perspectives towards biomarkers and their role in treatment optimization, where treatment intensity is reduced to minimize toxicity. METHODS: Thirty-nine academic and community oncologists participated in semi-structured qualitative interviews, providing perspectives on optimization approaches to chemotherapy treatment. Interviews were audio-recorded, transcribed, and analyzed by 2 independent coders utilizing a consta

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

Efficacy of fibrin-rich platelets and leukocytes (L-PRF) in tissue repair in surgical oral procedures in patients using zoledronic acid-case-control study.

INTRODUCTION: Medication-related osteonecrosis of the jaws (MRONJ) is a complication that develops in patients who use or have used antiresorptive or antiangiogenic medications for the treatment of bone metabolic disease and bone metastases. Clinically, MRONJ is characterized by the appearance of an inflammation in soft tissues and exposure of necrotic bone tissue in mandible or maxilla, for a period of 8 weeks, in patients with no history of head and neck radiotherapy that were being or are being treated with antiresorptive and/or antiangiogenic agents. The fibrin-rich platelets and leukocyte

Oral mucosal injury caused by mammalian target of rapamycin inhibitors: emerging perspectives on pathobiology and impact on clinical practice.

In recent years oral mucosal injury has been increasingly recognized as an important toxicity associated with mammalian target of rapamycin (mTOR) inhibitors, including in patients with breast cancer who are receiving everolimus. This review addresses the state-of-the-science regarding mTOR inhibitor-associated stomatitis (mIAS), and delineates its clinical characteristics and management. Given the clinically impactful pain associated with mIAS, this review also specifically highlights new research focusing on the study of the molecular basis of pain. The incidence of mIAS varies widely (2-78%

Determinants of Adverse Events in Patients with Cancer Who Practiced Self-Medication: A Cross-Sectional Study in Southwestern Uganda.

BackgroundCancer therapies have been the cornerstone in cancer care. Co-morbidities and Adverse Events (AEs) often encourage some patients with cancer to resort to self-medication in search of relief or better symptom management. While self-medication is a key aspect of self-care and may offer some relief, it also poses risks, especially the potential for AEs. Limited data exist in Uganda, particularly at the Mbarara Regional Referral Hospital (MRRH) Cancer Unit, regarding the prevalence and determinants of AEs.ObjectiveTo determine the prevalence and factors associated with AEs among self-med

The Role of Monoclonal Antibodies in the First-Line Treatment of Transplant-Ineligible Patients with Newly Diagnosed Multiple Myeloma.

Elderly transplant-ineligible (NTE) patients represent the majority of patients affected by multiple myeloma (MM). Elderly patients are a highly heterogeneous population, with large variability in health and functional status. Thus, choosing their optimal treatment is challenging. A wide range of first-line treatments is available, and novel-agent combinations, including monoclonal antibodies (mAbs), have recently entered clinical practice. The combination of the anti-CD38 mAb daratumumab with bortezomib, melphalan and prednisone (Dara-VMP) or lenalidomide and dexamethasone (Dara-Rd) demonstra

Novel targeted treatments in hairy cell leukemia and other hairy cell-like disorders.

In the category of mature B-cell neoplasms, splenic B-cell lymphoma and leukemia were clearly identified and include four distinct entities: hairy cell leukemia (HCL), splenic marginal zone lymphoma (SMZL), splenic diffuse red pulp lymphoma (SDRPL) and the new entity named splenic B-cell lymphoma/leukemia with prominent nucleoli (SBLPN). The BRAFV600E mutation is detected in nearly all HCL cases and offers a possibility of targeted therapy. BRAF inhibitors (BRAFi) represent effective and promising therapeutic approaches in patients with relapsed/refractory HCL. Vemurafenib and dabrafenib were

Эффективность мультицензурных упражнений в обычном балансе по балансу и координации в гериатрическом народонаселении: систематический обзор.

Ухудшение баланса является одной из главных причин снижения, заболеваемости и потери независимости у пожилых людей. Несмотря на широкое использование традиционных методов подготовки по вопросам сбалансированности, в последнее время внимание сместилось на мультисенсорные мероприятия, включая задачи по балансированию, двойную целевую подготовку и учения на основе извращений, которые ориентированы на визуальные, жилые и проприоцептивные системы и могут дать более высокие результаты за счет улучшения сенсорной интеграции и послеурального контроля. В свете потенциальных возможностей для улучшения р

The history of cancer pain and bone-targeted agents: 10 most commonly asked questions.

The prevalence of pain and skeletal complications of metastatic bone disease is high and an important factor, which contributes to decreased quality of life and low survival rate. Bone-targeted agents are well-established therapies to reduce the skeletal-related events in patients with bone metastasis. However, the analgesic effect of these medications is still controversial. The objective of this review is to summarize the existing evidence about the use of bone-targeted agents in the treatment of metastatic bone pain, trying to answer to the 10 most commonly asked questions in this matter. T