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Health-related quality of life following bisphosphonate therapy in individuals with Paget's disease of bone - A study from a teaching hospital in Southern India.

BACKGROUND: Paget's disease of bone (PDB) is associated with considerable morbidity because of bony pains, fractures, and deformities. Remission, as assessed by reduction in alkaline phosphatase levels, does not necessarily correlate with improvement in quality of life (QoL). Health-related quality of life (HR-QoL) in affected individuals is not well-studied in India. This study attempts to describe the QoL in individuals with PDB. METHODS: In this prospective observational study spanning 6 years (Jan 2017-Dec 2022), we included 29 treatment-naïve patients diagnosed with PDB based on clinical

Early mortality after chemotherapy as a quality indicator-the leukemia perspective.

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… They may often reject the advice of the cancer and supportive care experts who recommend hospice or terminal care. …

Успешное лечение пациента с множественной миеломой во время беременности: отчет по делу и обзор литературы.

Множественная миелома (ММ) в связи с беременностью является редким явлением, и консенсус отсутствует. Необходимо в срочном порядке повысить уровень информированности о расследованиях, необходимых для предполагаемого диагноза ММ во время беременности, и оптимизировать управление им. МЕТОДЫ: Случай MM, произошедший во время беременности, представлен с отдельными подробностями, включая клиническое представление, результаты лабораторных исследований, диагностический процесс, курс по естественным заболеваниям, терапевтические подходы и результаты. После этого был проведен поиск литературы, а имеющи

Cancer Treatment near the End-of-Life Becomes More Aggressive: Changes in Trend during 10 Years at a Single Institute.

PurposeThe purpose of this study was to investigate and compare cancer treatment near the end-of-life (EOL) over a 10-year period.Materials and methodsPatients with advanced solid cancer at Seoul National University Hospital who received palliative chemotherapy and had died were enrolled. We categorized the consecutive patients according to two time periods: 2002 (n=57) and 2012 (n=206). Aggressiveness of cancer treatment near the EOL was evaluated.ResultsThe median patient age was 62, and 65.4% of patients (n=172) were male. Time from the last chemotherapy to death (TCD) was found to have bee

High prevalence of cardiovascular and respiratory abnormalities in advanced, intensively treated (transplanted) myeloma: The case for 'late effects' screening and preventive strategies.

OBJECTIVES: Modern management of myeloma has significantly improved survival, with increasing numbers of patients living beyond a decade. However, little is known about the long-term cardiovascular and respiratory status of intensively treated and multiply relapsed survivors. METHODS: We performed detailed cardiovascular and respiratory evaluations in patients with intensively treated, advanced but stable myeloma. All patients had received at least two lines of treatment, including at least one haematopoietic stem cell transplantation procedure, but had stable, controlled disease and were off

Роль Neurofilament fight (NfL) и глиального фибрового кислотного белка (GFAP) в MS и AQP4-NMOSD: развитие клинического применения.

Важную роль в диагностике, мониторинге и оценке терапевтической реакции в таких условиях, как мультипликативный склероз (MS) и аквапорин-4 Нейромиелит Оптика Спектрум (AQP4-NMOSD), играют плавучие биомаркеры, такие, как глиальные фибриллярные протеины (GFAP) и Neurofilament Light (NfL). Эти биомаркеры позволяют получить ключевые сведения о патофизиологических механизмах, лежащих в основе этих заболеваний, что позволяет осуществлять эффективные последующие мероприятия и применять индивидуализированные методы лечения, которые имеют существенно важное значение для улучшения результатов лечения па

Participation and Influencing Factors in the Decision-Making of Life-Sustaining Treatment: A Focus on Deceased Patients with Hematologic Neoplasms.

PurposeThis study aimed to investigate the involvement of patients who died from hematologic neoplasms in the decision-making process surrounding the withdrawal of life-sustaining treatment (LST).MethodsA total of 255 patients diagnosed with hematologic neoplasms who ultimately died following decisions related to LST during their end-of-life period at a university hospital were included in the study. Data were retrospectively obtained from electronic medical records and analyzed utilizing the chi-square test, independent t-test, and logistic regression.ResultsIn total, 42.0% of patients partic

Лейкемия в период беременности: диагностика и терапевтический подход (обзор).

Цель настоящего исследования заключается в оценке эпидемиологических, диагностических и терапевтических данных о гематологических заболеваниях в период беременности. Лейкемия в период беременности встречается редко, а литературные данные не являются обширными. Факторы риска, эпидемиология и патогенез этих заболеваний не разработаны в полной мере. Кроме того, имеется подробный доклад о осложнениях в период беременности и об общем (на три месяца) лечении этих заболеваний, в частности о стратегии их лечения. В настоящем исследовании описывается возможность обеспечения в будущем беременности у жен

CPUY201112, a novel synthetic small-molecule compound and inhibitor of heat shock protein Hsp90, induces p53-mediated apoptosis in MCF-7 cells.

Heat-shock protein 90 (Hsp90) is highly expressed in many tumor cells and is associated with the maintenance of malignant phenotypes. Targeting Hsp90 has had therapeutic success in both solid and hematological malignancies, which has inspired more studies to identify new Hsp90 inhibitors with improved clinical efficacy. Using a fragment-based approach and subsequent structural optimization guided by medicinal chemistry principles, we identified the novel compound CPUY201112 as a potent Hsp90 inhibitor. It binds to the ATP-binding pocket of Hsp90 with a kinetic dissociation (Kd) constant of 27

Reciprocal interactions between osteoclasts and nociceptive sensory neurons in bone cancer pain.

Many common cancers such as breast, prostate, and lung cancer metastasize to bones at advanced stages, producing severe pain and functional impairment. At present, the current pharmacotherapies available for bone cancer pain are insufficient to provide safe and efficacious pain relief. In this narrative review, we discuss the mechanisms used by cancer cells within the bone tumor microenvironment (TME) to drive bone cancer pain. In particular, we highlight the reciprocal interactions between tumor cells, bone-resorbing osteoclasts, and pain-sensing sensory neurons (nociceptors), which drive bon

Impact of whole-body vibration exercise on physical performance and bone turnover in patients with monoclonal gammopathy of undetermined significance.

OBJECTIVE: Monoclonal Gammopathy of Undetermined Significance (MGUS) is a risk factor for reduced physical performance, osteoporosis, and fractures due to compromised musculoskeletal metabolism. In this condition it is unknown whether whole-body vibration (WBV) exercise favorably alters physical performance and bone metabolism. METHODS: To evaluate the effect of three-months WBV exercise (30 min; 2x/week) including an optional three-month extension on physical performance, bone metabolism and bone mineral density. Endpoints included functional assessments, bone turnover markers and bone miner

Isolated compression of the ulnar motor branch due to carpal joint ganglia: clinical series, surgical technique and postoperative outcomes.

The entrapment of the ulnar nerve in Guyon's canal (GC) is a well-known wrist canalicular syndrome which is usually followed by a gradual combination of both sensitive and motor symptomatology. However, GC nerve compression could also cause a pure hand motor dysfunction. This condition, less frequent than the classic Guyon's syndrome, can be difficult to diagnose. Authors report a case series of eight patients affected by isolated compression of the ulnar nerve motor branch, due to piso-triquetrum or triquetro-hamate joint ganglia. Surgical technique and postoperative outcomes are discussed in

Side effects of analgesia may significantly reduce quality of life in symptomatic multiple myeloma: a cross-sectional prevalence study.

BACKGROUND: Pain is a common symptom in patients with multiple myeloma (MM). Many patients are dependent on analgesics and in particular opioids, but there is limited information on the impact of these drugs and their side effects on health-related quality of life (HRQoL). METHOD: In a cross-sectional study, semi-structured interviews were performed in 21 patients attending the hospital with symptomatic MM on pain medications. HRQoL was measured using items 29 and 30 of the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30. RESULTS: Patients were able to recall a med

Modeling osteoporosis to design and optimize pharmacological therapies comprising multiple drug types.

For the treatment of postmenopausal osteoporosis, several drug classes with different mechanisms of action are available. Since only a limited set of dosing regimens and drug combinations can be tested in clinical trials, it is currently unclear whether common medication strategies achieve optimal bone mineral density gains or are outperformed by alternative dosing schemes and combination therapies that have not been explored so far. Here, we develop a mathematical framework of drug interventions for postmenopausal osteoporosis that unifies fundamental mechanisms of bone remodeling and the mec

Nuclear receptors in health and disease: signaling pathways, biological functions and pharmaceutical interventions.

Nuclear receptors (NRs) are a large family of ligand-dependent transcription factors that regulate the expression of a wide range of target genes in response to endogenous and exogenous ligands, including steroid hormones, thyroid hormone, vitamin D, retinoic acid, fatty acids, and oxidative steroids. Upon ligand binding, nuclear receptors form dimer complexes with transcriptional cofactors, which interact with specific DNA sequences in the promoter or enhancer regions of target genes to modulate gene expression. This process plays a crucial role in many physiological processes such as reprodu

Bisphosphonate Use in Acute Spinal Cord Injury: A Focused Systematic Review on Zoledronic Acid.

Spinal cord injury (SCI) causes significant bone loss as a long-term complication, increasing fracture risk and healthcare costs. Bisphosphonates are widely studied for mitigating bone loss since they can prevent fractures and preserve rehabilitation potential in acute SCI patients. Zoledronic acid, in particular, stands out due to its high potency, dosing convenience, and better patient adherence. This review aims to evaluate the efficacy of bisphosphonates, particularly zoledronic acid, in mitigating bone loss in acute SCI. A systematic review was conducted following the Preferred Reporting

MYC inhibitors in multiple myeloma.

The importance of MYC function in cancer was discovered in the late 1970s when the sequence of the avian retrovirus that causes myelocytic leukemia was identified. Since then, over 40 years of unceasing research have highlighted the significance of this protein in malignant transformation, especially in hematologic diseases. Indeed, some of the earliest connections among the higher expression of proto-oncogenes (such as MYC), genetic rearrangements and their relation to cancer development were made in Burkitt lymphoma, chronic myeloid leukemia and mouse plasmacytomas. Multiple myeloma (MM), in

Изменяющиеся схемы первоначальной обработки RRMS в Финляндии (2013 - 2022 годы): Понимание из общенационального регистра множественных склерозов.

ОКРУЖАЮЩАЯ СЛЕДУЮЩАЯ ДЕЯТЕЛЬНОСТЬ: Изменяется лечение повторно излучаемого склероза (RRMS). В Финляндии имеется ограниченный объем данных о первоначальной обработке ОРУО. ЦЕЛЬ: Наши цели заключались в изучении тенденций в области первоначального лечения с целью модификации болезней (ДМТ) для пациентов, страдающих ОРМС в период с 2013 по 2022 год, задержек с лечением, факторов, связанных с выбором ДРМ, схем переключения ОРМ и последствий пандемии COVID-19. МЕТОДЫ: В этом ретроспективном исследовании регистра использовались вторичные данные из финского регистра MS. DMT были классифицированы в ка

Multimodality Imaging Reveals Rare Hereditary Transthyretin Amyloidosis Mimicking Hypertrophic Cardiomyopathy.

BACKGROUND: Distinguishing hypertrophic cardiomyopathy from phenocopies remains a diagnostic challenge in younger patients presenting with unexplained ventricular hypertrophy. CASE SUMMARY: A 52-year-old Moroccan woman previously diagnosed with nonobstructive hypertrophic cardiomyopathy presented with recurrent pericardial chest pain, poorly tolerating angiotensin-converting enzyme inhibitors and beta-blockers. Cardiac magnetic resonance showed asymmetric hypertrophy and papillary muscle hypertrophy suggestive of hypertrophic cardiomyopathy, with markedly elevated native T1 mapping and extrac

Development of a Hybrid Simulated Patient Experience to Practice Care of the Dying Older Adult.

IntroductionCare of the dying older adult includes critical skills that emerging physicians should master but are not consistently taught. Simulation has been shown to be an excellent tool for teaching these skills in a standardized fashion. Simulation allows direct observation to assess and provide learner feedback. Our goal was to develop a learning activity to practice skills caring for the older adult at the end of life and identify areas in need of improvement.MethodsWe developed a hybrid simulation in which fourth-year medical students and internal medicine (IM) residents cared for a 70-