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Cancer Pain Is Not One-Size-Fits-All: Evolving from Tradition to Precision.

Cancer pain remains a significant challenge in oncology, profoundly affecting patients' quality of life, function, and prognosis. Historically under-recognized and managed with a uniform, opioid-centric approach, cancer pain was often inadequately treated. Advances in pain assessment, multimodal analgesia, and supportive care have improved outcomes, yet traditional algorithms frequently fail to address the complex, heterogeneous nature of cancer pain. Contemporary management is shifting toward precision and personalized medicine, integrating genetic, molecular, and biomarker data with individu

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… The adverse effects include sedation, dry mouth, constipation, urinary retention, weight gain and QT prolongation. Nortriptyline (TCA) is a secondary-amine and an active metabolite of amitriptyline. Nortriptyline is used at an oral dose of 25–75 mg/day. … Side effects include dry mouth, blurred vision, constipation, urinary retention, and tachycardia [ 56 ]. …

Drug-Drug Interactions of Cannabidiol with Standard-of-Care Chemotherapeutics.

Cannabidiol (CBD) is an easily accessible and affordable Marijuana (Cannabis sativa L.) plant derivative with an extensive history of medical use spanning thousands of years. Interest in the therapeutic potential of CBD has increased in recent years, including its anti-tumour properties in various cancer models. In addition to the direct anticancer effects of CBD, preclinical research on numerous cannabinoids, including CBD, has highlighted their potential use in: (i) attenuating chemotherapy-induced adverse effects and (ii) enhancing the efficacy of some anticancer drugs. Therefore, CBD is ga

Defining diagnostic trajectories in patients with podocytopathies.

Podocytopathies are glomerular disorders in which podocyte injury drives proteinuria and progressive kidney disease. They encompass a broad spectrum of aetiologies, resulting in pathological pictures of minimal-changes, focal segmental glomerulosclerosis, diffuse mesangial sclerosis or collapsing glomerulopathy. Despite improvement in classifying podocytopathies as a distinct group of disorders, the histological definition fails to capture the relevant biological heterogeneity underlying each case, manifesting as extensive variability in disease progression and response to therapies. Increasin

Epigenetic modification in diabetic kidney disease.

Diabetic kidney disease (DKD) is a common microangiopathy in diabetic patients and the main cause of death in diabetic patients. The main manifestations of DKD are proteinuria and decreased renal filtration capacity. The glomerular filtration rate and urinary albumin level are two of the most important hallmarks of the progression of DKD. The classical treatment of DKD is controlling blood glucose and blood pressure. However, the commonly used clinical therapeutic strategies and the existing biomarkers only partially slow the progression of DKD and roughly predict disease progression. Therefor

Улучшения в множественном склерозе.

Растет глобальная распространенность множественного склероза (MS), а ранняя диагностика и лечение имеют важное значение для смягчения последствий инвалидности. Несмотря на то, что в последнее время терапевтические достижения привели к значительному сокращению числа рецидивов, прогрессивные и дегенеративные аспекты НР по-прежнему создают серьезные проблемы. Обновление в этом году диагностических критериев McDonald направлено на повышение чувствительности и содействие более раннему использованию методов лечения асимптоматических заболеваний. Кроме того, новые биомаркеры получат развитие в клинич

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… Sphincter dysfunction, particularly urinary retention, can also occur. Lhermitte's phenomenon is an electrical sensation migrating down the back upon neck flexion. …

Unstable Pathologic Vertebral Fractures in Multiple Myeloma : Propensity Score Matched Cohort Study between Reconstructive Surgery with Adjuvant Radiotherapy and Radiotherapy Alone.

ObjectiveAlthough radiotherapy (RT) is recommended for multiple myeloma (MM) involving spine, the treatment of choice between reconstructive surgery with RT and RT alone for pathologic vertebral fractures (PVFs) associated with structural instability or neurologic compromises remains controversial. The purpose of this study was to evaluate the clinical efficacies of reconstructive surgery with adjuvant RT for treatment of MM with PVFs by comparing with matched cohorts treated with RT alone.MethodsTwenty-eight patients underwent reconstructive surgery followed by RT between 2008 and 2015 in a s

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… Bowel dysfunction was associated with constipation, loss of sphincter control, whereas urinary retention was recorded as bladder dysfunction. …

Outcomes of Laparoscopic Peritoneal Dialysis Catheter Placement Using an Optimal Placement Technique.

BackgroundPeritoneal dialysis (PD) is a widely employed renal replacement modality. A prospective study was conducted to determine the short-term and midterm outcomes and complication rates associated with a standardized optimal laparoscopic peritoneal dialysis catheter placement technique.MethodsAll patients undergoing laparoscopic PD catheter placement by one surgeon using our standardized method over a 5-year period were entered into a prospective database. Patients were evaluated preoperatively and postoperatively through office visits. Development of complications was assessed using follo

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… The 3 noncatheter-related complications included two patients that experienced postoperative urinary retention that spontaneously resolved and a third patient who developed hypervolemia requiring inpatient admission. …

Real-World Data and Machine Learning to Predict Cardiac Amyloidosis.

(1) Background: Cardiac amyloidosis or "stiff heart syndrome" is a rare condition that occurs when amyloid deposits occupy the heart muscle. Many patients suffer from it and fail to receive a timely diagnosis mainly because the disease is a rare form of restrictive cardiomyopathy that is difficult to diagnose, often associated with a poor prognosis. This research analyses the characteristics of this pathology and proposes a statistical learning algorithm that helps to detect the disease. (2) Methods: The hospitalization clinical (medical and nursing ones) records used for this study are the ba

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… Signs | Diagnose Vital signs | Blood pressure, heart rate, temperature, oxygen, sugar Nursing diagnoses | Constipation, subjective constipation, diarrhea, fecal incontinence, risk of constipation, impaired urinary output, urinary retention, nausea, or risk of falls. …

Neurology

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Evaluating the Impact of Insurer-Sponsored Health Coaching on Hospitalization and Costs in India: A Retrospective Cohort Study.

Health coaching programs are emerging as a promising intervention to improve disease management and reduce healthcare costs, particularly in the context of insurer-sponsored wellness initiatives. While such programs have shown positive outcomes in Western healthcare settings, their effectiveness in India remains underexplored. This study examines the impact of a health coaching program implemented by a prominent Indian health insurer (Aditya Birla Health Insurance), focusing on hospitalization rates and claims paid among high-risk policyholders. To assess the intervention's effectiveness, a re

RNA Therapeutics in Viral Infections and Cancer: Mechanisms, Challenges, and Prospects: A Review.

Background: RNA therapeutics represent a rapidly advancing field with significant potential for treating viral infections and cancer. This review examines the current landscape of RNA-based strategies, including siRNA, miRNA mimics, and antisense oligonucleotides. For viral infections, the focus is on hepatitis B (HBV) and C (HCV), HIV, and SARS-CoV-2. Approaches include targeting viral transcripts directly (e.g., siRNAs against HBV surface antigen) or host factors critical for viral replication (e.g., anti-miR-122 miravirsen for HCV). The successful development of mRNA vaccines for COVID-19 i

Primary hyperhidrosis: an updated review.

BACKGROUND: Hyperhidrosis (HH) is a condition characterized by excessive sweating beyond the physiological needs of thermoregulation. HH can be classified as primary (idiopathic) hyperhidrosis (PHH) or secondary hyperhidrosis (SHH), which is associated with underlying medical conditions, medications or systemic disorders. This narrative review provides an updated overview of PHH, with a focus on epidemiology, aetiopathogenesis, clinical manifestations, diagnostic approaches and current management strategies, particularly highlighting pharmacological and procedural treatment options. METHODS:

Monoclonal Gammopathies and the Bone Marrow Microenvironment: From Bench to Bedside and Then Back Again.

Multiple myeloma (MM) is an incurable hematologic malignancy characterized by a multistep evolutionary pathway, with an initial phase called monoclonal gammopathy of undetermined significance (MGUS), potentially evolving into the symptomatic disease, often preceded by an intermediate phase called "smoldering" MM (sMM). From a biological point of view, genomic alterations (translocations/deletions/mutations) are already present at the MGUS phase, thus rendering their role in disease evolution questionable. On the other hand, we currently know that changes in the bone marrow microenvironment (TM

Nontraumatic Spinal Cord Injury: Epidemiology, Etiology and Management.

The spinal cord is a conduit within the central nervous system (CNS) that provides ongoing communication between the brain and the rest of the body, conveying complex sensory and motor information necessary for safety, movement, reflexes, and optimization of autonomic function. After a traumatic spinal cord injury (SCI), supraspinal influences on the peripheral nervous system and autonomic nervous system (ANS) are disrupted, leading to spastic paralysis, sympathetic blunting, and parasympathetic dominance, resulting in cardiac dysrhythmias, systemic hypotension, bronchoconstriction, copious re

Efficacy and safety of reduced-dose daratumumab plus bortezomib and dexamethasone (DVd-lite) in newly diagnosed MGRS patients.

BackgroundClone-directed therapy is essential for managing monoclonal gammopathy of renal significance (MGRS), as it reduces the nephrotoxic monoclonal protein burden and preserves renal function. However, due to the rarity and frequent misdiagnosis of MGRS, there is no evidence-based standard first-line treatment for MGRS.MethodsThis open-label, single-arm, prospective clinical trial assessed the efficacy and safety of the combination of reduced-dose daratumumab (Dara), bortezomib, and dexamethasone (DVd-lite) in ten newly diagnosed MGRS patients. The treatment protocol consisted of six cycle

Комплексный подход к дифференцированию системного лейкоцита от других аутоиммунных заболеваний, вызываемых оптическим невритом.

Системная волчанка (SLE) представляет собой сложное аутоиммунное заболевание со значительной заболеваемостью и смертностью. Ранняя диагностика имеет решающее значение для эффективного управления. В качестве потенциальных первых признаков SLE появились окулярные проявления, в частности оптический нейрит (ON). В этом систематическом обзоре литературы анализируются 23 исследования, включая восемь ретроспективных исследований, пять межсекторальных исследований, два групповых исследования, четыре тематических доклада, один обзор описательной части и три систематического обзора литературы, в целях и

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… However, highly recurrent SLE-related longitudinally extensive transverse myelitis (LETM), a disease of contiguous, inflammatory spinal lesions that cause symptoms of paralysis, paresthesias, and urinary retention, is also reported [ 22 ]. …

Inpatient Medicine

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Efficacy of percutaneous vertebroplasty for the relief of osteoblastic spinal metastasis pain.

The aim of the present manuscript was to retrospectively evaluate the efficacy of fluoroscopy-guided percutaneous vertebroplasty (PVP) for the relief of osteoblastic spinal metastases pain. PVP was performed in 39 consecutive patients with 82 osteoblastic metastatic spinal vertebras. 19 vertebras had pathologic compressive fracture and the other 63 vertebras had no compressive fracture with obvious imaging abnormalities. The ages of the patients ranged from 40 to 77 years with a mean age of 58.5±9.0 years. Visual analog scale (VAS) and QLQ-BM22 score were used to evaluate pain and quality of l

ВРЕМЯ АНДОКРИСНОЛОГИИ COVID-19-2021 Борьба с диабетом инсипидом и гипонатрамией.

AbstractCOVID-19 , изменила характер медицинских консультаций, сделав упор на виртуальное консультирование пациентов, что имеет отношение к пациентам с диабетом инсипиду (ДИ) или гипонатрамией. Основным осложнением лечения демопрессией в ДИ является разбавляющая гипонатраемия. Поскольку плазменный мониторинг натрия не всегда возможен во время COVID-19, мы рекомендуем откладывать дозу десмопрессина раз в неделю до тех пор, пока не произойдет акварез, позволяющий экстрактировать избыточную оставляемую воду. Пациенты должны ежедневно измерять вес своего тела. Пациенты с детективом-детективом, пом

PROCEEDINGS 32nd Symposium ESVN-ECVN WROCLAW, POLAND 12th-14th September 2019. Selected research communications of the 32nd Symposium of the ESVN-ECVN Wroclaw, Poland 12th to 14th September 2019.

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