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Review of Hematology-Oncology Emergencies for Internal Medicine Residents.

The prevalence of cancer continues to grow globally every year. With therapeutic advances over the recent decades, the prevalence of individuals living with cancer continues to increase. Internal medicine residents can see patients admitted to the hospital for cancer-related emergencies. Early identification and appropriate management of these emergencies have been shown to improve mortality and morbidity. In this article, we aim to review the recent updates in the management of commonly encountered oncologic emergencies in the practice of internal medicine residents. This review will cover sp

Machine learning for acute kidney injury: Changing the traditional disease prediction mode.

Acute kidney injury (AKI) is a serious clinical comorbidity with clear short-term and long-term prognostic implications for inpatients. The diversity of risk factors for AKI has been recognized in previous studies, and a series of predictive models have been developed using traditional statistical methods in conjunction with its preventability, but they have failed to meet the expectations in limited clinical applications, the rapid spread of electronic health records and artificial intelligence machine learning technology has brought new hope for the construction of AKI prediction models. In

Usability testing of an electronic patient-reported outcome system linked to an electronic chemotherapy prescribing and patient management system for patients with cancer.

BackgroundPeople affected by cancer experience a wide range of symptoms which have a major impact on their functioning and health-related quality of life (HRQoL). One way to measure the impact of cancer symptoms is through the use of patient-reported outcomes.MethodsAn electronic patient-reported outcome (ePRO) application (ChemoPRO®) was designed to be used by cancer patients to report their symptoms and communicate with their clinical team. Usability testing sessions were conducted with people with lived experience of cancer to understand how real users interact with the ChemoPRO® system. On

CAR-Based Cell Therapy in Head and Neck Cancer: A Comprehensive Review on Clinical Applicability.

Background/Objectives: Chimeric antigen receptor T-cell (CAR-T) therapy is a novel form of adoptive cellular immunotherapy that involves modifying autologous T cells to recognize and target tumor-associated antigens (TAAs) on malignant cells, independent of major histocompatibility complex (MHC) restriction. Although CAR-T therapy has shown remarkable success in treating hematologic malignancies, its efficacy in solid tumors remains limited, largely due to the lack of tumor-specific antigens and the complexity of the tumor microenvironment. This review aims to explore the rationale for continu

Анализ траекторий заболеваний, ведущих к множественным склерозам: общенациональное когортное исследование.

ОКРУЖАЮЩАЯ СРЕДА: Продромальная фаза множественного склероза (MS) получает все большее признание, однако в большинстве исследований основное внимание уделяется изолированным симптомам или статичной коморбиде, в результате чего меняющаяся структура преднамеренного бремени болезней недооценивается. ЦЕЛЬ: Охарактеризовать динамические траектории заболеваний, предшествующие НР, путем моделирования продольной сети. МЕТОДЫ: ЗДРАВООХРАНЕНИЯ 10,273 Психиатрические заболевания и 47,167 Были проанализированы соответствующие меры контроля в Швеции. Были построены сети совместного лечения заболеваний thre

CRS and ICANS: Early detection and personalized management.

T-cell-redirected immunotherapies, including chimeric antigen receptor T-cell therapy and bispecific antibodies, have transformed the treatment of relapsed or refractory hematologic malignancies. However, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) remain the major immune-mediated toxicities that can complicate treatment delivery and contribute to morbidity and non-relapse mortality. CRS is characterized by systemic inflammatory amplification involving activated T cells, tumor cells, monocytes/macrophages, endothelial activation, and cytok

Trichloroethylene: An Invisible Cause of Parkinson's Disease?

The etiologies of Parkinson's disease (PD) remain unclear. Some, such as certain genetic mutations and head trauma, are widely known or easily identified. However, these causes or risk factors do not account for the majority of cases. Other, less visible factors must be at play. Among these is a widely used industrial solvent and common environmental contaminant little recognized for its likely role in PD: trichloroethylene (TCE). TCE is a simple, six-atom molecule that can decaffeinate coffee, degrease metal parts, and dry clean clothes. The colorless chemical was first linked to parkinsonism

Longitudinal studies on financial toxicity in cancer patients: a scoping review.

ObjectiveThis scoping review focuses on financial toxicity in cancer patients, aiming to identify its measurement time points, assessment tools, developmental trends, and influencing factors. Based on existing evidence, this review reveals the occurrence trajectory and long-term impacts of financial toxicity among cancer patients. It can provide a reference for improving patients' financial well-being in clinical practice and optimizing the medical security system at the health policy level and also points out key directions for future related research.MethodsThis study strictly followed the m

Outcomes of hospitalized hematologic oncology patients receiving rapid response system activation for acute deterioration.

BackgroundPatients with hematologic malignancies who are admitted to hospital are at increased risk of deterioration and death. Rapid response systems (RRSs) respond to hospitalized patients who clinically deteriorate. We sought to describe the characteristics and outcomes of hematologic oncology inpatients requiring rapid response system (RRS) activation, and to determine the prognostic accuracy of the SIRS and qSOFA criteria for in-hospital mortality of hematologic oncology patients with suspected infection.MethodsWe used registry data from two hospitals within The Ottawa Hospital network, b

Clinical Associations with Hospital Escalation Among COVID-19 Patients Receiving Remdesivir in a Hospital-at-Home Service: A Real-World Cohort Study.

Background/Objectives: Hospital-at-home (HaH) programs expanded hospital capacity during the COVID-19 pandemic, but data on which HaH patients receiving intravenous (IV) remdesivir may require hospital escalation is limited. We therefore aimed to explore clinical characteristics associated with escalation to inpatient care. Methods: Single-center, retrospective cohort of adults with confirmed COVID-19 who received IV remdesivir via a HaH service was employed (September 2020-September 2024). Primary outcome was hospital escalation. Associations between baseline variables and escalation were ass

Essential Medicinal Chemistry of Essential Medicines.

Since 1977, the World Health Organization publishes a list of essential medicines, i.e., those that satisfy the priority health care needs of the population and are selected with regard to disease prevalence and public health relevance, evidence of clinical efficacy, and safety, as well as comparative costs and cost-effectiveness. The Essential Medicines List (EML) is an invaluable tool for all countries to select those medicines that have an excellent risk/benefit ratio and that are reputed to be of pivotal importance to health. In the present perspective, we describe the chemical composition

Naked antibodies and antibody-drug conjugates: targeted therapy for childhood acute lymphoblastic leukemia.

The treatment of childhood acute lymphoblastic leukemia (ALL) has reached overall survival rates exceeding 90%. The present and future challenges are to cure the remainder of patients still dying from disease, and to reduce morbidity and mortality in those who can be cured with standard-of-care chemotherapy by replacing toxic chemotherapy elements while retaining cure rates. With the novel therapeutic options introduced in the last years, including immunotherapies and targeted antibodies, the treatment of ALL is undergoing major changes. For B-cell precursor ALL, blinatumomab, an anti-CD19 bis

Taste and smell disturbances in patients with chronic oral graft vs. host disease: An observational study.

BackgroundA common complication of allogeneic hematopoietic stem cell transplantation (alloHSCT) is chronic oral graft vs. host disease (cGvHD). Oral cGvHD may present as mucosal lesions, salivary gland dysfunction, and trismus. Moreover, taste and smell ability may be affected, but the prevalence, nature and severity of altered taste and smell function, and their impact on quality of life (QoL) are understudied.AimTo identify the prevalence, nature, and severity of taste and smell disturbances, their impact on QoL and to assess whether altered taste/smell ability is associated with oral mucos

Application and Challenges of Chimeric Antigen Receptor T Cell Therapy in Systemic Rheumatic Diseases and Autoimmune Disorders.

Chimeric antigen receptor T (CAR-T) cell therapy, originally developed for hematologic malignancies, has emerged as a transformative candidate for systemic rheumatic diseases and autoimmune disorders (AIDs). Its unique efficacy in refractory AIDs relies on depleting autoreactive B cells and driving antigen-naïve immune reconstitution, achieving durable drug-free remission in early-phase trials. Despite promising clinical and serological responses lasting 2-5 years without long-term immunosuppression, the field faces unmet needs: complex manufacturing, limited tissue penetration, antigen escape

Mitigation and Management of Common Toxicities Associated with the Administration of CAR-T Therapies in Oncology Patients.

Chimeric antigen receptor T-cell (CAR-T) therapies are one of the main approaches among targeted cellular therapies. Despite the potential benefit and durable responses observed in some patients receiving CAR-T therapies, serious and potentially fatal toxicities remain a major challenge. The most common CAR-T-associated toxicities include cytokine release syndrome (CRS), neurotoxicity, cytopenias, and infections. While CRS and neurotoxicity are generally managed with tocilizumab and corticosteroids, respectively, high-grade toxicities can be life-threatening. Close postinfusion monitoring and

Impact of the COVID-19 pandemic on the diagnosis and treatment of onco-hematologic patients: a discussion paper.

We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatmen

Совпадение в полном тексте источника
… Rapid response teams aimed at detecting patients at risk of deterioration on hospital wards, through monitoring systems and predictive scores such as the National Early Warning Score (NEWS), have been shown to be effective in reducing complications such as cardiorespiratory arrests, ICU readmissions …

Characteristics of registered clinical trials assessing treatments for COVID-19: a cross-sectional analysis.

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has prompted many initiatives to identify safe and efficacious treatments, yet little is known regarding where early efforts have focused. We aimed to characterise registered clinical trials assessing drugs or plasma treatments for COVID-19. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional analysis of clinical trials for the treatment of COVID-19 that were registered in the USA or in countries contributing to the WHO's International Clinical Trials Registry Platform. Relevant trial entries of drugs or plasma were downloaded on 26 M

Совпадение в полном тексте источника
… Surrogate or biomarker included any measure of SARS-CoV-2 or any blood test; clinical scales included measures of oxygenation, Sequential Organ Failure Assessment score, National Early Warning Score 2 score, lung injury score or any measure of pulmonary harms; and clinical outcomes included symptoms, …

Множественная стратификация риска склероза и прогнозирование расходов на здравоохранение с использованием машинного обучения.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Растущая доступность медицинских данных дает возможность более активно бороться с такими хроническими заболеваниями, как множественный склероз (МС). Мы поставили перед собой цель разработать подход к машинному обучению (ML) для выявления пациентов с повышенным уровнем риска и прогнозирования их расходов на медицинское обслуживание. МЕТОДЫ: Мы провели ретроспективный анализ деидентифицированных коммерческих страховых требований 267,000 (неполные лица)631 с MS), с января 2016 по июнь 2018. Ежемесячные данные о претензиях были агрегированы, и 72 ML регрессия и 63 :: были по

The Neurocognitive Impact of CAR T Cell Therapy in Hematological Cancers: A Systematic Review of Cognitive Function, Quality of Life, and Psychological Outcomes.

BackgroundChimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of hematological malignancies, offering durable remissions. However, concerns regarding its neurocognitive and psychological impact have emerged, particularly in patients experiencing immune effector cell-associated neurotoxicity syndrome (ICANS). Despite growing clinical use, the long-term effects on cognitive function, psychological well-being, and quality of life (QoL) remain unclear.ObjectiveThis systematic review evaluates the neurocognitive, psychological, and QoL outcomes associated with CAR T-cell

Dengue virus infection in hematopoietic stem cell transplant recipients: A case series and comparative literature review from dengue endemic region.

This case series describes the wide spectrum of clinical presentation, laboratory findings, and morbidity/mortality associated with dengue fever in hematopoietic stem cell transplant recipients, treated in a dengue endemic region. The risk of acquiring viral infections increases manifold after transplant due to the severely immunocompromised state amid conditioning toxicity and immunosuppressive therapy. The classical warning signs of dengue viremia are often masked in posttransplant patients, leading to a missed diagnosis of dengue and grave consequences observed in some of the patients. Accu