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Availability and Access to Orphan Drugs for Rare Cancers in Bulgaria: Analysis of Delays and Public Expenditures.

Rare cancers are defined by an annual incidence of fewer than 6 per 100,000. Bearing similarities to rare diseases, they are associated with substantial health inequalities due to diagnostic complexity and delayed access to innovative therapies. This situation is further aggravated in Southeastern European countries like Bulgaria, where limited public resources and expertise underscore the need for additional policy and translational research on rare cancers. This study aimed to explore the availability and access to orphan drugs for rare cancers in Bulgaria for the period of 2020-2023. We cro

Response and progression-free survival according to planned treatment duration in patients with relapsed multiple myeloma treated with carfilzomib, lenalidomide, and dexamethasone (KRd) versus lenalidomide and dexamethasone (Rd) in the phase III ASPIRE study.

BACKGROUND: In ASPIRE, carfilzomib, lenalidomide, and dexamethasone (KRd) significantly improved progression-free survival (PFS) and response rates versus lenalidomide and dexamethasone (Rd) in patients with relapsed multiple myeloma. Per protocol, patients received KRd for a maximum of 18 cycles followed by Rd to progression, so the benefit/risk profile of KRd to progression was not established. METHODS: This post hoc analysis evaluated the efficacy and safety of KRd versus Rd at 18 months from randomization. Cumulative rates of complete response (CR) or better over time and PFS hazard ratio

Rare central nervous system lymphomas.

Central nervous system (CNS) lymphomas are rare malignancies characterised by lymphoid infiltration into the brain, spinal cord, cranial nerves, meninges and/or eyes in the presence or absence of previous or concurrent systemic disease. Most CNS lymphomas are of the diffuse large B-cell lymphoma (DLBCL) subtype for which treatment strategies, particularly the use of high-dose methotrexate-based protocols and consolidation with autologous stem cell transplantation, are well established. Other histopathological subtypes of CNS lymphoma are comparatively less common with published data on these r

Средиземноморская диета и достаточность питательных микроэлементов в связи с риском повторного возникновения множественных склерозов: тематическое исследование.

Множественный склероз (MS) является хроническим аутоиммунным и нейродегенеративным заболеванием, под влиянием экологических факторов, включая рацион питания. Средиземное питание (MeDi), богатое антивоспалительными и антиокислительными соединениями, а также адекватность питательных микроэлементов могут снизить риск и прогрессировать в плане НР. АИМ: Цель настоящего исследования заключается в изучении связей между Средиземноморским диетическим счётом (MDS), средним коэффициентом достаточности (MAR) и риском, связанным с НР, в рамках контроля за конкретными случаями. МЕТОДЫ: Это тематическое иссл

" Nucleolus in Human Beasons: Ribosome Biogenesis " , " Nucleolar Survey " и " Terrapeutic Opportunities " .

Nucleolus превратился в динамичную и многофункциональную субядерную органилию, интегрирующую рибосомный биогенез с клеточным ростом и сигнализацией стресса. Регулирование нуклеолярной функции все чаще признается в качестве главного движителя человеческих заболеваний, связывающего изменённое рибосомное производство и нуклеолярное наблюдение с раком, рибосомопатиями, синдромами преждевременного старения, нейродегенерацией и иммунными расстройствами. В этом обзоре мы интегрируем структурные, молекулярные и болезнетворные перспективы нуклеолярной биологии для определения того, как рипосомный биоге

Cardiotoxicity Induced by Anticancer Therapies: A Call for Integrated Cardio-Oncology Practice.

The introduction of novel oncologic therapies, including targeted agents, immunotherapies, and antibody-drug conjugates, has transformed the therapeutic landscape of cancer care. This evolution has resulted in a dual clinical scenario; while survival outcomes have markedly improved, leading to a growing population of long-term cancer survivors, an increasing incidence of previously unrecognized treatment-related toxicities has emerged. Among these, cardiovascular adverse events represent some of the most prevalent and clinically significant complications observed in both conventional chemother

Anticancer natural products from the Middle East and North Africa: biodiversity, mechanisms, and translational challenges.

Cancer remains one of the leading causes of morbidity and mortality worldwide, imposing substantial clinical, societal, and economic burdens. Despite major advances in surgical oncology, systemic chemotherapy, radiation therapy, molecularly targeted therapeutics, and immune checkpoint inhibition, contemporary cancer treatment remains constrained by dose-limiting toxicities, intratumoral and intertumoral heterogeneity, and the inexorable emergence of multifaceted drug resistance mechanisms. These persistent therapeutic challenges have reinstated interest in natural products (NPs) as evolutionar

Proceedings of Réanimation 2020, the French Intensive Care Society International Congress.

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Perspectives in Melanoma: meeting report from the Melanoma Bridge (December 1st-3rd, 2022-Naples, Italy).

Outcomes for patients with melanoma have improved over the past decade with the clinical development and approval of immunotherapies targeting immune checkpoint receptors such as programmed death-1 (PD-1), programmed death ligand 1 (PD-L1) or cytotoxic T lymphocyte antigen-4 (CTLA-4). Combinations of these checkpoint therapies with other agents are now being explored to improve outcomes and enhance benefit-risk profiles of treatment. Alternative inhibitory receptors have been identified that may be targeted for anti-tumor immune therapy, such as lymphocyte-activation gene-3 (LAG-3), as have se

Оптимизированное назначение упражнений для уменьшения онкологической усталости у выживших после первичного лечения у женщин с раком молочной железы: систематический обзор и доза-ответный сетевой мета-анализ.

ОБЪЕКТ: Психофизиологический стресс у пациентов с онкологическими заболеваниями (CRF) значительно снижает качество жизни у выживших после рака молочной железы. Хотя физические упражнения рекомендуются в клинических руководствах для уменьшения CRF, эффективные и оптимальные дозы остаются неопределёнными. Настоящее исследование направлено на изучение зависимости дозы упражнений от CRF у выживших после рака молочной железы. МЕТОДЫ: Доза упражнений рассчитывалась как произведение продолжительности, частоты и интенсивности, выраженная в метаболических эквивалентах минут в неделю (METs-min/неделя),

Cardiorespiratory fitness in long-term lymphoma survivors after high-dose chemotherapy with autologous stem cell transplantation.

BackgroundCardiorespiratory fitness as measured by peak oxygen consumption (VO2peak) is a strong predictor of longevity and may be compromised by anticancer therapy, inactivity, and smoking. We compared VO2peak among lymphoma survivors (LSs) with reference data from healthy sedentary subjects, after a 10.2-year (mean) follow-up post high-dose chemotherapy with autologous stem cell transplantation (HDT-ASCT). We further examined the association between VO2peak and treatment, physical activity, smoking, pulmonary, and cardiac function.MethodsLymphoma survivors treated with HDT-ASCT in Norway 198

Current status and perspectives of genetic testing in gastrointestinal cancer (Review).

Genetic testing has become widespread in daily medical care for gastrointestinal (GI) cancers. However, unlike breast cancer and non-small cell lung cancer, in which personalized medicine targeting various driver genes is standardized, the incidence of targeted gene abnormalities in GI cancers is low. Nevertheless, such abnormalities may be linked to therapeutic agents and the further development of therapeutic agents for personalized medicine for GI cancers is desired. A liquid biopsy is of great benefit in offering clinical decision support, in applications such as GI cancer screening, surgi

Анализ многократной миеломы (ММ) и Моноклональной гаммопатии неопределенных знаков (MGUS)

История семьи является известным фактором риска для множественной миеломы (ММ) и ее предшественника, моноколональной гаммопатии неопределённого значения (МГУС). Предыдущие исследования в рамках всей ассоциации генома (ОСГ) выявили 35 общие loci, связанные с риском MM и 21 связанные с MGS. Цель этого исследования заключалась в выявлении менее распространенных и редких генетических loci, предвосхищающих MM/MGUS, путем проведения анализа последовательности связей на основе целых экспозиций (WES).МЕТОДЫ: Мультиточечный анализ связей был проведен с использованием многоточечного двигателя быстрого с

Advances in the understanding and therapeutic manipulation of cancer immune responsiveness: a Society for Immunotherapy of Cancer (SITC) review.

Cancer immunotherapy-including immune checkpoint inhibition (ICI) and adoptive cell therapy (ACT)-has become a standard, potentially curative treatment for a subset of advanced solid and liquid tumors. However, most patients with cancer do not benefit from the rapidly evolving improvements in the understanding of principal mechanisms determining cancer immune responsiveness (CIR); including patient-specific genetically determined and acquired factors, as well as intrinsic cancer cell biology. Though CIR is multifactorial, fundamental concepts are emerging that should be considered for the desi

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… The impact of socioeconomic status on survival after cancer in the United States: findings from the National Program of Cancer Registries Patterns of Care Study. Cancer. 2008;113:582–91. doi: 10.1002/cncr.23567. 139. Cortellini A, Tucci M, Adamo V, et al. …

Interventions for preventing falls in older people in care facilities and hospitals.

BackgroundFalls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010 and updated in 2012.ObjectivesTo assess the effects of interventions designed to reduce the incidence of falls in older people in care facilities and hospitals.Search methodsWe searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (August 2017); Cochrane Central Register of Controlled Trials (2017, Issue 8); and MEDLINE, Embase, CINAHL and trial registers to August 2017.Selection crite

Пациентский опыт биопсихосоциального воздействия синдрома Гильен-Барре: обзор.

Синдром фоновой гильии-барре (GBS) — острый аутоиммунный расстройство периферической нервной системы, которое может привести к слабости мышц, дыхательной недостаточности и длительной инвалидности. Хотя клинические аспекты были широко изучены, данные о биопсихосоциально-духовном воздействии на взрослых остаются ограниченными.2005) и был представлен в соответствии с руководящими принципами PRISMA-ScR. Поиски литературы проводились в Пуббмеде, Скопусе и EBCOCOhost для исследований, опубликованных с января 2015 и январь 2025. Используя систему PCC, мы включили проверенные первичные исследования по

12-Month Teriparatide Treatment Reduces New Vertebral Compression Fractures Incidence And Back Pain And Improves Quality Of Life After Percutaneous Kyphoplasty In Osteoporotic Women.

PurposeDefine the effectiveness of teriparatide (TPTD) treatment on reducing the incidence of new vertebral compression fractures (NVCFs) and back pain and improving quality of life after percutaneous kyphoplasty (PKP).MethodsTwo years of clinical follow-up data from primary osteoporotic women who had experienced initial osteoporotic vertebral compression fractures (OVCFs) and received PKP plus 12-month TPTD (n=113) or basic treatment (BT) of calcium and vitamin D supplements (n=208) were retrospectively collected. The risk of NVCFs over each 6-month period in the TPTD group was evaluated and

Vegetable Gardening and Health Outcomes in Older Cancer Survivors: A Randomized Clinical Trial.

IMPORTANCE: Cancer survivors experience accelerated functional decline that threatens independence and quality of life. Previous studies have suggested that vegetable gardening may improve diet, physical activity, and physical function in this vulnerable population, which comprises more than 5% of the US population. OBJECTIVE: To assess whether diet, physical activity and functioning, and other outcomes improved in older cancer survivors assigned to a vegetable gardening intervention compared with a waitlist. DESIGN, SETTING, AND PARTICIPANTS: From May 11, 2016, to May 2, 2022, a 2-arm, asse

Цитомегаловирус возрождается под упреждающей терапией после пересадки стволовых клеток аллогенной гематополией: структура, выживание и факторы риска в Республике Корея.

ВВЕДЕНИЕ: Для ретрансплантации цитомегаловируса (CMV) использовалась упреждающая терапия при трансплантации стволовых клеток с использованием аллогенетической гематополиетической гемоглобы (алло-HSCT). Неясно, имеет ли эта стратегия более низкие клинические результаты в районах, эндемичных для ВИЧ, и требуется ли более агрессивная профилактика. МЕТОДЫ: Мы ретроспективно проанализировали модели и выживаемость после возобновления КМВ у пациентов, проходящих упреждающую терапию после алло-ХСХТ, и провели оценку пациентов с высокой степенью риска, которые могли бы извлечь пользу из агрессивной про

Stereotactic Body radiotherapy and pedicLE screw fixatioN During one hospital visit for patients with symptomatic unstable spinal metastases: a randomized trial (BLEND RCT) using the Trials within Cohorts (TwiCs) design.

BackgroundSpinal metastases can lead to unremitting pain and neurological deficits, which substantially impair daily functioning and quality of life. Patients with unstable spinal metastases receive surgical stabilization followed by palliative radiotherapy as soon as wound healing allows. The time between surgery and radiotherapy delays improvement of mobility, radiotherapy-induced pain relief, local tumor control, and restart of systemic oncological therapy. Stereotactic body radiotherapy (SBRT) enables delivery of preoperative high-dose radiotherapy while dose-sparing the surgical field, al