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Cryoglobulin Test and Cryoglobulinemia Hepatitis C-Virus Related.

Cryoglobulins are immunoglobulins that precipitate in serum at temperatures below 37°C and resolubilize upon warming. The clinical syndrome of cryoglobulinemia usually includes purpura, weakness, and arthralgia, but the underlying disease may also contribute other symptoms. Blood samples for cryoglobulin are collected, transported, clotted and spun at 37°C, before the precipitate is allowed to form when serum is stored at 4°C in a Wintrobe tube for at least seven days. The most critical and confounding factor affecting the cryoglobulin test is when the preanalytical phase is not fully complete

Bortezomib-induced painful neuropathy in patients with multiple myeloma.

Neurotoxicity towards the peripheral nervous system which appears clinically in the form of painful neuropathy is an essential dose-limiting factor during the treatment of multiple myeloma. In this review article different forms of this painful neuropathy are presented together with currently available diagnostic tools which are usually applied to confirm the diagnosis. Also, the most often used neurological scales estimating neurological deficit are presented. Special attention is paid to the management of the reversibility of bortezomib-induced neuropathic pain.

Myxedema Coma as the Initial Presentation of Undiagnosed Hypothyroidism: A Rare but Reversible Emergency.

Myxedema coma is a rare, life-threatening endocrine emergency representing the extreme manifestation of untreated hypothyroidism. It usually presents with nonspecific symptoms such as confusion, hypothermia, and bradycardia, which can lead to delayed recognition, particularly in elderly patients with multiple comorbidities. We report the case of a 77-year-old man with hypertension, stage 4 chronic kidney disease, anemia of chronic disease, myeloma, and prostate cancer who presented with reduced consciousness following a period of increasing lethargy and confusion. On arrival, he was hypotensiv

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… Triggers for decompensation in hypothyroid patients often include recurrent illnesses such as infection or sepsis, extreme cold exposure, sedative use, cardiovascular events, or metabolic disturbances, all of which can precipitate decompensation in already susceptible patients [ 5 ]. …

Targeting CD38 Across Autoimmune and Plasma Cell-Driven Immune-Mediated Diseases: Rationale, Clinical Evidence, and Emerging Therapeutic Landscape.

Autoimmune diseases remain a major cause of chronic morbidity despite substantial advances in targeted immunomodulatory therapies. In many autoantibody-mediated conditions, disease refractoriness and relapse are driven by long-lived plasma cells, which are largely resistant to conventional immunosuppression and upstream B cell-directed strategies. CD38, a surface molecule highly expressed on plasmablasts and plasma cells and functionally involved in immunometabolic regulation, has emerged as a promising therapeutic target to overcome this limitation. Clinical interest in anti-CD38 therapy has

Immunotherapy for pediatric solid tumors: overcoming biological barriers through rational multimodal combinations.

Pediatric solid tumors remain among the most treatment-refractory childhood malignancies, defined by biological features that have largely resisted the immunotherapeutic advances transforming adult oncology. Exceptionally low tumor mutational burden, sparse neoantigen landscapes, and profoundly immunosuppressive tumor microenvironments collectively undermine the T cell-dependent mechanisms on which most current immunotherapies depend. Yet the field is undergoing a meaningful shift. Anti-GD2 monoclonal antibodies have established a survival benchmark in high-risk neuroblastoma, and next-generat

The Treatment-induced Neuropathy Assessment Scale (TNAS): a psychometric update following qualitative enrichment.

BackgroundThe validation of the Treatment-induced Neuropathy Assessment Scale (TNAS v2.0), a patient-reported outcome measure of symptoms associated with cancer treatment-induced peripheral neuropathy (TIPN), was previously reported. Further patient input (qualitative interviewing, cognitive debriefing) suggested that the measure should be modified to better reflect the TIPN experience. We report the performance of a revised version (TNAS v3.0) for assessing TIPN across cancer treatments. This TNAS version incorporates extensive patient input, in accordance with FDA guidance on the development

Neurotoxicity associated with cancer chemotherapy: the first study in the Palestinian healthcare system.

BackgroundChemotherapy-induced neurotoxicity is a significant concern in cancer treatment as it adversely affects treatment outcomes. However, research on this subject within the Palestinian healthcare system is limited. This study aimed to evaluate the prevalence, clinical manifestations, and associated factors of neurotoxicity in cancer patients receiving chemotherapy in Palestine.MethodsThis retrospective cohort study included 196 cancer patients who underwent chemotherapy at multiple hospitals across Palestine. Data on patient demographics, cancer characteristics, chemotherapy regimens, an

Последние достижения в лечении и профилактике периферической нейропатии после многократного лечения миеломы.

Заболеваемость множественной миеломой (ММ) из года в год увеличивается, и для контроля за состоянием требуется химиотерапия. С появлением новых протеиновых ингибиторов, иммуномодуляторов и моноклональных антител, прогнозы пациентов значительно улучшились. Однако периферическая нейропатия, вызванная лекарственными препаратами, ограничивает дозу и продолжительность лечения, что серьезно сказывается на качестве жизни пациентов и результатах лечения. Несмотря на то, что нейропатии, вызванные химиотерапией, привлекли к себе большое внимание, их механизм и эффективные профилактические и лечебные мер

Mechanisms of Chemotherapy-Induced Peripheral Neuropathy.

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects caused by antineoplastic agents, with a prevalence from 19% to over 85%. Clinically, CIPN is a mostly sensory neuropathy that may be accompanied by motor and autonomic changes of varying intensity and duration. Due to its high prevalence among cancer patients, CIPN constitutes a major problem for both cancer patients and survivors as well as for their health care providers, especially because, at the moment, there is no single effective method of preventing CIPN; moreover, the possibilities of treating t

Applied information retrieval and multidisciplinary research: new mechanistic hypotheses in complex regional pain syndrome.

BackgroundCollaborative efforts of physicians and basic scientists are often necessary in the investigation of complex disorders. Difficulties can arise, however, when large amounts of information need to reviewed. Advanced information retrieval can be beneficial in combining and reviewing data obtained from the various scientific fields. In this paper, a team of investigators with varying backgrounds has applied advanced information retrieval methods, in the form of text mining and entity relationship tools, to review the current literature, with the intention to generate new insights into th

После полиомиелита в Австралии: наблюдательное исследование и анализ тенденций за 10-летний период по месяцам, местоположению и сопоставимым состояниям

БАКGROUND: На данный момент нет точной оценки пост-полио-ситуаций в Австралии. Настоящее наблюдательное исследование направлено на предоставление обобщения госпитализаций за 10-летний период в Австралии с акцентом на ежегодные, ежемесячные и региональные тенденции, а также сравнение с четырьмя подобными нейрологическими состояниями. МЕТОДЫ: Ретроспективное исследование поздних эффектов полио и пост-полио-синдрома с 2011 по 2021 год. Основные данные были получены через процесс запроса данных в 2022 году через Австралийский институт здравоохранения и благополучия. Анализ проводился с использова

Oncolytic Virus Therapy in a New Era of Immunotherapy, Enhanced by Combination with Existing Anticancer Therapies: Turn up the Heat!

Oncolytic viral therapy is a promising treatment for cancer, where 'cold' tumour cells can become 'hot' to the host immune system. However, with few FDA approved therapies, development of new strategies for more cancer types has been slow and relatively unsuccessful in recent years, Combination therapy has been successful for other types of cancer treatment, therefore, may be a viable alternative to improve the efficacy of oncolytic viral therapy which may reduce some of the adverse events of currently used monotherapies, oncolytic virus therapy and chemotherapy being mutually complimentary wi

Diagnosis and management of monoclonal gammopathy of clinical significance.

The term "monoclonal gammopathy of clinical significance" (MGCS) refers to any plasma cell or B-cell clonal disorder that does not meet the current criteria for malignant disorders but produces a monoclonal protein that directly or indirectly results in organ damage. The most commonly affected organs are the kidneys, nerves, and skin. This review summarizes the current classification of MGCS and its diagnostic and treatment approaches.

Acupuncture for Bortezomib-Induced Peripheral Neuropathy: Not Just for Pain.

BackgroundBortezomib-induced peripheral neuropathy (BIPN) is a common and debilitating side effect. Our pilot study demonstrated that acupuncture is safe and can decrease total neuropathic symptoms. However, there is lack of knowledge in which individual BIPN symptoms benefited from acupuncture.PurposeTo characterize individual symptoms reduced by acupuncture in patients with BIPN.MethodsPatients with multiple myeloma treated with bortezomib who developed BIPN grade 2 or above, based on National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), were enrolled and rece

Grzybowski's Generalized Eruptive Keratoacanthomas in a Patient with Terminal Kidney Disease-An Unmet Medical Need Equally Ameliorated by Topical Imiquimod Cream and Lapacho Tea Wraps: A Case Report.

IntroductionDevelopment of singular keratoacanthoma (KA) is generally considered a benign condition as it has a tendency to regress spontaneously in spite of histological similarity to squamous cell carcinoma. Most KAs undergo excision to rule out differential diagnoses. Several alternative treatment modalities (keratinolytic, ablative, immunomodulating, antiproliferative, or targeted therapy) have been described in the past with varying success, underlining the therapeutic challenges associated with large or multiple lesions. Isomorphic response (Koebner phenomenon) may limit the efficacy of

Chemotherapy-Induced Peripheral Neuropathy: Epidemiology, Pathomechanisms and Treatment.

PurposeThis review provides an update on the current clinical, epidemiological and pathophysiological evidence alongside the diagnostic, prevention and treatment approach to chemotherapy-induced peripheral neuropathy (CIPN).FindingsThe incidence of cancer and long-term survival after treatment is increasing. CIPN affects sensory, motor and autonomic nerves and is one of the most common adverse events caused by chemotherapeutic agents, which in severe cases leads to dose reduction or treatment cessation, with increased mortality. The primary classes of chemotherapeutic agents associated with CI

Dermatologic conditions in women receiving systemic cancer therapy.

As advances in cancer therapies have improved cancer-related survival, novel therapeutics have also introduced a variety of dermatologic toxicities, and an increased number of patients are living with these sequalae. Women with cancer in particular experience a spectrum of dermatologic conditions that affect their skin, hair, nail, and mucosal surfaces. Studies have shown that these toxic effects can significantly affect quality of life and alter a woman's self-image, cultural identity, femininity, sexuality, and mental health. In severe instances, dermatologic toxicities may even disrupt canc

Case report and review: Angiosarcoma with thrombocytopenia after total hip arthroplasty.

Total hip arthroplasty (THA) is a common treatment for osteoarthritis and is also performed for other conditions, such as secondary arthritis due to developmental dysplasia of the hip. Various THA types may be complicated by osteolysis and an inflammatory pseudotumor due to an adverse reaction to metal debris. Rarely, THA has been associated with malignant tumors, but their causality remains unclear. In this case report, we describe a female patient with developmental dysplasia of the hip. She had undergone left metal-on-polyethylene THA, acetabular revision of the THA, and left total knee art

Risk factors and time to symptomatic presentation in leukaemia, lymphoma and myeloma.

BackgroundUK policy aims to improve cancer outcomes by promoting early diagnosis, which for many haematological malignancies is particularly challenging as the pathways leading to diagnosis can be difficult and prolonged.MethodsA survey about symptoms was sent to patients in England with acute leukaemia, chronic lymphocytic leukaemia (CLL), chronic myeloid leukaemia (CML), myeloma and non-Hodgkin lymphoma (NHL). Symptoms and barriers to first help seeking were examined for each subtype, along with the relative risk of waiting >3 months' time from symptom onset to first presentation to a doctor

Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome.

The recent outbreak of Covid19 has required urgent treatments for numerous patients. No suitable vaccines or antivirals are available for Covid19. The efficiency against Covid19 of WHO therapies of choice, that are two antivirals developed for other pathologies, is controversial. Therefore, alternative approaches are required. Intravenous (IV) Vitamin C (Vit-C) has emerged as one of the other alternatives for this purpose. Here we review the effects of IV Vit-C on the immune system response, the antiviral properties of IV Vit-C, and finally the antioxidant properties of IV Vit-C to specificall