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Articles Related to Therapy

Radiation Dose to Oesophagus in Breast Cancer Patients Receiving Radiation Therapy: A Retrospective Study

Background: Breast cancer is the most common cancer in women worldwide. Management of Breast cancer requires multidisciplinary team approach (viz, Surgery, Chemotherapy, Radiation therapy, Hormonal therapy & Targeted therapy). Radiotherapy reduces the risk of breast cancer mortality for women after breast conserving surgery and for women after mastectomy for node-positive disease. One of the organs at risk in breast cancer therapy is esophagus. As such, there is potential to expose greater volumes of esophagus to radiation. This may result in increased frequency and severity of acute radiation esophagitis during treatment. Aims and Objectives: To evaluate dosimetric parameters such as mean dose (Dmean) maximum dose (Dmax) which may influence the incidence and severity of esophagitis in breast cancer patients receiving radiotherapy. Material and Methods: Treatment plans of post mastectomy patients who had already received adjuvant RT of dose 50 Gy in 25 # over 5 weeks to the chest wall along with Supraclavicular field (SCF) using 3-Dimensional Conformal Radiation Therapy (3D CRT) and Intensity Modulated Radiation Therapy (IMRT) were selected. Mean dose (Dmean) and maximum dose (Dmax) to esophagus was assessed. Results: Dosimetric parameters assessed are Dmean and Dmax. Dmean assessed up to less than or equal to 11Gy and Dmax assessed upto less than or equal to 34Gy. The average of Dmean in this study is 8.34Gy which is within normal limits of prescribed dose. The mean Of Dmax in this study is 24.80Gy which is in limits of prescribed dose. Conclusion: Increased dose to esophagus in observed when IMRT is used especially when supraclavicular or internal mammary nodes are involved. Routine contouring of esophagus and planning accordingly may reduce oesophageal dose and acute oesophageal toxicity.
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Therapy-related Myeloid Neoplasms after Pediatric Solid Cancer in a Single Reference Cancer Center in Brazil

Pediatric cancer overall survival has increased due to improvements in treatment. However, long-term adverse effects are a challenge for this population. Secondary myeloid neoplasm (MN) is one of the complications of solid tumor treatment. Therapy-related myeloid neoplasms (t-MN), therapy-related acute myeloid leukemia (t-AML), and therapy-related myelodysplastic syndrome (t-MDS) are the most common events. The aim of this study was to report a large pediatric sample and the relevance of t-MN after pediatric solid tumor therapy. We conducted a retrospective study between 2000-2016 in a cohort of pediatric patients treated for solid tumors who developed a secondary MN by medical records review and analysis. Seven from 2178 pediatric patients who were previously treated for solid tumors, were diagnosed with t-MN in a reference cancer center in Brazil. The median age at primary tumor diagnosis was 12.8 years old. Osteosarcoma, atypical primitive neuroectodermal tumor (PNET), Ewing sarcoma, and retinoblastoma were the most frequent solid tumors associated with t-MN. Three patients had a story of familiar cancer, and one patient with osteosarcoma had Li-Fraumeni syndrome confirmed. The median latency period to secondary MN was ten months and the prevalence rate was 0.32%. Two patients developed t-MDS and five, t-AML. All these patients received cytotoxic agents’ high doses that may have been associated with t-MN development. t-MN initial control, as well as unfavorable cytogenetic abnormalities, may have contributed to the poor outcome. We described the rarity of t-MN related to previous solid tumor therapy in a large pediatric sample in a Brazilian Cancer Center and their poor prognosis.
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The Presence of Minority HIV Drug Resistance Variants in The Protease and Gag Regions Confers Poor Response to Therapy Among Subtype A And D Patients

Objective: To determine the prevalence of minority drug resistance variants in the protease and Gag regions among patients failing a protease inhibitor (PI) based regimen with or without a susceptible genotype based on Sanger sequencing technology. Methods: Samples were obtained from patients who were failing on a protease inhibitor-based regimen (n = 500). Sanger based sequencing was performed as part of the standard of care. Mutation analysis was performed using the Stanford HIV drug Resistance database. A subset of these patient samples was grouped into two categories: those failing a PI based with mutations in the protease region (n = 100) and those failing on a PI based regimen without mutations in the protease region (n = 128). These samples were then analyzed in the protease and Gag regions using Next Generation Sequencing (NGS) technology and analysis of the drug resistance mutations was performed at the 20% and 1% cutoffs. Results: An initial analysis of the protease region for patients failing with drug resistance mutations revealed that most patients harbored mutations that confer resistance to Lopinavir and Atazanavir, but these mutations had little effect on Darunavir. Furthermore, NGS revealed that in patients failing with and without drug resistance mutations, minority drug resistance mutations were present at each of the drug resistance codons and at codons that confer multi-drug resistance to protease inhibitors. Further analysis of the Gag gene revealed more genetic diversity among patients failing with no mutations in the protease as evidenced by the proportion of polymorphisms at each codon. Conclusion: Based on Sanger sequencing, a proportion of patients fail a PI based regimen with a susceptible genotype. However, these patients harbor minority variants in the protease and numerous polymorphisms in the Gag region which when combined these could explain their poor response to therapy. Therefore, in order to improve patient care in low resource settings, there is need to adapt NGS as the standard genotyping technique so that minority variants are captured much earlier. In addition, since mutations in the Gag region also play a role in response to PIs, this region should be included in the routine monitoring for response to therapy in patients on a PI based regimen.
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Liquorice-Induced Pseudohyperaldosteronism with Severe Hypokalaemia in a Young Patient Living with HIV: A Rare Case Presentation and Literature Review

HIV-1 infection treatment has greatly improved with the availability of combined antiretroviral therapy (cART). Unlike Tenofovir Disoproxil Fumarate, Tenofovir Alafenamide has a more favourable renal profile, even if proximal tubulopathy and electrolyte disturbances have been reported. As earlier as 4000 years ago, liquorice root was used for some medical treatments. Excessive liquorice intake is described to cause a state of mineralocorticoid excess. However, liquorice-induced hypokalaemia usually occurs with mild clinical manifestations and a severe presentation is rare.
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Analysis of Risk Factors of Acute Myocardial Infarction Combined with Ventricular Septal Rupture

A total of 2090 cases of acute myocardial infarction and 63 cases of acute myocardial infarction combined with ventricular septal perforation were collected from Fuwai Huazhong Cardiovascular Hospital from September 2017 to January 2021. 189 cases of type 1 acute myocardial infarction were randomly selected according to the ratio of 1:3 as a control group, the patients collected and analyzed clinical data, the risk factors of AMI and VSR.
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Cardio-Vascular Outcome Assessment of Dual Antiplatelet Therapy beyond 12 Months Following Drug Eluting Stent Implantation - Real World Scenario

In spite of recommendation for antiplatelet therapy following drug eluting stent (DES) implantation, the prescription for antiplatelet therapy in real world clinical practice varies from centre to centre as per physician discretion. The study was intended to assess the cardiovascular outcomes and bleeding complications of dual antiplatelet therapy (DAPT) beyond 12 months following DES implantation.
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Correlation between Overall Survival and Quality of Life in Patients with Esophageal Cancer: A Comparison between Radiation and Chemoradiation

Desirable treatment options for inoperable esophageal cancer considering not only overall survival (OS) but also quality of life (QOL) during the entire clinical course remain unclear. We evaluated OS and QOL during the clinical course of patients with inoperable esophageal cancer undergoing chemoradiation or radiation. Forty-four patients with inoperable esophageal cancer between 2015 and 2020 were included in this retrospective study.
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The Pharyngeal Muscle Trainer for the Therapy of Primary Snoring -An innovative therapy approach

Snoring is a concomitant of sleeping. This phenomenon is not only considered annoying, but also often taboo because it affects the privacy of those affected. In addition, however, snoring can be the cause of sometimes life-threatening diseases, such as hypertension, stroke and myocardial infarction.
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Two-Years Follow-Up in a Multidrug-Resistant HIV-1-Infected Woman Treated with Ibalizumab

Diarrhoea is a common and diverse aetiology problem in HIV infected patients that can cause deterioration in the quality of life, malnutrition and failure of antiretroviral therapy (ART). Ibalizumab (IBA), a humanized monoclonal antibody that binds to domain 2 of CD4 T lymphocytes receptor, has been recently approved for treating adults infected with multidrug-resistant HIV-1 infection for whom it is otherwise not possible to construct a suppressive antiviral regimen.
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Long-Term Survival in Glioblastoma: Case Report

Glioblastoma is the most common and most deadly type of primary brain malignant tumors. despite applying the best trimodal treatment consisting of surgery chemoterapy and radiotherapy, there are few patients who survive decades after treatment.
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Successful use of Eltrombopag for Management of Temozolomide Related Severe Prolonged Thrombocytopenia and Aplastic Anaemia in The Treatment of Glioblastoma Multiforme (GBM) in a Regional Centre: A Case Report and Literature Review

Temozolomide is an orally administered chemotherapeutic drug used concurrently with radiation for the treatment of newly diagnosed glioblastoma. Although the addition of Temozolomide has shown to improve overall survival, it is commonly associated with haematological complications. Eltrombopag is an oral thrombopoietin (TPO) receptor agonist that is also used off-label for temozolomide-induced aplastic anaemia.
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Multiple Sclerosis Disease Modifying Therapy and Cancer risks

Multiple sclerosis (MS) is a chronic inflammatory condition not commonly associated with cancer. Although since 1993 with the introduction of disease modifying therapies (DMTs), changing the natural history of the disease, cancer risk appears associated with some of these new therapies. We present the most common risks associated with each DMTs.
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Hyperbaric Oxygen Therapy Improves Cognition in Patients Severe TBI; A Prospective Study

Cognitive impairment post TBI is an important factor in rehabilitation outcomes. Pharmacological and therapeutic services do not directly address damage to the cortical infrastructure. Hyperbaric Oxygen Therapy is known to improve brain function and healing.
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Drug Therapy Problems and Clinical Outcomes Among Patients with Human Epidermal Growth Factor Receptor 2 (HER2) Positive Breast Cancer on Trastuzumab-Based Therapy in a Kenyan Tertiary Health Facility

Breast cancer ranks first among the most commonly diagnosed cancers in Kenyan females and globally. Treatment is challenging because it is a heterogeneous disease with several subtypes. There has been a significant change in the treatment of Human Epidermal Growth Factor Receptor 2 (HER2) positive breast cancer subtypes following the introduction and widespread use of HER2 targeted therapies.
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Effect of Seed Thermotherapy to Reduce the Viral Diseases of Faba Bean (Vicia Faba L.) in the Interandean Valley of Cochabamba, Bolivia

In Bolivia, the faba bean (Vicia faba L.) is cultivated in the Andean region, Altiplano and Interandean valleys. In these valleys mediumsized and early varieties are cultivated.
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Editorial Board Members Related to Therapy

Emil Bulatov

Associate Professor
Department of Chemical Biology Group
Institute of Fundamental Medicine and Biology
Kazan Federal University
Russia

Rammurti T. Kamble

Professor of Medicine
Baylor College of Medicine
United States

Seyed Khosrow Tayebati

Professor
Department of Experimental Medicine and Public Health
University of Camerino
Italy

Rajajeyakumar Manivel

Assistant Professor
Department of Physiology
Chennai Medical College Hospital & Research Centre (SRM Group)
Irungalur, Trichy, Tamilnadu
India

Massimo Caputo

Professor
Congenital Cardiac Surgery
Bristol Heart Institute
United Kingdom

Tao Liu

Children's Cancer Institute
University of New South Wales
Australia

Ren-Ke Li

Professor
Laboratory Medicine and Pathobiology
University of Toronto
Canada

BRUCE D CHESON

Professor of Medicine
Division of Hematology and Oncology
Georgetown University Hospital
United States

Alain L Fymat

President/CEO and Professor
International Institute of Medicine and Science
Rancho Mirage
California
USA

ADRIAN M. BARANCHUK

Associate Professor
Department of Biomedical and Molecular Sciences
Queen’s University
Canada
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