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In the early decades since the introduction in the early '80s of immunoglobulin therapy many studies tried to identify which clinical indications might benefit from the therapy, which treatment’s schedules are effective and safe. It is universally accepted that immunoglobulin therapy is a life-saving treatment in patients with PID. The rise of new indications for further different clinical conditions resulted in a steady increase in demand for immunoglobulins. Currently the consumption of immunoglobulin for PID represents a small fraction of the market. In the recent past we have been observing: 1) An increase in the demand for plasma and in the consequent need to increase the number of donors; 2) Changes in methods to improve IgG recovery and to increase productivity as a response to growing clinical demand; 3) Introduction of immunoglobulin treatments with higher concentration; 4) Changes in the timing of administration with an increase in the rate of infusion; 5) Introduction of immunoglobulin treatment administered subcutaneously mainly confined initially to patients with PID and later extended to other clinical indications which often require higher volumes of infusion. Doctors following patients with PID were initially alarmed only to a possible risk of shortage. More relevant and less discussed appear the possible consequences of: 1) the risk of an improper transfer of information on treatments from a clinical indication to another. In particular, the idea of a mere replacement function in patients with PID might possibly be borrowed from the model of other clinical conditions requiring a replacement such as haemophilia. In PID, immunoglobulin treatment instead is obviously replacing a missing feature. However, other immune alterations are responsible for the large number of PID-associated diseases including inflammatory manifestations and tumors, common causes of morbidity and mortality. The immunomodulatory effects of immunoglobulin administered at replacement dosages on multiple cells and immune system functions are still largely to be checked in in vitro studies and in vivo. 2) the changes in the immunoglobulin production and schedules of administration. These should have been assessed in studies of drug surveillance, necessary in order to evaluate on large numbers of what it is initially reported on patients enrolled in the pivotal clinical trials, usually in the absence of most of the main disease-associated clinical conditions affecting pharmacokinetics, efficacy and tolerability. Severe side effects are now more frequently reported. This requires surveillance studies in order to verify the tolerability. Nowadays, personalized health research presents methodologic challenges, since emphasis is placed on the individual response rather than on the population. Even within a universally accepted indication, such as in PID, the identification of prognostic markers should guide the therapeutic intervention. 3) the risk of a decrease in the surveillance and monitoring of PID-associated clinical conditions. In fact, self- administration of immunoglobulins administered subcutaneously increased the independence of a number of patients. On the other hand, it led to the reduction in the number of contacts between specialized centers and patients who often require a close monitoring of disease-associated conditions. A wide debate between experts is necessary to afford the new challenge on immunoglobulin usage.
Immunedeficienc --- Manufacture --- adverse events --- Personalised treatment --- Immunoglobulin Therapy --- Mechanism
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This concise book serves as a practical primer for the care of patients with primary brain tumors. Divided into two major sections, the first provides chapters with key information for each major brain tumor type. This includes basic information about etiology, epidemiology, clinical features, pathology, imaging, diagnostic workup, and treatment. The second section of the book features chapters that delve into supportive care management with specifics about management for each of the major conditions. This includes tumor-related epilepsy, venous thromboembolism in brain tumor patients, and corticosteroid management and toxicity. Detailed and clinically-focused information about chemotherapy regimens, dosing, monitoring, management of toxicities and patient education are also provided. Brain Tumors is a quick resource in the inpatient setting or in the clinic and educational resource to help new providers in the neuro-oncology field with the accumulated knowledge of clinicians with practical experience. .
Neurology. --- Internal medicine. --- Internal Medicine. --- Brain Neoplasms. --- Antineoplastic Agents. --- Drug-Related Side Effects and Adverse Reactions --- Radiotherapy --- adverse events. --- Brain --- Tumors.
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This open access book provides a concise yet comprehensive overview on how to build a quality management program for hematopoietic stem cell transplantation (HSCT) and cellular therapy. The text reviews all the essential steps and elements necessary for establishing a quality management program and achieving accreditation in HSCT and cellular therapy. Specific areas of focus include document development and implementation, audits and validation, performance measurement, writing a quality management plan, the accreditation process, data management, and maintaining a quality management program. Written by experts in the field, Quality Management and Accreditation in Hematopoietic Stem Cell Transplantation and Cellular Therapy: A Practical Guide is a valuable resource for physicians, healthcare professionals, and laboratory staff involved in the creation and maintenance of a state-of-the-art HSCT and cellular therapy program.
Haematology --- Oncology --- Hematology --- Blood Transfusion Medicine --- Internal Medicine --- outcome analysis --- structural indicators --- process indicators --- Hematopoietic Stem Cell Transplantation --- Quality Management --- Audits --- Qualification and Validation --- Personnel Requirements --- Performance Measurement --- Tracking and Traceability --- Adverse Events --- Quality Management Plan --- Accreditation --- Data Management --- Training --- Risk Management --- JACIE
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Cancer remains one of the main causes of morbidity and mortality worldwide. Although many pharmacological and clinical advances have been made, there is a constant need for new molecules to improve the overall options for treatment. Natural compounds from animal, microbial, vegetal, or fungal origin represent countless sources of new compounds that can be used as anticancer drugs, provided their activity, bioavailability, and toxicity are adequate. This book aims to compile both original articles and reviews that cover the most recent advances in the use of natural compounds for cancer treatment, and provide new objectives and advice for future research in the field of biological activity of natural compounds.
microbiota --- treatment --- n/a --- sulforaphane --- synergy --- epigenetic --- natural compound --- xenohormesis --- anticancer --- miR-663 --- tyrosine kinase inhibitors --- acetylation --- epidemiology --- double-blinded --- inflammation --- bladder cancer --- polypharmacology --- animal model --- synbiotics --- resveratrol --- royal jelly --- 5-aza-2’-deoxycytine --- saponins --- phenolics --- cardiovascular disease --- antioxidant --- colorectal cancer --- trypsin inhibitors --- seeds --- green tea --- Gac --- randomized clinical trial --- melanoma --- adverse events --- extraction --- microbiome --- Momordica cochinchinensis --- freeze dried extract --- renal cell carcinoma --- methylation --- cancer --- probiotics --- 5-aza-2'-deoxycytine
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Cardiology and cardiovascular sciences are two rapidly growing areas in medicine, with heart diseases being the number one cause of death worldwide. The last four decades have witnessed many developments in various cardiological sciences, including coronary artery disease, valve disease, heart failure, congenital heart diseases, and cardiovascular imaging, with a number of newly developed concepts, such as cardio-oncology, cardio-renal diseases, and preventive cardiology. This Special Issue (SI) of the Journal of Clinical Medicine, entitled “JCM-Advances in Cardiology”, focuses on recent advances in the cardiological sciences. It published 8 research articles of significant clinical and scientific value.
ST segment elevation myocardial infarction --- COVID-19 --- primary percutaneous intervention --- Coptic clergy --- mortality --- cardiovascular risk factors --- prevalence --- major adverse events --- obesity --- ACE2 --- renin–angiotensin system --- extraction --- reimplantation --- pacing --- ICD --- CRT --- dilated cardiomyopathy (DCM) --- LMNA --- lamin A --- lamin C --- next generation sequencing (NGS) --- myocarditis --- arrhythmias --- telemonitoring --- implantable cardioverter defibrillator --- implantable loop recorder --- Holter ECG --- metabolic-dysfunction-associated fatty liver disease (MAFLD) --- hepatic steatosis --- SteatoTest --- adipokines --- adiponectin --- visfatin --- cardiovascular disease --- n/a --- renin-angiotensin system
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Over the last few decades, remarkable progress has been made in understanding the aetiology and pathophysiology of diseases and many new theories emphasize the importance of the small bowel ‘ecosystem’ in the pathogenesis of acute and chronic illness. Emerging factors such as microbiome, stem cells, innate intestinal immunity and the enteric nervous system along with mucosal and endothelial barriers have key role in the development of gastrointestinal and extra-intestinal diseases. Therefore, the small intestine is considered key player in metabolic disease development, including diabetes mellitus, and other diet-related disorders such as celiac and non-celiac enteropathies. Another major field is drug metabolism and its interaction with microbiota. Moreover, the emergence of gut-brain, gut-liver and gut-blood barriers points toward the important role of small intestine in the pathogenesis of common disorders, such as liver disease, hypertension and neurodegenerative disease. However, the small bowel remains an organ that is difficult to fully access and assess and accurate diagnosis often poses a clinical challenge. Eventually, the therapeutic potential remains untapped. Therefore, it is due time to direct our interest towards the small intestine and unravel the interplay between small-bowel and other gastrointestinal (GI) and non-GI related maladies.
capsule endoscopy --- Crohn’s disease --- mucosal healing --- small bowel --- gut brain axis --- microbiota --- functional gastrointestinal disorders --- inflammatory bowel disease (IBD) --- adult stem cells --- surgical site infections (SSIs) --- probiotics --- prebiotics --- synbiotics --- surgery --- adverse events --- meta-analysis --- systematic review --- hyperspectral imaging --- multispectral imaging --- clinical diagnosis --- biomedical optical imaging --- gastroenterology --- medical diagnostic imaging --- small-bowel mass --- small-bowel bulge --- video capsule endoscopy --- cystic fibrosis --- gut microbiota --- intestinal inflammation --- fecal calprotectin --- dysbiosis index --- celiac disease --- biomarker --- serology --- enteropathy --- n/a --- colon cancer --- cancer risk --- collagenous colitis --- lung cancer --- microscopic colitis --- skin cancer --- squamous cell carcinoma --- Crohn's disease
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Adverse drug reactions are one of the major constraints when using drugs. These adverse reactions can impact healthcare systems as strongly as many prevalent diseases. Identifying DNA variants associated with adverse drug reactions can help personalize medicine and sustain healthcare systems. This book delves into new advances in pharmacogenetics of cardiovascular, cancer, and nervous system drugs. It may be useful for clinicians and patients to understand the basics of pharmacogenetics.
5-fluorouracil --- capecitabine --- fluoropyrimidine --- thymidylate synthase --- thymidylate synthase enhancer region --- upstream stimulatory factor 1 --- adverse drug reactions --- pharmacogenomics --- epistasis --- random forest --- statin --- cardiovascular disease --- colorectal cancer --- personalised medicine --- toxicity --- (es)citalopram --- drug-gene-interaction --- drug-drug-interaction --- drug-drug-gene-interaction --- the PharmLines initiative --- antipsychotic agents --- pharmacogenetics --- cytochrome P-450 enzyme system --- psychotic disorders --- precision medicine --- direct oral anticoagulants --- clinical implementation --- atorvastatin --- SLCO1B1 --- HLA --- cutaneous adverse drug reaction --- SCAR --- genetic polymorphism --- antiepileptics --- CYP450 enzymes --- platelet reactivity --- single-nucleotide variants --- acute coronary syndrome --- clopidogrel --- genotype --- allele --- polymorphism --- HLA B --- CYP2C9*3 --- cutaneous adverse drug reactions (CADRs) --- anti-epileptic drugs (AEDS) --- phenytoin (PHT) --- genetic risk factors --- South India --- India --- cardiology --- adverse events --- guidelines --- n/a
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Conventional lung cancer treatments were once limited to surgery, radiation, and chemotherapy. However, gefitinib, a targeted drug, was launched in 2004, and the situation changed. Cancer cases that were highly responsive to gefitinib were later discovered to have epithelial growth factor receptor (EGFR) mutations. This discovery opened the door for biomarker-based treatment strategies. Subsequently, several EGFR-tyrosine kinase inhibitors (TKI) were developed, and they became a new mainstay of treatment for non-small cell lung cancer. In recent years, many mechanisms of resistance to EGFR-TKI have been elucidated; a mutation in the T790M gene at exon 20 is found in half of the resistant cases. Hence, osimertinib, which specifically inhibits EGFR despite this T790M gene mutation, was developed to achieve long-term progression-free survival. Other driver mutations that are similar to the EGFR mutation were discovered, including the EML4-ALK fusion gene (discovered in 2007), ROS1 gene, and BRAF gene mutations. The TKIs for each of these fusion genes were developed and are used as therapeutic agents. Another advancement in advanced non-small cell lung cancer is the development of immune checkpoint inhibitors. Four PD-1/PD-L1 inhibitors, including nivolumab, are currently available for treatment of lung cancer. These drugs prevent an escape from the cancer immunity cycle. This ensures that cancer cells will express cancer antigens, causing an anticancer immune response. Due to cancer immunotherapy, long-term survival is possible. The biomarker development for cancer immunotherapy and its side effects are actively being studied.
non-small cell lung cancer --- previously treated patients --- phase I/II trial --- chemotherapy --- docetaxel --- S-1 --- immunotherapy --- rechallenge --- retrospective analysis --- pulmonary pleomorphic carcinoma --- prognostic factor --- glucose transporter 1 --- lung cancer --- multiple cancers --- metastasis --- sequencing --- mutation --- genomic diagnosis --- FDG-PET --- immune checkpoint inhibitor --- PD-1 --- prognosis --- RAD51B methylation --- PD-L1 expression --- predictive biomarker --- PD-1 blockade --- interstitial lung disease --- pulmonary fibrosis --- radiology and other imaging --- non-small-cell lung cancer --- epidermal growth factor receptor --- tyrosine kinase inhibitors --- TP53 mutations --- responsiveness --- targeted therapy --- network meta-analysis --- stage IIIA-N2 --- surgery --- immune checkpoint inhibitors --- biomarker --- nonsmall cell lung cancer --- HIP1R --- PD-L1 --- RUNX1 --- methylation --- survival --- EGFR-TKI --- T790M --- osimertinib --- immune-related adverse events --- endocrine disorders --- tumor-bearing patients --- PD-1 inhibitors --- PD-L1 inhibitors --- meta-analysis --- nivolumab --- Expanded Access Program --- real-world data --- daily practice --- prognostic factors --- NSCLC --- KRAS --- DNA polymerase beta --- platinum-based first-line --- adjuvant chemotherapy --- β-catenin --- lung neoplasms --- nucleotide-diphosphate kinase --- recurrence --- unresectable --- salvage surgery --- oligometastasis
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