Guidelines for Complications of Cancer Treatment Vol VIII Part B

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ManagementPostural exercisesDisorder for which Posture Effects of oropharyngealposture appropriatedimensions and bolus(symptom of disorders) flowInefficient oral Chin up Uses gravity to clean oraltransitcavity from bolus(reduced posteriorlingual propulsionof bolusDelay in triggering Chin down Widens valleculae tothe pharyngealprevent bolus enteringswallowairway, narrows airway(blous past ramusentrance ,reducing risk ofof mandible,aspirationbut pharyngealswallow is nottriggered)Reduced posterior Chin down Pushes tongue base closemotion of theto the posteriortongue basepharyngeal wall(residue invalleculae)Reduced closure Chin down Puts epiglottis is moreof laryngealprotective position:entrance andnarrows laryngealvocal foldsentrance(aspiration duringswallow)221
Head rotated to the Improves vocal folddamaged sideclosure by applyingextrinsic pressureUnilateral Head rotated to the Eliminates damaged sidepharyngeal paresis damaged side of pharynx from bolus(residue onpathone side of thepharynx)Unilateral oral Head tilt to stronger Direct bolus downand pharyngeal side stronger side by gravityweakness on thesame side(residue in mouthand pharynx onsame side )Reduced Lying down on Eliminates the effect ofpharyngeal one side gravity on pharyngealcontractionresidue(residue spreadthroughoutpharynx)Cricopharyngeal Head rotated Pulls cricoid cartilagedysfunctionaway from posterior(residue inpharyngeal wall, reducingpyriform sinuses)resting pressure in cricopharyngeal sphincterRationale for application of Postural techniques to variousswallowing disorders.Logeman A., Jeri (1998), Chapter 5: Evaluation of swallowingdisorders. Evaluation and Treatment of swallowing disorderssecondedition,181.Chapter 6: Management of the patient with oropharyngealswallowing disorders, 198222
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Guidelines forComplications ofCance
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Dedicated toAll our patients atThe
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Section IIHead & Neck 151Complicati
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PrefaceTreatment of cancer by vario
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Section — IGeneralContributorsDr.
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6. Complications after breast recon
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promises to reduce this risk of ser
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preceded by increased sensory hyper
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had significant lymphoedema. The fa
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2. Smoking as a risk factor for wou
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4. Preoperative core needle biopsy
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eduction mammoplasty, and axillary-
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postoperative wound infection follo
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ablative surgical treatment for car
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postoperative seroma formation usin
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dressing consisted of a circumferen
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mastectomies with axillary node cle
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mastectomy for breast cancer. Early
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monitored for the development of po
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modality, and tumor stage distribut
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26. Pain and other symptoms during
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28. Coping, catastrophizing and chr
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surgical technique at the time of m
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0.001), 0.315 cm +/- 1.27 at the an
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or heat and superficial incision is
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RecommendationsA. Preparation of th
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3. Mangram AJ, Horan TC, Pearson ML
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Mild hypothermia increases blood lo
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Perioperative Normothermia to Reduc
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Priorities: Restoration of circulat
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than 1.5 times control values but f
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outcomes that may result from the u
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Preoperative Preparation of the Pat
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patients, or other patients who may
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Obstruction can occur at the level
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c. Administer face mask preoxygenat
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5. The use of exhaled carbon dioxid
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disorder) may occur after an episod
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undergoing general anesthesia, eith
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anesthesia awareness occurred in ea
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The current guidelines are actually
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o S - Strong Recommendation -Commit
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oSource control ASAP after successf
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oooWean steroids once vasopressors
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Mechanical ventilation of sepsis-in
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o CVVH offers easier management inh
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critically ill patient that are con
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Rivers E, Nguyen B, Havstad S, et a
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in survival of 7.6%. By the second
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parameters (gastric mucosal Pco2, s
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syndrome. We therefore conducted a
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Complications After Limb SalvageSur
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local tumor and to preserve as much
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femoral head to the center of the k
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4. Griffin AM, Parsons JA, Davis AM
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20. Roberts P, Chan D, Grimer RJ, e
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An infection can have disastrous co
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and facilitating reimplantation sur
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features of a two-stage revision is
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patients had an amputation. Two oth
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its main role is confined to ruling
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2. Capanna R, Morris HG, Campanacci
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21. Wilson MG, Kelley K, Thornhill
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39. Love C, Marwin SE, Tomas MB, Kr
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5. A systematic review of 25 RCT’
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(cefazolin or cefuroxime) or penici
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should be based on the isolates fro
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such as concomitant use of prophyla
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Surgical techniqueAdherence to meti
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2. Another small prospective random
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Antibiotic prophylaxis for dental a
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Antimicrobial Prophylaxis in Orthop
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35. Tai CC, Nirvani AA, Holmes A, e
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53. Parker MJ, Roberts C. Closed su
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Vessel Related Issues in Sarcoma:Ev
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sequences may be of value. They cau
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an excellent alternative to amputat
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5. Hünerbein M, Hohenberger P, Str
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Oral IncompetenceOral competence is
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flap is insensate and has no motor
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16. R. Song, Y. Gao, Y. Song, Y. Yu
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The incidence is usually lower afte
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Late fibrotic phase: Attempted tiss
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Ref: A Lyons, N Ghazali/ British J
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17. Store G, Boysen M. Mandibular o
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amino acids, proteins and traces of
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RTOG, EORTC and CTCAE, version 3 fo
Page 180 and 181: difference in the disease related p
Page 182 and 183: References1. Bourhis J, Rosine D. R
Page 184 and 185: with head and neck cancer. N Engl J
Page 186 and 187: MucositisMucositis is an inflammato
Page 188 and 189: Type of cancer: high risk for mucos
Page 190 and 191: Oral care protocol1. Brush all toot
Page 192 and 193: 3. El-Sayed S, Nabid A, ShelleyW, e
Page 194 and 195: 1) Recipient site problems- The maj
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Page 198 and 199: General Complications- Deep vein th
Page 200 and 201: Nerve Injuries(Recurrent and Superi
Page 202 and 203: paramedian position, it will result
Page 204 and 205: along with its variations, and a me
Page 206 and 207: anatomy as related to surgery of th
Page 208 and 209: Risk factorsCentral compartment (Le
Page 210 and 211: Goal - To raise serum calcium level
Page 212 and 213: Pharyngocutaneous Fistula (PC Fistu
Page 214 and 215: Based on our institutional practice
Page 216 and 217: fistula: The Memorial University ex
Page 218 and 219: Risk factors (LOE-5)Patient factors
Page 220 and 221: oCircumferencial excision and inser
Page 222 and 223: y trauma or tumor, exposing the und
Page 224 and 225: Arytenoid cartilage is reported to
Page 226 and 227: Filntisis, G.A., et al. “Laryngea
Page 228 and 229: As high as 52% patients are detecte
Page 232 and 233: References1) Objective assessment o
Page 234 and 235: Diagnosis Average time to hypothyro
Page 236 and 237: Management of Facial Nerve InjuryIn
Page 238 and 239: 2. Interposition or cable graft (to
Page 240 and 241: Prevention of corneal exposure Tars
Page 242 and 243: flushing) and localized sweating (g
Page 244 and 245: Other options :1. Intracutaneous in
Page 246 and 247: Shoulder Dysfunction or PainfulShou
Page 248 and 249: EMG studies on scapulo-humeral and
Page 250 and 251: Chyle Fistula after Neck Dissection
Page 252 and 253: Rationale:LCTs, which constitute 70
Page 254 and 255: CSF Leak after Craniofacial Resecti
Page 256 and 257: to the muscle to recreate the orbit
Page 258 and 259: Conservative treatmentIt is logical
Page 260 and 261: Complications Associated with use o
Page 262 and 263: Following is the example of hematol
Page 264 and 265: ooooooo direct interaction with the
Page 266 and 267: ooooointravenously over 15 minutes
Page 268 and 269: in most of the patients. The common
Page 270: Section — IIIRadiotherapyContribu
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Page 275 and 276: function. In general, with conventi
Page 277 and 278: like ultrasonography, CT scan, endo
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Acute symptoms usually subside seve
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granulocytopenia, thrombocytopenia
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adiation therapy), IMRT (intensity-
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patients who have received radical
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ate expected in the standard popula
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adjusting for competing causes of d
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therapy (3D-CRT) and intensity modu
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attributed to use of cisplatin base
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Conclusion:Incidence of SMN is incr
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11. Travis LB, Fossa SD, Schonfeld
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adiation-related solid SMNs will in
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0.71, p
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5.65%) within 45 years after a CNS
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adiation damage though supporting v
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without calcification. Inflammation
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patients treated using the original
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incidence of valvular thickening at
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12. Hancock S, Hoppe R. Long-term c
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syndrome and bronchiolitis oblitera
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Darby SC, McGale P, Taylor CW, Peto
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undertaken, based on individual pat
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Pathophysiological Aspects:The func
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Symptoms: Symptoms related to pulmo
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Prevention of Pneumonitis and Lung
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genotyping analysis of single nucle
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Registry of Patients. We computed I
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eceived elective nodal irradiation
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Int J Radiat Oncol Biol Phys. 1995
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worsening during the treatment shou
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Differential Diagnosis: This sign i
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Dose Incidence Comments Author>30 G
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PET scan findings have been describ
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3. Pallis CA, Louis S, Morgan RL.:
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24. Abbatucci JS, Delozier T, Quint
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and summarized into specific recomm
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adequate. With the increasing use o
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Complications are mainly described
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IQ decline is associated with sever
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activity’ of a person, essentiall
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development after brain tumor thera
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Highest relative risk of second can
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Suggested Reading:A) Neuropsycholog
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aseline. Male sex, longer symptomat
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number of patients. Cognition was p
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16 years, the corresponding value w
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15 of 20 (75%) subjects, endocrine
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OBJECTIVE: To assess cerebrovascula
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hypometabolism. Of the 17 patients
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10-20 months, with an average of 18
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Febrile NeutropeniaNeutropenia is w
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Approach to initial antibiotic use
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Known colonization with Penicillin/
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DocumentedinfectionsSuggesteddurati
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Zygomycosis and other mold infectio
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Overall risk Examples Febrile neutr
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Broad spectrum DOSE Spectrum Commen
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Role of G-CSF-Primary Prophylaxis:R
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Chemotherapy Induced Nausea andVomi
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Level I Level II Level III Level IV
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Types & doses of AntiemeticsDrug &
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supported by a meta-analysis, which
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and follow-up after treatment for n
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day 1; aprepitant and dexamethasone
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2-3: APR 80 mg every day) or a cont
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Late Effects in Childhood CancerSur
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to increase their awareness about l
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Contd...Score2BStatement of consens
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6 Kurkure PA, Achrekar S, Uparkar U
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nonirradiated group did not differ
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Gaslini Children’s Research Hospi
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Our ACT model has 3 basic facets; p
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The relative risk of developing TLS
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the excretion of uric acid and phos
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hyperuricemia (> 7.5 mg/dL), treatm
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hydration, and the administration o
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which the different drugs are admin
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Table 2. Cairo-Bishop clinical Tumo
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Table 4 Patient Stratification by R
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Table 6 Management of Electrolyte A
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of TLS and improve the management o
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4. Efficacy and safety of rasburica
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Pulmonary Toxicity of Antineoplasti
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Though there are many chemotherapeu
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corticosteroids with variable respo
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Nephrotoxicity ofChemotherapeutic D
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associated with use of carbopltin c
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Table 2 Chemotherapeutics Requiring
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against ifosfamide nephrotoxicity.
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The incidence of mucositis involvin
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7. Obesity - Probably due to over d
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conditioning treatment and for 3 da
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References and Recommended Readings
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metabolism for activity, cyclophosp
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delays excretion and eventually res
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Combination Chemotherapy:Combinatio
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Vincristine: No dose reduction if b
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19. Slichenmyer WJ, Rowinsky EK, Gr
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AlopeciaCommon drugs causing alopec
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dependent, occurring from 8 days to
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Cancer Induced Anemia (CIA)Introduc
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system. There is an upregulation of
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time may represent increasing anemi
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(rHuEPO) whiles the other received
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Table 3. Improvements in Hemoglobin
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2. Groopman JE, Itri LM. Chemothera
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epoetin alfa versus oral iron or no
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NOTES
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