Guidelines for Complications of Cancer Treatment Vol VIII Part B

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12. Hancock S, Hoppe R. Long-term complications oftreatment and cancer mortality after Hodgkin’s disease.Semin Radiat Onco; 6:225-242. (1996)13. Hancock, S.L., Donaldson, S.S. and Hoppe, R.T. Cardiacdisease following treatment of Hodgkin’s disease inchildren and adolescents. J. Clin. Oncol. 11: 1208–1215.(1993)14. Stewart, J. R.; Fajardo, L. F. Dose response in humanand experimental radiation-induced heart disease.Application of the nominal standard dose (NSD)concept. Radiology; 99:403-408. (1971)15. Stewart J, Hancock E, Hancock S. radiation injury toheart: risk factors, diagnosis, prevention and treatment.Front Radiat Ther Oncol (1998)16. Donaldson SS, Kaplan HS. Complications of treatmentof Hodgkin’s disease in children. Cancer Treat Rep;66:977-989. (1982)17. Byhardt R, Brace K, Ruckdeschel J, Chang P, Martin R,Wiernik P. Dose and treatment factors in radiation-relatedpericardial effusion associated with the mantle techniquefor Hodgkin’s disease. Cancer; 35:795-802. (1975)18. Glanzmann C, Kaufmann P, Jenni R, Hess OM,Huguenin P. Cardiac risk after mediastinal irradiationfor Hodgkin’s disease. Radiothr Oncol; 46:51-62. (1998)Suggested Reading:J Clin Oncol. 2007 Sep 1;25(25):3991-4008. Epub2007 Jun 18.American Society of Clinical Oncology clinical evidencereview on the ongoing care of adult cancer survivors: cardiacand pulmonary late effects.307
Carver JR, Shapiro CL, Ng A, Jacobs L, Schwartz C, VirgoKS, Hagerty KL, Somerfield MR, Vaughn DJ; ASCOCancer Survivorship Expert Panel.Abramson Cancer Center of the University of Pennsylvania,Philadelphia, PA, USA.PURPOSE: To review the evidence on the incidence of longtermcardiac or pulmonary toxicity secondary to chemotherapy,radiotherapy, or trastuzumab in symptomatic andasymptomatic cancer survivors. METHODS: An AmericanSociety of Clinical Oncology Panel reviewed pertinentinformation from the literature through February 2006.RESULTS: Few studies directly addressing the benefits ofscreening for long-term cardiac or pulmonary toxicity inasymptomatic cancer survivors who received chemotherapy,radiotherapy, or trastuzumab were identified. The reviewedliterature included primarily retrospective and cross-sectionalstudies describing the incidence of cardiac and pulmonary lateeffects. Anatomic and/or functional abnormalities have beenassociated with use of all currently available anthracyclinesand their derivatives. Trastuzumab-related cardiac dysfunctionrarely causes death, and in most cases is reversible withimprovement in cardiac function on drug discontinuation and/or treatment with cardiac medications. The estimated aggregateincidence of radiation-induced cardiac disease is 10% to 30%by 5 to 10 years post-treatment, although the incidence maybe lower with modern techniques. Radiation pneumonitis isreported in 5% to 15% of lung cancer patients receivingdefinitive external-beam radiation therapy. A minority ofpatients may develop progressive pulmonary fibrosis; latecomplications include cor pulmonale and respiratory failure.Bleomycin-induced pneumonitis is an acute rather than lateeffect of treatment. Late pulmonary complications in bonemarrow or stem cell transplantation patients who developinterstitial pneumonitis include idiopathic pneumonia308
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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
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difference in the disease related p
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References1. Bourhis J, Rosine D. R
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with head and neck cancer. N Engl J
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MucositisMucositis is an inflammato
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Type of cancer: high risk for mucos
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Oral care protocol1. Brush all toot
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3. El-Sayed S, Nabid A, ShelleyW, e
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1) Recipient site problems- The maj
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estoration of vascular flow to tiss
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General Complications- Deep vein th
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Nerve Injuries(Recurrent and Superi
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paramedian position, it will result
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along with its variations, and a me
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anatomy as related to surgery of th
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Risk factorsCentral compartment (Le
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Goal - To raise serum calcium level
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Pharyngocutaneous Fistula (PC Fistu
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Based on our institutional practice
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fistula: The Memorial University ex
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Risk factors (LOE-5)Patient factors
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oCircumferencial excision and inser
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y trauma or tumor, exposing the und
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Arytenoid cartilage is reported to
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Filntisis, G.A., et al. “Laryngea
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As high as 52% patients are detecte
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ManagementPostural exercisesDisorde
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References1) Objective assessment o
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Diagnosis Average time to hypothyro
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Management of Facial Nerve InjuryIn
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2. Interposition or cable graft (to
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Prevention of corneal exposure Tars
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flushing) and localized sweating (g
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Other options :1. Intracutaneous in
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Shoulder Dysfunction or PainfulShou
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EMG studies on scapulo-humeral and
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Chyle Fistula after Neck Dissection
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Rationale:LCTs, which constitute 70
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CSF Leak after Craniofacial Resecti
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to the muscle to recreate the orbit
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Conservative treatmentIt is logical
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Complications Associated with use o
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Following is the example of hematol
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ooooooo direct interaction with the
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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
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Page 281 and 282: Acute symptoms usually subside seve
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Page 287 and 288: patients who have received radical
Page 289 and 290: ate expected in the standard popula
Page 292 and 293: adjusting for competing causes of d
Page 294 and 295: therapy (3D-CRT) and intensity modu
Page 296 and 297: attributed to use of cisplatin base
Page 298 and 299: Conclusion:Incidence of SMN is incr
Page 300 and 301: 11. Travis LB, Fossa SD, Schonfeld
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Page 306 and 307: 5.65%) within 45 years after a CNS
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Page 310 and 311: without calcification. Inflammation
Page 312 and 313: patients treated using the original
Page 314 and 315: incidence of valvular thickening at
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Page 320 and 321: Darby SC, McGale P, Taylor CW, Peto
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Page 324 and 325: Pathophysiological Aspects:The func
Page 326 and 327: Symptoms: Symptoms related to pulmo
Page 328 and 329: Prevention of Pneumonitis and Lung
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Page 336 and 337: Int J Radiat Oncol Biol Phys. 1995
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Page 340 and 341: Differential Diagnosis: This sign i
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Page 344 and 345: PET scan findings have been describ
Page 346 and 347: 3. Pallis CA, Louis S, Morgan RL.:
Page 348 and 349: 24. Abbatucci JS, Delozier T, Quint
Page 350 and 351: and summarized into specific recomm
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Page 354 and 355: Complications are mainly described
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Page 360 and 361: development after brain tumor thera
Page 362 and 363: Highest relative risk of second can
Page 364 and 365: 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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