Guidelines for Complications of Cancer Treatment Vol VIII Part B

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dependent, occurring from 8 days to 15 years after radiationtherapy. The shorter the time interval the more severe thereaction is. The higher doses of the initial radiation may playa role as well. The mechanism of action is not clear but theoriesimplicate both microvasculature effects, stem cell damage withdefective repair mechanisms, and impaired cutaneousimmunologic action 9Hyperpigmentation and Nail ChangeHyperpigmentation of the skin and nails and nail changes arevery common with chemotherapeutic drugs. The commondrugs causing these changes are arsenic trioxide, bleomycin,cisplatin, flurouracil, methotrexate and hydroxyurea. Hairchanges may also occur with regrowth. Many theories havebeen suggested, including a direct toxic effect on melanocytes,increased drug presence due to vascular changes, and increasedtoxicity of the skin secondary to eccrine gland drug secretion.Increased levels of adrenocorticotropic hormone (ACTH) andmelanocyte stimulating hormone (MSH) and drug-induceddepletion of tyrosinase inhibitors have been suggested aspotential factors 9 Postinflammatory hyperpigmentation froma variety of cutaneous eruptions is also seen.1. M Perry, The Chemotherapy Source Book,4 edi 2008136-1422. Roudier-Pujol C, Jan V. Drug-induced alopecia[Review]. Ann Dermatol Venereol 2000; 127(Suppl1):S26-S283. Randall J, Ream E. Hair loss with chemotherapy: at aloss over its management? Eur J Cancer Care (Engl)2005;14(3):223-2314. Extra JM, Rousseau F, Bruno R, et al. Phase I andpharmacokinetic study of Taxotere (RP 56976; NSC628503) given as a short intravenous infusion. CancerRes 1993; 53(5):1037-1042.475
5. Batchelor D. Hair and cancer chemotherapy:consequences and nursing care literature study. Eur JCancer Care (Engl) 2001;10(3):147-163.6. Tosti A, Piraccini BM, Vincenzi C, et al. Permanentalopecia after busulfan chemotherapy. Br J Dermatol2005;152(5):1056-1058.7. Lotem M, Hubert A, Lyass O, et al. Skin toxic effects ofpolyethylene glycol-coated liposomal doxorubicin . ArchDermatol 2000;136(12):1475-14808. Gordon KB, Tajuddin A, Guitart J, et al. Hand-footsyndrome associated with liposome-encapsulateddoxorubicin therapy. Cancer 1995;75(8):2169-2173.9. Susser WS, Whitaker-Worth DL, Grant-Kels JM.Mucocutaneous reactions to chemotherapy. J Am AcadDermatol 1999; 40(3):367-398476
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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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ooooointravenously over 15 minutes
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in most of the patients. The common
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Section — IIIRadiotherapyContribu
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nodes are involved or suspected to
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function. In general, with conventi
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like ultrasonography, CT scan, endo
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catheter passed through the anus in
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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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Page 440 and 441: Table 2. Cairo-Bishop clinical Tumo
Page 442 and 443: Table 4 Patient Stratification by R
Page 444 and 445: Table 6 Management of Electrolyte A
Page 446 and 447: of TLS and improve the management o
Page 448 and 449: 4. Efficacy and safety of rasburica
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Page 452 and 453: Though there are many chemotherapeu
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Page 456 and 457: Nephrotoxicity ofChemotherapeutic D
Page 458 and 459: associated with use of carbopltin c
Page 460 and 461: Table 2 Chemotherapeutics Requiring
Page 462 and 463: against ifosfamide nephrotoxicity.
Page 464 and 465: The incidence of mucositis involvin
Page 466 and 467: 7. Obesity - Probably due to over d
Page 468 and 469: conditioning treatment and for 3 da
Page 470 and 471: References and Recommended Readings
Page 472 and 473: metabolism for activity, cyclophosp
Page 474 and 475: delays excretion and eventually res
Page 476 and 477: Combination Chemotherapy:Combinatio
Page 478 and 479: Vincristine: No dose reduction if b
Page 480 and 481: 19. Slichenmyer WJ, Rowinsky EK, Gr
Page 482 and 483: AlopeciaCommon drugs causing alopec
Page 486 and 487: Cancer Induced Anemia (CIA)Introduc
Page 488 and 489: system. There is an upregulation of
Page 490 and 491: time may represent increasing anemi
Page 492 and 493: (rHuEPO) whiles the other received
Page 494 and 495: Table 3. Improvements in Hemoglobin
Page 496 and 497: 2. Groopman JE, Itri LM. Chemothera
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Page 500 and 501: NOTES
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