Guidelines for Complications of Cancer Treatment Vol VIII Part B

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Mechanical ventilation of sepsis-induced ALI/ARDSo Noninvasive ventilation may be considered in theminority of ALI/ARDS patients with mild tomoderate hypoxemic respiratory failure. Thepatients need to be hemodynamically stable,comfortable, easily arousable, able to protect/cleartheir airway, and expected to recoverrapidly (2B) WNew Recommendation, absent in 2004 guidelinesUse a weaning protocol and an SBT regularly to evaluatethe potential for discontinuing mechanical ventilation(1A) So SBT options include a low level of pressure supportwith continuous positive airway pressure 5 cmH2O or a T piece.o Before the SBT, patients should beo Arousable, hemodynamically stableo have no new potentially serious conditionso have low ventilatory and PEEP requiremento Require FIO 2levels can be given with face maskor nasal cannula 2004 ADo not use a pulmonary artery catheter for the routinemonitoring of patients with ALI/ARDS (1A) SUse a conservative fluid strategy for patients withestablished ALI who do not have evidence of tissuehypoperfusion (1C) So New Recommendation, absent in 2004 guidelinesSedation, analgesia, and neuromuscular blockade insepsisoUse sedation protocols with a sedation goal forcritically ill mechanically ventilated patients (1B) S83
ooUse either intermittent bolus sedation or continuousinfusion sedation to predetermined end points(sedation scales), with daily interruption/lighteningto produce awakening. Re-titrate ifnecessary (1B) SAvoid neuromuscular blockers where possible.Monitor depth of block with train-of-four whenusing continuous infusions (1B) S2004 B, B, EGlucose controloUse intravenous insulin to control hyperglycemiain patients with severe sepsis followingstabilization in the ICU (1B) So Aim to keep blood glucose < 150 mg/dL (8.3mmol/L) using a validated protocol for insulin doseadjustment (2C) W 2004 DooProvide a glucose calorie source and monitor bloodglucose values every 1–2 hrs (4 hrs when stable)in patients receiving intravenous insulin (1C) S 2004 EInterpret with caution low glucose levels obtainedwith point of care testing, as these techniques mayoverestimate arterial blood or plasma glucosevalues (1B) S New Recommendation, absent in 2004guidelinesRenal replacementoIntermittent haemodialysis and CVVH areconsidered equivalent (2B) S84
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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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Page 43 and 44: 26. Pain and other symptoms during
Page 45 and 46: 28. Coping, catastrophizing and chr
Page 47 and 48: surgical technique at the time of m
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Page 51 and 52: or heat and superficial incision is
Page 53 and 54: RecommendationsA. Preparation of th
Page 55 and 56: 3. Mangram AJ, Horan TC, Pearson ML
Page 57 and 58: Mild hypothermia increases blood lo
Page 59 and 60: Perioperative Normothermia to Reduc
Page 61 and 62: Priorities: Restoration of circulat
Page 63 and 64: than 1.5 times control values but f
Page 65 and 66: outcomes that may result from the u
Page 67 and 68: Preoperative Preparation of the Pat
Page 69 and 70: patients, or other patients who may
Page 71 and 72: Obstruction can occur at the level
Page 74 and 75: c. Administer face mask preoxygenat
Page 76 and 77: 5. The use of exhaled carbon dioxid
Page 78 and 79: disorder) may occur after an episod
Page 80 and 81: undergoing general anesthesia, eith
Page 82 and 83: anesthesia awareness occurred in ea
Page 84 and 85: The current guidelines are actually
Page 86 and 87: o S - Strong Recommendation -Commit
Page 88 and 89: oSource control ASAP after successf
Page 90 and 91: oooWean steroids once vasopressors
Page 94 and 95: o CVVH offers easier management inh
Page 96 and 97: critically ill patient that are con
Page 98 and 99: Rivers E, Nguyen B, Havstad S, et a
Page 100 and 101: in survival of 7.6%. By the second
Page 102 and 103: parameters (gastric mucosal Pco2, s
Page 104 and 105: syndrome. We therefore conducted a
Page 106 and 107: Complications After Limb SalvageSur
Page 108 and 109: local tumor and to preserve as much
Page 110 and 111: femoral head to the center of the k
Page 112 and 113: 4. Griffin AM, Parsons JA, Davis AM
Page 114 and 115: 20. Roberts P, Chan D, Grimer RJ, e
Page 116 and 117: An infection can have disastrous co
Page 118 and 119: and facilitating reimplantation sur
Page 120 and 121: features of a two-stage revision is
Page 122 and 123: patients had an amputation. Two oth
Page 124 and 125: its main role is confined to ruling
Page 126 and 127: 2. Capanna R, Morris HG, Campanacci
Page 128 and 129: 21. Wilson MG, Kelley K, Thornhill
Page 130 and 131: 39. Love C, Marwin SE, Tomas MB, Kr
Page 132 and 133: 5. A systematic review of 25 RCT’
Page 134 and 135: (cefazolin or cefuroxime) or penici
Page 136 and 137: should be based on the isolates fro
Page 138 and 139: such as concomitant use of prophyla
Page 140 and 141: 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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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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Guidelines for Complications of Cancer Treatment Vol VIII Part B

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