scholarly journals Bone Cancer Pain, Mechanism and Treatment

2021 ◽  
Author(s):  
Sonny Hermanus Johannes Sliepen
Keyword(s):  
Tumor Cell ◽  
Sensory Nerve ◽  
Antibody Therapy ◽  
Bone Cancer ◽  
Nerve Fibers ◽  
World Health ◽  
Bone Cancer Pain ◽  
Ectopic Firing ◽  
Health Organization ◽  
Strong Opioids

The world health organization (WHO) has predicted a global amount of 19 million cancer cases by 2025. Breast, prostate and lung cancer are common cancer types and show metastasis in 60 to 84% of the cases, with 75 to 90% experiencing life-altering cancer-induced bone pain (CIBP), characterized by continuous, dull progressive pain with movement-induced incident peaks and random breakthrough spikes. Therefore, it is the most difficult pain condition to treat. CIBP is a unique type of pain with neuropathic and nociceptive components. Briefly, an invading tumor cell disturbs the healthy balance of the bone resulting in an acidic microenvironment, activating sensory fibers in the bone. The invaded tumor cell and adjacent stromal cells secrete mediators initiating an immune response with transcriptional signaling, resulting in increased cytokines and growth factors. Sensory nerve fibers are damaged and start to sprout, causing ectopic firing, and as tumors grow in size they activate mechanoreceptors. Aside from bisphosphonates and antibody therapy, CIBP is treated by a range of NSAIDs to strong opioids, but remains undertreated in one-third of cases. This chapter discusses the accompanying CIBP of bone tumors, the mechanism of action and current treatments.

Tumor-induced injury of sensory nerve fibers in bone cancer pain

2004 ◽  
Vol 62 ◽  
pp. 21-22
Author(s):  
Ma’Ann Sabino ◽  
N. Luger ◽  
C. Keyser ◽  
M. Schwei ◽  
D. Mach ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Sensory Nerve ◽  
Bone Cancer ◽  
Nerve Fibers ◽  
Bone Cancer Pain

Tumor-induced injury of primary afferent sensory nerve fibers in bone cancer pain

2005 ◽  
Vol 193 (1) ◽  
pp. 85-100 ◽  
Author(s):  
Christopher M. Peters ◽  
Joseph R. Ghilardi ◽  
Cathy P. Keyser ◽  
Kazufumi Kubota ◽  
Theodore H. Lindsay ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Sensory Nerve ◽  
Bone Cancer ◽  
Nerve Fibers ◽  
Bone Cancer Pain ◽  
Primary Afferent

scholarly journals Intradural Schwannoma Exacerbating the Symptoms of Degenerative Lumbar Stenosis: Case Report

2017 ◽  
Vol 36 (01) ◽  
pp. 38-42
Author(s):  
Lucas Meguins ◽  
Raphael Abílio ◽  
Herbert Santos ◽  
Linoel Valsechi ◽  
Elísio Duarte ◽  
...  
Keyword(s):  
Case Report ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Nerve Fibers ◽  
World Health ◽  
Lumbar Pain ◽  
Uneventful Recovery ◽  
Motor Deficits ◽  
Health Organization ◽  
Lumbar Spinal

Introduction Schwannoma is a common intradural slow-growing, benign and encapsulated tumor that originates from the myelin sheaths of the nerve fibers. However, a lumbar schwannoma complicating the symptoms of spinal stenosis is an extremely rare association. Aim To describe the case of a woman presenting a lumbar schwannoma in association with spinal stenosis. Case Report A 53 year-old female was referred to neurosurgical evaluation due to the worsening of a lumbar pain that was irradiating to the left inferior leg along the anterolateral surface. A neurological examination revealed motor deficits for extension of the left leg and attenuation of the left patellar reflex. Magnetic resonance imaging (MRI) showed lumbar spinal stenosis due to flavum ligament hypertrophy and disc herniation in the L3L4 and L4L5 segments, and an expansive lesion with homogeneous contrast enhancement occupying the left neuroforamen of the L3L4 segment. The patient underwent surgical resection of the tumor and decompression of the stenotic segments with posterior screw instrumentation from L3 to L5. She presented an uneventful recovery and significant improvement of the lumbar pain, and was still free of symptoms 6 months after surgery. An anatomopathological examination defined the tumor as a schwannoma (Grade I – World Health Organization [WHO]). Conclusion The present study highlights that lumbar schwannoma is a possible etiology complicating the symptoms of patients with previous lumbar spinal stenosis. It is important to treat both pathologies to improve the patients' symptoms.

scholarly journals Effect of SARS-CoV-2 Mutations on the Efficacy of Antibody Therapy and Response to Vaccines

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 914
Author(s):  
Ahmed Yaqinuddin ◽  
Areez Shafqat ◽  
Junaid Kashir ◽  
Khaled Alkattan
Keyword(s):  
Monoclonal Antibody ◽  
Protective Immunity ◽  
Antibody Therapy ◽  
Antiviral Drugs ◽  
World Health ◽  
Significant Morbidity ◽  
Vaccination Programs ◽  
The World ◽  
Feasible Option ◽  
Health Organization

SARS-CoV-2 causes severe acute respiratory syndrome, which has led to significant morbidity and mortality around the world. Since its emergence, extensive prophylactic and therapeutic countermeasures have been employed to successfully prevent the spread of COVID-19. Extensive work has been undertaken on using monoclonal antibody therapies, mass vaccination programs, and antiviral drugs to prevent and treat COVID-19. However, since antiviral drugs could take years to become widely available, immunotherapy and vaccines currently appear to be the most feasible option. In December 2020, the first vaccine against SARS-CoV-2 was approved by the World Health Organization (WHO) and, subsequently, many other vaccines were approved for use by different international regulators in different countries. Most monoclonal antibodies (mAbs) and vaccines target the SARS-CoV-2 surface spike (S) protein. Recently, mutant (or variant) SARS-CoV-2 strains with increased infectivity and virulence that evade protective host antibodies present either due to infection, antibody therapy, or vaccine administration have emerged. In this manuscript, we discuss the different monoclonal antibody and vaccine therapies available against COVID-19 and how the efficacy of these therapies is affected by the emergence of variants of SARS-CoV-2. We also discuss strategies that might help society cope with variants that could neutralize the effects of immunotherapy and escape the protective immunity conferred by vaccines.

scholarly journals DETERMINATION OF PARAPROTEIN IN SERUM AND URINE BY ELECTROPHORESIS FOR DIAGNOSING MULTIPLE MYELOMA (MM), EXPERIENCES FROM THE PHF UNIVERSITY CLINIC OF HEMATOLOGY FOR THE PERIOD FROM 2015 TO 2017

2019 ◽  
Vol 34 (4) ◽  
pp. 895-901
Author(s):  
Bosko Gjorgjievski ◽  
Dino Karpicarov ◽  
Biljana Gjorgjeska
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Plasma Cells ◽  
Bone Cancer ◽  
Study Data ◽  
World Health ◽  
Blood Calcium ◽  
Health Organization ◽  
Serum And Urine

Introduction: Multiple myeloma is a clonal disorder characterized by the proliferation of mature B cells (plasma cells) in the bone marrow i.e. the appearance of monoclonal immunoglobulin fraction (M component, paraprotein) in the serum or occasionally only during electrophoresis, in the urine. Generally, multiple myeloma is the most common primary bone cancer which can be defined as a malignant tumor of the bone marrow. Regarding the benign form (MGUS, monoclonal gammopathy of undetermined significance), it should be noted that it is about 100 times more common than the myeloma. In order to diagnose this disease, serum and urine are examined by electrophoresis because this technique firstly enables the separation of the proteins and then the detection of the desired group of proteins, in the specific case, the paraprotein group. However, the presence of such proteins in serum or urine is not always a sign for multiple myeloma, so in order to diagnose this disease, additional tests need to be done. These tests include: determination of the number of blood cells, determination of the level of blood calcium, determination of the level of urea and creatinine, determination of the percentage of plasma cells in the bone marrow. Besides these tests, the usual additional test includes detection of β–2–microglobulin, which is another protein that can be produced by multiple myeloma cells.Aims of the study: Overview of the diagnosis of multiple myeloma by determination of the paraprotein in serum or urine by electrophoresis; Determination of the prevalence of multiple myeloma in patients on the territory of the Republic of N. Macedonia from 2015 to 2017; Analysis of the obtained data in relation to the gender and the age of the patients.Materials and methods: For the purpose of this study, data obtained from multiple myeloma patients, diagnosed and treated at the PHF University Clinic of Hematology, were analyzed. The data were collected over a period of three years (from 2015 to 2017). The study included patients over 40 years of age. The entire research was done in the laboratory of PHF University Clinic of Hematology.Results: According to the research, 19 patients with multiple myeloma were registered in 2015, 22 patients with multiple myeloma were registered in 2016 and 25 patients with multiple myeloma were registered in 2017. In terms of gender, this disease is more common in men and in terms of age, the same disease is most prevalent in patients between 70 and 90 years of age.Conclusion: The incidence of multiple myeloma is approximately 5 to 7 patients per 100,000 persons annually. The disease data obtained in this study are identical to those of the World Health Organization (WHO). In most patients who were diagnosed with multiple myeloma, renal dysfunction was also observed.

A Rare Primary Intraosseous Schwannoma of the Tibia

2020 ◽  
Author(s):  
Xueqing Liu ◽  
Yunlong Ding ◽  
Yanling Shen ◽  
Wensheng Yang
Keyword(s):  
Bone Tumors ◽  
Distal Tibia ◽  
Nerve Fibers ◽  
World Health ◽  
Lytic Lesion ◽  
Myelinated Nerve ◽  
Primary Bone Tumors ◽  
Intraosseous Schwannoma ◽  
Rare Benign Tumor ◽  
Health Organization

Abstract Background: Primary intraosseous schwannoma is a rare benign tumor derived from schwanncells that cover myelinated nerve fibers, accounting for less than 0.2% of all primary bone tumors. Because of its rarity, the new World Health Organization classification of bone tumors has deleted it.Case presentation: A 29-year-old woman presented with a history of intermittent pain on her right ankle over three years. Radiological examination revealed a multilocular cystic and lytic lesion in the distal tibia. Histologically, the tumor was composed of spindle shaped cells, similar to soft tissue neurilemmoma. The patient underwent a surgical resection of the intraosseous lesion. After a 38-month follow-up, the symptoms were significantly relieved and there was no clinical or radiological recurrence.Conclusion: Primary intraosseous schwannoma is a rare benign bone tumor. The pathologists should be aware of the incidence of the tumor, although WHO has deleted it.

scholarly journals SARS-CoV-2: Immune Response Elicited by Infection and Development of Vaccines and Treatments

2020 ◽  
Vol 11 ◽  
Author(s):  
Gisela Canedo-Marroquín ◽  
Farides Saavedra ◽  
Catalina A. Andrade ◽  
Roslye V. Berrios ◽  
Linmar Rodríguez-Guilarte ◽  
...  
Keyword(s):  
Immune Response ◽  
Clinical Trials ◽  
Clinical Manifestations ◽  
Antibody Therapy ◽  
Phase Iii ◽  
World Health ◽  
Proinflammatory Mediators ◽  
Major Player ◽  
Health Organization ◽  
In The Beginning

The World Health Organization (WHO) announced in March a pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This new infectious disease was named Coronavirus Disease 19 (COVID-19), and at October 2020, more than 39,000,000 cases of SARS-CoV-2 have been detected worldwide leading to near 1,100,000 deaths. Clinically, COVID-19 is characterized by clinical manifestations, such as fever, dry cough, headache, and in more severe cases, respiratory distress. Moreover, neurological-, cardiac-, and renal-related symptoms have also been described. Clinical evidence suggests that migration of immune cells to the affected organs can produce an exacerbated release of proinflammatory mediators that contribute to disease and render the immune response as a major player during the development of the COVID-19 disease. Due to the current sanitary situation, the development of vaccines is imperative. Up to the date, 42 prototypes are being tested in humans in different clinical stages, with 10 vaccine candidates undergoing evaluation in phase III clinical trials. In the same way, the search for an effective treatment to approach the most severe cases is also in constant advancement. Several potential therapies have been tested since COVID-19 was described, including antivirals, antiparasitic and immune modulators. Recently, clinical trials with hydroxychloroquine—a promising drug in the beginning—were suspended. In addition, the Food and Drug Administration (FDA) approved convalescent serum administration as a treatment for SARS-CoV-2 patients. Moreover, monoclonal antibody therapy is also under development to neutralize the virus and prevent infection. In this article, we describe the clinical manifestations and the immunological information available about COVID-19 disease. Furthermore, we discuss current therapies under study and the development of vaccines to prevent this disease.

Correlation of glucose consumption and tumor cell density in astrocytomas

1993 ◽  
Vol 79 (6) ◽  
pp. 853-858 ◽  
Author(s):  
Karl Herholz ◽  
Uwe Pietrzyk ◽  
Jürgen Voges ◽  
Roland Schröder ◽  
Marco Halber ◽  
...  
Keyword(s):  
Tumor Cell ◽  
Cell Density ◽  
Diagnostic Yield ◽  
Glucose Consumption ◽  
Cell Types ◽  
World Health ◽  
Content Type ◽  
Positron Emission ◽  
Stereotactic Frame ◽  
Health Organization

✓ To determine histological correlates of the variability of glucose consumption in astrocytomas, the authors performed positron emission tomography (PET) with 18F-2-fluoro-2-deoxy-D-glucose (FDG) and matched the PET scans three-dimensionally with computerized tomography scans obtained in a stereotactic frame before biopsy. Ten patients with astrocytomas of World Health Organization Grade 2 or 3 were studied; patients with glioblastomas, oligodendrogliomas, or oligoastrocytomas were excluded from the study to avoid any confounding effects of different cell types and necroses. In samples of pure tumor, glucose consumption correlated significantly with cell density, but not with nuclear polymorphism. It is concluded that tumor cell density is a major determinant of glucose consumption in astrocytomas. The use of PET with FDG may help to locate the highest cell density and thus improve the diagnostic yield of stereotactic biopsy.

scholarly journals Nursing Care for a Patient in the Course of Diabetic Foot with the Use of Innovative URGO Dressings that Stimulate Wound Healing

2019 ◽  
Vol 4 (5) ◽  
Keyword(s):  
Wound Healing ◽  
Blood Glucose ◽  
Nursing Care ◽  
Diabetic Foot ◽  
Nerve Fibers ◽  
Diabetic Foot Syndrome ◽  
World Health ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Health Organization

In the 21st century, diabetic foot syndrome (ZSC) affects patients with advanced diabetes. Referring to the scope of the WHO World Health Organization, "diabetic foot syndrome" is the result of infection, small and large blood vessels in the features of neuropathic nerve fibers resulting from increased blood glucose levels, as well as ischemia of varying levels. Untreated diabetic foot can be completed even to amputation ends in different ways of healing managed by patients whose chances of improvement in health can also be used using therapy [1-5].

scholarly journals Chemokine receptor CXCR4 activates the RhoA/ROCK2 pathway in spinal neurons that induces bone cancer pain

2020 ◽  
Vol 16 ◽  
pp. 174480692091956 ◽  
Author(s):  
Heng Xu ◽  
Chong Peng ◽  
Xue-Tai Chen ◽  
Ying-Ying Yao ◽  
Li-Ping Chen ◽  
...  
Keyword(s):  
Body Weight ◽  
Cancer Pain ◽  
Tumor Cell ◽  
Bone Cancer ◽  
Bone Cancer Pain ◽  
Sprague Dawley ◽  
Tumor Cell Implantation ◽  
Sprague Dawley Rats ◽  
Gland Carcinoma ◽  
Cell Implantation

Background Chemokine receptor CXCR4 has been found to be associated with spinal neuron and glial cell activation during bone cancer pain. However, the underlying mechanism remains unknown. Furthermore, the RhoA/ROCK2 pathway serves as a downstream pathway activated by CXCR4 during bone cancer pain. We first validated the increase in the expressions of CXCR4, p-RhoA, and p-ROCK2 in the spinal dorsal horn of a well-characterized tumor cell implantation-induced cancer pain rat model and how these expressions contributed to the pain behavior in tumor cell implantation rats. We hypothesized that spinal blockade of the CXCR4-RhoA/ROCK2 pathway is a potential analgesic therapy for cancer pain management. Methods Adult female Sprague–Dawley rats (body weight of 180–220 g) and six- to seven-week old female Sprague–Dawley rats (body weight of 80–90 g) were taken. Ascitic cancer cells were extracted from the rats (body weight of 80–90 g) with intraperitoneally implanted Walker 256 mammary gland carcinoma cells. Walker 256 rat mammary gland carcinoma cells were then injected (tumor cell implantation) into the intramedullary space of the tibia to establish a rat model of bone cancer pain. Results We found increased expressions of CXCR4, p-RhoA, and p-ROCK2 in the neurons in the spinal cord. p-RhoA and p-ROCK2 were co-expressed in the neurons and promoted by overexpressed CXCR4. Intrathecal delivery of CXCR4 inhibitor Plerixafor (AMD3100) or ROCK2 inhibitor Fasudil abrogated tumor cell implantation-induced pain hypersensitivity and tumor cell implantation-induced increase in p-RhoA and p-ROCK2 expressions. Intrathecal injection of stromal-derived factor-1, the principal ligand for CXCR4, accelerated p-RhoA expression in naive rats, which was prevented by postadministration of CXCR4 inhibitor Plerixafor (AMD3100) or ROCK2 inhibitor Fasudil. Conclusions Collectively, the spinal RhoA/ROCK2 pathway could be a critical downstream target for CXCR4-mediated neuronal sensitization and pain hypersensitivity in bone cancer pain, and it may serve as a potent therapeutic target for pain treatment.

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