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Arab A, Karimi E, Bagherniya M, Sathyapalan T, Sahebkar A. The effect of probiotic and synbiotic consumption on the most prevalent chemotherapy-related complications: A systematic review of current literature. Curr Med Chem 2022; 29:5462-5473. [PMID: 35430970 DOI: 10.2174/0929867329666220415114343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/03/2022] [Accepted: 02/09/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND To date, many investigations have employed pro-/synbiotic to examine their effects on chemotherapy-related side effects; nevertheless, their findings are inconclusive. To address this issue, we carried out a systematic review to explore the effect of pro-/synbiotic consumption on chemotherapy-related side effects, including nausea, vomiting, mucositis, diarrhea, and constipation in adults using randomized controlled trials (RCTs). METHODS The electronic databases, including PubMed, Scopus, and ISI Web of Sciences, were searched systematically from the earliest available date to March 2021 to identify eligible studies. The quality of the enrolled studies was done based on the Cochrane Collaboration Risk of Bias tool. RESULTS A total of 10 studies involving 788 individuals were included in the current systematic review with a sample size ranging from 25 to 200, and the mean age ranged from 51.04 to 66.91 years. The findings of this study imply that probiotics consumption may be more effective in terms of mucositis compared to other complications. CONCLUSION Further good-quality RCTs with better methodology are called to determine whether and how pro-/synbiotics can prevent or treat chemotherapy-induced side effects. The current systematic review findings may help investigators for future studies regarding the selection study population and probiotic strains.
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Affiliation(s)
- Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Karimi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Research Development Center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Bagherniya
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Thozhukat Sathyapalan
- Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, UK
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Medicine, The University of Western Australia, Perth, Australia.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Voglino V, Persano G, Crocoli A, Castellano A, Serra A, Giordano U, Natali GL, Di Paolo PL, Martucci C, Stracuzzi A, Inserra A. Hemorrhage During Induction Chemotherapy in Neuroblastoma: Additional Risk Factors in High-Risk Patients. Front Pediatr 2021; 9:761896. [PMID: 34869118 PMCID: PMC8635199 DOI: 10.3389/fped.2021.761896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/11/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Neuroblastoma is the most common solid extracranial tumor in children. Patients affected by neuroblastoma are stratified into low, intermediate, and high risk in terms of event-free and overall survival. Some high-risk patients have an additional risk of acute hemorrhagic complications during induction chemotherapy. Aim: To find easily and rapidly assessed parameters that help clinicians identify those patients affected by high-risk neuroblastoma who have an additional risk of hemorrhagic complications. Methods: The clinical notes of patients diagnosed with high-risk neuroblastoma from January 2013 until February 2021 were retrospectively reviewed. Clinical, demographic and laboratory data, biological characteristics of the tumor, and information about treatment and hospital stay were identified. Results: In the examined period, 44 patients were diagnosed with high-risk neuroblastoma. Four of these patients had hemorrhagic complications within 2-7 days after the initiation of induction chemotherapy; two patients had hemothorax, one patient had hemoperitoneum and one patient had hemothorax and hemoperitoneum. The patient with isolated hemoperitoneum was treated with blood components transfusions, clotting factors and colloids infusions; the three patients with hemothorax underwent thoracostomy tube placement and respiratory support. At initial presentation, patients who suffered from hemorrhagic complications had a higher degree of hypertension (stage 2, p = 0.0003), higher levels of LDH (median 3,745 U/L, p = 0.009) and lower levels of hemoglobin (mean 7.6 gr/dl, p = 0.0007) compared to other high-risk patients. Conclusions: A subgroup of "additional" high-risk patients can be identified within the high-risk neuroblastoma patients based on mean arterial pressure, LDH levels and hemoglobin levels at presentation. Further studies to define cut-off values and optimal management strategies for these patients are needed.
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Affiliation(s)
- Valerio Voglino
- Surgical Oncology-General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Giorgio Persano
- Surgical Oncology-General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alessandro Crocoli
- Surgical Oncology-General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Aurora Castellano
- Onco-Hematology Unit, Department of Onco-Hematology and Gene Therapy, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Annalisa Serra
- Onco-Hematology Unit, Department of Onco-Hematology and Gene Therapy, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Ugo Giordano
- Sport and Hypertension Medicine Unit, Department of Cardiac Surgery, Cardiology, Heart and Lung Transplant, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Gian Luigi Natali
- Radiology Unit, Department of Diagnostic Imaging, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Pier Luigi Di Paolo
- Radiology Unit, Department of Diagnostic Imaging, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Cristina Martucci
- Surgical Oncology-General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alessandra Stracuzzi
- Pathology Unit, Department of Laboratories, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alessandro Inserra
- Surgical Oncology-General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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Burns ST, Damon L, Akagi N, Laszik Z, Ko AH. Rapid Improvement in Gemcitabine-associated Thrombotic Microangiopathy After a Single Dose of Eculizumab: Case Report and Review of the Literature. Anticancer Res 2020; 40:3995-4000. [PMID: 32620643 DOI: 10.21873/anticanres.14393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 11/10/2022]
Abstract
We present here the case of a 39-year-old man with metastatic pancreatic carcinoma receiving chemotherapy with the combination of gemcitabine and nab-paclitaxel as part of a clinical trial. Despite an impressive response to therapy, he ultimately developed profound anasarca, renal insufficiency, progressive cytopenias, and malignant hypertension 6 months into his treatment course. The diagnosis of gemcitabine-associated thrombotic microangiopathy (G-TMA) was made based on renal biopsy, and receipt of the anti-C5 monoclonal antibody eculizumab proved successful at reversing his deteriorating clinical course and improving his laboratory parameters. This case illustrates the importance of recognizing this rare but serious complication, and highlights one potential therapeutic option that can be used in the appropriate clinical context.
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Affiliation(s)
- Shohei T Burns
- Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco, CA, U.S.A
| | - Lloyd Damon
- Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco, CA, U.S.A
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, U.S.A
| | - Naomi Akagi
- Department of Pathology, University of California, San Francisco, CA, U.S.A
| | - Zoltan Laszik
- Department of Pathology, University of California, San Francisco, CA, U.S.A
| | - Andrew H Ko
- Division of Hematology and Oncology, Department of Medicine, University of California, San Francisco, CA, U.S.A.
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, U.S.A
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Ahmad H, Haider J, Siddiqui SS, Naz S, Nihal F, Alam SN. Subacute Peristomal Necrotizing Fasciitis Detected During Adjuvant Chemotherapy for Adenocarcinoma Rectum: Case Report on a Unique Presentation and Description of a Simple Surgical Strategy for Treatment. Cureus 2018; 10:e2075. [PMID: 29560288 PMCID: PMC5856418 DOI: 10.7759/cureus.2075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Necrotizing fasciitis (NF) is a rare entity with its subacute form being even rarer. The condition has also been described to occur in the peristomal area in relation to different clinical scenarios. However, it has not been described in the setting of adjuvant chemotherapy where these medications have already been given. While the diagnosis may be delayed or missed due to the subtle symptomatology of the indolent subacute form of NF, another reason for a delayed or missed diagnosis may be the excessive use of tape and the stoma belt around the stomal appliance to prolong the life of the appliance beyond its recommended days of usage due to economic constraints. This, in turn, covers a larger area around the peristomal skin and developing skin changes associated with necrotizing fasciitis. Despite the less aggressive presentation of the subacute form, it may still represent a unique surgical challenge in this setting, as the chemotherapy-induced neutropenia bound to occur a few days after the chemotherapy may expose the patient to serious complications at that time. As such, the surgical plan at the time of presentation may become the determinant of morbidity and mortality. Here, a case is presented of a young patient who underwent abdominoperineal resection for stage III adenocarcinoma of the rectum. He was referred to us on the day of the fourth cycle of adjuvant chemotherapy by the oncology service where he had received part of his chemotherapy regimen. On presentation, he was found to be having significant skin changes in the peristomal area consistent with necrotizing fasciitis despite being clinically stable. The authors present this unique case as a study from which many lessons can be learned. They also explain the thought process behind a well-planned but simple surgical strategy that was implemented with a successful patient outcome. In addition to describing this surgical strategy, the case report is concluded by highlighting some factors that may raise suspicion of this condition and by emphasizing routine history-taking for peristomal symptomatology and a thorough examination of the peristomal site prior to administration of chemotherapy in patients with stomata, as this condition, if overlooked, may lead to a fatal outcome.
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Affiliation(s)
- Humaid Ahmad
- Department of Surgery / Hepatopancreatobiliary and Liver Transplant Unit, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Jahanzaib Haider
- Department of Surgery / Hepatopancreatobiliary and Liver Transplant Unit, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Sheeraz S Siddiqui
- Department of Surgery, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Sumbul Naz
- Department of Surgery, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Faizan Nihal
- Department of Surgery, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Shams Nadeem Alam
- Hepatopancreatobiliary and Liver Transplant Unit, Dow University of Health Sciences (DUHS), Karachi, Pakistan
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Graboń K, Paczesny Ł, Kruczyński J. Avascular Necrosis of Femoral Condyles in a Patient Treated Due to Lymphoma. A Case Study. Ortop Traumatol Rehabil 2017; 19:469-480. [PMID: 29154231 DOI: 10.5604/01.3001.0010.5832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Periarticular avascular osteonecrosis is one of the most severe joint diseases and may result in complete joint destruction. It may affect patients after chemotherapy involving regimens including steroids. The paper describes the case of a female patient who was just under 18 years old when she underwent surgery due to bilateral osteonecrosis of the femoral condyles that developed in the course of treatment of a haematological malignancy. The aim of the paper is to present clinical and imaging-based assessment of the outcome of surgical treatment by reconstruction of osteochondral joint defects with a collagen membrane and bone grafts. In this patient, radiographic and clinical improvement of the joints treated was noted in a 24-month follow-up period. The available literature indicates that this is the first example of using this technique in the treatment of articular lesions associated with osteonecrosis caused by aggressive chemotherapy. The so-called "sandwich" technique is useful in these cases and may be recommended by the present authors.
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Affiliation(s)
- Kamil Graboń
- Szpital Cito Care, Citomed sp. z o.o., Toruń / Cito Care Private Hospital, Citomed Health Center, Toruń Pododdział Ortopedii / Orthopaedic Ward
| | - Łukasz Paczesny
- Szpital Cito Care, Citomed sp. z o.o., Toruń / Cito Care Private Hospital, Citomed Health Center, Toruń Pododdział Ortopedii / Orthopaedic Ward
| | - Jacek Kruczyński
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznań University of Medical Sciences Klinika Ortopedii Ogólnej, Onkologicznej i Traumatologii / Department of General Orthopaedics, Musculoskeletal Oncology and Trauma Surgery
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Miller KK, Gorcey L, McLellan BN. Chemotherapy-induced hand-foot syndrome and nail changes: a review of clinical presentation, etiology, pathogenesis, and management. J Am Acad Dermatol. 2014;71:787-794. [PMID: 24795111 DOI: 10.1016/j.jaad.2014.03.019] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 03/04/2014] [Accepted: 03/07/2014] [Indexed: 12/13/2022]
Abstract
Chemotherapy-induced hand-foot syndrome and nail changes are common complications of many classic chemotherapeutic agents and the newer molecular targeted therapies. They significantly impact patient quality of life, and frequently necessitate chemotherapy dose intensity modification or reduction. We aim to describe the epidemiology, pathogenesis, clinical presentation, and current evidence-based treatment options for these entities.
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