Search results for " Prospective"

showing 10 items of 244 documents

Evaluation of the performance of Dutch Lipid Clinic Network score in an Italian FH population: The LIPIGEN study

2018

Abstract Background and aims Familial hypercholesterolemia (FH) is an inherited disorder characterized by high levels of blood cholesterol from birth and premature coronary heart disease. Thus, the identification of FH patients is crucial to prevent or delay the onset of cardiovascular events, and the availability of a tool helping with the diagnosis in the setting of general medicine is essential to improve FH patient identification. Methods This study evaluated the performance of the Dutch Lipid Clinic Network (DLCN) score in FH patients enrolled in the LIPIGEN study, an Italian integrated network aimed at improving the identification of patients with genetic dyslipidaemias, including FH.…

MaleSettore MED/09 - Medicina InternaGenetic testingPredictive Value of TestFamilial hypercholesterolemia030204 cardiovascular system & hematologyDecision Support Technique0302 clinical medicineRetrospective StudieRisk FactorsCardiovascular DiseaseGenetic MarkerProspective Studies030212 general & internal medicineAge of OnsetProspective cohort studyeducation.field_of_studymedicine.diagnostic_testMiddle AgedDutch Lipid Clinic Network score; Familial hypercholesterolemia; Genetic testing; Adult; Age of Onset; Biomarkers; Cardiovascular Diseases; Cholesterol LDL; Female; Genetic Markers; Genetic Predisposition to Disease; Genetic Testing; Humans; Hyperlipoproteinemia Type II; Italy; Male; Middle Aged; Phenotype; Predictive Value of Tests; Prospective Studies; Reproducibility of Results; Retrospective Studies; Risk Assessment; Risk Factors; Decision Support Techniques; Mutation3. Good healthCholesterolPhenotypeItalyCardiovascular DiseasesFemaleCardiology and Cardiovascular MedicineHumanAdultGenetic Markersmedicine.medical_specialtyDutch Lipid Clinic Network scorePopulationFamilial hypercholesterolemiaReproducibility of ResultPhysical examinationDutch Lipid Clinic Network score; Familial hypercholesterolemia; Genetic testing; Cardiology and Cardiovascular MedicineRisk AssessmentLDLDecision Support TechniquesHyperlipoproteinemia Type II03 medical and health sciencesPredictive Value of TestsInternal medicinemedicineHumansGenetic Predisposition to DiseaseFirst-degree relativeseducationRetrospective StudiesGenetic testingDutch Lipid Clinic Network score; Familial hypercholesterolemia; Genetic testingbusiness.industryRisk FactorReproducibility of ResultsSettore MED/13 - ENDOCRINOLOGIABiomarkerCholesterol LDLmedicine.diseaseMissing dataDutch Lipid Clinic Network score Familial hypercholesterolemia Genetic testingProspective StudieMutationAge of onsetbusinessBiomarkers
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Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: A comparative risk a…

2014

High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010.

MaleSettore MED/09 - Medicina Internakidney diseaseEndocrinology Diabetes and Metabolismhumanoscoste de las enfermedadesDiseaseGlobal HealthCohort StudiesEndocrinologyCost of Illnesscardiovascular diseaseHealth TransitionRisk Factorstransición sanitariaestudios prospectivosRenal Insufficiency Chronic -- complications -- epidemiology -- mortalityevaluación de riesgosRenal InsufficiencyProspective StudiesChronicestudios de cohortesMetabolic Syndromeeducation.field_of_studydiabetesMortality rateAge Factors; Cardiovascular Diseases; Cohort Studies; Cost of Illness; Diabetes Complications; Female; Health Surveys; Humans; Male; Metabolic Syndrome X; Prospective Studies; Renal Insufficiency Chronic; Risk Assessment; Risk Factors; Sex Factors; Spatio-Temporal Analysis; Global Health; Health Transition; Internal Medicine; Endocrinology Diabetes and Metabolism; EndocrinologyMetabolic Syndrome XCardiovascular Diseases -- complications -- epidemiology -- mortalityAge FactorsCardiovascular diseaseDiabetes Mellitus chronic kidney diseaseDiabetes Complications -- epidemiology -- mortalitySciences bio-médicales et agricolesDiabetes and MetabolismCardiovascular Diseasesencuestas de saludFemaleanálisis temporoespacialRisk assessmentcomplicaciones de la diabetesinsuficiencia renalmedicine.medical_specialtyCardiovascular disease; kidney disease; diabetes mortalityPopulationenfermedades cardiovascularesMetabolic Syndrome X -- complications -- epidemiology -- mortalityRisk AssessmentArticleDiabetes ComplicationsSex FactorsSpatio-Temporal Analysiscardiovascular disease; chronic kidney disease; diabetes; mortalityInternal medicineEnvironmental healthDiabetes mellitusmedicineAge Factors; Cardiovascular Diseases; Cohort Studies; Cost of Illness; Diabetes Complications; Female; Health Surveys; Humans; Male; Metabolic Syndrome X; Prospective Studies; Renal Insufficiency Chronic; Risk Assessment; Risk Factors; Sex Factors; Spatio-Temporal Analysis; Global Health; Health Transition; Endocrinology Diabetes and Metabolism; Internal Medicine; EndocrinologyInternal Medicinefactores de riesgoHumansRisk factorRenal Insufficiency Chroniceducationbusiness.industrydiabetes mortalitymedicine.diseasemortalityHealth SurveysEndocrinologyRelative riskAge Factors; Cardiovascular Diseases/complications; Cardiovascular Diseases/epidemiology; Cardiovascular Diseases/mortality; Cohort Studies; Cost of Illness; Diabetes Complications/epidemiology; Diabetes Complications/mortality; Female; Global Health; Health Surveys; Health Transition; Humans; Male; Metabolic Syndrome X/complications; Metabolic Syndrome X/epidemiology; Metabolic Syndrome X/mortality; Prospective Studies; Renal Insufficiency Chronic/complications; Renal Insufficiency Chronic/epidemiology; Renal Insufficiency Chronic/mortality; Risk Assessment; Risk Factors; Sex Factors; Spatio-Temporal Analysisbusinesschronic kidney diseaseKidney diseaseThe Lancet Diabetes and Endocrinology
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Tapentadol in cancer pain management: a prospective open-label study.

2012

OBJECTIVES: The aim of this prospective, open-label study was to evaluate the efficacy and tolerability of tapentadol (TP) in the management of cancer pain. METHODS: A 4 weeks' prospective study was carried out in 50 opioid-naive cancer patients with moderate-severe pain. Each patient initially received twice-daily doses of slow-release TP 50 mg. Doses were then managed to maintain adequate relief or dose-limiting toxicity, on the basis of the clinical response. The following parameters were recorded at weekly intervals for 4 weeks: pain and opioid-related adverse effects, quality of life measured with the Spitzer score, TP escalation index percent (TPEI%) and TP escalation index in mg (TPE…

MaleSettore MED/41 - AnestesiologiaPainNeuropathic painCancer pain Neuropathic pain Opioids Tapentadol AnalgesiaQuality of lifePhenolsNeoplasmsMedicineCancer pain; Neuropathic pain; Opioids; Tapentadol; Aged; Analgesics; Female; Humans; Male; Middle Aged; Neoplasms; Pain; Pain Measurement; Phenols; Prospective Studies; Medicine (all)HumansProspective StudiesCancer painAdverse effectProspective cohort studyAgedPain MeasurementAnalgesicsbusiness.industryMedicine (all)General MedicineMiddle AgedTapentadolClinical trialOpioidsTapentadolTolerabilityAnesthesiaNeuropathic painFemaleCancer painbusinessmedicine.drugCurrent medical research and opinion
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Pain Perception and Stabilometric Parameters in People With Chronic Low Back Pain After a Pilates Exercise Program

2016

Various exercise interventions, such as Pilates exercises and traditional physical therapy methods, are employed to decrease low back pain (LBP). Nonspecific low back pain (NSLBP) is distinct from LBP, however, as the distribution of pain is restricted to the region between the costal margin and the inferior gluteal. The aim of our randomized controlled trial was to evaluate the effects of a program of Pilates exercises on pain perception and stabilometric parameters in patients with NSLBP. Thirty-eight participants were randomly allocated, using a 1:1 scheme, to either the experimental group (EG) or control group (CG). The EG completed a 14-week program of Pilates exercises, performed thri…

MaleSeverity of Illness Indexlaw.inventionDisability Evaluation0302 clinical medicineRandomized controlled triallawProspective Studies030212 general & internal medicineProspective cohort studyPain MeasurementMedicine (all)StatisticsChronic painPain PerceptionGeneral MedicineMiddle AgedPrognosisLow back painOswestry Disability IndexTreatment OutcomePatient SatisfactionExercise Movement TechniquesFemaleChronic Painmedicine.symptomExercise Movement TechniqueSettore M-EDF/01 - Metodi E Didattiche Delle Attivita' MotorieHumanAdultmedicine.medical_specialtyPrognosiStatistics Nonparametric03 medical and health sciencesPatient satisfactionPhysical medicine and rehabilitationSeverity of illnessmedicineHumansAdult; Chronic Pain; Exercise Movement Techniques; Female; Humans; Low Back Pain; Male; Middle Aged; Pain Measurement; Pain Perception; Patient Satisfaction; Prognosis; Prospective Studies; Severity of Illness Index; Statistics Nonparametric; Treatment Outcome; Disability Evaluation; Medicine (all)NonparametricSettore M-EDF/02 - Metodi E Didattiche Delle Attivita' Sportivebusiness.industryPosturographymedicine.diseaseProspective StudiePhysical therapybusinessLow Back Pain030217 neurology & neurosurgeryMedicine
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The GENDER ATTENTION Observational Study: Gender and Hormonal Status Differences in the Incidence of Adverse Events During Cyclosporine Treatment in …

2017

Introduction: Female sex has been shown to be a risk factor for the development of adverse drug reactions; however, this has not been studied for cyclosporine (CsA). The aim of this study was to investigate, in Italian dermatological practice, the influence of gender and menopause and related hormones on the incidence of adverse events (AEs) during CsA treatment in psoriatic patients. Methods: Multicenter, prospective, observational study conducted from May 2011 to June 2013. Patients with plaque psoriasis, undergoing a new CsA administration course, or about to start it, were enrolled in the outpatient clinics of Italian dermatological centers. During the 2–6 months of study duration, pati…

MaleSex FactorRate ratio030226 pharmacology & pharmacyGonadal Steroid HormoneSeverity of Illness Index0302 clinical medicineOutpatient clinicAdverse drug reaction; Cyclosporine; Dermatology; Female; Gender; PsoriasisPharmacology (medical)030212 general & internal medicineProspective StudiesProspective cohort studyGonadal Steroid HormonesOriginal ResearchIncidence (epidemiology)IncidenceMedicine (all)General MedicineMiddle AgedMenopausePostmenopauseItalyCyclosporineFemaleSettore MED/35 - MALATTIE CUTANEE E VENEREEHumanAdultmedicine.medical_specialtyAdolescentAdverse drug reaction; Cyclosporine; Dermatology; Female; Gender; Psoriasis; Adolescent; Adult; Cyclosporine; Female; Gonadal Steroid Hormones; Humans; Incidence; Italy; Male; Middle Aged; Postmenopause; Prospective Studies; Psoriasis; Severity of Illness Index; Sex Factors; Young Adult; Pharmacology (medical)Adverse drug reactionDermatology03 medical and health sciencesYoung AdultSex FactorsInternal medicineSeverity of illnessmedicineHumansPsoriasisRisk factorAdverse effectPsoriasibusiness.industryGendermedicine.diseaseSurgeryAdverse drug reaction; Cyclosporine; Dermatology; Female; Gender; Psoriasis; Medicine (all); Pharmacology (medical)Prospective StudiebusinessAdverse drug reaction; Cyclosporine; Dermatology; Female; Gender; Psoriasis;
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Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU: a prospective cohort…

2021

Abstract Background The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. Methods We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for…

MaleShort term mortalityCritical Care and Intensive Care MedicineCohort Studies0302 clinical medicinekwetsbaarheidMedicine and Health Sciences80 and overMedicine610 Medicine & healthProspective cohort studyCorrelation of Data11 Medical and Health SciencesAged 80 and overOUTCOMESIntensive care unitsFrailtyVIP1Aged&nbspMedical emergencies. Critical care. Intensive care. First aidScale (social sciences)Femaleprospectief onderzoekLife Sciences & BiomedicineCRITICALLY-ILL PATIENTS 80 and overStudy groupsmedicine.medical_specialtyAnestesi och intensivvård80 jaar en ouder610 Medicine & healthINTENSIVE-CAREBED AVAILABILITYNO03 medical and health sciencesCritical Care MedicineIntensive caresterfteGeneral & Internal MedicineHumansIntensive care units; Aged; 80 and over; Frailty; Prospective studies; MortalityIn patientddc:610Aged 80 and over; Frailty; Intensive care units; Mortality; Prospective studies; Aged 80 and over; Cohort Studies; Correlation of Data; Female; Frailty; Humans; Intensive Care Units; Logistic Models; Male; Mortality; Prospective StudiesMortalityAgedScience & TechnologyAnesthesiology and Intensive Carebusiness.industryRC86-88.9Research030208 emergency & critical care medicineADULTSAged 80 and over; Frailty; Intensive care units; Mortality; Prospective studies;Emergency & Critical Care MedicineLogistic Models030228 respiratory systemintensivecareafdelingenAged 80 and overCritical illnessEmergency medicineVIP2 study group&nbspCRITICAL ILLNESSbusinessProspective studies
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Improving survival with deferiprone treatment in patients with thalassemia major: A prospective multicenter randomised clinical trial under the auspi…

2009

The prognosis for thalassemia major has dramatically improved in the last two decades. However, many transfusion-dependent patients continue to develop progressive accumulation of iron. This can lead to tissue damage and eventually death, particularly from cardiac disease. Previous studies that investigated iron chelation treatments, including retrospective and prospective non-randomised clinical trials, suggested that mortality, due mainly to cardiac damage, was reduced or completely absent in patients treated with deferiprone (DFP) alone or a combined deferiprone-deferoxamine (DFP-DFO) chelation treatment. However, no survival analysis has been reported for a long-term randomised control …

MaleThalassemiaKaplan-Meier Estimatelaw.inventionchemistry.chemical_compoundRandomized controlled triallawCause of DeathNeoplasmsDeferiproneProspective StudiesChildCause of deathHazard ratioHematologyMiddle AgedCombined Modality TherapySurvival RateThalassemia survival chelation treatment trial thalassemia majorCombinationSplenectomyMolecular MedicineDrug Therapy CombinationFemaleDeferiproneAdultmedicine.medical_specialtyAdolescentPyridonesDeferoxamineIron Chelating AgentsYoung AdultDrug TherapyInternal medicinemedicineHumansBlood TransfusionAdolescent; Adult; Blood Transfusion; Cause of Death; Chelation Therapy; Child; Combined Modality Therapy; Deferoxamine; Drug Therapy; Combination; Female; Heart Failure; Humans; Iron Chelating Agents; Kaplan-Meiers Estimate; Male; Middle Aged; Neoplasms; Proportional Hazards Models; Prospective Studies; Pyridones; Splenectomy; Survival Rate; Young Adult; beta-ThalassemiaMolecular BiologySurvival rateKaplan-Meiers EstimateSurvival analysisProportional Hazards ModelsHeart Failurebusiness.industryProportional hazards modelbeta-ThalassemiaCell Biologymedicine.diseaseChelation TherapySurgerychemistrybusiness
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Impact of direct acting antivirals (DAAs) on cardiovascular events in HCV cohort with pre-diabetes

2021

Background and aims: Beyond type 2 diabetes, even a condition of prediabetes is associated with an increased cardiovascular (CV) risk, and HCV infection coexistence represents an exacerbating factor. CV prognosis improvement in prediabetes represents a challenge, due to the increasing prevalence of this metabolic condition worldwide. Hence, we aimed to prospectively assess how direct acting antivirals (DAAs) could affect major cardiovascular events (MACE) in a prediabetic HCV positive cohort. Methods and results: In this prospective multicenter study, we enrolled HCV patients with overt prediabetes. We compared a subgroup of patients treated with DAAs with untreated prediabetic controls. We…

MaleTime FactorsEndocrinology Diabetes and MetabolismCardiovascular risk Direct acting antiviralsHepatitis C virusPrediabetes Aged Antiviral Agents Cardiovascular Diseases FemaleHeart Disease Risk Factors Hepatitis C Humans Incidence Italy Longitudinal Studies Male Middle Aged Prediabetic State Prospective Studies Protective Factors Retrospective Studies Risk AssessmentTime Factors Treatment Outcome Viral LoadMedicine (miscellaneous)Type 2 diabetes030204 cardiovascular system & hematologymedicine.disease_causeDIRECT ACTING ANTIVIRALSLiver disease0302 clinical medicineLongitudinal StudiesProspective StudiesPrediabeteseducation.field_of_studyNutrition and DieteticsIncidenceMiddle AgedViral LoadHepatitis CTreatment OutcomeItalyCardiovascular DiseasesCohortFemaleCardiology and Cardiovascular Medicinemedicine.medical_specialtyHepatitis C virusPopulation030209 endocrinology & metabolismAntiviral AgentsRisk AssessmentPrediabetic State03 medical and health sciencesInternal medicinemedicineHumanseducationAgedRetrospective Studiesbusiness.industryProtective FactorsCardiovascular riskmedicine.diseaseHeart Disease Risk FactorsDirect acting antiviralHepatitis C virubusinessPrediabetesMace
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Longterm Retention of Tumor Necrosis Factor-α Inhibitor Therapy in a Large Italian Cohort of Patients with Rheumatoid Arthritis from the GISEA Regist…

2012

Objective.To evaluate 4-year retention rates of tumor necrosis factor-α (TNF-α) inhibitors adalimumab, etanercept, and infliximab among patients with longstanding rheumatoid arthritis (RA), as derived from an Italian national registry.Methods.The clinical records of 853 adult patients with RA in the GISEA (Gruppo Italiano Studio Early Arthritis) registry were prospectively analyzed to compare drug survival rates and the baseline factors that may predict adherence to therapy.Results.In 2003 and 2004, 324 patients started treatment with adalimumab, 311 with etanercept, and 218 with infliximab. After 4 years, the global retention rate of anti-TNF-α therapy was 42%. Etanercept survival (51.4%) …

MaleTime FactorsHealth StatusArthritisKaplan-Meier EstimateReceptors Tumor Necrosis FactorEtanerceptlaw.inventionEtanerceptArthritis RheumatoidRandomized controlled triallawRheumatoidMonoclonalReceptorsImmunology and AllergyProspective StudiesRegistriesskin and connective tissue diseasesProspective cohort studyHumanizedAntibodies Monoclonal; Antibodies Monoclonal Humanized; Antirheumatic Agents; Arthralgia; Arthritis Rheumatoid; Biological Markers; Drug Substitution; Female; Health Status; Humans; Immunoglobulin G; Italy; Joints; Kaplan-Meier Estimate; Male; Middle Aged; Pain Measurement; Prospective Studies; Receptors Tumor Necrosis Factor; Survival Rate; Time Factors; Tumor Necrosis Factor-alpha; RegistriesPain MeasurementDrug SubstitutionAntibodies MonoclonalMiddle AgedArthralgiaAdalimumab; Antibodies Monoclonal; Antibodies Monoclonal Humanized; Antirheumatic Agents; Arthralgia; Arthritis Rheumatoid; Biomarkers; Drug Substitution; Etanercept; Female; Health Status; Humans; Immunoglobulin G; Infliximab; Italy; Joints; Kaplan-Meier Estimate; Male; Middle Aged; Pain Measurement; Prospective Studies; Receptors Tumor Necrosis Factor; Survival Rate; Time Factors; Tumor Necrosis Factor-alpha; RegistriesSurvival RateItalyRheumatoid arthritisAntirheumatic AgentsBiological MarkersAdalimumab; Drug survival; Etanercept; Infliximab; Adalimumab; Antibodies Monoclonal; Antibodies Monoclonal Humanized; Antirheumatic Agents; Arthralgia; Arthritis Rheumatoid; Biomarkers; Drug Substitution; Etanercept; Female; Health Status; Humans; Immunoglobulin G; Infliximab; Italy; Joints; Kaplan-Meier Estimate; Male; Middle Aged; Pain Measurement; Prospective Studies; Receptors Tumor Necrosis Factor; Survival Rate; Time Factors; Tumor Necrosis Factor-alpha; Registries; Rheumatology; Immunology; Immunology and AllergyFemalemedicine.drugmusculoskeletal diseasesmedicine.medical_specialtyImmunologyAntibodies Monoclonal HumanizedAntibodiesRheumatologyDrug survivalInternal medicineAdalimumabmedicineHumansSurvival ratebusiness.industryTumor Necrosis Factor-alphaArthritisAdalimumabmedicine.diseaseInfliximabInfliximabSurgeryImmunoglobulin GJointsbusinessTumor Necrosis FactorBiomarkers
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Sirolimus Use in Liver Transplant Recipients With Hepatocellular Carcinoma: A Randomized, Multicenter, Open-Label Phase 3 Trial

2016

International audience; BACKGROUND:We investigated whether sirolimus-based immunosuppression improves outcomes in liver transplantation (LTx) candidates with hepatocellular carcinoma (HCC).METHODS:In a prospective-randomized open-label international trial, 525 LTx recipients with HCC initially receiving mammalian target of rapamycin inhibitor-free immunosuppression were randomized 4 to 6 weeks after transplantation into a group on mammalian target of rapamycin inhibitor-free immunosuppression (group A: 264 patients) or a group incorporating sirolimus (group B: 261). The primary endpoint was recurrence-free survival (RFS); intention-to-treat (ITT) analysis was conducted after 8 years. Overal…

MaleTime FactorsIntention to Treat Analysimedicine.medical_treatmentMedizinPROGRESSIONKaplan-Meier EstimateLiver transplantationGastroenterologyImmunosuppressive Agent0302 clinical medicineEVEROLIMUSRENAL-CELL CARCINOMARisk FactorsMedicine and Health SciencesClinical endpointAge FactorSirolimuProspective StudiesIMMUNOSUPPRESSIONTOR Serine-Threonine KinaseTOR Serine-Threonine KinasesHazard ratioLiver NeoplasmsAge FactorsImmunosuppressionMiddle AgedCANCER3. Good healthIntention to Treat AnalysisEuropeRAPAMYCIN INHIBITORSTreatment OutcomeTARGETLocalLiver Neoplasm030220 oncology & carcinogenesisCombinationDisease ProgressionSURVIVAL[SDV.IMM]Life Sciences [q-bio]/Immunology030211 gastroenterology & hepatologyDrug Therapy CombinationFemaleImmunosuppressive Agentsmedicine.drugHumanAdultmedicine.medical_specialtyCanadaCarcinoma HepatocellularTime Factor[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/SurgeryRisk AssessmentDisease-Free Survival03 medical and health sciencesYoung AdultDrug TherapyInternal medicinemedicineHumansAdult; Age Factors; Aged; Australia; Canada; Carcinoma Hepatocellular; Disease Progression; Disease-Free Survival; Drug Therapy Combination; Europe; Female; Humans; Immunosuppressive Agents; Intention to Treat Analysis; Kaplan-Meier Estimate; Liver Neoplasms; Male; Middle Aged; Neoplasm Recurrence Local; Prospective Studies; Risk Assessment; Risk Factors; Sirolimus; TOR Serine-Threonine Kinases; Time Factors; Treatment Outcome; Young Adult; Liver Transplantation; TransplantationRECURRENCEMETAANALYSISAgedSirolimusTransplantationEverolimusIntention-to-treat analysisbusiness.industryRisk FactorCarcinomaAustraliaHepatocellular3126 Surgery anesthesiology intensive care radiologySurgeryLiver TransplantationTransplantationProspective StudieNeoplasm RecurrenceSirolimusNeoplasm Recurrence Localbusiness
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