Thiotepa (INN), sold under the brand name Tepadina, is a medication used to treat cancer.Thiotepa is an organophosphorus compound with the formula (C2H4N)3PS. It is an analog of N,N′,N′′-triethylenephosphoramide (TEPA), which contains tetrahedral phosphorus and is structurally akin to phosphate. It is manufactured by heating aziridine with thiophosphoryl chloride. Medical uses
Thiotepa is indicated for use in combination with other chemotherapy agents to treat cancer. This can be with or without total body irradiation (TBI), as a conditioning treatment prior to allogeneic or autologous hematopoietic progenitor cell transplantation (HPCT) in hematological diseases in adults and children. These diseases include Hodgkins disease and leukaemia. Thiotepa is also used with high-dose chemotherapy with HPCT support to treat certain solid tumors in adult and children.Thiotepa is used in the palliation of many neoplastic diseases. The best results are found in the treatment of adenocarcinoma of the breast, adenocarcinoma of the ovary, papillary thyroid cancer and bladder cancer. Thiotepa is used to control intracavitary effusions caused by serosal neoplastic deposits. Intravesical use
Thiotepa is used as intravesical chemotherapy in bladder cancer.It may be used prophylactically to prevent seeding of tumor cells at cystoscopic biopsy; as an adjunctive agent at the time of biopsy; or as a therapeutic agent to prevent recurrence after cystoscopic resection of bladder tumor (transurethral resection of bladder tumor, TURBT). Efficacy in tumor control may reach 55%. The main toxicity of this therapy is bone marrow suppression due to systemic absorption of the drug.
Body-focused repetitive behavior (BFRB) is an umbrella name for impulse control behaviors involving compulsively damaging ones physical appearance or causing physical injury.Body-focused repetitive behavior disorders (BFRBDs) in ICD-11 is in development.BFRB disorders are currently estimated to be under the obsessive-compulsive spectrum. They are also associated with ADHD and anxiety. Causes
The cause of BFRBs is unknown.Emotional variables may have a differential impact on the expression of BFRBs.Research has suggested that the urge to repetitive self-injury is similar to a body-focused repetitive behavior but others have argued that for some the condition is more akin to a substance abuse disorder.Researchers are investigating a possible genetic component. Onset
BFRBs most often begin in late childhood or in the early teens. Diagnosis
Types
The main BFRB disorders are:
Skin
Dermatillomania (excoriation disorder), skin picking
Dermatophagia, skin nibbling
Mouth
Morsicatio buccarum, cheek biting
Morsicatio labiorum, inner lip biting
Morsicatio linguarum, tongue biting
Hands
Onychophagia, nail biting
Onychotillomania, nail picking
Nose
Rhinotillexomania, compulsive nose picking
Hair
Trichophagia, hair nibbling
Trichotemnomania, hair cutting
Trichotillomania, hair pulling
Eyes
Mucus fishing syndrome - compulsion to remove or "fish" strands of mucus from the eye

Treatment
Psychotherapy
Treatment can include behavior modification therapy, medication, and family therapy. The evidence base criteria for BFRBs is strict and methodical. Individual behavioral therapy has been shown as a "probably effective" evidence-based therapy to help with thumb sucking, and possibly nail biting. Cognitive behavioral therapy was cited as experimental evidence based therapy to treat trichotillomania and nail biting; a systematic review found best evidence for habit reversal training and decoupling. Another form of treatment that focuses on mindfulness, stimuli and rewards has proven effective in some people.