scholarly journals Ataxia and mobility in children following surgical resection of posterior fossa tumour: A longitudinal cohort study

2021 ◽  
Author(s):  
H Hartley ◽  
S Lane ◽  
B Pizer ◽  
L Bunn ◽  
B Carter ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Posterior Fossa ◽  
Rating Scale ◽  
Functional Mobility ◽  
Low Grade ◽  
Posterior Fossa Tumour ◽  
Gradual Improvement ◽  
Median Reduction ◽  
Median Baseline ◽  
Median Increase

Abstract Purpose To report the course of ataxia in children up to 2 years post-operatively, following surgical resection of a posterior fossa tumour (PFT). Methods Thirty-five children, (median age 9 years, range 4–15) having resection of PFT, were assessed using the Scale for the Assessment and Rating of Ataxia (SARA), Brief Ataxia Rating Scale (BARS) and the mobility domain of the Paediatric Evaluation of Disability Index (PEDI-m) at initial post-operative period (baseline), 3 months, 1 year and 2 years post-operatively. Results Baseline median scores of the SARA and BARS were 8.5 (range 0–35.5), and 7 (0–25) respectively. Ataxia improved at 3 months (median SARA and BARS reduction 3.5 and 4, respectively). Additional gradual improvements in SARA were recorded at 1 (median reduction 2) and 2 years post-operatively (median reduction 0.5). Median baseline PEDI-m was 54.75 (range 15.2–100) with improvement at 3 months (median increase 36.95) and small improvement at 1 year (median increase 2.5) and 2 years (median increase 5.8). Children with medulloblastoma and midline tumours (median baseline SARA 10 and 11, respectively) demonstrated more severe ataxia than children with low-grade gliomas and unilateral tumours (median baseline SARA 7.5 and 6.5, respectively). Conclusion The largest improvement in ataxia scores and functional mobility scores is demonstrated within the first 3 months post-operatively, but ongoing gradual improvement is observed at 2 years. Children with medulloblastoma and midline tumour demonstrated higher ataxia scores long term.

scholarly journals QOL-05. E-SURVEY OF CURRENT INTERNATIONAL PHYSIOTHERAPY PRACTICE FOR CHILDREN WITH ATAXIA FOLLOWING SURGICAL RESECTION OF POSTERIOR FOSSA TUMOUR

2018 ◽  
Vol 20 (suppl_2) ◽  
pp. i158-i158
Author(s):  
Helen Hartley ◽  
Bernie Carter ◽  
Lisa Bunn ◽  
Ram Kumar ◽  
Elizabeth Cassidy ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Posterior Fossa ◽  
Posterior Fossa Tumour ◽  
Physiotherapy Practice

scholarly journals Physiotherapy versus Consecutive Physiotherapy and Cognitive Treatment in People with Parkinson’s Disease: A Pilot Randomized Cross-Over Study

2021 ◽  
Vol 11 (8) ◽  
pp. 687
Author(s):  
Valentina Varalta ◽  
Paola Poiese ◽  
Serena Recchia ◽  
Barbara Montagnana ◽  
Cristina Fonte ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Treatment Group ◽  
Cognitive Rehabilitation ◽  
Rating Scale ◽  
Verbal Learning ◽  
Functional Mobility ◽  
Cognitive Treatment ◽  
Rehabilitation Programs ◽  
Significant Difference

Background: Parkinson’s disease (PD) is characterized by motor and cognitive dysfunctions that can usually be treated by physiotherapy or cognitive training, respectively. The effects of consecutive physiotherapy and cognitive rehabilitation programs on PD deficits are less investigated. Objective: We investigated the effects of 3 months of physiotherapy (physiotherapy treatment group) or consecutive physiotherapy and cognitive (physiotherapy and cognitive treatment group) rehabilitation programs on cognitive, motor, and psychological aspects in 20 PD patients. Methods: The two groups switched programs and continued rehabilitation for another 3 months. The outcomes were score improvement on cognitive (Montreal Cognitive Assessment, Frontal Assessment Battery, Trail Making Test, Verbal Phonemic Fluency, Digit Span, and Rey Auditory Verbal Learning), motor (Unified Parkinson’s Disease Rating Scale-III, Berg Balance Scale, Two-Minute Walking Test, and Time Up and Go), and psychological (Beck Depression Inventory and State-Trait Anxiety Inventory) scales. Results: Between-group comparison revealed a significant difference in functional mobility between the two rehabilitation programs. Improvements in walking abilities were noted after both interventions, but only the patients treated with consecutive training showed better performance on functional mobility and memory tasks. Conclusion: Our findings support the hypothesis that consecutive physiotherapy plus cognitive rehabilitation may have a greater benefit than physiotherapy alone in patients with PD.

scholarly journals IMG-18. ASSESSMENT OF SUSPECTED DISEASE PROGRESSION USING MULTIPARAMETRIC 18F-CHOLINE PET/MRI IN CHILDHOOD AND TEENAGE-YOUNG ADULT GLIOMAS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii358-iii358
Author(s):  
Valentina Ferrazzoli ◽  
Ananth Shankar ◽  
Julia Cockle ◽  
Christine Tang ◽  
Ahmed Al-khayfawee ◽  
...  
Keyword(s):  
Disease Progression ◽  
Posterior Fossa ◽  
Cerebral Blood Volume ◽  
Posterior Fossa Tumour ◽  
Recurrent Tumour ◽  
Normal Appearing White Matter ◽  
Conventional Mri ◽  
Apparent Diffusion ◽  
Teenagers And Young Adults

Abstract OBJECTIVES Evaluation of post-treatment glioma burden remains a significant challenge in children, teenagers and young adults (TYA). The aim of this study was to evaluate the utility of ChoPET/MRI for evaluation of suspected disease progression in childhood and TYA gliomas. METHODS 27 patients (mean age 14 years, range 6–21 years) with suspected glioma disease progression were evaluated with ChoPET/MRI (n=59). Relative cerebral blood volume (rCBV), apparent diffusion coefficient (ADC) and maximum standardised uptake values (SUVmax) in enhancing (enh) and non-enhancing (ne) tumour and normal-appearing white matter (wm) were calculated (rCBVenh, rCBVne, rCBVwm, ADCenh, ADCne, ADCwm, SUVenh, SUVne, SUVwm). 2 blinded radiologists scored tumour probability (1 = unlikely; 5 = definitely). Sensitivity and specificity calculated with gold standard histopathology or clinical follow-up. RESULTS Accuracy for the detection of residual/recurrent tumour on conventional MRI was 96.3% (91.7% ≤14 years, 100% ≥15 years) and ChoPET was 73.1% (66.7% ≤14 years, 80.0% ≥15 years). Lack of agreement was observed in 9/27 patients, with ChoPET superior to MRI in 1 case of a posterior fossa tumour. Tumour component analysis demonstrated significantly higher SUVenh and SUVne than SUVwm (SUVenh: p<0.001; SUVne: p=0.004, equivalent to results were observed for ADV and rCBV (ADCenh, ADCne: p<0.001 vs ADCwm; rCBVenh, rCBVne: p<0.001 vs rCBVwm). CONCLUSIONS MRI is more sensitive than ChoPET in the evaluation of suspected disease progression in TYA gliomas. However, quanititative ChoPET is able to detect enhancing and non-enhancing tumour and may be helpful in evaluating posterior fossa disease where MRI is equivocal.

Audit of regional screening guidelines for vestibular schwannoma

1998 ◽  
Vol 112 (9) ◽  
pp. 860-864 ◽  
Author(s):  
P. J. D. Dawes ◽  
J.-P. Jeannon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Posterior Fossa ◽  
Vestibular Schwannoma ◽  
Acoustic Neuroma ◽  
Resonance Imaging ◽  
Posterior Fossa Tumour ◽  
Screening Guidelines ◽  
Magnetic Resonance Imaging Mri

AbstractAn audit of 334 patients who underwent magnetic resonance imaging (MRI) as investigation for a possible diagnosis of vestibular schwannoma was carried out to assess adherence to previously agreed screening guidelines. This represents one year's activity. A posterior fossa tumour was identified in 12 patients. Scan requests were judged to be inappropriate for 28 cases. The issues surrounding the screening for acoustic neuroma are discussed.

Pain relief with elastic therapeutic taping

2021 ◽  
pp. bmjspcare-2021-003381
Author(s):  
Ekta Gupta ◽  
Courtland Lee ◽  
Amy Ng ◽  
Eduardo Bruera
Keyword(s):  
Rating Scale ◽  
Symptom Burden ◽  
Substantial Improvement ◽  
Functional Mobility ◽  
Background Information ◽  
Symptom Improvement ◽  
Plantar Surface ◽  
Pain Rating Scale ◽  
Pain Improvement

Background and purposeChemotherapy-induced peripheral neuropathy (CIPN) occurs in 19%–85% of patients undergoing cancer treatment. Due to the high symptom burden, specifically pain in the soles of feet, we explore the role of elastic therapeutic (ET) taping for treatment of CIPN.Case descriptionWe report two cases of patients with CIPN-induced foot pain while admitted to the hospital. Their background information, including chemotherapy history, treatments trialed and effects of ET on their pain, is discussed. Each patient underwent ET using the epidermis, dermis, fascia technique for CIPN. An occupational therapist applied ET to the plantar surface of both feet to the ankle with 0% stretch on the tape for 24–96 hours. We also showed the effect of symptom improvement in their individualized rehabilitation session following application of ET.OutcomesPain score, verbally documented by 10 point numerical pain rating scale, decreased by >50% in both patients within 24 hours of application. This reflects a substantial improvement in pain with the intervention of ET. This allowed for improved tolerance in engaging in functional mobility, with improvement in distances ambulated.DiscussionET taping of the distal leg and foot showed pain improvement for these two patients. Our findings suggest that a clinical trial aimed at better characterising the role of ET in these patients is justified.

EPCO-17. METHYLATION ANALYSIS OF MATCHED PRIMARY AND RECURRENT IDHmt ASTROCYTOMA; AN UPDATE FROM THE GLIOMA LONGITUDINAL ANALYSIS NL (GLASS-NL) CONSORTIUM

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi5-vi5
Author(s):  
Wies Vallentgoed ◽  
Anneke Niers ◽  
Karin van Garderen ◽  
Martin van den Bent ◽  
Kaspar Draaisma ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Surgical Resection ◽  
Molecular Mechanisms ◽  
Relative Proportion ◽  
Low Grade ◽  
High Grade ◽  
Primary Tumors ◽  
Genome Wide ◽  
Dna Methylation Profiling ◽  
Methylation Profiling

Abstract The GLASS-NL consortium, was initiated to gain insight into the molecular mechanisms underlying glioma evolution and to identify markers of progression in IDH-mutant astrocytomas. Here, we present the first results of genome-wide DNA-methylation profiling of GLASS-NL samples. 110 adult patients were identified with an IDH-mutant astrocytoma at first diagnosis. All patients underwent a surgical resection of the tumor at least twice, separated by at least 6 months (median 40.9 months (IQR: 24.0, 64.7). In 37% and 18% of the cases, patients were treated with radiotherapy or chemotherapy respectively, before surgical resection of the recurrent tumor. DNA-methylation profiling was done on 235 samples from 103 patients (102 1st, 101 2nd, 29 3rd, and 3 4th resection). Copy number variations were also extracted from these data. Methylation classes were determined according to Capper et al. Overall survival (OS) was measured from date of first surgery. Of all primary tumors, the methylation-classifier assigned 85 (87%) to the low grade subclass and 10 (10%) to the high grade subclass. The relative proportion of high grade tumors increased ~three-fold at tumor recurrence (32/101, 32%) and even further in the second recurrence (15/29, 52%). Methylation classes were prognostic, both in primary and recurrent tumors. The overall DNA-methylation levels of recurrent samples was lower than that of primary samples. This difference is explained by the increased number of high grade samples at recurrence, since near identical DNA-methylation levels were observed in samples that remained low grade. In an unsupervised analysis, DNA-methylation data derived from primary and first recurrence samples of individual patients mostly (79%) cluster together. Recurrent samples that do not cluster with their primary tumor, form a separate group with relatively low genome-wide DNA-methylation. Our data demonstrate that methylation profiling identifies a shift towards a higher grade at tumor progression coinciding with reduced genome-wide DNA-methylation levels.

Sign in / Sign up

Export Citation Format

Share Document