Risk Stratification of Medulloblastoma: A Paradigm for Future Childhood Brain Tumor Management Strategies

2010 ◽  
Vol 11 (2) ◽  
pp. 124-126 ◽  
Author(s):  
Roger J. Packer
Keyword(s):  
Brain Tumor ◽  
Risk Stratification ◽  
Management Strategies ◽  
Childhood Brain Tumor ◽  
Tumor Management

scholarly journals A National Consensus Survey for Current Practice in Brain Tumor Management I: Antiepileptic Drug and Steroid Usage

2020 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Sung Kwon Kim ◽  
Jangsup Moon ◽  
Jin Mo Cho ◽  
Kyung Hwan Kim ◽  
Se Hoon Kim ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Antiepileptic Drug ◽  
Current Practice ◽  
National Consensus ◽  
Tumor Management

scholarly journals High Prevalence of Weight Gain in Childhood Brain Tumor Survivors and Its Association With Hypothalamic-Pituitary Dysfunction

2021 ◽  
pp. JCO.20.01765
Author(s):  
Jiska van Schaik ◽  
Ichelle M. A. A. van Roessel ◽  
Netteke A. Y. N. Schouten-van Meeteren ◽  
Laura van Iersel ◽  
Sarah C. Clement ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Tumor ◽  
Weight Gain ◽  
Standard Deviation Score ◽  
Cardiometabolic Health ◽  
Low Grade ◽  
Childhood Brain Tumor ◽  
Significant Weight Gain ◽  
Overweight Or Obesity

PURPOSE Childhood brain tumor survivors (CBTS) are at risk for developing obesity, which negatively influences cardiometabolic health. The prevalence of obesity in CBTS may have been overestimated in previous cohorts because of inclusion of children with craniopharyngioma. On the contrary, the degree of weight gain may have been underestimated because of exclusion of CBTS who experienced weight gain, but were neither overweight nor obese. Weight gain may be an indicator of underlying hypothalamic-pituitary (HP) dysfunction. We aimed to study prevalence of and risk factors for significant weight gain, overweight, or obesity, and its association with HP dysfunction in a national cohort of noncraniopharyngioma and nonpituitary CBTS. METHODS Prevalence of and risk factors for significant weight gain (body mass index [BMI] change ≥ +2.0 standard deviation score [SDS]), overweight, or obesity at follow-up, and its association with HP dysfunction were studied in a nationwide cohort of CBTS, diagnosed in a 10-year period (2002-2012), excluding all craniopharyngioma and pituitary tumors. RESULTS Of 661 CBTS, with a median age at follow-up of 7.3 years, 33.1% had significant weight gain, overweight, or obesity. Of the CBTS between 4 and 20 years of age, 28.7% were overweight or obese, compared with 13.2% of the general population between 4 and 20 years of age. BMI SDS at diagnosis, diagnosis of low-grade glioma, diabetes insipidus, and central precocious puberty were associated with weight gain, overweight, or obesity. The prevalence of HP dysfunction was higher in overweight and obese CTBS compared with normal-weight CBTS. CONCLUSION Overweight, obesity, and significant weight gain are prevalent in CBTS. An increase in BMI during follow-up may be a reflection of HP dysfunction, necessitating more intense endocrine surveillance.

scholarly journals A National Consensus Survey for Current Practice in Brain Tumor Management II: Diffuse Midline Glioma and Meningioma

2020 ◽  
Vol 8 (1) ◽  
pp. 11
Author(s):  
Sung Kwon Kim ◽  
Hong In Yoon ◽  
Wan-Soo Yoon ◽  
Jin Mo Cho ◽  
Jangsup Moon ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Current Practice ◽  
National Consensus ◽  
Tumor Management ◽  
Diffuse Midline Glioma

The Fragility and Tenacity of Hope

Save My Kid ◽  
2020 ◽  
pp. 156-172
Author(s):  
Amanda M. Gengler
Keyword(s):  
Brain Tumor ◽  
Daily Life ◽  
Management Strategies ◽  
Illness Management ◽  
Stepping Stone ◽  
Life Threatening Illness ◽  
The World ◽  
Life Threatening ◽  
Emotional Dynamics

Chapter 7 introduces the author’s sudden personal immersion into the world of negotiating life-threatening illness. When Amanda Gengler’s father was diagnosed with a terminal brain tumor, the significant advantages of care-captaining and the potential consequences of care-entrusting were brought into even sharper relief. By living an experience somewhat parallel to that of the families she was studying, she found the emotional dynamics at the root of these illness management strategies crystalizing in her own daily life. She also learned intimately that hope can ultimately serve as both a stepping stone and a stumbling block as illness unfolds.

A multiparametric ICD algorithm for heart failure risk stratification and management: an analysis in clinical practice

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
L Calo" ◽  
V Bianchi ◽  
D Ferraioli ◽  
L Santini ◽  
A Dello Russo ◽  
...  
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Clinical Practice ◽  
Risk Stratification ◽  
Management Strategies ◽  
Cardiac Resynchronization ◽  
Office Visits ◽  
Increased Risk ◽  
Patients At Risk ◽  
Observation Period

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The HeartLogic algorithm combines multiple implantable cardioverter defibrillator (ICD) sensors to identify patients at risk of heart failure (HF) events. Purpose We sought to evaluate the risk stratification ability of this algorithm in clinical practice. We also analyzed the alert management strategies adopted in the study group and their association with the occurrence of HF events. Methods The HeartLogic feature was activated in 366 ICD and cardiac resynchronization therapy ICD patients at 22 centers. The HeartLogic algorithm automatically calculates a daily HF index and identifies periods IN or OUT of an alert state on the basis of a configurable threshold (in this analysis set to 16). Results The HeartLogic index crossed the threshold value 273 times (0.76 alerts/patient-year) in 150 patients over a median follow-up of 11 months [25-75 percentile: 6-16]. Overall, the time IN the alert state was 11% of the total observation period. Patients experienced 36 HF hospitalizations and 8 patients died of HF (rate: 0.12 events/patient-year) during the observation period. Thirty-five events were associated with the IN alert state (0.92 events/patient-year versus 0.03 events/patient-year in the OUT of alert state). The hazard ratio in the IN/OUT of alert state comparison was (HR: 24.53, 95% CI: 8.55-70.38, p < 0.001), after adjustment for baseline clinical confounders. Alerts followed by clinical actions were associated with a lower rate of HF events (HR: 0.37, 95% CI: 0.14-0.99, p = 0.047). No differences in event rates were observed between in-office and remote alert management. By contrast, verification of HF symptoms during post-alert examination was associated with a higher risk of HF events (HR: 5.23, 95% CI: 1.98-13.83, p < 0.001). Conclusions This multiparametric ICD algorithm identifies patients during periods of significantly increased risk of HF events. The rate of HF events seemed lower when clinical actions were undertaken in response to alerts. Extra in-office visits did not seem to be required in order to effectively manage HeartLogic alerts, while post-alert verification of symptoms seemed useful in order to better stratify patients at risk of HF events.

Role of Hospital Medicine in Management of Intracranial Brain Tumors

2019 ◽  
pp. 57-73
Author(s):  
Donald Y. Ye ◽  
Thana Theofanis ◽  
Tomas Garzon-Muvdi ◽  
James J. Evans
Keyword(s):  
Risk Factors ◽  
Brain Tumor ◽  
Postoperative Complications ◽  
Brain Tumors ◽  
Management Strategies ◽  
Hospital Medicine ◽  
Intracranial Tumors ◽  
Medical Oncologists ◽  
Insight Into

Intracranial tumors reflect a broad range of benign and malignant processes that are often managed by neurosurgeons and medical oncologists. Patients presenting with new brain tumors will undergo biopsies or resection for tissue diagnosis and resolution of neurological symptoms. These patients have significant perioperative risk factors that must be addressed to ensure the best possible outcomes. Hospitalists play a pivotal role in identifying these risk factors and offering management strategies prior to the development of an operative plan. This chapter provides insight into the range of preoperative considerations and postoperative complications that a hospitalist may face when managing brain tumor patients.

scholarly journals Late effects after childhood brain tumor treatment: it’s not just about the radiation

2019 ◽  
Vol 21 (5) ◽  
pp. 565-567 ◽  
Author(s):  
Derek S Tsang ◽  
Kim Edelstein
Keyword(s):  
Brain Tumor ◽  
Late Effects ◽  
Childhood Brain Tumor ◽  
Tumor Treatment

Exploiting Laboratory Insights to Improve Outcomes of Pediatric Central Nervous System Tumors

2016 ◽  
pp. e540-e546 ◽  
Author(s):  
Giles W. Robinson ◽  
Hendrik Witt ◽  
Adam Resnick
Keyword(s):  
Brain Tumor ◽  
Molecular Mechanisms ◽  
Therapeutic Potential ◽  
Pediatric Brain Tumor ◽  
Pediatric Brain Tumors ◽  
Low Grade ◽  
Short Period ◽  
Tumor Management ◽  
The Impact ◽  
Pediatric Brain

Over a relatively short period of time, owing to improvements in biotechnology, our ability to identify the molecular mechanisms within pediatric brain tumors has dramatically increased. These findings have reshaped the way that we describe these diseases and have provided insights into how to better treat these often devastating diseases. Although still far from reaching the full therapeutic potential these advancements hold, the impact of these findings is steadily taking hold of pediatric brain tumor management. In this article, we summarize the major discoveries within three common pediatric brain tumor categories; medulloblastoma, ependymoma, and low-grade glioma. We discuss the current impact of these findings on treatment and the direction these findings may take the field of pediatric neuro-oncology.

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