scholarly journals Neoplastic meningitis in solid tumours: updated review of diagnosis, prognosis, therapeutic management, and future directions

2021 ◽  
Author(s):  
E. García Molina ◽  
M. Penas-Prado
Keyword(s):  
Neoplastic Meningitis ◽  
Solid Tumours ◽  
Therapeutic Management ◽  
Future Directions

Neoplastic meningitis—Is MRI as sensitive as CSF cytology?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9566-9566
Author(s):  
H. M. Strik ◽  
P. Proemmel ◽  
S. Pilgram-Pastor ◽  
J. H. Buhk
Keyword(s):  
High Sensitivity ◽  
Neoplastic Meningitis ◽  
Solid Tumours ◽  
Lower Sensitivity ◽  
Neoplastic Disease ◽  
Haematological Malignancies ◽  
Csf Cytology ◽  
Cell Counts ◽  
Solid Malignancies ◽  
Haematological Neoplasms

9566 Background: Although CSF cytology and MRI are standard methods for the diagnosis of neoplastic meningitis (NM), this complication of neoplastic disease still remains to be difficult to detect in some cases. We therefore re-evaluated the sensitivity of gadolinium(GD)-enhanced MRI and cerebrospinal-fluid (CSF)-cytology for the diagnosis of LM differentially for solid and haematological malignancies and for normal or elevated cell counts. Methods: We identified retrospectively 101 cases of NM diagnosed in our CSF laboratory since 1990 with complete data of both MRI and CSF-cytology. 34 had haematological, 67 solid neoplasms. CSF-cell counts were increased in 63 and normal in 35 patients. Results: For haematological neoplasms, MRI was positive in 53%. CSF cytology was positive in 97%. In solid tumours, we found MRI-sensitivity of 0.81 and cytological sensitivity of 0.76. With normal CSF-cell-counts, MRI was positive in 63%, (0.57 haematological, 0.75 solid malignancies), CSF-cytology in 78%, (0.9 in haematological, 0,64 in solid neoplasms). In cases of increased cell-counts, MRI-sensitivity was 0.75 (0.52 for haematological, 0.87 for solid malignancies), and sensitivity of CSF-cytology was 0.89 (1.0 for haematological and 0.82 for solid neoplasms). 23 patients were treated with intrathecal MTX or Ara-C, 16 patients with liposomal Ara-C. 62 patients were not treated intrathecally. Conclusions: We confirmed here the high overall sensitivity of MRI for the diagnosis of neoplastic meningitis. The best sensitivity, however, was seen in solid tumours and elevated cell counts. In haematological malignancies, a markedly lower sensitivity of MRI was seen. Of note, we consider the very high sensitivity of cytology in haematological malignancies to be artificial due to methodological reasons of this retrospective study. We conclude that MRI is a very sensitive method to detect NM especially in solid tumours and elevated cell counts. With normal cell counts and haematological neoplasms, CSF-cytology remains to be superior to radiological methods. [Table: see text]

Imatinib Mesylate for the Treatment of Solid Tumours: Recent Trials and Future Directions

2007 ◽  
Vol 3 (4) ◽  
pp. 273-283
Author(s):  
Carlo Smirne ◽  
Anna Carbone ◽  
Tiziana Scirelli ◽  
Graziella Bellone
Keyword(s):  
Imatinib Mesylate ◽  
Solid Tumours ◽  
Future Directions

On Future Directions in Pathology

1982 ◽  
Vol 40 ◽  
pp. 274-277
Author(s):  
Benjamin F. Trump ◽  
Irene K. Berezesky ◽  
Raymond T. Jones
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Clinical Pathology ◽  
Future Directions ◽  
Diagnostic Pathology ◽  
The Past ◽  
Transmission Electron ◽  
Organ Systems ◽  
The Many

The role of electron microscopy and associated techniques is assured in diagnostic pathology. At the present time, most of the progress has been made on tissues examined by transmission electron microscopy (TEM) and correlated with light microscopy (LM) and by cytochemistry using both plastic and paraffin-embedded materials. As mentioned elsewhere in this symposium, this has revolutionized many fields of pathology including diagnostic, anatomic and clinical pathology. It began with the kidney; however, it has now been extended to most other organ systems and to tumor diagnosis in general. The results of the past few years tend to indicate the future directions and needs of this expanding field. Now, in addition to routine EM, pathologists have access to the many newly developed methods and instruments mentioned below which should aid considerably not only in diagnostic pathology but in investigative pathology as well.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

Translating Principles of Speech Science to Clinical Practice: Current and Future Trends in Craniofacial Disorders

2008 ◽  
Vol 18 (1) ◽  
pp. 31-40 ◽  
Author(s):  
David J. Zajac
Keyword(s):  
Clinical Practice ◽  
Speech Intelligibility ◽  
Current Practice ◽  
Computer Assisted ◽  
Behavioral Management ◽  
Single Word ◽  
Future Directions ◽  
Speech Science ◽  
The Impact ◽  
Opinion Article

Abstract The purpose of this opinion article is to review the impact of the principles and technology of speech science on clinical practice in the area of craniofacial disorders. Current practice relative to (a) speech aerodynamic assessment, (b) computer-assisted single-word speech intelligibility testing, and (c) behavioral management of hypernasal resonance are reviewed. Future directions and/or refinement of each area are also identified. It is suggested that both challenging and rewarding times are in store for clinical researchers in craniofacial disorders.

The Collaborative Medical and Behavioral Management of Chronic Cough

2009 ◽  
Vol 19 (2) ◽  
pp. 49-57
Author(s):  
Brian E. Petty ◽  
Seth H. Dailey
Keyword(s):  
Medical Care ◽  
Chronic Cough ◽  
Therapeutic Management ◽  
Ambulatory Setting ◽  
Behavioral Management ◽  
Speech Language Pathologists ◽  
Speech Language Pathologist ◽  
The Many ◽  
Frequent Reason

Abstract Chronic cough is the most frequent reason cited by patients for seeking medical care in an ambulatory setting and may account for 10% to 38% of a pulmonologist's practice. Because chronic cough can be caused by or correlated with a wide array of disorders and behaviors, the diagnosis of etiologic factors and determination of appropriate therapeutic management in these cases can prove to be daunting for the physician and speech-language pathologist alike. This article will describe the phenomenon of chronic cough, discuss the many etiologic factors to consider, and review some of the more common ways in which speech-language pathologists and physicians collaborate to treat this challenging condition.

ELECTRON MICROSCOPIC ASSESSMENT OF SMEARED OR IMPRINTED SPECIMENS OF SOLID TUMOURS

Pathology ◽  
2001 ◽  
Vol 33 (2) ◽  
pp. 226-229 ◽  
Author(s):  
Jane E. Dahlstrom ◽  
Lesley E. Maxwell
Keyword(s):  
Solid Tumours ◽  
Electron Microscopic

Renal denervation - a clinical update and future directions

VASA ◽  
2013 ◽  
Vol 42 (4) ◽  
pp. 239-251
Author(s):  
Kai Mortensen ◽  
Klaas Franzen ◽  
Michael Reppel ◽  
Joachim Weil
Keyword(s):  
Renal Denervation ◽  
Future Directions ◽  
Scientific Background

The aim of this review is to give a contemporary update on renal denervation therapy focusing particularly on the scientific background and present literature as well as on different technical approaches and potential future directions.

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