Association Between IDH1 and IDH2 Mutations and Preoperative Seizures in Patients with Low-Grade Versus High-Grade Glioma: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 111 ◽  
pp. e539-e545 ◽  
Author(s):  
Kevin Phan ◽  
Wyatt Ng ◽  
Victor M. Lu ◽  
Kerrie L. McDonald ◽  
Jacob Fairhall ◽  
...  
2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi246-vi246
Author(s):  
Ahmad Almekkawi ◽  
Tarek El Ahmadieh ◽  
Karl Abi-Aad ◽  
Salah Aoun ◽  
Najib EL Tecle ◽  
...  

Abstract BACKGROUND 5-aminolevulinic acid is a reliable tool for optimizing high-grade glioma resection. However, its efficacy in low-grade glioma resection remains unclear. OBJECTIVE To study the role of 5-aminolevulinic acid in low-grade glioma resection and assess positive fluorescence rates and effect on the extent of resection. METHODS A systematic review of PubMed, Google Scholar, and Cochrane was performed from the date of inception to February 1, 2019. Studies that correlated 5-aminolevulinic acid fluorescence with low-grade glioma in the setting of operative resection were selected. Studies with biopsy only were excluded. Positive fluorescence rates were calculated. Quality index of the selected papers using the Downs and Black criteria checklist was provided. RESULTS Twelve articles met the selection criteria with 244 histologically-confirmed low-grade glioma patients who underwent microsurgical resection. All patients received 20 mg/kg body weight of 5-aminolevulinic acid. Only 60 patients (n=60/244; 24.5%) demonstrated visual intra-operative 5-aminolevulinic acid fluorescence. The extent of resection was reported in 4 studies, however, the data combined low- and high-grade tumors. Only 2 studies reported on tumor location. Only 3 studies reported on clinical outcomes. The Zeiss OPMI Pentero microscope was most commonly used across all studies. The average quality index was 14.58 (range: 10–17) which correlated with an overall good quality. CONCLUSION There is an overall low correlation between 5-aminolevulinic acid fluorescence and low-grade glioma. Advances in visualization technology and using standardized fluorescence quantification methods may further improve the visualization and reliability of 5-aminolevulinic acid fluorescence in low-grade glioma resection.


2019 ◽  
Vol 21 (Supplement_4) ◽  
pp. iv14-iv14
Author(s):  
Shivani Soni ◽  
Matthew Williamas ◽  
Antonia Lannie

Abstract Introduction Brain tumour patients face a variety of challenges during diagnosis and treatment. Although most treating clinicians are familiar with these, it can be difficult to obtain a comprehensive overview of which are the most common problems, which patients they affect and how to address them. Methods We conducted a systematic review of all work relating to the lived experience of patients and carers of a glioblastoma. We identified articles published between 2008 and 2018 these had to be published in English, using the search terms cares and patients, lived experience, glioblastoma and perspective with relative alternative terms. We excluded articles that were previous systematic reviews, included low grade/brain metastasis from another primary site and articles that combined results for patients and carers. We extracted key theme and concerns, and summarised and tabulated and developed a discussion/recommendation. Results We identified 405 potential studies. We rejected 374 after screening abstract and titles, and a further 23 on further review. This left a set of 8 unique publications. The 8 publications included were comprised of qualitative studies that explored patient and carers experience at different points in the patient pathway. The main concerns/themes identified were issues around communication specifically the shock of diagnosis, re-negotiating relationships and finally accessing support. Conclusions This is the first systematic review that collates the lived experience of patients with high grade gliomas. It differs from the palliative care literature and from the James Lind Alliance, and is more specific than generic health needs assessments that are being used in practice.


2021 ◽  
pp. 036354652110279
Author(s):  
Austin M. Looney ◽  
Blake M. Bodendorfer ◽  
Stiles T. Donaldson ◽  
Robert B. Browning ◽  
Jorge A. Chahla ◽  
...  

Background: Increasing evidence supports surgical intervention for hip abductor tears; however, the influence of fatty infiltration (FI) on outcomes after repair remains uncertain and has been addressed only in small case series. Purpose: To clarify the relationship between FI and surgical outcomes for hip abductor tears. Study Design: Meta-analysis; Level of evidence, 4. Methods: A systematic review and meta-analysis was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. FI severity was assessed by Goutallier-Fuchs (G-F) grade. The relationship between FI and improvement in Harris Hip Score (HHS)/modified Harris Hip Score (mHHS) and visual analog scale (VAS) score for pain was examined with mixed-effects metaregression. Outcomes with open and endoscopic techniques were also compared. Results: A total of 4 studies (206 repairs in 201 patients) were eligible. High-grade FI was associated with significantly less improvement in HHS/mHHS than both no FI (6.761 less; 95% CI, 3.983-11.570; P = .002) and low-grade FI (7.776 less; 95% CI, 2.460-11.062; P < .001) but did not significantly influence VAS score ( P > .05). Controlling for FI severity, we found no significant difference in HHS/mHHS improvement between open versus endoscopic repair ( P > .05 at each level), but open repair resulted in significantly greater improvement in VAS score for every G-F grade (all P < .005). Conclusion: Surgical intervention for symptomatic hip abductor tendon tears improved outcomes as reflected by change in HHS/mHHS; however, the presence of high-grade FI resulted in less improvement. FI severity did not influence VAS scores for pain. Although no differences were found between open and endoscopic repairs in terms of FI-adjusted improvement in HHS/mHHS, open repairs resulted in significantly greater pain relief at each FI level.


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