scholarly journals Case-based review: pediatric medulloblastoma

2017 ◽  
Vol 4 (3) ◽  
pp. 138-150 ◽  
Author(s):  
Cassie N Kline ◽  
Roger J Packer ◽  
Eugene I Hwang ◽  
David R Raleigh ◽  
Steve Braunstein ◽  
...  
Keyword(s):  
Multimodal Approach ◽  
Ongoing Research ◽  
Group 4 ◽  
Pediatric Medulloblastoma ◽  
Life Threatening ◽  
The Central Nervous System ◽  
Group 3 ◽  
Multiagent Chemotherapy ◽  
Active Investigation

AbstractMedulloblastoma is the most common malignant brain tumor affecting children. These tumors are high grade with propensity to metastasize within the central nervous system and, less frequently, outside the neuraxis. Recent advancements in molecular subgrouping of medulloblastoma refine diagnosis and improve counseling in regards to overall prognosis. Both are predicated on the molecular drivers of each subgroup—WNT-activated, SHH-activated, group 3, and group 4. The traditional therapeutic mainstay for medulloblastoma includes a multimodal approach with surgery, radiation, and multiagent chemotherapy. As we discover more about the molecular basis of medulloblastoma, efforts to adjust treatment approaches based on molecular risk stratification are under active investigation. Certainly, the known neurological, developmental, endocrine, and psychosocial injury related to medulloblastoma and its associated therapies motivate ongoing research towards improving treatment for this life-threatening tumor while at the same time minimizing long-term side effects.

scholarly journals Evaluation of Some Male and Female Rats’ Reproductive Hormones Following Administration of Aspartame With or Without Vitamin C or E

2021 ◽  
Vol 45 (2) ◽  
pp. 14-20
Author(s):  
Omar H Azeez
Keyword(s):  
Vitamin C ◽  
Reproductive Hormones ◽  
Female Rats ◽  
Control Group ◽  
Male And Female ◽  
Group 4 ◽  
Male And Female Rats ◽  
Group 3 ◽  
Group 2

Aspartame (ASP) is a sugar substitute. Its use rose because it has been demonstrated to have deleterious effects after being metabolized. In the presence of antioxidant vitamins C or E, the effects of ASP on reproductive hormones of adult male and female Albino Wister rats were investigated. A total of eighty male and female rats were used in this study. The rats were divided into four groups: group 1, received no treatment; group 2, received ASP at 40 mg/kg BW; group 3, received ASP at 40 mg/kg BW with vitamin C at 150 mg/kg BW; and group 4, received ASP at 40 mg/kg BW and vitamin E at 100 mg/kg BW. All treatments were given orally by gavage needle once daily for consecutive 90 days. The levels of estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone hormone (TH) were measured after 90 days in blood plasma. In comparison with the control group, ASP treatment resulted in lower levels of E2, FSH, and LH in male and female rats. When the antioxidants vitamin C or E was given, the effects of ASP were reversed, and the levels of E2, LH, and FSH were increased. The testosterone hormone was likewise significantly increased by ASP, but testosterone hormone concentrations were decreased by vitamin C or E treatments. Long-term ASP consumption caused interfering with testicular and ovarian hormonal activity, while vitamins C and E on the other hand, overcome longstanding consumption ASP's effects.

scholarly journals PATH-25. APPLICABILITY OF A NOMOGRAM INCLUDING CLINICAL AND MOLECULAR VARIABLES IN THE STRATIFICATION OF RISK GROUPS IN PEDIATRIC MEDULLOBLASTOMA

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi148-vi148
Author(s):  
Bruna Mançano ◽  
Rui Reis ◽  
Leticia Leal ◽  
Flavia de Paula ◽  
Carlos Almeida Jr ◽  
...  
Keyword(s):  
Survival Rates ◽  
Disease Free Survival ◽  
Risk Groups ◽  
Molecular Characteristics ◽  
Childhood And Adolescence ◽  
Tumor Subtypes ◽  
Group 4 ◽  
Pediatric Medulloblastoma ◽  
Group 3 ◽  
Multiple Variables

Abstract Medulloblastoma is the most common type of malignant brain tumor that occurs during childhood and adolescence. Currently, this pathology comprises at least four different molecular tumor subtypes (WNT, SHH, group 3 or C and group 4 or D) which have their own molecular characteristics, distinct clinical presentations and are associated with different survival rates. The purpose is to evaluate the applicability of a nomogram that includes clinical and molecular variables in pediatric medulloblastomas in the routine of the Hospital de Cancer de Barretos. The series l consists of 85 pediatric patients from 0 to 18 years old, diagnosed with medulloblastoma attended at the Hospital de Cancer de Barretos (HCB), from January 2000 to December 2017. The molecular subgroups will be performed using the Nanostring technique. This research intends to implement a nomogram that uses several variables known and involved in the treatment and prognosis of patients, this nomogram with multiple variables will show the clinical and molecular effect of each variable to predict disease-free survival and survival overall in 3 and 5 years. Thus, we will have the opportunity to analyze these characteristics in order to improve survival and reduce morbidity and consequently mortality during treatment for the different subgroups of medulloblastomas.

scholarly journals Preclinical Models of Craniospinal Irradiation for Medulloblastoma

Cancers ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 133 ◽  
Author(s):  
Jennifer L. Stripay ◽  
Thomas E. Merchant ◽  
Martine F. Roussel ◽  
Christopher L. Tinkle
Keyword(s):  
Small Animal ◽  
Craniospinal Irradiation ◽  
Tumor Control ◽  
Preclinical Models ◽  
Treatment Interventions ◽  
Leptomeningeal Seeding ◽  
Group 4 ◽  
Pediatric Medulloblastoma ◽  
Group 3

Medulloblastoma is an embryonal tumor that shows a predilection for distant metastatic spread and leptomeningeal seeding. For most patients, optimal management of medulloblastoma includes maximum safe resection followed by adjuvant craniospinal irradiation (CSI) and chemotherapy. Although CSI is crucial in treating medulloblastoma, the realization that medulloblastoma is a heterogeneous disease comprising four distinct molecular subgroups (wingless [WNT], sonic hedgehog [SHH], Group 3 [G3], and Group 4 [G4]) with distinct clinical characteristics and prognoses has refocused efforts to better define the optimal role of CSI within and across disease subgroups. The ability to deliver clinically relevant CSI to preclinical models of medulloblastoma offers the potential to study radiation dose and volume effects on tumor control and toxicity in these subgroups and to identify subgroup-specific combination adjuvant therapies. Recent efforts have employed commercial image-guided small animal irradiation systems as well as custom approaches to deliver accurate and reproducible fractionated CSI in various preclinical models of medulloblastoma. Here, we provide an overview of the current clinical indications for, and technical aspects of, irradiation of pediatric medulloblastoma. We then review the current literature on preclinical modeling of and treatment interventions for medulloblastoma and conclude with a summary of challenges in the field of preclinical modeling of CSI for the treatment of leptomeningeal seeding tumors.

Primary and secondary cutaneous CD30+lymphoproliferative disorders: a report from the Dutch Cutaneous Lymphoma Group on the long-term follow-up data of 219 patients and guidelines for diagnosis and treatment

Blood ◽  
2000 ◽  
Vol 95 (12) ◽  
pp. 3653-3661 ◽  
Author(s):  
Marcel W. Bekkenk ◽  
Françoise A. M. J. Geelen ◽  
Pieter C. van Voorst Vader ◽  
F. Heule ◽  
Marie-Louise Geerts ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Involvement ◽  
Lymphoproliferative Disorders ◽  
Group 4 ◽  
Long Term Follow Up ◽  
Node Involvement ◽  
Group 3 ◽  
Group 2 ◽  
Multiagent Chemotherapy ◽  
Group 1

Abstract To evaluate our diagnostic and therapeutic guidelines, clinical and long-term follow-up data of 219 patients with primary or secondary cutaneous CD30+ lymphoproliferative disorders were evaluated. The study group included 118 patients with lymphomatoid papulosis (LyP; group 1), 79 patients with primary cutaneous CD30+ large T-cell lymphoma (LTCL; group 2), 11 patients with CD30+ LTCL and skin and regional lymph node involvement (group 3), and 11 patients with secondary cutaneous CD30+ LTCL (group 4). Patients with LyP often did not receive any specific treatment, whereas most patients with primary cutaneous CD30+ LTCL were treated with radiotherapy or excision. All patients with skin-limited disease from groups 1 and 2 who were treated with multiagent chemotherapy had 1 or more skin relapses. The calculated risk for systemic disease within 10 years of diagnosis was 4% for group 1, 16% for group 2, and 20% for group 3 (after initial therapy). Disease-related 5-year-survival rates were 100% (group 1), 96% (group 2), 91% (group 3), and 24% (group 4), respectively. The results confirm the favorable prognoses of these primary cutaneous CD30+ lymphoproliferative disorders and underscore that LyP and primary cutaneous CD30+ lymphomas are closely related conditions. They also indicate that CD30+ LTCL on the skin and in 1 draining lymph node station has a good prognosis similar to that for primary cutaneous CD30+ LTCL without concurrent lymph node involvement. Multiagent chemotherapy is only indicated for patients with full-blown or developing extracutaneous disease; it is never or rarely indicated for patients with skin-limited CD30+ lymphomas.

Primary and secondary cutaneous CD30+lymphoproliferative disorders: a report from the Dutch Cutaneous Lymphoma Group on the long-term follow-up data of 219 patients and guidelines for diagnosis and treatment

Blood ◽  
2000 ◽  
Vol 95 (12) ◽  
pp. 3653-3661 ◽  
Author(s):  
Marcel W. Bekkenk ◽  
Françoise A. M. J. Geelen ◽  
Pieter C. van Voorst Vader ◽  
F. Heule ◽  
Marie-Louise Geerts ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Involvement ◽  
Lymphoproliferative Disorders ◽  
Group 4 ◽  
Long Term Follow Up ◽  
Node Involvement ◽  
Group 3 ◽  
Group 2 ◽  
Multiagent Chemotherapy ◽  
Group 1

To evaluate our diagnostic and therapeutic guidelines, clinical and long-term follow-up data of 219 patients with primary or secondary cutaneous CD30+ lymphoproliferative disorders were evaluated. The study group included 118 patients with lymphomatoid papulosis (LyP; group 1), 79 patients with primary cutaneous CD30+ large T-cell lymphoma (LTCL; group 2), 11 patients with CD30+ LTCL and skin and regional lymph node involvement (group 3), and 11 patients with secondary cutaneous CD30+ LTCL (group 4). Patients with LyP often did not receive any specific treatment, whereas most patients with primary cutaneous CD30+ LTCL were treated with radiotherapy or excision. All patients with skin-limited disease from groups 1 and 2 who were treated with multiagent chemotherapy had 1 or more skin relapses. The calculated risk for systemic disease within 10 years of diagnosis was 4% for group 1, 16% for group 2, and 20% for group 3 (after initial therapy). Disease-related 5-year-survival rates were 100% (group 1), 96% (group 2), 91% (group 3), and 24% (group 4), respectively. The results confirm the favorable prognoses of these primary cutaneous CD30+ lymphoproliferative disorders and underscore that LyP and primary cutaneous CD30+ lymphomas are closely related conditions. They also indicate that CD30+ LTCL on the skin and in 1 draining lymph node station has a good prognosis similar to that for primary cutaneous CD30+ LTCL without concurrent lymph node involvement. Multiagent chemotherapy is only indicated for patients with full-blown or developing extracutaneous disease; it is never or rarely indicated for patients with skin-limited CD30+ lymphomas.

scholarly journals Pitfalls in the Diagnosis and Management of Invasive Pneumococcal Meningoencephalitis – What We Can Learn From a Case

2017 ◽  
Vol 10 ◽  
pp. 117954761772550
Author(s):  
Pascale S Grzonka ◽  
Raoul Sutter
Keyword(s):  
Case Fatality Rate ◽  
Pneumococcal Meningitis ◽  
Case Fatality ◽  
Rapid Diagnosis ◽  
Common Type ◽  
Neurological Sequelae ◽  
Management Of Complications ◽  
Life Threatening ◽  
The Central Nervous System

Invasive pneumococcal meningitis is a life-threatening infectious disease affecting the central nervous system. It continues to be the most common type of community-acquired acute bacterial meningitides. Despite advances in neuro-critical care, the case fatality rate remains high. Rapid diagnosis and initiation of antibiotic therapy precludes mortality and long-term neurological sequelae in survivors. However, not all cases are easily recognised, and unanticipated complications may impede optimal course and outcome. Here, we describe a case of invasive pneumococcal meningoencephalitis in a 65-year-old man with an unusual initial presentation and pitfalls in the course of the disease. We highlight the importance of early diagnosis and treatment as well as recognition and management of complications.

scholarly journals Maxillary anterior alignment stability in Class I and Class II malocclusions treated with or without extraction

2015 ◽  
Vol 86 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Willian Juarez Granucci Guirro ◽  
Karina Maria Salvatore Freitas ◽  
Guilherme Janson ◽  
Marcos Roberto de Freitas ◽  
Camila Leite Quaglio
Keyword(s):  
Class Ii ◽  
Class I ◽  
Maxillary Incisor ◽  
Class Ii Malocclusion ◽  
Group 4 ◽  
Posttreatment Period ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

ABSTRACT Objective:  To compare the postretention stability of maxillary incisors alignment in subjects with Class I and II malocclusion treated with or without extractions. Materials and Methods:  The sample comprised 103 subjects with initial maxillary anterior irregularity greater than 3 mm and was divided into four groups: group 1 comprised 19 patients with Class I malocclusion treated with nonextraction (mean initial age = 13.06 years); group 2 comprised 19 patients with Class II malocclusion treated with nonextraction (mean initial age = 12.54 years); group 3 comprised 30 patients with Class I malocclusion treated with extractions (mean initial age = 13.16 years); group 4 comprised 35 patients with Class II malocclusion treated with extractions (mean initial age = 12.99 years). Dental casts were obtained at three different stages: pretreatment (T1), posttreatment (T2), and long-term posttreatment (T3). Maxillary incisor irregularity and arch dimensions were evaluated. Intergroup comparisons were performed by one-way analysis of variance followed by Tukey tests. Results:  In the long-term posttreatment period, relapse of maxillary crowding and arch dimensions was similar in all groups. Conclusion:  Changes in maxillary anterior alignment in Class I and Class II malocclusions treated with nonextractions and with extractions were similar in the long-term posttreatment period.

scholarly journals Immediate and long-term results of carotid endarterectomy in different periods of ischemic stroke

2020 ◽  
Vol 28 (3) ◽  
pp. 312-322
Author(s):  
Anton N. Kazantsev ◽  
Konstantin P. Chernykh ◽  
Nona E. Zarkua ◽  
Roman Yu. Lider ◽  
Ekaterina A. Burkova ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Long Term Results ◽  
Lethal Outcome ◽  
Group 4 ◽  
Hospitalization Period ◽  
Rehabilitation Period ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. Analysis of hospital and long-term results of carotid endarterectomy (CEA) in different periods of acute cerebrovascular event (ACVE). Materials and Methods. The given study was retrospective and was conducted using the method of patients sampling. In the period from 2010 to 2019, 1113 patients with ACVE in history who were later conducted CEA, were selected. Depending on the time interval between the last ACVE and CAE, all the patients were divided into 4 groups: the 1st group in the acutest period of ACVE (1-3 days) (n=24; 2.2%); the 2nd group in the acute period of ACVE (up to 28 days) (n=493; 44.3%); the 3rd group in the early rehabilitation period of ACVE (up to 6 months) (n=481; 43.2%); the 4th group in the late rehabilitation period of ACVE (up to 2 years) (n=115; 10.3%). The long-term period was 34.812.5 months. Results. In the hospitalization period of observation the following complications were found: lethal outcome ((group 1 0%; group 2 0.4% (n=2); group 3 0.2% (n=1); group 4 0%; р=0.16)); myocardial infarction ((group 1 0%; group 2 0.4% (n=2); group 3 0%; group 4 0.9% (n=1); р=0.35)); ACVE/transient ischemic attack (TIA), ((group 1 4.2% (n=1); group 2 0.4% (n=2); group 3 0.2% (n=1); group 4 0%; р1-2=0.01; р1-3=0.009; р1-4=0.01)). By the end of hospitalization period the composite endpoint consisting of lethal outcome + myocardial infarction + ACVE/TIA made in group 1 4.2% (n=1), in group 2 1.2% (n=6), in group 3 0.4% (n=2), in group 4 2.6% (n=3), р=0.08. Complications of the long-term follow-up period were: lethal outcome from all causes ((group 1 25% (n=6); group 2 5.5% (n=27); group 3 7.3% (n=35); group 4 14% (n=16); р1-2=0.002; р1-3=0.008; р2-4=0.012)); lethal outcome from cardiovascular causes ((group 1 4.2% (n=1); group 2 3.6% (n=18); group 3 4.8% (n=23); group 4 5.2% (n=6); р=0.79)), myocardial infarction ((group 1 12.5% (n=3); group 2 3.6% (n=18); group 3 5.4% (n=26); group 4 6.1% (n=7); р=0.15)), ACVE/TIA ((group 1 16.6% (n=4); group 2 6.3% (n=31); group 3 6% (n=29); group 4 11.3% (n=13); р=0.05)); composite endpoint including lethal outcome + myocardial infarction + ACVE/TIA ((group 1 54.2% (n=13); group 2 15.4% (n=76); group 3 18.7% (n=90); group 4 31.3% (n=36); р1-2=0.0001; р1-3=0.0001; р1-4=0.005; р2-4=0.0006; р3-4=0.012)). Conclusion. Application of CEA demonstrated effectiveness and safety in the acute and early rehabilitation period of ACVE.

P–194 Impact of cryopreservation duration on pregnancy outcomes of vitrified-warmed blastocysts transfer using an open-device system

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Q Zheng ◽  
H Zhang ◽  
S Xu ◽  
F Xu ◽  
F Xiong ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Clinical Pregnancy ◽  
Miscarriage Rate ◽  
Storage Duration ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Abstract Study question Is there a negative effect of long-term cryopreservation upon pregnancy outcomes after transfer of vitrified-warmed blastocysts stored in an open-device system? Summary answer Prolonged cryopreservation of vitrified blastocysts up to 24 months increased the incidences of clinical pregnancy, ongoing pregnancy, and live birth, while decreased early miscarriage rate. What is known already Vitrification is adopted as the dominant approach for cryopreservation of human oocytes and embryos. However, little is known about the potential effect of prolonged storage after vitrification on the genomic integrity and metabolism of embryos. Several studies have sought to decipher the effect of cryopreservation duration on IVF pregnancy outcomes, but few were confined to vitrification and the results were inconsistent. Study design, size, duration This retrospective study included 6722 patients undergoing their first vitrified-warmed blastocyst transfer (VBT) cycles from January 2015 to June 2019 in a single fertility center in South China. The study was approved by the hospital’s Ethics Committee. Participants/materials, setting, methods A total of 6722 eligible patients were divided into five groups according to the storage duration after vitrification: Group I: 0–3 months; Group II: 3–6 months; Group III: 6–12 months; Group IV: 12–24 months; Group V: 24–36 months. The IVF pregnancy outcomes were compared between groups. Multivariate logistic regression was conducted to evaluate the independent effect of storage duration on pregnancy outcomes. Main results and the role of chance The odds of clinical pregnancy outcomes were similar from Group 1 to 4. However, the chance of clinical pregnancy (Group 1 as reference; Group 2: adjusted odds ratio (aOR)= 1.04, 95% CI 0.93–1.17; Group 3: aOR = 1.02, 95% CI 0.84–1.25; Group 4: aOR = 0.93, 95% CI 0.66–1.31; Group 5: aOR = 0.54, 95% CI 0.38–0.76) , ongoing pregnancy (Group 2: aOR=0.99, 95% CI 0.89–1.11; Group 3: aOR = 0.94, 95% CI 0.77–1.14; Group 4: aOR = 0.87, 95% CI 0.62–1.22; Group 5: aOR = 0.41, 95% CI 0.29–0.60), and live birth rate (Group 2: aOR=1.00, 95% CI 0.89–1.12; Group 3: aOR = 0.98, 95% CI 0.81–1.19; Group 4: aOR = 0.91, 95% CI 0.65–1.27; Group 5: aOR = 0.46, 95% CI 0.32–0.66) significantly decreased, while the early miscarriage rate (Group 2: aOR=1.11, 95% CI 0.92–1.35; Group 3: aOR =1.25, 95% CI 0.92–1.70; Group 4: aOR = 1.33, 95% CI 0.77–2.31; Group 5: aOR = 2.42, 95% CI 1.36–4.31) significantly increased as the storage duration increased up to 24–36 months. Limitations, reasons for caution The primary limitation of this study was its retrospective nature. Besides, as all these data come from a single IVF treatment center, the results should be confirmed by a larger multicenter study. Wider implications of the findings: Our study provides more evidence about the negative impact of long-term storage of vitrified embryos on the clinical outcome. Clinicians should adapt FET strategies based on the embryo storage duration. Trial registration number Not applicable

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