scholarly journals How I treat anaplastic glioma without 1p/19q codeletion

ESMO Open ◽  
2019 ◽  
Vol 4 (Suppl 2) ◽  
pp. e000534 ◽  
Author(s):  
Anna Berghoff ◽  
Martin van den Bent
Keyword(s):  
Molecular Analysis ◽  
Anaplastic Astrocytoma ◽  
Daily Routine ◽  
Adjuvant Temozolomide ◽  
Small Patient Number ◽  
Central Nervous System Tumour ◽  
Small Patient ◽  
Personalised Treatment ◽  
Middle Aged Adults

Anaplastic astrocytoma without 1p/19q codeletion is a rare primary central nervous system tumour occurring primarily in middle-aged adults and associated with a median survival of 5–10 years. The major corner stone of treatment is maximal safe neurosurgical resection, followed by radiotherapy and chemotherapy. Several clinical trials addressed the optimal adjuvant treatment; however, interpretation has been challenged by the recent molecular marker-based reclassification of tumour. The interim study of the CATNON trial strongly suggests the addition of 12 adjuvant cycles of temozolomide in addition to radiotherapy after maximal safe resection in patients with anaplastic astrocytoma without 1p/19q codeletion. Based on more recently presented data from the second interim analysis of the CATNON trial and from the molecular analysis, benefit from temozolomide during and after radiotherapy is limited to patients with isocitrate dehydrogenase-mutated anaplastic astrocytoma. Given the small patient number in the single subgroups and the so far missing neurocognitive and quality of life data, more mature analyses needs to be awaited to draw final conclusions on the application of concurrent temozolomide treatment for the daily routine in patients who already are scheduled for adjuvant temozolomide. Further molecular analysis is ongoing to define personalised treatment approaches in patients with anaplastic astrocytoma.

scholarly journals 696 Quality of sleep is the only predictor of suicide during Covid-19 lockdown in University students?

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A272-A272
Author(s):  
Alessandra Castelnuovo ◽  
Samantha Mombelli ◽  
Daniela Bottoni ◽  
Antonella Somma ◽  
Andrea Fossati ◽  
...  
Keyword(s):  
Medical Students ◽  
Suicidal Ideation ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Social Stress ◽  
Depression Symptoms ◽  
Daily Routine ◽  
Quality Of Sleep ◽  
Suicidal Thoughts

Abstract Introduction COVID-19 epidemic led to great psychological and social stress, related to anxiety, depression, sleep disorders, suicidal risk and behavior, and changes in daily routine. The aim of this study was to assess the psychological impact of COVID-19 lockdown in Italian students. We focused on perceived sleep quality, anxiety and depression symptoms, and mostly on risk of suicide. Methods A total of 307 students (mean age 22.84±2.68) completed Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II). In our study, we focused on item 9 of BDI-II, that is related to suicide. We divided our sample on presence or absence of suicidal ideation based on this item. Results We found that 30.1% showed depressive, while 38.2% anxious symptoms. Concerning item 9 of BDI-II (suicidal thoughts or wishes), 84.7% answered that they do not have any thoughts of killing themselves, while 15.3% answered that they have some suicidal ideation. Concerning sleep variables, we found that 58% of our sample showed a PSQI total score higher than 5 (poor quality of sleep), and a global worsening in sleep quality and increase of insomnia both in student with and without suicidal ideation. Conclusion Our results on risk of suicide are in line with literature. Recent reviews focused on suicidal ideation in medical students found that depressive symptoms and suicidal ideation are common among medical students, finding a prevalence of suicidal ideation of 11%. Several studies suggest that sleep disorders are a risk factor for suicidal thoughts and behaviours. Our findings show that sleep cannot considered a predictive factor of risk of suicide during health emergency, because the risk is polyfactorial. Support (if any) None

scholarly journals ECOCAPTURE@HOME: Protocol for the Remote Assessment of Apathy and Its Everyday-Life Consequences

2021 ◽  
Vol 18 (15) ◽  
pp. 7824
Author(s):  
Valérie Godefroy ◽  
Richard Levy ◽  
Arabella Bouzigues ◽  
Armelle Rametti-Lacroux ◽  
Raffaella Migliaccio ◽  
...  
Keyword(s):  
Everyday Life ◽  
New Technologies ◽  
Electrodermal Activity ◽  
Real Life ◽  
Smartphone Application ◽  
Measurement Model ◽  
Strong Impact ◽  
Active Data ◽  
Personalised Treatment

Apathy, a common neuropsychiatric symptom associated with dementia, has a strong impact on patients’ and caregivers’ quality of life. However, it is still poorly understood and hard to define. The main objective of the ECOCAPTURE programme is to define a behavioural signature of apathy using an ecological approach. Within this program, ECOCAPTURE@HOME is an observational study which aims to validate a method based on new technologies for the remote monitoring of apathy in real life. For this study, we plan to recruit 60 couples: 20 patient-caregiver dyads in which patients suffer from behavioral variant Fronto-Temporal Dementia, 20 patient-caregiver dyads in which patients suffer from Alzheimer Disease and 20 healthy control couples. These dyads will be followed for 28 consecutive days via multi-sensor bracelets collecting passive data (acceleration, electrodermal activity, blood volume pulse). Active data will also be collected by questionnaires on a smartphone application. Using a pool of metrics extracted from these passive and active data, we will validate a measurement model for three behavioural markers of apathy (i.e., daytime activity, quality of sleep, and emotional arousal). The final purpose is to facilitate the follow-up and precise diagnosis of apathy, towards a personalised treatment of this condition within everyday life.

Improving quality of life for dialysis patients through telecare

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 80-83 ◽  
Author(s):  
Karl A Stroetmann ◽  
Peter Gruetzmacher ◽  
Veli N Stroetmann
Keyword(s):  
Quality Of Life ◽  
Low Cost ◽  
Video Communication ◽  
Daily Routine ◽  
Dialysis Patients ◽  
Home Dialysis ◽  
Service Support ◽  
Initial Results ◽  
Selection Of

Home dialysis can improve the care and quality of life for patients with renal failure. We have explored the possibility of extending home care to more patients needing continuous ambulatory peritoneal dialysis (CAPD) using telemedicine. We tested videoconferencing support for five CAPD patients using low-cost ISDN equipment (128 kbit/s). Initial results indicated that it was possible to integrate video-communication into the daily routine of the clinic and the response from patients was surprisingly positive. Selection of appropriate, affordable technology and the ISDN service support by the telecommunications provider proved to be considerably more difficult than anticipated. The first indications also suggest medical advantages for home teledialysis.

scholarly journals Benefits of Sustained Physical Activity From Middle-Age To Early Old Age On Quality Of Life In Early Old Age

2022 ◽  
Author(s):  
Mikyung Lee ◽  
Hyeonkyeong Lee ◽  
Ki Jun Song ◽  
Young-Me Lee
Keyword(s):  
Quality Of Life ◽  
Old Age ◽  
Secondary Data ◽  
Activity Levels ◽  
Related Quality ◽  
Health Related ◽  
Using Data ◽  
Middle Aged Adults ◽  
Early Old Age

Abstract This secondary data analysis study aimed to examine the changes in physical activities (PAs) over time (2009-2017) in the same participants and to determine an association between changes in PA and health-related quality of life (HRQoL) in early older adults (n=994) using data from the Korea Health Panel Survey. The HRQoL was measured using the EuroQol quality-of-life system and the amount of PA were grouped to 4 activity levels (remained inactive, became inactive, became active, and remained active). The association of changes in PA over 8 years with HRQoL was examined using logistic regression analysis while controlling for socioeconomic and behavioral factors. The total PA decreased from 1,859.72±1,760.01 MET-minutes in 2009 to 1,264.80 ±1,251.14 MET-minutes in 2017 (P < 0.001). In 2017, 142 (14.3%) remained inactive, whereas 419 (42.2%) remained active. The participants who remained inactive at early old age were more likely to be at the lowest 10% HRQoL of the sample (odds ratio = 1.95, 95% confidence interval = 1.09–3.48). This indicates that educating middle-aged adults who are relatively inactive must be a priority in order to maintain and improve PA, enhance HRQoL, and maximize the benefits of PA in old age.

scholarly journals ISOLASI DAN IDENTIFIKASI PATOGEN GETAH KUNING MANGGIS MELALUI PENDEKATAN POSTULAT KOCH DAN ANALISIS SECARA MOLEKULER

2014 ◽  
Vol 14 (2) ◽  
pp. 142-151
Author(s):  
I Ketut Suada ◽  
Ni Wayan Suniti
Keyword(s):  
Fusarium Oxysporum ◽  
Molecular Analysis ◽  
Fruit Quality ◽  
Irrigation Treatment ◽  
Causal Agent ◽  
Isolation And Identification ◽  
Fungus Species ◽  
Cell Turgor ◽  
Bitter Fruit

Isolation and identification of mangosteen yellow latex pathogen through Koch’s Postulate application and molecular analysis. The yellow latex disease decreases fruit quality of mangosteen because exogenic latex causes dirty fruit and the endogenic latex makes the bitter fruit taste and does not deserve to be consumed. The causal agent of the disease caused phusilogical disorder so that cells break due to unstability of cell turgor, the drift irrigation treatment was able to decrease the disease of 35.22%, therefore the causal agent could be microbe that promote the yellow latex. This research was aimed to find the yellow latex pathogens with its characteristics. The Koch Postulate was apllied to isolate and proved the microbes associated to the yellow latex and molecular analysis was constructed subsequently to find the microbe species.  The result of the research proved that there were three fungus species as the biotic agent responsible to the disease. The fungus were Verticillium albo-atrum with the highest pathogenecity ( 74.87%), followed by Fusarium oxysporum ( 70.15%), and Pestalotia macrotricha (20.32%).

Implementing a patient-centred outcome measure in daily routine in a specialist palliative care inpatient hospital unit: An observational study

2016 ◽  
Vol 31 (3) ◽  
pp. 275-282 ◽  
Author(s):  
Alze Pereira dos Santos Tavares ◽  
Carolina Paparelli ◽  
Carolina Sassaki Kishimoto ◽  
Silvia Avo Cortizo ◽  
Karen Ebina ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Of Care ◽  
Missing Data ◽  
Outcome Measure ◽  
Symptom Control ◽  
Daily Practice ◽  
Daily Routine ◽  
Palliative Care Outcome Scale ◽  
Care Outcome

Background: Gathering clinical evidence data on patients’ palliative care needs is paramount to identify changes in outcomes over time and maintaining on-going quality improvement. Implementation of patient-centred outcome measures has been widely recommended. The routine use of these instruments in daily practice is challenging and not widespread. Aim: To implement a patient-centred outcome measure in daily practice and fulfil one quality indicator: improve pain during the 72 h after admission, in at least 75% of patients. Design: An observational prospective study. The Palliative care Outcome Scale was used at admission (T0), third day (T1) and weekly. Setting/participants: Hospital palliative care unit with 17 individual rooms. All patients admitted to the unit were included in the study. Results: Preliminary results ( N = 84) revealed inconsistent and missing data (14%). Symptoms were sub-optimally controlled by T1. Processes changed, and only a team member could apply Palliative care Outcome Scale. Doctors were encouraged to grasp the meaning of Palliative care Outcome Scale results for each patient. The post-pilot included 317 patients. No missing data occurred. There was an improvement in most items between T0 and T1: ‘pain’ and ‘other symptoms’ presented statistical significant differences ( p < 0.05). Conclusion: Implementing a patient-centred outcome measure in a hospital palliative care service is feasible and improves quality of care. Controlling high pain at T0 improved (>80%) by T1. Results became more consistent and symptom control was improved overall. Patients are evaluated based on holistic domains by an interdisciplinary team and we have added a much needed measure to help guide improvement of the quality of care provided.

Problems Related to Menstruation and Their Effect on Daily Routine of Students of a Medical College in Delhi, India

2008 ◽  
Vol 20 (3) ◽  
pp. 234-241 ◽  
Author(s):  
Anamika Sharma ◽  
Devender K. Taneja ◽  
Pragya Sharma ◽  
Renuka Saha
Keyword(s):  
Treatment Seeking ◽  
Daily Routine ◽  
Menstrual Disorders ◽  
Undergraduate Medical Students ◽  
Careful Evaluation ◽  
Medical College ◽  
Common Effect ◽  
Seeking Behavior ◽  
Girl Students

Menstrual problems are common among young girls. These deserve careful evaluation as uncorrected menstrual problems may adversely affect the daily routine and quality of life. The aim of this article is to study the prevalence and the effect of menstrual disorders on daily routine among unmarried undergraduate medical students and their treatment-seeking behavior. Of 276 undergraduate girl students, 112 were sampled by stratified random sampling. All the consenting participants were given a pretested semistructured questionnaire to collect their responses by personal interviews. The data collected were analyzed. Premenstrual syndrome (67%) and dysmenorrhea (33%) were perceived by the study subjects as the most distressing problems associated with menstruation. The most common effect of menstrual problems on daily routine reported by the study subjects was in the form of prolonged resting hours (54%) followed by inability to study (50%). More than half (52%) of the subjects discussed their problems with their mother, and 60% of the study subjects were opted for allopathic treatment for their menstrual problems.

PATH-27. MGMT PROMOTER STATUS IN IDH1/2 MUTANT ANAPLASTIC ASTROCYTOMA PATIENTS ASSESSED BY DNA METHYLATION PROFILING AND QMS-PCR: A REPORT FROM THE EORTC BRAIN TUMOR GROUP

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi120-vi121
Author(s):  
Mircea Tesileanu ◽  
Pim French ◽  
Marc Sanson ◽  
Alba Ariela Brandes ◽  
Wolfgang Wick ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Anaplastic Astrocytoma ◽  
Methylation Status ◽  
High Grade Glioma ◽  
Phase Iii ◽  
Kappa Score ◽  
Adjuvant Temozolomide ◽  
Tumor Group ◽  
Dna Methylation Profiling ◽  
Methylation Profiling

Abstract BACKGROUND Temozolomide efficacy in high-grade glioma is related to MGMTp methylation. We compared the prognostic and predictive effect of MGMTp between DNA methylation profiling (MGMT-STP27 model) and qMS-PCR in IDH1/2mt anaplastic astrocytoma patients. METHODS The 2x2 factorial design phase III CATNON trial randomized 751 adult patients with newly diagnosed 1p/19q non-codeleted anaplastic glioma to 59.4Gy radiotherapy, radiotherapy with concurrent temozolomide, radiotherapy with 12 cycles of adjuvant temozolomide, or radiotherapy with concurrent and adjuvant temozolomide. MGMTp methylation status was assessed with the MGMT-STP27 model using 850k EPIC data, and qMS-PCR. IDH1/2 mutation status was determined with next-generation sequencing. OS was measured from randomization date. RESULTS We identified 444 IDH1/2mt anaplastic astrocytoma patients. MGMTp was methylated in 365/440 patients (83.0%) with MGMT-STP27 data, and 168/361 patients (46.5%) with qMS-PCR data. The agreement between both modalities is 59.9% (Cohen’s Kappa score 0.229). At database lock, 289 patients with MGMT-STP27 data were alive and 236 patients with qMS-PCR data. The median OS of MGMTp methylated glioma patients was 9.1 yrs [95%CI 7.5-not reached] for the MGMT-STP27 model, and not reached [95%CI 9.1-not reached] for qMS-PCR. For MGMTp unmethylated glioma patients, the median OS was 6.9 yrs [95%CI 6.2-not reached] for the MGMT-STP27 model, and 6.8 yrs [95%CI 6.2-9.7] for qMS-PCR. The HR for OS based on MGMTp methylation was 0.88 [95%CI 0.58-1.31] for the MGMT-STP27 model, and 0.72 [95%CI 0.50-1.03]) for qMS-PCR. The HR for OS after radiotherapy with any temozolomide vs radiotherapy alone for the MGMT-STP27 model was 0.53 [95%CI 0.37-0.78] for MGMTp methylated, and 0.54 [95%CI 0.25-1.18] for MGMTp unmethylated glioma patients; and for MS-PCR was 0.34 [95%CI 0.19-0.61] for MGMTp methylated, and 0.53 [95%CI 0.33-0.85] for MGMTp unmethylated glioma patients. CONCLUSION MGMTp methylation, regardless of assay, was neither prognostic nor predictive for outcome to temozolomide in IDH1/2mt anaplastic astrocytoma patients.

scholarly journals INNV-07. THE KOREAN SOCIETY FOR NEURO-ONCOLOGY (KSNO) GUIDELINE FOR GLIOMAS: VERSION 2019.01

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi131-vi132
Author(s):  
Young Zoon Kim ◽  
Chae-Yong Kim ◽  
Do Hoon Lim ◽  
Dong-Sup Chung
Keyword(s):  
Anaplastic Astrocytoma ◽  
Poor Performance ◽  
Diffuse Astrocytoma ◽  
Molecular Feature ◽  
Who Grade ◽  
Korean Society ◽  
Brain Radiotherapy ◽  
Adjuvant Temozolomide ◽  
Radiotherapy Alone ◽  
Temozolomide Chemotherapy

Abstract BACKGROUND There was no practical guideline for the management of patients with central nervous system (CNS) tumor in Korea for many years. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, started to prepare a guideline for CNS tumors from February 2018. METHODS The Working Group was composed of 35 multidisciplinary medical experts in Korea. References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of keywords. RESULTS First, for the glioblastoma as WHO Grade IV Gliomas, the maximal safe resection if feasible is recommended. Patients aged ≤ 70 years with good performance should be treated by concurrent chemoradiotherapy with temozolomide followed by adjuvant temozolomide chemotherapy (Stupp’s protocol) or standard brain radiotherapy alone. However, those with poor performance should be treated by hypofractionated brain radiotherapy (preferred) ± concurrent or adjuvant temozolomide or temozolomide alone (Level III) or supportive treatment. Second, for the WHO Grade III Gliomas, patients with anaplastic astrocytoma, IDH-mutant should be treated by standard brain radiotherapy followed by adjuvant temozolomide chemotherapy, or Stupp’s protocol, or standard brain radiotherapy with neoadjuvant or adjuvant PCV chemotherapy, or Standard brain radiotherapy alone (Level III). However, those anaplastic astrocytoma, IDH-wildtype should be treated by the protocol for glioblastoma. Third, for the WHO Grade II Gliomas, patients with diffuse astrocytoma, IDH-wildtype without molecular feature of glioblastoma should be treated by standard brain radiotherapy and adjuvant temozolomide chemotherapy (Level III), or standard brain radiotherapy alone, or observation. And patients with diffuse astrocytoma IDH-mutant and oligodendroglioma (IDH-mutant and 1p/19q codeletion) should be treated according to the risk factors. CONCLUSION The recent KSNO’s guideline recommends that glioma should be treated according to the molecular as well as histological features. However, the practice can be limited by the National Insurance for Health in Korea.

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