scholarly journals Burkitt Lymphoma of Central Nervous System in an elderly-patient: A new approach with a modified classic regimen

2021 ◽  
pp. 244
Author(s):  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Tumor Response ◽  
Progression Free Survival ◽  
Clinical Prognosis ◽  
Free Survival ◽  
New Approach ◽  
The Central Nervous System ◽  
Unfit Patients ◽  
The One

Burkitt’s lymphoma (BL) is one of the high-grade lymphomas, characterized by a rapid growth. They are usually treated with intensive chemotherapy regimens, being normally chemo-sensitive, but at the expense of high toxicity secondary to treatment. Additionally, the compromise of the central nervous system (CNS) implies a major risk as well as greater toxicity, taking into account a worse clinical prognosis with a requirement of more intensive schemes to achieve control of the disease. This implies doubts in the management of older patients with BL with CNS compromise, in whom toxicity is a limitation to these therapies, and there are no other alternatives that offer better benefit in terms of less frequent or severe adverse events, with similar outcomes in terms of progression-free survival (PFS) or overall survival (OS). Therefore, clarifying cases such as the one we report below allows us to provide a therapeutic alternative for older or unfit patients, in whom the intention of treatment should be to seek a good tumor response, but without ignoring the potential toxicity of chemotherapy.

Central Nerve System Impairment, AMA Guides, Sixth Edition: An Overview

2018 ◽  
Vol 23 (1) ◽  
pp. 10-13
Author(s):  
James B. Talmage ◽  
Jay Blaisdell
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Neurological Impairment ◽  
Sixth Edition ◽  
Central Nerve System ◽  
The Central Nervous System ◽  
The One ◽  
Nerve System ◽  
The Brain

Abstract Injuries that affect the central nervous system (CNS) can be catastrophic because they involve the brain or spinal cord, and determining the underlying clinical cause of impairment is essential in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), in part because the AMA Guides addresses neurological impairment in several chapters. Unlike the musculoskeletal chapters, Chapter 13, The Central and Peripheral Nervous System, does not use grades, grade modifiers, and a net adjustment formula; rather the chapter uses an approach that is similar to that in prior editions of the AMA Guides. The following steps can be used to perform a CNS rating: 1) evaluate all four major categories of cerebral impairment, and choose the one that is most severe; 2) rate the single most severe cerebral impairment of the four major categories; 3) rate all other impairments that are due to neurogenic problems; and 4) combine the rating of the single most severe category of cerebral impairment with the ratings of all other impairments. Because some neurological dysfunctions are rated elsewhere in the AMA Guides, Sixth Edition, the evaluator may consult Table 13-1 to verify the appropriate chapter to use.

scholarly journals Treatment of secondary central nervous system involvement in systemic aggressive B cell lymphoma using R-MIADD chemotherapy: a single-center study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuchen Wu ◽  
Xuefei Sun ◽  
Xueyan Bai ◽  
Jun Qian ◽  
Hong Zhu ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Central Nervous System Involvement ◽  
Central Nervous System Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
High Dose ◽  
Cns Involvement ◽  
The Central Nervous System ◽  
Secondary Central Nervous System

Abstract Background Secondary central nervous system lymphoma (SCNSL) is defined as lymphoma involvement within the central nervous system (CNS) that originated elsewhere, or a CNS relapse of systemic lymphoma. Prognosis of SCNSL is poor and the most appropriate treatment is still undetermined. Methods We conducted a retrospective study to assess the feasibility of an R-MIADD (rituximab, high-dose methotrexate, ifosfamide, cytarabine, liposomal formulation of doxorubicin, and dexamethasone) regimen for SCNSL patients. Results Nineteen patients with newly diagnosed CNS lesions were selected, with a median age of 58 (range 20 to 72) years. Out of 19 patients, 11 (57.9%) achieved complete remission (CR) and 2 (10.5%) achieved partial remission (PR); the overall response rate was 68.4%. The median progression-free survival after CNS involvement was 28.0 months (95% confidence interval 11.0–44.9), and the median overall survival after CNS involvement was 34.5 months. Treatment-related death occurred in one patient (5.3%). Conclusions These single-centered data underscore the feasibility of an R-MIADD regimen as the induction therapy of SCNSL, further investigation is warranted.

scholarly journals Cytokines, brain proteins, and growth factors in acute stroke patients: A pilot study

2021 ◽  
Vol 12 ◽  
pp. 366
Author(s):  
Atif Zafar ◽  
Mudassir Farooqui ◽  
Asad Ikram ◽  
Sajid Suriya ◽  
Duraisamy Kempuraj ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pilot Study ◽  
Temporal Trends ◽  
Multiplex Assay ◽  
Plasma Samples ◽  
Stroke Patients ◽  
Clinical Prognosis ◽  
The Central Nervous System ◽  
Inflammatory Molecules

Background: Immunomodulation and cell signaling involve several cytokines, proteins, and other mediators released in response to the trauma, inflammation, or other insults to the central nervous system. This pilot study is part of the registry designed to evaluate the temporal trends among these molecules after an acute ischemic stroke (AIS) in patients. Methods: Twelve AIS patients were enrolled within 24 hours of the symptoms onset. Two sets of plasma samples were collected: First at admission and second at 24 hours after admission. Cytokines/chemokines and other inflammatory molecules were measured using multiplex assay kit. Results: An increased trend in IL-6 (22 vs. 34 pg/ml), IL-8/CXCL8 (87 vs. 98 pg/ml), MMP-9 (16225 vs. 18450 pg/ml), and GMF-β (999 vs. 3739 pg/ml) levels was observed overtime after an AIS. Patients ≤60 years had lower levels of plasma MCP-1/CCL2 (50–647 vs. 150–1159 pg/ml), IL-6 (9–25 vs. 20–68 pg/ml), and IL-8 (30– 143 vs. 72–630 pg/ml), when compared with patients >60 years old. Conclusion: Cytokines/chemokines and other inflammatory mediators play an important role in the pathogenesis of stroke in addition to mediating poststroke inflammation. Further research is needed to evaluate and characterize the cumulative trends of these mediators for the clinical prognosis or as surrogate biomarkers.

scholarly journals OTHR-04. Gynecological Malignancies With Metastasis To The Central Nervous System: A Case Series and Systematic Review of the Literature

2021 ◽  
Vol 3 (Supplement_3) ◽  
pp. iii15-iii15
Author(s):  
Azeem Sajjad ◽  
Adeleso Adesina ◽  
Penelope Halkiadakis ◽  
Kelsey Murphy ◽  
Kathleen Mulligan ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Overall Survival ◽  
Nervous System ◽  
Literature Review ◽  
Metastatic Disease ◽  
Case Series ◽  
Progression Free Survival ◽  
Gynecologic Malignancies ◽  
Free Survival ◽  
Cns Metastasis

Abstract Introduction Gynecologic malignancies are an increasingly common proportion of central nervous system metastatic disease. As genetic sequencing technology improves and becomes more accessible, mutations associated with CNS metastasis are easier to elucidate. The aims of this case series and systematic literature review are to describe the patient population with CNS metastatic disease from a gynecologic primary, and to investigate why the proportion of CNS metastasis from gynecologic malignancies is increasing. Ultimately, we hope to improve understanding of this subset of metastatic CNS malignancies and improve management strategies. Methods A literature review of articles describing patients from 1990–2020 who were diagnosed with CNS metastasis from a known gynecologic primary malignancy was performed. Demographics, cancer type, mutation characteristics, management for metastatic disease, progression free survival, number of CNS metastases, and location of metastatic disease were assessed. Inclusion criteria were age>18 years, diagnosis of primary ovarian, uterine, or cervical cancer with confirmed metastatic disease to the CNS, including brain parenchyma, leptomeninges, or intradural spinal cord or dural metastases. Exclusion criteria included pediatric population and bony metastases (e.g., bony spine metastases without evidence of meningeal/parenchymal invasion). Results Our review showed that patients with gynecological metastasis to the CNS generally have worse outcomes regarding overall survival, progression free survival, and quality of life than patients without CNS metastasis. Discussion Our results infer that the reported increase in incidence of CNS metastasis from gynecologic malignancies is a reflection of improvement of detection given advances in technology, improved patient follow up, and increased overall survival of patients with gynecologic malignancies. Further characterization of mutations from gynecologic malignancies associated with brain metastasis could result in development of more treatment options for patients in the future and help determine factors that contribute to developing metastasis to the CNS of various degrees, thus, potentially inform treatment strategies.

scholarly journals Identification of a Novel BRCA1 Alteration in Recurrent Melanocytoma Resulting in Increased Proliferation

2020 ◽  
Vol 79 (11) ◽  
pp. 1233-1238
Author(s):  
Teresa San-Miguel ◽  
Lara Navarro ◽  
Beatriz Sánchez-Sendra ◽  
Javier Megías ◽  
Lisandra Muñoz-Hidalgo ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Prognostic Value ◽  
Proliferation Index ◽  
Benign Neoplasms ◽  
Epigenetic Changes ◽  
Epigenetic Landscape ◽  
Meningeal Melanocytoma ◽  
The Central Nervous System ◽  
The One

Abstract Primary meningeal melanocytomas are rare tumors of the central nervous system. Although they are considered benign neoplasms, some reports describe recurrent rates up to 45%. Little is known about their genetic and epigenetic landscape because of their infrequency. Even less has been described about markers with prognostic value. Here we describe a patient who developed a primary meningeal melanocytoma, suffered 3 recurrences in a period of 6 years and died of the tumor. The genetic and epigenetic changes explored confirmed GNAQ mutation as an initiating event. We found an epigenetic alteration of GSTP1, a feature that has recently been described in meningiomas, from the beginning of the disease. In addition, there was loss of heterozygosity in BRCA1 beginning in the second recurrence that was linked to an increase in the proliferation index; this suggested a progression pathway similar to the one described in uveal melanomas. These findings underscore the necessity of further research focused on these tumors.

Infestations expérimentales de crabes juvéniles par la sacculine. Ultrastructure des racines parasitaires en croissance et relations avec la niasse ganglionnaire ventrale de l'hôte

1981 ◽  
Vol 59 (9) ◽  
pp. 1818-1826 ◽  
Author(s):  
Geneviève G. Payen ◽  
Michelle Hubert ◽  
Yves Turquier ◽  
Claudio Rubiliani ◽  
Colette Chassard-Bouchaud
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Connective Tissue ◽  
Host Defense ◽  
Root Cells ◽  
Sacculina Carcini ◽  
The Central Nervous System ◽  
The One ◽  
Host Tissues

Experimental infestations of young Carcinus with Sacculina carcini indicate that the ventral ganglionic mass (VGM) is the first "target" of the parasite roots into the host tissues. As in pubescent crabs naturally parasitized, either with or without an external visceral sac, the roots penetrate and invade that area of the central nervous system during the first month of infestation.Ultrastructural study of the developing roots, in contact with the VGM, leads to the conclusion that apart from a few embryonic characters, the root cells show a cytostructure similar to the one that has been observed in the roots naturally parasitizing pubescent crabs, whether the external visceral sac is present or not.In the two cases of infestation the roots which cross the neurolemma bring about a marked disorganization of ganglia in consequence of the alteration of the neuroglia, neuropiles and neurosecretory areas.An action of the parasite at a distance, i.e. in the absence of contact of the roots with the ganglia, also occurs. It is especially marked as early as 1 month after infestation by a degeneration of the secretory perikarya.A thin sheath of connective tissue is sometimes visible between the growing roots and the VGM of juvenile crabs. However, the existence of that tissue cannot be definitely attributed to a host defense reaction.No effect of the developing parasite on the already differentiated external sex characters of the host has been noticed within the limits of the experiments.

scholarly journals On reciprocal innervation of antagonistic muscles.―Eighth note

1905 ◽  
Vol 76 (509) ◽  
pp. 269-297 ◽  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Hind Limb ◽  
Spinal Reflex ◽  
Flexion Reflex ◽  
Reflex Reaction ◽  
The Central Nervous System ◽  
Spinal Region ◽  
The One ◽  
Antagonistic Muscles

The following note deals more especially with observations on inhibition occurring in instances of "reciprocal innervation" obtained as a spinal reflex reaction. My view is that inhibition of this kind is part and parcel of the normal reflex process, so that in a reflex it goes on side by side with excitation of other muscles opposed to those which are inhibited. One main consideration which supported the view is the correspondence of the skin-fields whence the reflex contraction of the one set of muscles and the inhibition of the opposed set of muscles can be elicited. So, also, the correspondence of the afferent nerve-trunks, and of the points of surface of the central nervous system whence are elicited the two effects. But to test the view further, I have now attempted to examine in some particulars the conditions attaching to the initiation, and the course run by the two phenomena under comparable circumstances. I. Even in one and the same spinal region the modes of origination, time-relations, etc., of the several elicitable, e. g ., in the dog's hind limb, the "extensor thrust," the "direct-flexion reflex," the "scratch reflex," differ so greatly for each of the types as compared with the others, that in order to compare the inhibition phenomenon with the excitation phenomenon it is important to take both the phenomena from the same type-reflex. The type-reflex I have taken for the purpose has been the "direct-flexion reflex" of the hind limb.

Differential Biological Activity of Estradiol Metabolites

PEDIATRICS ◽  
1978 ◽  
Vol 62 (6) ◽  
pp. 1128-1133
Author(s):  
Jack Fishman ◽  
Charles Martucci
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Biological Activity ◽  
Estrogenic Activity ◽  
Critical Role ◽  
Pituitary Hormone ◽  
Clear Cut ◽  
The Central Nervous System ◽  
Estradiol Metabolites ◽  
The One

Assessment of the biological potency of an estrogen in the human has been and remains a formidable task. The problem arises not only from the lack of a readily distinguished physiological endpoint, but also from the diversity of the biological actions of the estrogens. Estrogens exert proliferative effects in recognized target tissues such as endometrium, vagina, and breast,1 and this action is the one commonly associated with the term "estrogenicity." Estrogens, however, also participate in inducing a host of other peripheral responses in tissues such as blood, bone, skin, and others.2 More importantly, the estrogens also exercise major regulatory functions in the central nervous system, including control of pituitary hormone secretion3 and influencing behavior such as food intake4 and sexual receptivity.5 Much attention had been devoted to the design of estrogen structures that would exhibit a specific type of estrogenic activity, such as gonadotropic regulation, without retaining any uterotropic action. Despite the vast numbers of structures synthesized, little clear-cut separation of these activities has been achieved, suggesting that these dual actions of estrogens may be inextricably linked to each other. On the other hand, much effort has also gone into the study of the mechanism of estrogen action in the uterus and in the central nervous system; despite much progress in both directions, little evidence of a commonality between these two responses to estradiol has so far emerged, suggesting that they may not be directly linked. In our studies, we sought to examine whether estradiol metabolism may play a critical role in the expression of the biological activity of the female sex hormone.

Sign in / Sign up

Export Citation Format

Share Document