Patterns of skull base meningioma progression after failed radiosurgery

2007 ◽  
Vol 106 (1) ◽  
pp. 30-35 ◽  
Author(s):  
William T. Couldwell ◽  
Chad D. Cole ◽  
Ossama Al-Mefty

Object Stereotactic radiosurgery has been reported to be an effective alternative to surgical removal of small to medium benign meningiomas as well as an adjuvant treatment modality to reduce the risk of tumor progression after subtotal resection. Its efficacy has been proved by excellent short-term radiosurgically demonstrated control rates, which have been reported to approach or exceed 90% in many contemporary studies involving the use of either linear accelerator–based systems or the Gamma Knife. Little is known, however, regarding the growth patterns of meningiomas that fail to stabilize after radiosurgery. Methods The authors report 13 cases of benign skull base meningiomas (World Health Organization Grade I) that demonstrated progression after radiosurgical treatment as a primary or an adjuvant therapy. Several tumors demonstrated rapid growth immediately after radiosurgical treatment, whereas other lesions progressed in a very delayed manner in some patients (up to 14 years after treatment). Regardless of the interval after which it occurs, tumor growth can be quite aggressive once it has begun. Conclusions Skull base meningioma growth can be aggressive after failed radiosurgery in some patients, and treatment failure can occur at long intervals following treatment. Special attention must be devoted to such significant occurrences given the increasing number of patients undergoing stereotactic radiosurgery for benign tumors, and careful extended (> 10 years) follow up must be undertaken in all patients after radiosurgery.

Author(s):  
Yosef Dastagirzada ◽  
Olga Klauberg ◽  
Kathleen Sheerin ◽  
Seth Lieberman ◽  
Richard Lebowitz ◽  
...  

AbstractSoon after the World Health Organization declared the severe acute respiratory syndrome coronavirus 2 a global health emergency on January 30, 2020, New York City was plagued by the virus and its health system and economy pushed to their limits. The majority of the limited neurosurgical data in relation to COVID-19 is anecdotal and the higher theoretical risk of transmission of the virus among skull base aerosol generating (SBAG) cases has not been investigated or discussed in a neurosurgical population. We discuss a series of 13 patients who underwent 15 SBAG surgical procedures during the peak of COVID-19 in our hospital system and the protocols use perioperatively for their procedures. Our data support that with proper preoperative testing, a well-delineated surgical algorithm, and appropriate personal protective equipment, emergent/urgent cases can be done safely in hospitals that are currently experiencing high volumes of COVID-19 cases as we did in March to May of 2020.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Andrea Pacifici ◽  
Daniele Carbone ◽  
Roberta Marini ◽  
Luciano Pacifici

Odontomas represent the most common type of odontogenic benign jaws tumors among patients younger than 20 years of age. These tumors are composed of enamel, dentine, cementum, and pulp tissue. According to the World Health Organization classification, two distinct types of odontomas are acknowledged: complex and compound odontoma. In complex odontomas, all dental tissues are formed, but appeared without an organized structure. In compound odontomas, all dental tissues are arranged in numerous tooth-like structures known as denticles. Compound odontomas are often associated with impacted adjacent permanent teeth and their surgical removal represents the best therapeutic option. A case of a 20-year-old male patient with a compound odontoma-associated of impacted maxillary canine is presented. A minimally invasive surgical technique is adopted to remove the least amount of bone tissue as far as possible.


2021 ◽  
Vol 39 (1) ◽  
pp. 240
Author(s):  
Erlandson Ferreira SARAIVA ◽  
Leandro SAUER ◽  
Basílio De Bragança PEREIRA ◽  
Carlos Alberto de Bragança PEREIRA

In December of 2019, a new coronavirus was discovered in the city of Wuhan, China. The World Health Organization officially named this coronavirus as COVID-19. Since its discovery, the virus has spread rapidly around the world and is currently one of the main health problems, causing an enormous social and economic burden. Due to this, there is a great interest in mathematical models capable of projecting the evolution of the disease in countries, states and/or cities. This interest is mainly due to the fact that the projections may help the government agents in making decisions in relation to the prevention of the disease. By using this argument, the health department of the city (HDC) of Campo Grande asked the UFMS for the development of a mathematical study to project the evolution of the disease in the city. In this paper, we describe a modeling procedure used to fit a piecewise growth model for the accumulated number of cases recorded in the city. From the fitted model, we estimate the date in which the pandemic peak is reached and project the number of patients who will need treatment in intensive care units. Weekly, was sent to HDC a technical report describing the main results.


2018 ◽  
Vol 18 (4) ◽  
pp. 230-239 ◽  
Author(s):  
Rashmi K Ambasta ◽  
Rohan Gupta ◽  
Dhiraj Kumar ◽  
Saurabh Bhattacharya ◽  
Aditi Sarkar ◽  
...  

Abstract Diabetes and colon cancer are the leading cause of mortality worldwide. According to World Health Organization, the number of patients with diabetes and cancer is going to be elevated by 50% in 2020. However, several flavonoids have been known to be useful in reducing the chance of cancer/diabetes but the hunt of a single biomolecule that can act as therapeutic and preventive molecules for future epidemic continues. In this review, we aim to perform an illustration of all researches done that target molecular signaling using luteolin in cancer/diabetes and predicted target protein using PharmMapper. The search confirms that luteolin can be a remedial molecule for both cancer and diabetes via acting on variety of signaling pathway. Furthermore, we also intend to illustrate/compare the predicted and verified molecular modes of action of luteolin. Fluorescence in situ hybridization analysis confirms the expression of CCND1 in colon cancer while immunofluorescence analysis confirms the CDK4 in diabetes. Finally, an effort has been made to map docking of marker protein-luteolin at a particular site using docking software. This review gives a holistic overview about luteolin as a therapeutic molecule for cancer/diabetes via acting on multiple signaling cascade such as p53, Wnt, eNOS, iNOS, SOD and MMP9, with especial emphasis on the cyclin-CDK pathway. Altogether, the review concludes that luteolin can be a molecule for the therapy of both cancer and diabetes by acting on broad signaling pathway.


Micromachines ◽  
2019 ◽  
Vol 10 (3) ◽  
pp. 203 ◽  
Author(s):  
Taek Lee ◽  
Jae-Hyuk Ahn ◽  
Jinha Choi ◽  
Yeonju Lee ◽  
Jin-Myung Kim ◽  
...  

During the last 30 years, the World Health Organization (WHO) reported a gradual increase in the number of patients with cardiovascular disease (CVD), not only in developed but also in developing countries. In particular, acute myocardial infarction (AMI) is one of the severe CVDs because of the high death rate, damage to the body, and various complications. During these harmful effects, rapid diagnosis of AMI is key for saving patients with CVD in an emergency. The prompt diagnosis and proper treatment of patients with AMI are important to increase the survival rate of these patients. To treat patients with AMI quickly, detection of a CVD biomarker at an ultra-low concentration is essential. Cardiac troponins (cTNs), cardiac myoglobin (cMB), and creatine kinase MB are typical biomarkers for AMI detection. An increase in the levels of those biomarkers in blood implies damage to cardiomyocytes and thus is related to AMI progression. In particular, cTNs are regarded as a gold standard biomarker for AMI diagnosis. The conventional TN detection system for detection of AMI requires long measurement time and is labor-intensive and tedious. Therefore, the demand for sensitive and selective TN detection techniques is increasing at present. To meet this demand, several approaches and methods have been applied to develop a TN detection system based on a nanostructure. In the present review, the authors reviewed recent advances in TN biosensors with a focus on four detection systems: (1) An electrochemical (EC) TN nanobiosensor, (2) field effect transistor (FET)-based TN nanobiosensor, (3) surface plasmon resonance (SPR)-based TN nanobiosensor and (4) surface enhanced Raman spectroscopy (SERS)-based TN nanobiosensor.


2017 ◽  
Vol 14 (4) ◽  
pp. 341-350 ◽  
Author(s):  
Hirotaka Hasegawa ◽  
Shunya Hanakita ◽  
Masahiro Shin ◽  
Tomoyuki Koga ◽  
Wataru Takahashi ◽  
...  

Abstract BACKGROUND Stereotactic radiosurgery (SRS) has been accepted as a therapeutic option for intracranial meningiomas; however, the detailed data on outcomes in elderly patients remain unclear. OBJECTIVE To delineate the efficacy of SRS for meningiomas in elderly patients. METHODS The outcomes of 67 patients aged ≥65 yr who underwent SRS for benign intracranial meningioma (World Health Organization grade I) between 1990 and 2014 at our institution were retrospectively analyzed. The median age was 71 yr (range, 65-83 yr), and the mean and median follow-up were 62 and 52 mo (range, 7-195 mo), respectively. Tumor margins were irradiated with a median dose of 16 Gy, and the median tumor volume was 4.9 cm3 (range, 0.7-22.9 cm3). RESULTS Actuarial local tumor control rates at 3, 5, and 10 yr after SRS were 92%, 86%, and 72%, respectively. Previous surgery and parasagittal/falcine location were statistically significant predictive factors for failed tumor control. Mild or moderate adverse events were noted in 9 patients. No severe adverse event was observed. A higher margin dose was significantly associated with adverse events by univariate analysis. CONCLUSION SRS is one of the standard therapies for meningiomas in elderly patients, providing both favorable tumor control and a low risk of adverse events under minimum invasiveness.


2001 ◽  
Vol 19 (15) ◽  
pp. 3547-3553 ◽  
Author(s):  
Juergen Debus ◽  
Martina Wuendrich ◽  
Andrea Pirzkall ◽  
Angelika Hoess ◽  
Wolfgang Schlegel ◽  
...  

PURPOSE: Large skull-base meningiomas are difficult to treat due to their proximity or adherence to critical structures. We analyzed the long-term results of patients with skull-base meningiomas treated by a new approach with high-precision fractionated stereotactic radiotherapy. PATIENTS AND METHODS: One hundred eighty-nine patients with benign meningiomas were treated with conformal fractionated stereotactic radiotherapy between 1985 and 1998. Patients were undergoing a course of radiotherapy either as primary treatment, following subtotal resection, or for recurrent disease. The median target volume was 52.5 mL (range, 5.2 to 370 mL). The mean radiation dose was 56.8 Gy (± 4.4 Gy). Follow-up examinations, including magnetic resonance imaging, were performed at 6-month intervals thereafter. RESULTS: The median follow-up period was 35 months (range, 3 months to 12 years). Overall actuarial survival for patients with World Health Organization (WHO) grade I meningiomas was 97% after 5 years and 96% after 10 years. Local tumor failure was observed in three of 180 patients with WHO grade I tumors and was significantly higher in two of nine patients with WHO grade II tumors. A volume reduction of more than 50% was observed in 26 patients (14%). Preexisting cranial nerve symptoms resolved completely in 28% of the patients. Clinically significant treatment-induced toxicity was seen in 1.6% of the patients. No treatment-related deaths occurred. CONCLUSION: The results of this study demonstrate that fractionated stereotactic radiotherapy is safe and effective in the therapy of subtotally resected or unresectable meningiomas. The overall morbidity and incidence subacute and late side effects of this conformal radiotherapy approach were low.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1057-1057
Author(s):  
Lucía Pienovi ◽  
Carmen Donangelo ◽  
Cecilia Severi

Abstract Objectives To compare the relationship between maternal weight gain during pregnancy and anthropometric indices of Uruguayan children under 4 years examined by two different criteria for adequate pregnancy weight gain: Atalah et al. (AEA) widely used in Latin America and Institute of Medicine (IOM). Methods Descriptive study of data from the First National Survey of Child Health, Nutrition and Development of Uruguay (ENDIS) of children (n = 1602; age 24.3 ± 10.6 months) recruited in 2013. Weight and height of the children were measured. Child birth weight (BW) and pregnancy weight gain (PregWG) were reported at the interview. PregWG was classified as adequate or excessive according to AEA and IOM criteria. Z scores for weight-for-age (WAZ), height-for-age (HAZ), weight-for-height (WHZ) and body mass index-for-age (BAZ) of the children were obtained from the Growth Patterns of World Health Organization. Results Prevalence of excessive PregWG was higher based on AEA (51.2%) compared to IOM (38.9%) criteria (P < 0.001). Excessive PregWG was associated with higher child BW compared to adequate PregWG using both criteria (AEA: 3361 ± 525 g and 3203–550 g, IOM: 3379 ± 543 g and 3224–534 g, respectively) (P < 0.001). Prevalence of macrosomic BW (>4000 g) with excessive PregWG was similar using AEA (10%) and IOM (12%). WAZ was higher with excessive compared to adequate PregWG using AEA (0.52 ± 1.07 and 0.32 ± 1.66, respectively) (P < 0.005) but not different by using IOM (0.51 ± 1.08 and 0.37 ± 1.55, respectively) (P = 0.057). HAZ was lower with excessive compared to adequate PregWG based on AEA (−0.4 ± 1.12 and −0.23 ± 1.10, respectively) (P = 0.001) but not different based on IOM (−0.7 ± 1.15 and −0.18 ± 1.09, respectively) (P = 0.057). WHZ and BAZ did not differ by PregWG categories using AEA or IOM. Conclusions Prevalence of excessive weight gain during pregnancy was higher using AEA compared to IOM criteria. However, only subtle differences in the associations between adequacy of pregnancy weight gain and child anthropometric indices were observed when using AEA or IOM criteria. Funding Sources Instituto Nacional de Estadística, Uruguay.


Author(s):  
Emeka E. Orisakwe ◽  
Andrew J. Ross ◽  
Peter O. Ocholla

Background: With millions of South Africans infected with human immunodeficiency virus (HIV) and less than 10% of the population aware of their HIV status, HIV counselling and testing (HCT) is the first step in any attempt to reduce the number of new infections. For those who test negative, HCT personalises the risks and reinforces preventative messages whilst for those who are positive, it is the gateway to accessing counselling and care. The Health Belief Model postulates that knowledge and attitude influence behaviour. The aim of this study was to determine whether knowledge of HIV and the attitude of patients referred for HCT correlated with a willingness to test for HIV.Methods: One hundred and seventy two patients referred for HCT were randomly selected over a three month period. Data were collected by a research assistant using the modified standardised World Health Organization (WHO)–Global AIDS Project (GAP) questionnaire.Results: Ninety per cent of the participants demonstrated sound knowledge of HIV, acquired immune deficiency syndrome (AIDS) and HCT. Despite the 90% of the participants with sound knowledge only 71.5% of the participants tested for HIV. There was no statistically significant difference in knowledge between those who tested and those who did not test for HIV. Twenty five per cent of those who refused to test stated that they had already made up their mind not to test for HIV before the counselling session.Conclusions: Despite excellent knowledge of HIV, a significant number of patients referred for HCT do not test for HIV.


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