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Neurosurgical Techniques and Strategies
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Jonathan E. Martin, Ian F. Pollack, Robert F. Keating
Benign tumors present in the intradural extramedullary compartment95 are relatively straightforward to address from a surgical perspective. Neurofibromas, schwannomas,and myxopapillary ependymomas can typically be accessed via an appropriately localized laminectomy. Neuromonitoring can be of utility during resection based on surgeon preference. Spinal deformity is rare following resection of these tumors; despite this, laminoplasty can be considered during closure at the discretion of the surgeon. Drop metastasis from a primary central nervous system tumor should always be considered on the differential diagnosis, and investigated with complete craniospinal imaging when appropriate.6
Artificial Intelligence
Published in Lawrence S. Chan, William C. Tang, Engineering-Medicine, 2019
Once they collected this data, they performed an unsupervised clustering. They ultimately ended up with 82 different central nervous system tumor classes. Each class was characterized by a distinct DNA methylation profile. Of these 82 classes of tumors, 29 mapped directly to a single entity in the WHO classification scheme (for instance, diffuse midline glioma), another 29 mapped to a subcategory of an entity in the WHO classification (for instance glioblastoma G34). The remaining 24 classes were more complicated: 19 of them could be associated with several WHO classes (a one to one mapping did not exist) and the remaining five were classes that simply had been defined by WHO.
“My Patient is Hysterical”
Published in Paul Ian Steinberg, Psychoanalysis in Medicine, 2020
A high index of suspicion of organic mental disorder is necessary in medically ill patients with psychiatric symptoms, even when there is symptomatic evidence of psychiatric disturbance accompanied by many psychosocial stressors. The psychiatrist must function in his role as a physician, even – perhaps especially – when medical specialists are making psychiatric diagnoses. Concurrent medical and psychiatric investigation is necessary when differentiating medical from psychiatric disturbance is difficult. This obviates unnecessary medical investigations and the withholding of indicated psychiatric treatment when a psychiatric condition can be positively identified, as well as avoiding a psychiatric diagnosis being made by exclusion, with the consequent danger that a psychiatric symptom of a medical condition may not be adequately investigated. Mrs. F’s catatonic symptoms appear to have been a manifestation of hypertensive encephalopathy, elevated serum cortisol levels, or both. Apart from the initial symptomatic recovery following haloperidol treatment, the catatonic symptoms recurred during episodes of uncontrolled hypertension. However, many patients with similar degrees of hypertension have normal mental states. With the exception of the hydrochlorthiazide–amiloride combination, which has been associated with stupor, none of Mrs. F’s medications are associated with catatonic symptoms. As Mrs. F was started on the combination five months prior to admission, it seems unlikely that her stupor was attributable to medications. An undetected central nervous system tumor may have been a contributing factor to her symptoms. As well, the psychiatric presentation might have represented a functional psychiatric disorder, with the diagnosis of adrenal tumor being incidental.
Health-related quality of life among Malaysian pediatric survivors of central nervous system tumor
Published in Pediatric Hematology and Oncology, 2023
Revathi Rajagopal, Nur’Aini Raman, Lai Choo Ong, Jen Chun Foo, Choong Yi Fong
The survival of children treated for primary brain tumors has improved remarkably over the last several decades due to advances in multi-modal treatment including surgical resection, chemotherapy, radiotherapy, and peripheral blood autologous stem cell transplantation.1–3 However, pediatric central nervous system tumor survivors (CNSTS) often experience significant negative late effects of the disease and its treatment. CNSTS are more likely to experience physical, cognitive, behavioral and neurological deficits that may impact their health-related quality of life (HRQOL).4–6 HRQOL is a multidimensional construct that comprises of physical, psychological and social domains of functioning. It is an important outcome measure in children during and after cancer treatment to evaluate the disease and treatment impact on individual’s quality of life.7
Synergistic Effect of Gefitinib and Temozolomide on U87MG Glioblastoma Angiogenesis
Published in Nutrition and Cancer, 2022
Afshin Karami, Maryam Hossienpour, Ehsan Mohammadi Noori, Mehdi Rahpyma, Khadijeh Najafi, Amir Kiani
Due to the metastatic proliferation of cancer cells, adequate oxygen and nutrient supply and excretion of waste products in these cells are essential (1). This is accomplished by forming a new network of lymphatic and blood vessels through processes of angiogenesis and lymphangiogenesis, respectively (2, 3). Angiogenesis and its related factors in the tumor microenvironment play a crucial role in tumor expansion and metastasis (1, 3). Matrix Metalloproteinase (MMPs) and Vascular Endothelial Growth Factor (VEGF) play a crucial role in the angiogenesis process (4). MMPs such as MMP 2 and 9, are a large group of endopeptidase enzymes related to tissue remodeling and matrix degradation in cancer invasion (5). Also, VEGF as a growth factor overexpressed in many cancers that its overexpression has been reported with poor prognosis and survival in glioblastoma patients (6). Glioblastoma multiforme (GBM) is the most aggressive brain tumor and according to previous studies, angiogenesis is one of the most prominent indications of glioblastoma (7). Despite significant advances in the understanding, prevention, and treatment of Glioblastoma, the disorder is the most frequently occurring malignant central nervous system tumor that has an incidence of 0.59–3.69 per 100 000 and its accounts for approximately 27% of all primary brain tumors (8, 9). Due to the high mortality rate, the average survival of patients is usually less than one year (10, 11). Many therapies against GBM including surgery, radiotherapy, and chemotherapy agents are not effective because of the aggressive metastatic and infiltrative nature of the tumor (12).
Novel Immunotherapeutics for Treatment of Glioblastoma: The Last Decade of Research
Published in Cancer Investigation, 2019
Emaad Khansur, Ashish H. Shah, Kyle Lacy, Ricardo J. Komotar
Glioblastoma is the most lethal primary central nervous system tumor with an incidence rate of 3.19 per 100,000 person-years, averaging around 13,000 cases diagnosed in the United States per year (1). Over the last 15 years, treatment for glioblastoma multiforme (GBM) included maximal safe surgical resection with combination radiotherapy and adjuvant temozolomide chemotherapy (2). Despite this treatment, overall 5-year survival still remains poor with an average survival of 14 months after initial diagnosis (2–4). Although there have been significant advances in understanding the basic pathogenesis of GBM (Grade IV), median survival of patients has changed little in the last 25 years. Because of the dismal prognosis, attention has shifted to alternative adjuvant treatment modalities.