Current Issue : January - March Volume : 2020 Issue Number : 1 Articles : 7 Articles
Background: The treatment strategy for brain metastasis (BM) in patients with epidermal growth factor receptor\n(EGFR) -mutant lung adenocarcinoma (LAC) remains controversial. In the present study, we compared the efficacy\nof brain radiotherapy (RT) in combination with tyrosine kinase inhibitors (TKIs) and TKIs alone for advanced LAC\npatients with EGFR mutations and BM.\nMethods: We retrospectively studied 78 patients diagnosed with EGFR-mutant LAC who developed BM. These\npatients were divided into two groups: 49 patients in the combination treatment group who received brain RT in\ncombination with EGFR-TKIs (including 23 patients with asymptomatic BM before RT); 29 patients in the TKI group\nwho received EGFR-TKI targeted therapy alone (including 22 patients with asymptomatic BM before TKI treatment).\nResults: The median intracranial progression-free survival (iPFS) of the combination treatment group was longer\nthan that of the TKI alone group (21.5 vs. 15 months; P = 0.036). However, there were no significant differences in\nmedian progression-free survival (PFS, 12 vs. 13 months; P = 0.242) and median overall survival (mOS, 36 vs. 23\nmonths; P = 0.363) between the two groups. Further analysis of asymptomatic BM showed that both the median\niPFS and the mOS of the combination treatment group were significantly longer than for the TKI alone group (iPFS,\n21.5 vs. 14.8 months, P = 0.026; mOS, 36 vs. 23 months, P = 0.041). Cox multivariate regression analysis found no\nindependent adverse predictors of iPFS in all patients.\nConclusions: The synchronous combination of brain RT and TKIs was superior to EGFR-TKIs alone for EGFR-mutant\nLAC patients with BM. The combination treatment group exhibited longer iPFS, while the PFS and OS were not\nsignificantly different between the two groups. In addition, the combination treatment could result in better iPFS and\nOS in those with asymptomatic BM. Therefore, addition of brain RT was useful for intracranial metastatic lesions....
Background. Obstructive sleep apnea syndrome (OSAS) affects up to 4% of a pediatric population, with many comorbidities in the\nmedium-long term. Functional alterations in the prefrontal cortex (PFC) may explain why OSAS impacts aspects such as executive\nfunctions, memory, motor control, attention, visual-spatial skills, learning, and mood regulation. Emotional intelligence (EI) is a\ncomplex neuropsychological function that could be impaired in many clinical conditions. Purpose. The aim of the study is to\nevaluate the difference in emotional intelligence skills among children with OSAS and healthy subjects (nOSAS). Methods.\n129 children .................................
Aim. To assess the clinical course of disability, cognitive, and emotional impairments in patients with severe TBI (s-TBI) from 3\nmonths to up to 7 years post trauma. Methods. A prospective cohort study of s-TBI in northern Sweden was conducted. Patients\naged 18-65 years with acute Glasgow Coma Scale 3-8 were assessed with the Glasgow Outcome Scale Extended (GOSE), the\nHospital Anxiety and Depression Scale (HADS), and the Barrow Neurological Institute Screen for Higher Cerebral Functions\n(BNIS) at 3 months, 1 year, and 7 years after the injury. Results. The scores on both GOSE and BNIS improved significantly\nfrom 3 months����....
Trigeminal neuropathic pain is a chronic pain condition caused by damage or\ninflammation of the trigeminal nerve or its branches, with both peripheral and central nervous\nsystem dysfunction contributing to the disorder. Trigeminal pain conditions present with diagnostic\nand therapeutic challenges to healthcare providers and often require multiple therapeutic\napproaches for pain reduction. This review will provide the overview of pathophysiology in\nperipheral and central nociceptive circuits that are involved in neuropathic pain conditions\ninvolving the trigeminal nerve and the current therapeutics that are used to treat these disorders.\nRecent advances in treatment of trigeminal pain, including novel therapeutics that target ion\nchannels and receptors, gene therapy and monoclonal antibodies that have shown great promise in\npreclinical studies and clinical trials will also be described....
Background: Primary central nervous system (CNS) small lymphocytic lymphoma (SLL), as a type of low-grade\nlymphoma, is extremely rare. The diagnosis of CNS SLL is challenging due to its variable clinical and radiological\nfeatures, which may overlap with those of diffuse large B-cell lymphoma (DLBCL). Primary CNS SLL differs from\nDLBCL in that it has an indolent clinical course and a good prognosis. Thus, it is important to distinguish SLL from\nDLBCL. By reviewing the literature, only two cases of low-grade SLL, primarily located in the CNS and involving the\nbrain parenchyma and dura, have been reported. To our knowledge, primary CNS SLL in the bilateral ventricles has\nnever been reported. Interestingly, the two cases in our report are identical in terms of the clinical presentations,\nmagnetic resonance imaging (MRI) features, pathological results and prognoses.\nCase presentation: Both patients presented with headaches. MRI suggested solid lesions located in the bilateral\nventricles that were isointense on T1-weighted images and hypointense on T2-weighted images. After the injection\nof contrast agent (gadolinium, Gd), the intraventricular lesions were homogeneously enhanced and hyperperfused.\nCSF cytology revealed malignant cells. Brain biopsy revealed diffuse proliferation of small lymphocytes with positive\nlabelling of B-cell immunomarkers. The primary origin in the CNS was confirmed with no evidence of systemic\nlymphoma. Two patients were given high doses of methotrexate-based chemotherapy and were free from\nsymptoms and progression for more than 1-year of follow-up.\nConclusions: The presence of homogeneously enhanced intraventricular MRI lesions should raise the suspicion of\nprimary CNS SLL....
Objective: The objective of this study is to report a case of spinal cord compression,\nwhich is a rare complication of neurofibromatosis type 1. Observation:\nWe report the case of a 45-year-old man, which presented a syndrome\nof thoracic spinal cord compression at the stage of spastic paraparesis. Its installation\nwas gradually over 6 months associated with the inaugural back\npain. He had a clinical history of neurofibromatosis type 1 with â??Cafe-au-laitâ?\nspots. There were multiple painless nodules under the skin of different size on\nthe chest, forearms and legs. A large isolated nodule, purplish was observed\non the chest. The neuro-imaging showed a para-spinal anterior mass expansion\ninside the spinal canal causing spinal compression at the level of the\nsecond and third thoracic vertebra. It extends into the intervertebral foramen\nof the third and fourth thoracic vertebra leading to a scalloping. A\nsecond large heterogeneous left intra-abdominal mass containing cyst areas\nand calcifications was discovered in imaging. After a spinal decompression\nwith laminectomy of the second and third thoracic vertebra, the reduction\nof pain and motor recovery was gradual. The large nodule excision was\nperformed. Histology found a plexiform neurofibroma. Excision of the left\nintra-abdominal mass could not be performed because the patientâ??s consent\nhad not been obtained. Conclusion: The spinal cord compression is a rare\ncomplication of neurofibromatosis type 1. However, it is essential to think\nabout it in front of any spinal cord symptoms or any atypical long term spinal\npain....
Background: The aim of this present study was to compare the prevalence and type of trauma experienced by community\nsample with the outpatient sample with mental disorders.\nMethods: A total of 354 outpatients, aged 14-35 years old, with mood disorders, schizophrenia and other psychotic\ndisorders, adjustment disorder and anxiety disorder were recruited from a tertiary psychiatric hospital. A total of\n100 healthy controls were recruited from the Singapore general population by snowballing. The Childhood Trauma\nQuestionnaire-Short Form (CTQ-SF) designed to measure childhood trauma and the severity (e.g., physical abuse,\nemotional abuse, sexual abuse, physical neglect and emotional neglect) was administered to participants. Sociodemographic\nand clinical characteristics were obtained from interviews with the participants and from outpatientsâ??\nmedical records, respectively. Independent sample t tests and Chi-square tests were used to investigate the differences\nbetween the outpatient and community samples.\nResults: Overall the CTQ-SF total and domain scores indicated that outpatient sample experienced higher rate of\ntraumatic life events in childhood than community sample. Two most reported trauma types were emotional abuse\n(n = 81, 59.1%) and physical neglect (n = 74, 54%) reported by the mood disorder group. In the community sample,\nemotional neglect (n = 46, 46%) and physical neglect (n = 18, 18%) were the most commonly reported trauma type.\nOverall outpatient sample (n = 80, 22.6%) and community sample (n = 28, 28%) reported at least one type of trauma.\nConclusion: The findings indicate higher rates of CTQ-SF total and domain scores in outpatient sample demonstrating\na higher rate of traumatic life events in childhood compared to community sample. Further research in childhood\ntrauma is needed to improve the knowledge in psychiatric clinic practices....
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