Journal of Neuroendocrinology, Volume 0, Issue ja, -Not available-.
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Δευτέρα 29 Οκτωβρίου 2018
Gray matter differences associated with age and sex hormone levels between premenopausal and perimenopausal women, a voxel‐based morphometry study
Fractionated stereotactic radiation therapy for adrenal metastases: contributing to local tumor control with low toxicity
Abstract
Purpose
To report on the Erlangen (UK-Er) experience with linear accelerator stereotactic body radiation therapy (LINAC SBRT) for adrenal metastasis from various primary tumors.
Materials and methods
33 patients were treated. Primary sites included lung (n = 19), melanoma (n = 8), colorectal (n = 2), hepatocellular (n = 1), esophageal (n = 2), and breast cancer (n = 1). 14 patients were treated palliatively, 19 patients were treated with local curative intent.
Radiation treatment
Treatment planning was done based on an exhale, mid-ventilation, and inspiration CT series. Further planning CTs were done to check for the correctness of the breathing pattern. Irradiation was performed using a NOVALIS (Varian, Palo Alto, CA, USA; Brainlab AG, München, Germany) linear accelerator. The isocenter was verified before each treatment session using the BrainLab ExacTrac® (Brainlab AG, München, Germany) system to minimize setup errors. Dose was prescribed to the planning target volume (PTV) surrounding 90% isodose.
Follow-up
Depending on their overall performance status and prognosis, patients received clinical check-ups and radiological imaging. Median follow-up was 11 months.
Statistical analysis
IBM SPSS v. 24 was used for univariate analysis using Kaplan–Meier curves, nonparametric Kruskal–Wallis test, and the chi-square test for frequency distributions. Toxicity was graded according to NCI CTCAE v4.0. Depending on radiologic imaging, patients were classified as stable, regression, and progression.
Results
Median survival was 11 months, median PFS was 5 months. Median local failure-free survival was 21 months. Patients who were treated with curative intent showed a better survival curve (p < 0.0001) and PFS (p = 0.004). BED ranged from 42 to 108.8 Gy, median BED was 67.2 Gy. Three BED groups were formed. Overall survival curves differed significantly (p = 0.046), favoring the high-dose group. 21 patients were free from any adverse events or discomfort. In 7 cases, a grade I toxicity was noted.
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A study of neurite orientation dispersion and density imaging in ischemic stroke
Publication date: Available online 29 October 2018
Source: Magnetic Resonance Imaging
Author(s): Zhenxiong Wang, Shun Zhang, Chengxia Liu, Yihao Yao, Jingjing Shi, Ju Zhang, Yuanyuan Qin, Wenzhen Zhu
Abstract
Objectives
To demonstrate the feasibility of the neurite orientation dispersion and density imaging (NODDI) technique in characterizing the microstructural changes in brain tissues during ischemic stroke and to compare its sensitivity with diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI).
Methods
Seventy-one patients with hyperacute/acute/subacute ischemic stroke were enrolled in the study. A multishell diffusion magnetic resonance imaging (dMRI) protocol was performed for each subject. Diffusion data were analyzed using the NODDI and diffusional kurtosis estimator toolboxes. Then, NODDI metrics between the lesions and the contralateral tissues were compared to evaluate their values in ischemic stroke. NODDI metrics among different stroke periods and the correlations between NODDI and the duration since stroke onset were analyzed as well. To compare the NODDI's sensitivity with established diffusion techniques, paired t-tests were performed to determine the absolute percentage changes of diffusion metrics between NODDI and DTI/DKI.
Results
Compared with the contralateral tissues, lesions showed significantly increased values of intracellular volume fraction (Vic) and orientation dispersion index (ODI) and decreased values of isotropic volume fraction (Viso). ODI value was significantly different among three periods and showed fair to good positive correlation with the duration since stroke onset (R = 0.450). NODDI metrics showed significantly larger absolute percentage changes than that of DTI and DKI (P < 0.05, respectively).
Conclusion
NODDI allowed efficient evaluation of microstructural changes in brain tissues during ischemic stroke and showed increased sensitivity compared with DTI and DKI. The possible biophysical mechanisms underlying ischemia could be further elucidated using this advanced diffusion technique.
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Gellan gum-based gels with tunable relaxation properties for MRI phantoms
Publication date: Available online 28 October 2018
Source: Magnetic Resonance Imaging
Author(s): Pawel Brzozowski, Kalin I. Penev, Francisco M. Martinez, Timothy J. Scholl, Kibret Mequanint
Abstract
Object
The research follows the analysis of gellan gum-based gels as novel MRI phantom material with the implementation of a design of experiments model to obtain tunable relaxation properties.
Materials and methods
Gellan gum gels doped with newly synthesized superparamagnetic iron oxide nanoparticles (SPIONs) and either MnCl2 or GdCl3 were prepared and scanned from 230 μT to 3 T. Nineteen gel samples were formulated with varying concentrations of contrast agents to determine the linear, quadratic, and interactive effects of the contrast agents by a central composite design of experiment. To inhibit microbial growth in the gels and to enable long-term use, methyl 4‑hydroxybenzoate (methylparaben) was utilized.
Results
The model containing SPIONs and metal salts relaxivity was analyzed with ANOVA, and the resulting significant coefficients were tabulated. The mathematical model was able to accurately predict the intended relaxation property from the concentration of the contrast agent with adjusted R2 values > 0.97 for longitudinal (R1) relaxation rates and 0.87 for transverse (R2) relaxation rates.
Conclusion
The gel material maintained physical, chemical, and biological stability for at least four months and contained controllable relaxation properties while maintaining optical clarity.
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PentoxIfylline and Tocopherol for the Treatment of Post-radiotherapy Fibrosis in Head and Neck Cancer Patients
Condition: Head and Neck Fibrosis
Interventions: Combination Product: Arm B: A combination of pentoxifylline and tocopherol acetate in addition to best standard care [a structured programme of rehabilitation exercises] for 6 months; Procedure: • Arm A: Best standard of care only [a structured programme of rehabilitation exercises] for 6 months
Sponsors: University College, London; National Institute for Health Research, United Kingdom
Not yet recruiting
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Interventions: Combination Product: Arm B: A combination of pentoxifylline and tocopherol acetate in addition to best standard care [a structured programme of rehabilitation exercises] for 6 months; Procedure: • Arm A: Best standard of care only [a structured programme of rehabilitation exercises] for 6 months
Sponsors: University College, London; National Institute for Health Research, United Kingdom
Not yet recruiting
https://ift.tt/2OSuMx0
GP-induced Chemotherapy Combined With IMRT and TPF-induced Chemotherapy Combined With IMRT in the Treatment of Distant Metastatic Nasopharyngeal Carcinoma
Condition: Advanced Nasopharyngeal Carcinoma
Interventions: Drug: GP+IMRT; Drug: TPF+IMRT
Sponsor: Guiyang Medical University
Not yet recruiting
https://ift.tt/2COSAuH
Interventions: Drug: GP+IMRT; Drug: TPF+IMRT
Sponsor: Guiyang Medical University
Not yet recruiting
https://ift.tt/2COSAuH
An Algorithmic Approach to the Treatment of Frontal Fibrosing Alopecia-A Systematic Review
Publication date: Available online 28 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Yemisi Dina, Crystal Aguh
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Present and future perspective of photodynamic therapy for cutaneous squamous cell carcinoma
Publication date: Available online 28 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Uma Keyal, Anil Kumar Bhatta, Guolong Zhang, Xiuli Wang
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer. Surgery remains the main stay of treatment but, some patients are not eligible for surgery and more importantly, lesions at critical site need nonsurgical approach for tissue preservation. In this context, photodynamic therapy (PDT) has been extensively studied as noninvasive or minimally invasive treatment and studies have shown promising results in terms of safety, efficacy and cosmetic outcome. Also, studies have proposed different mechanism for its efficacy. However, human studies demonstrating its efficacy are limited in terms of sample size and tumor depth of invasion. Exciting results are mainly seen in case report in microinvasive SCC, which is defined as SCC limited to papillary dermis. This inadequacy is due to inadequate penetration of topically applied photosensitizers through keratinized tumor surface. To overcome these hurdles, pretreatment with lasers or microneedles and encapsulation of photosensitizers into nanoparticles have been tried. Hence, present paper will discuss studies that have demonstrated the efficacy and safety of PDT for cSCC, studies that have postulated the mechanism of action of PDT, agents that have been used as PDT enhancers and finally, the recent use of adjuvant therapy in combination with PDT.
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Scholar : Studies in Theatre and Performance, Volume 38, Issue 3, November 2018 is now available online on Taylor & Francis Online
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Dissociation of Appetitive Overexpectation and Extinction in the Infralimic Cortex
Abstract
Behavioral change is paramount to adaptive behavior. Two ways to achieve alterations in previously established behavior are extinction and overexpectation. The infralimbic (IL) portion of the medial prefrontal cortex controls the inhibition of previously established aversive behavioral responses in extinction. The role of the IL cortex in behavioral modification in appetitive Pavlovian associations remains poorly understood. Here, we seek to determine if the IL cortex modulates overexpectation and extinction of reward learning. Using overexpectation or extinction to achieve a reduction in behavior, the present findings uncover a dissociable role for the IL cortex in these paradigms. Pharmacologically inactivating the IL cortex left overexpectation intact. In contrast, pre-training manipulations in the IL cortex prior to extinction facilitated the reduction in conditioned responding but led to a disrupted extinction retrieval on test drug-free. Additional studies confirmed that this effect is restricted to the IL and not dependent on the dorsally-located prelimbic cortex. Together, these results show that the IL cortex underlies extinction but not overexpectation-driven reduction in behavior, which may be due to regulating the expression of conditioned responses influenced by stimulus–response associations rather than stimulus–stimulus associations.https://ift.tt/2yG6yvV
Regorafenib or rechallenge chemotherapy: which is more effective in the third-line treatment of metastatic colorectal cancer?
Abstract
Purpose
To assess the efficacy and safety of regorafenib versus rechallenge chemotherapy in previously treated mCRC patients in third-line setting.
Materials and methods
The data of 104 patients diagnosed with mCRC enrolled from 2010 to 2017 in six oncology centers were analyzed. Tumor treatment options were obtained from follow-up and treatment files. Rechallenge chemotherapy was identified as the re-use of the regimen which was previously administered to patients in one of the therapy lines and obtained disease control, these were the patients whose disease did not progress within 3 months.
Results
A total of 104 patients had received previously two lines of chemotherapy regimens for mCRC. Of these, 73 patients with mCRC who received regorafenib and 31 those who received rechallenge chemotherapy in third-line therapy were analyzed. Overall survival was better with rechallenge than it was with regorafenib (HR 0.29 95% CI 0.16–0.54, p < 0.001). Median OS was 12.0 months (95% CI 8.1–15.9) in rechallenge versus 6.6 months (95% CI 6.0–7.3) in regorafenib group (p < 0.001). Progression-free survival in the rechallenge group showed a higher median value of 9.16 months (95% CI 7.15–11.18) versus with that recorded in the regorafenib group of 3.41 months (95% CI 3.01–3.82), in favor of rechallenge chemotherapy. The most common adverse events of regorafenib was liver function test abnormality and hand–foot syndrome. Although grade 3 or 4 adverse events were similar, non-hematologic toxicities were more common than those of rechallenge.
Conclusions
Rechallenge is still a valuable option against regorafenib in patients who achieved disease control in one of the first two lines of therapy. Even though mCRC patients treated with regorafenib benefited clinically from this treatment, we revealed that chemotherapy rechallenge compared to regorafenib was more effective in the third-line treatment for mCRC patients.
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An Update on Drug-Induced Pigmentation
Abstract
Drug-induced pigmentation accounts for up to 20% of all cases of acquired pigmentation. A thorough review of medical history and previous and ongoing medications as well as a complete skin examination can guide diagnosis. Implicated agents include alkylating/cytotoxic agents, analgesics, antiarrhythmics, anticoagulants, antiepileptics, antimalarials, antimicrobials, antiretrovirals, metals, prostaglandin analogs, and psychotropic agents, among others. Confirming true drug associations can be challenging, especially in the setting of delayed onset of pigmentation and coexisting polypharmacy.
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A randomized controlled trial protocol assessing the effectiveness, safety and cost‐effectiveness of methotrexate vs. ciclosporin in the treatment of severe atopic eczema in children: the TREatment of severe Atopic eczema Trial (TREAT)
British Journal of Dermatology, EarlyView.
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Suprapubic catheterization is expedient for the surgical excision of female genital tumors
Dermatologic Therapy, EarlyView.
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Cutaneous localization of angioimmunoblastic T‐cell lymphoma may masquerade as B cell lymphoma or classical Hodgkin lymphoma: a histologic diagnostic pitfall
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
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Publication date: September 2017 Source: Free Radical Biology and Medicine, Volume 110 Author(s): Lucía Fernández-del-Río, Anish Nag, Elen...
