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https://www.readbyqxmd.com/read/28628492/complete-remission-of-intrathecal-metastases-with-lorlatinib-therapy-in-a-heavily-pretreated-alk-positive-lung-cancer-patient
#1
Maximilian J Hochmair, Sophia Schwab, Helmut Prosch
Patients with lung cancer who show EML4-ALK translocation are routinely treated with ALK tyrosine kinase inhibitors, although in the majority of cases, these patients develop resistance over time. The central nervous system is a common of site of recurrence in this population, which calls for next-generation drugs that can penetrate into the brain and achieve clinically meaningful central nervous system activity. Here, I report the case of a female patient diagnosed with adenocarcinoma of the lung in 2005, at the age of 46 years, who underwent lobectomy and then experienced a series of progression episodes 6 years later...
June 16, 2017: Anti-cancer Drugs
https://www.readbyqxmd.com/read/28620571/leptomeningeal-carcinomatosis-in-recurrent-non-small-cell-lung-cancer-a-case-report-and-review-of-current-treatment-modalities
#2
Saqib Abbasi, Elias Moussaly, Jean P Atallah
Leptomeningeal carcinomatosis (LC) is an uncommon sequelae of non-small cell lung cancer. The treatment modalities for LC have historically been limited with an overall poor prognosis. This case report outlines a 76-year-old female who presented with recurrence of non-small cell lung cancer as LC. LC is difficult to treat, and options include radiation, chemotherapy (systemic and intrathecal), as well as targeted therapies. This case outlines a unique approach and reviews the current literature on the effectiveness of these options in non-small cell lung cancer...
May 12, 2017: Curēus
https://www.readbyqxmd.com/read/28615337/accumulation-of-methylglyoxal-increases-the-advanced-glycation-end-products-levels-in-drg-and-contributes-to-lumbar-disc-herniation-induced-persistent-pain
#3
Cui-Cui Liu, Xin-Sheng Zhang, Yu-Ting Ruan, Zhu-Xi Huang, Su-Bo Zhang, Meng Liu, Hai-Jie Luo, Shao-Ling Wu, Chao Ma
Lumbar disc herniation (LDH) with discogenic low back pain and sciatica is a common and complicated musculoskeletal disorder. The underlying mechanisms are poorly understood and there are no effective therapies for LDH-induced pain. In the present study, we found that the patients who suffered from LDH-induced pain had elevated plasma methylglyoxal (MG) levels. In rats, implantation of autologous nucleus pulposus (NP) to the left lumbar 5 spinal nerve root, which mimicked LDH, induced mechanical allodynia and increased MG level in plasma and dorsal root ganglion (DRG) and enhanced the excitability of small DRG neurons (< 30μm in diameter)...
June 14, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28598536/characteristics-and-outcome-in-patients-with-central-nervous-system-involvement-treated-in-european-pediatric-acute-myeloid-leukemia-study-groups
#4
Ursula Creutzig, Michael N Dworzak, Martin Zimmermann, Dirk Reinhardt, Lucie Sramkova, Jan Pierre Bourquin, Henrik Hasle, Jonas Abrahamsson, Gertjan Kaspers, Mary M van den Heuvel, Ardine M J Reedijk, Barbara De Moerloose, Franco Locatelli, Riccardo Masetti
BACKGROUND: There is no consensus on the treatment for pediatric patients with acute myeloid leukemia and initial central nervous system (CNS) involvement. METHODS: To evaluate different CNS-directed treatment options (intrathecal [IT] therapy, CNS irradiation, hematopoietic stem cell transplantation [HSCT]), 261 patients (excluding acute promyelocytic leukemia) with initial CNS involvement treated in trials with similar intensive chemotherapy by four cooperative European study groups (1998-2013) were studied and compared with CNS-negative patients from the Berlin-Frankfurt-Münster group...
June 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28588689/safety-of-neural-stem-cell-transplantation-in-patients-with-severe-traumatic-brain-injury
#5
Zhigang Wang, Yong Luo, Lvan Chen, Wu Liang
Neural stem cell (NSC) therapy is a promising treatment for traumatic brain injury (TBI). In addition, mesenchymal stem cells (MSCs) have been investigated for the treatment of TBI due to their functions in neural regeneration and their neurotrophic effect. In the present study, the safety, feasibility and biological effects of autologous MSC-derived NSC-like cell transplantation were investigated in 10 patients with severe TBI. All patients received intravenous or intrathecal injections of human NSC-like cells and were evaluated with physical and neurological examinations, routine laboratory tests and neuroradiological findings...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28579851/transformation-of-follicular-lymphoma-to-a-high-grade-b-cell-lymphoma-with-myc-and-bcl2-translocations-and-overlapping-features-of-burkitt-lymphoma-and-acute-lymphoblastic-leukemia-a-case-report-and-literature-review
#6
Alina M Bischin, Russell Dorer, David M Aboulafia
Most commonly, histologic transformation (HT) from follicular lymphoma (FL) manifests as a diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS). Less frequently, HT may result in a high-grade B-cell lymphoma (HGBL) with MYC and B-cell lymphoma protein 2 (BCL2) and/or BCL6 gene rearrangements, also known as "double-hit" or "triple-hit" lymphomas. In the 2016 revision of the World Health Organization (WHO) classification of lymphoid neoplasms, the category B-cell lymphoma, unclassifiable was eliminated due to its vague criteria and limiting diagnostic benefit...
2017: Clinical Medicine Insights. Blood Disorders
https://www.readbyqxmd.com/read/28573049/biphalin-a-dimeric-enkephalin-alleviates-lps-induced-activation-in-rat-primary-microglial-cultures-in-opioid-receptor-dependent-and-receptor-independent-manners
#7
Katarzyna Popiolek-Barczyk, Anna Piotrowska, Wioletta Makuch, Joanna Mika
Neuropathic pain is relatively less responsive to opioids than other types of pain, which is possibly due to a disrupted opioid system partially caused by the profound microglial cell activation that underlines neuroinflammation. We demonstrated that intrathecally injected biphalin, a dimeric enkephalin analog, diminished symptoms of neuropathy in a preclinical model of neuropathic pain in rats (CCI, chronic constriction injury of the sciatic nerve) at day 12 postinjury. Using primary microglial cell cultures, we revealed that biphalin did not influence cell viability but diminished NO production and expression of Iba1 in LPS-stimulated cells...
2017: Neural Plasticity
https://www.readbyqxmd.com/read/28567288/gad-antibody-associated-limbic-encephalitis-in-a-young-woman-with-apeced
#8
Anna Kopczak, Adrian-Minh Schumacher, Sandra Nischwitz, Tania Kümpfel, Günter K Stalla, Matthias K Auer
The autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) syndrome is a genetic disorder caused by a mutation in the autoimmune regulator (AIRE) gene. Immune deficiency, hypoparathyroidism and Addison's disease due to autoimmune dysfunction are the major clinical signs of APECED. We report on a 21-year-old female APECED patient with two inactivating mutations in the AIRE gene. She presented with sudden onset of periodic nausea. Adrenal insufficiency was diagnosed by means of the ACTH stimulation test...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28561813/therapeutic-approaches-for-spinal-muscular-atrophy-sma
#9
REVIEW
M Scoto, R S Finkel, E Mercuri, F Muntoni
Spinal muscular atrophy (SMA) is an autosomal recessive neurodegenerative disorder characterized by progressive muscle wasting and loss of muscle function due to severe motor neuron dysfunction, secondary to mutations in the survival motor neuron 1 (SMN1) gene. A second neighboring centromeric gene, SMN2, is intact in all patients but contains a C-to-T variation in exon 7 that affects a splice enhancer and determines exclusion of exon 7 in the majority of its transcript, leading to an unstable protein that cannot substitute for mutant SMN1...
May 31, 2017: Gene Therapy
https://www.readbyqxmd.com/read/28560830/intrathecal-opioid-therapy-for-non-malignant-chronic-pain-a-long-term-perspective
#10
Barbara Kleinmann, Tilman Wolter
OBJECTIVES: Many patients with intrathecal opioid pumps do adhere to the therapy for many years but there is scarce knowledge about the long-term effects of intrathecal opioid therapy (IOT) of more than three years. We sought to assess the long-term efficacy and the presence of typical side-effects and complications of IOT. METHODS: A chart review was conducted on all patients with intrathecal opioid pumps that had been treated at our institution between 1.11.1990 and 31...
May 30, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28557056/spinal-set7-9-may-contribute-to-the-maintenance-of-cancer-induced-bone-pain-in-mice
#11
Li-Hua Hang, Zhen-Kai Xu, Shi-You Wei, Wei-Wei Shu, Hong Luo, Jian Chen
Cancer-induced bone pain (CIBP) profoundly influences patients' quality of life. Exploring the mechanisms by which CIBP occurs is essential for developing efficacious therapies. Various studies have shown that proinflammatory factors were involved in CIBP. SET domain containing lysine methyltransferase 7/9 (SET7/9) may modulate the expression of NF-κB-dependent proinflammatory genes in vitro. However, whether SET7/9 may participate in the maintenance of CIBP remains unknown. In this study, NCTC 2472 cells were inoculated into the intramedullary space of the femur to establish a mouse model of CIBP...
May 29, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28552531/a-causal-relationship-between-the-neurotherapeutic-effects-of-mir182-7a-and-decreased-expression-of-prdm5
#12
Weiqi Ling, Xu Xu, Jinbo Liu
BACKGROUND: Spinal cord injury (SCI) is terrible damage resulting in the deficiencies and necrosis of neurology and causes infinite inconvenience to sufferers. The therapy of SCI still meets a larger number of problems. Therefore, the underlying mechanism and novel therapy of acute SCI (ASCI) are urgent to explore. MATERIALS AND METHODS: The SCI model was established in rats. The expression of miR-182/miR-7a and PRDM5 at mRNA level was detected by quantitative real-time PCR and the protein expression of PRDM5 and c-caspase 3 was assessed by western blotting assays...
May 25, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28550041/central-nervous-system-involvement-in-acute-lymphoblastic-leukemia-is-mediated-by-vascular-endothelial-growth-factor
#13
Vera Münch, Luca Trentin, Julia Herzig, Salih Demir, Felix Seyfried, Johann M Kraus, Hans A Kestler, Rolf Köhler, Thomas F E Barth, Geertruy Te Kronnie, Klaus-Michael Debatin, Lüder H Meyer
In acute lymphoblastic leukemia (ALL), central nervous system (CNS) involvement is a major clinical concern. Despite non-detectable CNS leukemia in many cases, prophylactic CNS-directed conventional intrathecal chemotherapy is required for relapse free survival indicating subclinical CNS manifestation in most patients. However, CNS-directed therapy is associated with long-term sequelae including neurocognitive deficits and secondary neoplasms. Therefore, molecular mechanisms and pathways mediating leukemia cell entry into the CNS need to be understood in order to identify targets for prophylactic and therapeutic interventions and develop alternative CNS-directed treatment strategies...
May 26, 2017: Blood
https://www.readbyqxmd.com/read/28535569/reinstituting-the-bolus-new-reasoning-for-an-existing-technique
#14
Porter W McRoberts, Jason E Pope, Catalina Apostol
Improved intrathecal (IT) pump technology is increasing the accuracy of IT opioid bolus dosing and promising advances in pain therapy. Opioid bolus dosing can be used with a minimal continuous infusion or it can function as the sole therapy. Bolus-only dosing is characterized by minimal use of opioid (often less than 1 mg of IT morphine). It achieves adequate pain control while reducing tolerance and possibly opioid-induced hyperalgesia. It may prevent receptor saturation, and provide a "washing out" of the opioid receptor that prevents the observed dose escalation resulting from continuous infusions...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535095/managing-cns-disease-in-adults-with-acute-lymphoblastic-leukemia
#15
Richard A Larson
The central nervous system (CNS) is an important site of involvement by acute lymphoblastic leukemia (ALL) in adults. The prevalence is sufficiently high that prophylactic treatment is routinely given to this sanctuary site in order to eradicate occult disease that might otherwise lead to a relapse. A lumbar puncture should be routinely performed in all newly diagnosed patients with ALL. The risks of CNS leukemia vary by phenotype and genotype. Preventive treatment of the CNS during post-remission therapy has become an integral part of all current ALL treatment protocols...
May 23, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28535084/impact-of-initial-csf-findings-on-outcome-among-patients-with-national-cancer-institute-standard-and-high-risk-b-cell-acute-lymphoblastic-leukemia-a-report-from-the-children-s-oncology-group
#16
Naomi Winick, Meenakshi Devidas, Si Chen, Kelly Maloney, Eric Larsen, Leonard Mattano, Michael J Borowitz, Andrew Carroll, Julie M Gastier-Foster, Nyla A Heerema, Cheryl Willman, Brent Wood, Mignon L Loh, Elizabeth Raetz, Stephen P Hunger, William L Carroll
Purpose To determine the prognostic significance of blasts, and of white and red blood cells, in CSF samples at diagnosis of acute lymphoblastic leukemia (ALL), a uniform CSF and risk group classification schema was incorporated into Children's Oncology Group B-cell ALL (B-ALL) clinical trials. Methods CSF status was designated as follows: CNS1, no blasts; CNS2a to 2c, < 5 WBCs/μL and blasts with/without ≥ 10 RBCs/μL or ≥ 5 WBCs/μL plus blasts, with WBCs ≥ 5 times the number of RBCs; CNS3a to 3c, ≥ 5 WBCs/μL plus blasts with/without ≥ 10 RBCs/μL or clinical signs of CNS disease...
May 23, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28534039/alemtuzumab-and-intrathecal-methotrexate-failed-in-the-therapy-of-rasmussen-encephalitis
#17
Zuzana Liba, Petr Sedlacek, Vera Sebronova, Alice Maulisova, Bertil Rydenhag, Josef Zamecnik, Martin Kyncl, Pavel Krsek
No abstract text is available yet for this article.
July 2017: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/28533993/bilateral-external-ventricular-drain-placement-and-intraventricular-irrigation-combined-with-concomitant-serial-prone-patient-positioning-a-novel-treatment-for-gravity-dependent-layering-in-bacterial-ventriculitis
#18
Andrew K Chan, Harjus S Birk, John K Yue, Ethan A Winkler, Michael W McDermott
A feared complication of ventricular access for drainage or shunting is ventriculitis. Early diagnosis and treatment is vital to prevent morbidity and mortality. Efficacy of directed antibiotic therapy in ventriculitis is limited by increasing multidrug resistant microorganisms and insufficient systemic antibiotic absorption into the cerebrospinal fluid. Treatment may involve intravenous and/or intrathecal antibiotics as well as external ventricular drainage. We present the first case report suggesting a potential role of a novel technique - direct ventricular catheter-mediated continuous saline irrigation and serial prone patient positioning - to treat a fulminant bacterial ventriculitis...
April 18, 2017: Curēus
https://www.readbyqxmd.com/read/28529158/evaluation-of-direct-and-cell-mediated-triple-gene-therapy-in-spinal-cord-injury-in-rats
#19
Rustem Robertovich Islamov, Andrey Alexandrovich Izmailov, Mikhail Evgenyevich Sokolov, Philip Olegovich Fadeev, Farid Vagizovich Bashirov, Anton Alexandrovich Eremeev, Gulnara Ferdinantovna Shaymardanova, Maxim Michaylovich Shmarov, Boris Savelyevich Naroditskiy, Yuri Alexandrovich Chelyshev, Igor Aleksandrovich Lavrov, András Palotás
Current treatment options for spinal cord injury (SCI) are scarce. One of the most promising innovative approaches include gene-therapy, however no single gene has so far been shown to be of clinical relevance. This study investigates the efficacy of various combinations of vascular endothelial growth factor (VEGF), glial cell-derived neurotrophic factor (GDNF), angiogenin (ANG) and neuronal cell adhesion molecule (NCAM) in rats. Multiple therapeutic genes were administered intrathecally either via adenoviral vectors or by using genetically modified human umbilical cord blood mononuclear cells (hUCBMCs)...
May 18, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28529027/management-of-postneurosurgical-meningitis-narrative-review
#20
REVIEW
Khetam Hussein, Roni Bitterman, Ben Shofty, Mical Paul, Ami Neuberger
BACKGROUND: Infections complicating neurosurgery pose unacceptable mortality and morbidity. AIMS: To summarize what is known about the epidemiology, diagnosis and treatment of post-neurosurgical meningitis (PNM). SOURCES: PubMed, references of identified studies and reviews, and personal experience when evidence was lacking. CONTENT: The incidence and pathogen distribution of PNM is highly variable. A shift towards Gram-negative bacteria has been observed with use of antibiotic prophylaxis and antibiotic-coated devices directed mainly against Gram-positive bacteria...
May 18, 2017: Clinical Microbiology and Infection
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