Kangroed8361
This study clarifies the incidence of prolactin-producing pituitary adenomas without hyperprolactinemia and determines the appropriate treatment strategy for these tumors.
This retrospective analysis focused on prolactin-producing adenomas without hyperprolactinemia, which were initially treated by surgery as nonfunctioning pituitary adenomas. Among 942 patients with histologically confirmed pituitary adenoma, 114 (12.1 %) patients, consisting of 68 men and 46 women, who had prolactin-producing adenomas without hyperprolactinemia were identified between April 2005 and March 2019.
Of the 114 patients identified, 13 (11.4 %) had prolactin mono-expressions, 18 (15.8 %) had pit-1 lineage hormonal expressions, and 83 (72.8 %) had paradoxical immunoexpression out of the pituitary differentiation lineage, including prolactin. During the follow-up period, 19 patients suffered tumor progression, and 14 required salvage treatment. Of the 19 patients, 11 underwent gamma knife radiosurgery, and none of them experie suffered further tumor progression and underwent additional salvage treatments.
Out of the pituitary differentiation lineage, paradoxical hormonal expression occurred in three-quarters of the patients identified. Further surgery or gamma knife radiosurgery should be given priority in times of tumor progression because most patients were resistant to dopamine agonists.
Out of the pituitary differentiation lineage, paradoxical hormonal expression occurred in three-quarters of the patients identified. Further surgery or gamma knife radiosurgery should be given priority in times of tumor progression because most patients were resistant to dopamine agonists.
Neurosurgical procedures are life- and function-saving but carry a risk of adverse events (AE) which can cause permanent neurologic deficits. Unfortunately, there is lack of clearly defined AEs associated with given procedures, and their reporting is non-uniform and often arbitrary. However, with an increasing number of neurosurgical procedures performed, there is a need for standardization of AEs for systematic tracking. Such a system would establish a baseline for future quality improvement strategies.
To review our institutional AEs and devise standardized titles specific to the spine, tumor, functional, and vascular neurosurgery divisions.
A review of prospective monthly-reported morbidity and mortality (M&M) conference data within the Department of Neurological Surgery was conducted from January 2017 to December 2019. An AE was defined as any mortality, an "unintended and undesirable diagnostic or therapeutic event", "an event that prolongs the patient's hospital stay", or an outcome with permanent or transient neurologic deficit.
A total of 1096 AEs from 7418 total procedures (14.8 %) were identified. Of those, 418 (5.6 %) were in cerebrovascular, 249 (3.4 %) were in neuro-oncology and 429 (5.8 %) were in the spine & functional divisions. The most common AEs across all divisions were infection (17 %), hemorrhage (11 %) and cerebrospinal fluid (CSF) leak (7.8 %). Other AEs were indirectly related to the neurosurgical procedure, such as deep vein thrombosis or pulmonary embolism (2.7 %), or pneumothorax (0.3 %).
This work illustrates standardized AEs can be implemented universally across the spectrum of neurological surgery. Standardization can help identify recurring AE patterns through better tracking.
This work illustrates standardized AEs can be implemented universally across the spectrum of neurological surgery. Standardization can help identify recurring AE patterns through better tracking.
The interaction between pregnancy and diffuse low-grade glioma (DLGG) is poorly investigated. The goal of this study was to provide further insights into the relationship between pregnancy and DLGG.
A total of 12 patients were selected from a shared database of DLGGs, according to the following inclusion criteria DLGG diagnosis in post-partum, DLGG recurrence after pregnancy in patients previously operated for DLGG. The extent of surgical resection (EOR) at first surgery were evaluated. All cases were assessed based on the 2016 WHO classification. The tumor growing patter, expresses by preoperative ΔT2T1 MRI index was evaluated.
In four cases newly diagnosed DLGG were detected patients in post-partum. Seven women, previously operated for DLGG, experienced pregnancy during the natural history of glioma, and were affected by tumor recurrence after pregnancy. NVP-TAE684 manufacturer One singular had an incidental LGG not surgically treated, who presented an important tumor growth after pregnancy. Radiological and surgical data wehe mechanisms by which the pregnancy, in patients with a pervious surgery for DLGG, may influence tumor regrowth in comparison with the natural history of the disease.
Mobile stroke units (MSUs), specialized ambulances with a built-in computed tomography (CT) scanner and telemedicine connected stroke team, have been on the rise in recent years largely due to the 'time is brain' concept. link2 We aim to report our initial experience since establishing our MSU, the first unit in the Tri-state area, and assess its impact on the stroke standards of care timeline.
We conducted a retrospective analysis of a prospectively maintained database of all MSU dispatched cases from August 2019 to March 2020.
Of 195 MSU responses, 101 were treated and transported by the MSU. The mean time (hrmm) of dispatch to scene arrival was 007+003, scene arrival to CT start was 010+003, CT start to teleneuro start was 005+003, teleneuro start to scene departure was 006+005, scene departure to hospital arrival was 012+006, and hospital arrival to arterial puncture was 259+101. The mean time of dispatch to arterial puncture was 334+102. The mean teleneuro consult duration was 004+002. The mean time of last know well (LKW) to tPA administration was 128+048 with 4 (57.1 %) patients receiving tPA within 60 min of LKW and 5 (71.4 %) patients receiving tPA within 90 min. The mean time of dispatch to tPA was 037+009 and scene arrival to tPA administration was 028+007.
MSUs may expedite each step along the stroke standards of care. In theory, this should drastically improve functional outcomes. However, the impact on functional outcomes or reductions in stroke-related morbidity is still unknown.
MSUs may expedite each step along the stroke standards of care. In theory, this should drastically improve functional outcomes. However, the impact on functional outcomes or reductions in stroke-related morbidity is still unknown.Surface-enhanced Raman scattering (SERS)-based aptasensors display high sensitivity for influenza A/H1N1 virus detection but improved signal reproducibility is required. Therefore, in this study, we fabricated a three-dimensional (3D) nano-popcorn plasmonic substrate using the surface energy difference between a perfluorodecanethiol (PFDT) spacer and the Au layer. This energy difference led to Au nanoparticle self-assembly; neighboring nanoparticles then created multiple hotspots on the substrate. The localized surface plasmon effects at the hot spots dramatically enhanced the incident field. Quantitative evaluation of A/H1N1 virus was achieved using the decrease of Raman peak intensity resulting from the release of Cy3-labeled aptamer DNAs from nano-popcorn substrate surfaces via the interaction between the aptamer DNA and A/H1N1 virus. The use of a Raman imaging technique involving the fast mapping of all pixel points enabled the reproducible quantification of A/H1N1 virus on nano-popcorn substrates. Average ensemble effects obtained by averaging all randomly distributed hot spots mapped on the substrate made it possible to reliably quantify target viruses. The SERS-based imaging aptasensor platform proposed in this work overcomes the issues inherent in conventional approaches (the time-consuming and labor-intensiveness of RT-PCR and low sensitivity and quantitative analysis limits of lateral flow assay kits). Our SERS-based assay for detecting A/H1N1 virus had an estimated limit of detection of 97 PFU mL-1 (approximately three orders of magnitude more sensitive than that determined by the enzyme-linked immunosorbent assay) and the approximate assay time was estimated to be 20 min. Thus, this approach provides an ultrasensitive, reliable platform for detecting viral pathogens.Single-walled carbon nanohorns (SWCNHs), a type of tapered carbon nanomaterials, are generally prepared by laser ablation method, arc method, and Joule heating method without the addition of metal catalysts, which makes them pure and environmentally friendly. The obtained aggregates of SWCNHs mainly have three different types of structure, dahlia-like, bud-like, and seed-like. Over the past few decades, they have been widely used in the fields of energy, medicine, chemistry, and sensing. The SWCNHs-based sensors have shown high sensitivity, rapid response, and excellent stability, which are mainly attributed to the excellent electrical conductivity, large electrochemical window, large specific surface area, and mechanical strength of SWCNHs. link3 In this review, we systematically summarizes the structures, synthesis methods, and sensing applications of SWCNHs, including electrochemical sensors, photoelectrochemical sensors, electrochemiluminescence sensors, fluorescent sensors, and resistive sensors. Moreover, the development prospects of SWCNHs in this field are also discussed.Despite blood pressure being one the leading modifiable risk factors for cardiovascular disease and death, it is severely under-monitored. For this challenge we propose a finger artery non-invasive tono-oscillometric monitor (FANTOM) which is an automated low-cost instrument for measuring blood pressure and hemodynamic parameters from the fingertip. The sensing technology is highly scalable and could be integrated to a pulse oximeter probe for increased patient comfort. A tonometric cuff-less mechatronic system is used to apply pressure on the fingertip for (i) measuring oscillometric blood pressure, (ii) recording arterial waveform and for (iii) constructing central blood pressure (CBP) waveform. Clinical study on volunteers (n = 33) was performed against a commercially available arm cuff device yielding systolic and diastolic readings ((mean±SD) mmHg) of (-0.9 ± 7.3) mmHg and (-3.3 ± 6.6) mmHg respectively. The results comply with the Association for the Advancement of Medical Instrumentation (AAMI) standard for non-invasive blood pressure monitors. The arterial pulse recording morphology was compared against a volume clamp device (CNSystems CNAP 500) (n = 3) resulting in similar performance. Comparison of CBP against a pulse wave analysis (PWA) device (Atcor Medical Sphygmocor XCEL) (n = 5) revealed central aortic systolic pulse (CASP) and central augmentation index (cAIx) estimates with precision and accuracy of (2.0 ± 3.7) mmHg and (1.4 ± 6.2)% respectively. In conclusion, the results indicate that the proposed technology could be useful in the development of new portable or wearable blood pressure monitors. The sensing technology is highly scalable and could be integrated to a pulse oximeter probe for increased patient comfort.Oxalate is commonly employed as adjuvant of pesticide agent, causing renal injury of human even in trace residues. Despite the great achievements of the existing point-of-care testing (POCT) technology, accurate on-site screening of oxalate remains a tricky issue. To this aim, we proposed a "lab in a tube" platform which integrated portable hydrogel kit with smartphone for real-time monitoring of oxalate to achieve quantitatively precise analysis. In this work, a stimuli-responsive hydrogel-based kit was constructed via embedding manganese dioxide (MnO2) nanosheets into sodium alginate hydrogel system. Based on the intrinsic oxidase-like activity, MnO2 nanosheets-based nanozyme triggered color reaction by introducing a common sensing probe 3,3',5,5'-tetramethylbenzidine. Meanwhile, the presence of oxalate would decompose MnO2 nanosheets, inducing the decrease of nanozyme activity, which resulted in the color response of portable kit. Coupling with ImageJ software, the image information of kit captured via smartphone could be transduced into the hue intensity, which provided a directly quantitative tool to detect oxalate with a detection limit of 8.
