Kringmcneil5672

BACKGROUND To determine the RP2D of RRx-001, a radiosensitizer with vascular normalizing properties, when used with whole-brain radiation therapy (WBRT) for brain metastases, and to assess whether quantitative changes in perfusion MRI after RRx-001 correlate with response. METHODS Five centers participated in this phase I/II trial of RRx-001 given once pre-WBRT then twice weekly during WBRT. Four dose levels were planned (5 mg/m2, 8.4 mg/m2, 16.5 mg/m2, 27.5 mg/m2). Dose-escalation was managed by the TITE-CRM algorithm. Linear mixed models were used to correlate change in 24-hour T1, Ktrans (capillary permeability) and Vp (plasma volume) with change in tumor volume. RESULTS Between 2015-2017, 31 patients were enrolled. Two patients dropped out prior to any therapy. Median age was 60 years (range, 30-76) and 12 were male. The most common tumor types were melanoma (59%) and non-small cell lung cancer (18%). No DLT's were observed. The most common severe adverse event was grade 3 asthenia (6.9%, 2/29). The median intracranial response rate was 46% (95%CI 24-68) and median OS was 5.2 months (95%CI 4.5-9.4). No neurologic deaths occurred. Among 10 patients undergoing DCE-MRI, a reduction in Vp 24 hours after RRx-001 was associated with reduced tumor volume at 1 and 4 months (p≤0.01). CONCLUSIONS The addition of RRx-001 to WBRT is well-tolerated with favorable intracranial response rates. Because activity was observed across all dose levels, the RP2D is 10 mg twice weekly. A reduction in Vp by DCE-MRI 24 hours after RRx-001 suggests anti-angiogenic activity associated with longer-term tumor response. OBJECTIVES Lack of standardization and inaccurate dosimetry assessment in pre-clinical research is hampering the translational opportunities for new radio-therapeutic interventions. The aim of this work was to develop and implement an end-to-end dosimetry test for small animal radiation research platforms to monitor and help improving accuracy of dose delivery and standardization across institutions. METHODS The test is based on a bespoke zoomorphic heterogeneous mouse and WT1 Petri dish phantoms with alanine as reference detector. Alanine measurements within the mouse phantom were validated with MC simulations at 0.5 mm Cu x-ray reference beam. Energy dependence of alanine in medium x-ray beam qualities was taken into consideration. For the end-to-end test, treatment plans considering tissue heterogeneities were created in Muriplan TPS and delivered to the phantoms at five Institutions using XXX small animal irradiation platforms. Mean calculated dose to the pellets were compared to alanine measured dose. REproviding an independent and traceable dosimetric validation in pre-clinical research involving small animal irradiations. INTRODUCTION Second impact syndrome (SIS) is a devastating condition occurring in sport-induced mild brain injury. SIS is drastically defined by anamnestic, clinical and radiological criteria, which is unusual in the field of cranial traumatology. The purpose of this study was to provide a literature review of this syndrome. MATERIAL AND METHODS We conducted a literature review of all published studies on PubMed. The keywords were "second impact syndrome AND catastrophic head injury", "second impact syndrome AND sport", "repeat concussion AND catastrophic brain injury", "catastrophic head injury AND concussion", "catastrophic head injury", "concussion AND second impact syndrome", "concussion AND repetitive head injury". RESULTS Eighty-two full-text articles were assessed for eligibility. Finally, 41 studies were included in qualitative synthesis and 21 were included in quantitative synthesis Discussion The number of cases reported in the literature was extremely small compared to the population at risk, i.e., the number of athletes exposed to repeated concussions. SIS was similar to talk and die syndrome, with which it shares certain characteristics. If we consider SIS according to "talk and deteriorate" tables, it opens up interesting perspectives because they are specific in children and adolescents. Taking into account the scarcity of this syndrome, one may question whether athlete-intrinsic features may be involved in at least some cases of SIS. On a pathophysiological level, many explanations remained unsatisfactory because they were unable to explain all the clinical phenomena and observed lesions. Triggering the trigeminocardiac reflex is a crucial element in explaining the sequence of clinical events. Its association with a state of neurogenic inflammation provides an almost complete explanation for this particular condition. Finally, on a practical level, a concussion occurring during the playing of a sport must be considered as any other injury before allowing a return to play. selleck compound BACKGROUND In this systematic review, we aim to evaluate the latest evidence on the efficacy and safety of conventional jailed balloon technique and modified jailed balloon technique for bifurcation lesion, and also whether the former or latter is more effective for preventing side branch occlusion during main branch stenting in bifurcation lesions. METHODS We performed comprehensive search on studies assessing the efficacy and safety of conventional jailed balloon and modified jailed balloon technique for bifurcation lesion from several electronic databases. RESULTS There were 908 patients from six studies comprising of 615 in conventional jailed balloon technique group and 293 in modified jailed balloon technique group. Side branch loss was lower in modified jailed balloon technique group, however, the proportion of lesions with TIMI flow less then 3 in the final percutaneous coronary intervention result was somewhat higher in the modified jailed balloon technique group. The efficacy issue regarding side branch dissection was reported as high as 3.4%, especially at proximal stent edge in conventional jailed balloon technique group, but not quantitatively described in the modified jailed balloon technique group. Zero percent major adverse cardiovascular events at 9-12 months follow up was demonstrated in modified jailed balloon technique group, and 1-5% in the conventional jailed balloon group at a longer observation period up to 2.7 years. CONCLUSION Our study showed that modified jailed balloon technique is potentially better compared to conventional jailed balloon in terms of side branch loss, dissection, and major adverse cardiovascular events. Further controlled studies are warranted for definite conclusion.