Downskaae8612

With DBSEMS, there were no instances of kinking, and reflux cholangitis that developed in one patient due to duodenal obstruction was resolved by duodenal stenting. Elapsed time to recurrent biliary obstruction was longer with DBSEMS than FCSEMS (200 vs. 99 days), although the difference was not significant (P = 0.06).

DBSEMS can help prevent cholangitis due to stent kinking after EUS-CDS, thus increasing stent patency.

DBSEMS can help prevent cholangitis due to stent kinking after EUS-CDS, thus increasing stent patency.

This article provides for the first time an overview of the most often nominated European neurologists for the Nobel Prize, who never received the award. It sheds light on candidates from France, Germany, Italy, Russia, and the UK during the first half of the 20th century. The aim is to highlight the candidates in the field of neurology, to discuss key arguments in the nomination letters, and to raise questions about research trends and hotspots in European neurology 1901-1950.

Using the Nobel nomination database which contains >5,000 nominations in the prize category physiology or medicine from 1901 to the early 1950s, we listed European neurologists who were nominated more than once during this time period. We then collected nomination letters and jury reports of the prime candidates in the archive of the Nobel Committee for physiology or medicine in Sweden to explore nomination networks and motives.

We pinpointed scholars like Joseph Babinski, Vladimir Bektherev, Sir Henry Head, Eduard Hitzig, and Ugo Cerletti. The nomination motives were diverse, ranging from "lifetime" achievements and textbooks to singular (eponymous) discoveries. Issues of scientific priority disputes were central in most nomination letters.

Nobel Prize nominations constitute a lens through which credit and recognition around major contributions in neurology during the 20th century can be examined. They are unique sources that enable the reconstruction of both research trends in the field and the reputation of individual neurologists.

Nobel Prize nominations constitute a lens through which credit and recognition around major contributions in neurology during the 20th century can be examined. They are unique sources that enable the reconstruction of both research trends in the field and the reputation of individual neurologists.Treating malignant tumors of the anterior skull base (ASB) is a challenging task, given their late presentation, diverse histology, and involvement of an intricate anatomical space requiring complex surgery. Advances in imaging, gradual refinement of surgical and reconstruction techniques, and improvement of perioperative care during recent decades have resulted in improved clinical outcomes for patients. In addition, assessing functional outcomes and quality-of-life issues have become a fundamental part in the holistic care of patients with ASB tumors. Once dominated by open procedures, the modern field of skull base surgery is rapidly incorporating endoscopic techniques. These techniques have been previously reserved for sinonasal inflammatory diseases, but in recent years they have sequentially and increasingly been applied to more complex disorders. The list of indications includes intracranial pathologies and malignant sinonasal neoplasms with skull base involvement. Open ASB surgery in this new era is reserved for selected cases, yet it is still considered the "gold standard" for treating ASB malignancy. The paucity of evidence-based data regarding the management of ASB tumors is still a major limit of the discipline of ASB surgery, resulting from the rarity and high degree of heterogeneity of these tumors. Therefore, no guidelines exist and prospective large cohort collaborative studies are required in order to consolidate our knowledge of the behavior of each histology encountered, and to assess the clinical and quality-of-life outcomes of the different treatment modalities currently used.The inclusion of systemic therapy in the multimodal approach of locally advanced sinonasal cancers, at least in some selected histologies, may improve locoregional control and reduce the frequency of distant metastasis, allowing longer survival. Response to induction chemotherapy is a strong prognostic factor for a patient's outcome and it may improve disease control by surgery and radiation. Concurrent chemoradiation aims at increasing locoregional control in squamous cell cancer of the head and neck; this is particularly important in sinonasal cancers, with a risk of local relapse of about 30%. buy Vorinostat Selected histologies may benefit from specific drug combinations, according to varying chemosensitivity. Intestinal-type adenocarcinoma carrying a functional p53 protein may be treated with preoperative cisplatin, 5-fluorouracil, and leucovorin. Sinonasal undifferentiated carcinoma is a chemosensitive disease, where the multimodal approach is necessary to counterbalance the severe prognosis. Sinonasal neuroendocrine carcinoma and olfactory neuroblastoma may benefit from systemic treatments, but their added value has not been so clearly defined yet. Multimodality trials are ongoing to test the activity of induction chemotherapy followed by locoregional curative treatment. A deeper knowledge of the molecular deregulations of these diseases could help in identifying targeted therapies.Particle therapy is a comparatively new radiotherapy treatment form allowing the application of extremely conformal treatment plans. In head and neck malignancies, especially in the paranasal sinus and anterior skull base, this technology is very valuable in order to maintain normal tissue tolerance of critical structures while still applying high doses to the tumour. The following paper will further explore the rationale of particle therapy and available clinical experience of the most commonly treated malignancies arising in these anatomical sites. The potential of particle therapy for re-irradiation in tumours of the paranasal sinus and anterior skull base will also be summarised.Anterior skull base tumors represent a challenge for radiation therapy (RT) planning given the close proximity of the target lesion to numerous critical structures in this complex anatomic location. Despite this challenge, surgery followed by postoperative RT is a common treatment paradigm for malignant sinonasal tumors that has been associated with improved outcomes compared to single-modality treatment. Therefore, technological advancements allowing for increasingly conformal target coverage and sparing of organs at risk are important to accomplish the goal of delivering RT with the highest therapeutic ratio possible. Such advances include both intensity-modulated RT and volumetric-modulated arc therapy, which allow RT to be delivered more precisely than ever before. Furthermore, stereotactic radiosurgery can deliver highly conformal doses of external beam RT in a single or limited number of fractions for the definitive or postoperative management of benign lesions of the anterior base of the skull. These sophisticated photon-based RT strategies have allowed for exciting advances in the contemporary treatment of anterior skull base tumors that will continue to improve patient outcomes and reduce toxicity for years to come.