Gliomas, particularly high-grade gliomas, represent the most common and aggressive tumors of the CNS and are still burdened by high mortality and a very poor prognosis, regardless of the type of ...therapy. Their diagnosis and monitoring rely on imaging techniques and direct biopsy of the pathological tissue; however, both procedures have inherent limitations. To address these limitations, liquid biopsies have been proposed in this field. They could represent an innovative tool that could help clinicians in the early diagnosis, monitoring, and prognosis of these tumors. Furthermore, the rapid development of next-generation sequencing (NGS) technologies has led to a significant reduction in sequencing cost, with improved accuracy, providing a molecular profile of cancer and leading to better survival results and less disease burden. This paper focuses on the current clinical application of liquid biopsy in the early diagnosis and prognosis of cancer, introduces NGS-related methods, reviews recent progress, and summarizes challenges and future perspectives.
This study focuses on anti-trauma mats designed for buffaloes’ comfort, using as raw materials rubber powder from end-of-life tyres (ELTs) and an isocyanate-based polyurethane resin binder. The first ...part of the study focused on mat formulation. Whilst it was possible to select a unique combination of raw materials and design features, it was necessary to investigate the relationship between three critical parameters affecting mat consistency and therefore buffalo comfort: binder quantity, mat thickness, and desired final mat density (bulk). In order to quantitatively assess the variation in hardness, various combinations were investigated within well-defined ranges based on the relevant literature. The results obtained from nine selected combinations indicate that increases in the three critical parameters do not induce a real phase transition in the final product consistency, although the hardness suggests an increasing trend. The mats consistently exhibited a moderately soft/hard consistency, offering environmental benefits in terms of increased rubber usage and potentially reduced chemical binder, depending on the desired thickness. The selected mixture showed excellent resistance to heavy chemical loads, suggesting reliability for frequent cleaning operations. The second part of the study involved field trials of the mats with calves. This involved monitoring their weight gain and appetite levels over a 90-day period. The results showed excellent growth performance compared to uncoated grids (i.e., weight gain was approximately 20% higher at the end of the observation period); this was similar to that achieved with the use of straw bedding. However, compared to straw bedding, the mats (i) exhibit long-term durability, with no signs of wear from washing or trampling over the months of the trial, (ii) allow for quick and efficient cleaning, and (iii) enable companies to save on labour, material (straw), and waste disposal costs, while maintaining (or even improving) the same welfare levels associated with the use of straw.
The pterional approach and anterior interhemispheric approach are both valid surgical routes for the treatment of anterior skull base meningiomas. Comparative studies of these two surgical routes are ...not yet reported in the literature.
This retrospective study aims to compare the surgical outcome of both approaches, pros, and cons as well as potential postoperative complications.
In this retrospective study the following variables were evaluated: age, sex, meningioma location, symptoms, post-surgical complications, Simpson grade, follow-up/Outcome (maximum six months), hospital stay (days), Intraoperative time (minutes), intra-operative blood loss (mL).
This retrospective study included a total of 22 patients (18 females and 4 males) with a female/male ratio of 4,5/1. The mean age was 59,5 ± 12,59 years. In 13 patients (59%) an anterior interhemispheric approach was performed; in 9 (41%) patients an extended pterional approach. Comparing the two surgical techniques operative time it was found a significant difference between the two approaches (p = 0,03), and a significant difference (p = 0,016) was found in blood losses during surgical procedures: a lower operative time with a higher blood loss was found performing the anterior interhemispheric approach.
The pterional approach and anterior interhemispheric approach are two possible surgical options for the treatment of anterior skull base meningiomas. Both approaches have achieved optimal results, with total tumor resection in most patients and a low complication rate, and that the best approach depends mainly on the experience of the surgeons. A larger cohort of patients with a longer follow-up is needed to propose an algorithm to select the most suitable surgical route for surgical resection, thus reducing the risks.
Spine represents the most common site for metastatic disease involvement. Due to the close relationship between the spinal cord and critical structures, therapeutical management of metastatic spinal ...cord disease remains challenging. Spinal localization can lead to neurological sequelae, which can significantly affect the quality of life in patients with a limited life expectancy. The authors conducted a systematic literature review according to PRISMA guidelines in order to determine the impact of the most updated palliative care on spinal metastases. The initial literature search retrieved 2526 articles, manually screened based on detailed exclusion criteria. Finally, 65 studies met the inclusion criteria and were finally included in the systematic review. In the wide scenario of palliative care, nowadays, recent medical or surgical treatments represent valuable options for ameliorating pain and improving patients QoL in such this condition.
Background In patients hospitalized with acutely decompensated heart failure, unresolved signs and symptoms of fluid overload have been consistently associated with poor outcomes. Regardless of ...dosing and type of administration, intravenous loop diuretics have not reduced heart failure events or mortality in patients with acutely decompensated heart failure. The results of trials comparing intravenous loop diuretics to mechanical fluid removal by isolated venovenous ultrafiltration have yielded conflicting results. Studies evaluating early decongestive strategies have shown that ultrafiltration removed more fluid and was associated with fewer heart failure–related rehospitalization than intravenous loop diuretics. In contrast, when used in the setting of worsening renal function, ultrafiltration was associated with poorer renal outcomes and no reduction in heart failure events. Methods The AVOID-HF trial seeks to determine if an early strategy of ultrafiltration in patients with acutely decompensated heart failure is associated with fewer heart failure events at 90 days compared with a strategy based on intravenous loop diuretics. Study subjects from 40 highly experienced institutions are randomized to either early ultrafiltration or intravenous loop diuretics. In both treatment arms, fluid removal therapies are adjusted according to the patients' hemodynamic condition and renal function. The study was unilaterally terminated by the sponsor in the absence of futility and safety concerns after the enrollment of 221 subjects, or 27% of the originally planned sample size of 810 patients. Conclusions The AVOID-HF trial's principal aim is to compare the safety and efficacy of ultrafiltration vs that of intravenous loop diuretics in patients hospitalized with acutely decompensated heart failure. Because stepped treatment approaches are applied in both ultrafiltration and intravenous loop diuretics groups and the primary end point is time to first heart failure event within 90 days, it is hoped that the AVOID-HF trial, despite its untimely termination by the sponsor, will provide further insight on how to optimally decongest patients with fluid-overloaded heart failure.
PDF
