Impact of age and co-morbidities in patients with newly diagnosed glioblastoma: a pooled data analysis of three prospective mono-institutional phase II studies

To analyse the impact of age and co-morbidities on compliance and outcomes in GBM patients enrolled in three prospective phase II trials. GBM patients (??18?years) were treated with radiotherapy (60?Gy) or enrolled in a Fractionated Stereotactic Conformal-Radiotherapy Phase II trial (69.4?Gy). Concomitant and adjuvant chemotherapy with Temozolomide (TMZ) was administered. Charlson Index Co-morbidity (CCI) was used to assess co-morbidity. Toxicity was evaluated according to RTOG score. Survival analysis was performed by the Kaplan?CMaier. Influence of age and co-morbidity was evaluated using log-rank test. From 2001 to 2008, 146 patients were enrolled: 56 (38.4?%) aged over 65 and 90 under 65. CCI ??1 was observed in 41?% of elderly and 22?% of young group. Patients?? compliance was 97.9?% for radio-chemotherapy. Acute toxicity was mild with no difference between the groups. Global median progression-free survival (PFS) and overall survival (OS) were 12 and 18?months, respectively. Age, surgery and radiation dose correlated with survival (p?=?0.01, p?=?0.04 and p?=?0.03). CCI ??2 did not show any influence on OS. Our data show that elderly with a good performance status and few co-morbidity may be treated as younger patients; moreover, age confirms a negative impact on survival while CCI ??2 did not correlated with OS.     

Enterprise Implementation of Digital Pathology: Feasibility,Challenges, and Opportunities

Digital pathology is becoming technically possible to implement for routine pathology work. At our institution, we have been using digital pathology for second opinion intraoperative consultations for over 10 years. Herein, we describe our experience in converting to a digital pathology platform for primary pathology diagnosis. We implemented an incremental rollout for digital pathology on subspecialty benches, beginning with cases that contained small amounts of tissue (biopsy specimens). We successfully scanned over 40,000 slides through our digital pathology system. Several lessons (both challenges and opportunities) were learned through this implementation. A successful conversion to digital pathology requires pre-imaging adjustments, integrated software and post-imaging evaluations.     

Sinus augmentation procedure via the lateral window technique—Reducing invasiveness and preventing complications: A narrative review

Sinus augmentation has become an integrated surgical phase in posterior maxillary implant prosthesis reconstruction. Since the residual alveolar bony height usually requires additional volume particularly at this anatomical region, sinus floor augmentation is advocated routinely. Over the years, Implant success rate is proved to be comparable to the one in the pristine bone, which is well documented in the literature. Anatomical aspects as well as surgeon skills are at most importance to achieve predictable outcome. In this narrative review, the different osteotomy techniques, the indications toward 1 or 2-stage approaches, the control of the Schneiderian membrane integrity as well as the management of intra- and post-operative complications are thoroughly discussed according the current data. In light of the excellent long-term implant success rate concurrent with the application of contemporary advanced techniques of the sinus augmentation via the lateral wall osteotomy approach, reduce invasiveness and less complication occurrences are well documented. A well-codified patient selection involving the rhinologist as an integral medical team would be significantly beneficial toward early diagnosis. In-depth knowledge of the anatomy, execution of a well standardized surgical technique, and understanding the complication etiology and their management are prerequisites for reducing patient morbidity to minimal discomfort and predictable successful outcome.     

Maximum bite force following unilateral implant‐supported prosthetic treatment: within‐subject comparison to opposite dentate side

Bite force is a significant component of chewing and masticatory function. The literature lacks studies that compare bite force values of implant‐supported fixed bridges to natural dentition within same subjects. The objective of the study was to assess maximum occlusal bite force (MBF) among patients with an implant‐supported fixed prosthesis and compare it to their opposite dentate side and also to determine the effect of gender, age and Body Mass Index (BMI) on maximum occlusal bite force. Forty patients (20 males and 20 females, mean age = 42·7 ± 9·6 years) with an implant‐supported fixed prosthetic rehabilitation on one side and dentate on the other side were recruited into this study. Participants' MBF were measured bilaterally at the first molar region using a digital hydraulic occlusal force gauge (GM10). The measurements were repeated three times (with 45 s intervals between times) for each side, and the highest value of the bite force (MBF) was recorded for each side. The mean MBF was 577·9 N at the implant‐supported prosthesis side and 595·1 N at the dentate side. The average MBF was higher at the dentulous side (P < 0·05). Maximum occlusal bite force was higher in males and participants with higher weight and height. However, BMI was not significantly related to MBF values. Maximum occlusal bite force values at the dentate side were slightly (3%) but significantly higher than MBF at implant‐supported prosthesis side. Males, taller patients and patients with higher weights had higher MBF values. Body mass index was not significantly related to MBF values.     

Endothelial glycocalyx on brain endothelial cells is lost in experimental cerebral malaria

We hypothesized that the glycocalyx, which is important for endothelial integrity, is lost in severe malaria. C57BL/6 mice were infected with Plasmodium berghei ANKA, resulting in cerebral malaria, or P. chabaudi AS, resulting in uncomplicated malaria. We visualized the glycocalyx with transmission electron microscopy and measured circulating glycosaminoglycans by dot blot and ELISA. The glycocalyx was degraded in brain vasculature in cerebral and to a lesser degree uncomplicated malaria. It was affected on both intact and apoptotic endothelial cells. Circulating glycosaminoglycan levels suggested that glycocalyx disruption preceded cerebral manifestations. The contribution of this loss to pathogenesis should be studied further.     

Fast 3D optical reconstruction in turbid media using spatially modulated light

A method to perform fast 3-D optical reconstruction, based on structured light, in thick samples is demonstrated and experimentally validated. The experimental and reconstruction procedure, based on Finite Elements Method, used to reconstruct absorbing heterogeneities, with arbitrary arrangement in space, is discussed. In particular we demonstrated that a 2D sampling of the source Fourier plane is required to improve the imaging capability.