Journal of Neurosciences in Rural Practice最新文献_第6页

Automated intracranial hemorrhage detection in traumatic brain injury using 3D CNN 应用3D CNN自动检测外伤性脑损伤颅内出血

Q4 CLINICAL NEUROLOGY

Journal of Neurosciences in Rural Practice

Pub Date : 2023-09-23 DOI: 10.25259/jnrp_172_2023

Deepak Agrawal, Latha Poonamallee, Sharwari Joshi, Vaibhav Bahel

Objectives: Intracranial hemorrhage (ICH) is a prevalent and potentially fatal consequence of traumatic brain injury (TBI). Timely identification of ICH is crucial to ensure timely intervention and to optimize better patient outcomes. However, the current methods for diagnosing ICH from head computed tomography (CT) scans require skilled personnel (Radiologists and/or Neurosurgeons) who may be unavailable in all centers, especially in rural areas. The aim of this study is to develop a neurotrauma screening tool for identifying ICH from head CT scans of TBI patients. Materials and Methods: We prospectively collected head CT scans from the Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi. Approximately 738 consecutive head CT scans from patients enrolled in the department were collected for this study spanning a duration of 9 months, that is, January 2020 to September 2020. The metadata collected along with the head CT scans consisted of demographic and clinical details and the radiologist’s report which was used as the gold standard. A deep learning-based 3D convolutional neural network (CNN) model was trained on the dataset. The pre-processing, hyperparameters, and augmentation were common for training the 3D CNN model whereas the training modules were set differently. The model was trained along with the save best model option and was monitored by validation metrics. The Institute Ethics Committee permission was taken before starting the study. Results: We developed a 3D CNN model for automatically detecting the ICH from head CT scans. The screening tool was tested in 20 cases and trained on 200 head CT scans, with 99 normal head CT and 101 CT scans with some type of ICH. The final model performed with 90% sensitivity, 70% specificity, and 80% accuracy. Conclusion: Our study reveals that the automated screening tool exhibits a commendable level of accuracy and sensitivity in detecting ICH from the head CT scans. The results indicate that the 3D CNN approach has a potential for further exploring the TBI-related pathologies.

目的:颅内出血(ICH)是外伤性脑损伤(TBI)的一种常见且可能致命的后果。及时识别脑出血对于确保及时干预和优化患者预后至关重要。然而，目前通过头部计算机断层扫描(CT)诊断脑出血的方法需要熟练的人员(放射科医生和/或神经外科医生)，这些人员可能在所有中心都没有，特别是在农村地区。本研究的目的是开发一种神经创伤筛查工具，用于从脑外伤患者的头部CT扫描中识别脑出血。材料和方法:我们前瞻性地收集了新德里全印度医学科学研究所神经外科的头部CT扫描。本研究收集了该科室入组患者的约738个连续头部CT扫描，时间跨度为9个月，即2020年1月至2020年9月。与头部CT扫描一起收集的元数据包括人口统计和临床细节以及用作金标准的放射科医生报告。在数据集上训练了一个基于深度学习的三维卷积神经网络(CNN)模型。预处理、超参数和增强是训练3D CNN模型的常见方法，但训练模块的设置不同。该模型与保存最佳模型选项一起训练，并通过验证指标进行监视。在开始研究之前，已经获得了研究所伦理委员会的许可。结果:我们建立了一个3D CNN模型，用于从头部CT扫描中自动检测脑出血。筛选工具在20个病例中进行了测试，并对200个头部CT扫描进行了训练，其中99个是正常的头部CT, 101个是某些类型的脑出血的CT扫描。最终模型的灵敏度为90%，特异性为70%，准确性为80%。结论:我们的研究表明，自动筛查工具在从头部CT扫描中检测脑出血方面表现出值得称赞的准确性和敏感性。结果表明，3D CNN方法具有进一步探索tbi相关病理的潜力。

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引用次数: 0

Expression and association of vascular endothelial growth factor, vascular endothelial growth factor receptor, and phosphorylated signal transducer and activator of transcription factor 3 in malignant gliomas 血管内皮生长因子、血管内皮生长因子受体、磷酸化信号转导因子及转录因子3在恶性胶质瘤中的表达与关联

Q4 CLINICAL NEUROLOGY

Journal of Neurosciences in Rural Practice

Pub Date : 2023-09-18 DOI: 10.25259/jnrp_155_2023

Praveena Edura, Ramya Vokuda, Subhashini Ramamoorthi, Bheemanathi Hanuman Srinivas, Surendar Kumar Verma, Gopalakrishnan Sasidharan

Objectives: Angiogenesis is one of the main characteristic features of malignant gliomas. Phosphorylated signal transducer and activator of transcription factor 3 (pSTAT3) is not only involved in glioma cell proliferation, anti-apoptosis, and immunosuppression but also plays a key role in cell migration and invasion. Constitutively, activated pSTAT3 induces expression of vascular endothelial growth factor (VEGF) and its receptor VEGFR, leading to endothelial cell proliferation and abnormal microvascular formation causing peritumoral edema (PTE). PTE is one of the significant contributors to mortality in malignant gliomas. Therefore, understanding the molecular mechanism involved in the evolution of gliomas is necessary. This study was to assess the level of expression of pSTAT3, VEGF, and VEGFR in malignant gliomas and analyze the extent of PTE and the extent of expression of one or more of these markers. Materials and Methods: This study included 84 patients categorized as per the World Health Organization classification of central nervous system tumors into grade IV, III, and II gliomas to investigate the expression of pSTAT3, VEGF, and VEGFR by immunohistochemistry. Furthermore, the presence or absence of PTE was determined using magnetic resonance imaging/computed tomography scans in these patients. Results: The association between the markers (pSTAT3, VEGFR, and VEGF) and the extent of PTE in these patients was statistically significant ( P < 0.05). Conclusion: The pSTAT3, VEGF-R, and VEGF signaling pathways could contribute to peritumoral edema and might be a regulatory mechanism during PTE formation during tumorigenesis and progression.

目的:血管生成是恶性胶质瘤的主要特征之一。磷酸化信号转导因子3 (pSTAT3)不仅参与胶质瘤细胞的增殖、抗凋亡和免疫抑制，而且在细胞迁移和侵袭中起关键作用。组成性地，激活的pSTAT3诱导血管内皮生长因子(VEGF)及其受体VEGFR的表达，导致内皮细胞增殖和异常微血管形成，导致肿瘤周围水肿(PTE)。PTE是恶性胶质瘤死亡的重要原因之一。因此，了解胶质瘤进化的分子机制是必要的。本研究旨在评估恶性胶质瘤中pSTAT3、VEGF和VEGFR的表达水平，并分析PTE的程度以及其中一种或多种标志物的表达程度。材料与方法:本研究纳入84例按照世界卫生组织中枢神经系统肿瘤分类分为IV级、III级和II级胶质瘤的患者，通过免疫组化研究pSTAT3、VEGF和VEGFR的表达。此外，使用磁共振成像/计算机断层扫描来确定这些患者是否存在PTE。结果:pSTAT3、VEGFR、VEGF标志物与PTE程度的相关性有统计学意义(P <0.05)。结论:pSTAT3、VEGF- r和VEGF信号通路参与了肿瘤发生和发展过程中PTE形成的调控机制。

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引用次数: 0

Correlation of progesterone receptors and P63 to the histological grade of meningiomas: Review and significance in an African population 孕激素受体和P63与脑膜瘤组织学分级的相关性:非洲人群的回顾和意义

Q4 CLINICAL NEUROLOGY

Journal of Neurosciences in Rural Practice

Pub Date : 2023-09-18 DOI: 10.25259/jnrp_332_2023

Chidiebere Chidubem Eluke, Onyekachi Itohan Aniume, Bankole Daniel Olusina, Okechukwu Charles Okafor, Babatunde Josiah Olasode

Objectives: Meningiomas, a common neoplasm of the central nervous system, is a widely studied meningeal tumor. According to the World Health Organization (WHO) 2021 classification of meningiomas, there are 15 subtypes that have been grouped into grades 1, 2, and 3. The WHO grade 1 meningiomas are generally grouped as benign while the WHO grades 2 and 3 tumors are grouped as malignant. Progesterone receptors and P63 are common immunohistochemical markers that have proven useful in the diagnosis, grading, and prognostication of many neoplasms such as breast carcinoma, prostate carcinoma, and gastrointestinal tumors in histopathology practice. The application of these immunohistochemical markers to the grading of meningiomas has been reported and their usefulness documented in reports from Africa, Europe, North America, South America, and Asia. This study, therefore, seeks to determine if these findings are applicable to the meningiomas seen in an African population. Materials and Methods: A 10-year review of results and histologically diagnosed cases of meningiomas received in the Department of Morbid Anatomy, University of Nigeria, Enugu. Immunostaining for progesterone receptors (PgRs) and P63 were done and results compared with histologic grades. Results: The three WHO grades of meningioma were assessed in this study. M: F ratio was 1:1.4 and peak age was 41–50 years age range (SD ± 16.54). The majority of the cases were WHO grade 1 (86.1%) while the WHO grades 2 and 3 tumors were 8% and 5.9%, respectively. The fibrous variant was the most common subtype (27.1%). There was no correlation between progesterone receptor and P63 immunopositivity to the WHO grades of meningioma ( P = 0.112 and P = 0.138, respectively). Conclusion: Our study showed that progesterone receptors and P63 immunopositivity did not correlate with the WHO grades of meningiomas. This may be due to the predominant variant of meningioma seen in this study. These findings indicate that PgR antagonist may not be an effective alternative for treatment in patients with inoperable meningiomas. Furthermore, P63 immunopositivity may not be a sufficient grading tool for managing meningiomas in our population.

目的:脑膜瘤是一种常见的中枢神经系统肿瘤，是一种被广泛研究的脑膜肿瘤。根据世界卫生组织(WHO) 2021年脑膜瘤分类，共有15种亚型，分为1级、2级和3级。WHO 1级脑膜瘤一般归为良性，WHO 2级和3级脑膜瘤归为恶性。黄体酮受体和P63是常见的免疫组织化学标志物，在组织病理学实践中已被证明对许多肿瘤的诊断、分级和预后有用，如乳腺癌、前列腺癌和胃肠道肿瘤。这些免疫组织化学标记物在脑膜瘤分级中的应用已被报道，其有效性在非洲、欧洲、北美、南美和亚洲的报告中得到证实。因此，本研究旨在确定这些发现是否适用于非洲人群中的脑膜瘤。材料和方法:对尼日利亚大学埃努古病态解剖学系接收的脑膜瘤的10年结果和组织学诊断病例进行回顾。对孕激素受体(pgr)和P63进行免疫染色，并将结果与组织学分级进行比较。结果:本研究对脑膜瘤的三个WHO分级进行了评估。M: F比值为1:1.4，峰值年龄为41 ~ 50岁(SD±16.54)。WHO 1级肿瘤占多数(86.1%)，WHO 2级肿瘤占8%，WHO 3级肿瘤占5.9%。纤维型变异是最常见的亚型(27.1%)。黄体酮受体和P63免疫阳性与脑膜瘤WHO分级无相关性(P = 0.112和P = 0.138)。结论:我们的研究表明，孕激素受体和P63免疫阳性与脑膜瘤的WHO分级无关。这可能是由于本研究中脑膜瘤的主要变异所致。这些发现表明，PgR拮抗剂可能不是治疗不能手术脑膜瘤患者的有效选择。此外，P63免疫阳性可能不是一个足够的分级工具来管理脑膜瘤在我们的人群。

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引用次数: 0

Short-segment percutaneous fusion versus open posterior fusion with screw in the fractured vertebra for thoracolumbar junction burst vertebral fracture treatment 短节段经皮椎体融合与开放后路螺钉融合治疗胸腰椎交界段爆裂性椎体骨折

Q4 CLINICAL NEUROLOGY

Journal of Neurosciences in Rural Practice

Pub Date : 2023-09-18 DOI: 10.25259/jnrp_370_2023

Andrea Perna, Andrea Franchini, Franco Lucio Gorgoglione, Felice Barletta, Biagio Moretti, Andrea Piazzolla, Maria Beatrice Bocchi, Calogero Velluto, Francesco Tamburrelli, Luca Proietti

Objectives: The treatment options for thoracolumbar junction burst fractures remain a topic of controversy. Short-segment percutaneous fixation (SSPF) and short-segment open fixation including the fractured level (SSOFIFL) are both viable procedures for managing these fractures. At present, there is a lack of evidence in the literature demonstrating the absolute superiority of one treatment over the other. This study aimed to compare these two surgical strategies with a focus on radiological and clinical outcomes. Materials and Methods: This retrospective case–control multicenter analysis involved patients with A3 and A4 vertebral fractures at the thoracolumbar junction (T11–L2) who underwent surgical treatment with either SSPF or SSOFIFL in the participating centers. Clinical outcomes were measured using the Oswestry Disability Index and visual analogue scale (VAS) both pre- and postoperatively. Radiological outcomes included kyphotic deformity (KD), anterior vertebral body height (AVBH), segmental kyphosis, and sagittal alignment parameters. Results: A total of 156 patients were enrolled in the study, with 81 patients in Group A (SSPF) and 75 patients in Group B (SSOFIFL). Group B demonstrated better correction of KD (Group B: 3.4 ± 2.7° vs. Group A: 8.3 ± 3.2°, P = 0.003), AVBH, and sagittal alignment. A minor loss of correction was observed in Group B with respect to Group A (0.9 ± 1.7° vs 4.3° ± 2.1°, P = 0.043). Blood losses were lower in Group A (78 ± 15 min vs. 118 ± 23 min, P = 0.021) as well as during surgery (121.3 ± 34 mL vs. 210.2 ± 52 mL, P = 0.031), but the post-operative hemoglobin levels were comparable between the two groups. Conclusion: SSOFIFL appears to show a major amount of KD correction and prevent loss of correction. This technique should be the preferred choice whenever possible. However, SSPF can be considered a valid alternative for damage control in polytrauma patients and fractures with low KD.

目的:胸腰段连接处爆裂骨折的治疗选择仍然是一个有争议的话题。短节段经皮内固定(SSPF)和短节段开放内固定(SSOFIFL)都是治疗这些骨折的可行方法。目前，文献中缺乏证据表明一种治疗方法比另一种治疗方法具有绝对优势。本研究的目的是比较这两种手术策略，重点是放射学和临床结果。材料和方法:本回顾性病例对照多中心分析纳入了在参与中心接受SSPF或SSOFIFL手术治疗的胸腰椎连接处(T11-L2) A3和A4椎体骨折患者。术前和术后采用Oswestry残疾指数和视觉模拟量表(VAS)测量临床结果。放射学结果包括后凸畸形(KD)、前椎体高度(AVBH)、节段性后凸和矢状面对齐参数。结果:共有156例患者入组，其中A组(SSPF) 81例，B组(SSOFIFL) 75例。B组表现出更好的KD矫正(B组:3.4±2.7°，A组:8.3±3.2°，P = 0.003)、AVBH和矢状面对齐。B组相对于A组有轻微的矫正损失(0.9±1.7°vs 4.3°±2.1°，P = 0.043)。A组出血量较低(78±15 min vs. 118±23 min, P = 0.021)，术中出血量较低(121.3±34 mL vs. 210.2±52 mL, P = 0.031)，但两组术后血红蛋白水平相当。结论:SSOFIFL似乎显示了大量的KD校正，并防止了校正的丢失。无论何时，这种技术都应该是首选。然而，对于多发创伤患者和低KD骨折患者，SSPF可以被认为是一种有效的损伤控制方法。

{"title":"Short-segment percutaneous fusion versus open posterior fusion with screw in the fractured vertebra for thoracolumbar junction burst vertebral fracture treatment","authors":"Andrea Perna, Andrea Franchini, Franco Lucio Gorgoglione, Felice Barletta, Biagio Moretti, Andrea Piazzolla, Maria Beatrice Bocchi, Calogero Velluto, Francesco Tamburrelli, Luca Proietti","doi":"10.25259/jnrp_370_2023","DOIUrl":"https://doi.org/10.25259/jnrp_370_2023","url":null,"abstract":"Objectives: The treatment options for thoracolumbar junction burst fractures remain a topic of controversy. Short-segment percutaneous fixation (SSPF) and short-segment open fixation including the fractured level (SSOFIFL) are both viable procedures for managing these fractures. At present, there is a lack of evidence in the literature demonstrating the absolute superiority of one treatment over the other. This study aimed to compare these two surgical strategies with a focus on radiological and clinical outcomes. Materials and Methods: This retrospective case–control multicenter analysis involved patients with A3 and A4 vertebral fractures at the thoracolumbar junction (T11–L2) who underwent surgical treatment with either SSPF or SSOFIFL in the participating centers. Clinical outcomes were measured using the Oswestry Disability Index and visual analogue scale (VAS) both pre- and postoperatively. Radiological outcomes included kyphotic deformity (KD), anterior vertebral body height (AVBH), segmental kyphosis, and sagittal alignment parameters. Results: A total of 156 patients were enrolled in the study, with 81 patients in Group A (SSPF) and 75 patients in Group B (SSOFIFL). Group B demonstrated better correction of KD (Group B: 3.4 ± 2.7° vs. Group A: 8.3 ± 3.2°, P = 0.003), AVBH, and sagittal alignment. A minor loss of correction was observed in Group B with respect to Group A (0.9 ± 1.7° vs 4.3° ± 2.1°, P = 0.043). Blood losses were lower in Group A (78 ± 15 min vs. 118 ± 23 min, P = 0.021) as well as during surgery (121.3 ± 34 mL vs. 210.2 ± 52 mL, P = 0.031), but the post-operative hemoglobin levels were comparable between the two groups. Conclusion: SSOFIFL appears to show a major amount of KD correction and prevent loss of correction. This technique should be the preferred choice whenever possible. However, SSPF can be considered a valid alternative for damage control in polytrauma patients and fractures with low KD.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"145 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135153213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors predicting outcomes of endoscopic endonasal approach in craniopharyngioma patients 预测颅咽管瘤患者鼻内内镜入路预后的因素

Q4 CLINICAL NEUROLOGY

Journal of Neurosciences in Rural Practice

Pub Date : 2023-09-18 DOI: 10.25259/jnrp_364_2023

Chin Taweesomboonyat, Raywat Noiphithak, Pree Nimmannitya, Sakchai Sae-Heng

Objectives: Endoscopic endonasal approach (EEA) is commonly used for resection of craniopharyngioma (CP). Treatment outcomes of EEA for CP were related to numerous factors; however, they have been evaluated in few studies. The objective of this study is to investigate factors associated with the outcomes of CP following this operation. Materials and Methods: The records of patients with CP, who underwent EEA at our institution from January 2014 to June 2022, were retrospectively reviewed. Surgical outcomes, including the extent of resection, visual recovery, and endocrinological outcomes, were reported. Clinical and radiographic factors were analyzed for their associations with treatment outcomes using logistic regression analyzes. Results: This study cohort consisted of 28 patients with CP. Gross total resection (GTR) was achieved in 12 patients (43%). Post-operative visual status improved, stabilized, and deteriorated in 89%, 6%, and 6% of the patients, respectively. There were no patients recovered from pre-operative pituitary dysfunctions, while post-operative hypoadrenalism, hypothyroidism, and hypogonadism were found in 9 (36%), 11 (42%), and 4 (22%) patients, respectively. Post-operative permanent diabetic insipidus was found in 13 patients (50%). Greater suprasellar extension of the tumor was associated with a lower rate of GTR ( P = 0.011). Diabetes mellitus (DM) was associated with poor visual recovery ( P = 0.022). Larger tumor size and Puget grade 2 were associated with postoperative hypoadrenalism ( P = 0.01 and 0.023, respectively). In addition, Puget grade 2 was associated with post-operative hypothyroidism ( P = 0.017). Conclusion: For EEA in CP, the extent of resection could be determined by suprasellar extension of the tumor. DM was a poor predicting factor for visual recovery, while larger tumors and Puget grade 2 had a higher risk of post-operative hypopituitarism.

目的:内镜下鼻内入路(EEA)是颅咽管瘤(CP)切除术的常用方法。EEA治疗CP的疗效与多种因素有关;然而，很少有研究对它们进行了评估。本研究的目的是探讨与该手术后CP预后相关的因素。材料与方法:回顾性分析我院2014年1月至2022年6月行EEA的CP患者的记录。报告了手术结果，包括切除程度、视力恢复和内分泌结果。使用logistic回归分析临床和影像学因素与治疗结果的关系。结果:该研究队列包括28例CP患者。12例患者(43%)实现了总切除(GTR)。术后视力状况分别有89%、6%和6%的患者改善、稳定和恶化。术前垂体功能障碍无恢复，术后肾上腺功能减退9例(36%)，甲状腺功能减退11例(42%)，性腺功能减退4例(22%)。术后出现永久性糖尿病尿崩13例(50%)。较大的鞍上肿瘤延伸与较低的GTR率相关(P = 0.011)。糖尿病(DM)与视力恢复差相关(P = 0.022)。肿瘤大小和Puget分级2级与术后肾上腺素减退相关(P分别为0.01和0.023)。此外，Puget 2级与术后甲状腺功能减退相关(P = 0.017)。结论:对于CP的EEA，可根据肿瘤的鞍上延伸程度判断切除范围。DM是视力恢复的一个较差的预测因素，而较大的肿瘤和Puget 2级患者术后垂体功能减退的风险较高。

{"title":"Factors predicting outcomes of endoscopic endonasal approach in craniopharyngioma patients","authors":"Chin Taweesomboonyat, Raywat Noiphithak, Pree Nimmannitya, Sakchai Sae-Heng","doi":"10.25259/jnrp_364_2023","DOIUrl":"https://doi.org/10.25259/jnrp_364_2023","url":null,"abstract":"Objectives: Endoscopic endonasal approach (EEA) is commonly used for resection of craniopharyngioma (CP). Treatment outcomes of EEA for CP were related to numerous factors; however, they have been evaluated in few studies. The objective of this study is to investigate factors associated with the outcomes of CP following this operation. Materials and Methods: The records of patients with CP, who underwent EEA at our institution from January 2014 to June 2022, were retrospectively reviewed. Surgical outcomes, including the extent of resection, visual recovery, and endocrinological outcomes, were reported. Clinical and radiographic factors were analyzed for their associations with treatment outcomes using logistic regression analyzes. Results: This study cohort consisted of 28 patients with CP. Gross total resection (GTR) was achieved in 12 patients (43%). Post-operative visual status improved, stabilized, and deteriorated in 89%, 6%, and 6% of the patients, respectively. There were no patients recovered from pre-operative pituitary dysfunctions, while post-operative hypoadrenalism, hypothyroidism, and hypogonadism were found in 9 (36%), 11 (42%), and 4 (22%) patients, respectively. Post-operative permanent diabetic insipidus was found in 13 patients (50%). Greater suprasellar extension of the tumor was associated with a lower rate of GTR ( P = 0.011). Diabetes mellitus (DM) was associated with poor visual recovery ( P = 0.022). Larger tumor size and Puget grade 2 were associated with postoperative hypoadrenalism ( P = 0.01 and 0.023, respectively). In addition, Puget grade 2 was associated with post-operative hypothyroidism ( P = 0.017). Conclusion: For EEA in CP, the extent of resection could be determined by suprasellar extension of the tumor. DM was a poor predicting factor for visual recovery, while larger tumors and Puget grade 2 had a higher risk of post-operative hypopituitarism.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135154323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Microsurgery for symptomatic extratumoral cyst formation in vestibular schwannoma post-radiosurgery 前庭神经鞘瘤放射术后症状性瘤外囊肿形成的显微外科治疗

Q4 CLINICAL NEUROLOGY

Journal of Neurosciences in Rural Practice

Pub Date : 2023-09-11 DOI: 10.25259/jnrp_384_2023

Arthur Hosmann, Basant K. Misra

引用次数: 0

Impact of disability in the quality of life of patients with traumatic brachial plexus injuries based on a questionnaire survey in a tertiary center in South India. 残疾对创伤性臂丛神经损伤患者生活质量的影响——基于南印度一家三级中心的问卷调查。

IF 1.4 Q4 CLINICAL NEUROLOGY

Journal of Neurosciences in Rural Practice

Pub Date : 2023-07-01 Epub Date: 2022-10-22 DOI: 10.25259/JNRP-2021-12-26-R1-(2260)

Lekshmi S Bhooshan, Vinu V Gopal, P T Baburaj

Objectives: The aim of the study was to assess the disability and its impact in the health-related quality of life (HRQOL) and its various domains in patients with traumatic brachial plexus injury (TBPI).

Materials and methods: A descriptive cross-sectional questionnaire survey was conducted on 41 patients with TBPI in a tertiary care center in South India. The assessment of disability and HRQOL was done as per the guidelines of the Gazette of India (2001) and WHO BREF questionnaire, respectively. The association between disability and HRQOL was determined using Chi-square test.

Results: All patients were males in the age group 16-60 years (mean age 36.8 ± 14.4 years). Etiology was road traffic accident in 90.2% of cases. About 51.2% had pan-plexus injuries and 53.7% had their dominant limb affected. The mean total disability was 80.39 ± 13.86% and the mean total HRQOL score was 188.46 ± 83.44 out of 400. It was found that disability due to TBPI significantly reduced the HRQOL (Fisher's exact P = 0.005) and the psychological domain was the most significantly affected (P = 0.017, Kruskal-Wallis test). Pan-plexus injuries with an involvement of dominant upper limb had significant impact in the HRQOL. Twenty-one patients (51.2%) complained of neuropathic pain and they had a significantly reduced quality of life (QOL) (mean QOL = 23.3, P < 0.001). It was also found that productive age group (26-55 years) had a significantly reduced QOL as compared to the extreme age groups (P = 0.000). Unemployed patients had a significantly reduced QOL as compared to those with permanent/temporary job (P = 0.024). Marital status was found to have no significant relationship with the total HRQOL (P = 0.647). Those belonging to the poor socioeconomic strata (below poverty line) had poor HRQOL as compared to those above poverty line and the relationship was found to be significant (P = 0.000).

Conclusion: TBPIs significantly affected all domains of QOL, especially in unemployed patients in the productive age group in the poor socioeconomic strata. The pan-brachial plexus involvement of dominant upper limb and associated neuropathic pain were the most important factors which negatively affected the QOL. Among the codomains of the QOL, psychological domain was the most significantly affected irrespective of the severity of the injury.

目的：本研究旨在评估创伤性臂丛神经损伤（TBPI）患者的残疾及其对健康相关生活质量（HRQOL）及其各个领域的影响。材料和方法：对南印度一家三级医疗中心的41名TBPI患者进行描述性横断面问卷调查。残疾和HRQOL的评估分别按照《印度公报》（2001年）和世界卫生组织BREF问卷的指导方针进行。采用卡方检验确定残疾与HRQOL之间的相关性。结果：所有患者均为男性，年龄16～60岁，平均年龄36.8±14.4岁。90.2%的病例病因为道路交通事故。约51.2%的患者有泛神经丛损伤，53.7%的患者有优势肢体受到影响。平均总残疾率为80.39±13.86%，平均HRQOL总分为188.46±83.44分（满分400分）。研究发现，TBPI导致的残疾显著降低了HRQOL（Fisher精确P=0.005），心理领域受到的影响最为显著（P=0.017，Kruskal-Wallis检验）。泛神经丛损伤伴支配性上肢受累对HRQOL有显著影响。21名患者（51.2%）抱怨神经性疼痛，他们的生活质量（QOL）显著降低（平均QOL=23.3，P<0.001）。研究还发现，与极端年龄组相比，生产年龄组（26-55岁）的生活质量显著降低（P=0.000）。与长期/临时工作的患者相比，失业患者的生活质量明显降低（P=0.024）。婚姻状况与总HRQOL没有显著关系（P=0.647）。属于贫困社会经济阶层（贫困线以下）的人与贫困线以上的人相比HRQOL较差，并且这种关系显著（P=0.000）。结论：TBPI显著影响生活质量的所有领域，尤其是在社会经济贫困阶层的生产年龄组的失业患者中。支配性上肢的泛臂丛神经受累和相关的神经性疼痛是影响生活质量的最重要因素。在生活质量的共域中，无论损伤的严重程度如何，心理域都受到最显著的影响。

{"title":"Impact of disability in the quality of life of patients with traumatic brachial plexus injuries based on a questionnaire survey in a tertiary center in South India.","authors":"Lekshmi S Bhooshan, Vinu V Gopal, P T Baburaj","doi":"10.25259/JNRP-2021-12-26-R1-(2260)","DOIUrl":"10.25259/JNRP-2021-12-26-R1-(2260)","url":null,"abstract":"Objectives: The aim of the study was to assess the disability and its impact in the health-related quality of life (HRQOL) and its various domains in patients with traumatic brachial plexus injury (TBPI).Materials and methods: A descriptive cross-sectional questionnaire survey was conducted on 41 patients with TBPI in a tertiary care center in South India. The assessment of disability and HRQOL was done as per the guidelines of the Gazette of India (2001) and WHO BREF questionnaire, respectively. The association between disability and HRQOL was determined using Chi-square test.Results: All patients were males in the age group 16-60 years (mean age 36.8 ± 14.4 years). Etiology was road traffic accident in 90.2% of cases. About 51.2% had pan-plexus injuries and 53.7% had their dominant limb affected. The mean total disability was 80.39 ± 13.86% and the mean total HRQOL score was 188.46 ± 83.44 out of 400. It was found that disability due to TBPI significantly reduced the HRQOL (Fisher's exact P = 0.005) and the psychological domain was the most significantly affected (P = 0.017, Kruskal-Wallis test). Pan-plexus injuries with an involvement of dominant upper limb had significant impact in the HRQOL. Twenty-one patients (51.2%) complained of neuropathic pain and they had a significantly reduced quality of life (QOL) (mean QOL = 23.3, P < 0.001). It was also found that productive age group (26-55 years) had a significantly reduced QOL as compared to the extreme age groups (P = 0.000). Unemployed patients had a significantly reduced QOL as compared to those with permanent/temporary job (P = 0.024). Marital status was found to have no significant relationship with the total HRQOL (P = 0.647). Those belonging to the poor socioeconomic strata (below poverty line) had poor HRQOL as compared to those above poverty line and the relationship was found to be significant (P = 0.000).Conclusion: TBPIs significantly affected all domains of QOL, especially in unemployed patients in the productive age group in the poor socioeconomic strata. The pan-brachial plexus involvement of dominant upper limb and associated neuropathic pain were the most important factors which negatively affected the QOL. Among the codomains of the QOL, psychological domain was the most significantly affected irrespective of the severity of the injury.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"14 3","pages":"413-417"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neurotrophin-3 gene polymorphism in schizophrenia and its relation with diseases severity and cognitive dysfunction. 精神分裂症患者神经营养素-3基因多态性及其与疾病严重程度和认知功能障碍的关系。

IF 1.4 Q4 CLINICAL NEUROLOGY

Journal of Neurosciences in Rural Practice

Pub Date : 2023-07-01 Epub Date: 2023-07-20 DOI: 10.25259/JNRP_34_2022

Neha Keshri, Hanumanthappa Nandeesha, Medha Rajappa, Vikas Menon

Objectives: Synaptic plasticity markers are known to alter in schizophrenia. The objective of the study was to investigate the genotype and allele frequency of neurotrophin-3 (NT-3) gene polymorphism (rs6489630, rs6332, and rs11063714) and plasma NT-3 levels in schizophrenia and their relation with cognitive status.

Materials and methods: The study was conducted on 216 Schizophrenia patients and 216 controls. Single-nucleotide polymorphism (SNP) of NT-3 and its plasma levels were assessed in both groups. Cognitive status was evaluated using Addenbrooke Cognitive examination-III scores.

Results: The rs6489630 polymorphism was found to be significantly associated with the severity of schizophrenia (P = 0.004). The CT genotype (P = 0.02, OR = 1.631 [1.10-2.43]) and minor allele T (P = 0.004, OR = 1.58 [1.16-2.16]) of rs6489630 conferred an increased susceptibility to develop schizophrenia. The rs6332 variant was found to affect cognitive status significantly in schizophrenia (P = 0.040), and memory dysfunction was seen in individuals with AG (P < 0.01) and AA variant (P = 0.03) of rs6332.

Conclusion: We conclude that SNPs of NT-3 enhance the risk of schizophrenia and are related to cognitive dysfunction.

目的：已知突触可塑性标记物在精神分裂症中发生改变。本研究旨在探讨精神分裂症患者神经营养因子-3（NT-3）基因多态性（rs6489630、rs6332和rs11063714）的基因型和等位基因频率以及血浆NT-3水平及其与认知状态的关系。材料和方法：本研究对216例精神分裂症患者和216例对照组进行了研究。对两组NT-3的单核苷酸多态性（SNP）及其血浆水平进行评估。使用Addenbrooke认知检查III评分评估认知状态。结果：rs6489630多态性与精神分裂症的严重程度显著相关（P=0.004）。rs648963的CT基因型（P=0.02，OR=1.631[1.10-2.43]）和次要等位基因T（P=0.004，OR=1.58[1.16-2.16]）增加了精神分裂症发生的易感性。rs6332变异株对精神分裂症患者的认知状态有显著影响（P=0.040），在rs6332的AG变异株（P<0.01）和AA变异株（P=0.03）患者中发现记忆功能障碍。结论：NT-3的SNPs增加了精神分裂症的风险，并与认知功能障碍有关。

{"title":"Neurotrophin-3 gene polymorphism in schizophrenia and its relation with diseases severity and cognitive dysfunction.","authors":"Neha Keshri, Hanumanthappa Nandeesha, Medha Rajappa, Vikas Menon","doi":"10.25259/JNRP_34_2022","DOIUrl":"10.25259/JNRP_34_2022","url":null,"abstract":"Objectives: Synaptic plasticity markers are known to alter in schizophrenia. The objective of the study was to investigate the genotype and allele frequency of neurotrophin-3 (NT-3) gene polymorphism (rs6489630, rs6332, and rs11063714) and plasma NT-3 levels in schizophrenia and their relation with cognitive status.Materials and methods: The study was conducted on 216 Schizophrenia patients and 216 controls. Single-nucleotide polymorphism (SNP) of NT-3 and its plasma levels were assessed in both groups. Cognitive status was evaluated using Addenbrooke Cognitive examination-III scores.Results: The rs6489630 polymorphism was found to be significantly associated with the severity of schizophrenia (P = 0.004). The CT genotype (P = 0.02, OR = 1.631 [1.10-2.43]) and minor allele T (P = 0.004, OR = 1.58 [1.16-2.16]) of rs6489630 conferred an increased susceptibility to develop schizophrenia. The rs6332 variant was found to affect cognitive status significantly in schizophrenia (P = 0.040), and memory dysfunction was seen in individuals with AG (P < 0.01) and AA variant (P = 0.03) of rs6332.Conclusion: We conclude that SNPs of NT-3 enhance the risk of schizophrenia and are related to cognitive dysfunction.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"14 3","pages":"501-508"},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reducing the risks of nuclear war - the role of health professionals. 降低核战争的风险——卫生专业人员的作用。

IF 1.4 Q4 CLINICAL NEUROLOGY

Journal of Neurosciences in Rural Practice

Pub Date : 2023-07-01 Epub Date: 2023-08-16 DOI: 10.25259/JNRP_394_2023

Kamran Abbasi, Parveen Ali, Virginia Barbour, Kirsten Bibbins-Domingo, Marcel G M Olde Rikkert, Andy Haines, Ira Helfand, Richard Horton, Bob Mash, Arun Mitra, Carlos Monteiro, Elena N Naumova, Eric J Rubin, Tilman Ruff, Peush Sahni, James Tumwine, Paul Yonga, Chris Zielinski

引用次数: 0

Glioma diagnosis and comprehensive management during COVID-19 pandemic: A proposed algorithm. 新冠肺炎大流行期间的胶质瘤诊断和综合管理：一种拟议的算法。

IF 1.4 Q4 CLINICAL NEUROLOGY

Journal of Neurosciences in Rural Practice

Pub Date : 2023-07-01 Epub Date: 2023-06-16 DOI: 10.25259/JNRP_45_2022

Cindy Cecilia, Djohan Ardiansyah

The coronavirus disease 2019 (COVID-19) has significantly changed the health-care system. COVID-19 patients with comorbidities are more likely to have severe disease, often leading to death. As one primary concern in this pandemic era, glioma patients have an incidence of 30%. It has a high mortality rate. Glioma has multiple comorbidities, at risk of contracting COVID-19, such as elderly, taking high-dose steroid therapy with adjuvant radiotherapy (RT) and chemotherapy. An algorithm for patient-doctor communication, inpatient-outpatient selection, and treatment goals in glioma patients should be carefully made according to local preparation for COVID-19. Surgery, RT, and chemotherapy should be tailored individually to increase survival rate, quality of life, and reduce the risk of COVID-19 exposure. All communication between the health-care provider and patient will be using telemedicine. The patient who requires to visit the inpatient ward will be carefully selected. Asymptomatic glioma or with no progressivity of the disease should have the treatment postponed. Symptomatic high-grade glioma patients with progressive neurological deficits and increased intracranial pressure will be treated with COVID-19 protocols. Surgery, RT, and chemotherapy, especially Temozolomide, will be given after evaluating the patient's age, Karnofsky Performance Scale (KPS) Score, and molecular finding of O6-methylguanine DNA methyltransferase (MGMT), isocitrate dehydrogenase, and gene 1p/9q. Therefore, it is necessary to have a modified algorithm for glioma patients during this pandemic.

Key messages: A strategy to minimize hospital contact for glioma patients in a pandemic crisis while not delaying their diagnostics and treatments.

2019冠状病毒病（新冠肺炎）显著改变了医疗保健系统。患有合并症的新冠肺炎患者更有可能患上严重疾病，通常会导致死亡。作为这个流行病时代的主要关注点之一，神经胶质瘤患者的发病率为30%。它的死亡率很高。胶质瘤有多种合并症，有感染新冠肺炎的风险，如老年人、接受高剂量类固醇治疗、辅助放疗（RT）和化疗。应根据新冠肺炎的本地准备情况，谨慎制定神经胶质瘤患者的患者与医生沟通、患者内外选择和治疗目标的算法。手术、RT和化疗应单独定制，以提高生存率和生活质量，并降低新冠肺炎暴露的风险。医疗保健提供者和患者之间的所有通信都将使用远程医疗。将仔细选择需要访问住院病房的患者。无症状的神经胶质瘤或没有进展性的疾病应推迟治疗。有症状的高级别神经胶质瘤患者伴有进行性神经功能缺损和颅内压升高，将接受新冠肺炎方案治疗。手术、RT和化疗，尤其是替莫唑胺，将在评估患者的年龄、Karnofsky性能量表（KPS）评分以及O6甲基鸟嘌呤DNA甲基转移酶（MGMT）、异柠檬酸脱氢酶和基因1p/9q的分子发现后进行。因此，在这场疫情期间，有必要为神经胶质瘤患者制定一种改进的算法。关键信息：在疫情危机中尽量减少神经胶质瘤患者与医院的接触，同时不延误他们的诊断和治疗。

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