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1.
Ann R Coll Surg Engl ; 103(10): e314-e316, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34448654

RESUMO

We report an intracerebral schwannoma originating in the angular gyrus of a 20-year-old female that was incidentally diagnosed after she presented with a post-traumatic seizure. After comprehensive investigations, including functional magnetic resonance imaging, she underwent a computed tomography-guided stereotactic resection of the lesion. Pathological examination confirmed features of a schwannoma. After six years of follow-up, she remains well, without any evidence of recurrence. Intracerebral schwannomas are extremely uncommon: fewer than 90 cases have been reported. We present a comprehensive summary of the literature and a discussion of novel theories on the pathogenesis of intracerebral schwannomas.


Assuntos
Neoplasias Encefálicas/diagnóstico , Neurilemoma/diagnóstico , Lobo Parietal , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Neurilemoma/cirurgia , Neuroimagem , Lobo Parietal/diagnóstico por imagem , Lobo Parietal/patologia , Lobo Parietal/cirurgia , Radiocirurgia , Tomografia Computadorizada por Raios X , Adulto Jovem
2.
J Neurooncol ; 153(1): 99-107, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33791952

RESUMO

PURPOSE: Glioblastoma prognosis is poor. Treatment options are limited at progression. Surgery may benefit, but no quality guidelines exist to inform patient selection. We sought to describe variations in surgical management at progression, highlight where further evidence is needed, and build towards a consensus strategy. METHODS: Current practice in selection of patients with progressive GBM for second surgery was surveyed online amongst specialists in the UK and Europe. We complemented this with an assessment of practice in a retrospective cohort study from six United Kingdom neurosurgical units. We used descriptive statistics to analyse the data. RESULTS: 234 questionnaire responses were received. Maintaining or improving patient quality of life was key to decision making, with variation as to whether patient age, performance status or intended extent of resection was relevant. MGMT methylation status was not important. Half considered no minimum time after first surgery. 288 patients were reported in the cohort analysis. Median time to second surgery from first surgery 390 days. Median overall survival 815 days, with no association between time to second surgery and time to death (p = 0.874). CONCLUSIONS: This is the most wide-ranging examination of contemporaneous practice in management of GBM progression. Without evidence-based guidelines, the variation is unsurprising. We propose consensus guidelines for consideration, to reduce heterogeneity in decision making, support data collection and analysis of factors influencing outcomes, and to inform clinical trials to establish whether second surgery improves patient outcomes, or simply selects to patients already performing well.


Assuntos
Glioblastoma , Tomada de Decisão Clínica , Estudos de Coortes , Glioblastoma/cirurgia , Humanos , Qualidade de Vida , Estudos Retrospectivos , Inquéritos e Questionários
3.
Ann R Coll Surg Engl ; 97(5): e81-2, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26264110

RESUMO

Spondylodiscitis is often iatrogenic in nature. We report the case of a 69-year-old man presenting with spondylodiscitis and associated epidural abscess following transrectal ultrasonography guided prostate biopsy despite ciprofloxacin cover. To our knowledge, this is the first case of spondylodiscitis secondary to fluoroquinolone resistant Escherichia coli.


Assuntos
Biópsia por Agulha/efeitos adversos , Discite/etiologia , Abscesso Epidural/etiologia , Próstata/patologia , Antibacterianos/uso terapêutico , Bacteriemia , Discite/microbiologia , Farmacorresistência Bacteriana , Abscesso Epidural/microbiologia , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/patologia , Humanos , Masculino
4.
Clin Sci (Lond) ; 87(6): 707-10, 1994 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-7874863

RESUMO

1. Oral creatine supplementation has been shown to increase muscle creatine and phosphocreatine concentrations with consequent benefits on performance during short-term maximal exercise. However, recently there have been anecdotal reports that creatine supplementation can also influence the pattern of substrate utilization and improve performance during more prolonged, submaximal exercise, which, based on recent experimental evidence, may have some scientific justification. 2. Eight men performed a continuous incremental exercise test running at 10 km/h on a motorized treadmill at predetermined workloads from 50% to 90% of maximal oxygen uptake, before and after 5 days of creatine supplementation (4 x 5 g daily). Exercise was performed for 6 min at each workload to achieve a steady state, and respiratory gas exchange and blood lactate concentrations were measured during the last 30 s at each workload. Measurements were also made at 5-min intervals for the first 15 min of recovery. 3. The results showed no measurable effect of creatine supplementation on respiratory gas exchange and blood lactate concentrations during either incremental submaximal exercise or recovery. This suggests that creatine supplementation does not influence substrate utilization during and after this type of exercise.


Assuntos
Creatina/administração & dosagem , Lactatos/sangue , Troca Gasosa Pulmonar/efeitos dos fármacos , Adulto , Teste de Esforço , Humanos , Masculino , Consumo de Oxigênio/efeitos dos fármacos
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