Chiari 1 Malformation in a Child with Febrile Seizures, Parasomnias, and Sleep Apnea Syndrome

Introduction. The type I is the most common Chiari malformation in children. In this condition, the lower part of the cerebellum, but not the brain stem, extends into the foramen magnum at the base of the skull leading to disturbances in cerebrospinal fluid circulation and to direct compression of nervous tissue. Case report. We describe a 4-year-old Caucasian female child with febrile seizures, headache, parasomnias, and a delay of speech. The child underwent a magnetic resonance imaging to investigate these neurological signs, disclosing a Chiari malformation type 1. The polysomnography showed a mild-moderate sleep-disordered breathing, increased number of central sleep apneas, and generalized spike waves at sleep onset. Conclusions. Seizures have been seldom described in CM1 patients. The main reasons for performing MRI in this case were frequent seizures, a delay of speech, and headache, leading to an unexpected diagnosis of CM1. Polysomnography detected a discrete SDB.

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Fertility-sparing surgery in advanced stage malignant ovarian germ cell tumor: a case report

Malignant ovarian germ cell tumor is a rare type of disease, which generally has a good prognosis due to the high chemosensitivity of this type of tumor.

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Residual stress of porcelain-fused to zirconia 3-unit fixed dental prostheses measured by nanoindentation

Publication date: Available online 16 December 2017
Source:Dental Materials
Author(s): Vinicius P. Fardin, Estevam A. Bonfante, Paulo G. Coelho, Malvin N. Janal, Nick Tovar, Lukasz Witek, Dimorvan Bordin, Gerson Bonfante
ObjectiveTo evaluate the residual stress (nanoindentation based on hardness) of fatigued porcelain-fused to zirconia 3-unit fixed dental prostheses (FDP) with different framework designs.MethodsTwenty maxillary 3-unit FDP replacing second-premolar (pontic) were fabricated with conventional framework-design (even-thickness of 0.5mm and 9mm² connector area) and modified framework-design (thickness of 0.5mm presenting lingual collar connected to proximal struts and 12mm² connector area). Connector marginal ridges were loaded and the fractured and suspended FDPs were divided (n=3/each) into: (1) Fractured zirconia even-thickness (ZrEvenF); (2) Suspended zirconia even-thickness (ZrEvenS); (3) Fractured zirconia with modified framework (ZrModF); (4) Suspended zirconia with modified framework (ZrModS); (5) Non-fatigued FDP with conventional framework design (Control). The FDPs were nanoindented at 0.03mm (Region of Interest (ROI) 1), 0.35mm (ROI 2) and 1.05mm (ROI 3) distances from porcelain veneer outer surface with peak load 4000μN. The Linear Mixed Analysis of Variance (ANOVA) Model on ranks and Least Significant Difference Test on ranks (95%) were used.ResultsHighest rank hardness values were found for Control group and ZrModS, whereas the lowest values were found in ZrModF. Statistical differences (p=0.000) were found among all groups except for comparison between ZrModS and Control group (p=0.371). Hardness between ROIs were statistically significant different (p<0.001) where ROI 1 presented the lowest values.SignificanceFramework-design modification did not influence the residual stress of porcelain-fused to zirconia fatigued 3-unit FDP. Whereas fractured FDPs showed the highest residual stress compared to suspended and control FDPs. Residual stress increased as nanoindented away from framework.



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Multiparametric MR imaging of the Prostate

Publication date: Available online 16 December 2017
Source:Radiologic Clinics of North America
Author(s): Stephen Thomas, Aytekin Oto

Teaser

Multiparametric MR imaging is widely embraced for the diagnosis, staging, and surveillance of prostate cancer. However, normal anatomic structures and many benign entities have overlapping imaging features with prostate cancer. Although some of these entities require biopsy and histopathologic diagnosis, some have characteristic imaging features that are suggestive of their diagnosis. Knowledge of these pitfalls is important in establishing a correct diagnosis and avoiding unnecessary biopsies, as these entities are encountered routinely in clinical practice.


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Prostate MR Imaging

Publication date: Available online 16 December 2017
Source:Radiologic Clinics of North America
Author(s): Aytekin Oto




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Circulating tumour DNA, a promising biomarker for the management of colorectal cancer

Publication date: Available online 16 December 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Shelize Khakoo, Alexandros Georgiou, Marco Gerlinger, David Cunningham, Naureen Starling
Circulating cell free tumour DNA (ctDNA) maintains the same genomic alterations that are present in the corresponding tumour, thereby allowing for quantitative and qualitative real-time evaluation in body fluids as an alternative to onerous repeat biopsies. Improvements in the sensitivity of techniques used to identify ctDNA has led to a surge of research investigating its role in the detection of: early disease, relapse, response to therapy and emerging drug resistance mechanisms. Following curative surgery, ctDNA detection is a promising marker of minimal residual disease and could better select patients for adjuvant chemotherapy. Longitudinal monitoring could help identify early relapse. In metastatic disease, ctDNA can predict response to chemotherapy prior to evidence of disease progression on imaging and investigate novel primary and acquired resistance mechanisms to targeted therapies. More experience in detecting, analysing and interpreting ctDNA within prospective trials, will better define its role for implementation into routine clinical practice.



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A SYSTEMATIC REVIEW OF THE SAFETY PROFILE OF THE DIFFERENT COMBINATIONS OF FLUOROPYRIMIDINES AND OXALIPLATIN IN THE TREATMENT OF COLORECTAL CANCER PATIENTS

Publication date: Available online 16 December 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Chiara Baratelli, Clizia Zichi, Massimo Di Maio, Maria Pia Brizzi, Cristina Sonetto, Giorgio Vittorio Scagliotti, Marco Tampellini
The available fluoropyrimidines and oxaliplatin combinations for colorectal cancer patients have different safety profiles. The aim of this systematic review was to compare their toxicities.The eligible studies were classified as: no bolus; 5-FU single bolus; 5-FU double bolus; capecitabine. We calculated the incidence of "any-grade" and "severe" toxicity for haematological and non-haematological adverse events of each group.We identified 184 treatment groups; compared to 5-FU double bolus, except for high-grade anaemia, all the groups showed reduced risk of haematological toxicities, with the most relevant advantages for single bolus regimens. Concerning non-haematological toxicities, compared to double bolus, the single bolus group showed a statistically significant reduced risk for many gastrointestinal toxicities and for pheripheral neuropathy.This is the first systematic review of the toxicity profile of different 5-FU or capecitabine and oxaliplatin regimens. Single 5-FU bolus is associated with a definitely favourable toxicity profile, both for haematological and non-haematological toxicity.



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