Publications by authors named "Tareq Juratli"

Purpose: Analysis of autofluorescence holds promise for brain tumor delineation and diagnosis. Therefore, we investigated the potential of a commercial confocal laser scanning endomicroscopy (CLE) system for clinical imaging of brain tumors.

Methods: A clinical CLE system with fiber probe and 488 nm laser excitation was used to acquire images of tissue autofluorescence.

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Objective: To differentiate glioma grading and determine isocitrate dehydrogenase (IDH) mutation status, which are crucial for prognosis assessment and treatment planning in glioma patients.

Methods: This retrospective study included patients diagnosed with adult diffuse glioma from 1 January, 2018 to 31 July, 2023 in two independent institutions. It documented and analysed clinical and radiographic features.

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Purpose: Mutations in the Isocitrate Dehydrogenase (IDH) genes, IDH1 or IDH2, define a group of adult diffuse gliomas associated with a younger age at diagnosis and better prognosis than IDH wild-type glioblastoma. Within IDH mutant gliomas, a small fraction of astrocytic tumors present with grade 4 histologic features and poor prognosis. In molecular studies, homozygous deletion of CDKN2A/B is independently predictive of poor prognosis and short survival.

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  • The study focuses on the reconstruction of scalp defects, emphasizing the importance of interdisciplinary cooperation for both short-term wound closure and long-term aesthetic integrity.
  • Researchers analyzed 31 patients with soft tissue defects, noting factors such as defect size and previous surgeries, with various reconstruction methods employed including rotation flaps and free muscle flaps.
  • The findings revealed a significant rate of revision surgeries due to complications, but ultimately all wounds were successfully closed, highlighting the effectiveness of local and free flap techniques for complex scalp reconstructions.
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  • - Papillary craniopharyngioma (PCP) is a rare, benign tumor that accounts for about 20% of craniopharyngioma cases, primarily affecting adults and linked with the hypothalamus, presenting challenges in both diagnosis and surgical treatment due to its location.
  • - Symptoms often involve visual deficits and psychiatric issues in about 45% of patients, with MRI being effective for detection but finding only half of the cases; surgical approaches vary, with endoscopic endonasal techniques offering better outcomes.
  • - Most PCPs have the BRAFV600E mutation, which activates a key cellular signaling pathway, suggesting they may respond positively to targeted therapies like BRAF/MEK inhibitors, as shown in a recent
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  • - The study investigates the implications of Germany's 2023 law requiring recording of working hours in surgery, focusing on surgeons' perspectives regarding personnel availability and work conditions.
  • - Utilizing 20 qualitative interviews and an online questionnaire with 186 responses, the research found strong support (82%) for working time recording among surgeons, with varied opinions on improvement through in-house dialogue.
  • - Key findings highlight a preference for transponder-based systems among surgeons with long hours, as well as challenges related to transparency, compensatory time off, and the need for better communication and strategic planning in hospitals.
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Purpose: Raman spectroscopy (RS) is a promising method for brain tumor detection. Near-infrared autofluorescence (AF) acquired during RS provides additional useful information for tumor identification and was investigated in comparison with RS for delineating brain tumors in situ.

Methods: Raman spectra were acquired together with AF in situ within the solid tumor and at the tumor border during routine brain tumor surgeries (218 spectra; glioma WHO II-III, n = 6; GBM, n = 10; metastases, n = 10; meningioma, n = 3).

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  • Infrared (IR) spectroscopy can be used during surgery to help diagnose aggressive types of meningiomas based on established grading systems and molecular characteristics.
  • The study analyzed samples from 47 meningiomas and found that IR spectral differences were more distinct between WHO grades 2 and 3, with aggressive tumors showing specific changes in carbohydrate and nucleic acid levels.
  • Neural network classifiers demonstrated better accuracy in identifying tumor malignancy compared to traditional methods, suggesting that IR spectroscopy could improve precision medicine for brain tumor diagnosis in the future.
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Purpose: The study aims to examine the possible correlation between genomic alterations and preoperative olfactory function in patients with olfactory groove meningioma (OGM), due to the frequent presence of olfactory impairment.

Methods: We utilised next-generation sequencing to analyse samples from 22 individuals with OGM in order to detect driver mutations. Tumour morphology was assessed using preoperative imaging, whereas olfactory function was examined using Sniffin' Sticks.

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Background: Successful treatment of spinal dural arteriovenous fistulas (SDAVF) requires prompt diagnosis with definitive fistula localization and non-delayed treatment. Magnetic resonance imaging (MRI) is used for the screening and follow-up of SDAVF, although the value of MRI signs such as myelopathy and flow voids is controversial. Therefore, we investigated the predictive value of MRI signs pre- and post-treatment and their correlation with the neurological status of SDAVF patients.

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  • - Spinal dural arteriovenous fistulas (SDAVFs) are uncommon but make up a large portion of spinal vascular malformations, predominantly affecting older males, with gait disturbances being the most common initial symptom.
  • - A study analyzed records of 81 patients treated for SDAVF, revealing that surgical methods had higher closure rates compared to endovascular techniques, though both approaches were utilized over a span from 2002 to 2023.
  • - Post-treatment outcomes showed significant reductions in back pain, with many patients achieving improved motor scores during follow-ups, although some experienced treatment-related complications and incomplete fistula closure.
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  • The Kaplan-Meier method can overestimate the risk of cancer coming back, especially when other events like death happen first, but the Aalen-Johansen method can give a more accurate picture by considering these events.
  • A study looked at research articles about meningiomas (a type of brain tumor) since 2020 and found that only a few used the better method.
  • It showed that not using the Aalen-Johansen method mostly led to overestimating the recurrence risk, especially in older patients with more serious tumors.
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  • The study investigates the distribution of clinically actionable mutations in foramen magnum (FM) meningiomas, which are challenging to surgically treat and have high risks associated with them.
  • Targeted next-generation sequencing was performed on 62 FM meningiomas, excluding those related to radiation or neurofibromatosis type 2, and various patient and tumor characteristics were evaluated.
  • Results showed that 93.5% of tumors had significant driver mutations, with TRAF7 and AKT1E17K being the most common, and their mutations were linked to specific tumor locations relative to the brainstem.
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Background: The co-occurrence of infective endocarditis (IE) and primary spinal infections (PSI) like spondylodiscitis (SD) and isolated spinal epidural empyema (ISEE) has been reported in up to 30% of cases and represents a life-threatening infection that requires multidisciplinary management to be successful. Therefore, we aimed to characterize the clinical phenotypes of PSI patients with concomitant IE and furthermore to assess the accuracy of the modified Duke criteria in this specific population.

Methods: We conducted a retrospective cohort study in consecutive SD and ISEE patients treated surgically at our University Spine Center between 2002 and 2022 who have undergone detailed phenotyping comprising demographic, clinical, imaging, laboratory, and microbiologic assessment.

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Background: Personalized clinical management of spondylodiscitis (SD) and isolated spinal epidural empyema (ISEE) is challenging due to limited evidence of microbiologic findings and their clinical impact during the clinical course of the disease. We aimed to characterize clinico-microbiological and imaging phenotypes of SD and ISEE to provide useful insights that could improve outcomes and potentially modify guidelines.

Methods: We performed chart review and collected data on the following parameters: bacterial antibiogram-resistogram, type of primary spinal infection, location of spinal infection, source of infection, method of detection, clinical complications (sepsis, septic embolism, and endocarditis), length of hospital and intensive care unit (ICU) stay, relapse rate, and disease-related mortality in patients with proven pyogenic SD and ISEE treated surgically in a university hospital in Germany between 2002 and 2022.

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Purpose: Atypical meningiomas could manifest early recurrence after surgery and even adjuvant radiotherapy. We aimed to construct a clinico-radiomics model to predict post-operative recurrence of atypical meningiomas based on clinicopathological and radiomics features.

Materials And Methods: The study cohort was comprised of 224 patients from two neurosurgical centers.

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Background: Owing to the lack of evidence on the diagnostics, clinical course, treatment, and outcomes of patients with extremely rare spinal intradural abscess (SIA) and spinal epidural abscess (SEA), we retrospectively analyzed and compared a cohort of patients to determine the phenotyping of both entities.

Methods: Over a period of 20 years, we retrospectively analyzed the electronic medical records of 78 patients with SIA and SEA.

Results: The patients with SIA showed worse motor scores (MS scores) on admission (SIA: 20 ± 26 vs.

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Glioma are clinically challenging tumors due to their location and invasiveness nature, which often hinder complete surgical resection. The evaluation of the isocitrate dehydrogenase mutation status has become crucial for effective patient stratification. Through a transdisciplinary approach, we have developed an F-labeled ligand for non-invasive assessment of the IDH1R132H variant by using positron emission tomography (PET) imaging.

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Glioblastomas (GBM) are the most common primary brain tumors in adults and associated with poor clinical outcomes due to therapy resistances and destructive growth. Interactions of cancer cells with the extracellular matrix (ECM) play a pivotal role in therapy resistances and tumor progression. In this study, we investigate the functional dependencies between the discoidin domain receptor 1 (DDR1) and the integrin family of cell adhesion molecules for the radioresponse of human glioblastoma cells.

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Purpose: Multimodal therapies have significantly improved prognosis in glioma. However, in particular radiotherapy may induce long-term neurotoxicity compromising patients' neurocognition and quality of life. The present prospective multicenter study aimed to evaluate associations of multimodal treatment with neurocognition with a particular focus on hippocampal irradiation.

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  • The study investigates the effectiveness of postoperative epidural suction-irrigation drainage (ESID) in treating patients with spondylodiscitis (SD) and isolated spinal epidural empyema (ISEE) over a 20-year period.
  • It compares outcomes between 208 patients who underwent ESID and those who did not, revealing higher rates of surgical site infections, reoperations, and relapse in the ESID group.
  • The findings suggest that ESID may negatively impact treatment success for SD patients, indicating it's a significant risk factor for treatment failure.
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Malignant brain tumors, known as H3K27-altered diffuse midline glioma (DMG) and H3G34-mutant diffuse hemispheric glioma (DHG), can affect individuals of all ages and are classified as CNS WHO grade 4. We comprehensively characterized 390 H3F3A-mutant diffuse gliomas (201 females, 189 males) arising in pediatric patients (under 20 years old) and adults (20 years and older) evaluated by the CGP program at Foundation Medicine between 2013 and 2020. We assessed information from pathology reports, histopathology review, and clinical data.

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Background: Schwannomas are common peripheral nerve sheath tumors that can cause severe morbidity given their stereotypic intracranial and paraspinal locations. Similar to many solid tumors, schwannomas and other nerve sheath tumors are primarily thought to arise due to aberrant hyperactivation of the RAS growth factor signaling pathway. Here, we sought to further define the molecular pathogenesis of schwannomas.

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