Phase I trial of dose escalation for preoperative stereotactic radiosurgery for patients with large brain metastases.

Background: Single-session stereotactic radiosurgery (SRS) or surgical resection alone for brain metastases larger than 2 cm results in unsatisfactory local control. We conducted a phase I trial for brain metastases(>2 cm) to determine the safety of preoperative SRS at escalating doses.

Methods: Radiosurgery dose was escalated at 3 Gy increments for 3 cohorts based on maximum tumor dimension starting at: 18 Gy for >2-3 cm, 15 Gy for >3-4 cm, and 12 Gy for >4-6 cm.

Methodological issues in yoga therapy research among psychiatric patients.

Yoga therapy has been widely accepted as part of the evidence-based modern healthcare system. Although research publications are growing in leaps and bounds, many methodological issues pose stumbling blocks. In this narrative review, various issues like standalone or add-on treatment, blinding, randomization, nature of dependent and intervening variables, duration of intervention, sustainability of effects, attrition bias, adherence and accuracy, all or none performance, diverse schools, heterogeneity and multidimensionality, assortment, permutations, and combinations of different components, neglect of essential ingredients, mindfulness, catch-22 situation, credentials of the instructors, cultural factors, naivety, multicentric studies, duration of collection of data, primary or standard treatment, interdisciplinary research, statistical lapses, qualitative research, biomedical research are discussed.

Effect of pedicle screw placement into the fractured vertebra in management of unstable thoracolumbar and lumbar fractures.

Background: Pedicle screw insertion at the level of the fractured vertebra has been shown to improve clinical and radiological outcomes in unstable thoracolumbar and lumbar fractures, albeit this requires further evidence. The study aims to evaluate the effect of pedicle screw placement on the fractured vertebra in such cases.

Methods: A prospective study included adult patients with thoracolumbar and lumbar fractures treated with short-segment posterior instrumentation with a pedicle screw into the fractured vertebra.

In Vitro Evaluation of a Composite Gelatin-Hyaluronic Acid-Alginate Porous Scaffold with Different Pore Distributions for Cartilage Regeneration.

Although considerable achievements have been made in the field of regenerative medicine, since self-repair is not an advanced ability of articular cartilage, the regeneration of osteochondral defects is still a challenging problem in musculoskeletal diseases. Cartilage regeneration aims to design a scaffold with appropriate pore structure and biological and mechanical properties for the growth of chondrocytes. In this study, porous scaffolds made of gelatin, hyaluronic acid, alginate, and sucrose in different proportions of 2 g (S2) and 4 g (S4) were used as porogens in a leaching process.

Reappraising the neurosurgical significance of the pterion location, morphology, and its relationship to optic canal and sphenoid ridge and neurosurgical implications.

Frontolateral craniotomy procedures have advanced from conventional craniotomy to mini-craniotomy, and to contemporary keyhole surgery. In this context, it is important for the neurosurgeon to precisely locate the pterion. The distance of the pterion center from midpoint of zygomatic arch and posterolateral margin of frontozygomatic suture was studied bilaterally in 50 whole adult skulls in Indian ethnic group.

Mediterranean diet adherence and rate of cerebral Aβ-amyloid accumulation: Data from the Australian Imaging, Biomarkers and Lifestyle Study of Ageing.

Accumulating research has linked Mediterranean diet (MeDi) adherence with slower cognitive decline and reduced Alzheimer's disease (AD) risk. However, no study to-date has examined the relationship between MeDi adherence and accumulation of cerebral Aβ-amyloid (Aβ; a pathological hallmark of AD) in older adults. Cognitively normal healthy control participants of the Australian Imaging, Biomarkers and Lifestyle (AIBL) Study of Ageing completed the Cancer Council of Victoria Food Frequency Questionnaire at baseline, which was used to construct a MeDi score for each participant (score range 0-9; higher score indicating higher adherence).

Risk Score for the Development of Veno-Occlusive Disease after Allogeneic Hematopoietic Cell Transplant.

A risk score identifying patients at high risk for veno-occlusive disease (VOD) may aid efforts to study preventive strategies for this uncommon complication of hematopoietic cell transplantation (HCT). Patients receiving a first allogeneic HCT between 2008 and 2013 as reported to the Center for International Blood and Marrow Transplant Research (N = 13,097) were randomly divided into training and validation sets. Independent prognostic factors for development of VOD by day +100 after HCT were identified with a multivariate logistic regression model.

Management of important adverse events associated with inotuzumab ozogamicin: expert panel review.

Inotuzumab ozogamicin (InO), a humanized anti-CD22 monoclonal antibody conjugated to the cytotoxic antibiotic agent calicheamicin, has demonstrated efficacy in the phase 3 INO-VATE study of adults with relapsed or refractory acute lymphoblastic leukemia (ALL). Findings from the study showed clinically important adverse events (AEs) associated with InO, with veno-occlusive disease (VOD) reported as a major non-hematologic AE. Other important or serious AEs include neutropenia, febrile neutropenia, thrombocytopenia, infusion-related reactions, tumor lysis syndrome, and prolonged QT syndrome.

New class of precision antimicrobials redefines role of S-layer in virulence and viability.

There is a medical need for antibacterial agents that do not damage the resident gut microbiota or promote the spread of antibiotic resistance. We recently described a prototypic precision bactericidal agent, Av-CD291.2, which selectively kills specific strains and prevents them from colonizing mice.

A rare case of 46,XX gonadal dysgenesis and Mayer-Rokitansky-Kuster-Hauser syndrome.

46,XX gonadal dysgenesis is a rare genetically heterogeneous disorder characterized by underdeveloped ovaries with consequent, impuberism, primary amenorrhea, and hypergonadotropic hypogonadism. Mullerian agenesis or Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by congenital aplasia of the uterus and the upper part (2/3) of the vagina in a woman with normal development of secondary sexual characteristics and a normal 46,XX karyotype. The phenotypic manifestations of MRKH syndrome may sometimes overlap with various other syndromes and require accurate delineation.

Construct damage and loosening around glenoid implants: A longitudinal micro-CT study of five cadaver specimens.

The evolution of failure of bone and cement leading to loosening of glenoid components following shoulder arthroplasty is not well understood. The purpose of this study was to identify and visualize potential mechanisms of mechanical failure within cadavers, cemented with two types of components, and subject to cyclic loading. Five glenoid cadaver bones were implanted with either a three-pegged polyethylene component, or prototype posteriorly augmented component which addresses posterior bone loss.

Pachydermoperiostosis - a case report of complete form and literature review.

Pachydermoperiostosis, also known as Touraine-Solente-Golé syndrome/Rosenfeld-Kloepfer syndrome/primary or idiopathic Hypertrophic osteoarthropathy, is an autosomal-dominant/autosomal recessive inherited disorder with variable expression. In its complete form, it is characterized by pachyderma (thickening of the facial skin), skeletal changes (periostosis), excessive sweating (hyperhydrosis), and acropachia (digital clubbing). We report a patient with skeletal symptoms, associated with pachyderma and clubbing of fingers.

Aqueous based Povidone-iodine related chemical burn under the tourniquet (a case report) and literature review.

Chemical burn under pneumatic tourniquet is an iatrogenic preventable injury and is rarely reported in the literature. The important mechanisms are maceration, irritation, and prolonged use of the tourniquet and pressure. This rare adverse complication occurred in a 35-year old man who underwent anterior cruciate ligament reconstruction of left knee.

Hamstring graft size and anthropometry in south Indian population.

Background And Aim: The role of anthropometric measurements in the prediction of hamstring autograft size in Indian population remains unclear. Till now, no studies have been done on Indian population.

Methods: We evaluated 41 consecutive patients (34 males, 7 females) prospectively with anterior cruciate ligament deficiency scheduled for reconstruction using hamstring autograft at our institution between June 2011 and June 2013.

Male health clinic strategy in control of STI/HIV: a program review.

A community-based, longitudinal interventional study was conducted in a slum in north-east (NE) Mumbai, using a pretested, semi-structured proforma and a pre- and follow-up interview schedule to assess the male health clinic (MHC) strategy as an approach for the control of sexually transmitted infections (STIs) in males. The focus groups that emerged for behavior change communication (BCC) activities were clients in second and third decades of life, unmarried and married but not staying with wife, clients with no permanent place of occupation, clients with habit of alcohol, and illiterate clients. Postintervention, there was an overall increase in STI knowledge score, alcohol habit score, and high-risk sexual activity score.

Management of ulcers in lymphoedematous limbs.

Lymphoedema is a progressive condition that can have a marked physical and psychological impact on affected patients and significantly reduce the quality of life. The ulcers on chronic lymphoedema patient, which often also makes it impossible for them to work. If left untreated, tends to progress or worsen.

Low grade mucoepidermoid carcinoma in a setting of Warthin's tumor.

Warthin's tumor also known as papillary cystadenoma lymphomatosum is a common benign salivary gland neoplasm that occurs exclusively in parotid gland. Rarely, the tumor can undergo carcinomatous or lymphomatous transformation of epithelial or lymphoid component, respectively. Herein, we describe a case of 55-year-old female who had undergone parotidectomy for a rapidly growing tumor in the right parotid gland.

Prediction and stratification of the future cardiovascular arrhythmic events: signal averaged electrocardiography versus ejection fraction.

Cardiac arrhythmias as cause of sudden cardiac death remains an important public health problem. The availability of effective treatment in terms of the implantable defibrillator makes it critical to identify individuals at risk. An essential step in this process is the use of noninvasive techniques to screen patients and identify those at risk.