The impact of inpatient rehabilitation on function and survival of newly diagnosed patients with glioblastoma.

Objective: To examine the impact of an inpatient rehabilitation program on functional improvement and survival among patients with newly diagnosed glioblastoma multiforme (GBM) who underwent surgical resection of the brain tumor.

Design: A retrospective cohort study of newly diagnosed patients with GBM between 2003 and 2010, with survival data updated through January 23, 2013.

Setting: An urban academic nonprofit medical center that included acute medical and inpatient rehabilitation.

Effectiveness of radiotherapy for elderly patients with anaplastic gliomas.

Postoperative radiotherapy (RT) is utilized routinely in the management of anaplastic World Health Organization Grade III gliomas (AG), including anaplastic astrocytoma (AA) and anaplastic oligodendroglioma (AO). However, the optimal role of RT in elderly AG patients remains controversial. We evaluated the effectiveness of RT in elderly AG patients using a national cancer registry.

Interspinous device versus laminectomy for lumbar spinal stenosis: a comparative effectiveness study.

Background Context: Currently no studies directly compare effectiveness between interspinous devices (IDs) and laminectomy in lumbar spinal stenosis (LSS) patients.

Purpose: To compare reoperations, complications, and costs between LSS patients undergoing ID placement versus laminectomy.

Study Design: Retrospective comparative study.

Malignant intracerebral nerve sheath tumors: a case report with review of the literature.

The occurrence of benign nerve sheath tumors within the neuroaxis is uncommon. Even rarer is the finding within brain parenchyma, termed malignant intracerebral nerve sheath tumors (MINST). We present a case of MINST which occurred in the frontal lobe of an 18-year-old male that recurred almost 4 years later.

Does 30-day readmission affect long-term outcome among glioblastoma patients?

Background: Research on readmissions has focused mainly on the economic and resource burden it places on hospitals.

Objective: To evaluate the effect of 30-day readmission on overall survival among newly diagnosed glioblastoma multiforme (GBM) patients.

Methods: A nationwide cohort of GBM patients diagnosed between 1991 and 2007 was studied using the Surveillance, Epidemiology and End Results Medicare database.

Cystic glioblastoma: an evaluation of IDH1 status and prognosis.

Background: Controversy exists regarding the prognostic significance of cystic features in newly diagnosed glioblastoma multiforme (GBM) and the pathological origin of cystic GBMs.

Objective: To determine whether cystic GBMs develop from low-grade gliomas by evaluating IDH1 status and to evaluate the differences in overall survival between patients with cystic and noncystic tumors.

Methods: We retrospectively reviewed the records of 351 consecutive newly diagnosed adult GBM patients treated at our institution from October 1997 to November 2011; patients with >50% cystic tumor composition were further identified.

Survival and prognostic factors of anaplastic gliomas.

Background: The prognosis of patients with anaplastic glioma tumors is relatively favorable compared with patients with glioblastoma multiforme.

Objective: To estimate survival differences between anaplastic astrocytoma (AA) and anaplastic oligodendroglioma (AO) patients and factors associated with survival prognosis.

Methods: A nationwide cohort of grade III glioma patients diagnosed between 1990 and 2008 was studied using the Surveillance, Epidemiology, and End Results registry.

Comparison of survival between cerebellar and supratentorial glioblastoma patients: surveillance, epidemiology, and end results (SEER) analysis.

Background: Cerebellar glioblastoma multiforme (cGBM) is rare, and although there is a general belief that these tumors have a worse prognosis than supratentorial GBM (sGBM), few studies have been published to support this belief.

Objective: To investigate the effect of cerebellar location on survival through a case-control design comparing overall survival time of cGBM and sGBM patients.

Methods: The Surveillance, Epidemiology, and End Results (SEER) registry was used to identify 132 patients with cGBM (1973-2008).

The effect of weight in the outcomes of meningioma patients.

Background: Meningiomas are more prevalent in women and mostly benign in nature. Our aim was to evaluate the association of weight and outcomes of meningioma patients undergoing craniotomy.

Methods: A retrospective analysis of meningioma patients discharged postcraniotomy between 1998 and 2007 was conducted.

Improving outcomes in patients with vestibular schwannomas: microsurgery versus radiosurgery.

Vestibular schwannomas (VSs) account for 6% of all intracranial tumors. Historically, VSs have been treated with microsurgery (MS); however, stereotactic radiosurgery (SRS) has emerged as a viable alternative. This review seeks to compare the tumor control rates, functional outcomes, and costs associated with these two modalities.

Urinary tract infections in meningioma patients: analysis of risk factors and outcomes.

Background: Urinary tract infections (UTIs) account for about 35% of all nosocomial infections and 75% are associated with the use of urethral catheters.

Aim: The goal of this study was to evaluate preoperative factors associated with the risk of UTI and to estimate the impact of UTIs on patient outcome and resource utilization.

Methods: Adult meningioma patients treated with craniotomy in US hospitals between 2002 and 2007 were queried from the Nationwide Inpatient Sample (NIS) database.

Racial disparities in Medicaid patients after brain tumor surgery.

The presence of healthcare-related disparities is an ongoing, widespread, and well-documented societal and health policy issue. We investigated the presence of racial disparities among post-operative patients either with meningioma or malignant, benign, or metastatic brain tumors. We used the Medicaid component of the Thomson Reuter's MarketScan database from 2000 to 2009.

Prognosis of patients with multifocal glioblastoma: a case-control study.

Object: The prognosis of patients with glioblastoma who present with multifocal disease is not well documented. The objective of this study was to determine whether multifocal disease on initial presentation is associated with worse survival.

Methods: The authors retrospectively reviewed records of 368 patients with newly diagnosed glioblastoma and identified 47 patients with multifocal tumors.

The effect of transfer and hospital volume in subarachnoid hemorrhage patients.

Introduction: Prompt management of aneurysmal subarachnoid hemorrhage (SAH) is critical. Literature is inconclusive regarding outcomes for patients directly admitted to specialized centers versus transferred from lower-volume hospitals. Providers are often unclear about the safety of transferring critical patients.

Trends in surgical use and associated patient outcomes in the treatment of acoustic neuroma.

Objective: To investigate recent trends in surgical volume and associated patient outcomes in the treatment of acoustic neuromas.

Methods: A retrospective analysis was performed using the Nationwide Inpatient Sample database from 2000-2007; cases from 2005 were excluded because of coding inconsistencies. Univariate and multivariate analyses were used to describe surgical trends and analyze inpatient outcomes.

The effect of centralization of caseload for primary brain tumor surgeries: trends from 2001-2007.

Background: Improved patient outcomes have been associated with high-caseload hospitals for a multitude of conditions. This study analyzed adult patients undergoing surgical resection or biopsy of primary brain tumors. The aim of this study is two-fold: (1) to evaluate whether the trend towards centralization of primary brain tumor care in the US has continued during the period of between 2001 and 2007, and (2) to analyze volume-outcome effects.

Glioma stem cell research for the development of immunotherapy.

Malignant gliomas are characterized by its invasiveness and dissemination, resulting in frequent tumor recurrence after surgical resection and/or conventional chemotherapy and radiation therapy. Various strategies of active and passive immunotherapy in developing stages have shown promise to increase patient survival time with little severe side effects. In recent years, glioma stem cells had been isolated from patient tumor specimens.

Racial and gender disparities and the role of primary tumor type on inpatient outcomes following craniotomy for brain metastases.

Background: Race and gender disparities in outcomes have been documented in many cancers. Our study evaluated the role of race, gender, and tumor primary site in predicting in-hospital mortality, discharge disposition, and complications among patients with brain metastases.

Methods: Using Nationwide Inpatient Sample (NIS) data from 1998 to 2007, we evaluated in-patient outcomes of brain metastases patients who underwent a craniotomy in U.

Loss of PTEN is not associated with poor survival in newly diagnosed glioblastoma patients of the temozolomide era.

Introduction: Pre-temozolomide studies demonstrated that loss of the tumor suppressor gene PTEN held independent prognostic significance in GBM patients. We investigated whether loss of PTEN predicted shorter survival in the temozolomide era. The role of PTEN in the PI3K/Akt pathway is also reviewed.

Epidemiology and the global burden of stroke.

Objective: Stroke remains one of the most devastating of all neurological diseases, often causing death or gross physical impairment or disability. As numerous countries throughout the world undergo the epidemiological transition of diseases, trends in the prevalence of stroke have dramatically changed.

Methods: All major international epidemiological articles published during the past 20 years addressing the global burden of stroke were reviewed.

Immunotherapy targeting glioma stem cells--insights and perspectives.

Introduction: Glioblastoma multiforme (GBM) is the most aggressive and lethal primary malignant brain tumor. Although progress has been made in current conventional therapies for GBM patients, the effect of these advances on clinical outcomes has been disappointing. Recent research into the origin of cancers suggest that GBM cancer stem cells (GSC) are the source of initial tumor formation, resistance to current conventional therapeutics and eventual patient relapse.

Predictors of inpatient complications and outcomes following surgical resection of hypothalamic hamartomas.

Background: Our aim was to identify the preoperative factors associated with a greater risk of poor inpatient outcomes in those undergoing resection of hypothalamic hamartomas.

Methods: We performed a multi-institutional retrospective cohort analysis via the Nationwide Inpatient Sample (1998 - 2007). Patients of any age who underwent resection of hypothalamic hamartomas were identified by ICD-9 coding.

Vaccines for glioblastoma and high-grade glioma.

Vaccination by administering tumor antigen plus cell-free or cellular adjuvant has garnered hope for more effective, less toxic therapy for patients with malignant brain tumors including glioblastoma multiforme. To determine if this approach demonstrates ample clinical promise, all published reports of vaccination for glioma were evaluated. These reports suggest vaccination is associated with low toxicity and favorable clinical outcomes.

Whole brain radiation therapy (WBRT) alone versus WBRT and radiosurgery for the treatment of brain metastases.

Background: Historically, whole brain radiation therapy (WBRT) has been the main treatment for brain metastases. Stereotactic radiosurgery (SRS) delivers high dose focused radiation and is being increasingly utilized to treat brain metastases. The benefit of adding radiosurgery to WBRT is unclear.

T cells enhance stem-like properties and conditional malignancy in gliomas.

Background: Small populations of highly tumorigenic stem-like cells (cancer stem cells; CSCs) can exist within, and uniquely regenerate cancers including malignant brain tumors (gliomas). Many aspects of glioma CSCs (GSCs), however, have been characterized in non-physiological settings.

Methods: We found gene expression similarity superiorly defined glioma "stemness", and revealed that GSC similarity increased with lower tumor grade.