DCE-MRI perfusion and permeability parameters as predictors of tumor response to CCRT in patients with locally advanced NSCLC

In this prospective study, 36 patients with stage III non-small cell lung cancers (NSCLC), who underwent dynamic contrast-enhanced MRI (DCE-MRI) before concurrent chemo-radiotherapy (CCRT) were enrolled. Pharmacokinetic analysis was carried out after non-rigid motion registration. The perfusion parameters including Blood Flow (BF), Blood Volume (BV), Mean Transit Time (MTT) and permeability parameters including endothelial transfer constant (Ktrans), reflux rate (Kep), fractional extravascular extracellular space volume (Ve), fractional plasma volume (Vp) were calculated, and their relationship with tumor regression was evaluated. The value of these parameters on predicting responders were calculated by receiver operating characteristic (ROC) curve. Multivariate logistic regression analysis was conducted to find the independent variables. Tumor regression rate is negatively correlated with V e and its standard variation V e-SD and positively correlated with K trans and Kep. Significant differences between responders and non-responders existed in Ktrans, Kep, Ve, Ve-SD, MTT, BV-SD and MTT-SD (P < 0.05). ROC indicated that Ve < 0.24 gave the largest area under curve of 0.865 to predict responders. Multivariate logistic regression analysis also showed Ve was a significant predictor. Baseline perfusion and permeability parameters calculated from DCE-MRI were seen to be a viable tool for predicting the early treatment response after CCRT of NSCLC. © 2016 The Author(s)

Evaluation of vestibular functions in children with vertigo attacks

Aim: To examine vestibular system functions in children with episodic vertigo attacks. Methods: Thirty four children (20 males) aged 4–18 years with paroxysmal dizziness and/or vertigo attacks were evaluated. A medical history for vestibular symptoms and migraine was taken. Vestibular and auditory functions were assessed. Results: Chronic headache attacks consistent with migraine were reported in 12 children and motion sickness was reported in 30. Family history in first degree relatives was positive for migraine in 29 children and for episodic vertigo in 22. Electronystagmography and videonystagmography showed two types of nystagmus: spontaneous vestibular nystagmus (41%) and benign paroxysmal positional nystagmus (BPPN) (59%). The first type of nystagmus was assessed as a sign of vestibulopathy and the patients with BPPN were diagnosed as having benign paroxysmal positional vertigo (BPPV). Audiometric examination in four cases revealed bilateral sensory neural hearing loss in low frequencies. Pure tone averages in 30 cases were within normal ranges; however low frequencies in 28 of them were approximately 10 dB lower than high frequencies. Unilateral caloric responses diminished in eight children. Conclusions: Peripheral vestibular problems in childhood present in a wide spectrum, which varies from a short episode of dizziness to a typical vestibular attack with fluctuating sensory neural hearing loss or episodes of BPPV. A considerable number of these vestibular problems might be related to the migraine syndrome

The effect of having a children with cerebral palsy on quality of life, burn-out, depression and anxiety scores: A comparative study

Background. The caregivers of children with cerebral palsy (CP) should overcome the difficulties and complications arising from their children's impairments. It may be stressful for the caregivers when the balance between these inevitable demands and their own social needs impairs. Therefore, the primary caregiver, may experience several psycho-social problems. Aim. To compare the quality of life (QoL), mental health and burnout of caregivers of patients with CP and healthy controls. The effects of the functional limitations of children with CP on the QoL, mental health and burnout of caregivers have also been evaluated. Design. Cross-sectional, comparative.Setting. Outpatient. Population. One hundred and forty-three caregivers of children with CP and 60 caregivers of typically developing children were recruited for the study. Materials and methods. The inventories related to QoL, mental health and burnout of the caregivers for both groups were compared. The correlations between functional limitations of the children with CP and QoL, mental health and burnout of their caregivers have been analyzed. Results. Caregivers in CP group had poorer QoL, worser mental health, and higher burnout levels compared to the controls. The functional limitations of the children with CP were correlated with impairment of QoL and depression scores of their caregivers, but not with the anxiety or burnout scores. Conclusion. Having a disabled child has interference on caregivers' QoL and mental health and increases the burnout. Furthermore, as the functional impairment level of the child increases, the interference does too. Clinical rehabilitation impact. Health professionals working in this area should also consider the mental health and the QoL of caregivers and should develop interventions that support and nurture the family as a whole