MENINGIOMAS OF THE CEREBELLAR TENTORIUM: THE RESULTS OF SURGICAL TREATMENT

Aim of the study was to evaluate the surgeries of tentorial meningiomas in Neurosurgical Department No.1 of the Novosibirsk Institute of Traumatology and Orthopedics. Material and methods. Study includes 64 patients with tentorial meningiomas of different location, treated surgically from 2008 to 2017. Among them 55 (85.9 %) were female patients and 9 were male (14.1 %) with average age of 62.9 years in females and 56.7 years in males. For diagnostic purposes, the patients were performed brain magnetic resonance imaging and/or computed tomography with or without contrast agents. In this series, 83 % of the tumors were of large or giant (with diameter of more than 4 cm). In 63 cases the tumors were typical meningiomas and only 1 case was a malignant anaplastic meningioma. Results. All patients were treated surgically in one or two steps. Overall, there were 70 standard microsurgical resections. Electromyography with Neuropack-2 («NIHON KOHDEN Corp.», Japan) was performed to control brain stem function during the surgery, with short latency auditory evoked potentials (SLAEPs) received. When sinus walls were affected, the tumor matrix was processed with 20W neodymium laser in coherent mode and ablation. In 63 cases, gross-total resection was achieved: Simpson I (76.6 %, n = 49) and Simpson II (21.8 %, n = 14). One patient (1.6 %) was treated with subtotal resection because of complicated surgical approach and massive transverse sinus and sinus confluence bleeding. Post-operative mortality was 3.1 % (2 cases). SLAEP data did not demonstrate any significant irritation or damage to the brain stem with performed surgical approaches. There were no infections of the surgical wound, meninges, brain or CSF leaks after the surgery. Discussion. Tentorial meningiomas are rare brain tumors treated with gross-total tumor resection when possible. Performed surgeries resulted in mild functional decrease in quality of life, but Karnofsky scale for each patient was returning to its original state in 2 weeks. Complications, including neurological disability, presented in 19 % (n = 12) of the patients, and post-operative mortality did not exceed the common literature data. Most of the focal neurological disabilities have disappeared in 2 weeks after the surgery

Effect of multiple forging and annealing on microstructure and mechanical properties of a high-manganese steel

The effect of multiple forging and annealing on the microstructure and mechanical properties of a high-manganese steel is considered. An austenitic high-manganese steel, Fe-0.03C-28Mn-1.5Al (all in wt.%), with an average grain size of about 37 qm was used as th initial material in this study. Multiple forging at room temperature was carried out up to a total true strain of 2. Multiple forging was accompanied by deformation twinning and resulted in significant strengthening. The steel samples subjected to multiple forging demonstrate an increase in the strength properties with an increase in the total strain, while elongation decrease

The Microstructure and Strength of UFG 6060 alloy after superplastic deformation at a lower homologous temperature

The paper reports on the features of low-temperature superplasticity of the heat-treatable aluminum Al-Mg-Si alloy in the ultrafine-grained state at temperatures below 0.5 times the melting point as well as on its post-deformation microstructure and tensile strengt

Использование рифапентина для превентивной химиотерапии детей из групп риска развития туберкулеза

The objective: to compare efficacy of preventive treatment of children with latent tuberculosis infection using various regimens of anti-tuberculosis drugs and assess the risk of adverse events to these drugs.Subjects and Methods. 117 children of 2-17 years old with latent tuberculosis infection [a positive result of the test with tuberculous recombinant allergen (TRA)] were enrolled in the prospective study. They received preventive treatment with the regimen containing isoniazid and rifapentine. The comparison group included 84 children who received isoniazid and rifampicin.Results. In terms of safety and efficacy of chemotherapy regimens in the study, the best results were obtained when using the regimen containing isoniazid and rifapentine: the therapy was well tolerated, hepatotoxic reactions were registered in 1.7% of children. After a full course of preventive treatment in 24 months of follow-up, there was a statistically significant decrease in the proportion of hyperergic results of the skit test with TRA from 44 (41.9%) to 0 (0%) χ2 McNemar 43.00; p < 0.01; and conversion of the TRA test result from positive to negative was observed in 18.1% of children.Цель исследования: сравнить эффективность превентивного лечения детей с латентной туберкулезной инфекцией при использовании различных схем противотуберкулезных препаратов и оценить риск развития нежелательных явлений при них.Материалы и методы. В проспективное исследование взято 117 детей 2-17 лет с латентной туберкулезной инфекцией [положительная проба с аллергеном туберкулезным рекомбинантным (АТР)], которым проведено превентивное лечение схемой, включающей изониазид и рифапентин. В группу сравнения включено 84 ребенка, получавших схему изониазид и рифампицин.Результаты. По безопасности и эффективности схем химиотерапии в проведенном исследовании наилучшие результаты получены при использовании схемы изониазид и рифапентин: переносимость терапии была удовлетворительная, гепатотоксические реакции зарегистрированы у 1,7% детей.При проведении полного курса превентивного лечения через 24 мес. наблюдения зарегистрировано статистически значимое снижение доли гиперергических тестов при кожной пробе с АТР с 44 (41,9%) до 0 (0%) χ2 МакНемар 43,00; p < 0,01, конверсия положительной пробы с АТР в отрицательную у 18,1% детей

Patients with coronary artery disease and diabetes need improved management: a report from the EUROASPIRE IV survey: a registry from the EuroObservational Research Programme of the European Society of Cardiology

Background: In order to influence every day clinical practice professional organisations issue management guidelines. Cross-sectional surveys are used to evaluate the implementation of such guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary European guidelines. Methods: A total of 6187 patients (18–80 years) with coronary artery disease and known glycaemic status based on a self reported history of diabetes (previously known diabetes) or the results of an oral glucose tolerance test and HbA1c (no diabetes or newly diagnosed diabetes) were investigated in EUROASPIRE IV including patients in 24 European countries 2012–2013. The patients were interviewed and investigated in order to enable a comparison between their actual risk factor control with that recommended in current European management guidelines and the outcome in previously conducted surveys. Results: A total of 2846 (46%) patients had no diabetes, 1158 (19%) newly diagnosed diabetes and 2183 (35 %) previously known diabetes. The combined use of all four cardioprotective drugs in these groups was 53, 55 and 60%, respectively. A blood pressure target of 9.0% (>75 mmol/mol). Of the patients with diabetes 69% reported on low physical activity. The proportion of patients participating in cardiac rehabilitation programmes was low (≈40%) and only 27% of those with diabetes had attended diabetes schools. Compared with data from previous surveys the use of cardioprotective drugs had increased and more patients were achieving the risk factor treatment targets. Conclusions: Despite advances in patient management there is further potential to improve both the detection and management of patients with diabetes and coronary artery disease

Efficacy and safety of canagliflozin when used in conjunction with incretin-mimetic therapy in patients with type 2 diabetes

Aims: To assess the efficacy and safety of canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, in patients with type 2 diabetes enrolled in the CANagliflozin cardioVascular Assessment Study (CANVAS) who were on an incretin mimetic [dipeptidyl peptidase-4 (DPP-4) inhibitor or glucagon-like peptide-1 (GLP-1) receptor agonist]. Methods: CANVAS is a double-blind, placebo-controlled study that randomized participants to canagliflozin 100 or 300 mg or placebo added to routine therapy. The present post hoc analysis assessed the efficacy and safety of canagliflozin 100 and 300 mg compared with placebo in subsets of patients from CANVAS who were taking background DPP-4 inhibitors or GLP-1 receptor agonists with or without other antihyperglycaemic agents at week 18. Results: Of the 4330 patients in CANVAS, 316 were taking DPP-4 inhibitors and 95 were taking GLP-1 receptor agonists. At 18 weeks, canagliflozin 100 and 300 mg provided larger placebo-subtracted reductions in glycated haemoglobin (HbA1c) in patients taking DPP-4 inhibitors [-0.56% (95% confidence interval [CI]: -0.77, -0.35), and -0.75% (95% CI: -0.95, -0.54), respectively] and GLP-1 receptor agonists [-1.00% (95% CI: -1.35, -0.65), and -1.06% (95% CI: -1.43, -0.69), respectively]. Body weight and blood pressure (BP) reductions were seen with canagliflozin versus placebo in both subsets. Higher incidences of genital mycotic infections and osmotic diuresis-related adverse events (AEs) were seen with canagliflozin compared with placebo. The incidence of hypoglycaemia was numerically higher with canagliflozin versus placebo; nearly all events occurred in patients on background insulin or insulin secretagogues. Conclusions: In patients on background incretin mimetics, canagliflozin improved HbA1c, body weight and BP, with an increased incidence of AEs related to SGLT2 inhibition

Common and rare variant association analyses in amyotrophic lateral sclerosis identify 15 risk loci with distinct genetic architectures and neuron-specific biology

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with a lifetime risk of one in 350 people and an unmet need for disease-modifying therapies. We conducted a cross-ancestry genome-wide association study (GWAS) including 29,612 patients with ALS and 122,656 controls, which identified 15 risk loci. When combined with 8,953 individuals with whole-genome sequencing (6,538 patients, 2,415 controls) and a large cortex-derived expression quantitative trait locus (eQTL) dataset (MetaBrain), analyses revealed locus-specific genetic architectures in which we prioritized genes either through rare variants, short tandem repeats or regulatory effects. ALS-associated risk loci were shared with multiple traits within the neurodegenerative spectrum but with distinct enrichment patterns across brain regions and cell types. Of the environmental and lifestyle risk factors obtained from the literature, Mendelian randomization analyses indicated a causal role for high cholesterol levels. The combination of all ALS-associated signals reveals a role for perturbations in vesicle-mediated transport and autophagy and provides evidence for cell-autonomous disease initiation in glutamatergic neurons

Common and rare variant association analyses in amyotrophic lateral sclerosis identify 15 risk loci with distinct genetic architectures and neuron-specific biology

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with a lifetime risk of one in 350 people and an unmet need for disease-modifying therapies. We conducted a cross-ancestry genome-wide association study (GWAS) including 29,612 patients with ALS and 122,656 controls, which identified 15 risk loci. When combined with 8,953 individuals with whole-genome sequencing (6,538 patients, 2,415 controls) and a large cortex-derived expression quantitative trait locus (eQTL) dataset (MetaBrain), analyses revealed locus-specific genetic architectures in which we prioritized genes either through rare variants, short tandem repeats or regulatory effects. ALS-associated risk loci were shared with multiple traits within the neurodegenerative spectrum but with distinct enrichment patterns across brain regions and cell types. Of the environmental and lifestyle risk factors obtained from the literature, Mendelian randomization analyses indicated a causal role for high cholesterol levels. The combination of all ALS-associated signals reveals a role for perturbations in vesicle-mediated transport and autophagy and provides evidence for cell-autonomous disease initiation in glutamatergic neurons