421 research outputs found
Bilateral Cavitations of Ganglionic Eminence: A Fetal MR Imaging Sign of Halted Brain Development
SUMMARY: Ganglionic eminence is the main transitory proliferative structure of the ventral telencephalon in human fetal brain and it contributes for at least 35% to the population of cortical interneurons; however data on the human GE anomalies are scarce. We report 5 fetal MR imaging observations with bilateral symmetric cavitations in their GE regions resembling an inverted open C shape and separating the GE itself form the deeper parenchyma. Imaging, neuropathology, and follow-up features suggested a malformative origin. All cases had in common characteristics of lissencephaly with agenesis or severe hypoplasia of corpus callosum of probable different genetic basis. From our preliminary observation, it seems that GE cavitations are part of conditions which are also accompanied by severe cerebral structure derangement
Joint modelling of bivariate longitudinal data : Application to the recovery of sexual function and urinary continence
(E0871) The following methodological issues occur in the context of the longitudinal study of sexual dysfunction and urinary incontinence after radical prostatectomy: (i) high dropout rate due to the extremely sensitive nature of the investigated outcomes; (ii) correlation between the two outcomes; (iii) non-linearity of the recovery trajectories. To address all these issues, we propose the use of a joint modelling approach, including a bivariate linear mixed model with splines for the two outcomes and a proportional hazards model for the time to dropout. We applied the model to data from consecutive patients underwent robotic-assisted radical prostatectomy at European institute of oncology from May 2015 to July 2016. Preand post-surgical sexual and urinary functional conditions were evaluated using the expanded prostate cancer index composite questionnaire. Six hundred forty three patients were included in the analysis. At one year after surgery, only 55% of patients returned the questionnaire. Parameters estimation was based on the maximisation of the likelihood function achieved through the implementation of an EM algorithm. A Gauss Hermite approximation was also used for some of the integrals involved. To assess the effect of nonrandom dropout mechanisms on the parameter estimates, we calculated the index of local sensitivity to non-ignorability
Major hepatectomy for perihilar cholangiocarcinoma in elderly patients: is it reasonable?
Introduction: We sought to evaluate the effect of age on postoperative outcomes among patients undergoing major liver surgery for perihilar cholangiocarcinoma (PHCC). Methods: 77 patients were included. Patients were categorized into two groups: the â< 70-year-oldsâ group (n = 54) and the ââ„ 70-year-oldsâ group (n = 23). Results: Median LOS was 19 both for < 70-year-old group and â„ 70-year-old group (P = 0.72). No differences in terms of severe complication were detected (44.4% ClavienâDindo 3â4â5 in < 70-year-old group vs 47.8% in â„ 70-year-old group, P = 0.60). Within 90 postoperative days, 11 patients died, 6 in < 70-year-old group (11.3%) and 5 in â„ 70-year-old group (21.7%), P = 0.29. The median followâup was 20 months. The death rate was 72.2% and 78.3% among patients < 70 years old and â„ 70 years old. The OS at 2 and 5 years was significantly higher among the < 70 years old (57.0% and 27.7%) compared to the â„ 70 years old (27.1% and 13.6%), P = 0.043. Adjusting for hypertension and Charlson comorbidity index in a multivariate analysis, the HR for age was 1.93 (95% CI 0.84â4.44), P = 0.12. Relapse occurred in 43 (81.1%) patients in the < 70-year-old group and in 19 (82.6%) patients in the â„ 70-year-old group. DFS at 12, 24, and 36 months was, respectively, 59.6, 34.2, and 23.2 for the < 70 -year-old group and 32.5, 20.3, and 13.5 for the â„ 70-year-old group (P = 0.26). Adjusting for hypertension and Charlson comorbidity index in a Cox model, the HR for age was 1.52 (95% CI 0.67â3.46), with P = 0.32. Conclusions: â„ 70-year-old patients with PHCC can still be eligible for major liver resection with acceptable complication rates and should not be precluded a priori from a radical treatment
Radiological Features of Male Breast Neoplasms: How to Improve the Management of a Rare Disease
The primary aim of our study was to assess the main mammographic and ultrasonographic features of invasive male breast malignancies. The secondary aim was to evaluate whether a specific radiological presentation would be associated with a worse receptor profile. Radiological images (mammography and/or ultrasound) of all patients who underwent surgery for male invasive breast cancer in our institution between 2008 and 2023 were retrospectively analyzed by two breast radiologists in consensus. All significant features of radiological presentation known in the literature were re-evaluated. Fifty-six patients were selected. The mean age at surgery of patients was 69 years (range: 35-81); in 82% of cases (46 patients), the histologic outcome was invasive ductal carcinoma. A total of 28 out of 56 (50%) patients had preoperative mammography; in 9/28 cases (32%), we found a mass with microcalcifications on mammography. The mass presented high density in 25 out of 28 patients (89%); the mass showed irregular margins in 15/28 (54%) cases. A total of 46 out of 56 patients had preoperative ultrasounds. The lesion showed a solid mass in 41/46 (89%) cases. In 5/46 patients (11%), the lesion was a mass with a mixed (partly liquid-partly solid) structure. We did not find any statistically significant correlation between major types of radiological presentation and tumor receptor arrangement. Knowledge of the main radiologic presentation patterns of malignant male breast neoplasm can help better manage this type of disease, which is rare but whose incidence is increasing
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