Recent progress towards development of effective systemic chemotherapy for the treatment of malignant brain tumors

Systemic chemotherapy has been relatively ineffective in the treatment of malignant brain tumors even though systemic chemotherapy drugs are small molecules that can readily extravasate across the porous blood-brain tumor barrier of malignant brain tumor microvasculature. Small molecule systemic chemotherapy drugs maintain peak blood concentrations for only minutes, and therefore, do not accumulate to therapeutic concentrations within individual brain tumor cells. The physiologic upper limit of pore size in the blood-brain tumor barrier of malignant brain tumor microvasculature is approximately 12 nanometers. Spherical nanoparticles ranging between 7 nm and 10 nm in diameter maintain peak blood concentrations for several hours and are sufficiently smaller than the 12 nm physiologic upper limit of pore size in the blood-brain tumor barrier to accumulate to therapeutic concentrations within individual brain tumor cells. Therefore, nanoparticles bearing chemotherapy that are within the 7 to 10 nm size range can be used to deliver therapeutic concentrations of small molecule chemotherapy drugs across the blood-brain tumor barrier into individual brain tumor cells. The initial therapeutic efficacy of the Gd-G5-doxorubicin dendrimer, an imageable nanoparticle bearing chemotherapy within the 7 to 10 nm size range, has been demonstrated in the orthotopic RG-2 rodent malignant glioma model. Herein I discuss this novel strategy to improve the effectiveness of systemic chemotherapy for the treatment of malignant brain tumors and the therapeutic implications thereof

Craniopharyngioma: a review of long-term visual outcome

PURPOSE:To assess the clinical presentation and long-term visual outcome in a series of patients with craniopharyn-gioma. METHODS:Retrospective case review. RESULTS:Thirty-six patients were reviewed, comprising 19 female patients and 17 male patients. The age range was 2-77 years with a bimodal distribution of 17 children (mean age 10 years) and 19 adults (mean age 47 years). Blurred vision was the most common visual complaint (23 cases, 64%) and headache the most frequent systemic complaint (19 cases, 53%). The average duration of systemic symptoms was 45 weeks compared to 10 weeks for visual symptoms. Deficits in visual acuity occurred in 13 patients (36%) and showed no significant change from initial presentation to final review. Sixteen patients (44%) had bitemporal hemianopia on presentation and pleomorphism (change from one type of visual field defect to another) occurred in 11 patients. Recurrence of tumour occurred in 15 patients (42%) and was more likely in children (59%) than adults (26%). The mean time period to recurrence was 7 years. The average follow-up period for all cases was 10 years. CONCLUSION:Patients with craniopharyngioma generally present late, and the visual symptoms are often preceded by a long history of systemic symptoms. Children are more likely to present with systemic symptoms than adults. Visual field pleomorphism is a feature of craniopharyngioma and occurred in one-third of the patients. Local recurrence is common. Although magnetic resonance imaging is the recommended means of follow up, regular neuro-ophthalmic review is useful in the early detection of anterior visual pathway compression by recurrent tumour

Marital Adjustment

The definition of this construct is one of the most controversial topics in the literature. On the basis of various contributions, marital adjustment can be defined as a multidimensional indicator of the quality of marital relationship. Evolution of the Construct Marital adjustment is one of the most studied dimensions in the couple and family research literature. According to Spanier (1976, p. 15), already by the 1970s, marital adjustment was \u201cprobably the most frequently investigated dependent variable in the field\u201d. Also during the last 30 years, family researchers and scholars have maintained a strong interest on marital adjustment, as an outcome (Shriner 2009). The literature on marital adjustment reveals a variety of factors that are related to the dyadic adjustment (e.g., individual aspects like personality traits, irrational beliefs, and dysfunctional emotions Abbasi 2017; Filipovi\u107 et al. 2016 and relational aspects like romantic attachment and dyadic coping (Young et al. 2017). Over the last decade, a substantial number of studies have focused on the role of personality traits in predicting the quality of adult romantic relationships (Abbasi 2017; Lampis et al. 2018; Rusu et al. 2019)