Recurrent atypical meningiomas: combining surgery and radiosurgery in one effective multimodal treatment

OBJECTIVE: Owing to their rarity and proteiform pathologic features, the clinical behavior of atypical meningiomas is not yet well characterized. Though the extent of resection is believed to be a key determinant of prognosis, limited data exist regarding optimal management of patients with recurrent disease. METHODS: In this 20-year retrospective case series, we reviewed the medical records of 46 patients with recurrent atypical meningiomas (185 lesions, 89 of which were local, 78 marginal, and 18 distant recurrences); treatment was radiosurgery (n = 60), surgery (n = 56), or both (n = 8). The median follow-up period was 53 months. Outcome measures were length of overall survival and disease-free intervals and prognostic factors for survival. RESULTS: Overall, the median progression-free survival was 26 months at the first recurrence and 100 months thereafter (the sum of the later intervals). Multivariate analysis showed that no treatment-related factors influenced prognosis, whereas recurrence at the skull base was a significant tumor-related factor limiting further treatment. Irrespective of treatment type, the recurrence-free interval was increasingly shorter during the clinical course, with a higher occurrence of marginal and distant lesions migrating to the midline and to the skull base. In sporadic cases, disease-free intervals were longer after wide craniotomy, tumor and dural resection with tumor-free margin. CONCLUSIONS: The disease-free interval was substantially similar after surgery and radiosurgery for treating recurrent disease in patients with atypical meningiomas. Surgery is the mainstay for prolonging survival, while radiosurgery can be an adjuvant strategy to gain time for clinical observation and planning aggressive surgical treatment

Primary intramedullary neurocytoma: case report and literature analysis

Background:Primary intramedullary neurocytoma is extremely rare. Due to its rarity, it is difficult to collect a wide series in a single institution to perform a survival analysis and give indications about prognosis and treatment.Case Description:Here, we report on a case of a 37-year-old woman with primary intramedullary neurocytoma and perform a systematic statistical analysis of cases reported in the literature. Of 21 articles found, 15 studies and the present case (22 patients) were eligible for the analysis. We studied the impact of age, sex, number of involved levels ( 642 vs. >2), entity of resection, postoperative radiotherapy (RT), proliferation index (Ki67) on the neurological outcome of patients, and on the recurrence of the tumor. Comparison of categorical variables was performed by the \u3c72 statistic. The Kaplan\u2013Meier curves were plotted to calculate the progression-free survival (PFS) of these patients. PConclusions:We think that the goal of the surgery should be to preserve a good neurological function even if a residual tumor has to be left. Ki67 should be always evaluated due to its impact on the prognosis. Although adjuvant RT significantly improved the neurological function, its role in preventing the tumor recurrence is not clearly defined

Il monitoraggio sismico dei vulcani attivi della Campania: rete sismica ed analisi dei dati. (Luglio-Dicembre 2001

La Rete Sismica dell’Osservatorio Vesuviano (RSOV) è una rete regionale costituita da stazioni sismiche analogiche a corto periodo e stazioni digitali a larga banda con trasmissione continua dei segnali al Centro di Acquisizione (Fig. 1). La Rete è progettata per il monitoraggio delle aree vulcaniche attive della Campania (Vesuvio, Campi Flegrei, Ischia) e fornisce informazioni relative alla sismicità a scala regionale rilevata dalla Rete Sismica Nazionale Centralizzata (INGV – Centro Nazionale per il Monitoraggio della Sismicità). Il miglioramento e la standardizzazione della Rete iniziato nella prima metà del 2000 è continuato nel 2001 con la ristrutturazione di alcune stazioni (SFT, HR9, OTV, SSB, SMC, SOR) e la conversione a tre componenti di due stazioni dell’area vesuviana (BKE e CPV). Particolare attenzione è stata posta nel miglioramento dell’accoppiamento sismometrobasamento al fine di migliorare il rapporto segnale-rumore, comunque elevato a quasi tutte le stazioni a causa dell’alto grado di urbanizzazione delle aree monitorate. E’ stata completata, inoltre, la ristrutturazione del Ponte Radio Centralizzato posto presso la sede di Via Manzoni. Questa operazione ha comportato la sostituzione di tutti gli apparati radio riceventi, obsoleti o inadeguati, e la ridistribuzione del sistema delle antenne di ricezione. Futuri miglioramenti ed espansioni della Rete sono inseriti nel Piano Triennale delle attività dell’I.N.G.V. e prevedono la conversione in larga banda di alcune stazioni analogiche e la ridondanza dei sistemi di trasmissione (telemetria UHF e telefonica digitale) per garantire la continuità dell’acquisizione dei segnali.INGV Sezione di NApoli "Osservatorio Vesuviano"Published1IT. Reti di monitoraggio e sorveglianz

Il monitoraggio sismico dei vulcani attivi della Campania: rete sismica ed analisi dei dati

La Rete Sismica dell’Osservatorio Vesuviano (RSOV) è una rete regionale costituita da stazioni sismiche analogiche a corto periodo e stazioni digitali a larga banda con trasmissione continua dei segnali al Centro di Acquisizione (figura 1). La Rete è progettata per il monitoraggio delle aree vulcaniche attive della Campania (Vesuvio, Campi Flegrei, Ischia) e fornisce informazioni relative alla sismicità a scala regionale in collaborazione con la Rete Sismica Nazionale Centralizzata (INGV – Centro Nazionale per il Monitoraggio della Sismicità). Il miglioramento e la standardizzazione della Rete iniziato nella prima metà del 2000 è continuato nell’anno in corso con la ristrutturazione di alcune stazioni (SFT, HR9, OTV, SSB, SMC) e la conversione a tre componenti di due stazioni dell’area vesuviana (BKE e CPV). Particolare attenzione è stata posta nel miglioramento dell’accoppiamento sismometrobasamento al fine di migliorare il rapporto segnale-rumore; il rumore di fondo rimane comunque elevato a quasi tutte le stazioni a causa dell’alto grado di urbanizzazione delle aree monitorate. E’ stata completata, inoltre, la ristrutturazione del Ponte Radio Centralizzato posto presso la sede di Via Manzoni. Questa operazione ha comportato la sostituzione di tutti gli apparati radio riceventi, obsoleti o inadeguati, e la ridistribuzione del sistema delle antenne di ricezione. Futuri miglioramenti ed espansioni della Rete sono inseriti nel Piano Triennale delle attività dell’I.N.G.V. e prevedono la conversione in larga banda di alcune stazioni analogiche e la ridondanza dei sistemi di trasmissione (telemetria UHF e satellitare) per garantire la continuità dell’acquisizione dei segnali.INGV Sezione di Napoli "Osservatorio Vesuviano"Published1IT. Reti di monitoraggio e sorveglianz

Motivations for collaborating with industry: has public policy influenced new academics in Argentina?

Between 2005 and 2015 a series of science, technology and innovation policies were deployed in Argentina among which academic research collaborations with industry was particularly fostered. This paper studies the effect of those policies on newer researchers, defined as those with PhD or postdoctoral scholarships, looking at their motivations to collaborate and, to some extent, at their actual collaborations with Industry. Our hypothesis is that those policies had a positive effect on young academics’ perception of collaborations with industry, now conceived as a dimension of their job, and also on actual collaborations. To conduct our study, we used an original database constructed from an online survey answered by more than 600 newer researchers. Empirical results partly confirm our hypothesis: a direct policy encouraging collaborations by providing collaborative grants was not associated with actual collaborations, while orienting research towards strategic areas–defined by the Science and Technology Ministry- is

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Genome-wide association identifies nine common variants associated with fasting proinsulin levels and provides new insights into the pathophysiology of type 2 diabetes.

OBJECTIVE: Proinsulin is a precursor of mature insulin and C-peptide. Higher circulating proinsulin levels are associated with impaired β-cell function, raised glucose levels, insulin resistance, and type 2 diabetes (T2D). Studies of the insulin processing pathway could provide new insights about T2D pathophysiology. RESEARCH DESIGN AND METHODS: We have conducted a meta-analysis of genome-wide association tests of ∼2.5 million genotyped or imputed single nucleotide polymorphisms (SNPs) and fasting proinsulin levels in 10,701 nondiabetic adults of European ancestry, with follow-up of 23 loci in up to 16,378 individuals, using additive genetic models adjusted for age, sex, fasting insulin, and study-specific covariates. RESULTS: Nine SNPs at eight loci were associated with proinsulin levels (P < 5 × 10(-8)). Two loci (LARP6 and SGSM2) have not been previously related to metabolic traits, one (MADD) has been associated with fasting glucose, one (PCSK1) has been implicated in obesity, and four (TCF7L2, SLC30A8, VPS13C/C2CD4A/B, and ARAP1, formerly CENTD2) increase T2D risk. The proinsulin-raising allele of ARAP1 was associated with a lower fasting glucose (P = 1.7 × 10(-4)), improved β-cell function (P = 1.1 × 10(-5)), and lower risk of T2D (odds ratio 0.88; P = 7.8 × 10(-6)). Notably, PCSK1 encodes the protein prohormone convertase 1/3, the first enzyme in the insulin processing pathway. A genotype score composed of the nine proinsulin-raising alleles was not associated with coronary disease in two large case-control datasets. CONCLUSIONS: We have identified nine genetic variants associated with fasting proinsulin. Our findings illuminate the biology underlying glucose homeostasis and T2D development in humans and argue against a direct role of proinsulin in coronary artery disease pathogenesis

Spinal cord stimulation in chronic pain management

In this article, therapeutic electrical stimulation of the spinal cord is presented as a procedure of neuromodulation. The rationale behind its proposal and its mechanisms of action are considered in light of the results achieved in clinical practice. The author's experience is intermingled with the results of the most experienced team; experimental data are reported to support speculations on the mechanism of interaction with the activity of the central nervous system and to stress the need for a multidisciplinary approach to improve the efficacy and enlarge the field of application of neuromodulation, which is to be considered as a new medical discipline

A rare case of lumbar lateral meningocele

[no abstract available