Spinal radiosurgery - efficacy and safety after prior conventional radiotherapy

<p>Abstract</p> <p>Background</p> <p>Conventional external beam radiotherapy is a standard procedure for treatment of spinal metastases. In case of progression spinal cord tolerance limits further radiotherapy in pre-irradiated areas. Spinal stereotactic radiotherapy is a non-invasive option to re-treat pre-irradiated patients. Nevertheless, spinal radiosurgery results in relevant dose deposition within the myelon with potential toxicity. Aim of the study was to retrospectively analyse the efficacy and feasibility for salvage radiosurgery of spinal metastases.</p> <p>Methods</p> <p>During a period of 4 years (2005-2009) 70 lesions in 54 patients were treated in 60 radiosurgery sessions and retrospectively analysed. Clinical (pain, sensory and motor deficit) and radiological (CT/MRI) follow-up data were collected prospectively after radiosurgery. Pain - as main symptom - was classified by the Visual Analogue Scale (VAS) score. Every patient received single session radiosurgery after having been treated first-line with conventionally fractionated radiotherapy. Kaplan-Meier method and life tables were used to analyse freedom from local failure and overall survival.</p> <p>Results</p> <p>At a median follow-up of 14.5 months the actuarial rates of freedom from local failure at 6/12/18 months were 93%, 88% and 85%, respectively. The median radiosurgery dose was 1 × 18 Gy (range 10-28 Gy) to the median 70% isodose. The VAS score of patients with pain (median 6) dropped significantly (median 4, p = 0.002). In 6 out of 7 patients worse sensory or motor deficit after SRS was caused by local or distant failures (diagnosed by CT/MRI). One patient with metastatic renal cell carcinoma developed a progressive complete paraparesis one year after the last treatment at lumbar level L3. Due to multiple surgery and radiosurgery treatments at the lumbar region and further local progression, the exact reason remained unclear. Apart from that, no CTC grade III or higher toxicity has been observed.</p> <p>Conclusions</p> <p>By applying spinal radiosurgery relevant radiation doses can be limited to small parts of the myelon. This prevents myelopathic side effects and makes it an effective and safe treatment option for well-suited patients. Especially for previously irradiated patients with local failure or pain salvage SRS represents a valuable treatment option with high local control rates, low toxicity and significant pain reduction.</p

Bio-sensing textile based patch with integrated optical detection system for sweat monitoring

Sensors, which can be integrated into clothing and used to measure biochemical changes in body fluids, such as sweat, constitute a major advancement in the area of wearable sensors. Initial applications for such technology exist in personal health and sports performance monitoring. However, sample collection is a complicated matter as analysis must be done in real-time in order to obtain a useful examination of its composition. This work outlines the development of a textile-based fluid handling platform which uses a passive pump to gather sweat and move it through a pre-defined channel for analysis. The system is tested both in vitro and in vivo. In addition, a pH sensor, which depends on the use of a pH sensitive dye and paired emitter-detector LEDs to measure colour changes, has been developed. In vitro and on-body trials have shown that the sensor has the potential to record real-time variations in sweat during exercise

Climacteric Lowers Plasma Levels of Platelet-Derived Microparticles: A Pilot Study in Pre-versus Postmenopausal Women

Background: Climacteric increases the risk of thrombotic events by alteration of plasmatic coagulation. Up to now, less is known about changes in platelet-(PMP) and endothelial cell-derived microparticles (EMP). Methods: In this prospective study, plasma levels of microparticles (MP) were compared in 21 premenopausal and 19 postmenopausal women. Results: No altered numbers of total MP or EMP were measured within the study groups. However, the plasma values of CD61-exposing MP from platelets/megakaryocytes were higher in premenopausal women (5,364 x 10(6)/l, range 4,384-17,167) as compared to postmenopausal women (3,808 x 10(6)/l, range 2,009-8,850; p = 0.020). This differentiation was also significant for the subgroup of premenopausal women without hormonal contraceptives (5,364 x 10(6)/l, range 4,223-15,916; p = 0.047; n = 15). Furthermore, in premenopausal women, higher plasma levels of PMP exposing CD62P were also present as compared to postmenopausal women (288 x 10(6)/l, range 139-462, vs. 121 x 10(6)/l, range 74-284; p = 0.024). This difference was also true for CD63+ PMP levels (281 x 10(6)/l, range 182-551, vs. 137 x 10(6)/l, range 64-432; p = 0.015). Conclusion: Climacteric lowers the level of PMP but has no impact on the number of EMP in women. These data suggest that PMP and EMP do not play a significant role in enhancing the risk of thrombotic events in healthy, postmenopausal women. Copyright (C) 2012 S. Karger AG, Base

Polymeric chemosensor for the detection and quantification of chloride in human sweat. Application to the diagnosis of cystic fibrosis

We have developed a new extremely hydrophilic polymeric film suitable for the detection and quantification of chloride in human sweat directly on the skin. The film, or membrane, has chemically anchored 6-methoxyquinoline groups as chloride responsive fluorescent motifs. We have prepared the sensory material from a standard vinyl copolymer, by a convenient and easy solid-phase reaction. The sensory material has a water swelling percentage of 700%, facilitating an immediate detection of chloride, is reusable for at least 6 cycles and can be handled without care by unskilled persons. The initially high fluorescence of the material decreases in the presence of chloride, allowing the quantification of chloride concentration by using the colour definition of a digital picture or a fluorimeter. The suitability of the material to perform quantitative chloride analysis of human sweat by putting it in contact with the skin offers promise for its application in the sweat test used for the diagnosis of cystic fibrosis (CF).FEDER and both the Spanish Ministerio de Economía y Competitividad (MAT2014-54137-R and MAT2017-84501-R) and the Consejería de Educación – Junta de Castilla y León (BU092U16 and BU061U16

Iodine-125 brachytherapy for brain tumours - a review

Iodine-125 brachytherapy has been applied to brain tumours since 1979. Even though the physical and biological characteristics make these implants particularly attractive for minimal invasive treatment, the place for stereotactic brachytherapy is still poorly defined

Gender-specific and menstrual cycle dependent differences in circulating microparticles

In comparison to age-matched men, young women are at increased risk to suffer from venous thromboembolism (VTE). Some risk factors of inherited and acquired thrombophilia are known, but approximately 30% of the overall risk remains unexplained. Recently, a role for microparticles (MP) in coagulation has been suggested. We investigated, if gender- and menstrual cycle-specific differences in circulating MP exist. Platelet- and endothelial cell-derived microparticles (PMP, EMP) and subpopulations thereof were evaluated flow-cytometrically in healthy women (n = 27) in different phases of their menstrual cycles (follicular phase: n = 14, luteal phase: n = 13) and in healthy men (n = 18). Additionally, D-dimer levels were determined. Compared to men, women had elevated numbers of annexin V-binding MP (p = 0.007), PMP (CD61; p = 0.013), P-selectin-exposing PMP (p = 0.002) and E-selectin-exposing EMP (p = 0.009). During the luteal phase, women had strongly elevated concentrations of MP, PMP, P-selectin- and CD63-exposing PMP as well as E-selectin-exposing EMP (p = 0.001, p < 0.001, p = 0.004, p = 0.003, and p < 0.001, respectively), and the ratio of P-selectin-exposing PMP/platelet increased more than three-fold as compared to men (p = 0.01). When different phases of the menstrual cycle were analysed, MP (annexin V; p = 0.025), PMP (CD61: p < 0.001; CD63: p = 0.015) and E-Selectin-positive EMP (p = 0.006) were all increased in the luteal phase. Although D-dimer concentrations in women were increased compared to men (p = 0 = 0.006), no menstrual cycle-specific differences were observed. In summary, circulating MP and subpopulations thereof are increased in women when compared to men, and this increase seems to be modulated by the menstrual cycle. Therefore, circulating MP may be an additional risk factor contributing to the hitherto unexplained procoagulatory state of young wome