Langzeitverlaufsuntersuchung an Patienten mit shuntversorgtem Hydrozephalus:Vergleich verschiedener liquorableitender Systeme ; eine retrospektive Studie

Retrospektive Studie; Kollektiv: 974 Patienten, die zwischen 1974 und 1994 in der Neurochirurgie des Universitätsklinikums Münster bei Hydrozephalus mit einem ventrikuloperitonealen Shunt versorgt wurden. Fragen zu Ventiltyp, Revisionen, Beeinträchtigungen, Spannungsgefühl, Narbenkomplikationen, Auswirkung auf das Befinden, Wetterfühligkeit, Einschränkungen der Lebensqualität, geistige und körperliche Leistungsfähigkeit. Die Revisionshäufigkeit und Lebensqualität ist unabhängig von Ventiltyp und der Dauer der Ableitung. Ein eindeutiger Zusammenhang jedoch besteht zwischen dem Alter der Patienten bei der Operation Kinder beschreiben die Auswirkungen auf ihr Leben insgesamt als deutlich geringer sowie der Revisionshäufigkeit und der Lebensqualität, welche sich mit Zunahme der Revisionen deutlich verschlechtert. Insgesamt gesehen ist dennoch mehr als der Hälfte aller Patienten, einschließlich der mehrfach revidierten, ein Leben ohne jegliche Einschränkungen durch die Drainage möglich

Impact of early tumour shrinkage and resection on outcomes in patients with wild-type RAS metastatic colorectal cancer

Background Tumour shrinkage (TS) increases the possibility of resection in metastatic colorectal cancer (mCRC) and may improve tumour-related symptoms. Here we report prespecified secondary response-related end-points and exploratory TS/resection outcomes for patients with RAS wild-type (WT) tumours (no mutations in KRAS/NRAS exons 2/3/4) from the PRIME study (NCT00364013). Methods PRIME was a randomised phase 3 study comparing first-line panitumumab + FOLFOX4 versus FOLFOX4 in mCRC patients. Tumour response analyses were conducted to compare response rates and their impact on survival outcomes. Results Overall, 505 patients had RAS WT mCRC. More patients receiving panitumumab + FOLFOX4 versus FOLFOX4 had 6530% (59% versus 38%; P < 0.001) or 6520% (72% versus 57%; P < 0.001) TS at week 8 (early TS); consistent TS benefits were observed over the first 3c40 weeks of treatment. Objective response rate (P = 0.003), duration of response (P = 0.0027), depth of response (P = 0.0149), progression-free survival (PFS; P = 0.0015) and overall survival (OS; P = 0.0057) were improved in the panitumumab + FOLFOX4 group. Both early TS and resection were associated with improved PFS and OS. 2-year OS rates for patients who did (n = 64) versus did not (n = 441) undergo resection were 88% versus 40%; 2-year OS rates for patients who did (n = 45) versus did not (n = 460) undergo complete resection were 96% versus 41%. Conclusions More patients receiving panitumumab + FOLFOX4 versus FOLFOX4 had 6530% or 6520% TS at week 8; PFS and OS were also improved with panitumumab + FOLFOX4. The clinical value of achieving early TS in mCRC warrants further investigation

A Phase 1, Dose-Ranging Study to Assess Safety and Psychoactive Effects of a Vaporized 5-Methoxy-N,N-Dimethyltryptamine Formulation (GH001) in Healthy Volunteers

INTRODUCTION: 5-Methoxy-N,N-Dimethyltryptamine (5-MeO-DMT) is a tryptamine with ultra-rapid onset and short duration of psychedelic effects. Prospective studies for other tryptamines have suggested beneficial effects on mental health outcomes. OBJECTIVES: In preparation for a study in patients with depression, the present study GH001-HV-101 aimed to assess the impact of four different dose levels of a novel vaporized 5-MeO-DMT formulation (GH001) administered via inhalation as single doses, and in an individualized dose escalation regimen on the safety, tolerability, and the dose-related psychoactive effects in healthy volunteers (n=22). Further, we aimed to assess the impact on cognitive functioning, mood, and well-being. METHODS: The psychedelic experience was assessed with a novel Peak Experience Scale (PES), the Mystical Experience Questionnaire (MEQ), the Ego Dissolution Inventory (EDI), the Challenging Experience Questionnaire (CEQ), and the 5-Dimensional Altered States of Consciousness Questionnaire (5D-ASC). RESULTS: 5-MeO-DMT produced dose-related increments in the intensity of the psychedelic experience ratings on all questionnaires, except the CEQ. Prominent effects were observed following single doses of 6, 12, and 18 mg on PES and MEQ ratings, while maximal effects on PES, MEQ, EDI, and 5D-ASC ratings were observed following individualized dose escalation of 5-MeO-DMT. Measures of cognition, mood, and well-being were not affected. Vital signs at 1 and 3 h after administration were not affected and adverse events were generally mild and resolved spontaneously. CONCLUSIONS: Individualized dose escalation of 5-MeO-DMT may be preferable over single dose administration for clinical applications that aim to enhance the short-term psychoactive effects to elicit a strong therapeutic response. DISCLOSURE: This study was funded by GH Research PLC, Dublin, Ireland