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Are we witnessing the end of the biopsy as we know it? Is this the start of a revolution in cancer diagnostics and treatment where analysis of somatic mutations present in the blood, CSF, or urine followed by targeted therapy replaces the traditional surgery followed by chemo-radiation? Since 2016, molecular markers are an integral part of the 'glioma' treatment decision-making process- diagnostic, prognostic, and therapeutic. A lot of these somatic mutations that identify and prognosticate tumors are also detected in the adjoining bio-fluids in serum or CSF- the sampling of which is known as liquid biopsy.
The objective of this study is to review the advancement of scientific techniques that now allows the investigation of these bio-fluids, to diagnose, prognosticate and treat gliomas.
This review article is an exhaustive review of the literature that summarises the role of the three main liquid biopsy modalities- Circulating Tumor Cells, Cell-free Tumor DNA and Exosomes in the detection of known diagnostic and prognostic markers in gliomas.
The current review highlights the strengths and weaknesses of the diffrerent modalities in use, and their potential use in the clinical setting.
Liquid biopsies hold tremendous potential in the diagnosis and management of gliomas in the future.
Liquid biopsies hold tremendous potential in the diagnosis and management of gliomas in the future.
This study was to assess the proportion of patients that have bleeding complications, cure rates, and long-term bleeding events for each of the indications (monotherapy, pre- stereotactic radiosurgery (SRS), and presurgery) for AVM embolization.
Published literature in the PubMed database by May 2016 citing embolization results for AVMs using liquid embolic agents was reviewed. Additional studies were identified through reference searches in each reviewed article. A systematic review was performed to evaluate the bleeding complications, cure rate, and long-term bleeding risk.
We identified 30 studies, including 5103 patients. The overall cure rate was 18%. Curative embolization was achieved in 24% of monotherapy, 10% of pre-surgical, and 16% after pre-SRS. GYY4137 in vivo In the Onyx group, the cure rate was higher of 25% ( χ
= 6.25, P < 0.025). Multiple session (≥2) associated with a higher cure rate of 23% (χ
= 10.53, P < 0.005). The overall bleeding complication rate of transarterial embolization was 5%. The case fatality of bleeding complication was 31%. Onyx and pre-SRS embolization have a higher bleeding complication rate of 8%. The small studies reported a higher cure rate and bleeding complication rate than large studies.
Onyx has increased the cure rate and bleeding complication rate of AVM embolization. Multiple sessions are associated with a higher cure rate and do not increase the bleeding complication. Current pre-SRS AVM embolization has a higher bleeding complication rate. There are publication biases between small and large studies.
Onyx has increased the cure rate and bleeding complication rate of AVM embolization. Multiple sessions are associated with a higher cure rate and do not increase the bleeding complication. Current pre-SRS AVM embolization has a higher bleeding complication rate. There are publication biases between small and large studies.Wooden foreign body (WFB) injuries in children are common. They may report with acute presentation or be delayed as retained foreign body giving rise to complications. Cases with superficial skin penetration by these foreign bodies and acute presentation may be convenient to diagnose and remove. However, localising deeply impacted and chronically retained WFB is challenging, as they are usually not radiopaque and have a tendency to move deeper into the surrounding soft tissues with time. Foreign body retained for prolonged duration may present with either cellulitis, deep tissue infections, sinus, restriction of joint movements, necrotising fasciitis, osteomyelitis or tumour-like mass. We present an 8-year-old boy with discharging sinuses in the right iliac fossa and medial aspect of the right upper thigh, due to an impacted WFB for 3 months. Prompt radiological imaging and surgical removal helped him recover completely.Malrotation occurs in approximately 1 in 500 live births. However, the true incidence of malrotation is unknown since many asymptomatic patients fail to present. Approximately 90% of patients with malrotation are diagnosed within the 1st year of life. Eighty per cent of them are diagnosed within the 1st month of life. Nevertheless, there are recent reports of manifestations later in life both as emergency conditions and more chronic gastrointestinal symptoms. The relationship between malrotation and horseshoe kidney has not been fully understood, but few case reports have highlighted their occurrence in the same patient. The mode of presentation of this case and its association with a horseshoe kidney is the reason for this report. This was a case of malrotation associated with horseshoe kidney. He had exploratory laparotomy and Ladd's procedure. Malrotation is associated with horseshoe kidney which presented as gastric outlet obstruction. He responded well to treatment after Ladd's procedure.Blunt popliteal vascular injury in the paediatric population is exceedingly rare and in advanced trauma centres the management can be challenging. A case of blunt popliteal artery trauma in a 5 years old requiring distal bypass using reversed saphenous vein is herein described. It is noteworthy to mention the difficulties experienced in a limited resource setting, including limitations in small rural hospitals, inefficient timely transfer to specialised centres, inadequate numbers of highly trained surgeons in subspecialities such as microvascular surgery and finally ineffective support and rehabilitative services.Perforated gastric ulcer is a particularly rare cause of peritonitis in children. Only few cases have been reported in the literature. It is a serious emergency condition which can be overlooked leading to life-threatening consequences. We report a case of a 12-year-old girl who presented with acute abdominal pain and signs of peritonitis. Surgical exploration found a gastric perforation on the anterior side of the antrum. Primary repair of the perforation was performed after thorough decontamination and taking biopsies from its edges. The post-operative period was uneventful. Helicobacter pylori test was negative. Histopathology result was suggestive of ulceration in the gastric wall and did not isolate H. pylori. Gastro-duodenal ulcer perforation should be considered in the differential diagnosis of children presenting with acute abdomen, especially when imaging showing pneumoperitoneum.
Homepage: https://www.selleckchem.com/products/gyy4137.html
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