bluuebunny/crossref_metadata_2025_split huggingface dataset:
ML-03 RECONSIDERATION OF TREATMENT FOR ELDERLY PATIENTS WITH PRIMARY CENTRAL NERVE SYSTEM LYMPHOMAS
Authors: Shinojima Naoki , Fujimoto Kenji , Makino Keishi , Yamamoto Takahiro , Kuroda Jun-ichiro , Ohta Kazutaka , Takezaki Tatsuya , Oda Kazutaka , Nakamura Kazumi , Jono Hiroshi , Mikami Yoshiki , Mukasa Akitake 
Published: December 2019

Abstract

BACKGROUND
The therapeutic response to high-dose methotrexate therapy (HD-MTX) for primary central nervous system lymphoma (PCNSL) varies. Polyglutamylation (PG) is a reversible protein modification, tumor cells show frequent occurrence of PG. Intracellularly polyglutamylated MTX is not subject to competitive inhibition by leucovorin (LV). Tumor cells with high PG levels are selectively killed, whereas normal cells with lower PG are rescued by LV. We previously reported that PG is a predictor of therapeutic response to HD-MTX in PCNSL. However, PG did not affect overall survival (OS) in the elderly unlike the young patients, suggesting that there are other significant predictors in the elderly. The aim of this study is to identify the prognostic factors in aged PCNSL.

METHODS
The prognostic factors were investigated in 48 patients (M/F=23/25) aged 65 and older undergoing HD-MTX in our institute with data of area under the concentration-time curve of MTX, AUCMTX (μmol/L/h).

RESULTS
The median OS of elderly PCNSL was 937days. In the AUCMTX high group (median 1706.3 or more, n=24) and the low group (median below, n=24), OS was significantly shortened in the high group compared with the low group (median 728 vs 1290days, p=0.032). Even in multivariate analysis, AUC was the only independent poor prognostic factor of OS (p=0.031). On the other hand, AUC was not a prognostic factor for OS in PCNSL younger than 65 years. AUCMTX of aged PCNSL was significantly higher compared with younger patients (p&lt;0.01). These results suggested that PG may be a good prognostic factor of OS when AUCMTX is low.

CONCLUSION
In the aged PCNSL, OS was shortened when AUCMTX was high. With the results of the previous research, it is suggested that if PG levels is high in elderly PCNSL, the OS prolongation can be expected if the MTX dose is reduced.
MNG-08 VOLUMETRIC STUDIES IN ASYMPTOMATIC MENINGIOMAS: SLOWDOWN CASES AND GROWTH ARREST CASES
Authors: Hirayama Ryuichi , Nakagawa Tomoyoshi , Umehara Toru , Yokota Chisato , Kijima Noriyuki , Kinoshita Manabu , Kagawa Naoki , Kishima Haruhiko 
Published: December 2019

Abstract

BACKGROUND
The opportunity to follow up for asymptomatic meningiomas has increased. We have reported the risk of volume increase by individual continuous volume measurement of asymptomatic meningiomas. However, We have not reached fully understanding about natural history of meningiomas. Among cases are followed up over time, there are some cases that the volume increase rates slows down or almost stops are observed.

METHODS
We enrolled consecutive adult patients of asymptomatic meningiomas who follow-up for 2 years or more and 3 or more MRI scans. We performed sequential volumetric measurements on 95 patients (105 lesions) who met the criteria. We classified these transient volume curve of each lesion into three groups “Growing”, “Slowdown”, and “Growth arrest” for analysis.

RESULTS
The average age at the first visit was 62.8 years, the average follow-up period was 61.8 months, and the male-female ratio was 20:75 (male: female). There were 67 cases (73 lesions: 70.9%) that were in increasing trend, and 19 cases of those were received resection. Eleven cases (12 lesions: 11.7%) showed a tendency of “slow down” the increase rate, and one patient who became symptomatic led to surgical excision. In 18 cases (18 lesions: 17.4%) in which almost no volume change was observed during the observation period, no cases resulted in surgical treatment.

CONCLUSIONS
Among the meningiomas cases that have been followed for a long time, there are not a few those increase rate of tumor volume slows or does not change. Furthermore, most of these cases did not result in surgical treatment. The presence of these “Slowdown” and “Growth arrest” cases at a certain rate may have suggested the possibility of a Gompertz curve model as the natural course of meningiomas.
BT-03 A CASE OF ADULT-ONSET MEDULLOBLASTOMA PRESENTING WITH ATYPICAL CLINICAL COURSE AND MAGNETIC RESONANCE IMAGING
Authors: Ohue Shiro , Watanabe Masashi , Kusakabe Kousuke , Shinohara Tomoki , Fujiwara Satoshi , Ichikawa Haruhisa , Iwata Shinji , Okamoto Kensho , Ishida Yasushi 
Published: December 2019

Abstract
An 18-year-old woman gradually developed speech and gait disturbance for seven months. On admission, she presented with cerebellar ataxia and tetraparesis. Magnetic resonance images showed diffuse hyperintense lesions around the fourth ventricle in FLAIR, in addition to lesions of nodular diffusion restriction with enhancement. Heavily T2-weighted images revealed small cystic appearance within this lesion. We diagnosed her as classical medulloblastoma by open brain biopsy. We should consider medulloblastoma as a differential diagnosis of these characteristics around the fourth ventricle, even if magnetic resonance findings are atypical in point of no mass effect and heterogeneous enhancement.
CS-07 A CYSTIC LONG-SEGMENT CERVICAL SCHWANNOMA: A CASE REPORT
Authors: Takeshima Yuki , Takezaki Tatsuya , Hamasaki Tadashi , Tajiri Seiji , Mukasa Akitake 
Published: December 2019

Abstract
Schwannomas are the most common intradural extramedullary spinal tumors. However, they are usually solid tumors, and totally cystic changes are rare. Herein, we report a case of a 46-year-old male presenting with numbness of right limbs, right hemiplegia, and posterior neck pain for one year. MRI revealed a well-defined cystic long-segment, from C1 to C6, intradural extramedullary mass. The lesion showed hypointense on T1WI, hyperintense on T2WI, hyperintense on DWI, and it was marginally enhanced on the contrast image with Gd-DTPA. C1 laminectomy and hemi-laminectomy from C2 to C6 was performed for tumor resection. The tumor was found to be totally cystic and tensed with a jelly-like content. It was completely resected with the attachment of the C3 dorsal root. Histopathological examination confirmed it to be a schwannoma. The mechanism of cyst formation in schwannoma is considered as results of ischemic necrosis associated with tumor growth, or cystosis due to degeneration of Antoni-type B region. The long-segment, totally cystic intradural cervical schwannoma is rare, but it should be included in the differential diagnosis of a cystic mass in the spinal region. It can be difficult to distinguish cystic spinal schwannomas from other cystic lesions like arachnoid cyst, epidermoid cyst, and neurenteric cyst. Contrast enhanced MRI is useful by enhancing the margin of the tumor.
COT-04 FAMILY SUPPORT FOR PATIENTS WITH PRIMARY MALIGNANT BRAIN TUMORS BY PATIENT SUPPORT GROUP IN NATIONAL CANCER CENTER
Authors: Horikawa Mayumi , Kishi Tatsuya , Ishii Kazumi , Mori Ayako , Narita Yoshitaka , Miyakita Yasuji , Ohno Makoto , Takahashi Masamichi 
Published: December 2019

Abstract

BACKGROUND
A family support group for patients with primary malignant brain tumors in our hospital is called “Brain Tumor Family Table.” We conduct regular meetings, such as 30 minutes of medical lectures and 60 minutes of healthcare discussions, between participants and medical staff which is supervised by a nurse. To provide more effective family support, we report our activities.

METHOD
A total of 96 family members participated in 11 meetings from July 2015 to March 2019 and answered anonymous questionnaires about their participation. This survey evaluated their motivation for participation and the level of satisfaction toward the lectures and discussions by three-level scores and free description.

RESULT
Regarding the reason of their participation, 28.1% of the participants answered, “I want to talk to someone who is in the same condition.” We found that 83.3% of them were satisfied with the lectures, and 89.6% of them were satisfied with the discussions and conversations. The reasons for their satisfaction were: “I was happy to hear the story of other patients” (19.0%), “I feel positive toward patient care” (19.0%), and “I realized I was not alone” (17.2%). Moreover, 92.7% answered “I would like to participate in the next meeting.” Among them, 26.1% answered “I want to talk again,” 14.2% answered “I feel stable,” and 14.2% answered “I can get information.” There were other opinions, like “Sharing feelings is important” and “I would like to help others next time,” as well.

DISCUSSION
Malignant brain tumors are orphan cancers, and patients and their families lack the information about the disease and the chance to share their experiences. Hence, participants were quite satisfied with this meeting. We will improve our facilitating skills as an organizing body so that participants can share their experiences and feelings to reduce their loneliness and finally feel positive toward patient care.
COT-19 TREATMENT EXPERIENCE OF AND TIPS FOR ADMINISTRATING NOVO TTF
Authors: Shimada Daisuke , Kobayashi Keiichi , Saito Kuniaki , Matsumoto Yoshie , Shiokawa Yoshiaki , Nagane Motoo 
Published: December 2019

Abstract

BACKGROUNDS
Current standard of care for glioblastoma, consists of postoperative temozolomide (TMZ) concomitant with radiotherapy, followed by adjuvant TMZ monotherapy. Recently, an international phase 3 trial (EF-14) demonstrated that addition of tumor-treating fields (TTF) to adjuvant TMZ after completion of chemoradiotherapy extended median progression-free survival and overall survival by 2.7 months and 4.8 months, respectively, compared with TMZ alone in patients with newly diagnosed glioblastoma. TTF is now considered as a part of its initial treatment in the guideline in Japan (recommendation grade B). However,distinct from anticancer drugs,little is known or experienced using TTF as a therapeutic device so far, especially in management and handling.

METHODS
First six patients with newly diagnosed glioblastoma who underwent TTF were analyzed with special interest in medical and social supports to execute TTF at home.

RESULTS
TTF was first introduced in our institution in May 2016, but no patients were treated because of no coverage by medical insurance until December 2017. We further needed to wait to initiate TTF treatment until January 2019 when the contract to use TTF systems was finally made between the company and institution. Since then six patients were registered in five months. For its introduction to clinical practice,it is essential to establish new in-house environment with medical professions division in the facility including documentations of calculating instruction fees and usage guidance for home care application of TTF. It is also important to initiate providing information of TTF such as timing of visit by specific practitioners and potential medical and psychologic burdens to patients and their families during and after chemoradiotherapy to better understand this new modality leading to the consent acquisition.

CONCLUSIONS
Introducing TTF into clinical practice should accompany improvement of management in not only medical equipment and documentations but also patient care in hospital and home.
COT-21 EFFECT OF BEVACIZUMAB FOR PEDIATRIC HIGH GRADE GLIOMA
Authors: Tsukamoto Yoshihiro , Natsumeda Manabu , Okada Masayasu , Eda Takeyoshi , Yoshimura Junichi , Okamoto Kouichirou , Oishi Makoto , Fujii Yukihiko 
Published: December 2019

Abstract

INTRODUCTION
Bevacizumab (BEV) therapy has been used for pediatric high grade glioma,however the evidence and effectiveness are not understood yet.

METHODS
We report 7 cases (age 2 to 10 years old) of pediatric high grade glioma treated with BEV. One case is thalamic diffuse midline glioma H3K27 mutant (DMGH3K27M),one case is brain stem DMGH3K27M,one case is cerebellar high grade glioma,and 4 cases are diffuse intrinsic pontine glioma (DIPG) diagnosed clinically without biopsy. 5 cases were treated with BEV when diagnosed as recurrence after chemo-radiotherapy. One case was treated for rapid tumor progression during radiotherapy. One case was started on BEV therapy with radiation and concomitant temozolomide therapy.

RESULT
The number of times of BEV was 2 to 13 times (median 7 times). The period of BEV was 1 to 9 months (median 4 months). One case which was treated with BEV at rapid progression during radiation showed good response on imaging and improvement of symptoms. 4 of 5 cases who were treated at recurrence clinically showed mild symptomatic improvement. One case treated with BEV and radiotherapy initially was not evaluated. The adverse effects of BEV included wound complication of tracheostomy and rash.

CONCLUSION
BEV showed good response for rapid progression during radiotherapy,and mild response for recurrence cases. BEV is thought to be an effective therapeutic agent for pediatric HGG at recurrence and rapid tumor progression during radiotherapy.
Prevalence of systemic lupus erythematosus in Spain: higher than previously reported in other countries?
Authors: Cortés Verdú Raúl , Pego-Reigosa José M , Seoane-Mato Daniel , Morcillo Valle Mercedes , Palma Sánchez Deseada , Moreno Martínez María J , Mayor González Marta , Atxotegi Sáenz de Buruaga Joana , Urionagüena Onaindia Irati , Blanco Cáceres Boris A , Silva-Fernández Lucía , Sivera Francisca , Blanco Francisco J , Sánchez-Piedra Carlos , Díaz-González Federico , Bustabad Sagrario ,   for the Working Group Proyecto EPISER2016
Published: December 2019

Abstract

Objectives
Prevalence of SLE varies among studies, being influenced by study design, geographical area and ethnicity. Data about the prevalence of SLE in Spain are scarce. In the EPISER2016 study, promoted by the Spanish Society of Rheumatology, the prevalence estimate of SLE in the general adult population in Spain has been updated and its association with sociodemographic, anthropometric and lifestyle variables has been explored.

Methods
Population-based multicentre cross-sectional study, with multistage stratified and cluster random sampling. Participants were contacted by telephone to carry out a questionnaire for the screening of SLE. Investigating rheumatologists evaluated positive results (review of medical records and/or telephone interview, with medical visit if needed) to confirm the diagnosis. To calculate the prevalence and its 95% CI, the sample design was taken into account and weighing was calculated considering age, sex and geographic origin. Multivariate logistic regression models were defined to analyse which sociodemographic, anthropometric and lifestyle variables included in the telephone questionnaire were associated with the presence of SLE.

Results
4916 subjects aged 20 years or over were included. 16.52% (812/4916) had a positive screening result for SLE. 12 cases of SLE were detected. The estimated prevalence was 0.21% (95% CI: 0.11, 0.40). SLE was more prevalent in the rural municipalities, with an odds ratio (OR) = 4.041 (95% CI: 1.216, 13.424).

Conclusion
The estimated prevalence of SLE in Spain is higher than that described in most international epidemiological studies, but lower than that observed in ethnic minorities in the United States or the United Kingdom.
Facilitating Recovery of Daily Functioning in People With a Severe Mental Illness Who Need Longer-Term Intensive Psychiatric Services: Results From a Cluster Randomized Controlled Trial on Cognitive Adaptation Training Delivered by Nurses
Authors: Stiekema Annemarie P M , van Dam Michelle T , Bruggeman Richard , Redmeijer Jeroen E , Swart Marte , Dethmers Marian , Rietberg Kees , Wekking Ellie M , Velligan Dawn I , Timmerman Marieke E , Aleman André , Castelein Stynke , van Weeghel Jaap , Pijnenborg Gerdina M H , van der Meer Lisette 
Published: December 2019

Abstract

Background
Feasible and effective interventions to improve daily functioning in people with a severe mental illness (SMI), such as schizophrenia, in need of longer-term rehabilitation are scarce.

Aims
We assessed the effectiveness of Cognitive Adaptation Training (CAT), a compensatory intervention to improve daily functioning, modified into a nursing intervention.

Method
In this cluster randomized controlled trial, 12 nursing teams were randomized to CAT in addition to treatment as usual (CAT; n = 42) or TAU (n = 47). Daily functioning (primary outcome) was assessed every 3 months for 1 year. Additional follow-up assessments were performed for the CAT group in the second year. Secondary outcomes were assessed every 6 months. Data were analyzed using multilevel modeling.

Results
CAT participants improved significantly on daily functioning, executive functioning, and visual attention after 12 months compared to TAU. Improvements were maintained after 24 months. Improved executive functioning was related to improved daily functioning. Other secondary outcomes (quality of life, empowerment, negative symptoms) showed no significant effects.

Conclusions
As a nursing intervention, CAT leads to maintained improvements in daily functioning, and may improve executive functioning and visual attention in people with SMI in need of longer-term intensive psychiatric care. Given the paucity of evidence-based interventions in this population, CAT can become a valuable addition to recovery-oriented care.
Metabolic control of T cells in autoimmunity
Authors: Kono Michihito , Yoshida Nobuya , Tsokos George C. 
Published: December 2019

Purpose of review
Th1, Th17, and Treg cells play distinct roles in autoimmune diseases, including systemic lupus erythematosus, multiple sclerosis, and rheumatoid arthritis. During the last 5 years we have learned that T-cell metabolism affects cell survival, differentiation and fate of T cells.

Recent findings
We highlight recent studies which have reported on T-cell metabolism in autoimmune diseases, differences in cellular metabolisms in T-cell subsets among various diseases and transcription factors which control the expression and function of central metabolic enzymes.

Summary
Distinct metabolic processes control the function of T-cell subsets in autoimmune disease and known transcription factors control the activity of metabolic enzymes. The revealed insights into the metabolic events of immune cells offer opportunities for new therapeutic approaches.
Pilon Fractures in Patients Older Than 60 Years of Age: Should We Be Fixing These?
Authors: Haller Justin M. , Githens Michael , Rothberg David , Higgins Thomas , Nork Sean , Barei David 
Published: December 2019

Objectives:
To compare complications after operatively treated pilon fracture between elderly patients (≥60 years) and younger patients (<60 years).

Design:
Retrospective comparative study.

Setting:
Two Level-1 academic trauma.

Patients/Participants:
Of the 740 tibial plafond fractures (OTA/AO 43-B & 43-C) treated January 2006 through December 2016, 538 patients had a minimum of 1 year follow up.

Intervention:
Open reduction–internal fixation (ORIF).

Main Outcome Measurement:
Treatment failure defined as either nonunion or arthrosis.

Results:
A total of 72 patients comprised the elderly group (mean age 66 years) and 466 patients comprised the younger group (mean age 44 years) (P < 0.001). Besides significantly more tobacco use in the younger group, patient demographics and fracture characteristics did not differ. Locking plates were used significantly more in elderly patients (47% vs. 32%, P = 0.01). Using chi-square analysis, we were unable to detect a difference in treatment failure (elderly 43% vs. young 37%, P = 0.33), infection (elderly 10% vs. young 13%, P = 0.4), or malunion (elderly 3% vs. young 4%, P = 1.0). Using regression analysis, age >60 was not associated with treatment failure [odds ratio (OR) 1.2 (0.7–2.1), P = 0.52]. Bone loss (OR 2.7 [1.8–4.1], P < 0.001), open fracture (OR 1.6 [1–2.5], P = 0.03), and malreduction (OR 4.2 [2.5–7.3], P < 0.001) were associated with failure.

Conclusions:
Age >60 years is not an independent predictor of surgical treatment failure of pilon fractures as defined by nonunion or arthrosis. This is the largest cohort of pilon fracture in elderly patients and indicates that we should continue to treat elderly patients similar to their younger counterparts using ORIF.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Determination of the Prevalence From Clinical Diagnosis of Sacroiliac Joint Dysfunction in Patients With Lumbar Disc Hernia and an Evaluation of the Effect of This Combination on Pain and Quality of Life
Authors: Telli Hilal , Hüner Berrin , Kuru Ömer 
Published: December 2019

Study Design.
A prospective cross-sectional study.

Objective.
To evaluate the prevalence of sacroiliac joint dysfunction in patients with lumbar disc hernia and examine the variations in clinical parameters cause by this combination.

Summary of Background Data.
Although one of the many agents leading to lumbar pain is sacroiliac dysfunction, little progress has still been made to evaluate mechanical pain from sacroiliac joint dysfunction within the context of differential diagnosis of lumbar pain.

Methods.
Two hundred thirty-four patients already diagnosed with lumbar disc hernia were included in the study. During the evaluation, sacroiliac joint dysfunction was investigated using specific tests, pain levels with a Visual Analog Scale, and the presence of neuropathic pain using Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale. Other clinical assessments were performed using the Beck Depression Inventory, Health Assessment Questionnaire, and Tampa Kinesiophobia Scale.

Results.
63.2% of patients were female and 36.8% were male. Mean age was 46.72 ± 11.14 years. The level of sacroiliac joint dysfunction was 33.3% in the research population. In terms of sex distribution, the proportion of women was higher in the group with sacroiliac joint dysfunction (P < 0.05). No significant difference was observed in pain intensity assessed using a Visual Pain Scale between the groups (P > 0.05), but the level of neuropathic pain was significantly higher in the group with dysfunction (P < 0.05). In the group with sacroiliac joint dysfunction, the presence of depression was significantly higher (P = 0.009), functional capacity was worse (P < 0.001), and the presence of kinesophobia was higher (P = 0.02).

Conclusion.
Our study results will be useful in attracting the attention of clinicians away from the intervertebral disc to the sacroiliac joint in order to avoid unnecessary and aggressive treatments.

Level of Evidence: 2