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2 results on '"Anna Campello"'

1. Unresectable Clival Giant Cell Tumor, Tumor Control With Denosumab After Relapse: A Case Report and Systematic Review of the Literature

Author

Maria Grazia, Pionelli, Sebastian D, Asaftei, Elisa, Tirtei, Anna, Campello, Gianpaolo, Di Rosa, and Franca, Fagioli

Subjects
Giant Cell Tumor of Bone, clival bone, Adolescent, skull base, Bone Neoplasms, pediatric oncology, Hematology, GCT, Skull Base Neoplasms, Cranial Fossa, Posterior, Oncology, Pediatrics, Perinatology and Child Health, Humans, Female, Denosumab, Neoplasm Recurrence, Local
Abstract

Giant cell tumors (GCTs) of the skull base are rare entities. Although considered histologically benign, GCTs are locally aggressive with a high rate of local recurrence. The present case describes a 14-year-old girl with a clival GCT who underwent long-term therapy with denosumab after local relapse. To our knowledge, it is the second case described with a follow-up term2 years from the start of denosumab and who did not receive any other adjuvant treatment besides denosumab. The patient achieved a local control of the disease. According to the few available data, radical excision with adjuvant therapy helps in long-term control in uncommon sites, such as the skull. However, the definitive treatment is still controversial because of their rarity and few follow-up data. The present case highlights the benefit of denosumab and its safety as long-term therapy and contributes to the existing literature with analysis and evaluation of the management strategies and prognosis.

Published
2022

2. Sphenopalatine Ganglion Stimulation to Augment Cerebral Blood Flow

Author

Natan M. Bornstein, Jeffrey L. Saver, Hans-Christoph Diener, Philip B. Gorelick, Ashfaq Shuaib, Yoram Solberg, Thomas Devlin, Thomas Leung, Carlos A. Molina, David Skoloudik, Jan Fiksa, Derk Krieger, Grethe Andersen, Joerg Berrouschot, Carsten Hobohm, Dietmar Schneider, Bernd Griewing, Matthias Endres, Karl-Georg Hausler, Hubert Kimmig, Peter Ringleb, Christian Weimar, Matthias Schilling, Martin Kohrmann, Andreas Hetzel, Manfred Kaps, Raymond Cheung, Piotr Sobolewski, Walenty Nyke, Anna Czlonkowska, Adam Stepien, Brola Waldemar, Agnieszka Słowik, Stelmasiakiem Zbigniewem, Ignacy Lubiński, Pedro Portela, Tomas Segure, Joan Marti-Fabregas, Maria Alonso, Antonio Nunez, Miguel Blanco Miguel, Anna Campello, Joaquin Arenillas, Nash Marshall, David Chiu, Harish Shownkeen, Marilyn Rymer, Souvik Sen, Martin Roubec, Martin Kuliha, Ctirad Lakomý, David Tyl, David Kemlink, Ondřej Doležal, Petra Rekova, Veronika Krejčí, Anders Christensen, Bo Belhage, Christian Maschmann, Christian Kruse Larsen, Frank Pott, Hanne Christensen, Jakob Marstrand, Jens Kjellberg Nielsen, Per Meden, Svend Prytz, Sverre Rosenbaum, Jens Christian Hedemann Sorensen, Kaare Stenhoj Meier, Kare Schmift Ettrup, Kristina Dupont Hougaard, Paul Von Wietzel, Anett Stoll, Hans Schwetlick, Hendirk Pradel, Alexander Hemprich, Andreas Schulz, Bernhard Frerich, Christopher Weise, Dominik Michalski, Felix Schaller, Franziska Schiefke, Jens Helmrich, Johann Pelz, Martin Schnieder, Martin Schneider, Peter Matzen, Rudiger Langos, Stephan Müller-Duerwald, Sven Lukhaup, Ute Bauer, Wolfgang Kloppig, Erich Hiermann, Gregor Mucha, Hassan Soda, Renate Weinhardt, Teresa Mucha, Volker Ziegler, Alexander Abbushi, Benjamin Hotter, Benjamin Winter, Birgit Anthofer, Cornelia Noack, Dinah Laubisch, Gerd Heldge Schneider, Gerhard Jan Jungehulsing, Heiko Mueller, Jens Dreier, Jochen Fiebach, Julia Flechsenhar, Kersten Villringer, Martin Ebinger, Michael Rozanski, Peter Vajkoczy, Randolf Klingebiel, Robert Steinicke, Sandra Pittl, Sarah Hoffmann, Stephan Maul, Thomas Krause, Thomas Liman, Thomas Plath, Tim Nowe, Wolf Schmidt, Carsten Fritzsch, Christopher Haas, Hans-Gerd Will, Katja Haußmann-Betz, Mohsen Bayat, Tomazs Pordzik, Andreas Hug, Christian Jürgen Staff, Christoph Lichy, Georg Eggers, Manja Kloss, Martin Bendszus, Oliver Herrmann, Robin Seeberger, Soenke Schwarting, Stefan Rhode, Timolaos Rizos, Werner Hacke, Benedikt Frank, Bessi Bozkurt, Dagny Holle, Daniel Mueller, Dirk Koch, Hind Shanib, Joachim Sudendey, Johannes Brenck, Kolja Busch, Kristina Gartzen, Thomas Gasser, Tim Hagenacker, Boris Buerke, Gudrun Prigge, Jens Minnerup, Johannes Albers, Kai Wermker, Wolfram Schwindt, Ringlestein, Bernd Kallmünzer, Eva Hauer, Lorenz Breuer, Peter Schellinger, Rainer Kollmar, Roland Sauer, Stefan Schwab, Tobias Struffert, Anette Funfack, Anne Stechmann, Axel Schlaeger, Claus Laeppchen, Florian Schuchardt, Jan-Helge Klingler, Janine Reis, Johann Lambeck, Mirko Friedrich, Mona Laible, Philip Wellermeyer, Sandra Beck, Sebastian Rutsch, Wolf-Dirk Niesen, Christian Tanislav, Heidrun Schaaf, Heiko Kerkmann, Ingo Schirotzek, Jens Allendörfer, Stephanie Wolff, Alexander Yuk-Lun Lau, Anne Yin Yan Chan, Deyond Siu, Edward HC Wong, George Kwok Chu Wong, Howan Leung, Lawrence K.S. Wong, Xian Lun Zhu, Yannie Oi Yan Soo, Alan Choi Ting Tse, Gilberto Ka Kit Leung, Kar Ming Leung, Kwan Ngai Hung, May Wai Mei Kwan, Mona Man Yu Tse, Philip Tse, Ping Hon Chan, Raymand Lee, Richard Shek Kwan Chang, Shirley Yin Yu Pang, Sonny Fong Kwong Hon, Tat Sun Cheng, Wai Man Lui, Windsor Wai Wo Mak, Anna Sobota, Baeta Wiater, Barbara Loch, Genowefa Wolak, Irena Łabudzka, Jan Dabal, Marcin Grzesik, Monika Sledzinska, Renata Hatalska-Żerebiec, Wiktor Szczuchniak, Anna Gójska, Dariusz Nałęcz, Dariusz Gasecki, Grzegorz Kozera, Łukasz Dylewicz, Marcin Niekra, Mariusz Kwarciany, Piotr Chomik, Piotr Skowron, Adam Kobayashi, Grzegorz Chabik, Grzegorz Makowicz, Jan Bembenek, Julia Jędrzejewska, Michal Karlinski, Wojciech Czepiel, Bogdan Brodacki, Jacek Staszewski, Jarosław Kosek, Marcin Jadczak, Marta Durka-Kęsy, Krzysztof Kaluzny, Małgorzata Ziomek, Małgorzata Fudala, Zbigniew Sosnowski, Antoni Ferens, Elżbieta Szczygieł, Krzysztof Banaszkiewicz, Maciej Ziomek, Marcin Wnuk, Anna Szczepańska-Szerej, Ewa Jach, Grazyna Elzbieta Maslanko, Joanna Wojczal, Piotr Luchowski, Andrzej Kowalczyk, Jerzy Jakubiak, Joanna Kopcewicz, Maciej Gajda, Malgorzata Wichlinska-Lubinska, David Rodriguez, Estevo Santamarin, Jorge Pagola, Juan Lorente Guerrero, Marc Ribo, Marta Rubiera, Olga Maisterra, Soccoro Pinero, Valera Catalina Iglesias, Gerard Plans, Helena Quesada, Marco Alberto Aparicio Caballero, Pedro Cardona Portela, Antonio Belinchon De Diego, David Sopelana Garay, Máximo Rafael García Rodriguez, Oscar Ayo Martin, Silvia Crusat Braña, Jorge Garcia, Fernando Munoz Hernandez, Ignasi Catala, Josep Lluis Marti-Vilalta, Rachel Delgado Mederos, Schmid Cristian de Quintana, Sergi Martinez-Ramirez, Jaime Valcarcel Gonzalez, Jaime Masjuan Vallejo, Jorge Diamantopoulus, Marta Del Alamo, Pedro Domingo Poveda, Andres Garcia Pastor, Calros Fernandez Carballal, Fernando Diaz, Roberto Garcia Leal, Ruiz Juretschke, Eduardo Arán Echabe, Jose Castillo Sanchez, Manuel Rodriguez Yanez, Ramon Serramito Garcia, Rogelio Leira Muino, Susana Arias Rivas, Demian Manzano Lopez Gonzalez, Elisa Cuadrado, Eva Giralt, Gloria Villalba, Jaime Roquer, Ois Angel, Maria Jimenez, René Robles Cedeño, Ruy Salinas, Saioa Lejarreta, Yolanda Silva, Adela Fraile, Ana Calleja, Guillermo Arturo Cepeda Landínez, Nieves Tellez, Pablo Garcia Bermejo, Pérez Jaime Santos, Rosa Fernandez Herranz, Peter Hunt, Donald Browning, Michael Violette, Robert Hoddeson, James Rose, Jonathan Zhang, Avi Mazumdar, Henri Echiverri, James Chow, Darren Lovick, Martin Coleman, Naveed Akhtar, Rebecca Sugg, Adam Zanation, Anand Germanwala, Brent Senior, David Huang, Natalie Aucutt-Walter, Scott Kasner, Peter LeRoux, Rüdiger von Kummer, and Yuko Palesch

Subjects
Advanced and Specialized Nursing, medicine.medical_specialty, business.industry, medicine.medical_treatment, Medizin, Vasodilation, Stimulation, Thrombolysis, Blood–brain barrier, Collateral circulation, Ganglion, medicine.anatomical_structure, Cerebral blood flow, Internal medicine, medicine, Cardiology, Neurology (clinical), Augment, Cardiology and Cardiovascular Medicine, business
Abstract

Background and Purpose— Many patients with acute ischemic stroke are not eligible for thrombolysis or mechanical reperfusion therapies due to contraindications, inaccessible vascular occlusions, late presentation, or large infarct core. Sphenopalatine ganglion (SPG) stimulation to enhance collateral flow and stabilize the blood-brain barrier offers an alternative, potentially more widely deliverable, therapy. Methods— In a randomized, sham-controlled, double-masked trial at 41 centers in 7 countries, patients with anterior circulation ischemic stroke not treated with reperfusion therapies within 24 hours of onset were randomly allocated to active SPG stimulation or sham control. The primary efficacy outcome was improvement beyond expectations on the modified Rankin Scale of global disability at 90 days (sliding dichotomy), assessed in the modified intention-to-treat population. The initial planned sample size was 660 patients, but the trial was stopped early when technical improvements in device placement occurred, so that analysis of accumulated experience could be conducted to inform a successor trial. Results— Among 303 enrolled patients, 253 received at least one active SPG or sham stimulation, constituting the modified intention-to-treat population (153 SPG stimulation and 100 sham control). Age was median 73 years (interquartile range, 64–79), 52.6% were female, deficit severity on the National Institutes of Health Stroke Scale was median 11 (interquartile range, 9–15), and time from last known well median 18.6 hours (interquartile range, 14.5–22.5). For the primary outcome, improved 3-month disability beyond expectations, rates in the SPG versus sham treatment groups were 49.7% versus 40.0%; odds ratio, 1.48 (95% CI, 0.89–2.47); P =0.13. A significant treatment interaction with stroke location (cortical versus noncortical) was noted, P =0.04. In the 87 patients with confirmed cortical involvement, rates of improvement beyond expectations were 50.0% versus 27.0%; odds ratio, 2.70 (95% CI, 1.08–6.73); P =0.03. Similar response patterns were observed for all prespecified secondary efficacy outcomes. No differences in mortality or serious adverse event safety end points were observed. Conclusions— SPG stimulation within 24 hours of onset is safe in acute ischemic stroke. SPG stimulation was not shown to statistically significantly improve 3-month disability above expectations, though favorable outcomes were nominally higher with SPG stimulation. Beneficial effects may distinctively be conferred in patients with confirmed cortical involvement. The results of this study need to be confirmed in a larger pivotal study. Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT03767192.

Published
2019

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