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A 25-year Retrospective, Single Center Analysis of 343 WHO Grade II/III Glioma Patients: Implications for Grading and Temozolomide Therapy
Purpose: Classification and treatment of WHO grade II/III gliomas have dramatically changed. Implementing molecular markers into the WHO classification raised discussions about the significance of grading and clinical trials showed overall survival (OS) benefits for combined radiochemotherapy. As molecularly stratified treatment data outside clinical trials are scarce, we conducted this retrospective study. Methods: We identified 343 patients (1995-2015) with newly diagnosed WHO grade II/III gliomas and analyzed molecular markers, patient characteristics, symptoms, histology, treatment, time to treatment failure (TTF) and OS. Results: IDH-status was available for all patients (259 mutant, 84 IDH1-R132H-non-mutant). Molecular subclassification was possible in 173 tumors, resulting in diagnosis of 80 astrocytomas and 93 oligodendrogliomas. WHO grading remained significant for OS in astrocytomas/IDH1-R132H-non-mutant gliomas (p)
Impact and Risk Factors of Red Blood Cell Transfusion on Patients Undergoing Elective Primary Meningioma Resection
Background: Transfusion of red blood cells (RBC) in patients undergoing major elective cranial surgery is associated with increased morbidity, mortality and prolonged hospital length of stay (LOS). This retrospective single center study aims to identify the impact of RBC transfusions on skull-base and non-skull-base meningioma patients including the identification of risk factors for RBC transfusion. Methods: From October 2009 - October 2016 we retrospectively analyzed 423 primary meningioma patients undergoing surgery for primary meningioma resection our department. Results: Of these 423 patients, 68 (16.1%) received RBC transfusion and 355 (83.9%) did not receive RBC units. Preoperative anaemia rate was significantly higher in transfused patients (17.7%) compared to patients without RBC transfusion (6.2%; p = 0.0015). In transfused patients, postoperative complications as well as hospital LOS was significantly higher (p
Handbook of Intergenerational Justice
The contributors to this volume undertake to establish the foundations and definitions of intergenerational justice and to explore its capacity to guide us in policy and public opinion judgments we must make to face unprecedented issues. . . We are changing the biosphere and using resources to an extent never contemplated in the history of ethics. Deterioration of our oceans, loss of topsoil, insecurity about potable water supplies, the ozone hole, global warming, and the question about how to handle high-level nuclear waste which remains lethal perhaps 400,000 years from now, are some examples whose consequences reach far beyond inherited principles and policies of responsibility to others....
A Theory of Intergenerational Justice
This highly accessible book provides an extensive and comprehensive overview of current research and theory about why and how we should protect future generations. It exposes how and why the interests of people today and those of future generations are often in conflict and what can be done. It rebuts critical concepts such as Parfits' non-identity paradox and Beckerman's denial of any possibility of intergenerational justice. The core of the book is the lucid application of a veil of ignorance to derive principles of intergenerational justice which show that our duties to posterity are stronger than is often supposed. Tremmel's approach demands that each generation both consider and improve the well-being of future generations. To measure the well-being of future generations Tremmel employs the Human Development Index rather than the metrics of utilitarian subjective happiness. The book thus answers in detailed, concrete terms the two most important questions of every theory of intergenerational justice: what to sustain? and how much to sustain?
Gastrointestinal Malignancies
This book now published in its fully updated second edition comprehensively summarizes the current state of knowledge on malignancies of the gastrointestinal tract and highlights the latest efforts in multimodality treatment options before and after surgery, important ongoing trials as well as future areas of investigation. Dedicated organ-based chapters evaluate current treatments and management and provide information on incidence, etiology and biological characteristics. The state of the art in the radiologic and endoscopic staging of gastrointestinal malignancies is described, and guidance is offered on the role of interventional radiology and interventional gastroenterology in the treatment of these challenging tumors. In addition, the book explores novel and evolving treatments, including Immunotherapy, personalized systemic therapy and minimally invasive surgical and radiology techniques, and addresses patient-reported outcomes and survivorship challenges. It will be of benefit to all surgeons, oncologists and other specialists who treat these malignancies, as well as to trainees looking to increase their understanding of the field.
Irreversible Electroporation
Non-thermal irreversible electroporation is a new minimally invasive surgical p- cedure with unique molecular selectivity attributes – in fact it may be considered the first clinical molecular surgery procedure. Non-thermal irreversible electro- ration is a molecular selective mode of cell ablation that employs brief electrical fields to produce nanoscale defects in the cell membrane, which can lead to cell death, without an effect on any of the other tissue molecules. The electrical fields can be produced through contact by insertion of electrode needles around the undesirable tissue and non-invasively by electromagnetic induction. This new - dition to the medical armamentarium requires t...
Molecular and Cellular Neurobiology
Presents an account of the remarkable progress made in different areas of neurobiology. This book introduces the structure and development of the brain, showing how they are specialized for the functions they serve. It is concerned with hormones and neurotransmitters.
