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  1. Article: Clinical image: spondylodiscitis as a complication of urosepsis caused by extracorporeal shock wave lithotripsy for kidney stones.

    Gallina, Pasquale / Dardo, Maddalena / Pedone, Agnese / Travaglini, Fabrizio

    Oxford medical case reports

    2023  Volume 2023, Issue 1, Page(s) omac144

    Language English
    Publishing date 2023-01-18
    Publishing country England
    Document type Case Reports
    ZDB-ID 2766251-2
    ISSN 2053-8855
    ISSN 2053-8855
    DOI 10.1093/omcr/omac144
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Functional outcomes, extent of resection, and bright/vague fluorescence interface in resection of glioblastomas involving the motor pathways assisted by 5-ALA.

    Muscas, Giovanni / Orlandini, Simone / Bonaudo, Camilla / Dardo, Maddalena / Esposito, Alice / Campagnaro, Luca / Carrai, Riccardo / Fainardi, Enrico / Ciccarino, Pietro / Della Puppa, Alessandro

    Acta neurochirurgica

    2022  Volume 164, Issue 12, Page(s) 3267–3274

    Abstract: Background: 5-Aminolevulinic acid (5-ALA) fluorescence can maximize perirolandic glioblastoma (GBM) resection with low rates of postoperative sequelae. Our purpose was to present the outcomes of our experience and compare them with other literature ... ...

    Abstract Background: 5-Aminolevulinic acid (5-ALA) fluorescence can maximize perirolandic glioblastoma (GBM) resection with low rates of postoperative sequelae. Our purpose was to present the outcomes of our experience and compare them with other literature reports to investigate the potential influence of different intraoperative monitoring strategies and to evaluate the role of intraoperative data on neurological and radiological outcomes in our series.
    Methods: We retrospectively analyzed our prospectively collected database of GBM involving the motor pathways. Each patient underwent tumor exeresis with intraoperative 5-ALA fluorescence visualization. Our monitoring strategy was based on direct stimulation (DS), combined with cortical or transcranial MEPs. The radiological outcome was evaluated with CRET vs. residual tumor, and the neurological outcome as improved, unchanged, or worsened. We also performed a literature review to compare our results with state-of-the-art on the subject.
    Results: Sixty-five patients were included. CRET was 63.1%, permanent postoperative impairment was 1.5%, and DS's lowest motor threshold was 5 mA. In the literature, CRET was 25-73%, permanent postoperative impairment 3-16%, and DS lowest motor threshold was 1-3 mA. Our monitoring strategy identified a motor pathway in 60% of cases in faint fluorescent tissue, and its location in bright/faint fluorescence was predictive of CRET (p < 0.001). A preoperative motor deficit was associated with a worse clinical outcome (p < 0.001). Resection of bright fluorescent tissue was stopped in 26%, and fluorescence type of residual tumor was associated with higher CRET grades (p < 0.001).
    Conclusions: Based on the data presented and the current literature, distinct monitoring strategies can achieve different onco-functional outcomes in 5-ALA-guided resection of a glioblastoma (GBM) motor pathway. Intraoperatively, functional and fluorescence data close to a bright/vague interface could be helpful to predict onco-functional outcomes.
    MeSH term(s) Humans ; Glioblastoma/diagnostic imaging ; Glioblastoma/surgery ; Glioblastoma/pathology ; Aminolevulinic Acid ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/surgery ; Brain Neoplasms/pathology ; Retrospective Studies ; Neoplasm, Residual/surgery ; Efferent Pathways/pathology
    Chemical Substances Aminolevulinic Acid (88755TAZ87)
    Language English
    Publishing date 2022-09-10
    Publishing country Austria
    Document type Review ; Journal Article
    ZDB-ID 80010-7
    ISSN 0942-0940 ; 0001-6268
    ISSN (online) 0942-0940
    ISSN 0001-6268
    DOI 10.1007/s00701-022-05358-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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