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Tuttle Hede posted an update 7 months ago
Recent advances in cancer therapies have enabled many women diagnosed with malignancies during childhood and adolescence to survive longer and therefore to reach an age where they wish to conceive. When providing cancer treatment such as anticancer drugs and radiotherapy, attention is often paid to preserving future fertility, but little is known about maternal pregnancy risks, and in particular cardiovascular complications. Recent studies have shown that cardiovascular diseases such as cardiomyopathy, heart failure, and arrhythmias often occur during and soon after anticancer therapy. This has led to the emergence of the specialized field of “onco-cardiology” or “cardio-oncology,” in which oncologists and cardiologists collaborate, as well as the publication of multiple clinical practice guidelines. The interdisciplinary onco-cardiology team plays an important role in further improving the prognosis of cancer survivors. The current recommendation for women after anticancer therapy who wish to conceive is to undergo cardiovascular screening, regardless of whether there is a history of cardiovascular complications or not, in order to provide preconception counseling. Pregnancies in cancer-survivors, who experience cardiovascular complications, should be managed perinatally by a multidisciplinary team including obstetricians and cardiologists. Absence of cardiovascular disease on screening does not preclude the possibility that new cardiac dysfunction may occur during the perinatal period, especially in women with a history of high-dose anthracycline drug administration and/or radiation therapy. In such high-risk cases, follow-up of cardiac function throughout the perinatal period is required.
To measure the changes in cerebral oxygenation indices by near infrared time-resolved spectroscopy and the cerebral blood flow simultaneously after spinal anesthesia for cesarean section.
This prospective observational study was conducted for 25 pregnant women scheduled for elective cesarean section under spinal anesthesia. During a period of 15 min after spinal anesthesia, cerebral oxygenation (ScO
), and the total cerebral hemoglobin concentration (tHb) were measured using near infrared time-resolved spectroscopy and mean cerebral blood flow velocity (Vm) was measured using transcranial Doppler ultrasonography. Next, in the women who had nausea during the observed period, we compared these values when nausea was detected with those when it was not.
Mean arterial pressure (MAP) decreased to around 60 mmHg (by 25% compared to the control) 6min after spinal anesthesia. mTOR inhibitor Compared to the control, ScO
decreased by about 3% after 6min and then gradually increased. The tHb, which reflects cerebral blood volume started to decrease just after spinal anesthesia and this continued until 12 min (the decrease was about 12%). Vm decreased by about 7%. In the 14 women who had nausea, MAP, Vm, and ScO
values when nausea was detected were significantly lower than when it was not.
The changes in cerebral hemodynamics may be small after spinal anesthesia in ordinary cesarean section compared to the reduction of systemic arterial blood pressure. There might be greater decreases in cerebral blood flow and oxygenation when nausea occurred in the pregnant women who experienced it after spinal anesthesia.
The changes in cerebral hemodynamics may be small after spinal anesthesia in ordinary cesarean section compared to the reduction of systemic arterial blood pressure. There might be greater decreases in cerebral blood flow and oxygenation when nausea occurred in the pregnant women who experienced it after spinal anesthesia.This study investigated whether current state-of-the-art deep reasoning network analysis on psychometry-driven diffusion tractography connectome can accurately predict expressive and receptive language scores in a cohort of young children with persistent language concerns (n = 31, age 4.25 ± 2.38 years). A dilated convolutional neural network combined with a relational network (dilated CNN + RN) was trained to reason the nonlinear relationship between “dilated CNN features of language network” and “clinically acquired language score”. Three-fold cross-validation was then used to compare the Pearson correlation and mean absolute error (MAE) between dilated CNN + RN-predicted and actual language scores. The dilated CNN + RN outperformed other methods providing the most significant correlation between predicted and actual scores (i.e., Pearson’s R/p-value 1.00/ less then .001 and .99/ less then .001 for expressive and receptive language scores, respectively) and yielding MAE 0.28 and 0.28 for the same scores. The strength of the relationship suggests elevated probability in the prediction of both expressive and receptive language scores (i.e., 1.00 and 1.00, respectively). Specifically, sparse connectivity not only within the right precentral gyrus but also involving the right caudate had the strongest relationship between deficit in both the expressive and receptive language domains. Subsequent subgroup analyses inferred that the effectiveness of the dilated CNN + RN-based prediction of language score(s) was independent of time interval (between MRI and language assessment) and age of MRI, suggesting that the dilated CNN + RN using psychometry-driven diffusion tractography connectome may be useful for prediction of the presence of language disorder, and possibly provide a better understanding of the neurological mechanisms of language deficits in young children.
Crossing pathologies of the corticospinal tract (CST) are rare and often associated with genetic disorders. However, they can be present in healthy humans and lead to ipsilateral motor deficits when a lesion to motor areas occurs. Here, we review historical and current literature of CST crossing pathologies and present a rare case of asymmetric crossing of the CST.
Description of the case and systematic review of the literature were based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed database was searched for peer-reviewed articles in English since 1950. All articles on ipsilateral stroke, uncrossed CST, and associated neurologic disorders were screened. Furthermore, a literature review between the years 1850 and 1980 including articles in other languages, books, opinions, and case studies was conducted.
Only a few descriptions of CST crossing pathologies exist in healthy humans, whereas they seem to be more common in genetic disorders such as horizontal gaze palsy with progressive scoliosis or congenital mirror movements.
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