Several studies published to date about glioma surgery have addressed the validity of using novel technologies for intraoperative guidance and potentially improved outcomes. However, most of these reports are limited by questionable methods and/or by their retrospective nature. In this work, we performed a systematic review of the literature to address the impact of intraoperative assistive technologies on the extent of resection (EOR) in glioma surgery, compared to conventional unaided surgery. We were also interested in two secondary outcome variables: functional status and progression-free survival. We primarily used PubMed to search for relevant articles. Studies were deemed eligible for our analysis if they (1) were prospective controlled studies; (2) used EOR as their primary target outcome, assessed by MRI volumetric analysis; and (3) had a homogeneous study population with clear inclusion criteria. Out of 493 publications identified in our initial search, only six matched all selection criteria for qualitative synthesis. Currently, the evidence points to 5-ALA, DTI functional neuronavigation, neurophysiological monitoring, and intraoperative MRI as the best tools for improving EOR in glioma surgery. Our sample and conclusions were limited by the fact that studies varied in terms of population characteristics and in their use of different volumetric analyses. We were also limited by the low number of prospective controlled trials available in the literature. Additional evidence-based high-quality studies assessing cost-effectiveness should be conducted to better determine the benefits of intraoperative assistive technologies in glioma surgery.
Factor structure of the Halstead Category Test was evaluated in patients with schizophrenia, heterogeneous forms of brain damage, and patient controls using confirmatory factor analysis. Analyses were performed including and excluding subtests 1 and 2. In the first analysis, a three-factor model was optimal, with subtests 1 and 2 loading on one factor (Counting), 3, 4, and 7 loading on a second factor (Spatial Positional Reasoning), and subtests 5 and 6 loading on a third factor (Proportional Reasoning). Excluding subtests 1 and 2, a two-factor solution was optimal consisting of the Spatial Positional (subtests 3 and 4) and Proportional Reasoning (subtests 5 and 6) factors, with subtest 7 loading on both factors. Optimal factor structures for the three groups were identical. Correlations between factor scores were similar among groups. Factor scores also correlated significantly (p <.01 ) with all of the other cognitive measures. It was concluded that the Category Test is a multidimensional procedure with factors associated in a general way with other cognitive abilities.
Central nervous system (CNS) restoration is an important clinical challenge and stem cell transplantation has been considered a promising therapeutic option for many neurological diseases. Objective: The present review aims to briefly describe stem cell biology, as well as to outline the clinical application of stem cells in the treatment of diseases of the CNS. Method: Literature review of animal and human clinical experimental trials, using the following key words: "stem cell", "neurogenesis", "Parkinson", "Huntington", "amyotrophic lateral sclerosis", "traumatic brain injury", "spinal cord injury", "ischemic stroke", and "demyelinating diseases". Conclusion: Major recent advances in stem cell research have brought us several steps closer to their effective clinical application, which aims to develop efficient ways of regenerating the damaged CNS.Keywords: stem cell, neurogenesis, neurological diseases, stem cell therapy. RESUMORestauração do sistema nervoso central (SNC) é um importante desafio clínico e o transplante de células-tronco tem sido considerado uma opção terapêutica promissora para muitas doenças neurológicas. Objetivo: O presente trabalho tem como objetivo descrever brevemente a biologia das células-tronco, assim como sua aplicação clínica no tratamento de doenças do SNC. Método: Revisão da literatura de experimentação
Malignant brain tumors, including glioblastoma multiforme (GBM), are known for their high degree of invasiveness, aggressiveness, and lethality. These tumors are made up of heterogeneous cell populations and only a small part of these cells (known as cancer stem cells) is responsible for the initiation and recurrence of the tumor. The biology of cancer stem cells and their role in brain tumor growth and therapeutic resistance has been extensively investigated. Recent work suggests that glial tumors arise from neural stem cells that undergo a defective process of differentiation. The understanding of this process might permit the development of novel treatment strategies targeting cancer stem cells. In the present review, we address the mechanisms underlying glial tumor formation, paying special attention to cancer stem cells and the role of the microenvironment in preserving them and promoting tumor growth. Recent advancements in cancer stem cell biology, especially regarding tumor initiation and resistance to chemo- or radiotherapy, have led to the development of novel treatment strategies that focus on the niche of the stem cells that make up the tumor. Encouraging results from preclinical studies predict that these findings will be translated into the clinical field in the near future.
Stem cells represent a promising step for the future of regenerative medicine. As they are able to differentiate into any cell type, tissue or organ, these cells are great candidates for treatments against the worst diseases that defy doctors and researchers around the world. Stem cells can be divided into three main groups: (1) embryonic stem cells; (2) fetal stem cells; and (3) adult stem cells. In terms of their capacity for proliferation, stem cells are also classified as totipotent, pluripotent or multipotent. Adult stem cells, also known as somatic cells, are found in various regions of the adult organism, such as bone marrow, skin, eyes, viscera and brain. They can differentiate into unipotent cells of the residing tissue, generally for the purpose of repair. These cells represent an excellent choice in regenerative medicine, every patient can be a donor of adult stem cells to provide a more customized and efficient therapy against various diseases, in other words, they allow the opportunity of autologous transplantation. But in order to start clinical trials and achieve great results, we need to understand how these cells interact with the host tissue, how they can manipulate or be manipulated by the microenvironment where they will be transplanted and for how long they can maintain their multipotent state to provide a full regeneration.
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