BACKGROUND AND PURPOSE:

Intracranial epidermoids temporal bone cholesteatomas, and head and neck epidermal inclusion cysts are typically slow-growing, benign conditions arising from ectodermal tissue. They exhibit increased signal on DWI. While much of the imaging literature describes these lesions as showing diffusion restriction, we investigated these qualitative signal intensities and interpretations of restricted diffusion with respect to normal brain structures. This study aimed to quantitatively evaluate the ADC values and histogram features of these lesions.

MATERIALS AND METHODS:

This retrospective study included children with histologically confirmed diagnoses of intracranial epidermoids, temporal bone cholesteatomas, or head and neck epidermal inclusion cysts. Lesions were segmented, and voxelwise calculation of ADC values was performed along with histogram analysis. ADC calculations were validated with a second analysis software to ensure accuracy. Normal brain ROIs—including the cerebellum, white matter, and thalamus—served as normal comparators. Correlational analysis and Bland-Altman plots assessed agreement among software tools for ADC calculations. Differences in the distribution of values between the lesions and normal brain tissues were assessed using the Wilcoxon rank sum and Kruskal-Wallis tests.

RESULTS:

Forty-eight pathology-proved cases were included in this study. Among them, 13 (27.1%) patients had intracranial epidermoids 14 (29.2%) had head and neck epidermal inclusion cysts, and 21 (43.7%) had temporal bone cholesteatomas. The mean age was 8.67 (SD, 5.30) years, and 27 (56.3%) were female. The intraclass correlation for absolute agreement for lesional ADC between the 2 software tools was 0.997 (95% CI, 0.995–0.998). The intracranial epidermoid head and neck epidermal inclusion cyst, and temporal bone cholesteatoma median ADC values were not significantly different (973.7 versus 875.7 versus 933.2 x 10^–6 mm²/s, P = .265). However, the ADCs of the 3 types of lesions were higher than those of 3 normal brain tissue types (933 versus 766, x 10^–6 mm²/s, P < .001).

CONCLUSIONS:

The ADC values of intracranial epidermoids, temporal bone cholesteatomas, and head and neck epidermal inclusion cysts are higher than those of normal brain regions. It is not accurate to simply classify these lesions as exhibiting restricted diffusion or reduced diffusivity without considering the tissue used for comparison. The observed hyperintensity on DWI compared with the brain is likely attributable to a relatively higher contribution of the T2 shinethrough effect.

BACKGROUND AND PURPOSE:

Periprocedural intracranial hemorrhage is one of common complications after stent placement for symptomatic intracranial atherosclerotic stenosis. This study was conducted to demonstrate predictors and long-term outcomes of periprocedural intracranial hemorrhage after stent placement for symptomatic intracranial atherosclerotic stenosis.

MATERIALS AND METHODS:

We retrospectively analyzed patients with symptomatic intracranial atherosclerotic stenosis stent placement in a prospective cohort at a high-volume stroke center. Clinical, radiologic, and periprocedural characteristics and long-term outcomes were reviewed. Periprocedural intracranial hemorrhage was classified as procedure-related hemorrhage (PRH) and non-procedure-related hemorrhage (NPRH). The long-term outcomes were compared between patients with PRH and NPRH, and the predictors of NPRH were explored.

RESULTS:

Among 1849 patients, 24 (1.3%) had periprocedural intracranial hemorrhage, including PRH (4) and NPRH (20). The postprocedural 30-day mRS was 0–2 in 9 (37.5%) cases, 3–5 in 5 (20.8%) cases, and 6 in 10 (41.7%) cases. For the 14 survivors, the long-term (median of 78 months) mRS were 0–2 in 10 (76.9%) cases and 3–5 in 3 (23.1%) cases. The proportion of poor long-term outcomes (mRS ≥3) in patients with NPRH was significantly higher than those with PRH (68.4% versus 0%, P = .024). Anterior circulation (P = .002), high preprocedural stenosis rate (P < .001), and cerebral infarction within 30 days (P = .006) were independent predictors of NPRH after stent placement.

CONCLUSIONS:

Patients with NPRH had worse outcomes than those with PRH after stent placement for symptomatic ICAS. Anterior circulation, severe preprocedural stenosis, and recent infarction are independent predictors of NPRH.

BACKGROUND AND PURPOSE:

Reocclusion after treatment is a concern in endovascular therapy for isolated intracranial atherothrombotic stroke-related large-vessel occlusion (AT-LVO). However, the optimal endovascular therapy technique for AT-LVO has not yet been investigated. This study evaluated the optimal endovascular therapy technique for AT-LVO in a real-world setting.

MATERIALS AND METHODS:

We conducted a historical, multicenter registry study at 51 centers that enrolled patients with AT-LVO. We divided the patients into 3 groups based on the endovascular therapy technique: mechanical thrombectomy alone, percutaneous transluminal angioplasty (PTA), and stent deployment. Mechanical thrombectomy alone was classified into the mechanical thrombectomy-only group; PTA and mechanical thrombectomy–PTA, into the PTA group; and mechanical thrombectomy–stent deployment, mechanical thrombectomy–PTA–stent deployment, PTA–stent deployment, and stent deployment–only into the stent group. The primary outcome was incidence of reocclusion of the treated vessels within 90 days of endovascular therapy completion.

RESULTS:

We enrolled 770 patients and analyzed 509 patients. The rates in the mechanical thrombectomy-only, PTA, and stent deployment groups were 40.7%, 44.4%, and 14.9%, respectively. Incidence rate of residual stenosis >70% of final angiography was significantly higher in the mechanical thrombectomy-only group than in the PTA and stent deployment groups (mechanical thrombectomy-only versus PTA versus stent deployment: 34.5% versus 26.3% versus 13.2%, P = .002). Reocclusion rate was significantly lower in the PTA group than in the mechanical thrombectomy-only group (adjusted hazard ratio, 0.48; 95% CI, 0.29–0.80). Of the patients, 83.5% experienced reocclusion within 10 days after endovascular therapy. Alarmingly, a substantial subset (approximately 62.0%) of patients experienced reocclusion within 2 days of endovascular therapy. Incidence of mRS scores of 0–2 ninety days after endovascular therapy was not significantly different among the 3 groups. Incidences of symptomatic intracranial hemorrhage, any other intracranial hemorrhage, and death were not significantly different.

CONCLUSIONS:

Incidence rate of reocclusion was significantly lower in the PTA group than in the mechanical thrombectomy-only group. We found no meaningful difference in reocclusion rates between the stent deployment and mechanical thrombectomy-only groups. In Japan, glycoprotein IIb/IIIa inhibitors are not reimbursed. Therefore, PTA might be the preferred choice for AT-LVOs due to the higher reocclusion risk with mechanical thrombectomy-only. Reocclusion was likely to occur within 10 days, particularly within 2 days post-endovascular therapy.

BACKGROUND AND PURPOSE:

Prediction of aneurysm instability is crucial to guide treatment decisions and to select appropriate patients with unruptured intracranial aneurysms (IAs) for preventive treatment. High-resolution 4D MR flow imaging and 3D quantification of aneurysm morphology could offer insights and new imaging markers for aneurysm instability. In this cross-sectional study, we aim to identify 4D MR flow imaging markers for aneurysm instability by relating hemodynamics in the aneurysm sac to 3D morphologic proxy parameters for aneurysm instability.

MATERIALS AND METHODS:

In 35 patients with 37 unruptured IAs, a 3T MRA and a 7T 4D MRI flow scan were performed. Five hemodynamic parameters—peak-systolic wall shear stress (WSS_MAX) and time-averaged wall shear stress (WSS_MEAN), oscillatory shear index (OSI), mean velocity, and velocity pulsatility index—were correlated to 6 3D morphology proxy parameters of aneurysm instability—major axis length, volume, surface area (all 3 size parameters), flatness, shape index, and curvedness—by Pearson correlation with 95% CI. Scatterplots of hemodynamic parameters that correlated with IA size (major axis length) were created.

RESULTS:

WSS_MAX and WSS_MEAN correlated negatively with all 3 size parameters (strongest for WSS_MEAN with volume (r = –0.70, 95% CI –0.83 to –0.49) and OSI positively (strongest with major axis length [r = 0.87, 95% CI 0.76–0.93]). WSS_MAX and WSS_MEAN correlated positively with shape index (r = 0.61, 95% CI 0.36–0.78 and r = 0.49, 95% CI 0.20–0.70, respectively) and OSI negatively (r = –0.82, 95% CI –0.9 to –0.68). WSS_MEAN and mean velocity correlated negatively with flatness (r = –0.35, 95% CI –0.61 to –0.029 and r = –0.33, 95% CI –0.59 to 0.007, respectively) and OSI positively (r = 0.54, 95% CI 0.26–0.74). Velocity pulsatility index did not show any statistically relevant correlation.

CONCLUSIONS:

Out of the 5 included hemodynamic parameters, WSS_MAX, WSS_MEAN, and OSI showed the strongest correlation with morphologic 3D proxy parameters of aneurysm instability. Future studies should assess these promising new imaging marker parameters for predicting aneurysm instability in longitudinal cohorts of patients with IA.

Over the past decades the zebrafish has emerged as an excellent model organism with which to study the biology of all glial cell types in nervous system development, plasticity, and regeneration. In this review, which builds on the earlier work by Lyons and Talbot in 2015, we will summarize how the relative ease to manipulate the zebrafish genome and its suitability for intravital imaging have helped understand principles of glial cell biology with a focus on oligodendrocytes, microglia, and astrocytes. We will highlight recent findings on the diverse properties and functions of these glial cell types in the central nervous system and discuss open questions and future directions of the field.

Central sleep apnoea (CSA) is characterised by recurrent episodes of airway cessation or reduction in the absence of respiratory effort. Although CSA is less common than obstructive sleep apnoea, it shares similar symptoms. CSA can be secondary to various medical conditions, high altitude and medication exposure. CSA can also emerge during obstructive sleep apnoea therapy. There are a range of treatment options and selecting the right therapy requires an understanding of the pathophysiology of CSA. This review explores the aetiology, pathophysiology and clinical management of non-hypercapnic CSA.

Why are there so many VPNs for Apple TV? Oh, right—geofencing.

Outgoing firm Principal Service Solutions says incoming staffing agency Manpower may bring the workers back.

Ça va mal pour Sidney Crosby et ses coéquipiers.

Amoury Lapointe a résisté à son arrestation lors d’une intervention de routine à laquelle il refusait de se soumettre dans son «véhicule diplomatique»

The National Accreditation Board for Testing and Calibration Laboratories (NABL), under the Quality Council of India (QCI), has announced a collaborative effort with Man─Made Textile Research Association (MANTRA) in Surat to deliver a specialized technical training programme on medical textiles testing.

Nick Guerin, CSP, director of environmental, health & safety at Tessy Plastics highlights how contract manufacturers are driving sustainability in the medical plastics industry.

This week, I’m rerunning some popular posts while we put the finishing touches on DCI’s new 2024-25 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Click here to see the original post from June 2024.

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The 340B contract pharmacy market shows little sign of slowing down. Drug Channels Institute’s exclusive analysis of the 2024 market reveals that:Read more »

Informa Connect’s PBM Contracting Summit
December 10-11, 2024 | Chicago, IL
Drug Channels readers save 10% with code 24DRCH10*

Experts from across the US come together each year at the PBM Contracting Summit to gain innovative and practical contracting strategies, master PBM innovation and design, improve patient care management and rising costs, understand the current legislative issues impacting contract negotiations and more. Join us in Chicago (or virtually) where you’ll benefit from two days of learning, education and networking, and will return to the office having mastered the complex PBM landscape.

You’ll hear from Matthew Gibbs, Pharm.D., Pharmacy Transformation Leader of Blue Shield of California as he leads a comprehensive discussion on the PBM landscape over the last year, and delves into the evolving trends and emerging challenges shaping the current industry today.

Other expert and thought leaders from within the industry are slated to present deep dive sessions, workshops and panels that will answer your most pressing questions:

• What are the latest legislative updates and proposed federal bills impacting PBM operations?
• What's on the horizon for alternative PBMs? What are the top intricacies of rebate eligibility? What are the market impacts of innovative models such as Mark Cuban's Cost Plus Drugs and Amazon's pharmacy model?
• What can be learned from the J&J lawsuit? Review the expansion of data access and the importance of employer's fiduciary duties.
• What are the challenges of vertical integration?
• How do PBMs manage their contracting processes with plan sponsors to create successful contracts?
• What are the most effective strategies for spread pricing and reimbursement models?
• What is the best solution to navigate the challenges of the 340B drug pricing program and PBM contracting?
• What is the best way to design and optimize benefits for covering GLP-1s?
• How can I ensure compliance with ERISA requirements?
• What are the latest developments in copay maximizer and accumulator programs?
• What market dynamics and barriers are impacting pricing and demand?
• What can be learned from the economic landscape of biosimilars and specialty therapeutics?
• And much more!

View the agenda for the PBM Contracting Summit to see the complete picture – the program, speakers, and more, visit www.informaconnect.com/pbm-contracting for further details and to register. Drug Channels readers will save 10% off when they use code 24DRCH10 and register prior to November 8, 2024.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates or other offers. Other restrictions may apply.

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The content of Sponsored Posts does not necessarily reflect the views of HMP Omnimedia, LLC, Drug Channels Institute, its parent company, or any of its employees. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@DrugChannels.net).

Consultations on the reclassification of two progestogen-only contraceptive pills from prescription-only to pharmacy medicines have been launched.

Venture creation in biotech is witnessing a sustained contraction. After the pandemic bubble’s over-indulgence, the venture ecosystem appears to have reset its pace of launching new startups. According to the latest Pitchbook data, venture creation in biotech hit its slowest

The post The Biotech Startup Contraction Continues… And That’s A Good Thing appeared first on LifeSciVC.

Pharmaceutical and biotech companies breathed a sigh of relief Monday when the Federal Circuit unanimously ruled in a precedential opinion that the mere sale of manufacturing services to create embodiments of a patented product is not a “commercial sale” of the invention that triggers the on-sale bar of 35 U.S.C. § 102(b) (pre-AIA).[1]  The en banc opinion...… Continue Reading

Waiting 30 Seconds Spanish

GOVERNMENT OF INDIA MINISTRY OF FINANCE DEPARTMENT OF REVENUENotification No. 26/2024-Central Excise New Delhi, the 23rd October, 2024.G.S.R........... (E). -In exercise of the powers conferred by

GOVERNMENT OF INDIAMINISTRY OF FINANCE (DEPARTMENT OF REVENUE)Notification No.27/2024-Central ExciseNew Delhi, the 28th October, 2024G.S.R.(E)...–In exercise of the powers conferred by sub-section(1) o

Probability of operating an alarm clock

Creating the food systems that people want & need across Central Asia will depend in part on how water is managed under climate uncertainty.

The post Innovations and smart water technologies key to food systems transformation in Central Asia first appeared on International Water Management Institute (IWMI).

In 2020, one in every four consultations from women was for sexual and reproductive health, and seemed to be the top consulted specialty online, according to insights from Practo.

bThe Human Contraception Antibody (HCA) is the new safe contraception method that stops sperm movement and also prevent from sexually transmitted infections/b.

Multiple sclerosis (MS) is a potentially disabling disease of the central nervous system in which the immune system attacks the protective sheath myelin that covers the nerve fibers.

A potential connection has been found between certain Gastrointestinal (GI) syndromes and the formation and rupture of intracranial (brain) aneurysms,

The visit for water professionals from South Asia laid the groundwork for furthering dialogue on transboundary river management for water security.

The post IWMI and GWP promote water cooperation through a study tour to Central Asia first appeared on International Water Management Institute (IWMI).

The visit for water professionals from South Asia laid the groundwork for furthering dialogue on transboundary river management for water security.

The post IWMI and GWP promote water cooperation through a study tour to Central Asia first appeared on International Water Management Institute (IWMI).

Male contraceptive drugs DMAU and 11 beta-MNTDC effectively reduce testosterone without causing unacceptable side effects, says a new study. The

Comprehensive systematic research spanning almost 50 years and 25 research finds a strong correlation between insecticide exposure such as organophosphates

medlinkAIDS/medlink-related deaths (!--ref1--) have decreased worldwide, except in Eastern Europe and Central Asia. According to the latest UNAIDS

Cogdell Spencer ERDMAN(SM) Announces New Contract in the Northwest Region

U.S. FDA Approves Natazia(TM), a New Oral Contraceptive for the Prevention of Pregnancy

MedAvante Opens Moscow Office and Successfully Completes First Centralized Ratings Assessment

FDA Approves New Combination Product Oral Contraceptive

1 in 10 Medicaid patients receive long-acting birth control methods such as IUDs and implants from their primary care physicians, revealed study published in iJAMA Health Forum.

Ramesh Babu emphasizes the transformative potential of decentralized identity solutions. By empowering individuals and reducing dependence on centralized entities, these systems promise a secure, private, and user-centric approach.

Karnataka government's alleged Muslim reservation proposal sparks controversy ahead of bypolls, but Chief Minister's Office denies the reports entirely.

:

The Appellant filed an (online/offline) RTI application dated 06.04.2023 seeking the following information:

"1. Please provide the below information of under all Railway Zones of Indian Railways on all India basis.

S.No Name of the Full postal Address Name of the Telephone/Mo Email ID of Railway with PIN code of officer bile Nos. of the the Unions/Mazdoor the Railway Bearers and Officers Railway Sanghs/Associati Union/Mazdorr Designations bearers Unions/Ma ons Sanghs/Association zdoor s Sanghs/As sociations

:

The Appellant filed an (online/offline) RTI application dated 06.04.2023 seeking the following information:

"1. Please provide the below information of under all Railway Zones of Indian Railways on all India basis.

S.No Name of the Full postal Address Name of the Telephone/Mo Email ID of Railway with PIN code of officer bile Nos. of the the Unions/Mazdoor the Railway Bearers and Officers Railway Sanghs/Associati Union/Mazdorr Designations bearers Unions/Ma ons Sanghs/Association zdoor s Sanghs/As sociations

Heard both sides.

https://www.mhc.tn.gov.in/judis

2. The Petitioner is the State Bank of India represented by its Branch Manager at their Zonal Office, Trichirappalli. Aggrieved by the common award passed by the First Respondent Central Government Industrial Tribunal (CGIT) at Chennai made in I.D.No.22 to 25 of 2007 dt. 27.7.2010 these writ petitions were filed by them.

3. The 1st Respondent CGIT by its Common Award granted the following relief to the 2nd Respondent workmen in all the WPs:-

“In the result all the petitioners in ID 22/2007, 23/2007, 24/2007 and ID 25/2007 are entitled to be reinstated into service forthwith with continuity of service and all attendant benefits but they are not entitled to back-wages for the whole period during which they remained out of employment of Respondent. After reinstatement into service the Management may start a process for the regularization of the workmen if and in accordance with the rules in vogue they are entitled to the same.”

The foreclosure crisis, while healing, is still ongoing in many parts of the country where homeowners are predominately black or populated by other minority groups.

The exam dates for Central Universities Common Entrance Test (CUCET 2016) has been announced recently. CUCET 2016 is held jointly by the Central Universities of Haryana, Jammu, Jharkhand, Kashmir, Karnataka, Kerala, Punjab, Rajasthan and Tamil Nadu. CUCET is held for admissions

The procedure for seeking admission to MBA, MCA, and M.E/ M.Tech/ M.Arch./ M.Plan. Degree programs for the academic year 2017-2018 consist of the following two steps: Appearing for the Tamil Nadu Common Entrance Test (TANCET) 2017 in March 2017.  Applying

NIFT 2023 Result: The National Institute of Fashion Technology ( NIFT ) 2023 result is link is activated on the official website of NIFT. The entrance examination was held for admission to the UG and PG programmes in 2023 academic year.

Manchester : Manchester University Press, [2018]