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Vestibular Schwannoma International Study of Active Surveillance Versus Stereotactic Radiosurgery: The VISAS Study. Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)00482-6. [PMID: 38588868 DOI: 10.1016/j.ijrobp.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/23/2024] [Accepted: 04/02/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE The present study assesses the safety and efficacy of stereotactic radiosurgery (SRS) versus observation for Koos grade 1 and 2 vestibular schwannoma (VS), benign tumors affecting hearing and neurological function. METHODS AND MATERIALS This multicenter study analyzed data from Koos grade 1 and 2 VS patients managed with SRS (SRS group) or observation (observation group). Propensity score matching balanced patient demographics, tumor volume, and audiometry. Outcomes measured were tumor control, serviceable hearing preservation, and neurological outcomes. RESULTS In 125 matched patients in each group with a 36-month median follow-up (P = .49), SRS yielded superior 5- and 10-year tumor control rates (99% CI, 97.1%-100%, and 91.9% CI, 79.4%-100%) versus observation (45.8% CI, 36.8%-57.2%, and 22% CI, 13.2%-36.7%; P < .001). Serviceable hearing preservation rates at 5 and 9 years were comparable (SRS 60.4% CI, 49.9%-73%, vs observation 51.4% CI, 41.3%-63.9%, and SRS 27% CI, 14.5%-50.5%, vs observation 30% CI, 17.2%-52.2%; P = .53). SRS were associated with lower odds of tinnitus (OR = 0.39, P = .01), vestibular dysfunction (OR = 0.11, P = .004), and any cranial nerve palsy (OR = 0.36, P = .003), with no change in cranial nerves 5 or 7 (P > .05). Composite endpoints of tumor progression and/or any of the previous outcomes showed significant lower odds associated with SRS compared with observation alone (P < .001). CONCLUSIONS SRS management in matched cohorts of Koos grade 1 and 2 VS patients demonstrated superior tumor control, comparable hearing preservation rates, and significantly lower odds of experiencing neurological deficits. These findings delineate the safety and efficacy of SRS in the management of this patient population.
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Impact of Multiple Sclerosis Subtypes on Pain Management in Patients With Trigeminal Neuralgia After Stereotactic Radiosurgery: An International Multicenter Analysis. Neurosurgery 2024; 94:838-846. [PMID: 38051068 DOI: 10.1227/neu.0000000000002790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/17/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Trigeminal neuralgia affects approximately 2% of patients with multiple sclerosis (MS) and often shows higher rates of pain recurrence after treatment. Previous studies on the effectiveness of stereotactic radiosurgery (SRS) for trigeminal neuralgia did not consider the different MS subtypes, including remitting relapsing (RRMS), primary progressive (PPMS), and secondary progressive (SPMS). Our objective was to investigate how MS subtypes are related to pain control (PC) rates after SRS. METHODS We conducted a retrospective multicenter analysis of prospectively collected databases. Pain status was assessed using the Barrow National Institute Pain Intensity Scales. Time to recurrence was estimated through the Kaplan-Meier method and compared groups using log-rank tests. Logistic regression was used to calculate the odds ratio (OR). RESULTS Two hundred and fifty-eight patients, 135 (52.4%) RRMS, 30 (11.6%) PPMS, and 93 (36%) SPMS, were included from 14 institutions. In total, 84.6% of patients achieved initial pain relief, with a median time of 1 month; 78.7% had some degree of pain recurrence with a median time of 10.2 months for RRMS, 8 months for PPMS, 8.1 months for SPMS ( P = .424). Achieving Barrow National Institute-I after SRS was a predictor for longer periods without recurrence ( P = .028). Analyzing PC at the last available follow-up and comparing with RRMS, PPMS was less likely to have PC (OR = 0.389; 95% CI 0.153-0.986; P = .047) and SPMS was more likely (OR = 2.0; 95% CI 0.967-4.136; P = .062). A subgroup of 149 patients did not have other procedures apart from SRS. The median times to recurrence in this group were 11.1, 9.8, and 19.6 months for RRMS, PPMS, and SPMS, respectively (log-rank, P = .045). CONCLUSION This study is the first to investigate the relationship between MS subtypes and PC after SRS, and our results provide preliminary evidence that subtypes may influence pain outcomes, with PPMS posing the greatest challenge to pain management.
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Clinical Outcomes and Patterns of Failure in Patients with High-Risk Atypical Meningioma Treated with Single Fraction vs. Hypofractionated Gamma Knife Radiosurgery. Int J Radiat Oncol Biol Phys 2023; 117:e156-e157. [PMID: 37784745 DOI: 10.1016/j.ijrobp.2023.06.982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The recently completed RTOG 0539 supports fractionated radiation therapy for patients categorized as having intermediate (3 yr PFS 93.8%) or high-risk (3 yr LC 68.9%) meningiomas. Stereotactic radiosurgery (SRS) has not been widely established in the treatment of WHO grade 2 atypical meningiomas given concern that there is a greater risk of microscopic infiltration and therefore requires larger margins than safely achievable with SRS. We look to review a consecutive cohort of patients at our institution who have been diagnosed with atypical meningioma treated with either single fraction Gamma Knife SRS (GK-sfSRS) or hypofractionated Gamma Knife SRS (GK-hfSRS). We review both control rates and patterns of failure. MATERIALS/METHODS Patients diagnosed with intermediate or high-risk WHO grade 2 meningioma per RTOG 0539 classification, without a history of prior radiation (RT) and treated with either GK-sfSRS or GK-hfSRS between 2014 to 2021 at our institution, were included. Patient charts were reviewed, and follow-up data were analyzed for local control (LC) and failure patterns. Local failure was defined as tumor recurrence within the prescription isodose line, marginal was ≤5 mm outside the prescription isodose line, and distant was >5 mm outside of the prescription isodose line Primary outcome was LC, and secondary outcomes were overall survival (OS) and progression free survival (PFS). RESULTS We identified 47 pathologically confirmed WHO grade 2 meningiomas in 27 patients. 33 lesions were treated with GK-sfSRS and 14 lesions with GK-hfSRS. 6 lesions were intermediate risk, and 41 were high-risk per RTOG 0539. With a median follow up of 36 months (range 2-86 mo), the 3yr LC was 82.7%, PFS was 83.1%, and OS was 96.3%. A total of 4 patients with 8 lesions failed treatment - all with high-risk disease. All failures were local (4) or marginal (4). The 4 local failures were all from a single patient with 4 distinct meningiomas that were treated with GK-sfSRS without surgical resection. The 4 marginal failures were all in patients treated with GK-sfSRS. There were no failures in patients treated with GK-hfSRS. CONCLUSION Our institutional data for patients with atypical meningiomas treated with radiosurgical techniques compare favorably to the patients treated with EBRT in RTOG 0539, though longer follow-up is needed to confirm these findings. Outside of one patient, no patients developed recurrence within the prescription volume. There were 4 tumors with marginal failures, suggesting that additional dural margins than what were prescribed may be meaningful. At our institution, we are increasingly moving to hypofractionated radiosurgery with 5 mm of dural margin when using radiosurgical techniques for high-risk atypical meningioma. However, longer term follow-up is needed to validate the use of radiosurgical techniques in atypical meningioma.
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Laparoscopic Versus Open Ventriculoperitoneal Shunt Placement: A Non-inferiority Study. J Clin Neurosci 2023; 115:24-28. [PMID: 37459828 DOI: 10.1016/j.jocn.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/05/2023] [Indexed: 08/23/2023]
Abstract
Ventriculoperitoneal shunt (VPS) insertion into the abdominal cavity had been done for decades via an open approach. Recently, the laparoscopic insertion of the peritoneal portion of the shunt has become an option. The aim of this study is to compare outcomes between these two approaches. We performed a single institution retrospective review of 104 consecutive adult patients between 2015 and 2017. Patients had peritoneal catheters placed either via an open approach by the neurosurgical team, or laparoscopically by general surgeons. Patient demographics and outcomes were compared using a non-inferiority analysis. Independent variables in the analysis included patient age, gender, race, BMI, surgery performed, previous VPS placement, previous abdominal procedures, and VPS indication, while dependent variables included length of stay (LOS), estimated blood loss (EBL), occurrence of shunt failure, and postoperative complications. Cohort analysis included 62 open and 42 laparoscopic cases with similar baseline characteristics. In terms of patient outcomes, EBL and hospital stay duration were shown to be non-inferior in the open group as compared to the laparoscopic group. We could not prove non-inferiority based on risk for overall or distal shunt failure. Neurosurgeons may reasonably continue to place peritoneal shunt catheters using a "traditional" method.
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Let's make size not matter: tumor control and toxicity outcomes of hypofractionated Gamma Knife radiosurgery for large brain metastases. J Neurooncol 2023; 163:587-595. [PMID: 37410346 DOI: 10.1007/s11060-023-04365-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/06/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE Management of patients with large brain metastases poses a clinical challenge, with poor local control and high risk of adverse radiation events when treated with single-fraction stereotactic radiosurgery (SF-SRS). Hypofractionated SRS (HF-SRS) may be considered, but clinical data remains limited, particularly with Gamma Knife (GK) radiosurgery. We report our experience with GK to deliver mask-based HF-SRS to brain metastases greater than 10 cc in volume and present our control and toxicity outcomes. METHODS Patients who received hypofractionated GK radiosurgery (HF-GKRS) for the treatment of brain metastases greater than 10 cc between January 2017 and June 2022 were retrospectively identified. Local failure (LF) and adverse radiation events of CTCAE grade 2 or higher (ARE) were identified. Clinical, treatment, and radiological information was collected to identify parameters associated with clinical outcomes. RESULTS Ninety lesions (in 78 patients) greater than 10 cc were identified. The median gross tumor volume was 16.0 cc (range 10.1-56.0 cc). Prior surgical resection was performed on 49 lesions (54.4%). Six- and 12-month LF rates were 7.3% and 17.6%; comparable ARE rates were 1.9% and 6.5%. In multivariate analysis, tumor volume larger than 33.5 cc (p = 0.029) and radioresistant histology (p = 0.047) were associated with increased risk of LF (p = 0.018). Target volume was not associated with increased risk of ARE (p = 0.511). CONCLUSIONS We present our institutional experience treating large brain metastases using mask-based HF-GKRS, representing one of the largest studies implementing this platform and technique. Our LF and ARE compare favorably with the literature, suggesting that target volumes less than 33.5 cc demonstrate excellent control rates with low ARE. Further investigation is needed to optimize treatment technique for larger tumors.
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Impact of domiciliary pharmacy visits on medication management in an elderly population. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2011. [DOI: 10.1111/j.2042-7174.1997.tb00895.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
This paper describes medication management by elderly patients living in their own homes, and the effects of patient counselling during five domiciliary pharmacy visits on patient compliance and medication management. The 190 subjects who completed the 12-month study were randomly allocated to either an intervention group (receiving counselling on the correct use and storage of their drugs during five domiciliary visits), a control (V) group (receiving visits but no counselling), or a control (NV) group (having no contact between an initial visit and the end of the study). The patients' drug knowledge, dexterity and cognitive functioning were assessed, and patients in all three groups were well matched at baseline. At each follow-up visit, patient compliance was measured using pill counts and interviews. After the initial visit, patients in the intervention group demonstrated better compliance, better drug storage practices and a reduced tendency to hoard drugs, and required fewer GP consultations, than patients in either of the control groups. The provision of the domiciliary pharmacy service was effective in detecting drug-related problems in a potentially high risk patient group. The effectiveness of such a service may be improved by increased transfer of patient information between community pharmacists and general medical practitioners.
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Attitudes of pharmacists, medical practitioners and nurses towards the development of domiciliary and other community pharmacy services. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2011. [DOI: 10.1111/j.2042-7174.1994.tb00768.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract
Surveys were undertaken to determine both the current extent of provision of non-dispensing services by community pharmacists, and pharmacists' attitudes, together with those of medical practitioners and district/practice nurses, towards the development of domiciliary and other community pharmacy services. Five out of a list of 10 professional services were available on the premises in the majority of pharmacies. Approximately 65 per cent of pharmacists undertook prescription collection and medicine delivery and 43 per cent provided domiciliary patient counselling at least once a week. Medical practitioners and nurses expressed high levels of support for the majority of the established services; the exceptions were blood pressure testing and cholesterol monitoring for both of which only 30 per cent of each group were in favour. Most pharmacists were willing, in principle, to train for and to provide a domiciliary service which would include counselling on the use and storage of medicines and the supply or fitting of appliances; support for these services was high among medical practitioners and nurses (85–88 per cent). The proportions of pharmacists who were willing, after training, to provide domiciliary management of total parenteral nutrition, pain control and chemotherapy were 68, 85 and 36 per cent, respectively, but medical practitioners and nurses generally were not in favour of these extended roles. The length of professional registration and frequency of contact with pharmacists were both factors which significantly influenced the level of support by medical practitioners but not by nurses.
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Protecting America. The top 10 priorities. NEWSWEEK 2001; 139:26-40. [PMID: 11710159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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IV. Genes, cells, drugs. Cures for the future. Fountains of youth. NEWSWEEK 2001; 138:84-6. [PMID: 11586859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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IV. Genes, cells, drugs. Cures for the future. New DNA in old bodies. NEWSWEEK 2001; 138:82-3. [PMID: 11586858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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I. The body, the brain, hormones. The brain in winter. NEWSWEEK 2001; 138:24-6, 28-9. [PMID: 11586844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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War on terror: biochem. Tracking anthrax. NEWSWEEK 2001; 138:36-9. [PMID: 11699428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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War on terror. Anxious about anthrax. NEWSWEEK 2001; 138:28-35. [PMID: 11682908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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In search of stem cells. NEWSWEEK 2001; 138:57. [PMID: 11558353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Did the President go far enough? NEWSWEEK 2001; 138:20-1. [PMID: 11572200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Trials--and errors. NEWSWEEK 2001; 138:38-42. [PMID: 11499274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Medicine. Dying for science. NEWSWEEK 2001; 138:36. [PMID: 11499246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Evolution. Bickering over old bones. NEWSWEEK 2001; 138:40. [PMID: 11499162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Memory's mind games. NEWSWEEK 2001; 138:52-4. [PMID: 11471439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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Cellular divide. NEWSWEEK 2001; 138:22-7. [PMID: 11460431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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Made-to-order medicine. NEWSWEEK 2001; 137:64-6, 68-9. [PMID: 11436376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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AIDS at 20. NEWSWEEK 2001; 137:34-7. [PMID: 11409053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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Religion and the brain. NEWSWEEK 2001; 137:50-7. [PMID: 11357807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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Are we getting smarter? NEWSWEEK 2001; 137:50-1. [PMID: 11338628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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The new old man. NEWSWEEK 2001; 137:46-7. [PMID: 11299714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Culture club. NEWSWEEK 2001; 137:48-50. [PMID: 11276913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Your child--learning. Wired for thought. NEWSWEEK 2001; 136:24-6, 28-30. [PMID: 11184684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
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Showdown in the DNA corral. NEWSWEEK 2001; 137:62. [PMID: 11234120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Solving the next genome puzzle. Identifying all our DNA was the easy part. Now, bring on the proteome. NEWSWEEK 2001; 137:52-3. [PMID: 11225091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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How it all starts inside your brain. NEWSWEEK 2001; 137:40-2. [PMID: 11246720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Searching for the God within. NEWSWEEK 2001; 137:59. [PMID: 11201273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Brave new monkey. NEWSWEEK 2001; 137:50-2. [PMID: 11196296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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The stereotype trap. NEWSWEEK 2000; 136:66-8. [PMID: 11185322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Cloning the endangered. NEWSWEEK 2000; 136:56-7. [PMID: 11184809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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The science of laughs. NEWSWEEK 2000; 136:75-6. [PMID: 11184538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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The drug charade. NEWSWEEK 2000; 136:42-5. [PMID: 11067259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Music on the mind. Scientists are finding that the human brain is prewired for music. Could this sublime expression of culture be as much about biology as art? NEWSWEEK 2000; 136:50-2. [PMID: 10977656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
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Stop blaming your genes. A new study shows that environment matters more than genetics in determining whether you get cancer. NEWSWEEK 2000; 136:53. [PMID: 10977657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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What families should do. Helping children lose weight means walking an emotional tightrope. How, and when, to step in. NEWSWEEK 2000; 136:44-7. [PMID: 10977314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Mind expansion: inside the teenage brain. NEWSWEEK 2000; 135:68. [PMID: 10915522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Decoding the human body. NEWSWEEK 2000; 135:50-7. [PMID: 10847893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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The nature of nurturing. A new study finds that how parents treat a child can shape which of his genes turn on. NEWSWEEK 2000; 135:64-6. [PMID: 10788148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Getting inside a teen brain. Hormones aren't the only reason adolescents act crazy. Their gray matter differs from children's and adults'. NEWSWEEK 2000; 135:58-9. [PMID: 10787984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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10 million orphans. For the children who have lost their parents to AIDS, grief is only the beginning of their troubles. The disease's lasting victims. NEWSWEEK 2000; 135:42-5. [PMID: 10787979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Rewiring your gray matter. The brain: you can teach an old brain new tricks. Neuroplasticity promises to give a whole new meaning to 'changing your mind'. NEWSWEEK 2000; 134:63-5. [PMID: 10848178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Abstract
A 57-year-old man with no previous medical history entered the emergency department with 2 days of painless vision loss in the left eye. The patient was diagnosed with central retinal vein occlusion (CRVO) and admitted for treatment. Further work-up revealed that the cause of his CRVO was a hyperviscosity syndrome secondary to multiple myeloma. The patient received two rounds of plasmapheresis with slight recovery of vision and was discharged 28 days later.
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Shaped by life in the womb. NEWSWEEK 1999; 134:50-7. [PMID: 10620972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Eying the fetal future. In the shadows, a controversial search for cures. NEWSWEEK 1998; 132:54-5. [PMID: 10338865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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From human embryos, hope for 'spare parts'--but research renews debate over use of fetal cells. NEWSWEEK 1998; 132:73. [PMID: 10187097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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The nursery's littlest victims. Hundreds of cases of 'crib death,' or SIDS, may in fact be infanticide. NEWSWEEK 1997; 130:72-3. [PMID: 10173264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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