Biography:

Iulia Karlsson has completed her PhD in Medical Biosciences at the age of 29 years from Swedish pharmaceutical company and works today as Regulatory Affairs Specialist and Head of Companion Diagnostics and Biomarker Development at Double Bond Pharmaceutical, an innovative pharmaceutical company founded in 2014 in Sweden. She has extensive experience in clinical studies both in human and veterinary medicine and a profound knowledge in human biology. 

Abstract:

INTRODUCTION: The efficacy of the local chemotherapeutical drug Temodex, constituted of temozolomide as active pharmaceutical ingredient and dextran phosphate as carrier, was studied in a phase II clinical trial.

AIM: To assess whether Temodex improves the standard of care treatment (Stupp) for patients with operable neuroepithelial brain tumors when administered into the cavity formed after tumor resection.

METHODS: An open, controlled, comparative, retro-prospective study with overall survival (OS) as primary endpoint. Totally 95 patients with Grade II-IV glioma were included in the control group and 41 in the Temodex group.

RESULTS: Median OS of patients with highly malignant, Grade III-IV, tumors was significantly improved in the Temodex group compared to control group (14.4 vs 9.1 months, respectively, p=0.0001). Median OS for all patients (Grade II-IV) in the Temodex group was 8.5 months longer compared to control (p=0.0001). Median PFS of patients with Grade III-IV tumors was 13.6 months in the Temodex group compared to 7.8 months in control (p=0.0001). Median PFS in patients with Grade IV tumors in the Temodex group was 12.9 months compared to 7.2 months in control (p=0,0001). One-year cumulative survival ratio of patients with Grade III-IV tumors was 51.9% higher in Temodex group compared to control  (p=0.0001). At the time of the latest analysis, 74.4% patients in Temodex and 94.4% patients in the control groups had died.

CONCLUSION: The current study of Temodex efficacy in combination with adjuvant chemo-radiotherapy against Grade II-IV tumors demonstrates an increase in both median OS as well as in median PFS.

Biography:

I am a qualified neurosurgeon with a background of 5 years of training and 4 years of practice as a neurosurgery specialty doctor, now working as a Neuro-oncology Neurosurgery Fellow at the Imperial College of London – Imperial College NHS Trust.

Our group’s research is focused on: 1) implementation of new technologies in neurosurgery to improve both diagnosis and treatment of brain tumours; 2) molecular pathways in brain tumours; 3) improving neurological and neuro-cognitive assessment in patients with brain tumours.

Abstract:

Statement of the problem: Resection and biopsy of brain gliomas is challenging. Extent of resection has been proven to be an independent prognostic factor to predict both progression free survival and overall survival, but tumour margins are often hard to identify, and intraoperative targeting areas of suspected high grade components might be difficult only basing on pre-operative imaging. We previously explored role of intra-operative 3D US on intrinsic brain tumours resection, and the possibility of combining pre-operative spectroscopy MRI scan and PET with neuronavigation in order to target high grade areas. We have now investigated role of a new diagnostic tool, the iKnife, in combination with 3D US technology.

Methodology and theoretical orientation. Twenty-five patients diagnosed with suspected gliomas were treated with intraoperative use of 3D US and iKnife. Data were collected regarding extent of resection based on 3D US finding and targeting of the high grade components as defined by neuronavigation data, iknife results, and histological analysis according to WHO classification.

Findings. Use of 3D US was confirmed to be helpful in terms of tumour resection and verifying real-time changes. Both ultrasound and iknife data both showed areas within a transforming tumour that corresponded with a higher cell count and mitotic index on histology. iKnife use is technique and operator dependant, needing a strictly standardized protocol to obtain reproducible results. 

Conclusions and significance. Intraoperative 3D US confirmed to be an extremely useful tool to both identify margins of resection and account for real time intraoperative changes. iKnife data were closely related to histological analysis, thus encouraging further data collection and studies to prove their efficacy and reliability.

Biography:

Dr. Arshad Zaman is an experienced neuro specialist with over 15 years’ experience in developing and clinically applying functional Magnetic Resonance Imaging (fMRI) at international centers of excellence. Previous studies encompass a spectrum of clinical applications (epilepsy, oncology) to state-of-the-art applications (e.g. pain relief, mental health, brain training). Current commitments centre around further development and clinical utilisation of fMRI.  

Abstract:

Functional magnetic resonance imaging (fMRI) allows non-invasive assessment of human brain function in vivo by detecting blood flow differences. From a powerful research tool actively utilised in cognitive neuroscience, clinical fMRI has evolved and matured into a robust clinical tool, implemented with a wide spectrum of patients. In this study, we further push the limits of this unique tool with paediatric patients. The purpose of this study is to present the experience of a large teaching hospital centre in the utility of clinical fMRI in a paediatric cohort and in particular focusing on the typical problems, pitfalls, solutions and benefits.  

Twenty children (5 - 16 years) underwent fMRI, over a period of 2 years, as part of the regional epilepsy pre-surgical evaluation programme. fMRI was performed on a 3T Philips scanner. Some of the children additionally underwent DTI (tractography). Paediatric dedicated fMRI paradigms consisted of motor, sensorimotor, visual, auditory, memory and speech tasks. In some cases we also compared pre- and postoperative fMRI. MRI image analysis was performed using SPM12.
In all cases, fMRI successfully revealed activation of the desired eloquent cortical territories. Speech and memory fMRI was challenging for some of the younger children in our cohort. Numerous cases successfully revealed evidence of neuroplasticity.

fMRI can be successfully applied in children and holds significant promise for both research and clinical purposes. Using dedicated paediatric protocols and paradigms can result in a more effective and successful clinical fMRI investigation. fMRI allows more accurate assessment of cortical resection margins and can determine if surgery is best performed with the patient awake or asleep. Clinical fMRI has significant potential to replace Wada for this challenging age group. Fusion of fMRI and DTI yields further useful clinical information in relevant cases.

Biography:

Abstract:

Stroke is the third leading cause of death and a leading cause of acquired disability.  It is divided into ischemic and haemorrhagic.  Ischaemic strokes are devided themselves according to territory affected or the causing mechanism. Knowledge of the pathophysiologic mechanisms of neuronal injury in stroke is essential to target treatment.

The goals of an imaging evaluation for acute stroke are to establish a diagnosis as early as possible and to obtain accurate information about the intracranial vasculature and brain perfusion for guidance in selecting the appropriate therapy.

A comprehensive overview including the current radiological investigations and their implications will be discussed , for example:  CT angiography can depict intravascular thrombi,  Diffusion-weighted MR imaging helps in detection of hyperacute ischemia.  Gradient-echo MR sequences is helpful in detecting a hemorrhage.

The status of neck and intracranial vessels can be evaluated with MR angiography, and a mismatch between findings on diffusion and perfusion MR images may be used to predict the presence of a penumbra.

Biography:

Abstract:

Currently there are no uniform standard treatments for newborn suffering from cerebral hypoxia-ischemia (HI) and to find new and effective strategies for treating the HI injury remains a key direction for future research. Present study was designed to demonstrate that optimal dose (1 or 3%) of Creatine monohydrate (Cr) for the treatment of neonatal HI in female albino mice. On postnatal day 10, animals were subjected to left carotid artery ligation followed by 8% hypoxia for 25 minutes. Following weaning on postnatal day 20, mice were divided into three treatments on the basis of diet supplementation (Normal rodent diet, 1% and 3% creatine supplemented diet) for 10 week. A battery of neurological tests (Rota rod, open field and Morris water maze) was used to demonstrate effect of Cr supplementation on neurofunction and infarct size following HI.

Open field test results indicated that Cr supplementation had significantly improved locomotory and exploratory behaviour in subjects. It was observed that Cr treated mice showed better neuromuscular coordination (rota rod) and improved spatial memory (Morris Water Maze test). A significant affect of creatine supplementation in reducing infarct size was also observed. Post hoc analysis of post hoc multiple comparisons revealed that mice supplemented with 3% Cr for 10 weeks performed better during Morris water maze test while 1% Cr supplementation improved the exploratory behaviour and gain in body weight than control group indicating that Cr supplementation has the potential to improve the neurofunction following neonatal brain damage.

Biography:

Raquel Neves. Nursing graduation in 2006 in Nursing School of Lisbon, Portugal. Completed her Master and Post-Specialization in Rehabilitation in 2013, Lisbon, Portugal. Working since 2006 with stroke patients in stroke wards. In the past she worked in Portugal (7years), KSA (2 years) and at the moment is a stroke coordinator in Amana Healthcare Hospital, Abu Dhabi, UAE. 

Abstract:

Ischaemic hearth disease and stroke are the leading two cases of premature death1 and stroke continues to increase, with 16.9 million of people being affected by stroke annually.

An estimated 50 million stroke survivors worldwide currently cope with significant physical, cognitive and emotional deficits and 25% to 74% of these survivors require some assistance or they need fully assistance of caregivers for activity of daily living2.

Following a stroke an individual may experience cognitive, physical and psychological deficits.

Evidence shows that the earlier rehabilitation is commenced the better the outcome for the stroke survivor and this principles should be applied in the acute and post-acute settings.

Following a stroke an individual may experience cognitive, physical and psychological deficits.

After the stroke, the first aim is to stabilize medical condition during the acute phase, and then to retrain the previously learnt tasks through actual trial and performance in the rehabilitation phase.

The main goal for stroke rehabilitation is to help stroke survivors relearning skills that are lost when part of the brain is damaged and to adjust him to this new condition.

Stroke rehabilitation is proactive, person-centered and goal-oriented process that should begin the first day after stroke. And the literature shows rehabilitation is not only related with physical recovery but also with reintegration of the person into the community and therefore the transition between hospital and community care.

A multidisciplinary team with a holistic, comprehensive and interactive approach should be in place to implement a stroke rehabilitation program as soon as possible, by setting realistic goals with the stroke survivor and family