Chemotherapy Impregnated Wafers

The implantation of degradable wafers impregnated with BCNU (Gliadel) has been used extensively at the time of re-operation for recurrent HGGs, and recently has been approved by the FDA for use at the time of initial surgery. In a large phase III trial enrolling 222 patients with recurrent HGGs, the use of Gliadel provided a statistically significant prolongation of survival of 8 weeks (from 23 to 31 weeks) for all HGG patients as well as for the GBM subgroup [31]. A recent multicenter prospective trial evaluated the use of Gliadel at initial surgery and reported median survival times of 13.9 vs 11.6 months for HGG patients receiving Gliadel vs placebo, with median survival of 13.5 vs 11.4 months in the GBM vs placebo group [32].

Complications associated with the use of Gliadel include infection, cerebral edema, wound-healing problems and CSF leak, particularly in patients with recurrent HGG. Careful attention to tissue handling and dural closure, with use of dural patches, helps to reduce these complications.

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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