Does EFSA statement on Monacolin content of nutraceutical combinations impair their lipid lowering effect? The LopiGLIK experience.

Background: Monacolin-K, the active component of red yeast rice (RYR), reduces cholesterol by inhibiting HMG-CoA reductase. Following safety concerns, the European Food Safety Authority (EFSA) recommended limiting Monacolin-K intake to less than 3 mg/day due to adverse effects at higher doses.

Case Presentation: A study comparing Armolipid Plus and LopiGLIK found LopiGLIK more effective in lowering LDL cholesterol, possibly due to slightly higher dosages of Berberine and Monacolin-K.

Microgravity Effects on Glioma Cells: A Comprehensive Review.

High-grade gliomas (HGGs) represent a formidable challenge in neuro-oncology due to their aggressive nature and resistance to current therapeutic interventions, which include surgery, radiation, chemotherapy, and emerging immunotherapies. Despite these efforts, the prognosis for patients remains poor, emphasizing the urgent need for novel treatment strategies. One promising avenue of exploration is microgravity, a condition experienced during spaceflight and simulated in laboratories on Earth, which induces significant physiological changes in cells and tissues.

IMProve-DURA: Investigations of Molecular Patient Profiles and Anatomical Cadaveric Characteristics of the Dura Mater-A Pilot Study Protocol.

Background: The dura mater, a fibrous membrane protecting the brain and spinal cord, is prone to lacerations during spinal surgery, often leading to complications such as cerebrospinal fluid (CSF) leakage. Anatomical differences in the spinal dura mater, particularly in regions under high biomechanical stress, suggest that chronic inflammatory processes may compromise its structural integrity. This pilot study investigates the molecular and anatomical characteristics of the spinal dura mater, focusing on its response to inflammation and the challenges of surgical repair.

Pre-treatment DTI markers: predicting clinical outcomes in microvascular decompression for classic trigeminal neuralgia - a systematic review.

Background And Purpose: Trigeminal neuralgia (TN) is a severe chronic pain condition, typically affecting patients over 50-year-old, caused by the compression of the nerve at the root entry zone (REZ) by blood vessels. While the diagnosis is clinical, advanced imaging like diffusion tensor imaging (DTI) is crucial to identify underlying causes and assessing nerve damage. DTI may help develop neuroimaging markers to improve understanding of TN and predict surgical outcomes.

Not Every Size Fits All: Surgical Corridors for Clival and Cervical Chordomas-A Systematic Review of the Literature and Illustrative Cases.

Clival chordomas represent a rare but clinically significant subset of skull base tumors, characterized by a locally aggressive nature and a location in proximity to vital neurovascular structures. Surgical resection, often combined with adjuvant therapies, remains the cornerstone of clival chordoma treatment, and various approaches and techniques have evolved to maximize tumor removal while preserving neurological function. Recent advancements in skull base surgery, imaging, and adjuvant therapies have improved outcomes by reducing morbidity and thus enhancing long-term survival.

The role of MRgFUS in the treatment of neuropsychiatric disorders: a state of the art.

Introduction: Magnetic resonance-guided focused ultrasound (MRgFUS) is a contemporary non-invasive ablative procedure that utilizes high- or low-intensity ultrasound, guided and monitored by magnetic resonance imaging (MRI). While MRgFUS has been established as an effective treatment for conditions like essential tremor and tremor-dominant Parkinson's disease, it has recently emerged as a safe and promising ablative minimally invasive procedure for the management of treatment-resistant psychiatric disorders. Indeed, despite the availability of various pharmacological and behavioral therapies, a subset of psychiatric patients remains refractory to conventional treatments.

Nuclear medicine imaging modalities to detect incidentalomas and their impact on patient management: a systematic review.

Purpose: This systematic review aims to investigate the role of nuclear imaging techniques in detecting incidentalomas and their impact on patient management.

Methods: Following PRISMA guidelines, a comprehensive literature search was conducted from February to May 2022. Studies in English involving patients undergoing nuclear medicine studies with incidental tumor findings were included.

Muscle MRI as a biomarker of disease activity and progression in myotonic dystrophy type 1: a longitudinal study.

Introduction: Myotonic dystrophy type 1 (DM1) is an autosomal dominant disease characterized by myotonia and progressive muscular weakness and atrophy. The aim of this study was to investigate the usefulness of longitudinal muscle MRI in detecting disease activity and progression in DM1, and to better characterize muscle edema, fat replacement and atrophy overtime.

Materials And Methods: This is a prospective, observational, longitudinal study including 25 DM1 patients that performed at least two muscle MRIs.

Hypothalamic Hemangioma-like Pilocytic Astrocytoma in an Adult Patient: A Systematic Review with a Focus on Differential Diagnosis and Neurological Presentation.

Pilocytic astrocytoma (PCA) are commonly observed as slow-growing noncancerous brain tumors in pediatric populations, but they can also occur in adults, albeit rarely. When located in diencephalic regions, particularly in the hypothalamus, they present unique diagnostic and management challenges due to their rarity and overlapping clinical and radiological features with other intracranial pathologies. This systematic review aims to provide a comprehensive understanding of hypothalamic PCA in adults, focusing on their differential diagnosis, neurological presentation, diagnostic modalities, treatment strategies.

No evidence of Fabry disease in a patient with the new p.Met70Val GLA gene variant.

Background: Fabry disease (FD) is a rare X-linked lysosomal storage disorder caused by variants in GLA gene leading to deficient α-galactosidase A enzyme activity. This deficiency leads to the accumulation of glycosphingolipids, particularly globotriaosylceramide (Gb3), in various tissues and organs, which can result in life-threatening complications. The clinical presentation of the disease can vary from the "classic" phenotype with pediatric onset and multi-organ involvement to the "later-onset" phenotype, which presents with predominantly cardiac symptoms.

Doppler-Derived Renal Functional Reserve in the Prediction of Postoperative Acute Kidney Injury in Patients Undergoing Robotic Surgery.

Background: Postoperative acute kidney injury (PO-AKI) is a frequent complication after surgery. Various tools have been proposed to identify patients at high risk for AKI, including preoperative serum creatinine or estimated glomerular filtration rate (eGFR), urinary cell cycle arrest, and tubular damage biomarkers; however, none of these can appropriately assess AKI risk before surgery. Renal functional reserve (RFR) screened by the Doppler-derived intraparenchymal renal resistive index variation (IRRIV) test has been proposed to identify patients at risk for AKI before a kidney insult.

COVID-19-related chemosensory changes: Findings from a prospective national database.

Objective: The aim of this study was to review findings from a large prospective national database of chemosensory disturbances associated with coronavirus disease 2019 (COVID-19) infection.

Data Sources: The Virginia Commonwealth University Smell and Taste Center national database of COVID-19 chemosensory disturbances.

Methods: A series of online surveys, first opened on April 10, 2020, was made accessible nationwide to any adult with sudden chemosensory dysfunction since January 2020.

Improving the quality of patient care in lung cancer: key factors for successful multidisciplinary team working.

International Guidelines as well as Cancer Associations recommend a multidisciplinary approach to lung cancer care. A multidisciplinary team (MDT) can significantly improve treatment decision-making and patient coordination by putting different physicians and other health professionals "in the same room", who collectively decide upon the best possible treatment. However, this is not a panacea for cancer treatment.

Multiple Abdominal abscesses following ventriculoperitoneal shunt placement in an immunosuppressed patient: An illustrative case.

Background: Ventriculoperitoneal (VP) shunt placement is one of the most performed procedures in neurosurgery to treat various types of hydrocephalus (HC). Immediate or late postoperative complications may quite commonly occur, especially in immunosuppressed patients, who are predisposed to develop rare and difficult-to-treat conditions.

Case Description: Herein, we report the case of a 41-year-old female patient with a prior history of acute myeloid leukemia, followed by a tetra-ventricular acute HC due to a spontaneous non-aneurysmal subarachnoid hemorrhage.

Serum neurofilament light chain levels correlate with small fiber related parameters in patients with hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN).

Background: Recent evidence suggests that both serum neurofilament light chain (sNfL) levels and small fiber related diagnostic variables may be valuable disease biomarkers of hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN). Our study aimed to explore the relations between sNfL and small fiber related skin biopsy and quantitative sensory testing (QST) parameters in a cohort of ATTRv-PN patients and pre-symptomatic carriers.

Methods: We retrospectively analyzed data from 13 ATTRv patients and 21 pre-symptomatic carriers who underwent sNfL dosage, skin biopsy, and QST, and analyzed correlations between sNFL, intraepidermal nerve fiber density (IENFD), and cold (CDT) and warm detection thresholds (WDT).

Large Skull Metastasis in Follicular Thyroid Carcinoma: A Comprehensive Case Presentation and Systematic Review.

Background:  Skull metastases from follicular thyroid carcinoma (FTC) are infrequent but clinically significant, often presenting with localized pain, neurologic deficits, and cranial nerve dysfunction. Early detection and accurate diagnosis pose challenges due to their asymptomatic nature in some cases.

Methods:  A systematic literature review, conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identified and analyzed 15 relevant studies focusing on large skull metastases in FTC.

Intraventricular Cerebral Metastases: A Comprehensive Systematic Review.

Background/aim: Intraventricular cerebral metastases (IVCM) are a rare but clinically significant subset of brain metastases. This systematic review aimed to provide a comprehensive analysis of IVCM by synthesizing current literature on epidemiology, clinical presentation, imaging features, pathophysiology, and treatment options.

Materials And Methods: A systematic literature search was conducted, identifying 11 relevant studies encompassing 11 studies encompassing 842 IVCM cases.

DNAJB11 Mutation in ADPKD Patients: Clinical Characteristics in a Monocentric Cohort.

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a late-onset cilia-related disorder, characterized by progressive cystic enlargement of the kidneys. It is genetically heterogeneous with and pathogenic variants identified in approximately 78% and 15% of families, respectively. More recently, additional ADPKD genes, such as , have been identified and included in the diagnostic routine test for renal cystic diseases.

The Use of Intraoperative Microvascular Doppler in Vascular Neurosurgery: Rationale and Results-A Systematic Review.

Surgical treatment of neurovascular lesions like intracranial aneurysms, arteriovenous malformations and arteriovenous dural fistulas is still associated with high morbidity. Several recent studies are providing increasing insights into reliable tools to improve surgery and reduce complications. Inadvertent vessel compromise and incomplete occlusion of the lesion represent the most possible complications in neurovascular surgery.

Improving mixed-reality neuronavigation with blue-green light: a comparative multimodal laboratory study.

Objective: This study aimed to rigorously assess the accuracy of mixed-reality neuronavigation (MRN) in comparison with magnetic neuronavigation (MN) through a comprehensive phantom-based experiment. It introduces a novel dimension by examining the influence of blue-green light (BGL) on MRN accuracy, a previously unexplored avenue in this domain.

Methods: Twenty-nine phantoms, each meticulously marked with 5-6 fiducials, underwent CT scans as part of the navigation protocol.

The role of extended reality in eloquent area lesions: a systematic review.

Objective: The surgical approach to lesions near eloquent areas continues to represent a challenge for neurosurgeons, despite all of the sophisticated tools currently used. The goal of surgery in eloquent areas is to maintain a good oncofunctional balance, that is, to preserve neurological function and ensure maximum tumor resection. Among all the available tools, extended reality (used to describe both virtual reality [VR] and mixed reality) is rapidly gaining a pivotal role in such delicate lesions, especially in preoperative planning, and recently, even during the surgical procedure.

Fluoroscopy-Assisted Freehand Versus 3D-Navigated Imaging-Assisted Pedicle Screw Insertion: A Multicenter Study.

Introduction: Pedicle screw placement is a widely accepted surgical procedure for spinal fixation. Despite increases in knowledge about and expertise in pedicle screw insertion techniques, overall reported screw misplacement rates are still high. Spinal neuronavigation and intraoperative computed tomography (CT) imaging improves the accuracy and safety of pedicle screw placement through the continuous monitoring of screw trajectory.