Publications by authors named "Pedro Maria"

Nerve tumors in the retroperitoneal space are a rarity. Radical surgery according to soft tissue tumors can lead to persistent pain and neurological deficits. This study aims to evaluate clinical outcomes of patients treated by a visceral- / neurosurgical approach.

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Objective: To assess internet usage among new patients seen by urologists and impact on post-consultation understanding for 4 common conditions: kidney stones, elevated prostate-specific antigen, male voiding, and female voiding.

Methods: We performed a prospective study of new urology patients at our diverse urban, academic urology practice for the above conditions over a 1-year period. A voluntary questionnaire assessed patients' internet use related to referred conditions prior to encounters.

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Article Synopsis
  • Peripheral nerve injuries can lead to the formation of neuromas, which are abnormal growths at the injury site that can stop nerves from healing properly.
  • Researchers studied human neuroma tissue and compared it to healthy nerves from the same person to understand what happens at the injury site over time (1-13 months after injury).
  • They found that even though the nerve repair cells called Schwann cells were present, they were in a "repair mode" and different from healthy cells, with signs of inflammation and reduced ability to form myelin, which is important for nerve function.
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  • * In a study of 530 patients, 12.1% required reoperation, mainly due to infection, with identifiable risk factors such as Peyronie's disease, high hemoglobin A1c levels, smoking, and significant blood loss during surgery.
  • * Using Arista™ powder during surgery reduced the chance of reoperation, while specific approaches (infrapubic) and underlying health issues (hypertension) increased the risk of infection-related reoperations.
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  • - The study highlights that most peripheral nerve tumors are benign, primarily consisting of schwannomas and neurofibromas, but also discusses rare tumors and non-tumorous lesions that can mimic these conditions, based on data from a German registry of 315 patients.
  • - The cohort includes 61 cases of unusual tumors, showcasing a range of pathological features and biological potentials, with diagnoses like malignant peripheral nerve tumors, perineurioma, hybrid tumors, and various extrinsic lesions like lymphoma and hemangioma.
  • - A definitive preoperative diagnosis is often challenging, necessitating collaboration among specialists in radiology, neurology, neuropathology, and neurosurgery to improve diagnosis and treatment options for patients.
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We report an unusual constellation of diseases in a 32-year-old woman with neurofibromatosis type 1 (NF1) diagnosed with the recently described precursor entity of malignant peripheral nerve sheath tumor (MPNST), the so-called atypical neurofibromatous neoplasm with unknown biological potential (ANNUBP) and a large symptomatic cervical arteriovenous fistula. An [F] 2-Fluoro-2-deoxy-D-glucose PET/CT (FDG-PET/CT) was performed to detect and stage a conspicuous symptomatic cervical tumor. The FDG-PET/CT showed high FDG uptake in one of the multiple known tumorous lesions associated with peripheral nerves.

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Efforts to minimize narcotic usage following inflatable penile prosthesis (IPP) implantation are vital, considering the current opioid epidemic in the United States. We aimed to determine whether pudendal nerve block (PNB) utilization in a multiethnic population undergoing primary IPP implantation can decrease rates of post-operative opiate usage. A single-institution, retrospective study was conducted on patients who underwent primary IPP implantation between December 2015 and June 2022.

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Objective: Peripheral nerve tumors (PNTs) are rare diseases. So far, no multicenter data on diagnostics, the efficacy of treatment, long-term outcomes, and health-related quality of life (HRQoL) exist. The establishment of the Peripheral Nerve Tumor Registry (PNTR) in 2015 allows for the systematic analysis of patients with tumors associated with peripheral nerves.

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Background: Geriatric patients, prone to adverse events (AEs) and low compliance with drugs, may benefit from minimally invasive surgical therapies (MISTs) for managing benign prostatic hyperplasia (BPH). We evaluated the efficacy, safety, and procedural characteristics of MISTs in geriatric patients with BPH.

Methods: PubMed/MEDLINE database was systematically searched for relevant articles through October 1, 2023.

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Article Synopsis
  • - Synaptic dysfunction plays a crucial role in SHANK-associated disorders like autism, schizophrenia, and Phelan-McDermid syndrome, but understanding its effects on synaptic structure is limited.
  • - The study used advanced imaging techniques (expansion and STED microscopy) to examine the synaptic nanostructures in both human and mouse brain tissues, focusing on SHANK3-KO mice.
  • - Findings revealed unique shape profiles of murine postsynaptic scaffolds and significant changes in the organization of synaptic domains due to SHANK3 deficiency, shedding light on the molecular mechanisms of synaptic dysfunction in neuropsychiatric disorders.
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Supracondylar humerus fractures are the most common elbow fractures in children up to 10 years of age. The incidence of associated nerve injuries varies up to 15% depending on the data. Traumatic and iatrogenic lesions mainly affect the ulnar nerve.

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Tumorous or tumour-like lesions of peripheral nerves are generally rare, heterogeneous and challenging to diagnose and treat. They may become apparent by a palpable swelling (lump) near nerves, sensory and/or motor deficits, pain to touch or neuropathic pain. In 91% of cases, tumours are benign.

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Brachial plexus reconstruction (BPR) consists of the complex surgical restoration of nerve structures. To further understand the underlying motor cortex changes and evaluate neuroplasticity after a successful surgery, we performed a navigated transcranial magnetic stimulation (nTMS) study mapping the postoperative motor representation of the formerly plegic arm. We conducted a prospective nTMS study mapping the musculocutaneous nerve as a representative, prominent target of BPR including a patient ( = 8) and a control group ( = 10).

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Introduction: A supracondylar process is a bony spur on the distal anteromedial surface of the humerus, and it is considered an anatomical variant with a prevalence of 0.4-2.7% according to anatomical studies.

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Background: Neurogenic Thoracic Outlet Syndrome (nTOS) describes a complex of symptoms caused by the compression of neural structures at the upper thoracic outlet. Typical symptoms include pain, numbness and motor weakness of the affected extremity. The incidence of nTOS is 2-3 per 100,000 and is highest between the ages of 25 and 40.

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Article Synopsis
  • * A study analyzed pre-, intra-, and postoperative data from 22 patients, primarily affecting nerves in the upper extremities, with various surgical interventions employed based on intraoperative findings.
  • * At a 10-month follow-up, most patients reported significant improvements in motor function, with clinical assessments showing increased muscle strength after surgical intervention.
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Objective: SARS-Cov-19 pandemic totally changed daily routine work in German hospitals. As hospital capacity was reduced, many surgeries were postponed or even cancelled. On March 25th 2020 the German Society of Neurosurgery (DGNC) published a statement in which urgent non-elective surgeries were defined for each neurosurgical domain, whereas elective interventions were deferred.

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Background: SHANKs are major scaffolding proteins at postsynaptic densities (PSDs) in the central nervous system. Mutations in all three family members have been associated with neurodevelopmental disorders such as autism spectrum disorders (ASDs). Despite the pathophysiological importance of SHANK2 and SHANK3 mutations in humans, research on the expression of these proteins is mostly based on rodent model organisms.

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(1) Background: The treatment of substance addiction is challenging and has persisted for decades, with only a few therapeutic options. Although there are some recommendations for specific treatments for Alcohol Use Disorder (AUD), there is no specific medication used to treat alcohol cravings, which could benefit millions of patients that are suffering from alcoholism. Cravings, or the urge to use drugs, refer to the desire to experience the effects of a previously experienced psychoactive substance.

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Article Synopsis
  • Meralgia paresthetica (MP) is a condition characterized by pain and sensory disturbances in the thigh, linked to rising rates of obesity and diabetes, with an incidence of 32 cases per 100,000 people annually.
  • * Diagnosis relies on symptoms and response to treatment, with advanced imaging and testing available for atypical cases; however, the quality of research on MP remains low.
  • * Current treatment outcomes show a significant success rate for pain relief through surgical methods (up to 85%), while evidence for newer therapies like radiofrequency and spinal cord stimulation is scarce.
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Background: Mesenchymal stromal cells (MSCs) have been shown to exert their therapeutic effects through the secretion of broad spectrum of paracrine factors, including extracellular vesicles (EVs). Accordingly, EVs are being pursued as a promising alternative to cell-based therapies. Menstrual blood-derived stromal cells (MenSCs) are a type of MSC that, due to their immunomodulatory and regenerative properties, have emerged as an innovative source.

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Introduction: A brachial plexus lesion is a devastating injury often affecting young, male adults after traffic accidents. Therefore, surgical restoration of elbow flexion is critical for establishing antigravity movement of the upper extremity. We analyzed different methods for musculocutaneous reconstruction regarding outcome.

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