Publications by authors named "Robertis M"

Background: Congenital craniovertebral junction anomalies (CCVJAs) encompass a diverse range of conditions characterized by distorted anatomy and significant variation in the pathways of neurovascular structures. This study aims to assess the safety and feasibility of tailoring posterior fixation for CCVJAs through intraoperative CT-based navigation.

Methods: An in-depth retrospective analysis was conducted on eight patients diagnosed with CCVJAs (excluding Arnold-Chiari malformation).

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  • The study compares the effectiveness of two surgical approaches for treating mobile spine chordomas: en bloc resection versus intralesional resection with adjuvant hadron therapy, focusing on local control (LC) and overall survival (OS).
  • In the analysis of 33 patients, no significant differences in LC between the two methods were found, but certain pre-operative factors like pathologic fractures were linked to a higher risk of local recurrence (LR).
  • Although en bloc resection is preferred for better outcomes, advances in hadron therapy provide a viable alternative for local control with manageable side effects when using intralesional surgery.
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  • - The development of neurosurgical guidelines has grown increasingly complex, posing challenges in their application due to varying methodologies and limited high-quality evidence.
  • - This mini review focuses on guidelines published since 1996, emphasizing the reliance on a few randomized controlled trials (RCTs) and the lag in timely updates, which complicates their relevance in clinical practice.
  • - To improve global applicability, especially in low- and middle-income countries, there's a call for increased inclusivity in guideline authorship and consideration of alternatives like consensus conferences for addressing these challenges.
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  • Non-contiguous two-level Anterior Cervical Discectomy and Fusion (ACDF) is a surgical option for treating degenerative cervical myelopathy, focusing on patients with spine and radicular compression at two separated cervical levels.
  • A study analyzed 32 patients who underwent this procedure, showing significant improvements in clinical scores and some changes in spinal alignment post-surgery, although one patient experienced worsening symptoms later.
  • Overall, the findings suggest that this surgical method is both safe and effective, though there is a small risk of worsening conditions in the non-fused segments.
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Background: Vertebral hemangioma is the most common benign tumor of the spine, diagnosed incidentally in most cases. In 0.4% of patients, the lesion is considered aggressive, causing neurological deficits.

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  • Epithelioid hemangioma (EH) is classified as a distinct benign tumor by the WHO, though it can exhibit locally aggressive behavior and rarely metastasizes.
  • The study focuses on eleven patients with spinal EH, analyzing their surgical, clinical, and radiographic data, revealing common symptoms like myelo-radicular compression and lytic vertebral body lesions.
  • A proposed treatment algorithm based on clinical experiences suggests that surgical intervention is necessary for symptomatic patients to manage this rare and complex condition effectively.
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Background: Degenerative cervical myelopathy (DCM) is a leading cause of nontraumatic spinal cord injury. Surgery aims to arrest neurological decline and improve conditions, but controversies surround risks and benefits in elderly patients, outcomes in mild myelopathy, and the risk of adjacent segment disease (ASD).

Methods: Retrospective data of patients who underwent anterior cervical discectomy and fusion for DCM in our hospital were collected.

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Immunotherapy can now be regarded as an attractive approach for cancer and infectious disease treatments [...

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Efficacy of novel cancer immunization protocols could be tested in cell line-derived xenograft tumor models (CDX), which are based on the implantation of human tumor cell lines into mice for the development of different tumors by numerous means, such as subcutaneous implantation and orthotopic, venial, or peritoneal injections. However, the disadvantages of this model are the biological alteration of the derived cells or the inability of the cell lines to accurately reflect the complexity of tumor heterogeneity. Therefore, syngeneic mouse models, which offer a relatively simple grafting technique, preservation of lineage hierarchy, and the ability to generate tumors in as little as 2-8 weeks, are being used to study potential future applications in medical treatment, particularly immunotherapies.

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Recent progress in developing new vaccination strategies against cancer requires the production of complex and reliable animal models reflecting the complexity of the tumors with their microenvironment. Mice can be considered a good source due to low cost and ease of being genetically modified, inoculated with tumor cell lines or treated by chemicals to induce different cancers. Despite significant limitations in modeling human cancer complexity, preclinical trials conducted in mice can efficiently contribute to understand molecular mechanisms of cancer, to closely resemble and follow carcinogenesis steps impossible to study into humans, and to test new anticancer therapies.

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Objective: The study aimed at evaluating the efficacy and the ability of D-wave monitoring combined with somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) to predict functional outcomes in intramedullary spinal cord tumor (IMSCT) surgery.

Methods: Between December 2011 and December 2020, all patients harboring IMSCT who underwent surgery at our institution were prospectively collected in a surgical spinal registry and retrospectively analyzed. Patient charts and surgical and histological reports were analyzed.

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Objective: To quantify the distribution of cauda equina nerve roots in supine and upright positions using manual measurements and radiomics features both in normal subjects and in lumbar spinal canal stenosis (LSCS) patients.

Methods: We retrospectively recruited patients who underwent weight-bearing MRI in supine and upright positions for back pain. 3D T2-weighted isotropic acquisition (3D-HYCE) sequences were used to develop a 3D convolutional neural network for identification and segmentation of lumbar vertebrae.

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Objective: The development of specific clinical and neurological symptoms and radiological degeneration affecting the segment adjacent to a spinal arthrodesis comprise the framework of adjacent-level syndrome. Through the analysis of a large surgical series, this study aimed to identify possible demographic, clinical, radiological, and surgical risk factors involved in the development of adjacent-level syndrome.

Methods: A single-center retrospective analysis of adult patients undergoing lumbar fusion procedures between January 2014 and December 2018 was performed.

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Electrochemotherapy (ECT) is a standard of care in veterinary and human oncology. The treatment induces a well-characterized local immune response which is not able to induce a systemic response. In this retrospective cohort study, we evaluated the addition of gene electrotransfer (GET) of canine IL-2 peritumorally and IL-12 intramuscularly to enhance the immune response.

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Lumbar drainage is commonly used in skull base surgery; however, very few cases of intracranial hypotension syndrome are reported to be caused by this procedure. We present a clinical case of lumbar drainage-assisted orbital and optic canal decompression surgery for a recurrent voluminous spheno-orbital meningioma, together with a literature review. A 49-year-old woman became confused and drowsy on postoperative day 3, after initially experiencing neurologic stability.

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YKL-40 is a heparin- and chitin-binding glycoprotein that belongs to the family of glycosyl hydrolases but lacks enzymatic properties. It affects different (patho)physiological processes, including cancer. In different tumors, YKL-40 gene overexpression has been linked to higher cell proliferation, angiogenesis, and vasculogenic mimicry, migration, and invasion.

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  • Aneurysmal subarachnoid hemorrhage (aSAH)
  • leads to serious complications and high rates of disability and death, with delayed cerebral ischemia (DCI) often occurring without visible vasospasm.
  • A study involving 133 aSAH patients
  • found that higher levels of lactate and glucose in cerebrospinal fluid (CSF) measured shortly after the hemorrhage were strong indicators of neurological decline and poor recovery after 3 months.
  • Monitoring CSF lactate and glucose
  • could help predict worsening neurological conditions after aSAH, highlighting the need for future research with larger patient groups to confirm these findings and improve treatment strategies.
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To date several studies address the important role of gut microbiome and its interplay with the human host in the health and disease status. However, the selection of a universal sampling matrix representative of the microbial biodiversity associated with the gastrointestinal (GI) tract, is still challenging. Here we present a study in which, through a deep metabarcoding analysis of the 16S rRNA gene, we compared two sampling matrices, feces (F) and colon washing feces (CWF), in order to evaluate their relative effectiveness and accuracy in representing the complexity of the human gut microbiome.

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Preclinical forms of gastrointestinal stromal tumor (GIST), small asymptomatic lesions, called microGIST, are detected in approximately 30% of the general population. Gastrointestinal stromal tumor driver mutation can be already detected in microGISTs, even if they do not progress into malignant cancer; these mutations are necessary, but insufficient events to foster tumor progression. Here we profiled the tissue microbiota of 60 gastrointestinal specimens in three different patient cohorts-micro, low-risk, and high-risk or metastatic GIST-exploring the compositional structure, predicted function, and microbial networks, with the aim of providing a complete overview of microbial ecology in GIST and its preclinical form.

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Background: Thoracic myelopathy can have different aetiologies. Based on the location and on the nature of spinal cord compression, different surgical approaches may be indicated.

Method: We present a rare case of thoracic myelopathy caused by the coexistence of a giant disc herniation, OPLL and OLF, and we describe the surgical approach, with a focus on technical nuances and strategies to avoid complications.

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Gene therapy has become an important approach for treating cancer, and electroporation represents a technology for introducing therapeutic genes into a cell. An example of cancer gene therapy relying on gene electrotransfer is the use of immunomodulatory cytokines, such as interleukin 2 (IL-2) and 12 (IL-12), which directly stimulate immune cells at the tumour site. The aim of our study was to determine the effects of gene electrotransfer with two plasmids encoding IL-2 and IL-12 in vitro and in vivo.

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Background: Ultrasound of the optic nerve sheath diameter (ONSD) has been used as a non-invasive and cost-effective bedside alternative to invasive intracranial pressure (ICP) monitoring. However, ONSD time-lapse behavior in intracranial hypertension (ICH) and its relief by means of either saline infusion or surgery are still unknown. The objective of this study was to correlate intracranial pressure (ICP) and ultrasonography of the optic nerve sheath (ONS) in an experimental animal model of ICH and determine the interval needed for ONSD to return to baseline levels.

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Colorectal cancer (CRC) initiation is believed to result from the conversion of normal intestinal stem cells (ISCs) into cancer stem cells (CSCs), also known as tumor-initiating cells (TICs). Hence, CRC evolves through the multiple acquisition of well-established genetic and epigenetic alterations with an adenoma-carcinoma sequence progression. Unlike other stem cells elsewhere in the body, ISCs cohabit with the intestinal microbiota, which consists of a diverse community of microorganisms, including bacteria, fungi, and viruses.

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Objective: Trigeminal neuralgia (TN) in patients with multiple sclerosis (MS) is a challenging condition to manage that is treated with Gamma Knife radiosurgery (GKRS). The aim of this report is to assess the safety, efficacy, and durability of GKRS for the treatment of TN in patients with MS. Our findings are compared with those of the existing literature and discussed.

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