Retrospective study of post-treatment I SPECT/CT imaging for personalizing therapy of patients with differentiated thyroid cancer.

The absence of anatomical landmarks in the whole body scan makes it challenging to precisely localize 131I uptake, which is used to treat patients with differentiated thyroid cancer (DTC). Recently, SPECT/CT studies have been utilized to increase the diagnostic sensitivity and specificity.

Pancreatic cancer liver metastasis mimicking focal nodular hyperplasia. A case report.

Metastases to the liver from gastroenteropancreatic neuroendocrine tumors are varied in their presentation and echogenicity on ultrasound. We present a case of adenocarcinoma of the pancreas with sporadic neuroendocrine differentiation and metastasis to the liver, referred for inclusion in a clinical study. Standard ultrasound showed two hypoechoic focal liver lesions.

Dual-tracer subtraction scintigraphy combined with SPECT/CT in preoperative patients with primary hyperparathyroidism.

Abstract.

Step-by-Step Implementation of Three-Dimensional Print Technology in Preoperative Neurosurgery Planning.

This study presents a detailed methodology for integrating three-dimensional (3D) printing technology into preoperative planning in neurosurgery. The increasing capabilities of 3D printing over the last decade have made it a valuable tool in medical fields such as orthopedics and dental practices. Neurosurgery can similarly benefit from these advancements, though the creation of accurate 3D models poses a significant challenge due to the technical expertise required and the cost of specialized software.

Focused extracorporeal shockwave therapy for the treatment of low back pain: a systematic review.

Introduction: Low back pain (LBP) is a common condition affecting up to 84% of people in their lifetime, with a prevalence of 11.9% and a high recurrence rate within the first year. Furthermore, chronic low back pain syndrome has been described in up to 7%, making it a significant health and socioeconomic problem.

Caffeine, Alcohol, and Drug Use as Work Adjuncts Among Neurosurgeons. Prevalence, Contributing Factors, and Proposed Strategies.

Background: Neurosurgeons may resort to caffeine, alcohol, and various drugs to maintain peak performance as they grapple with work demands and escalated stress. The prevalence of this controversial strategy remains largely unexplored.

Methods: An anonymous survey of 23 questions formulated by our research group was distributed through personal contacts and neurosurgical societies.

Clinical and genetic variability among Bulgarian patients with autosomal recessive spastic ataxia of Charlevoix-Saguenay.

Background: Autosomal recessive spastic ataxia ofCharlevoix-Saguenay (ARSACS) is a rare neurodegenerative disorder characterizedby early-onset cerebellar ataxia, peripheral sensorimotor neuropathy, and lowerlimb spasticity. We present clinical andgenetic data of the first Bulgarian patients diagnosed with ARSACS by wholeexome sequencing (WES).

Methods: Variant filtering was performed usinglocally established pipeline and the selected variants were analysed by Sangersequencing.

Intracavitary Applications for CEUS in PTCD.

Intracavitary contrast-enhanced ultrasound is widely accepted as a highly informative, safe, and easily reproducible technique for the diagnosis, treatment, and follow-up of different pathologies of the biliary tree. This review article describes the diverse applications for CEUS in intracavitary biliary scenarios, supported by a literature review of the utilization of the method in indications like biliary obstruction by various etiologies, including postoperative strictures, evaluation of the biliary tree of liver donors, and evaluation of the localization of a drainage catheter. We also provide pictorial examples of the authors' personal experience with the use of intracavitary CEUS in cases of PTCD as a palliative intervention.

Clinical characteristics and multimodal imaging can help diagnosing and treating mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy.

Objective: Mild malformation of cortical development with oligodendroglial hyperplasia and epilepsy (MOGHE) is a recently described, histopathologically and molecularly defined (SLC35A2-mutated) type of cortical malformation. Although increasingly recognized, the diagnosis of MOGHE remains a challenge. We present the characteristics of the first six patients diagnosed in Bulgaria, with the aim to facilitate identification, proper presurgical evaluation, and surgical treatment approach in this disease.

A giant synovial sarcoma of the left lung.

Primary pulmonary synovial sarcoma is an extremely rare and aggressive neoplasm that primarily affects young people and has a poor prognosis. Establishing this diagnosis requires the exclusion of a wide number of other neoplasms with multimodal clinical, imaging, histological, immunohistochemical, and cytogenetic assessment. We present a case of synovial sarcoma of the left lung in a 44-year-old man, diagnosed immunohistochemically after left lower lobectomy with atypical resection of the 5th segment.

Thoracic spinal anesthesia with intrathecal sedation for lower back surgery: a retrospective cohort study.

Background: Spinal anesthesia (SA) is a good alternative to general anesthesia (GA) for spine surgery. Despite that, a few case series concern the use of thoracic spinal anesthesia for short-duration surgical interventions. In search of an alternative approach to GA and a better opioid-free modality, we aimed to investigate the safety, feasibility, and patient satisfaction of thoracic SA for spine surgery.

Genetic Variant in a Patient with Epilepsy, Ophthalmological Anomalies, and Neurodevelopmental Delay.

We present the findings of a Whole Exome Sequencing in a 2-year-old boy, conceived via Fertilization with donor sperm, who suffers from an undiagnosed neurological syndrome. The following heterozygous variant in the gene was identified and classified as likely pathogenic: c.1655_1656, p.

European Medical Students' Views on Neurosurgery, with Emphasis on South-East Europe (Albania, Greece, Serbia, and Turkey).

Background: Neurosurgery, an intricate and dynamic surgical specialty, faces challenges in attracting medical graduates. Despite its potential appeal, a decreasing trend in medical students opting for surgical specialties, including neurosurgery, is noted. This study aims to assess European medical students' perceptions of neurosurgery, focusing on South-East Europe, and address concerns about the declining interest in this field.

Common differential diagnosis of low back pain in contemporary medical practice: a narrative review.

With a wide range of etiologies, low back pain (LBP) presents a true clinical challenge, finding its origins both in intrinsic spinal and systemic conditions, as well as referred ones. This review categorizes the LBP into these three groups and aims to offer a comprehensive look at the tools required to diagnose and differentiate them. The intrinsic etiologies are based on conditions that affect the musculoskeletal components of the lumbar spine, such as intervertebral disc disease, stenosis, muscular imbalance, and facet joint degeneration.

Characteristics of patients with severe asthma in primary and secondary care settings considered eligible for biological therapy - the Bulgarian RECOGNISE study.

Asthma is a major non-communicable disease. It affects both children and adults, but is the most common chronic condition among the former. While inhaled controller drugs stabilize the disease in most asthma patients, there are a certain number of people who suffer from severe asthma, which requires treatment escalation.

Evaluation of multidetector CT Hounsfield unit measurements as a predictor of efficacy and complications in percutaneous vertebroplasty for osteoporotic vertebral compression fractures.

Introduction: More than 30 years after the initial experience of Galibert and Deramond with percutaneous vertebroplasty, the procedure has gone through countless refinements and clinical evaluations. Predictors for the success and failure of the procedure in the literature vary and are focused on the duration of complaints, type of fracture, presence of edema on MRI scans, etc. We propose using a quantitative method based on a standard CT examination of the thoracic or lumbar spine to assess the risks and potential success of performing vertebroplasty.

Case Report: Transthyretin Glu54Leu-a rare mutation with predominant cardiac phenotype.

We report two unrelated Bulgarian families with hereditary transthyretin (ATTR) amyloidosis due to a rare p.Glu74Leu (Glu54Leu) pathogenic variant found in seven individuals-three of them symptomatic. Only one family with the same variant and with a Swedish origin has been clinically described so far.

First-degree relatives of patients with systemic lupus erythematosus: Autoreactivity but not autoimmunity?

Background: Systemic lupus erythematosus (SLE) is a disorder with a complex immunopathogenesis. It is well known that the disease begins with immunological alterations and autoantibody appearance in the serum years before clinical onset. As SLE has a strong tendency to familial aggregation, first-degree relatives (FDRs) constitute a group at elevated risk.

Developmental venous anomaly causing obstructive hydrocephalus due to aqueductal stenosis: а case report.

Cerebral developmental venous anomalies are asymptomatic benign cerebrovascular malformations that are commonly found accidentally on brain magnetic resonance imaging. It is not uncommon for cerebrospinal fluid flow to be obstructed at the level of the aqueduct of Sylvius, causing an obstructive non-communicating hydrocephalus. Most notable reasons for such an obstruction at that level are tumors, congenital etiology, or post-inflammatory gliotic atresia.

Reactivity Graph Yields Interpretable IgM Repertoire Signatures as Potential Tumor Biomarkers.

Combining adaptive and innate immunity induction modes, the repertoire of immunoglobulin M (IgM) can reflect changes in the internal environment including malignancies. Previously, it was shown that a mimotope library reflecting the public IgM repertoire of healthy donors (IgM IgOme) can be mined for efficient probes of tumor biomarker antibody reactivities. To better explore the interpretability of this approach for IgM, solid tumor-related profiles of IgM reactivities to linear epitopes of actual tumor antigens and viral epitopes were studied.

EXPLORE B: A prospective, long-term natural history study of patients with acute hepatic porphyria with chronic symptoms.

One-year data from EXPLORE Part A showed high disease burden and impaired quality of life (QOL) in patients with acute hepatic porphyria (AHP) with recurrent attacks. We report baseline data of patients who enrolled in EXPLORE Part B for up to an additional 3 years of follow-up. EXPLORE B is a long-term, prospective study evaluating disease activity, pain intensity, and QOL in patients with AHP with ≥1 attack in the 12 months before enrollment or receiving hemin or gonadotropin-releasing hormone prophylaxis.