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Glioblastoma multiforme (GBM) is a lethal brain tumor characterized by developmental hierarchical phenotypic heterogeneity, therapy resistance and recurrent growth. Neural stem cells (NSCs) from human central nervous system (CNS), and glioblastoma stem cells from patient-derived GBM (pdGSC) samples and cultured in both 2D well-plate and 3D monoclonal neurosphere culture system (pdMNCS). The pdMNCS model shows promise to establish a relevant 3D-tumor environment that maintains GBM cells in the stem cell phase within suspended neurospheres. Utilizing the pdMNCS, we examined GBM cell-lines for a wide spectrum of developmental cancer stem cell markers, including the early blastocyst inner-cell mass (ICM)-specific Nanog, Oct3/4,B, and CD133. We observed that MNCS epigenotype is recapitulated using gliomasphere-derived cells. CD133, the marker of GSC is robustly expressed in 3D-gliomaspheres and localized within the plasma membrane compartment. Conversely, gliomasphere cultures grown in conventional 2D culture quickly lost CD133 expression, indicating its variable expression is dependent on cell-culture conditions. Critically, this experiment demonstrates incomplete differentiation of cytoskeleton microtubules and intermediate filaments (IFs) of patient derived cells, similar to commercially available GBM cell lines. Subsequently, in order to determine whether Oct3/4 it was necessary for CD133 expression and cancer stemness, we transfected 2D and 3D culture with siRNA against Oct3/4 and found a significant reduction in gliomasphere formation. These results suggest that expression of Oct3/4,Aand CD133 suppress differentiation of GSCs.
Baastrup disease (BD) is a common cause of low back pain which is often underdiagnosed. It is characterized by adjacent interspinous processes contact and it can be associated with cystic lesions. The aim of this review is to evaluate the epidemiology, diagnosis, and treatment options of patients with BD.

The present study is performed according to PRISMA statement. MEDLINE via PubMed and Embase, Scopus, Cochrane Library database were searched using the keywords "Baastrup", "Kissing Spines", "Syndrome", "Disease". A total of 35 papers met our inclusion criteria. Full text were reviewed for demographic, clinical data and treatment.

1308 patients were included in the studies. The mean age of the enrolled patients was 59.6 years. The MF ratio was 1.31. Population-based studies demonstrated a decade on decade increase in the incidence. Standard and dynamic flexion-extension radiographs of the lumbar spine were performed in 213 (16.2%) of cases. MRI was performed in 735 patients (56,2%) whereas FDG PET/CT was used to demonstrate BD in 77 included cases (5.9%). CT scan was performed in 574 cases (43.9%). 26 studies reported the treatment choice for a total of 277 patients. selleck chemicals Anti-inflammatory drugs and physical therapy were chosen in 99 cases (35.7%). Percutaneous infiltrations and surgical decompression in 80 (28.9%) and 196 (70.7%) patients respectively.

Baastrup disease is a common cause of low back pain. Proper diagnosis needs for imaging investigations and dynamic flexion-extension radiographs. Conservative and surgical therapies are available but there is a need for randomized clinical trials.
Baastrup disease is a common cause of low back pain. Proper diagnosis needs for imaging investigations and dynamic flexion-extension radiographs. Conservative and surgical therapies are available but there is a need for randomized clinical trials.
The activities related to intrathecal baclofen (ITB) therapy could not be interrupted at the outbreak of COVID-19 pandemic due to possible life-threatening related complications such as withdrawal and over dosage syndromes. In this study we reported the different adopted strategies to manage patients with an ITB implanted infusion pump during the pandemic period and studied the impact of these strategies on experiences reported from patients and their caregivers, assessed through a specific survey.

Thirty-five patients (mean age 43.71 ± 12.33 years) were included. Their clinical and medical data were recorded and observed from March 2020 to March 2021 and different strategies implemented in order to limit patients and providers risk of exposure to COVID-19. The impact of these strategies was assessed trough a survey that was performed after the first two months of pandemic (coinciding with the period of general lockdown) and after one year from the pandemic onset.

We observed a statistically significant improvement of the following items difficulties in reaching medical clinic (p=0.0072), continuation of physical therapy (p=0.0021) and feelings of anxiety in medical conditions (p=0.0006). Considering the difficulties in communications with the medical staff we obtained optimal scores both at the beginning of pandemic and after one year from the pandemic onset without significant difference.

Our survey showed that the adopted strategies provided a feeling of confidence and safety among ITB patients and their caregivers during the COVID-19 pandemic. We think that a clear communication is always of paramount importance to manage these patients.
Our survey showed that the adopted strategies provided a feeling of confidence and safety among ITB patients and their caregivers during the COVID-19 pandemic. We think that a clear communication is always of paramount importance to manage these patients.
Intra-hospital transport (IHT) of neurosurgical intensive care (NICU) patients for cranial computed tomography (CCT) scans is associated with a high rate of complications. The potential of serum biomarkers to estimate the risk for complications associated with IHT and improve their safety remains underexplored. The present study investigated the influence of several serum biomarkers on IHT-associated complications in brain-injured NICU patients.

A total of 523 IHTs in 223 NICU patients were prospectively analysed (05/2019-05/2020). Haemoglobin, haematocrit, serum sodium, and albumin levels were evaluated as serum biomarkers. Each patient's demographic data, cranial computed tomography (CCT) scan, NICU parameters and modified Rankin Scale at discharge as well as indications, consequences, and complications of IHTs were analysed.

In 58.7% of all IHTs, at least one IHT-associated complication was observed with 60.1% of all IHTs having no therapeutic consequence. Significantly lower rates of increased intracranial pressure (ICP; p<0.0001), decreased cerebral perfusion pressure (CPP; p=0.03) as well as hemodynamic (p<0.0001) and pulmonary events (p=0.01) were observed in patients with higher haemoglobin levels prior to IHT. Additionally, higher haematocrit levels before IHT were associated with a fewer rate of hemodynamic (p<0.0001), pulmonary (p=0.006), ICP (p<0.0001), and CPP (p=0.01) events.

Higher levels of haemoglobin and haematocrit are associated with less complications with respect to ICP, CPP, hemodynamic and pulmonary events during IHT in NICU patients. Therefore, these biomarkers may be helpful for risk assessment of potential complications prior to IHT.
Higher levels of haemoglobin and haematocrit are associated with less complications with respect to ICP, CPP, hemodynamic and pulmonary events during IHT in NICU patients. Therefore, these biomarkers may be helpful for risk assessment of potential complications prior to IHT.
In the last decades, there has been a marked evolution in skull base surgery techniques and more recently a combination of different corridors has been proposed and used in order to improve angles of attack, shorten working distances, and ameliorate visualization of skull base lesions. Recently, the endoscopic endonasal and transorbital routes have been combined as multiportal approach to reach and treat complex skull base neoplasms. The aim of this paper is to examine data extracted from the recent literature about the feasibility and effectiveness of combined endonasal and transorbital endoscopic multiportal surgery.

A PubMed comprehensive search of literature published until October 2020 was conducted. Nine studies, regarding 24 patients, were included.

The majority of tumors were meningiomas (62,5%), mostly located at the spheno-orbital region (93,3%). GTR was accomplished in 10 patients (41,7%), NTR in 2 patients (8,3%). Endonasal transpterygoid approach (n = 8) and superior eyelid access (n = 17) were the most used routes used. No case of CSF fistula was observed, and the most common complication was a transient periorbital edema. The average hospitalization time (days) was 5 days.

A combined endoscopic endonasal and transorbital multiportal approach grants an adequate corridor to access several skull base tumors, such as those extending towards the paramedian aspects, providing good outcomes in terms of extent of tumor resection with acceptable rates of complications. These preliminary results might encourage the use of multiportal approaches in selected complex skull base neoplasms.
A combined endoscopic endonasal and transorbital multiportal approach grants an adequate corridor to access several skull base tumors, such as those extending towards the paramedian aspects, providing good outcomes in terms of extent of tumor resection with acceptable rates of complications. These preliminary results might encourage the use of multiportal approaches in selected complex skull base neoplasms.
The benefits of decompressive craniectomy (DC) have been demonstrated in malignant ischemic stroke and traumatic brain injuries with refractory intracranial hypertension (ICH) by randomized controlled trials. Some reports advocate the potential of DC in the context of ICH due to meningoencephalitis (ME) with focal cerebral edema but its interest remains controversial especially when there is diffuse cerebral edema. The aim of this study is to assess the benefits of DC in meningoencephalitis with malignant cerebral edema whether it is focal or diffuse.

We report two cases successfully treated in our instution, plus we conducted a systematic literature review focused on cases of DC in ME in compliance with prisma guidelines.

the first patient is a 36-years-old woman who suffered from fulminant pneumococcal meningoencephalitis (ME) with refractory ICH following a transphenoidal removal of pituitary adenoma. The second patient is a 20-years-old man suffering from neuromeningeal cryptococcosis with refractory ICH. In both cases DC led to major clinical improvement with a GOS-E 8 at one year. These results are consistent with the literature review which reports a favorable outcome in 85% of cases.

DC appears to be a promising therapeutic option in cases of ME with refractory ICH. Thus, reliable criteria will have to be defined to guide us in our practice in emergency cases where DC has not been part of the therapeutic arsenal yet.
DC appears to be a promising therapeutic option in cases of ME with refractory ICH. Thus, reliable criteria will have to be defined to guide us in our practice in emergency cases where DC has not been part of the therapeutic arsenal yet.
Degenerative disc disease is a major health concern in spine surgery. The aim of this article is to summarize the current knowledge about injectable regenerative therapies (Mesenchymal Stem Cells -MSC- or Platelet Rich Plasma - PRP) in degenerative disc disease.

A research and analysis of the literature on Pubmed, Medscape, MEDLINE, Google Scholar and Cochrane databases was performed, in accordance with the Preferential Reporting Items for - Systematic Reviews and Meta-analyses (PRISMA) flowchart. Only peer-reviewed randomized controlled trials (RCTs), prospective single-arm trials, case series, and cohort studies were included.

A total of 17 studies were included. All were homogeneous regarding indications to the procedure discogenic low-back pain for at least 3-6 months, failure of conservative treatment, MRI evidence of disc degeneration. A total of 182 patients were treated with MSC and 198 patients were treated with PRP. Considering the efficacy, the studies were heterogeneous in clinical evaluation systems; however, they all reported significant improvement in clinical and functional scores.
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