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6%) received an SDD. Drain misplacement occurred in 73 patients (15.8%). In 5 (6.9%) and 9 (12.3%) of these patients, iatrogenic bleeding and neurologic symptoms occurred, respectively. Intake of vitamin K antagonists (odds ratio [OR], 3.64) or different oral anticoagulants (OR, 10.24), and low preoperative Glasgow Coma Scale score (OR, 7.81) remained associated risk factors for drain misplacement after multivariate analysis. Patients with misplaced drains showed a strong association with postoperative bleeding (OR, 5.81), longer operation time (OR, 1.01), and hospitalization time (OR, 1.08) after multivariate analysis. CONCLUSIONS The occurrence of SDD misplacement is unignorable, because it leads to iatrogenic drain-associated complications and seems to affect bleeding events and hospitalization time of patients undergoing burr-hole drainage of cSDH. BACKGROUND Resection of vestibular schwannomas with good functional outcome remains a neurosurgical challenge. SC-43 In this study, we report on our initial experience with a suction spatula which allows free bimanual dissection of small tumors in a clear, bloodless surgical field in supine position. METHODS 41 patients underwent vestibular schwannoma surgery in supine position, using a suction spatula. To analyse its feasibility, eleven aspects of the device were compared to the regular retractor. RESULTS The suction spatula was successfully applied in all surgeries. Compared to a common spatula, the suction spatula showed superior performance during meatotomy, microsurgical and endoscopic tumor dissection as well as in management of bleedings. We noted no difference in ergonomics, compatibility, instrumental conflict, costs, reusability and sterilization issues. Minor performance was related to its thickness/size. There were no significant disadvantages according to our data. There were no surgical complications related to this device. CONCLUSIONS The main advantage of the suction spatula is in the treatment of small, mainly intrameatal vestibular schwannomas in supine patient position. It gives the surgeon a "third hand" while enabling a continuous bimanual dissection with two microinstruments without use of a regular suction tip. OBJECTIVE Recent studies have shown that the clinical outcome in patients treated with the unilateral biportal endoscopic technique, also known as biportal endoscopic spinal surgery (BESS) unilateral laminotomy bilateral decompression (ULBD) in the context of this study, is more favorable compared with those treated with microscopic ULBD. In this systematic review and meta-analysis, we assess the latest evidence on the use of BESS ULBD compared with microscopic ULBD in patients with lumbar spinal stenosis. METHODS We performed a systematic literature search of studies that compared BESS and microscopic ULBD from several databases. RESULTS There were 383 patients from 5 unique studies. Meta-analysis of visual analog scale score for low back pain showed no significant difference at baseline (P = 0.49), at 2-3 months (P = 0.69), and at the final follow-up (P = 0.26). There was no significant difference in visual analog scale score for leg pain and Oswestry Disability Index between the groups preoperatively (P = 0.76 and P = 0.95), at 2-3 months (P = 0.46 and P = 0.92), and at the final follow-up (P = 0.88 and P = 0.58). The mean operation time was similar in the BESS and microsurgery groups (P = 0.36). The BESS group was associated with shorter length of stay (mean difference -2.60 days [-3.39, -1.81]; P less then 0.001; I2 = 65%). Complications were similar in both groups (P = 0.26). Individual studies have shown that BESS was associated with early ambulation and less need for opioids. CONCLUSIONS Current evidence shows a lack of significant differences in terms of efficacy and safety between BESS and microsurgery. Further studies are required before drawing a definite conclusion. Breast cancer develops in the mammary glands during mammalian adulthood and is considered the second most common type of human carcinoma and the most incident and mortal in the female population. In contrast to other human structures, the female mammary glands continue to develop after birth, undergoing various modifications during pregnancy, lactation and involution under the regulation of hormones and transcription factors, including those encoded by the HOX clusters (A, B, C, and D). Interestingly, HOX gene deregulation is often associated to breast cancer development. Within the HOXB cluster, 8 out of the 10 genes present altered expression levels in breast cancer with an impact in its aggressiveness and resistance to hormone therapy, which highlights the importance of HOXB genes as potential therapeutic targets used to overcome the limitations of tamoxifen-resistant cancer treatments. Here, we review the current state of knowledge on the role of HOX genes in breast cancer, specially focus on HOXB, discussing the causes and consequences of HOXB gene deregulation and their relevance as prognostic factors and therapeutic targets. V.Caspase-8 is a cysteine - aspartate specific protease that classically triggers the extrinsic apoptotic pathway, in response to the activation of cell surface Death Receptors (DRs) like FAS, TRAIL-R and TNF-R. Besides it's roles in triggering death receptor-mediated apoptosis, Caspase-8 has also been implicated in the onsets of anoikis, autophagy and pyroptosis. Furthermore, Caspase-8 also plays a crucial pro-survival function by inhibiting an alternative form of programmed cell death called necroptosis. Low expression levels of pro-Caspase-8 is therefore associated with the malignant transformation of cancers. However, the long-held notion that pro-Caspase-8 expression/activity is generally lost in most cancers, thereby contributing to apoptotic escape and enhanced resistance to anti-cancer therapeutics, has been found to be true for only a minority of cancers types. In the majority of cases, pro-Caspase-8 expression is maintained and sometimes elevated, while it's apoptotic activity is regulated through different mechanisms. This supports the notion that the non-apoptotic functions of Caspase-8 offer growth advantage in these cancer types and have, therefore, gained renewed interest in the recent years. In light of these reasons, a number of therapeutic approaches have been employed, with the intent of targeting pro-Caspase-8 in cancer cells. In this review, we would attempt to discuss - the classic roles of Caspase-8 in initiating apoptosis; it's non-apoptotic functions; it's the clinical significance in different cancer types; and the therapeutic applications exploiting the ability of pro-Caspase-8 to regulate various cellular functions.
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