Notes

Bilateral subdural hygromas following endovascular coiling pertaining to cracked aneurysmal subarachnoid lose blood: a silly and also uncommon side-effect.
The complement system is a multi-functional system representing the first line host defense against pathogens in innate immune response, through three different pathways. Impairment of its function, consisting in deficiency or excessive deregulated activation, may lead to severe systemic infections or autoimmune disorders. These diseases may be inherited or acquired. Despite many diagnostic tools are currently available, ranging from traditional, such as hemolytic or ELISA based assays, to innovative ones, like next generation sequencing techniques, these diseases are often not recognized. As for therapeutic aspects, strategies based on the use of targeted drugs are now widespread. The aim of this review is to present an updated overview of complement system pathophysiology, clinical implications of its dysfunction and to summarize diagnostic and therapeutic approaches.
Inflammatory pseudotumors (IPTs) are rare benign conditions of unknown etiology that can affect any part of the body. IPTs are most commonly associated with Immunoglobulin G4 (IgG4)-related disease. Central nervous system IPTs, especially with pituitary involvement, are even rarer entities. The presence of an IgG4-negative pituitary IPT with simultaneous extracranial involvement has not been reported.

We present the case of a 41-year-old female with past medical history of rheumatoid arthritis and a diagnosis of pituitary IPT with coexisting sphenoidal (extracranial) involvement mimicking a pituitary macroadenoma at presentation. The patient underwent multiple consecutive biopsies, and an extensive workup prior to establishing the diagnosis. Laboratory work-up showed normal serum IgG4 and unremarkable liver function tests.

Pituitary lesions with simultaneous sphenoidal involvement in patients with IgG4-negative systemic inflammatory disease should raise the clinical suspicion for intracranial IPTs, as these tumors can mimic aggressive counterparts causing adjacent bony erosion, and local invasion.
Pituitary lesions with simultaneous sphenoidal involvement in patients with IgG4-negative systemic inflammatory disease should raise the clinical suspicion for intracranial IPTs, as these tumors can mimic aggressive counterparts causing adjacent bony erosion, and local invasion.
Incidentally found intra-spinal bullets are extremely rare, and have never been reported in the literature. The aim of this study is to report a rare case of an asymptomatic migrating intra-spinal bullet, emphasizing the role of cultural context in history taking, and describing its surgical retrieval technique.

We discuss a case of a 10-years old boy with an incidentally discovered intra-spinal bullet opposite to the L5 vertebral level, who presented 3 months after the suspected initial insult. Following its migration to the L3/L4 level intraoperatively, the bullet was forced to spontaneously return to its preoperative position by reverse Trendelenburg Position, Valsalva maneuver and Intrathecal saline infusion, thus avoiding extending the previously performed laminectomy.

The authors remind the readers that history is the cornerstone of the clinical practice, even in the most obscure cases. Many convoluted intra-operative situations could be resolved by utilizing basic anatomical and physiological principles.
The authors remind the readers that history is the cornerstone of the clinical practice, even in the most obscure cases. Many convoluted intra-operative situations could be resolved by utilizing basic anatomical and physiological principles.Intra-articular corrective osteotomy can be used to restore the anatomic position of knee surfaces for tibial plateau malunion (TPM) but precise restoration is not easy. The personalized surgical guide (PSG) might improve the TMP outcomes. CP 43 clinical trial This study developed a two-staged PSG method to provide registration and drill the bone for subsequent osteotomy. The tests were performed to compare the accuracy the proposed PSG and the conventional guide (Anterior cruciate ligament guide, ACLG). The results showed that the PSG provides better accuracy (0.50 ± 0.19 mm) than the ACLG (1.58 ± 0.67 mm). The results show the PSG method is a feasible alternative to the conventional ACLG procedure.Background Infectious disease-related public health emergencies (epidemics) may increase suicide risk, and high-quality evidence is needed to guide an international response. Aims We investigated the potential impacts of epidemics on suicide-related outcomes. Method We searched MEDLINE, EMBASE, PsycInfo, CINAHL, Scopus, Web of Science, PsyArXiv, medRxiv, and bioRxiv from inception to May 13-16, 2020. Inclusion criteria primary studies, reviews, and meta-analyses; reporting the impact of epidemics; with a primary outcome of suicide, suicidal behavior, suicidal ideation, and/or self-harm. Exclusion criteria not concerned with suicide-related outcomes; not suitable for data extraction. PROSPERO registration #CRD42020187013. Results Eight primary papers were included, examining the effects of five epidemics on suicide-related outcomes. There was evidence of increased suicide rates among older adults during SARS and in the year following the epidemic (possibly motivated by social disconnectedness, fears of virus infection, and concern about burdening others) and associations between SARS/Ebola exposure and increased suicide attempts. A preprint study reported associations between COVID-19 distress and past-month suicidal ideation. Limitations Few studies have investigated the topic; these are of relatively low methodological quality. Conclusion Findings support an association between previous epidemics and increased risk of suicide-related outcomes. Research is needed to investigate the impact of COVID-19 on suicide outcomes.Post workout multi-ingredient admixtures are commonly used to maximize recovery after exercise. The present double-blind, cross-over study compared the acute effects of ingesting a protein-vegan multi-ingredient (VGMT) vs. maltodextrin (MALT) on indices of muscle function. Ten trained males, (26.8 ± 1.9 years) performed two identical, 3-day resistance training periods (one workout-session per day) while receiving either VGMT or MALT (10 min after the completion of each workout). Following a baseline evaluation, we conducted assessments at, 1-h, 24-h and 48-h after the 3-day training period. Primary outcome included the evoked tensiomyography contraction velocity (Vc) of vastus medialis (VM), biceps femoris long head (BFLH) and anterior deltoids (AD). Secondary outcomes involved strength and power performance while the other tensiomyography variables [muscle displacement (Dm), contraction time (Tc)] were considered as exploratory. After 1-h, all the tensiomyography variables measured at VM and BFLH were similarly depressed in both treatments. Only MALT showed a significantly lower Vc (-0.02 m.s-1, 95% CI, -0.04, -0.01) in the AD. After 24-h, the VGMT treatment normalized all tensiomyography values. Conversely, impaired scores were observed in Vc for the VM (-0.03 m.s-1, 95% CI, -0.06, -0.01) and BFLH (-0.02 m.s-1, 95% CI, -0.05, 0.01) in the MALT treatment. Particularly, the Vc in VM was lower (p = 0.043) in MALT compared to VGMT. Overall, both treatments required 48-h to regain their performance capacity; however, VGMT produced better vertical jump and squat performance at 24-h vs. MALT. Compared to MALT, a vegan-protein multi-ingredient appears to hasten the recovery of muscular function over a 24-h period.
Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19.

This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels <140 mg/dL, 140-180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality.

Of the 11,312 patients, only 2128 (18.9%) had diabetes and 2289 (20.4%) died during hospitalization. The in-hospital mortality rates were 15.7% (<140 mg/dL), 33.7% (140-180 mg) and 41.1% (>180 mg/dL),
<.001. The cumulative probability of mortality was significantly higher in patients with hyperglycaemia compared to patients with normoglycaemia (log rank,
<.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypef diabetes. KEY MESSAGE Admission hyperglycaemia is a stronger and independent risk factor for mortality in COVID-19. Screening for hyperglycaemia, in patients without diabetes, and early treatment of hyperglycaemia should be mandatory in the management of patients hospitalized with COVID-19. Admission hyperglycaemia should not be overlooked in all patients regardless prior history of diabetes.A pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis that occurs either due to a pancreatic duct disruption or a pseudocyst extension. A pancreatic divisum, on the other hand, is a common anatomic variant of the pancreas that is rarely symptomatic. We describe a case of recurrent pleural effusion in a patient with a history of chronic pancreatitis. Investigations revealed the presence of a PPF and a concomitant complete pancreatic divisum. There was resolution of the pleural effusion on endoscopic therapy. This is the fourth reported case of a PPF in the setting of complete pancreatic divisum and the first reported case in a middle-aged female.Today, cancer still poses a serious threat to human, but there is no exact cure. Therefore, exploring to accomplish high therapeutic performance is a challenging and urgent task. Since the nanoparticles unique properties were discovered, they have displayed promising potential for more effective therapies and have been widely used in photodynamic therapy (PDT) and radiation therapy (RT). However, some special properties of the tumor microenvironment (TME) have seriously affected the therapeutic outcomes, so the modulation of the TME becomes critical. Manganese dioxide (MnO2), as a transition metal oxide, has been widely used in biomedical fields with special physical and chemical properties, especially in regulating the TME. Furthermore, MnO2 has widely applications in various cancer treatments, such as PDT, chemodynamic therapy (CDT), immunotherapy, and some specific collaborative treatment. Herein, we reviewed the recent applications of MnO2 modified nanomaterials in tumor therapies and theranostics, including TME regulation, controlled drug loading/delivery/release, and imaging.
This was a systematic review and meta-analysis.

Degenerative cervical myelopathy (DCM) with spondylolisthesis remains not well defined, poorly studied, and underreported and plays a minor role in the therapeutic decision-making. Spondylolisthesis, however, is not uncommon and may result in dynamic injury to the spinal cord. We aim to describe the impact of spondylolisthesis in DCM severity and postoperative outcomes.

Two independent reviewers conducted a Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA 2015)-based review between 1970 and May 2020 for articles reporting outcome of DCM in patients with degenerative cervical spondylolisthesis. Patient clinical and radiological data was recorded at baseline and during postoperative follow-up (FU). A meta-analysis comparing surgical outcome between DCM patients with and without spondylolisthesis assessed by the regular/modified Japanese Orthopaedic Association Assessment Scale (mJOA) recovery ratio was completed.

A total of 3 studies were included (1 ambispective and 2 retrospective cohorts); 607 patients with DCM were identified, 102 (16.
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