World Neurosurg
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The glioma microenvironment is heavily infiltrated by non-neoplastic myeloid cells, including bone marrow-derived macrophages and central nervous system-resident microglia. As opposed to executing the antitumor functions of immune surveillance, antigen presentation, and phagocytosis, these tumor-associated myeloid cells are co-opted to promote an immunosuppressive milieu and support tumor invasion and angiogenesis. This review explores evolving evidence and the research paradigms used to determine the interplay of tumor genetics, immune cell composition, and immune function in gliomas. Understanding these cells and how they are reprogrammed will be instrumental in finding new and effective treatments for these lethal tumors.
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Meta Analysis Comparative Study
Comparison of Blister Aneurysm Treatment Techniques: A Systematic Review and Meta-Analysis.
Blood blister aneurysms are small, thin-walled, rapidly growing side-wall aneurysms that have proved particularly difficult to treat, and evidence-based guidance for treatment strategies is lacking. A systematic review and meta-analysis was performed to aggregate the available data and compare the 3 primary treatment modalities. ⋯ Flow diversion seems to be an effective treatment strategy for ruptured blood blister aneurysms, with lower rates of perioperative complications compared with surgical and other endovascular techniques, but studies investigating long-term outcomes after flow diversion warrant further study.
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Meta Analysis
Determinants of surgical remission in prolactinomas: a systematic review and meta-analysis.
Prolactin-secreting tumors respond well to medical management, with a few patients requiring surgery. We conducted a systematic review and meta-analysis to study the determinants of surgical remission in these tumors. ⋯ Transsphenoidal surgery for prolactinomas may be particularly effective in small, noninvasive, treatment-naive tumors and may provide a viable first-line alternative to dopamine agonist therapy in such patients.
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Intraneural perineurioma is a rare peripheral nerve sheath tumor characterized by localized proliferation of perineurial cells. The literature consists predominantly of case reports and institutional series, with inconsistent and confusing nomenclature. We present a pooled analysis of all reported cases of intraneural perineurioma in the literature. ⋯ Intraneural perineurioma represents a benign focal lesion presenting with weakness and atrophy affecting adolescents and young adults. Most cases are managed nonoperatively and surgical treatment strategies are varied.
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Rheumatoid arthritis (RA) is a risk factor of lumbar spine surgical failure. The interest of anterior lumbar fusion in this context remains unknown. This retrospective study aimed to compare the outcome of anterior-only fusions between RA patients and non-RA (NRA) patients to treat lumbar spine degenerative disorders. ⋯ As noticed for posterior-only fusion, the anterior lumbar approach in RA patients does not seem to avoid the occurrence of an adjacent segment disease.