HIPPOCAMPAL GANGLIOSIDE COMPOSITION IS ALTERED BY METFORMIN AND LIRAGLUTIDE TREATMENT IN A HIGH-FAT HIGH-SUGAR DIET RAT MODEL.

Insulin resistance has many deleterious effects on the central nervous system, including the initiation and potentiation of neurodegeneration. While the pathogenesis of Alzheimer's disease has been extensively researched with many insights into the effects of amyloids and neurofibrillary tangles, the connection between the two pathogenic entities has not yet been fully elucidated. Gangliosides are commonly found in neuronal membranes and myelin, specifically in lipid rafts that have been linked to pathological amyloidogenesis. In this study, 64 Sprague Dawley rats with equal sex distribution were separated into four sex-specific groups, as follows: control group on standard diet; group on high-fat, high-sugar diet (HFHSD); group on HFHSD treated with metformin; and group on HFHSD treated with liraglutide. Free-floating immunohistochemistry of the rat hippocampi was performed to analyze group-specific and sex-specific changes in the composition of the four most common gangliosides found in neuronal membranes and myelin sheaths, GM1, GD1a, GD1b and GT1b. The groups on HFHSD showed glucose tolerance impairment and body weight increase at the end of the experiment, whereas the groups treated with pharmacotherapeutics had better insulin sensitivity and decreases in body weight by the end of the experiment. Most changes were observed for GM1 and GD1b. Positive immunoreactivity for GM1 was observed in the male group treated with liraglutide in regions where it is not physiologically found. The changes observed following HFHSD and liraglutide treatment were suggestive of ganglioside restructuring that might have implications on pathological amyloidogenesis. Metformin treatment did not significantly alter the hippocampal ganglioside composition in either sex.

Understanding Adult Central Nervous System Hemangioblastomas: A Systematic Review.

BACKGROUND: Adult hemangioblastomas (HBs) are rare World Health Organization central nervous system (CNS) grade 1 tumors, particularly affecting the posterior cranial fossa. They exhibit a gender bias, impacting men in their fifth and sixth decades of life and manifesting sporadically or as part of von Hippel Lindau disease. Understanding the intricacies of CNS HBs is crucial for clinical decision-making. METHODS: A systematic review of 576 articles was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Eligibility criteria included 3189 adult cases of CNS HBs. Data on patient demographics, tumor characteristics, symptoms, treatment modalities, complications, and outcomes were systematically extracted and synthesized. RESULTS: The review revealed a heterogeneous demographic distribution, with a male predominance. The median age at diagnosis was 44.7 years. Cranial HBs were more commonly located in the infratentorial (73%) than supratentorial (27%) compartments. Spinal HBs were mostly located in the cervical spine (44.3%), followed by thoracic (36.7%) and lumbar spine (12%). Clinical symptoms varied by location, emphasizing the importance of anatomical considerations. Surgical intervention-total resection (82% of cases)-was the preferred treatment modality, while radiotherapy was less common. Histological examination and immunohistochemistry aided in accurate diagnosis. Complications were location-specific, with intracranial complications more common in infratentorial tumors. Overall, favorable outcomes were prevalent (78% of cases), with low mortality rates. CONCLUSIONS: Adult CNS HBs present with diverse characteristics and clinical manifestations. Surgical intervention remains the mainstay treatment; ongoing research into genetic and molecular mechanisms may enhance our understanding of tumor pathology and lead to improved management strategies in the future.

Screening for Carpal Tunnel Syndrome in Patients on Chronic Hemodialysis.

OBJECTIVES: To determine the prevalence of carpal tunnel syndrome risk in patients on chronic hemodialysis (HD) using Levine questionnaire for assessment of carpal tunnel syndrome - related symptoms severity and patients' functional status and to examine the relation of the determined risk with the participants' demographic, anthropometric and laboratory data. PARTICIPANTS AND METHODS: This crosssectional study included 78 chronic HD patients at Department for Nephrology in University Hospital Osijek. All participants filled out the Levine questionnaire to examine the severity of carpal tunnel syndrome - related symptoms and their functional state. The participants' demographic, anthropometric and laboratory data were taken from the medical records and statistically analyzed by SPSS for Windows (version 16.0, SPSS Inc., Chicago, IL, SAD). RESULTS: Risk for carpal tunnel syndrome was found in 38.5% of the participants. No significant differences between patients with and without the risk were found in sex distribution, underlying kidney disease or vascular access. Patients at risk were older (P=0.044) and had higher body mass index (BMI), (t-test, P=0.019). Participants' age, BMI and predialytic serum urea concentration were independent predictors for carpal tunnel syndrome risk (P=0.033). CONCLUSION: The prevalence of risk for carpal tunnel syndrome among patients on chronic HD was found in more than one third of patients. Older age, higher BMI and higher predialytic serum urea concentration bear a higher risk. Electromyoneurography is thus often indicated in this population to confirm the diagnosis for consecutive surgical treatment.

Hemangioblastomas of the Posterior Cranial Fossa in Adults: Demographics, Clinical, Morphologic, Pathologic, Surgical Features, and Outcomes. A Systematic Review.

BACKGROUND: Posterior cranial fossa (PCF) hemangioblastomas are benign, highly vascularized, and well-differentiated tumors with well-described histopathologic features. Although relatively rare, this tumor is the most prevalent primary tumor of the cerebellum in adults. OBJECTIVE: Because the demographics of patients with such a tumor (as well as the clinical, morphologic, pathologic, surgical features, and outcomes) are not fully understood, we systematized characteristic patient and tumor features. METHODS: We undertook a systematic review of the English-language literature in PubMed for PCF hemangioblastomas in adults published in the past 31 years. We analyzed geographic distribution and year of publication of articles; demographic data of patients; presenting symptoms and clinical signs; tumor location and morphology; histopathologic features, extent of tumor resection, perioperative blood loss, and postoperative complications; length of hospital stay; and outcomes. RESULTS: We reviewed 207 articles describing 1759 infratentorial hemangioblastomas in a cohort of 1515 adult patients. We found female predominance in patients with Von Hippel-Lindau disease (VHLD) compared with male predominance in the general patient group. Symptoms of intracranial hypertension were more common in the VHLD group compared with the general group of patients. The cerebellar location was more common in the VHLD group and solid (parenchymatous) tumor was the most common type. Most patients underwent total resection but rate of resection did not differ between the general and VHLD groups. Most patients had a favorable outcome. CONCLUSIONS: The literature of adult PCF hemangioblastomas is limited and general surgical experience with such tumors is scarce because of their rarity. Rates of postoperative complications and mortality remain higher than expected. However, prognosis and surgical outcomes are generally favorable. Nevertheless, surgery of adult PCF hemangioblastomas is a demanding and challenging task.