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About 30% of patients with epilepsy have drug-resistant seizures. The aim of the current endeavor was to systematically review the existing evidence on the potential applications of microRNAs as biomarkers in people with difficult to treat temporal lobe epilepsy (TLE).

MEDLINE (accessed from PubMed) and Scopus from inception to March 18, 2020 were systematically searched for related published articles. In both electronic databases, the following search strategy was implemented, and these keywords (in the title/abstract) were used "microRNA" AND "temporal lobe epilepsy." Articles written in English that were human studies in people with epilepsy were all included in this search.

We could identify 16 articles about different aspects of microRNAs in the serum of patients with TLE. However, only three studies robustly investigated microRNAs as potential biomarkers in the diagnosis of drug-resistant TLE (microRNA-155 (upregulated), microRNA-129-2-3p (upregulated), microRNA-153 (downregulated)). One small study provided class II, and two small studies provided class III evidence.

While this systematic review identified three studies that provided some evidence on the potential applications of circulating serum microRNAs as biomarkers in people with drug-resistant TLE, the evidence is not robust yet. While these findings provide a new horizon, substantial challenges remain before the roles of microRNAs as biomarkers in the diagnosis of drug-resistant TLE can be translated into clinical practice.

While this systematic review identified three studies that provided some evidence on the potential applications of circulating serum microRNAs as biomarkers in people with drug-resistant TLE, the evidence is not robust yet. While these findings provide a new horizon, substantial challenges remain before the roles of microRNAs as biomarkers in the diagnosis of drug-resistant TLE can be translated into clinical practice.Chiari malformation type I (CM1) is defined as cerebellar tonsillar herniation below the level of the foramen magnum. Syncope, especially cough syncope, is a rare but important symptom of CM1 patients. Here, we report a CM1 patient, in combination with brainstem herniation (CM1.5), presenting with repetitive syncope who was successfully treated by decompressive surgery. A 43-year-old right-handed male, with 5-year history of repeated episodes of loss of consciousness in association with cough, was investigated. Neurological examination revealed slight muscle weakness, clumsiness, and sensory disturbance in the left upper limb. There was no sign of orthostatic hypotension or orthostatic intolerance. Cranial and spinal magnetic resonance imaging revealed a herniation of the cerebellar tonsils and a syringomyelia. Forced hyperventilation during electroencephalogram (EEG) induced brief generalized symmetric clonic convulsions with preserved consciousness, but no overt EEG seizure patterns or slow activities were found. Based on the diagnosis of CM1.5 with recurrent episodes of loss of consciousness, he underwent foramen magnum decompression. He has no recurrence of the episode after the surgery on 1 year follow-up. Decompressive surgery was an effective procedure for cough syncope and other symptoms of the current patient with CM1.5. Dissociation of cerebrospinal fluid pressure between the cranial and spinal compartments which leads further herniation of the cerebellar tonsils and subsequent compression on the cerebellum and the brainstem is considered to be the major mechanism of his cough syncope. Analysis of EEG can be useful not only to diagnose epileptic seizures but also to elucidate mechanisms of syncope and concurrent involuntary movements.Description of migraine pain is sometimes difficult for a patient. The simple words reported in the Classification of International Headache Society are not sufficient to explain both the patient's sense of discomfort and the emotional point of view. We analyzed works by international writers and novelists in the last centuries to explore the connotation of migraine in literature. We evaluated the literary insight of migraine, the description of migraine experience and the therapies proposed in novels, essays and short stories. In literature, migraine has still the negative connotation of an untreatable disease. It is described as a barrier for social, familial, and work activities. In more recent works, new therapies are not mentioned, confirming that scientific improvements both in acute phase and in prophylaxis are not part of the literary cultural mainstream.

Metabolic reprogramming within cancer cells has been recognized as a potential barrier to chemotherapy. Additionally, metabolic tumor heterogeneity is the one of factors behind discernible hallmarks such as drug resistance, relapse of the tumor and the formation of secondary tumors.

In this paper, cell-based assays including PI/annexin V staining and immunoblot assay were performed to show the apoptotic cell death in MCF-7 cells treated with DOX. Further, MCF-7 cells were lysed in a hypotonic buffer and the whole cell lysate was purified by a novel and specifically designed metabolite (~ 100 to 1000Da) fractionation system called vertical tube gel electrophoresis (VTGE). selleck chemical Further, purified intracellular metabolites were subjected to identification by LC-HRMS technique.

Cleaved PARP 1 in MCF-7 cells treated with DOX was observed in the present study. Concomitantly, data showed the absence of active caspase 3 in MCF-7 cells. Novel findings are to identify key intracellular metabolites assisted by VTGE systtracellular metabolites of MCF-7 cells treated by DOX. Here, these identified intracellular metabolites corroborate to caspase 3 independent and mitochondria induced apoptotic cell death in MCF-7 cells. Finally, these findings validate a proof of concept on the applications of novel VTGE assisted purification and analysis of intracellular metabolites from various cell culture models.

Gastric varices (GV) are an important complication of portal hypertension, and the current recommendation for management is beta-blocker therapy for primary prophylaxis and transjugular intrahepatic portosystemic shunt (TIPS) for active bleeding or secondary prophylaxis. Direct endoscopic injection of cyanoacrylate (CYA) glue has been investigated but has drawbacks including limited endoscopic characterization of GV and possible distal glue embolism. To this end, endoscopic ultrasound (EUS) has been pursued to help in characterization of GV, visualization of treatment in real time, and confirmation of obliteration with Doppler.

In this paper, we review treatments for GV involving EUS, including EUS-guided injection of CYA and coils, either alone or in combination. We also discuss less common methods, including EUS-guided injection of thrombin and absorbable gelatin sponge. We then review literature comparing EUS-guided methods with direct endoscopic therapy and comparing individual EUS-guided methods with one another.

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