MYJ-1633 (MYJ1633 / MYJ 1633)

Operative challenges and functional outcomes of salvage microsurgery in Gamma Knife-failed vestibular schwannoma: A 12-year institutional experience.

Birua Gyani J S GJS, Sadashiva Nishanth N, Thimmarayappa Arun A, Varshini Amrutha A et al.

Vestibular schwannoma (VS) is a benign tumor of the vestibular nerve. In selected cases, Gamma Knife radiosurgery (GKRS) is used due to its minimally invasive nature and reported tumor control rates of approximately 90%. Salvage microsurgery after failed GKRS is uncommon, and its technical difficulty remains debated. Some authors report increased surgical challenges, while others find no significant differences compared to primary microsurgery. This study presents our experience with salvage microsurgery for VS following failed GKRS, focusing on operative challenges and outcomes. This retrospective observational study was conducted at the National Institute of Mental Health and Neurosciences (NIMHANS), India. Between 2012 and 2023, 1633 patients underwent surgery for vestibular schwannoma, including primary and recurrent cases. Among these, 24 patients had previously received GKRS and subsequently required salvage microsurgery. We retrieved clinical, radiological, and operative data from institutional medical records and PACS imaging. GKRS parameters, including tumor volume and radiation dose, were obtained from the GKRS department. Of the 24 patients, eight were operated on for right-sided tumors, and sixteen for left-sided tumors. The mean tumor volume increased from 7.8 cc before GKRS to 19.13 cc at surgery. The median interval from symptom onset to GKRS was 28.91 months, while the median duration from GKRS to surgery was 28.81 months. Central contrast enhancement decreased at six months post-GKRS in 66.7% of cases. The mean operative time was 332.92 min, and the mean blood loss was 570 mL. Tumors were firm in 58.3% of cases and moderately vascular in 75%. The fifth and seventh cranial nerves were identified in 62.5% and 75.0% of cases, respectively. Tumor adherence to the brainstem was observed in 17 cases, while significant arachnoid thickening was present in only four cases. Salvage microsurgery after failed Gamma Knife radiosurgery for vestibular schwannoma is feasible and safe. However, post-radiosurgical tissue changes, such as adherence of the cranial nerves to the tumor and difficulty identifying the cranial nerves, make it technically more demanding than primary microsurgery, resulting in lower rates of gross total resection and a higher incidence of facial nerve morbidity. In this setting, a strategy prioritising maximal safe resection and functional preservation, rather than complete tumour clearance, is recommended.

Sex differences in subjective cognitive impairment among Chinese patients with depression: A large-scale cross-sectional study.

Wang Chongze C, Zhang Yao Y, Chen Nizhe N, Wang Xiaoxiao X et al.

Cognitive impairment is common in major depressive disorder (MDD) and is associated with impaired social functioning and an increased risk of relapse. Although sex differences in MDD are well documented, their specific role in subjective cognitive impairment (SCI) and related clinical correlates remains unclear. This study aimed to examine sex differences in SCI and its associated clinical risk factors within a large cohort of Chinese patients with MDD. This cross-sectional study included 2298 adults with MDD (665 males, 1633 females; mean [standard deviation] age, 30.88 [10.33] years). Sociodemographic and clinical characteristics were collected electronically. Participants completed the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, Generalised Anxiety Disorder-7 (GAD-7) for anxiety symptoms, 20-item Perceived Deficits Questionnaire-Depression (PDQ-D-20) for SCI and 20-item Toronto Alexithymia Scale (TAS-20) for alexithymia. Analysis of covariance and binary logistic regression were used to analyse sex differences in SCI and associated factors. Interaction analyses assessed whether these associations differed by sex, and sensitivity analyses used a more stringent SCI cutoff. The Benjamini-Hochberg false discovery rate (FDR) correction was applied to account for multiple testing. Of the 2298 participants, 67.9% (n = 1561) met the criterion for SCI. Females had significantly higher PDQ-D-20 scores than males (adjusted mean, 31.65 vs. 30.06; F = 6.25, p = 0.013) and a higher prevalence of SCI (69.8% vs. 63.3%, χ 2 = 9.17, p = 0.002). In both sexes, SCI was associated with TAS-20 scores (males: odds ratio [OR] = 1.08, 95% confidence interval [CI] 1.05-1.10; females: OR = 1.07, 95% CI 1.06-1.09) and PHQ-9 scores (males: OR = 1.17, 95% CI 1.11-1.24; females: OR = 1.12, 95% CI 1.08-1.16) (all p < 0.001; p-FDR < 0.001). GAD-7 scores were associated with SCI only among female patients (OR = 1.05, 95% CI 1.01-1.09; p = 0.008; p-FDR = 0.014), and this finding remained robust in sensitivity analyses. No interaction with sex was significant in the primary analysis (all p > 0.05), but a significant sex × TAS-20 interaction was observed under the more stringent cutoff (OR = 1.03, 95% CI 1.00-1.06; p = 0.024; p-FDR = 0.036). This study identifies significant sex differences in SCI among Chinese patients with MDD. Female patients reported greater SCI, and anxiety symptoms were associated with SCI only in the female subgroup. These findings support further investigation of sex-sensitive approaches to assessing and managing cognitive complaints in MDD.

Retraction notice to "Compression regulates gene expression of chondrocytes through HDAC4 nuclear relocation via PP2A-depended HDAC4 dephosphorylation" [Biochimica et Biophysica Acta (BBA) - Mol. Cell Res. 1863 (2016) 1633-1642].

Chen Chongwei C, Wei Xiaochun X, Wang Shaowei S, Jiao Qiang Q et al.

Clinical Course and Predictors of Biologic Therapy, Hospitalisation and Surgery: A Five-Year Prospective Study in Newly Diagnosed Inflammatory Bowel Disease.

Garre Ana A, Nuñez Ortiz Andrea A, Rubio Saioa S, Diz-Lois Palomares María Teresa MT et al.

This study aimed to describe the characteristics of newly diagnosed inflammatory bowel disease (IBD) patients and to analyse their clinical course within the first 5 years after diagnosis, including the need for surgery, hospitalisations and treatments. This prospective and large multicentre incident cohort registry in Spain enrolled adults diagnosed with Crohn's disease (CD), ulcerative colitis (UC) or unclassified IBD (IBD-U) in 2017 and followed them for 5 years. A total of 3301 patients were enrolled: 1526 with CD, 1633 with UC and 142 with IBD-U. Their median age at diagnosis was 43 years (interquartile range 31-56) and approximately 50% were male. Within 5 years post-diagnosis, 30% received biologics or JAK inhibitors (JAKi), 34% were hospitalised at least once and 9% underwent surgery. The cumulative incidence of biologic/JAKi treatment, hospitalisations and surgeries was higher among CD patients. Use of biologics/JAKi correlated with a more aggressive CD phenotype, greater UC extent and younger age at diagnosis. Biologics/JAKi treatment was associated with lower hospitalisation risk in both CD (Hazard ratio [HR] = 0.4, 95% confidence interval [CI] = 0.2-0.6) and UC patients (HR = 0.5, 95% CI = 0.2-0.9). However, it was not associated with the risk of abdominal surgery in CD but was linked to an increased risk of surgery in UC (HR = 11.9, 95% CI = 4.6-30.4). This large multicentre cohort demonstrated a higher use of biologics/JAKi during the first 5 years after IBD diagnosis than previously reported. Treatment with biologics/JAKi was associated with reduced risk of hospitalisation. However, under current clinical practice patterns, this therapeutic approach did not translate into lower risk of abdominal surgery.