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Background and Objectives: Sarcopenia, a condition characterized by muscle mass loss, is prevalent in up to 68% of rectal cancer patients and has been described as a negative prognostic factor, impacting overall survival and tumor response. While there are extensive data on rectal cancer globally, only a handful of studies have evaluated the role of sarcopenia in locally advanced rectal cancer (LARC). Our study aimed to investigate the relationship between sarcopenia, overall response rate, and toxicity in patients who underwent total neoadjuvant treatment (TNT) for LARC. Materials and Methods: We performed a retrospective study of patients with rectal cancer treated with TNT and surgery with curative intent between 2021 and 2023 at Prof. Dr. Ion Chiricuta Institute of Oncology, Cluj-Napoca. Sarcopenia was assessed on MRI images by measuring the psoas muscle area (PMA) at the level of the L4 vertebra before and after neoadjuvant therapy. The primary endpoints were the overall complete response rate (oCR) and acute toxicity. Results: This study included 50 patients with LARC. The oCR rate was 18% and was significantly associated with post-treatment sarcopenia (OR 0.08, p = 0.043). Patients who did not achieve a clinical or pathologic complete response had, on average, an 8% muscle loss during neoadjuvant therapy (p = 0.022). Cystitis and thrombocytopenia were significantly associated with post-treatment sarcopenia (p = 0.05 and p = 0.049). Conclusions: Sarcopenia and loss of psoas muscle during neoadjuvant therapy were negatively associated with tumor response in locally advanced rectal cancer. Thrombocytopenia and cystitis are more frequent in sarcopenic than non-sarcopenic patients undergoing neoadjuvant chemoradiation for rectal cancer. [ABSTRACT FROM AUTHOR]

Carcinoembryonic antigen(CEA) is a routine marker employed for follow-up of colorectal tumors. We aimed to determine whether a CEA increase within the normal range can be linked to a risk of recurrence. From the period of 2006–2013 we selected 78 consecutive patients with colorectal cancer, who underwent curative surgery with or without neo-/adjuvant chemo- or radiotherapy and had proper follow-up procedures. For analyzing CEA fluctuation, we used the smallest value of the CEA during follow-up as the reference. With the aid of a Chi-squared test, we have chosen the value of 1.1 ng/mL for significant CEA fluctuation. A total of 43.6% of patients had fluctuations in CEA of at least 1.1 ng/mL, with or without increases above 5 ng/mL. From these, in 79.4% of patients, the increases in CEA were explained either by recurrence (44.1%), adjuvant chemotherapy (20.6%) or benign pathology (14.7%). In 23% of the recurrences, a CEA increase of at least 1.1 ng/mL, but below 5 ng/mL, preceded the clinical relapse by a median of 8 months. Our conclusion is that an increase in CEA levels by at least 1.1 ng/mL within the normal range after curative treatment for colorectal cancer may serve as an early indicator of relapse or could be associated with other pathological conditions. [ABSTRACT FROM AUTHOR]

The 13th World Congress for Neurorehabilitation recently took place in Vancouver, Canada, attracting over 1,110 participants from more than 50 countries. The congress featured a diverse program with over 100 scientific sessions, including plenary talks, symposia, round tables, and workshops. The event focused on the concept of neurobiological reserve and its impact on patient care and neurorehabilitation. Topics discussed included brain health, neurological rehabilitation, funding and infrastructure challenges, spasticity management, and career development. The congress emphasized the importance of collaboration and networking among specialists in the field and concluded with the recognition of a neurorehabilitation project that benefited patients. The event showcased the growing interest in community-based rehabilitation and the need for new approaches in evidence-based medicine. [Extracted from the article]

The tumor-to-stroma ratio is a highly debated prognostic factor in the management of several solid tumors and there is no universal agreement on its practicality. In our study, we proposed confirming or dismissing the hypothesis that a simple measurement of stroma quantity is an easy-to-use and strong prognostic tool. We have included 74 consecutive patients with colorectal cancer who underwent primary curative abdominal surgery. The tumors have been grouped into stroma-poor (stroma < 10%), medium-stroma (between 10 and 50%) and stroma-rich (over 50%). The proportion of tumor stroma ranged from 5% to 70% with a median of 25%. Very few, only 6.8% of patients, had stroma-rich tumors, 4% had stroma-poor tumors and 89.2% had tumors with a medium quantity of stroma. The proportion of stroma, at any cut-off, had no statistically significant influence on the disease-specific survival. This can be explained by the low proportion of stroma-rich tumors in our patient group and the inverse correlation between stroma proportion and tumor grade. The real-life proportion of stroma-rich tumors and the complex nature of the stroma–tumor interaction has to be further elucidated. [ABSTRACT FROM AUTHOR]

Currently, only a limited set of molecular traits are utilized to direct treatment for metastatic CRC (mCRC). The molecular classification of CRC depicts tumor heterogeneity based on gene expression patterns and aids in comprehending the biological characteristics of tumor formation, growth and prognosis. Additionally, it assists physicians in tailoring the therapeutic approach. Microsatellite instability (MSI-H)/deficient mismatch repair proteins (MMRd) status has become a ubiquitous biomarker in solid tumors, caused by mutations or methylation of genes and, in turn, the accumulation of mutations and antigens that subsequently induce an immune response. Immune checkpoint inhibitors (ICI) have recently received approval for the treatment of mCRC with MSI-H/MMRd status. However, certain individuals experience either initial or acquired resistance. The tumor-programmed cell death ligand 1 (PD-L1) has been linked to the ability of CRC to evade the immune system and promote its growth. Through comprehensive research conducted via the PUBMED database, the objectives of this paper were to review the molecular characteristics linked to tumor response in metastatic CRC in light of improved patients' outcomes following ICI therapies as seen in clinical trials and to identify particular microRNAs that can modulate the expression of specific oncoproteins, such as PD-L1, and disrupt the mechanisms that allow the immune system to be evaded. [ABSTRACT FROM AUTHOR]

The article discusses the 2nd edition of the Romanian National Neurology Forum, which aimed to improve the healthcare system in Romania. Professionals from various fields came together to discuss strategic insights and perspectives on health policies, focusing on patient perspectives, medical practice, and public policy. Workshops were held on various neurological diseases, addressing issues such as diagnosis, treatment, care, and access to services. The article emphasizes the need for comprehensive approaches to address the challenges faced by the Romanian healthcare system. The forum brought together various stakeholders to find solutions for improving patient care and health policies, and the upcoming 2025 edition will continue this work. [Extracted from the article]

The article informs about the recent developments in neurorehabilitation, highlighting the integration of traditional and innovative approaches like virtual reality systems and neurostimulation techniques. Topics include insights from the WFNR-EFNR Central Asia Regional Meeting, emphasizing collaboration among specialists and addressing challenges in stroke healthcare systems, such as limited access to therapies, shortage of specialists, and inadequate infrastructure.

The status of predictive biomarkers in metastatic colorectal cancer is currently underdeveloped. Our study aimed to investigate the predictive value of six circulating exosomal miRNAs derived from plasma (miR-92a-3p, miR-143-3p, miR-146a-5p, miR-221-3p, miR-484, and miR-486-5p) for chemosensitivity, resistance patterns, and survival. Thirty-one metastatic colorectal cancer patients were selected before receiving first-line irinotecan- or oxaliplatin-based chemotherapy. Blood samples were harvested at baseline and 4–6 months after the initiation of chemotherapy. The levels of exosomal expression for each miRNA were analyzed by qPCR. Our results for patients receiving first-line FOLFOX showed significantly higher baseline levels of miR-92a-3p (p = 0.007 **), miR-146a-5p (p = 0.036 *), miR-221-3p (p = 0.047 *), and miR-484 (p = 0.009 **) in non-responders (NR) vs. responders (R). Of these, miR-92a-3p (AUC = 0.735), miR-221-3p (AUC = 0.774), and miR-484 (AUC = 0.725) demonstrated a predictive ability to discriminate responses from non-responses, regardless of the therapy used. Moreover, Cox regression analysis indicated that higher expression levels of miR-92a-3p (p = 0.008 **), miR-143-3p (p = 0.009 **), miR-221-3p (p = 0.016 *), and miR-486-5p (p = 0.019 *) at baseline were associated with worse overall survival, while patients expressing higher baseline miR-92a-3p (p = 0.003 **) and miR-486-5p (p = 0.003 **) had lower rates of progression-free survival. No predictive values for candidate microRNAs were found for the post-chemotherapy period. In line with these findings, we conclude that the increased baseline exosomal expression of miR-92a-3p and miR-221-3p seems to predict a lack of response to chemotherapy and lower OS. However, further prospective studies on more patients are needed before drawing practice-changing conclusions. [ABSTRACT FROM AUTHOR]

The article discusses the 20th edition of the Congress organized by the Academy for Multidisciplinary Neurotraumatology (AMN), reflecting on two decades of advancements in neurotrauma. It mentions the the AMN's commitment to advancing neurotrauma research and education through international collaborations and initiatives like the Neurotrauma Treatment Simulation Center (NTSC).

The article informs about the significant impact of dysphagia, particularly after a stroke, highlighting its challenges and multidisciplinary management approach involving medical professionals, nutrition specialists, and speech-language pathologists. Topics include insights from the first Dysphagia Course Series, emphasizing the importance of comprehensive education and collaborative efforts to enhance patient outcomes and address the silent struggle of dysphagia effectively.

The article offers information on the 18th International Summer School of Neurology and the 13th European Teaching Course on Neurorehabilitation held in Romania. Topics include insights on neurorehabilitation, neurotraumatology, migraines, Parkinson's disease, multiple sclerosis, stroke, vertigo, dementia, and myasthenia gravis. The events featured national and international speakers who presented on critical themes in neurology to enhance educational opportunities and refine clinical practice.

The article offers information on the 7th European Congress of Neurorehabilitation (ECNR) and its scientific program, which included workshops, plenary lectures, symposiums, ePoster sessions, and roundtables. Topics include the importance of neurorehabilitation, the Dysphagia Course Series, and highlights from the ECNR 2023 event, including the Opening Ceremony and plenary lectures on stem cells in stroke and biomaterials transplantation.

An editorial is presented on the neurorehabilitation and brain protection and recovery. It outlines the treatment options following ischemic stroke, highlighting the lessons from double-blind randomized trials in patients with mild ischemic stroke. An overview of the importance of creating promising paradigms and protocols for treatments and aligning the mechanisms of action with the design was showcased, and the two ant correlated sequences of post-lesional brain regulation is presented.

An editorial is presented which the National Neurology Forum 2023, highlighting its role in advancing neurology, discussing the National Strategy for Combating Cardiovascular and Cerebrovascular Diseases, and summarizing panel discussions on various neurological conditions and healthcare.It mentions that the forum emphasized collaboration, prevention, and improved patient care, aiming to enhance scientific knowledge and access to care for the Romanian population.

An interview with Professor Mayowa Owolabi, regional vice-president for Africa of the World Federation for Neurorehabilitation (WFNR), is presented. Owolabi shares his opinion about the 12th World Congress for NeuroRehabilitation held in Vienna, Austria. He discusses the role of hybrid multidisciplinary events in developing neurorehabilitation research and practice, clinical factors to consider in stroke neurorehabilitation, and ways to improve evidence-based international stroke guidelines.

The article discusses highlights of the European Federation of Neurorehabilitation Societies- World Federation for Neurorehabilitation (EFNR-WFNR) Eastern Europe Regional Meeting in conjunction with the Bristrita Clinical Neuroscience Conference, held in Bristrita, Romania on March 31 to April 1, 2023. Topics of presentations included post-stroke neurorecovery, cognitive decline post-stroke, pharmacological interventions in neurorehabilitation, and traumatic brain injury treatment developments.

The article focuses on the 12th World Federation for Neurorehabilitation hybrid Congress held from December 14 to 17, 2022 in Vienna (Austria) was a highly successful and intellectually stimulating event, bridges science and practical applications and offers insight into future avenues for neurorehabilitation. Topics include examines the World Federation for Neurorehabilitation is a multidisciplinary umbrella organization for national neurorehabilitation societies worldwide.

The article presents an interview with Claudio Bassetti currently serving as Professor of Neurology. Topics include studies showing that sleep loss and sleep apnea, increase the risk of stroke and dementia; and promoting sleep for fostering the health and by this having better lives, better body, brain and mental functions.

The article discusses Teaching Course on Rare Neurological Diseases began with a welcome address by Antonio Federico (Italy) and Dafin Muresanu (Romania), with the two highlighting the increased interest of stakeholders in this subject from neurology.

An interview with Professor Christian Matula is presented. He presents his brief professional background, including his leadership position at the General Hospital in Vienna, Austria. He talks about the Neurotrauma Treatment Simulation Center (NTSC) training program to improve the treatment of traumatic brain injuries (TBI). He explains how his experiences influenced his views on the treatment of neurotrauma.

The article presents the highlights of the 20th Congress of the Academy for Multidisciplinary Neurotraumatology (AMN) online conference held in May 2022. Topics include traumatic brain injuries (TBI), the use of oxiracetam nanodelivery for memory improvement, and the role of brain-derived neurotrophic factor (BDNF) in TBI. Presenters include Professor Karin Diserens, Doctor Pieter Vos, and Professor Alexandru V. Ciurea.

The article presents the highlights of the 20th Congress of the Academy for Multidisciplinary Neurotraumatology (AMN) online conference held in May 2022. Topics include the efforts to improve traumatic brain injury (TBI) treatments in low- and middle-income countries, TBI etiologies like traffic accidents, falls and loss of consciousness, and the implementation of neurotrauma programs. Panelists include Professor Dafin Muresanu, Tarek Lotfy of Egypt, and Irina Vlad of Romania.

The article presents the highlights of the 20th Congress of the Academy for Multidisciplinary Neurotraumatology (AMN) online conference held in May 2022. Topics include traumatic brain injury (TBI) research, the strategies in neurorehabilitation, and the trends in neuropsychological rehabilitation. Presenters include professors Johannes Vester and Andrew Maas, and Doctor Juan Carlos Arango-Lasprilla.

An interview with Professor Peter Lackner is presented. He presents a brief background of his professional career, including his focus on neurocritical care at the Medical University in Innsbruck, Austria. He talks about the Neurotrauma Treatment Simulation Center (NTSC) training program to improve treatments for traumatic brain injuries (TBI). He cites some challenges in the treatment and rehabilitation of patients with neurotrauma.

An interview with Professor Johannes Vester, President of the Academy for Multidisciplinary Neurotraumatology (AMN), is presented. He discusses the importance of face-to-face communication in advancing neurotrauma care, emphasizing the interdisciplinary sharing of scientific perspectives. He discusses the AMN's future developments, including promoting modern research approaches and expanding educational and teaching activities.

The article presents an interview with professor Jorge Hernández-Franco, an expert in neurological rehabilitation, discusses the World Congress for NeuroRehabilitation, highlighting its focus on transforming neurorehabilitation through technological advancements and research.

The article presents an interview with professor Karin Diserens, a specialist in neurology and rehabilitation, discusses the World Congress for Neurorehabilitation, emphasizing the integration of innovative techniques for diagnosing and treating disorders of consciousness.

The article presents an interview from the World Congress for NeuroRehabilitation, Professor Matilde Leonardi discusses the importance of rehabilitation as an essential health service, the role of multidisciplinary teams in neurorehabilitation and the significance of patient outcomes and follow-up.

The article presents an interview Wayne Feng, a Biomedical Engineering professor at Duke University, highlighting the importance of neurorehabilitation and fostering interdisciplinary teams and the advantages and limitations of transcranial direct current stimulation as a rehabilitation tool.

An interview with Profesor David Good, past president of the World Federation for NeuroRehabilitation, is presented. Good shares his opinion about the 11th World Congress for NeuroRehabilitation and its impact on young generations of neurorehabilitation specialists. He discusses the role of hybrid multidisciplinary events in developing neurorehabilitation research and practice and changes in motor recovery post-stroke.

An interview with Professor Wolfgang Grisold, the President of the World Federation of Neurology, is presented. Topics include Professor Grisold has contributed to peer-reviewed articles and projects in the fields of general neurology, neuro-oncology, neuromuscular disease, palliative care, and education; and discusses the World Congress for Neurorehabilitation, and the primary organizational gaps in neurorehabilitation at the international level.

The article presents an interview with William Slikker, serving as Director of the National Center for Toxicological Research, U.S. Food and Drug Administration (FDA). Topics include co-initiator of the International Conference on Neuroprotective Agents being so kind as in sharing the first-hand opinion on the event; and impact of neuroprotection on neurotoxicity in the context of the research presented at ICNA 2022.

The article presents the discussion on WFNS Symposium on Cerebrovascular Disease. Topics include creating a lot of anxiety and fear in many patients who definitely do not have long COVID problems; and patients having only mild CORONA problems have a higher tendency for developing the typical fatigue and cognitive problem with long COVID.

An editorial is presented on 17th International Summer School of Neurology event on July 8th. Topics include focusing on case studies of patients with diverse affections mainly depression, cognitive impairment, and discussing the role of neurotrophic factors; and modulation of synaptic transmission and their part as a therapeutic strategy in certain neurological disorders.

The article discusses highlights of the 17th International Summer School of Neurology held on July 8-10, 2022. Topics included the World Federation of Neurology action plan to address epilepsy and other neurological disorders, neurorehabilitation, post-stroke deficits and recovery, advances in neurorecovery, cognitive deficits after stroke, gold standard to improve traumatic brain injury (TBI) clinical research and neurobiological and neurophysiological evaluation of the lower sacral segments.

The article presents the highlights of the 20th Congress of the Academy for Multidisciplinary Neurotraumatology (AMN) online conference held in May 2022. Topics include the potential treatment for post-traumatic brain injury (TBI) cognitive issues, mild cognitive impairment, and TBI as a risk factor of dementia. Panelists include Nada Andelic of Norway, Peter Lackner of Austria, and Katrin Rauen of Switzerland.

The article presents the highlights of the 20th Congress of the Academy for Multidisciplinary Neurotraumatology (AMN) online conference held in May 2022. Topics include updates in traumatic brain injury (TBI) research, the link between TBI and stroke, and the effects of TBI to body organs like the heart, liver, and kidney. Panelists include Michael Chopp, Karin Diserens, and Andrew Maas.

An interview with Academy for Multidisciplinary Neurotraumatology (AMN) president Johannes Vester is presented. He talks about the Neurotrauma Treatment Simulation Center (NTSC) training program they organized in Vienna, Austria in May 2022 to improve treatment of patients with traumatic brain injuries (TBI). He explains how his experiences influenced his views on neurotrauma treatments. He cites the challenges in the strategies for TBI research.

An interview with Doctor Csomor Daniel is presented. He talks about his motivation for participating in the Neurotrauma Treatment Simulation Center (NTSC) training program in Vienna, Austria in 2022. He explains how his experiences influenced his view regarding neurotrauma treatment. He cites some challenges in the treatment of traumatic brain injuries (TBI).

The article presents the highlights of the 20th Congress of the Academy for Multidisciplinary Neurotraumatology (AMN) online conference held in May 2022. Topics include the vision and mission of AMN, the advancement of neurotraumatology research, AMN's cooperation with the World Federation of Neurorehabilitation (WFNR) and European Federation of Neurorehabilitation (EFNR), and the four pillars of AMN's neurotraumatology programs.

The authors reflect on the key role played by the Academy for Multidisciplinary Neurotraumatology (AMN) to advance research and education in neurotraumatology. Other topics include AMN's projects and activities like the Neurotrauma Treatment Simulation Center (NTSC) in Vienna, Austria and the effects of neurotrauma and traumatic brain injuries (TBI) in people, including in the physical, cognitive, and emotional levels.

An interview with Professor Andreas Winkler is presented. He presents a brief background of his professional career, including his work as neurologist, geriatrician and rehabilitation specialist at Klinik Pirawarth in Vienna, Austria. He talks about the challenges in the treatment of traumatic brain injuries (TBI). He discusses the AVANT program for the treatment of stroke.

Novel emerging therapies have changed paradigms in metastatic colorectal cancer. The advantages of molecular targeted treatments, either the anti-angiogenic or the anti-epidermal growth factor receptor drugs, reside in the fact that while their specificity for the cancer cell is higher, their toxicity on normal tissues is significantly lower when compared to chemotherapy. But when it comes to their safety, especially from a cardiovascular point of view, they still need to pass the test of time and further prospective studies are needed. Clinical trial patients are very well selected with regards to comorbidities and therefore, they often differ from real-life patients. In order to maximize the benefits from these drugs, we need to better identify the population at risk, understand and early diagnose their on- and off-target adverse effects and to adequately choose the diagnostic tools; with a better prevention and early treatment, the quality and quantity of our patients' lives can be significantly improved. [ABSTRACT FROM AUTHOR]

The progress made in the last few years made available a large amount of information that needs to be integrated and ordered by oncologists. Tumor markers are one of the pieces that physicians need to fit into the bigger puzzle. This article will detail the most frequent etiologies for the surges in the carcinoembryonic antigen (CEA), cancer-related antigen 72-4 (CA 72-4), cancer-related antigen 19-9 (CA 19-9) serum levels and their indications. Although tumor markers are an invaluable asset to medical practice, their role in screening, diagnosis and oncologic treatment remains poorly standardized. Ongoing or future clinical trials will shed light on pending problems. [ABSTRACT FROM AUTHOR]

Granulocyte-colony stimulating factor (G-CSF) is a glycoprotein, the second CSF, sharing some common effects with granulocyte macrophage-colony stimulating factor (GM-CSF), interleukin-3 (IL-3) and interleukin-5 (IL-5). G-CSF is mainly produced by fibroblasts and endothelial cells from bone marrow stroma and by immuno-competent cells (monocytes, macrophages). The receptor for G-CSF (G-CSFR) is part of the cytokine and hematopoietin receptor superfamily and G-CSFR mutations cause severe congenital neutropenia. The main action of G-CSF - G-CSFR linkage is stimulation of the production, mobilization, survival and chemotaxis ofneutrophils, but there are many other G-CSF effects: growth and migration of endothelial cells, decrease of norepinephrine reuptake, increase in osteoclastic activity and decrease in osteoblast activity. In oncology, G-CSF is utilized especially for the primary prophylaxis of chemotherapy-induced neutropenia, but it can be used for hematopoietic stem cell transplantation, it can produce monocytic differentiation of some myeloid leukemias and it can increase some drug resistance. The therapeutic indications of G-CSF are becoming more and more numerous: non neutropenic patients infections, reproductive medicine, neurological disturbances, regeneration therapy after acute myocardial infarction and of skeletal muscle, and hepatitis C therapy. [ABSTRACT FROM AUTHOR]