The immobility of patients confined to continuous bed rest continues to raise a couple of very serious challenges for modern medicine. In particular, the overlooking of sudden onset immobility (as in acute stroke) and the delay in addressing the underlying conditions are of utmost importance for the patient and, in the long term, for the medical and social systems. This paper describes the design principles and concrete implementation of a new smart textile material that can form the substrate of intensive care bedding, that acts as a mobility/immobility sensor in itself. The textile sheet acts as a multi-point pressure-sensitive surface that sends continuous capacitance readings through a connector box to a computer running a dedicated software. The design of the capacitance circuit ensures enough individual points to provide an accurate description of the overlying shape and weight. We describe the textile composition and circuit design as well as the preliminary data collected during testing to demonstrate the validity of the complete solution. These results suggest that the smart textile sheet is a very sensitive pressure sensor and can provide continuous discriminatory information to allow for the very sensitive, real-time detection of immobility.

Spinal metastasis remains a significant clinical issue, frequently resulting in substantial pain and disability among cancer patients. Conventional management strategies have historically included chemotherapy, radiotherapy, and open surgical intervention. However, advancements in minimally invasive spinal surgery (MISS) have notably shifted the therapeutic landscape. This review examines recent evidence surrounding MISS, directly comparing it to traditional open procedures. Current literature demonstrates that MISS typically results in reduced intraoperative blood loss, shorter hospitalization durations, decreased infection rates, and functional outcomes that are at least equivalent—if not superior—to those of open surgery. Additionally, the emergence of hybrid therapeutic approaches—specifically, the utilization of separation surgery followed by stereotactic radiosurgery—has shown promise in achieving local tumor control, particularly in select malignancies. This narrative review also evaluates contemporary clinical decision-making frameworks such as NOMS, LMNOP, and NESMS. Further, it advocates for the integration of advanced prognostic tools and tumor genomics to enable more personalized treatment strategies for individuals with spinal metastasis.

Pineal-region tumors are a histologically heterogeneous group of tumors and represent a rare occurrence, accounting for less than 1% of all adult intracranial tumors. Among these, primary pineal malignant melanomas (PPM) represent an even rarer entity, with only twenty-five cases being reported in the literature to date. We present the case of a 65-year-old patient who presented in our department for progressive headache, gait disturbance and memory impairment. Magnetic resonance imaging (MRI) of the brain revealed a solid mass in pineal region, measuring 2.2 × 1.2 × 2.0 cm and causing obstructive hydrocephalus. He underwent a third ventriculostomy, but we failed to obtain a sample for diagnostic purposes. The intraoperative surprise was the presence, at the level of the third ventricle, of multiple melanin deposits, which were not picked up by the MRI. Although the biopsy could not be performed and had to be obtained by stereotactic biopsy in a second intervention, the endoscopy findings allowed for the correct staging of the intracranial disease and appropriate treatment management.

Indications and treatment techniques in brain AVM very much change last years. Basically microsurgery, embolization, radiosurgery and observation, alone or combined are the actual methods reported in literature and also that we use in ours patients. We review the case we treated since all this methods becomes available for our cases. Indication was established according with Spetzler-Martin scale together with some additional factors: vascular high risk factors in AVM architecture: associated aneurysms or varix; compact unique nidus versus multiple, diffuse or associated proliferative angiopathy; rupture/unrupture AVM; patient status: GCS, age, comorbidities, personal wiling. Statistical studies (ARUBA) influenced patient decision. A lot of time is spend to explain to patient the actual knowledge about his/him disease. Clinical finding, images, pre and posttreatment, surgical records, complications and results are analyzed and compared with literature data. In our opinion microsurgical resection is the gold standard for low grade AWM if not general contraindications exist. There are still very difficult cases where we just observe the patient but results are usually bad. For ruptures difficult AVM we prefer to use first embolization and immediately after surgery if embolization was not complete. If the remaining part of the nidus are in deep seated vital areas embolization is completed by radiosurgery.

Background: Pituitary carcinoma (PC) is a rare and aggressive pituitary neuroendocrine tumor (PitNET) defined by non-contiguous craniospinal or systemic metastatic spread. Evidence guiding treatment is limited to case reports and case series. This systematic review aimed to characterize the clinicopathological features, treatment patterns, and prognostic determinants of PC through pooled individual patient data (IPD) analysis. Methods: A systematic search of PubMed/MEDLINE and Embase (January 1990 to March 2026) was conducted in accordance with PRISMA 2020 guidelines (PROSPERO: CRD420261402665). Individual patient data were extracted for 56 pre-specified variables from the identified literature. Two additional institutional cases were analyzed separately as illustrative clinical examples and are not part of the pooled statistical cohort. Survival was estimated using the Kaplan–Meier method with log-rank tests. Univariate and multivariable Cox proportional hazards regression and binary logistic regression (outcome: long-survivor status, defined as OS > 24 months) were performed on the pooled literature cohort. Results: A total of 111 patients from 93 papers were included (51 males (45.9%); median age at PC diagnosis 54 years (IQR 40–61)), with corticotroph lineage predominating (47.7%). Median OS from PC diagnosis was 19 months (IQR 9.5–46); one-year OS was 67.7% and two-year OS 52.0%. Multimodal treatment was associated with significantly longer OS (median 45 vs. 12 months; log-rank p = 0.004). In multivariable Cox regression (n = 88; C-index 0.725), any objective treatment response (HR 0.245, 95% CI 0.101–0.593, p = 0.002), functional tumor status (HR 2.041, 95% CI 1.017–4.095, p = 0.045), and age at PC diagnosis (HR 1.018/year, p = 0.049) were independently associated with OS. Logistic regression identified multimodal treatment (OR 5.29, p = 0.009), any treatment response (OR 5.47, p = 0.006), and early metastasis (OR 0.18, p = 0.024) as independent predictors of long-survivor status. Ki-67 increased significantly from initial to PC-stage diagnosis (median 7% vs. 12%; Wilcoxon p < 0.001), which is, to our knowledge, the first demonstration of this longitudinal rise in a pooled pituitary carcinoma cohort. Conclusions: PC carries a poor prognosis, with a median OS of 19 months. Multimodal therapy and achievement of objective response are the strongest determinants of prolonged survival. Prospective registries with standardized molecular profiling are needed to advance precision management of this ultra-rare malignancy.