Currently, there is no standard treatment for renal cell carcinoma (RCC) that is free of side effects and resistance. Additionally, limited information exists on how curcumin affects the gene expression profiles of patients with translocation renal cell carcinoma (tRCC) and papillary renal cell carcinoma (pRCC). The pathways responsible for metastasis in tRCC are still not well understood, and there is no established treatment or reliable biomarker to predict outcomes for metastatic tRCC. Primary clinical data from patients were retrieved from the TCGA database and analyzed using cBioPortal, stitch, string, R and Python. Various analyses were performed, including differential gene expression, protein-protein interaction (PPI) network analysis, drug-targeted gene analysis, gene ontology (GO), enrichment analyses, and systematic searches to assess the impact of curcumin on the transcriptomic profiles of tRCC, pRCC, and clear cell renal cell carcinoma (ccRCC). No significant impact of sensitive genes on survival in KIRC and KIRP was found, though a trend suggested they may delay disease progression. The combination of curcumin with sunitinib showed promise in overcoming drug resistance in ccRCC by inducing ferroptosis, reducing iron, and increasing ADAMTS18 expression. This study, leveraging data from the TCGA database and other databases explored the impact of curcumin on transcriptomic profiles in tRCC, pRCC, and clear cell RCC (ccRCC). Gene analysis revealed immune and metabolic differences, with KIRC showing a stronger immune response. This study is the first to propose that future research into the miR-148/ADAMTS18 genes and the ferroptosis pathway in tRCC and pRCC could lead to the development of new therapies and the identification of novel therapeutic targets, potentially overcoming drug resistance and metastasis.

Superior mesenteric artery syndrome (SMAS) is a rare condition found in approximately 2.67% of patients hospitalized with suspected duodenal obstruction. The average age of affected individuals is 23 years, with female-to-male ratio of 3:2. SMAS occurs due to compression of the middle third of the horizontal (third) portion of the duodenum between the aorta and the superior mesenteric artery, often developing in the context of rapid and significant weight loss. We present a case of a 32-year-old female patient who, after significant weight reduction and in otherwise good general health, developed complaints of nausea, heartburn, and epigastric pain. During the diagnostic process, differential diagnoses included gastroesophageal reflux disease, peptic ulcer disease, megaduodenum, aberrant pancreatic tissue, neoplasms, and SMAS. To establish the diagnosis, fluoroscopic examination with barium contrast was performed in the prone position to assess the degree of duodenal compression, along with a functional maneuver involving elevation of the upper body while resting on the elbows and knees. Fluoroscopy in the prone position revealed a narrowing of the duodenal lumen at the level of the inferior horizontal portion, from 3.5 to 0.8 cm in diameter over a 3.2 cm segment. The functional maneuver resulted in dilation of the narrowed segment to 3.0 cm, with restoration of evacuatory function. SMAS was confirmed by contrast-enhanced abdominal computed tomography (CT), which demonstrated a reduction in the aortomesenteric angle and distance – from 25° to 6° and from 8 to 2 mm, respectively. It was shown that fluoroscopy with barium contrast and functional testing is an effective diagnostic tool for SMAS. In cases with positive radiographic findings, the diagnosis should be confirmed by contrast-enhanced abdominal CT.

The little-studied anatomy of the convergence zones of the superficial and deep arteries of the brain – a new vector in clinical neurology

Recent research has shown that there are different drainage systems in the brain. During the drainage of cerebrospinal and interstitial fluids, intracerebral (intracranial) lymph is formed, which becomes part of the glymphatic system. Later, the glymphatic system was subdivided into periand paravascular spaces, but their existence has not yet been proven. The article contains data on the anatomy of the lamina cribrosa, its age-related changes, the characteristics of the lymphatic system and the theory of the existence of glymphatic vessels in this area. We also hypothesize that in addition to the classical view, which assumes that viruses enter the central nervous system (CNS) through the blood-brain barrier or with the help of immune cells, there are other routes of pathogen entry, for example through the glymphatic system. Possible routes of movement of cerebrospinal and interstitial fluids through the structures of the nervous system and other systems are considered. The lamina cribrosa is considered a possible portal of entry for viruses into the CNS, in particular for the SARS-CoV-2 virus. In our review, we analyzed the likely mechanisms of SARS-CoV-2 spread in the central nervous system and the possible consequences of previous viral disease.