Here, we present a rarely seen example of bilateral meningiomas exhibiting different malignancy grades, I (meningothelial) and II (atypical), recorded in a 72-year-old patient. The presence of two separated lesions of different grades in a single patient can elucidate meningioma progression. To this end, the involvement of specific protein markers of epithelial to mesenchymal transition (EMT), the process responsible for progression, was tested in both tumors. Protein expression status of specific epithelial (E-cadherin) and mesenchymal markers (N-cadherin, SNAIL&SLUG and TWIST1) was investigated. Furthermore, markers that are connected to Wnt signaling pathway–beta-catenin, GSK3beta and DVL1—were also analyzed. For signs of neurofibromatosis and schwanomatosis genetic testing was performed. Immunohistochemistry evaluated by immunoreactivity score (IRS) was used to determine the signal strengths and proteins’ location. Our results indicated that, in comparison to the grade I tumor, mesenchymal markers SNAIL and SLUG were upregulated in the atypical meningioma. TWIST1, beta-catenin and GSK3beta were upregulated in both grades, while E-cadherin was partially lost. A pronounced cadherin switch could not be established; however, N-cadherin showed widespread tissue presence. Genetic testing did not detect changes of NF2 or SMARCB1 genes denying germline origin of the lesions. The rare presence of two different grades in one patient elucidate previously unknown molecules involved in meningioma progression.
Background/Objectives: This study focused on the sub-national regional heterogeneity in childhood obesity prevalence across five countries in south-east Europe and the correlation between this heterogeneity and socioeconomic differences. Previous studies have mainly observed national or cross-national data but this study used a sub-national regional approach that may be beneficial in the further investigation of childhood obesity. Methods: Nationally representative samples of children from Croatia, Montenegro, North Macedonia, Serbia and Slovenia were selected using the COSI methodology and used to estimate regional childhood obesity prevalence values. The Sub-national Human Development Database provided data on the Sub-national Human Development Index (SHDI). The spatial autocorrelation analysis of childhood obesity prevalence in sub-national regions was performed and its association with sub-national human development was tested with an ordinary least squares regression model. Results: This study found statistically significant differences in childhood obesity prevalence across sub-national regions in Croatia, Slovenia and Serbia, while no such differences were observed in North Macedonia and Montenegro. There was moderate clustering in childhood obesity rates (Moran’s I = 0.337). The results indicated a significant negative association between SHDI and childhood obesity prevalence across the 48 regions (β = −66.63, p < 0.001). Conclusions: Future public health efforts should take into consideration regional differences in childhood obesity prevalence, and more targeted research is essential for understanding the mechanisms of resilience and vulnerability on a sub-national level.