Flow-diverter stents are a potent and efficient tool in the instrumentarium of neurointerventional radiologists for the treatment of intracranial aneurysms. With their implementation, some adverse effects and complications such as hemorrhagic and ischemic ones, have been seen as a potential downfall of the method. In-stent stenosis is one such complication, which until now has not received enormous attention due to its seemingly benign characteristic. In our study we propose a different point of view on this matter and aim to establish a potential mechanism for its development: a subacute postprocedural stent deformation, due to segmental vessel constriction as a reaction to the implant. We enrolled 48 patients between the ages of 31 and 71 (8 men) with aneurysms on the distal portions of the ICA, all of whom were treated with the p64 flow-diverter stent, to assess the incidence of this phenomenon, as well as establish a correlation between it and subsequent clinical symptoms. A protocol for short-term follow-up, consisting only of a high-dose fluoroscopy image of the implant (conducted on the 14th postprocedural day) was implemented to assess the state of the implant before endothelization was to be expected. Stent deformities were seen in 58% of cases. One patient with an observed stent deformity presented with several episodes of acute contralateral 1-sided weakness of the limbs. Seventy-one percent of those patients presented with a mild/moderate unilateral headache postprocedurally. A correlation between the deformity and a subsequent narrowing of the parent vessel diameter was established on follow-ups. Notable in-stent stenosis was reported in 35% of all cases. Cases with subacute stent deformities are presented in a nonnegligible percent of flow-diversion therapies with the p64 stent. A statistically significant association between the observed deformation and subsequent in-stent stenosis was observed on follow-up.

The presence of isolated low bone density of a single lumbar vertebra (difference of above 1 SD T-score between two adjacent vertebrae without a probable explanatory reason) seems to be one of the unsolved issues in clinical densitometry. The present study aims to investigate the epidemiology of the latter mentioned difference in BMD. In a prospective manner 4027 apparently healthy Bulgarian women between 50 and 65 years of age underwent а scan of the lumbar spine (L1–L4) on a DXA machine – Hologic Discovery A. The data were collected and analysed with the statistical package SPSS. In the observed group the incidence of the difference of above 1 SD T-score between two adjacent lumbar vertebrae without a causal visible abnormality is quite low – 1.34% (n = 54). In the study population, the mean T-score was 1.49 (±0.469 SD) and the difference itself was between – 1 and – 2.6 SD T-score. A consensus statement and a guideline for further clinical management of patients with this finding are necessary to be created.

Purpose of Review: Obesity is a growing global health challenge, with severe obesity projected to affect up to 25% of individuals with obesity by 2030. Bariatric surgery remains the most effective treatment, yet the molecular mechanisms underlying its metabolic benefits are not fully understood. This review summarizes current evidence on the role of microRNAs in bariatric/metabolic surgery and evaluates their potential as biomarkers and therapeutic targets. Recent Findings: Bariatric surgery induces significant alterations in circulating and tissue-specific miRNA profiles, particularly those involved in glucose metabolism, inflammation, and adipose tissue remodeling. Among the most frequently reported candidates, miR-122, miR-221, miR-27a, miR-126, miR-144, miR-222, miR-223, miR-375, miR-92a, and miR-155 have been associated with weight loss, improved insulin sensitivity, and diabetes remission. Emerging data suggest that these miRNAs may act not only as biomarkers of metabolic recovery but also as regulators of insulin signaling, inflammatory pathways, and adipocyte function. Summary: Current evidence supports a role for miRNAs in the metabolic adaptations observed after bariatric surgery. Although further validation is required, miRNAs show promise as minimally invasive biomarkers for predicting and monitoring treatment response and may provide insight into the molecular mechanisms underlying obesity remission and improvement of obesity-related comorbidities.