This manuscript is a narrative review of peer-reviewed studies of postdural puncture headache (PDPH) as the most common complication of a diagnostic and therapeutic lumbar puncture (LP) and LP due to the damage of the dura mater in epidural anesthesia.

Author searched articles related to the PDPH and its risk factors, pathophysiology diagnosis, differential diagnosis, and therapy. All studies according to the analyzed parameters and their relevance to the clinical practice, as well as quality of the study methods, were selected for further analysis.

The review presents the clinical and paraclinical prediction criteria for the onset, clinical features, course, and efficiency of specific therapeutic interventions which are of a particular clinical benefit for the prevention, pathogenetic treatment, and differential diagnosis of PDPH. The analysis of prediction parameters for the onset, clinical course, and associated symptoms and signs of PDPH is a contribution to the understanding of pathophysiology of intracranial hypotension, since PDPH can be considered a clinical model of intracranial hypotension.

Given that LP is a common procedure in clinical practice, it is necessary to have a comprehensive knowledge of the risk factors, pathophysiological, diagnostic, differentially diagnostic, and therapeutic aspects of PDPH.

Given that LP is a common procedure in clinical practice, it is necessary to have a comprehensive knowledge of the risk factors, pathophysiological, diagnostic, differentially diagnostic, and therapeutic aspects of PDPH.

Fingolimod, an oral sphingosine 1-phosphate receptor modulator, is approved by EMA for relapsing-remitting multiple sclerosis (RRMS).

To assess the effectiveness and safety of fingolimod in patients with RRMS in real-world clinical practice in Portugal.

Retrospective, multicentre, non-interventional study, reporting 3 years follow-up of data collected from October 2015 to July 2016. Sociodemographic data and previous treatments at baseline and data regarding disease evolution, including number of relapses, annualised relapse rates (ARR) and Expanded Disability Status Scale (EDSS), were collected.

Two-hundred and seventy-five participants were enrolled in the REALMS study. Results showed that the main reason to switch to fingolimod was failure of previous treatment (56.7%) and only 3.6% were naïve patients. In the total population, there was a significant decrease in ARR of 64.6% in the first year of treatment, 79.7% in the second year and 82.3% in the third year, compared with baseline. More than 67.0% of patients had no relapses during the 3 years after switching to fingolimod. EDSS remained stable throughout the study.

Therapy with fingolimod showed a sustained effectiveness and safety over the 3 years, particularly on patients switched from first-line drugs (BRACE). No new safety issues were reported.

Therapy with fingolimod showed a sustained effectiveness and safety over the 3 years, particularly on patients switched from first-line drugs (BRACE). No new safety issues were reported.

Paragangliomas are rare neuroendocrine tumors originating from chromaffin cells of extra-adrenal origin. Ninety percent of adrenergic tumors originate in the adrenal medulla and are known as pheochromocytomas; the remaining 10% are extra-adrenal and are called paragangliomas. Mediastinum paragangliomas is rare and commonly originate from the posterior mediastinum, while those originating from the middle posterior are quite rare. Some paragangliomas secrete catecholamines, leading to symptoms such as hypertension, tachycardia, and diabetes.

A 76-year-old woman visited our hospital for the treatment and further evaluation of diabetes. Her hemoglobin A1c levels had risen to 11.0%. SGC-CBP30 To investigate the cause of her diabetes, a contrast-enhanced chest computed tomography scan was performed, revealing a ring-enhancing tumor (30 × 30mm) in the middle mediastinum. The surgical resection was performed via video-assisted thoracic surgery. Surgery was performed using a vessel-sealing device; however, bleeding was persistent from the surrounding tissue. Total bleeding was 400g. Blood pressure fluctuations and arrhythmia did not occur during the operation. The patient’s uncontrolled diabetes was cured after the surgery, and the tumor was diagnosed as a functional paraganglioma.

We encountered a rare case of functional paraganglioma located in the middle mediastinum. Functional paragangliomas should be considered as a potential cause of uncontrolled diabetes, and a whole-body CT scan should be performed to investigate this possible cause.

We encountered a rare case of functional paraganglioma located in the middle mediastinum. Functional paragangliomas should be considered as a potential cause of uncontrolled diabetes, and a whole-body CT scan should be performed to investigate this possible cause.

Successful medical crowdfunding campaigns may alleviate or even eliminate the financial burden of expensive, cumulative medical bills. GoFundMe

crowdfunding pages for hepatitis C virus (HCV) patients were reviewed and analyzed to better understand the characteristics that contribute to a successful fundraising campaign in a disease often associated with patients with a lower social standing or stigma.

A pilot cross-sectional study of all publicly available GoFundMe

crowdfunding pages was conducted for posts related to HCV on GoFundMe

in June 2019. Similar to data extraction steps in a systematic literature review, page data were reviewed to identify whether the source of the patient’s HCV infection was disclosed, if disclosed then how did the patient report contracting the disease, and all costs reported in the description as part of the rationale for requesting funds. Descriptive statistics of category and numeric variables were reported for the full sample, and exploratory analyses were conducted in their public requests for financial assistance.

These exploratory findings yield important insights, both for patients or caregivers seeking support on GoFundMe® crowdfunding websites and for researchers interested in exploring the types of costs self-reported by patients in their public requests for financial assistance.