Search

Introduction: Intracranial lesions often require tissue diagnosis through stereotactic biopsies. Originating in the 1970s, this technique has progressed, but limitations and risks persist. Recently, robot-assisted techniques have made strides, providing the potential for safer and more precise procedures. This study assesses the effectiveness and safety of robot-assisted brain biopsies., Methods: Following Cochrane and PRISMA guidelines, PubMed, Embase, and Web of Science were searched for publications up to July 2024. Outcomes assessed included neurological deficits, hemorrhage, mortality, target point error, operative time, and length of stay. Data extraction and bias assessment were conducted using standardized methods, and statistical analysis was performed using R software., Results: In this meta-analysis, 27 papers were included, involving 2605 patients. The gender distribution was 1448 males to 1141 females. The mean error in millimeters for the entry point error was 1.04 (95%CI: 0.72-1.37), while the target point error was 1.08 (95%CI: 0.49-1.66). The mean operative time was 52.45 min (95%CI: 37.83-67.07). Diagnostic yield had an estimated rate of 98% (95%CI: 97-98%; I²=31%). The length of hospital stay was 4.64 days (95%CI: 3.13, 6.14), from admission to discharge. The postoperative hemorrhage had an estimated risk of 6% (95%CI: 4-9%; I²=71%), while for transient neurological deficits, it was 4% (95%CI: 2-6%; I²=60%). Finally, the death related to the procedure was found to have an estimated risk of 0% (95%CI: 0-0%; I²=0%)., Conclusion: Our study found that the diagnostic yield of stereotactic brain biopsy, especially with robotic assistance, has proven to be highly effective. Robot-assisted biopsies also seems to reduce operative times and demonstrate high precision with low entry point error and target point error. Additionally, complication rates appear to be relatively low, and the average hospital stay is favorably short, underscoring the advantages of robotic assistance in stereotactic brain biopsy procedures., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Epoxy-α-lapachone (Lap) and Epoxymethyl-lawsone (Law) are oxiranes derived from Lapachol and have been shown to be promising drugs for Leishmaniases treatment. Although, it is known the action spectrum of both compounds affect the Leishmania spp. multiplication, there are gaps in the molecular binding details of target enzymes related to the parasite's physiology. Molecular docking assays simulations were performed using DockThor server to predict the preferred orientation of both compounds to form stable complexes with key enzymes of metabolic pathway, electron transport chain, and lipids metabolism of Leishmania spp. This study showed the hit rates of both compounds interacting with lanosterol C-14 demethylase (-8.4 kcal/mol to -7.4 kcal/mol), cytochrome c (-10.2 kcal/mol to -8.8 kcal/mol), and glyceraldehyde-3-phosphate dehydrogenase (-8.5 kcal/mol to -7.5 kcal/mol) according to Leishmania spp. and assessed compounds. The set of molecular evidence reinforces the potential of both compounds as multi-target drugs for interrupt the network interactions between parasite enzymes, which can lead to a better efficacy of drugs for the treatment of leishmaniases.