Introduction: High grade gliomas (HGG) are a group of tumors with infiltrative nature in general. Surgery is the first step in their treatment. It can be beneficial in two aspects: firstly, in establishing normal intracranial pressure and, secondly, in reducing the tumour volume. The choice of method depends on the location of the lesion, the expected grade of malignancy, and the general condition of the patient. Despite constant development of neuro-oncology and microsurgical techniques, the 5-year survival rate in patients with HGG remains less than 10% and the median survival is still less than 2 years.&nbsp; Aim: At present, there is no final therapeutic &ldquo;segment&rdquo; to provide a better outcome than the complex treatment of HGG. Moreover, the treatment&rsquo;s relative efficacy and recurrence of these tumours carry an additional problem. The aim of this study was to estimate the overall survival of patients with HGG operated in our clinic and compare it with literature data.&nbsp; Materials and methods: One hundred twenty-one cranial operations for HGG were reviewed (conducted between 2014 and 2019). Summary characteristics of the various parameters were presented in respect to the radical nature of the operative intervention using Kaplan-Meier analysis and chi square tests. All patients were followed up at regular check-ups. Results: HGGs were 103 or 85.12% of all gliomas operated for the 2014-2019 period. The most common cases were in the 51 to 60 age group. The cases in men were twice as common. The most common localization of the neoplasm is in the temporal region (36.36%) and the rarest was found in the occipital region (3.30%). It was estimated that our operated patients with HGG had 12.23 months over-all survival. Gross total resected patients had a median survival (OS) of 14.53 months, while subtotal resected patients had a median survival (OS) of 10.44 months. It is estimated 7.97 months free tumor survival period (time to relapse - FTS) for our operated patients with HGG. Gross total resected patients had a median FTS of 10.88 months, while subtotal resected patients had median FTS of 5.70 months. We noticed permanent new neurological deficit (NND) in 20 patients (19.45%) operated with GTR, and in 5 patients (4.85%) operated with STR.&nbsp; Conclusions: Median survival - OS, free tumor survival period - FTS and new neurological deficit - NND were statistically significant (p<0.05) with extent of resection &ndash; GTR or STR in our study. Maximal safe radical (total) or supratotal resection is preferred in treating HGG.&nbsp;

Summary Craniometric points are essential for orienting neurosurgeons in their practice. Understanding the correlations of these points help to manage any pathological lesion located on the cortical surface and subcortically. The brain sulci and gyri should be identified before craniotomy. It is difficult to identify these anatomical structures intraoperatively (after craniotomy) with precision. The main purpose of this study was to collect as much information as possible from the literature and our clinical practice in order to facilitate the placement of craniotomies without using modern neuronavigation systems. Operative reports from the last five years on cranial operations for cortical and subcortical lesions were reviewed. All the craniotomies had been planned, using four methods: detection of craniometric points, computed tomography (CT) scans/topograms, magnetic resonance imaging (MRI) scans/topograms, and intraoperative real-time ultrasonography (USG). Retrospectively, we analyzed 295 cranial operations. Our analysis showed that operating on for cortical lesions, we had frequently used the first and the second method mentioned above (118 patients), while in cases of subcortical lesions, we had used craniometric points, MRI scans/topograms and intraoperative real-time USG as methods of neuronavigation (177 patients). These results show that craniometric points are essential in both neurosurgical procedures.

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Summary The term meningeal melanocytoma was first introduced by Limas and Tio in 1972 to figure out lesions of the central nervous system that, under light microscope view, have meningioma characteristics, and ultrastructural characteristics of melanocyte neoplasm, respectively. Meningeal melanocytomas (MM) represent 0.06-0.1% of brain tumors. The annual incidence is about 1 per 10 million. This type of neoplasm is rarely seen in clinical practice. A few cases have been reported in the literature. A 62-year-old man was admitted, complaining of trigeminal pain in the area of the I and II branches of CN V on the left of his face. He underwent two surgeries in a row. First, malignant melanoma, and then meningeal melanocytoma were histologically verified. Neurological examination demonstrated hyperpigmented left iris, neuralgic pain in I and II branches of CN V, latent central hemiparesis and hemihypesthesia for the right extremities, positive Babinski reflex on the right, positive axial pathological reflexes, and partial motor aphasia. Primary intracranial meningeal melanocytoma is difficult to diagnose preoperatively because of the tumor’s non-specific clinical and neuroradiological characteristics. So electron microscopy and immunohistochemical additional diagnostic confirmation are mandatory. Immunohistochemical findings - the presence of S-100 protein, vimentin, and antimelanocyte antigen HMB-45, no reaction for EMA and ultrastructural (melanosomes in different maturation, contacts type zonula adherens) are all in favour of the histopathological diagnosis of MM. Meningeal melanocytoma is a slow-growing tumor, biologically benign, and attempts for surgical radicalism are recommended. It is not entirely clear whether a malignant transformation of these tumors is possible. The role of chemotherapy also remains questionable and has not been documented as effective.

Media literacy is one of the key competencies and skills for living and working in the 21st century. Media literacy training is a life-long process, but it is of particular importance that it starts from early childhood, is continued and built on in secondary and higher education with the efforts of all formal and informal institutions and organizations. The research team from the Department of “Media and Public Communications” at the University of National and World Economy has been working on the project dedicated to media literacy training practices in secondary and higher schools in Bulgaria for three years. An important part of the research was the analysis of the results of the survey among teachers, conducted in the period 07.01.2022 – 23.02.2022 via the Microsoft Forms platform, in which 534 respondents participated. The survey showed that teachers understand the importance and significance of media literacy, integrate important related topics in the learning process of various school subjects, but also need to improve their qualifications for teaching media literacy.