Search Results (863)

Background: Adipose tissue surrounds organs and tissues in the body and can alter their function. It could secrete diverse biological molecules, including lipids, cytokines, hormones, and metabolites. In light of all this information, obesity can influence many tissues and organs in the body, and this situation makes obesity a central contributor to multiple disorders. It is very important to investigate the crosstalk between tissues and organs in the body to clarify the key mechanisms of obesity. Methods: In this study, we analyzed the gene expression profiles of the liver, skeletal muscle, blood, visceral, and subcutaneous adipose tissue. Differentially expressed genes (DEGs) were identified for each tissue, and functional enrichment and protein–protein interaction network analyses were performed on genes commonly identified across tissues. Priority candidate genes were identified using network-based centrality measures, and potential molecular intersection points were explored through host-pathogen interaction network analysis. This study provides an integrative framework for characterizing inter-tissue molecular patterns associated with obesity at the network level. Results: The muscle, subcutaneous adipose tissue, and blood have the highest number of DEGs. The subcutaneous adipose tissue and blood stand out due to the number of DEGs they possess, although liver and visceral adipose tissue have lower amounts. Cancer ranks first in terms of diseases associated with obesity, and this association is accompanied by leukemia, lymphoma, and gastric cancer. RPL15 and RBM39 are the top genes in both degree and betweenness metrics. The host–pathogen interaction network consists of 13 unique-host proteins, 54 unique-pathogen proteins, and 27 unique-pathogen organisms, and the Influenza A virus had the highest interaction. There were a small number of common metabolites in all tissues: 2-Oxoglutarate, Adenosine, Succinate, and D-mannose. Conclusions: In this study, we aimed to identify candidate molecules for obesity using an integrative approach, examining the gene profiles of different organs and tissues. The findings of this study suggest a possible link between obesity and immune-related biological processes. The network obtained from the host-pathogen interaction analysis, and especially the pathways associated with viral infections that stand out in the functional enrichment analysis, may overlap with molecular signatures linked to obesity. Furthermore, the co-occurrence of cytokine signaling, insulin, and glucose metabolism pathways in the enrichment results indicates that the response of cells to insulin may be affected in obese individuals, suggesting a potential interaction between immune and metabolic processes; however, further experimental validation is needed to reveal the direct functional effects of these relationships. Full article

Background: Perforator flaps improved the reconstruction paradigm in the lower extremity, increasing coverage possibilities. This study aims to quantify how added perforators could enhance standard geometrical patterns (compared to random flaps). Methods: A total of 29 cases of lower limb soft tissue reconstruction (STR)—52% trauma, 21% osteomyelitis with skin fistulas, 21% healing disorders with unstable scarring and 6% cancer-related surgery—were performed in our institution between 2012 to 2023 with geometric random (GR) local flaps (34%), geometric perforator-enhanced (GP) flaps (32%) or pure propeller perforator (PP) flaps (34%), were retrospectively analysed. Patients with proximal thigh defects, a follow up of less than 3 months and those who received an axial, muscle or free flap were excluded. Geometric patterns (as length:width ratio (L:W)) were compared among groups, analysing healing outcomes and complications. Results: Leg defects were categorized into 62% distal, 14% middle, 14% proximal third and 10% distal thigh. No significant difference in defect size was detected among groups. Mean flap size was significantly larger for GP (70.5 cm², (p < 0.05)) and PP (74.4 cm², (p < 0.01)) than GR (53.7 cm²). The L:W ratio was significantly higher in GP (L:W 2.2:1, (p < 0.05)) and PP (L:W 2.8:1, (p < 0.01)) than in GR (1.5:1), but no significant difference was found between GP and PP. A reduced complications rate (partial flap loss, infection, healing, revision surgery, etc.) was observed in the GP group, when compared to GR. Conclusions: Flap geometric design can be significantly improved by the inclusion of perforators, maintaining spatial advantages with larger ductility and improved vascular solidity. Full article

Background/Objectives: Targeted muscle reinnervation and regenerative peripheral nerve interface procedures have emerged as effective techniques for reducing post-amputation pain and preventing symptomatic neuroma formation. However, the optimal timing of these procedures remains debated. This study aims to compare complication and reoperation rates between acute and delayed advanced nerve interface procedures in lower-extremity amputees. Methods: A retrospective cohort study was conducted including 74 patients who underwent acute or delayed targeted muscle reinnervation and/or regenerative peripheral nerve interface procedures between 2019 and 2025 at a tertiary academic medical center. Procedures performed concurrently with amputation or during early-stage reconstruction were classified as acute, whereas procedures performed more than one month after amputation were classified as delayed interventions. The primary outcome was postoperative surgical complications occurring within one year. Mann–Whitney U and chi-square tests were used for group comparisons. Univariable and multivariable logistic regression analyses were performed to identify factors associated with surgical complications, adjusting for potential confounders. A p-value < 0.05 was considered statistically significant. Results: Of 80 limbs, 47 (58.8%) underwent acute and 33 (41.3%) underwent delayed procedures. One-year complication rates were 23.4% in the acute group, and 12.1% in the delayed group, with wound-related complications predominantly occurring in patients undergoing amputation for infection or vascular disease. Unexpected reoperation rates were 19.1% for acute and 12.1% for delayed interventions. On univariable and multivariable analyses, early procedures demonstrated higher odds of surgical complications. However, these associations did not reach statistical significance and were limited by baseline differences in patient comorbidity and etiology. Conclusions: Early advanced nerve interface procedures were performed in more medically complex patients and were associated with higher observed rates of surgical complications, whereas delayed procedures were associated with a higher incidence of recurrent symptomatic neuromas. These findings underscore the importance of patient selection, etiology of amputation, and surgical context, rather than timing alone, when determining the optimal approach to nerve interface reconstruction following lower-extremity amputation. Full article

Sarcocystis is a genus of heteroxenous, globally distributed apicomplexan parasites found in reptiles, birds, and mammals. Typically, sarcocysts develop in muscles of intermediate hosts, and oocysts sporulate in intestines of definitive hosts. The parasite’s life cycle is based on prey–predator relationships and usually involves two distinct host species. However, some Sarcocystis spp. can complete their full development within a single host species. Brown rats (Rattus norvegicus) are invasive, synanthropic, highly adaptable rodents that are true omnivores and opportunistic feeders. Therefore, it is possible that they can act as definitive hosts of Sarcocystis parasites. This study provides the first comprehensive assessment of Sarcocystis protists in brown rat intestinal samples under natural conditions, combining microscopy and molecular analyses. Of 27 brown rats investigated, 25.9% (7/27) of animals harbored oocysts/sporocysts of Sarcocystis spp. Based on nested PCR and sequencing of four genetic loci (18S rRNA, 28S rRNA, ITS1, and cox1), 59.3% of samples were positive for Sarcocystis spp. Parasites identified were genetically similar to Sarcocystis spp. using bird–bird, bird–Carnivora, rodent–Carnivora, or ungulate–Carnivora as their intermediate–definitive hosts. The present study suggests that synanthropic rodents may facilitate cross-ecosystem transmission of these parasites, increasing infection pressure on livestock, companion animals, and wildlife in human-dominated environments. Future molecular and dietary ecological studies are needed to assess the role of synanthropic and opportunistic hosts, such as the brown rat, in the transmission of Sarcocystis spp. Full article

White Spot Syndrome Virus (WSSV) remains one of the most devastating pathogens in global shrimp aquaculture, causing massive economic losses annually. This study employed comparative transcriptomics to elucidate the molecular basis of the differential resistance to WSSV between the highly susceptible Pacific white shrimp (Litopenaeus vannamei) and the remarkably resistant oriental river prawn (Macrobrachium nipponense). Our analysis of gill, hepatopancreas, and muscle tissues at 24 h post-infection revealed fundamentally distinct defense strategies. The resistant M. nipponense employs a unique “proactive homeostatic reinforcement” strategy, characterized by significant enrichment of pathways central to cellular homeostasis, including signal transduction, cellular processes, and transport/catabolism. This approach, supported by coordinated up-regulation of heat shock proteins and structural genes, enables effective viral control without triggering excessive immune activation. In contrast, susceptible L. vannamei displays either widespread metabolic dysregulation leading to systemic collapse in moribund individuals or dependency on specific immune pathways (Toll-like receptor signaling and apoptosis) in survivors. Through comparative KEGG analysis, we identified heat shock protein 70 kDa (HSP70, K03283) as a key conserved gene and functionally validated its critical role in antiviral defense using RNA interference. Knockdown of HSP70 in M. nipponense significantly increased cumulative mortality and viral load, confirming its essential protective function. These findings provide novel insights into crustacean antiviral immunity and identify promising genetic targets for breeding WSSV-resistant shrimp strains, offering sustainable solutions for disease management in aquaculture. Full article

Background: Emerging evidence suggests that COVID-19 may influence obstructive sleep apnea (OSA) pathophysiology by affecting upper airway collapsibility, ventilatory control, and arousal responses, raising the possibility of a bidirectional relationship. This study examined whether individuals with a history of COVID-19 show altered OSA-related physiological traits compared with those without prior infection. Methods: In a case–control study, 60 participants with a history of COVID-19 were compared to 60 matched controls who underwent overnight in-hospital polysomnography before the pandemic. The matching criteria included age (±5 years), gender, body mass index (BMI) (±5 kg/m²), and OSA presence. Key pathophysiological traits (collapsibility, loop gain, arousal threshold, muscle compensation) estimated from polysomnographic signals were compared, with adjustment for age, sex, BMI, and apnea–hypopnea index. Results: The participants (78% male, mean age 55 ± 12 years, BMI 29.4 ± 5.0 kg/m²) exhibited no meaningful differences in their average levels of collapsibility (Adj dif [95% CI]; V_passive: −1 [−4, 2] %_eupnea, p = 0.7), loop gain (LG₁: 0.01 [−0.04, 0.06], p = 0.7), or arousal threshold levels (−1 [−7, 4] %_eupnea) and showed similar levels of muscle compensation (V_comp: 5 [−1, 11], p = 0.12). However, a greater ventilatory response to arousal (7 [1, 12] %_eupnea) was associated with COVID-19 history. Conclusions: COVID-19 history is not associated with differences in key OSA pathophysiological traits, suggesting it is unlikely to explain observed differences in OSA presentation. The increased ventilatory response to arousal may have implications for treatment responses and outcomes. Full article

Background: Surgical treatment of periprosthetic joint infection (PJI) after total hip arthroplasty (THA) remains challenging, with thorough debridement seen as critical for success. While revision THA is well documented as the standard treatment for PJI, data on infection spread beyond the periprosthetic joint into surrounding soft tissue remain limited—this is the focus of our study. Methods: We retrospectively reviewed 558 patients who underwent a revision THA due to PJI at a single academic institution from January 2011 to December 2023. Out of 558 patients, 46 (8.2%) underwent a Magnetic Resonance Imaging (MRI) scan of their hip joint prior to their revision THA due to suspicion of a PJI. MRI reports were manually chart-reviewed to evaluate patients for evidence of infection spread beyond the constraints of the periprosthetic joint space. Results: Out of 46 patients with hip MRI prior to rTHA, 45 (97.8%) had pathological findings, and 34 (73.9%) had reports suggestive of periprosthetic joint fluid collection. The infected joint effusion extended in 30 cases (65.2%) from the capsule into the surrounding soft tissue, including the greater trochanteric region (17.4%), iliopsoas area (15.2%), anterolateral musculature (13.0%), surrounding soft tissue (10.8%), gluteal (8.7%) and obturator muscles (8.7%), and iliotibial band (4.3%). Capsule thickening was observed in 23.9% of the cases. Conclusions: Our study found that the vast majority (97.8%) of the hip MRIs had pathological findings, with periprosthetic joint fluid collection being a predominant feature in 73.9% of the cases. The extraarticular extension of these fluid collections was observed in over two-thirds (30/34) of affected patients, suggesting that PJI is often not confined to the capsule. MRI studies can help surgeons obtain prior knowledge of these cases and develop a more comprehensive surgical approach for infection debridement, potentially helping improve surgical treatment outcomes after PJI. Full article

Vibrio mimicus infection poses a severe threat to the sustainable aquaculture of yellow catfish (Pelteobagrus fulvidraco), a commercially important freshwater species of the order Siluriformes. To reveal the genetic mechanisms underlying the resistance to this pathogen, we established an infection model and integrated genome-wide association study (GWAS) and transcriptomics to identify key resistance loci and genes. Firstly, from whole-genome re-sequencing (WGRS) and high-quality genotypic data, six SNP loci significantly associated with resistance to V. mimicus were identified, which were annotated to 17 immune-related candidate genes. Notably, the rac2 gene associated with the locus Chr15:3,227,652 exhibited significantly differential expression in skin tissue. Through transcriptomic analysis, 6684 and 6616 differentially expressed genes were identified from the skin and muscle tissues, respectively. Functional enrichment analysis revealed that the skin, as the first line of defense against pathogens, prioritizes the activation of immune defense mechanisms, whereas muscle tissue responds to infection-induced stress primarily by regulating metabolic processes. Quantitative real-time PCR (qRT-PCR) validated that rac2 enhances the antibacterial capacity of yellow catfish in skin tissue by regulating the expression of NADPH oxidase complex subunits ncf1 and ncf4. This study reveals, for the first time, the core functional genes of yellow catfish associated with resistance to V. mimicus infection, providing theoretical support for disease-resistant breeding of this species. Full article

Intravesical Bacillus Calmette–Guérin (iBCG) immunotherapy is the standard adjuvant treatment of non-muscle-invasive bladder cancer (NMIBC). Among the potential complications, cases of mycotic aneurysms and acute respiratory distress syndrome (ARDS) are rare but can be life-threatening. Because prior reports have not included whole-genome sequencing (WGS) of clinical Mycobacterium bovis BCG (M. bovis BCG) isolates to assess whether the infecting strain acquires mutations in vivo, we performed WGS in a severe disseminated iBCG-related infection. A 72-year-old man with bladder cancer underwent iBCG instillation. Twelve months after the final instillation, the patient developed an abdominal aortic aneurysm, which was detected and treated with endovascular aneurysm repair (EVAR). Two months later, the patient presented with fever, abdominal pain, and septic shock. Contrast-enhanced computed tomography (CT) and ¹⁸F-fluorodeoxyglucose positron emission tomography/CT (FDG-PET/CT) showed rapid aneurysm enlargement. Ziehl–Neelsen staining and PCR of aortic material identified M. bovis BCG. Direct PCR on BAL fluid and urine was negative; however, BAL and urine culture subsequently grew M. bovis BCG, and PCR performed on the culture isolate confirmed M. bovis BCG. Despite combined antituberculosis triplet therapy (isoniazid, rifampicin, and ethambutol), the patient developed ARDS, which gradually improved after surgical management. WGS (with >96% genome coverage) showed the isolate was highly concordant with the vaccine strain and lacked additional virulence-associated mutations, including in esxM. This case illustrates that severe systemic iBCG-related complications can occur without detectable in vivo acquisition of virulence-enhancing mutations; however, interpretation is limited by the single-case design and the absence of host genetic susceptibility testing. Our findings underscore the need for prolonged vigilance regarding late-onset vascular and pulmonary complications after iBCG, and highlight the importance of early multidisciplinary management. Full article

Background: Pertussis, diphtheria, tetanus, poliomyelitis, and Haemophilus influenzae type b (Hib) infections pose severe threats to children’s health globally. This study evaluated the safety and immunogenicity of a novel Sabin strain-based adsorbed pentavalent vaccine (DTacP-sIPV/Hib), which offers potential advantages in biosafety and cost-effectiveness compared to wild-type poliovirus-based vaccines. Methods: A repeated-dose toxicity study was conducted in 190 Sprague-Dawley rats, randomly divided into negative control, adjuvant control, low-dose, and high-dose groups. Animals received five intramuscular injections at 21-day intervals, followed by a 56-day recovery period. Parameters assessed included local reactions, body temperature, hematology, serum biochemistry, coagulation, histopathology, T-cell subsets, cytokine levels, and antigen-specific immunogenicity. Results: The primary adverse reaction was dose-dependent local muscle swelling, which was fully reversible within 3–21 days. Only transient body temperature fluctuations and adjuvant-related hematological/biochemical abnormalities were observed, all resolving after the recovery period. No vaccine-related damage occurred in hepatic/renal function or immune organs. Immunogenicity data showed 100% seroconversion for all bacterial components 21 days after the first dose. The high-dose group achieved 100% seropositivity for all poliovirus serotypes after the second dose, while the low-dose group reached the same after the third dose, with no significant difference in antibody levels between dose groups. Conclusions: The DTacP-sIPV/Hib vaccine exhibits a favorable safety profile and robust immunogenicity in rats, supporting its further clinical development. The use of Sabin strains reduces biosafety risks and manufacturing costs, making this vaccine a promising candidate for immunization programs, especially in resource-limited regions. Full article

Background: Adult scoliosis following spinal fusion and subsequent hardware removal presents complex challenges, especially when deformity progresses in both the sagittal and coronal planes. Revision surgery is often recommended but it entails considerable risks. Conservative approaches, including Schroth-based physiotherapy and bracing, offer promising alternatives for select patients, particularly older adults with comorbidities or those who decline further surgery. Case Presentation: A woman with adolescent idiopathic scoliosis (diagnosed at age 13) underwent spinal fusion with Harrington rod instrumentation and costoplasty at age 24. She was de-instrumented two years later due to infection and developed progressive thoracic hyperkyphosis, coronal imbalance, and 12 cm loss of height over two decades. At age 47, she chose conservative management instead of revision surgery. Methods: She completed a 28-month program combining Schroth-based physiotherapy supervised by a certified therapist and part-time bracing. Outcomes included radiographs, inclinometry, spirometry, spinal-muscle ultrasound, height/posture measures, and SRS-22 and ODI scores. Results: Substantial clinical improvements were observed. Thoracic kyphosis decreased from 80° to 45° (44%) and the coronal thoracic curve was reduced from 48° to 32° (33%). Lumbar lordosis increased by 6°, standing height rose by 4 cm, and forced vital capacity improved by 900 mL (33%). The Oswestry Disability Index (ODI) score improved from 4% to 0%, and SRS-22 domains (pain, function, self-image, mental health, satisfaction) showed meaningful gains. The patient returned to full physical activity and avoided further surgery. Conclusion: This case highlights the potential of Schroth-based physiotherapy with bracing to reverse postural and functional decline in complex post-fusion scoliosis. It offers a viable non-surgical option when revision surgery poses a high risk or is declined and aligns with modern rehabilitative goals focused on long-term quality of life. Full article

Background: Computed tomography (CT) angiography is widely regarded as the gold standard for diagnosing acute aortic dissection. However, in patients with contraindications to iodinated contrast media, such as those with renal insufficiency or hemodynamic instability, non-contrast CT may offer a viable alternative for initial evaluation. Understanding the molecular mechanisms underlying aortic dissection, including extracellular matrix degradation, smooth muscle cell apoptosis, and inflammatory pathways, is crucial for developing novel diagnostic and therapeutic approaches. This report describes a single case of acute Stanford type A aortic dissection initially detected on non-contrast CT. Case Presentation: We describe a 74-year-old man who presented to the emergency department with fever and suspected infection, but without chest pain. An incidental finding on non-contrast CT revealed ascending aortic dilatation, pericardial effusion, and a suspected intimal flap. Subsequent CT angiography confirmed a Stanford type A aortic dissection. Conclusions: This case highlights the potential value of non-contrast CT in the early detection of aortic dissection, particularly when CT angiography cannot be performed. Recent advances in artificial intelligence (AI) and radiomic analysis have shown promise in augmenting the diagnostic capabilities of non-contrast CT by identifying subtle imaging features that may correlate with underlying molecular pathology and elude human observers. Emerging evidence suggests that radiomic features may reflect molecular alterations in the aortic wall, including metalloproteinase activity, collagen degradation, and inflammatory cell infiltration. Incorporating AI-assisted interpretation alongside insights into molecular mechanisms could facilitate earlier diagnosis, improve risk stratification, and guide personalized treatment strategies in critically ill patients. Although non-contrast CT has limited sensitivity for aortic dissection, it may still reveal crucial findings in selected cases and should be considered when contrast-enhanced imaging is not feasible. Ongoing progress in AI, radiomics, and molecular biomarker research may further expand the clinical applications of non-contrast CT in emergency cardiovascular care and bridge the gap between imaging phenotypes and molecular endotypes. These findings are hypothesis-generating and require validation in larger cohorts before clinical generalization. Full article

Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has posed major risks for healthcare workers (HCWs) worldwide. This study assessed the prevalence of infection and its relationship with demographic and clinical characteristics among HCWs at the University of Puerto Rico Adult Hospital. A total of 132 individuals were enrolled, of whom six tested positive (4.55%). The study population was predominantly female (78.8%) with a mean age of 41 years, and although men showed higher odds of infection (OR = 3.98), the difference was not significant. Symptom presence was strongly associated with infection: 7.4% of symptomatic participants tested positive compared to none of the asymptomatic (p < 0.001). Symptom count was also predictive, with those reporting three to four symptoms showing the highest positivity rate (14.8%) and those with five to ten symptoms at 6.7%. Specific symptoms including muscle pain (OR = 21.04, p = 0.002), taste loss (OR = 24.20, p = 0.002), smell loss (OR = 15.25, p = 0.024), and fever (OR = 20.50, p = 0.016) were significantly linked to infection, while others such as headache and congestion were not. These findings underscore the utility of symptom-based monitoring in occupational health, though the single-site design, modest sample size, reliance on self-report, and early pandemic diagnostic limitations may have led to underestimation of true cases. Full article

Congenital toxoplasmosis presents with a wide clinical spectrum, ranging from asymptomatic infection to severe disease with multi-organ failure. We report a rare fatal case of disseminated congenital toxoplasmosis in a human neonate. The infant initially had thrombocytopenia and mild hepatitis, which rapidly progressed to fulminant liver failure. Despite initiation of standard therapy with pyrimethamine, sulfadiazine, and folinic acid on postnatal day 25, the infant died two days later. Autopsy revealed widespread involvement of the liver, spleen, brain, heart, lungs, urinary bladder, and skeletal muscle. To further characterize the infection, genomic sequencing of the isolate (TgHsUS2) was performed, which placed it within clade C (Haplogroup 9) and closely related to reference strains P89 and TgCatBr3. Variant analysis showed type III-like alleles in ROP18, ROP16, and GRA15. These alleles are known to modulate host immunity and may have influenced disease severity in this case. This report highlights the need for rapid recognition and targeted therapy as well as how strain genomics can inform disease mechanisms. Prevention through prenatal screening and maternal treatment during pregnancy may reduce infant mortality. Full article

Bovine viral diarrhea virus (BVDV) poses a serious disease in cattle. Cachexia is a condition marked by weight loss and muscle wasting and is often observed in infected animals. This study reports a case series from Tiaret province, Algeria, aimed at detecting and genetically identifying BVDV in clinically cachectic cattle. A total of 100 cachectic animals from ten herds were examined using serological, molecular, and virological methods, including antibody ELISA, RT-qPCR, and virus isolation in cell culture. Overall, 93.6% of the animals tested were seropositive for BVDV, indicating extensive exposure to the sampled population. Higher antibody rates were observed in adults (≥12 months) and males compared to younger animals and females, but the differences were not statistically significant. Phylogenetic analysis of the 5′UTR sequences confirmed the presence of the BVDV-1f subtype closely related to sequences reported in Europe. Although BVDV was detected in animals within the sampled herds, the data does not support a causal conclusion that BVDV was the direct cause of cachexia in this case series; rather, its immunosuppressive effects may predispose cattle to secondary infections contributing to wasting. These results are specific to this opportunistic case series from Tiaret province and should be considered exploratory; broader and representative surveillance is required to assess the national epidemiological situation. Full article