Search Results (82)

Abdominal fat necrosis is a dystrophic–necrotic process that is relatively common in dairy cows. It is determined by productive strain (excess fat in the diet), negative energy balance after calving, a lack of physical activity, vitamin E and selenium deficiency, etc. Lipomatous masses are predominantly located in the omentum and mesentery in cattle, potentially causing intestinal obstruction. We report on an outbreak of abdominal fat necrosis that affected 135 of 220 cows and heifers (61.36%); this involved massive fat accumulation in the uterine and salpingian ligaments and severe reproductive disorders (reducing fertility to 20% in cows and 10% in heifers) caused by a hyperenergetic diet (supplementation with saturated fats). A transrectal ultrasound examination of the genital apparatus—both in heifers and in cows in the puerperium—revealed a diffuse pathological hyperechogenicity of the cervical folds, suggesting lipid infiltration, proliferation of the endocervical folds and hyperechogenic lipogranulomas located paracervically or in the uterine ligaments. An ultrasound examination of the ovaries showed the presence of parasalpingial lipogranulomas on the mesovarium, with a uniformly pixelated greasy appearance, that altered the topography of the salpinx, leading to the impossibility of oocyte retrieval. At the histopathological examination, in addition to the necrosis of adipocytes and the subacute–chronic inflammation of the abdominal and retroperitoneal adipose tissue, lipid infiltration of the uterine walls was also observed in the uterine ligaments and lymph nodes. Additionally, lipid infiltration was observed in the wall of the uterine artery. All muscular-type branches of the ovarian artery exhibited subendothelial (subintimal) amyloid deposits, severely reducing their lumen and leading to ischaemia. Amyloidosis was secondary to the systemic inflammatory process triggered by lipid deposition and necrosis. Fertility returned to normal 45–60 days after the exclusion of fat supplements from the diet and their replacement with a vitamin–mineral supplement rich in antioxidants. Full article

Cardiac cachexia (CC) is an advanced stage of heart failure (HF) characterized by structural and functional abnormalities in skeletal muscle, leading to muscle loss. Aerobic training provides benefits; however, the underlying molecular mechanisms remain poorly understood. This study aimed to investigate the therapeutic effects of aerobic training on transcriptomic alterations associated with disease progression in cachectic skeletal muscle. HF was induced in male Wistar rats by a single monocrotaline injection (60 mg/Kg). Aerobic training consisted of 30 min treadmill running at ~55% of maximal capacity, 5×/week for 4 weeks. Assessments included body mass, right ventricle mass, skeletal muscle fiber size and exercise tolerance. RNA-seq analysis was performed on the medial gastrocnemius muscle. Sedentary cachectic rats exhibited 114 differentially expressed genes (DEGs) while exercised cachectic rats had only 18 DEGs. Enrichment pathways analyses and weighted gene co-expression network analysis (WGCNA) identified potential key genes involved in disrupted lipid metabolism in sedentary cachectic rats, which were not observed in the exercised cachectic rats. Validation of DEGs related to lipid metabolism confirmed that Dgat2 gene expression was modulated by aerobic training in CC rats. These findings suggest that aerobic training mitigates transcriptional alterations related to lipid metabolism in rats with CC, highlighting its therapeutic potential. Full article

Background/Objectives: As aging leads to a decline in muscle mass, strength, and functional capacity, identifying effective, low-risk interventions for older adults is essential. Blood flow restriction training (BFRT) has gained recognition as a potential substitute for traditional high-load resistance training, offering comparable benefits with reduced mechanical stress. This scoping review explores current BFRT protocols—specifically cuff pressure, training frequency, and duration—and their impact on muscular strength, hypertrophy, and functional capabilities among healthy elderly individuals. Methods: Following PRISMA-ScR and Arksey and O’Malley’s framework, six databases were searched (2010–2024), yielding 13 eligible studies. Data were charted for BFRT parameters, training regimens, and outcomes related to strength, muscle size, and functionality. Risk of bias was assessed using Cochrane guidelines. Results: Low-load BFRT (20–40% 1RM), applied 2–4 times weekly for 6–12 weeks, significantly improved muscle strength, hypertrophy (e.g., quadriceps CSA), and functional performance (e.g., TUG, 6MWT). Cuff pressures ranged from 50 to 80% arterial occlusion pressure (AOP) for the lower limbs and 30–50% above systolic pressure for the upper limbs. Wider cuffs enhanced safety and comfort. BFRT demonstrated comparable or superior outcomes to conventional training in most studies, with minimal adverse effects reported. Conclusions: The existing evidence suggests that BFRT may be a promising intervention for improving muscle health and functionality in older adults; however, future research should focus on standardizing protocols, long-term outcomes, and tailored guidelines to optimize safety and efficacy. Full article

Arterial stiffness indicates early atherosclerotic changes prevalent in children and adolescents with type 1 diabetes (T1D), even in those with a well–controlled disease and without additional cardiovascular risk factors. This study aimed to determine whether low–density lipoprotein (LDL) cholesterol and cytokine levels can indicate vascular stiffness in pediatric patients without conventional microangiopathic complications who are not undergoing lipid–lowering therapy. The total study group consisted of 59 pediatric patients divided into two subgroups based on their LDL cholesterol levels and matched for age, age at onset, and duration of diabetes. The investigation involved the precise measurement of several biomarkers including tumor necrosis factor (TNF–α), interleukin 35 (IL-35), interleukin 4 (IL-4), interleukin 10 (IL-10), interleukin 12 (IL-12), interleukin 18 (IL-18), vascular endothelial growth factor (VEGF), Soluble Vascular Cell Adhesion Molecule–1 (sVCAM–1), Intercellular Adhesion Molecule–1 (ICAM-1), Soluble Platelet Selectin (sP–Selectin), Advanced Glycation End Products (AGEs), and Receptors for Advanced Glycation End Products (sRAGE). Arterial stiffness was assessed by calculating pulsatility indices in the common carotid artery and the peripheral arteries in the upper and lower limbs. The comparative analysis indicated that, in the subgroup with LDL cholesterol levels below 100 mg/dL, in comparison to the subgroup with LDL above 100 mg/dL, there was a significant increase in pulsatility indices in elastic and large muscle arteries and notably higher levels of IL-35, IL-10, sVCAM–1, and ICAM-1. This study is the first to recommend the pulsatility index of elastic and large muscular arteries as an effective diagnostic tool for evaluating early atherosclerotic lesions in children and adolescents diagnosed with type 1 diabetes. Elevated LDL cholesterol levels may contribute to vascular stiffness through mechanisms related to a weakened inflammatory response, highlighting the complex interaction between lipid levels, inflammation, and vascular health in patients with type 1 diabetes. Full article

Objectives: The ability to efficiently regulate body temperature is crucial during endurance activities such as trail running, especially during competitive events in hot conditions. Over the past decade, passive hyperthermia exposure has grown significantly in popularity as a means of improving acclimatization and performance in hot environments. The present study aims to compare the physiological changes that occur in a group of professional athletes due to passive sauna exposure (80–90 °C) and their own response to maximal aerobic performance. Methods: Twelve professional trail runners (eight men and four women) were tested in three conditions: (i) baseline; (ii) before; and (iii) after (a) passive dry sauna exposure and (b) a maximal endurance test. In both cases, physiological parameters such as heart rate, tympanic temperature, arterial and muscle oxygen saturation, and blood concentrations of glucose, total cholesterol, high-density lipoprotein (HDL) and hemoglobin were measured. Results: Sauna exposure produced similar trends in cardiovascular and metabolic responses to those occurring during exercise, but at a much lower physiological level. Glucose and HDL levels were both significantly elevated (or tended to be so) after sauna and exercise (p < 0.03 and p < 0.01, respectively). Athletes who mobilized the sum of substrates (glucose and HDL) performed the exercise test faster (r = −0.76; p < 0.004). The response of arterial oxygen saturation (decreased) was similar during sauna and exercise, but opposite at the muscular level (increased during sauna and decreased during exercise). Additionally, inter-individual variability in responses was noted for most of the other parameters, suggesting the existence of ‘responders’ and ‘non-responders’ to thermal stimuli. Conclusions: The physiological responses of trained endurance athletes are moderately impacted by passive sauna use. However, individual changes could be correlated with endurance performance and optimizing individualization. Heat stimuli promote different physiological responses in terms of cardiac function, oxygen kinetics and substrate mobilization, albeit to a lesser extent than exercise. Greater substrate mobilization during maximal endurance exercise was found to be correlated with better performance. Further studies are needed to explore the concepts of metabolic flexibility, as described here, and how heat exposure may improve systemic health and performance. Full article

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the coronavirus disease 2019 (COVID-19) pandemic that devastated the world. While this is a respiratory virus, one feature of the SARS-CoV-2 infection was recognized to cause pathogenesis of other organs. Because the membrane fusion protein of SARS-CoV-2, the spike protein, binds to its major host cell receptor angiotensin-converting enzyme 2 (ACE2), which regulates a critical mediator of cardiovascular diseases, angiotensin II, COVID-19 is largely associated with vascular pathologies. The present study examined the pulmonary vasculature of COVID-19 patients using large sample sizes and provides mechanistic information through histological observations. We studied 56 postmortal lung samples from COVID-19 patients. The comparative group consisted of 17 postmortal lung samples from patients who died of influenza A virus subtype H1N1. The examination of 56 autopsy lung samples showed thickened vascular walls of small pulmonary arteries after 14 days of disease compared to H1N1 influenza patients who died before the COVID-19 pandemic started. Pulmonary vascular remodeling in COVID-19 patients was associated with hypertrophy of the smooth muscle layer, perivascular fibrosis, edema and lymphostasis, inflammatory infiltration, perivascular hemosiderosis, and neoangiogenesis. We found a correlation between the duration of hospital stay and the thickness of the muscular layer of the pulmonary arterial walls. These results demonstrate that COVID-19 significantly affected the pulmonary vasculature in fatal-course patients, also suggesting the need for careful follow-up in non-fatal cases, at risk of pulmonary hypertension. Full article

(1) Background: Ischemic stroke is a major global public-health concern with complex pathogenesis. Current treatment strategies face challenges. Low-intensity pulsed ultrasound stimulation (LIPUS), a non-invasive neuromodulation technology, shows promise in treating ischemic stroke, yet its underlying mechanisms lack in-depth investigation, especially in quantitative efficacy evaluation. (2) Methods: This study aimed to develop a neuromuscular functional coupling-based dynamic time warping (DTW) model to evaluate LIPUS’s neuroprotective effects in a mouse model of ischemic stroke. A bilateral carotid artery occlusion (BCAO) model in mice was established, and LIPUS treatment was given. Time- and frequency-domain analyses of local field potentials (LFPs) and electromyography (EMG) were conducted, and outcomes were quantified using a percentage-based scoring system. (3) Results: The BCAO+LIPUS group scored significantly higher than the BCAO group. (4) Conclusions: This study demonstrated that LIPUS is neuroprotective in BCAO mice and that the DTW-100 assessment evaluation model can quantify the neuroprotective effects of LIPUS. Full article

The vertebral arteries supply blood to the upper spinal cord, brainstem, cerebellum, and posterior part of the brain. These arteries are susceptible to deformation from external factors such as muscular, ligamentous, or bony structures, and any interruption of blood flow may result in vertebrobasilar insufficiency. Among the osseous variants of the cervical spine with potential pathological significance, variations in the number, shape, and size of the foramen transversarium, as well as the presence of bony bridges in the first cervical vertebra, may suggest a predisposition to vertebrobasilar insufficiency. A skeletal sample from the post-Classical cemetery of Corfinio (12th–15th centuries CE; L’Aquila, Italy) was examined. Regarding the morphology of the foramen transversarium, shape variations were identified in 32 of the 108 vertebrae analysed (a prevalence of 29.6%). Particularly noteworthy are three findings in the atlas: (i) a high prevalence of foramen transversarium variants (35.7% for hypoplastic and double foramina), (ii) a coefficient of roundness consistent with a brachymorphic shape, and (iii) a high prevalence of bony bridges —especially ponticulus posticus (52.9%) and retrotransverse foramen (64.7%). All of these findings may indicate a predisposition to vertebrobasilar insufficiency in the individuals studied. It is hypothesised that external mechanical factors, such as carrying heavy loads on the head, neck, and shoulders due to work activities, along with possible genetic influences related to kinship, may have contributed to the high prevalence of these osseous variants. Full article

Background: Idiopathic inflammatory myopathies (IIMs), also known as myositis, are systemic autoimmune diseases characterized by chronic inflammation affecting the skin, muscles, and internal organs. Besides traditional risk factors and immune-mediated myocarditis, continuous activity of the immune system increases cardiovascular disease (CVD) risk, meaning that cardiovascular events are the leading causes of mortality in IIM patients. Statins are the most widely used lipid-lowering therapies, which reduce cardiovascular risk, but the fear of adverse muscular events inhibits the frequency of use. Methods: Our aim was to assess the CVD risk in a myositis cohort using the SCORE2 prediction system, carotid artery Doppler ultrasound measurement, and biomarkers; recommend individual lipid-lowering treatment; and follow the efficacy and adverse events of therapy in a 6-month treatment period. Results: The study population (80 IIM patients) was a middle-aged, female-dominant myositis cohort with an average disease duration of 9 years and low median global disease activity. Based on the SCORE2 evaluation, 78.8% of patients had medium/high CVD risk, while 73.13% had asymptomatic carotid plaque. After 6 months of adequate lipid-lowering therapy, 37.5% of patients reached a lower CVD risk category, the biomarker levels of atherosclerosis significantly decreased, and no progression in carotid plaques was detected. None of the patients reported an adverse muscular event or IIM relapse. Conclusions: Our findings proved that the CVD risk of patients with myositis is high, but carefully applied lipid-lowering treatment is the key to effective risk reduction. Risk stratification and the recommendation of preventive treatment are the responsibility of the treating physician. Full article

Objective: Cerebral vascularization is made of the symmetrical arterial system, with muscular walls, and the venous system, more variable and dominated by sinuses and jugular veins. Factors like age and posture influence this network, complicating its study. Phase-contrast MRI is the gold standard for quantifying cerebral circulation. This study aimed to quantify the dynamics of the cerebral blood system using PC-MRI. Materials and Methods: Thirty-six healthy adults participated. Imaging was performed on a 3T MRI (Philips Achieva) in a supine position. Two slices were acquired: intracranial and extracranial. In-house software analyzed flow curves over a cardiac cycle. Each vessel’s contribution was evaluated. Results: Extracranial venous drainage was categorized as jugular-dominant, equivalent, or peripheral-dominant. A similar classification applied intracranially. Intracranial flows showed low variability (5–9%), while extracranial venous flows, especially in the internal jugular veins, had higher variability (17–21%). Some extracranial veins were absent. Conclusions: There is significant venous heterogeneity in the extracranial region. PC-MRI enables the quantification of cerebral dynamics. Full article

Objectives: To investigate the findings associated with juvenile polyarteritis nodosa (PAN) on F18-FluoroDeoxyglucose (FDG), positron emission tomography combined with computed tomography (PET-CT). Methods: Patients diagnosed with juvenile PAN (onset <18 years) who underwent a PET-CT at diagnosis (before therapy) were enrolled. PET-CT images were systematically analyzed to identify abnormal findings associated with PAN. In addition, a systematic literature review was performed to identify previously published cases. Results: Six patients with biopsy-confirmed PAN were identified (age at onset 10–17 years). PET-CT was abnormal in all patients. Patchy muscular and subcutaneous FDG uptake with a symmetric distribution in the lower limbs was present in 4/6 patients. Increased FDG uptake in large arteries was found in 1/6 patients. FDG-avid bone lesions were identified in 2/6; additional MRI and bone biopsy results were consistent with chronic non-infectious osteomyelitis (CNO). Unspecific inflammatory findings (medullar and lymphoid organs hypermetabolism) were present in 6/6; these were the only abnormalities present in 2/6 patients. We found this pattern of PET-CT muscular involvement to differ from juvenile dermatomyositis and septic emboli (n = 7 and 2 patients, respectively). In addition, we identified four previously published cases of juvenile PAN investigated with PET-CT: one with FDG-avid muscular and subcutaneous foci, one with increased uptake in large arteries, and two with nonspecific signs (lymphoid organs hypermetabolism). Conclusions: This is the first series of juvenile PAN investigated with PET-CT. Diffuse, patchy hypermetabolic foci in the muscular and subcutaneous tissue of the lower limbs were the most common findings. These features should lead to suspicion of PAN. Further research is needed to assess the diagnostic value of PET-CT in PAN. Full article

Background: This case report describes the surgical management of pulmonary artery banding (PAB) in a cat diagnosed with an incomplete atrioventricular canal (AVC) defect and a concurrent muscular septal defect. It highlights the use of PAB as a palliative treatment to manage this rare congenital heart condition in companion animals. Case Presentation: A 9-month-old European long-haired male cat presented with clinical signs of heart failure. Pharmacological treatment with sildenafil and furosemide failed to stabilize the patient’s condition. Echocardiographic assessment revealed an incomplete AVC type A and a muscular septal defect. Pulmonary artery banding was performed to reduce pulmonary blood flow and alleviate heart failure symptoms. Pre- and postoperative echocardiographic evaluations were conducted to monitor structural and functional changes in the heart. Post-surgical outcomes included a marked reduction in the size of the right atrium and ventricle and a stable pulmonary artery flow velocity of 3.8 m/s. The cat has remained in very good condition without the need for pharmacotherapy for 13 months post-surgery and is still alive at the time of reporting. Conclusions: PAB proved effective as a palliative intervention for managing an incomplete AVC in this feline patient. The successful outcome suggests that PAB may offer significant long-term benefits and improved survival in selected cases of incomplete AVCs in cats. Full article

Background/Objectives: Vascular malformations form masses in subcutaneous and muscular tissues throughout the body and are occasionally misdiagnosed as subcutaneous nonvascular tumors. Understanding and differentiating their clinical and imaging features are crucial due to their different treatments and prognoses. This study aimed to report cases of nonvascular tumors that were initially misdiagnosed and treated as vascular malformations. Methods: In this retrospective observational study, we enrolled 14 (1.8%) patients with pathologically diagnosed nonvascular tumors from among 536 patients with 759 lesions of clinically diagnosed vascular malformations. Results: The average age at the initial visit was 41.9 years, with a male-to-female ratio of 3:11. Tumor locations included the lower limb in seven patients, the upper limb in five patients, and the trunk and head in one patient each. Ultrasound evaluation revealed 12 lesions of low-flow vascular malformations and two lesions of high-flow vascular malformations. These findings led to an initial diagnosis of venous or lymphatic malformations in 12 patients and arteriovenous malformations in two patients. Based on the clinical diagnosis, treatments administered before tumor resection included sclerotherapy in four patients and transcatheter arterial embolization in one patient. All patients underwent tumor resection. The final histopathological diagnoses included schwannoma in six patients, epidermal cyst and angiomyoma in two patients each, and other types of tumors in four patients. The average time from initial diagnosis to final histopathological diagnosis was 370 days. Conclusions: Multimodal diagnostic strategies, especially the use of ultrasound, enhance the differentiation between vascular malformations and nonvascular tumors. Full article

Background and Objectives: Proximal tibiofibular joint detachment (PTFJD) is a fibular untethering procedure during lateral closing-wedge high tibial osteotomy (LCWHTO) for varus knee osteoarthritis. However, the PTFJD procedure is technically demanding, and confirmation of clear joint separation is not straightforward. The aim of this study was to compare the degree of completion and safety of PTFJD versus tibial-sided osteotomy (TSO); this latter procedure is our novel technique for fibular untethering during LCWHTO. Materials and Methods: Sixteen fresh frozen cadaver knees from eight cadavers were included in the study. Among the eight pairs of knees, one knee was randomly assigned to undergo PTFJD and the other knee to undergo TSO, which separates the fibula by osteotomizing the lateral cortex of the proximal tibia at the medial side of the proximal tibiofibular joint for fibular untethering during LCWHTO. After each procedure with LCWHTO, the posterior compartment of each knee was dissected to compare the degree of procedural completion and the distance from the posterior detachment or osteotomy site to posterior neurovascular structures between PTFJD and TSO groups. The pass-through test crossing the separation site from anterior to posterior using an osteotome was also performed to evaluate the protective effect of the muscular structures of the posterior compartment. Results: In the PTFJD group, four of eight cases (50%) showed fibular head fractures rather than division of the proximal tibiofibular joint. In contrast, in all TSO cases, the lateral cortex of the proximal tibia was clearly osteotomized from the medial side of the posterior proximal tibiofibular joint. Distances from the posterior detachment or osteotomy site to the common peroneal nerve, popliteal artery, and anterior tibial artery in the PTFJD and TSO groups were 20.8 ± 3.3 mm and 22.9 ± 3.6 mm (p = 0.382), 11.0 ± 2.4 mm and 9.8 ± 2.8 mm (p = 0.382), and 14.8 ± 1.9 mm and 14.9 ± 2.5 mm (p = 0.721), respectively. In the pass-through test, an osteotome was able to pass anteriorly to posteriorly in all eight PTFJD group cases. However, the osteotome was blocked posteriorly by the popliteus muscle in the TSO group cases, indicating protection of posterior neurovascular structures during the TSO procedure. Conclusions: TSO, a novel fibular untethering procedure for LCWHTO, resulted in clear separation of the fibula from the lateral tibial cortex, and protection of posterior neurovascular structures by the popliteus muscle during the procedure. We anticipate that our novel surgical technique will provide more clear-cut and safer fibular untethering for LCWHTO. Full article

Pulmonary hypertension (PH) associated with heart failure with preserved ejection fraction (PH-HFpEF) represents a frequent form of PH related to left ventricular dysfunction. The pathophysiology of PH-HFpEF is intricate, and varied and includes vascular, cardiac, and pulmonary factors that contribute synergistically to developing this clinical syndrome. Improved knowledge of the pathophysiology of PH-HFpEF has paved the way for the use of new drugs such as angiotensin receptor neprilysin inhibitors (ARNIs), non-steroidal mineral corticoid receptor antagonist (nsMRA), sodium-glucose cotransporter inhibitors (SGLT2is), levosimendan, and glucagon-like peptide 1 (GLP-1) agonists. ARNIs are a widely used drug for the treatment of PH associated with heart failure with reduced ejection fraction. They have also recently been used in PH-HFpEF patients with hemodynamic benefits that need to be confirmed in future research. Finerenone is an innovative non-steroidal mineralocorticoid receptor antagonist that exhibits notable cardioprotective and renoprotective properties in individuals suffering from chronic diabetic kidney disease. It also enhances outcomes for patients with heart failure, whether they have mildly reduced or preserved ejection fraction. Moreover, in experimental studies, finerenone has been found to lower pulmonary artery pressure, reduce muscularization, and decrease the wall thickness of pulmonary arteries. SGLT2i have revolutionized the treatment of patients with heart failure irrespective of left ventricular ejection fraction, and their treatment is also associated with an improvement in the hemodynamics profile in patients with PH-HFpEF. Levosimendan is a widely used inodilator in the treatment of acute and advanced heart failure. In addition, its use in patients with PH-HFpEF (supported by the positive effects on pulmonary hemodynamics that levosimendan exerts) has recently demonstrated hemodynamic benefit in a small phase 2 study that paved the way for phase 3 studies and the creation of an oral formulation of levosimendan. Finally, GLP1 agonists are a class of drugs that, in preliminary evidence, have shown a positive effect on cardiac hemodynamics, mainly by facilitating left ventricular unloading. These effects, along with the reduction in insulin resistance and weight loss, likely lead to beneficial outcomes for PH-HFpEF patients, especially those with obesity as a comorbidity. Full article