Search Results (677)

Background and Clinical Significance: The term “boomerang sign” refers to a boomerang-shaped area of cytotoxic edema in the splenium of the corpus callosum. It is seen as hyperintense lesions on T2-weighted images, FLAIR and DWI in MRI. No specific pathomechanism leading to these changes in the splenium have been yet found; however, authors have listed a variety of potential causes. Case Presentation: The case presents a 38-year-old male patient after left cerebellopontine angle tumor resection with an abnormal, increased signal intensity within the corpus callosum (boomerang sign) in FLAIR MRI sequence. In the case of our patient, unlike the patients described in the literature, the changes in the commissure persist. Conclusions: These lesions could be caused by several factors such as the development of cerebellar edema and subarachnoid bleeding or hypertonic salt usage while in the intensive care unit. Full article

Background/Objectives: The incidence and prevalence of ischemic stroke, a leading cause of death and disability worldwide, are significantly higher in older adults than in younger individuals. Senescence induces a variety of biological changes that influence the pathogenesis of diseases such as ischemic stroke, thereby necessitating age-specific medical treatments. However, the molecular mechanisms underlying age-related differences in ischemic stroke progression remain poorly understood. Methods: We compared the histological and molecular features of ischemic stroke in a photothrombotic mouse model, focusing on 9-week-old (young) and 90-week-old (old) mice. Results: We found that microglial accumulation at the infarct region of the cerebral cortex was significantly lower in old mice than in young ones. This reduction in the microglial response was accompanied by a decrease in the morphological robustness of the astrocytes forming the glial scar. Furthermore, the mRNA expression of proinflammatory cytokines CXCL10, CCL2, and TNF-α, which were upregulated in the infarct region, was considerably higher in the old mice than in the young ones. Cytokine expression was well correlated with the mRNA levels of Toll-like receptor 4 (TLR4), a key regulator of neuroinflammation in old mice, but less correlated with them in young mice. Interestingly, Tlr4 mRNA expression in young mice was negatively correlated with the mRNA expression of the epigenetic regulator HDAC7, whereas this correlation was positive in old mice. Conclusions: These findings suggest that age-dependent changes in epigenetic regulation, such as the interaction between HDAC7 and TLR4, may contribute to the distinct pathological progression of ischemic stroke in older individuals. Full article

Amelanotic melanocytic nevi of the oral cavity are uncommon lesions that often present a diagnostic challenge for clinicians, primarily due to their nonspecific clinical appearance and the broad spectrum of possible differential diagnoses. These lesions can mimic a variety of benign and malignant conditions, requiring precise histopathological confirmation. The primary objective of this article is to present a comprehensive case report—tracing the course from initial presentation through diagnostic workup to final diagnosis—and to provide an overview of the current literature on oral amelanotic melanocytic nevi. We report the case of a 27-year-old female who presented with a small, exophytic mass located in the anterior mandibular gingival region. The lesion was asymptomatic and lacked pigmentation, adding to the diagnostic uncertainty. A range of differential diagnoses was considered, including pyogenic granuloma, peripheral ossifying fibroma, and squamous cell carcinoma. Due to the lesion’s limited size and accessibility, an excisional biopsy was performed under local anesthesia. Histopathological examination revealed an amelanotic melanocytic nevus, a rare variant characterized by the absence of melanin pigment, further complicating the clinical impression. The diagnosis was confirmed through immunohistochemical staining, which demonstrated melanocytic markers consistent with a nevus. The patient was followed up with for six months postoperatively, with no evidence of recurrence or malignant transformation. This case highlights the critical role of biopsy in achieving a definitive diagnosis, especially in lesions with atypical clinical presentations. It also underscores the importance of considering amelanotic melanocytic nevi in the differential diagnosis of nonpigmented oral lesions, as well as maintaining vigilance regarding the rare possibility of amelanotic melanoma. Full article

The topos of Vienna as the “stronghold of Christendom” emerged soon after the 1529 unsuccessful siege by the Ottomans. The city’s new strategic status not only spurred the building of new urban fortifications, it also stimulated the production of a large variety of printed texts and pictures that emphasized the necessity of Christian unity among divided Christians. In this context, this article aims to shed new light on the use of one Old Testament episode whose significance and polysemy has been largely overlooked for sixteenth-century Vienna: the attack of Jerusalem by the Assyrian King Sennacherib and his subsequent defeat through divine intervention under the city wall. Instrumental in defining a common spiritual approach to the fight, this Old Testament story can be considered a seminal basis for the paradigm of Vienna as a Jerusalem of unity and unanimity. To analyze the significance of this theme in Vienna, this article will first focus on its representation in Hanns Lautensack’s 1558/1559 famous cityscape before demonstrating that it originated from a far less known source: the 1532 sermons by the Bishop Johann Fabri. Full article

Hybrid necrosis in wheat is caused by an interaction between two genes, Ne1 and Ne2, that triggers the gradual death of plant tissue. This trait affects wheat breeding as the gene Ne2 is the same as the gene Lr13 for leaf rust resistance. We have built a three-marker haplotype that consists of single nucleotide polymorphism (SNP) marker information already available on genotyping arrays for the determination of the presence and absence of Ne2. In this work, test crosses of eight bread wheat varieties with known and unknown Ne1 carriers showed that six of them possessed Ne2. We analyzed a set of wheat varieties which had partial SNPs and phenotypic data, i.e., hybrid necrosis and leaf rust reactions, using Kompetitive Allele-Specific PCR (KASP) markers previously available for Ne2. The observed haplotypes of the SNP markers RAC875_c1226_652, Ra_c4397_542, and AX-110926324 perfectly matched the KASP marker variants for Ne2 and ne2. A prediction, based on these SNP haplotypes, of the distribution of Ne2 in wheat varieties, predominantly from Germany and released between 1900 and 2024, showed that breeding steadily increased the proportion of Ne2 in the German gene pool. Full article

Background: Self-medication is the use of medicinal products to treat self-diagnosed disorders or symptoms without the prescription or supervision of a healthcare professional. There is a lack of data about self-medication knowledge, attitudes, and practices among pharmacy undergraduates in Malaysia. This study assessed the knowledge, attitudes, and practices among undergraduate pharmacy students in Penang regarding self-medication. Method: A descriptive cross-sectional study was conducted using a self-administered, web-based survey (Google Forms), which was completed and responded to by 203 undergraduate pharmacy students from Penang, Malaysia, between October and December 2023. Descriptive statistics were used to summarize the socio-demographic characteristics of the participants. Associations between the socio-demographic characteristics of the participants and the knowledge, attitudes, and practices regarding self-medication were assessed using a chi-square test. Regression analyses were carried out to determine whether the socio-demographic characteristics of the participants were associated with practices of self-medication. Results: A total of 203 of the undergraduate pharmacy students completed the questionnaire. More than half of the participants’ age ranged between 19 and 21 years old, the majority were females (77.3%), and 31.5% of the participants had family members employed in the healthcare sector. Most respondents showed good knowledge in a variety of domains: 97.5% acknowledged the potential for drug interaction with other medications, indicating a high awareness of proper self-medication practices. A positive attitude was found regarding participants’ attitudes toward self-medication, and 65.5% practiced self-medication, primarily for treating minor illnesses (75.9%). Common conditions included fever (83.3%), cough/cold/flu (76.8%), and headache (71.4%). Reasons for not self-medicating included the absence of illness (20.2%), lack of knowledge/prior experience (19.2%), and fear of using the wrong medication (18.7%). Only academic year level was the predictor of practicing self-medication within the last six months among the participants. Conclusions: Generally, the participants possessed good knowledge and positive attitudes toward self-medication. The study revealed no significant associations between demographic characteristics and knowledge or attitudes. Insights from this research contribute to understanding self-medication practices among pharmacy students in Penang, informing potential interventions to promote responsible self-medication practices. Full article

In human medicine, neurological diseases have been associated with transient cardiac abnormalities. In horses, myocardial disease is rarely diagnosed and has been associated with a wide variety of causes. The aim of this article is to describe three horses with no previous cardiac disease, which all developed severe cardiomyopathy following neurological disease. A 5-year-old Shetland pony stallion was diagnosed with cardiomyopathy with arrhythmias following an episode of seizures caused by an accidental intra-arterial xylazine injection. A 20-year-old crossbred mare was hospitalised for an open fracture of the left maxillary bone with copious epistaxis from both nostrils and developed acute cardiomyopathy with arrhythmias following a venous air embolism. Both had elevated troponin concentrations. Multifocal areas of haemorrhages and coagulative necrosis within the myocardium were found at the post-mortem examination of a 4-year-old thoroughbred gelding who died shortly after suffering acute brain injury following a backward fall. Based on this report, we suggest that myocardial injury can also occur in horses following neurological disease. Equine patients with acute neurological disease may benefit from cardiac monitoring; otherwise, patients with unspecific or mild symptoms of cardiomyopathy are likely to remain unidentified. The prognosis associated with this type of cardiac disease remains to be defined. Full article

Latin America offers a unique point of view into the adaptation of viticulture to climate change through its rich diversity of climates, traditional knowledge, and scientific innovation. This review synthesizes the current research and technological developments across major wine-producing countries including Argentina, Brazil, Chile, Uruguay, the Dominican Republic, and Haiti. Argentina shows key adaptation strategies, including high-altitude vineyard relocation, clonal and rootstock selection, canopy and water management, and the conservation of Criolla and other autochthonous grapevine varieties. In Brazil, tropical viticulture and breeding programs led by Embrapa exemplify advancements in disease-resistant and climate-resilient cultivars. Chile’s heroic and southern viticulture highlights the importance of old vines, microclimatic heterogeneity, and territorial identity. Uruguay stands out for its terroir-based research and producer-led adaptation strategies. This review also addresses systemic challenges in scientific publishing, particularly the underrepresentation of Latin American researchers in global vitivinicultural discourse. These disparities underscore the need for inclusive science that values local knowledge and promotes equity in research funding and dissemination. Overall, Latin America stands out not only as a region highly vulnerable to climate change, but as an emerging model of adaptation and innovation, demonstrating how resilient, sustainable, and culturally rooted wine production can thrive under shifting environmental conditions. Full article

We report a case of spondylodiscitis caused by Aspergillus nidulans (SCAN). A. nidulans is a saprophytic fungus and emerging pathogen responsible for a variety of infections, although it is rarely implicated in osteoarticular infections. The patient was a 59-year-old immunocompromised patient with a history of lymphoma and splenectomy. Following diagnosis, the patient was promptly and effectively treated with voriconazole. A literature review underlines the distinctive features of the few case reports of SCAN, as well as the original features of the present case report. Full article

Soil, as the foundation for the survival of understory ginseng, directly impacts its growth and development. However, studies focusing on the role of soil in determining the quality of understory ginseng are limited. This study examines the relationship between quality and yield of 5-, 9-, and 17-year-old understory ginseng and their soil microbiota. The results indicate that with the increase in growth years, the overall biomass of understory ginseng generally shows an upward trend, while its quality slightly decreases at 9 years. Compared to the other two growth years, the soil from 9-year-old ginseng shows lower enzyme activity and pH and a higher abundance of pathogens. The 17 years soil has higher OM and AHN content, along with increased abundance of denitrifying and nitrogen-reducing bacteria. Correlation networks reveal that AK significantly influences ginsenoside content, while AP and AHN are more closely related to soil microorganisms. Compared with other types of ginsenosides, ginsenosides Rh2 and Rd are affected by a greater variety of soil microorganisms and chemical factors. As growth years increase, the changes in ginseng quality, soil nutrients, and soil microbiota do not follow a single linear trend; instead, there appears to be a bottleneck phase at certain intermediate stages. Full article

As spontaneous ascending aortic thrombi (AATs) are uncommon in modern clinical practice, despite the application of new technology and the widespread use of contrast-enhanced computer tomography during primary assessments in patients without underlying predisposing conditions, a thrombus floating in the ascending aorta is rarely discovered in a timely manner; moreover, the ascending tract represents an unusual site for thrombus formation. The clinical presentation of AATs is also often in the form of peripheral arterial embolization, which can cause a wide variety of symptoms, from stroke to limb ischemia, and thus delay correct diagnosis. Medical management is a risky strategy, while surgical treatment is usually challenging due to the risk of thrombus dislodgement and difficulties related to prior embolization complication management. In this study, faced with a peculiar case of embolic stroke in an otherwise healthy 71-year-old woman, we analyzed the status of knowledge on spontaneous ascending aortic thrombus treatments and outcomes. A multidisciplinary approach represents the best choice for defining a patient’s timing of surgery and ensuring the management of complications. Sequential multistage treatment minimizes further complications and prevents worsening patient outcomes, leading to the best management for every possible clinical presentation. A less invasive surgical approach could lead to complete resolution of the pathology, avoiding further potentially lethal complications, facilitating postoperative management, avoiding delayed treatments, and resulting in better outcomes. Full article

Introduction: The differential diagnosis of splenomegaly is a complex process that encompasses a wide variety of diseases. Moreover, it is not always standardized and lacks a definitive consensus on which tests should be performed and in what order. Gaucher disease (GD) and acid sphingomyelinase deficiency (ASMD) are lysosomal diseases (LD) that present with splenomegaly, the diagnosis of which requires a high index of suspicion and specific biochemical and genetic techniques. The aim of the project for the education and diagnosis of Gaucher disease and acid sphingomyelinase deficiency (PREDIGA) was to conduct educational training alongside an observational, multicenter, ambispective, cross-sectional, single-cohort study among patients having an enlarged spleen or undergone splenectomy to further assess these subjects to exclude two lysosomal diseases, namely GD and ASMD. Methods: Using dried blood spot (DBS) testing, we identified patients with abnormally low values of the enzymes glucocerebrosidase and acid sphingomyelinase, who then underwent sequencing of the GBA1 and SPMD1 genes, respectively. The study involved 34 hospitals and 52 medical specialists. Results: We identified 220 patients (208 adults and 12 children under 18 years) with cryptogenic splenomegaly or who had undergone splenectomy (12 patients) without having reached a diagnosis. The median age was 11 years (interquartile range [IQR] 3–16) in the pediatric population and 51 years (IQR 38–65) in the adult population. Lower-than-normal enzyme values were detected in 19 DBSs, confirming eight positive cases, which corresponded to six patients with GD and two with ASMD. The rest of the DBSs with low enzyme activity were not genetically confirmed (58%). We determined that lysosomal diseases accounted for 3.6% of cryptogenic splenomegaly/splenectomy cases in our setting: 2.7% were GD and 0.9% ASMD, in a ratio of 1 ASMD patient to every 3 GD patients. Lyso-GL1 values in patients with GD were elevated in all but one individual, corresponding to a child diagnosed at 4 months old. The variants detected in the GBA1 gene were consistent with the most frequent variants found in Spain. Discussion/Conclusion: The development and implementation of this protocol for the education and diagnosis of cryptogenic splenomegaly/splenectomy, even in asymptomatic patients, constitutes a comprehensive, simple, rapid, and effective screening method for the diagnosis of GD and ASMD. Full article

Background and Clinical significance: Plummer–Vinson (PV) syndrome is a rare medical entity diagnosed when iron-deficiency anemia, dysphagia, and esophageal webs occur in the same patient. PV syndrome has been associated with different autoimmune diseases, such as celiac disease (CD). CD is a chronic multisystemic disorder affecting the small intestine, but it is recognized as having a plethora of clinical manifestations secondary to the malabsorption syndrome that accompanies the majority of cases. However, similar to PV syndrome, a high percentage of CD patients are asymptomatic, and those who are symptomatic may present with a wide variety of gastrointestinal and extraintestinal symptoms, including iron-deficiency anemia, making the diagnosis challenging. Case presentation: We present the case of a 43-year-old Caucasian female patient with a 7-year history of iron-deficiency anemia and increased bowel movements (3–4 stools/day). Upper endoscopy demonstrated a narrowing at the proximal cervical esophagus from a tight esophageal stricture caused by a smooth mucosal diaphragm. A 36F Savary–Gilliard dilator was used to manage the stenosis. The distal esophagus and stomach were normal, but scalloping of the duodenal folds was noted, and CD was confirmed by villous atrophy and positive tissue transglutaminase antibodies. Dysphagia was immediately resolved, and a glute-free diet was implemented. Conclusions: The relationship between PV syndrome and CD is still a matter of debate. Some might argue that PV syndrome is a complication of an undiagnosed CD. In cases of PV syndrome, a CD diagnosis should be considered even in the absence of typical symptoms of malabsorption. Full article

Background/Objectives: Malnutrition in children is a challenge in South Asian countries, and understanding its relation with variety of social and economic conditions is imperative. The present systematic review examined the association between maternal employment and the nutritional status of children up to twelve years old from South Asia. Methods: An electronic search for research articles published in the English language between January 2011 and December 2024 was conducted in PubMed, Science Direct, and Web of Science databases. Results: A total of 10,247 articles from five South Asian countries were screened, resulting in the inclusion of 19 studies in the review based on well-defined inclusion and exclusion criteria. The findings showed that the association between maternal employment and children’s nutritional status was context-dependent, with adverse effects in children (stunting, wasting, and growth failure) when mothers worked in unskilled sectors—in low-paying jobs. Children of urban mothers had poor nutritional status, often exacerbated by the lack of or limited childcare support and financial assistance during their work absences. Additionally, many South Asian countries implemented maternal and paternal leave policies and benefits; however, the implementation challenges reduced maternal access to these benefits and predominantly favored mothers working in formal sectors. Conclusions: This systematic review underscores the necessity to strengthen the employment benefit programs for working women in South Asian countries, especially for mothers working in informal sectors. The provision of childcare assistance and supplementary financial benefits to women employed in informal sectors is essential to improve the child nutritional outcomes. Full article

Type 2 diabetes (T2D) is a chronic disease prevalent in the world, accompanied by a variety of diseases, endangering human health and safety. Bile acids (BAs) play an important role in the regulation of host glucose and lipid metabolism homeostasis, and are strictly regulated by gut microbiota. However, the relationship between key BAs, BAs transporters and signaling, as well as gut microbiota, and host metabolism in T2D remains elusive. In this study, 9-week-old db/db mice were used as diabetes model (db/db group, n = 10), and their wild-type (wt) littermates of same age were used as the healthy control (CON group, n = 10). After 8 weeks of feeding, the BA profiles and microbial composition in the colon, and gene expression level of BA regulatory factors were analyzed in the db/db and CON groups to explore the underlying mechanisms of T2D. Compared with healthy mice, the body weight, blood glucose and lipid levels of db/db mice were significantly increased. The concentrations of total BAs, primary BAs, conjugated BAs and non-12α–hydroxylated BAs (non-12–OH BAs) were significantly decreased, while Deoxycholic acid (DCA) in secondary BAs was increased in db/db group. Compared with wt mice, the synthesis of BAs in the liver was transformed from the alternative pathway to the classical pathway, and hepatic BAs transporters (NTCP, BSEP, MRP2, OATP–1 and OSTβ) and receptors (FXR and TGR5) were significantly down-regulated in the db/db mice. In the colon, the mRNA level of FXR was up-regulated, while TGR5 was down-regulated. The diabetic (db/db) mice presented a changed gut microbiota composition, including an increased abundance of secondary BAs-producing bacteria, Escherichia–Shigella, and a decreased the abundance of Akkermansia, which are involved in the synthesis of non-12–OH BAs. We further found that the reduced BA types in db/db mice were negatively correlated with metabolic-disorder-related indicators, while an increased DCA level had the opposite correlation. Our results shed light into how the imbalance of BAs’ metabolism mediated by intestinal flora may be potential mechanisms of T2D. Full article