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Cellular, Molecular and Clinical Aspects of Aortic Aneurysm-Vascular Physiology and Pathophysiology.Cells Feb 2024A disturbance of the structure of the aortic wall results in the formation of aortic aneurysm, which is characterized by a significant bulge on the vessel surface that... (Review)
Review
A disturbance of the structure of the aortic wall results in the formation of aortic aneurysm, which is characterized by a significant bulge on the vessel surface that may have consequences, such as distention and finally rupture. Abdominal aortic aneurysm (AAA) is a major pathological condition because it affects approximately 8% of elderly men and 1.5% of elderly women. The pathogenesis of AAA involves multiple interlocking mechanisms, including inflammation, immune cell activation, protein degradation and cellular malalignments. The expression of inflammatory factors, such as cytokines and chemokines, induce the infiltration of inflammatory cells into the wall of the aorta, including macrophages, natural killer cells (NK cells) and T and B lymphocytes. Protein degradation occurs with a high expression not only of matrix metalloproteinases (MMPs) but also of neutrophil gelatinase-associated lipocalin (NGAL), interferon gamma (IFN-γ) and chymases. The loss of extracellular matrix (ECM) due to cell apoptosis and phenotype switching reduces tissue density and may contribute to AAA. It is important to consider the key mechanisms of initiating and promoting AAA to achieve better preventative and therapeutic outcomes.
Topics: Male; Humans; Female; Aged; Aortic Aneurysm, Abdominal; Aorta; Cytokines; Phenotype; Apoptosis
PubMed: 38334666
DOI: 10.3390/cells13030274 -
The New England Journal of Medicine Sep 2023
Topics: Adult; Female; Humans; Acute Kidney Injury; Abdomen
PubMed: 37733312
DOI: 10.1056/NEJMcpc2027091 -
Theriogenology Oct 2023A retrospective study was carried out to investigate incidence, clinical signs and ultrasonographic findings of ovarian tumours in a population of dogs referred to the...
A retrospective study was carried out to investigate incidence, clinical signs and ultrasonographic findings of ovarian tumours in a population of dogs referred to the Veterinary Teaching Hospital of the University of Perugia (Italy) and Anicura Tyrus Veterinary Clinic (Terni, Italy). The period of study ranged from January 2005 to December 2021. A total of 1910 dogs were affected by neoplasia but only 35 of them (1.8%), of different breeds and ages, were found to have ovarian tumours. Ultrasound of the ovaries was performed based on clinical signs; the diagnosis was achieved after ultrasound findings prompted ovariohysterectomy and ovarian pathologic evaluation In our study, the age of bitches affected by ovarian neoplasia ranged from 3 to 20 years (mean 9.6 ± 3.8). The histopathological findings of ovarian masses identified 16 granulosa cell tumours (GCT) (46%), 7 adenomas (20%), 5 adenocarcinomas (14%), 2 teratomas (6%), 1 leiomyoma (3%), 1 luteoma (3%), 1 tecoma (3%), 1 dysgerminoma (3%), and 1 haemangiosarcoma (3%). In particular, with respect to clinical signs, 69% of bitches showed abnormalities of estrus cycle (short interestral interval, persistent estrus, prolonged interestral interval). The other main clinical signs included abdominal distention, palpable abdominal mass, vulvovaginal discharge, polyuria/polydipsia, mammary masses. When present, the laboratory abnormalities were slight anemia and leucocytosis with neutrophilia. The tumours were ultrasonographically classified as mainly solid: 12/35 (34%) (1 adenoma, 4 adenocarcinomas, 1 dysgerminoma, 1 haemangiosarcoma, 1 leyomioma, 1 luteoma, 1 GCT, 1 tecoma, 1 teratoma); solid with cystic component 13/35 (37%) (9 GCT, 2 Adenomas, 1 adenocarcinoma, 1 teratoma); and mainly cystic 10/35 (29%) (6 GCTs, 4 adenomas). In our study, the ultrasound examination allowed us to suspect ovarian neoplasia in asymptomatic subjects referred for breeding management or for preventive health check. On the basis of our data, we proposed to perform a complete periodic examination of the reproductive system once a year from 6 years. Nevertheless, the presence of ovarian neoplasms found in young subjects, during breeding management, suggest including routine ultrasound examination of the reproductive tract.
Topics: Female; Animals; Dogs; Dysgerminoma; Retrospective Studies; Luteoma; Hemangiosarcoma; Hospitals, Animal; Hospitals, Teaching; Ovarian Neoplasms; Granulosa Cell Tumor; Adenocarcinoma; Teratoma; Adenoma
PubMed: 37540955
DOI: 10.1016/j.theriogenology.2023.07.020 -
Life (Basel, Switzerland) Dec 2023Gastric ischemia is uncommon because the stomach has multiple collateral blood supplies. The etiology of gastric ischemia is vascular insufficiency caused by systemic...
Gastric ischemia is uncommon because the stomach has multiple collateral blood supplies. The etiology of gastric ischemia is vascular insufficiency caused by systemic hypotension, vasculitis, or disseminated thromboembolism. Mechanical causes include gastric volvulus and acute gastric distention. Uncommon as gastric ischemia is, we are the first to report a 65-year-old male who developed gastric ischemia leading to gastric pneumatosis 26 days after initial treatment for severe acute respiratory syndrome coronavirus-2 infection (SARS-CoV-2), via laparoscopic imaging. We conclude that physicians should be suspicious of gastric ischemia when the patient is infected with SARS-CoV-2 with severe abdominal pain and should proceed with medical conservative care instead of surgery.
PubMed: 38255662
DOI: 10.3390/life14010047 -
Cureus Mar 2024Spontaneous perforation of the colon is a rare disease defined as sudden perforation of a healthy colon without evidence of trauma or disease. These perforations are...
Spontaneous perforation of the colon is a rare disease defined as sudden perforation of a healthy colon without evidence of trauma or disease. These perforations are typically classified as either stercoral or idiopathic. Cecal perforation during pregnancy is an uncommon and potentially life-threatening condition requiring prompt recognition and surgical intervention. We present a case of a 33-year-old woman at 29 weeks and three days gestation presenting with spontaneous cecal perforation. She presented to the emergency department with diffuse abdominal pain and distention lasting for three days, associated with nausea and vomiting. Following evaluation, she was diagnosed with diffuse peritonitis. The diagnosis of this condition relies on both the clinical presentation and the utilization of radiographic imaging. The patient underwent an emergent explorative laparotomy with prompt surgical intervention to repair the 1.2 x 0.8 cm perforation found on her distended cecum. The surgical repair consisted of the excision of the edges and the primary suture of the perforation with an omental patch. Her post-procedure course was uneventful, and she later delivered a healthy baby at full term. This case highlights the importance of considering uncommon causes of acute abdominal pain in pregnant women to ensure timely diagnosis and management.
PubMed: 38595875
DOI: 10.7759/cureus.55862 -
European Journal of Pediatrics Nov 2023Functional gastrointestinal disorders (FGID) are disorders of gut-brain interactions characterized by chronic recurrent gastrointestinal symptoms and are reported to be...
UNLABELLED
Functional gastrointestinal disorders (FGID) are disorders of gut-brain interactions characterized by chronic recurrent gastrointestinal symptoms and are reported to be more common in obese individuals. The aim of the study was to evaluate FGID in obese children. A total of 405 children (6-18 years) were enrolled in this cross sectional study. The children were divided into two groups according to body mass index (BMI) as < 85th percentile and > 95th percentile. Diagnosis of FGID was based on ROME VI criteria. Demographic and clinical characteristics of the patients were evaluated. FGID and subgroups were determined. The mean age of the children was 12.73 ± 3.17 years; 52% (n = 211) of them was female and 47.9% (n = 194) was male. A total of 50.6% patients had BMI > 95th percentile, and 55.1% of those patients had FGID. The subgroups of FGID, functional abdominal pain disorders and functional defecation disorders were significantly more common in obese children than non-obese group (P < 0.01). Additionally, constipation-predominant irritable bowel syndrome (IBS), diarrhea-predominant IBS, functional diarrhea, and abdominal distention were significantly more common in obese children than non-obese children (P < 0.01).
CONCLUSION
FGID in obese children was found to be increased significantly. Assessment of functional gastrointestinal symptoms in obese children will prevent unnecessary examinations.
WHAT IS KNOWN
• Functional gastrointestinal disorders are reported to be more common in obese individuals.
WHAT IS NEW
• Functional abdominal pain disorders and functional defecation disorders were significantly more common in obese children than non-obese group. • Constipation-predominant irritable bowel syndrome (IBS), diarrhea-predominant IBS, functional diarrhea, and abdominal distention were significantly more common in obese children than non-obese children.
Topics: Humans; Male; Child; Female; Adolescent; Irritable Bowel Syndrome; Cross-Sectional Studies; Pediatric Obesity; Gastrointestinal Diseases; Diarrhea; Abdominal Pain; Surveys and Questionnaires; Constipation
PubMed: 37606702
DOI: 10.1007/s00431-023-05165-z -
Clinical Pediatrics Dec 2023
Topics: Humans; Male; Constipation; Infant
PubMed: 37038756
DOI: 10.1177/00099228231164992 -
Cureus Dec 2023A fibroepithelial polyp (FEP) of the penis is a rare benign swelling and often under-recognised lesion that has the potential to become malignant in some cases. The...
A fibroepithelial polyp (FEP) of the penis is a rare benign swelling and often under-recognised lesion that has the potential to become malignant in some cases. The pathogenesis is still unclear, but it is hypothesised to be due to chronic irritation most often associated with condom catheter use or phimosis. We describe a case of an FEP measuring 10 cm in largest diameter developing from the ventral prepuce with a longstanding post-radiation penoscrotal oedema. A 62-year-old male with a history of bladder cancer presented to the emergency department with abdominal distention, vomiting, and obstipation for three days to the emergency department. He had post-radiation penoscrotal edema for the last 10 years and penile tip growth for the last two years. Foley's catheter insertion was done through the urethra after dorsal slit of prepuce, and an incisional biopsy was sent, which was found to be an FEP.
PubMed: 38192923
DOI: 10.7759/cureus.50204 -
SAGE Open Medical Case Reports 2023Colonic volvulus is one of the most common causes of bowel obstruction. It could occur in different parts of the colon. The sigmoid is the most common part, but it...
Colonic volvulus is one of the most common causes of bowel obstruction. It could occur in different parts of the colon. The sigmoid is the most common part, but it rarely occurs in the transverse colon because of the colon's anatomical features. So, simultaneous sigmoid and transverse colon volvulus is a rare phenomenon that could endanger patients' lives due to its rarity, ischemia, necrosis of the colon wall, and the lack of a definite algorithm to approach this disease. So, it is essential to consider this disease as one of the most important differential diagnoses in patients with abdominal pain and distention. In this article, a 45-year-old male presented to the surgical ward with severe prolonged abdominal pain, diagnosed with simultaneous sigmoid and transverse colon volvulus during laparotomy.
PubMed: 37654550
DOI: 10.1177/2050313X231197001 -
Medicina (Kaunas, Lithuania) Jul 2023The potentially fatal COVID-19 pandemic has been associated with a largespectrum of clinical presentations. Beyond the classical pulmonary manifestations,... (Review)
Review
The potentially fatal COVID-19 pandemic has been associated with a largespectrum of clinical presentations. Beyond the classical pulmonary manifestations, gastrointestinal tract-related symptoms suchas nausea, diarrhea, abdominal distention and pain have been observed in patients, as a consequence of the binding of SARS-CoV-19 to Angiotensin-converting Enzyme 2 (ACE2) receptors in the gastrointestinal (GI) tract. The early recognition ofspecific imaging features, including hepatobiliary involvement, pancreatic involvement, development of solid organ infarcts, ischemic bowel changes and vascular occlusion, plays a key role through the course of the disease. Also, suspicious symptoms, especially in critically ill patients with clinical and biochemical markers of hypovolemia, necessitate timely imaging for bleeding complications. The aim of this pictorial review is to illustrate the spectrum of the GIimaging findings in patients with COVID-19. Awareness of diagnostic imaging hallmarks is crucial to optimize the management of these patients.
Topics: Humans; COVID-19; SARS-CoV-2; Pandemics; Gastrointestinal Diseases; Lung; Gastrointestinal Tract
PubMed: 37512143
DOI: 10.3390/medicina59071332