Search Results (3,286)

Background/Objectives: Lipedema is a chronic, progressive disorder of the adipo-fascial tissue characterized by abnormal subcutaneous fat accumulation, inflammation, fibrosis, pain, and edema. Despite its considerable impact on patients’ quality of life, it remains underdiagnosed. Recent studies have suggested a potential overlap between lipedema and hypermobility spectrum disorders (HSDs), both involving connective tissue dysfunction. This work explores the shared pathophysiological features of lipedema and HSD, highlighting clinical correlations, comorbidities, and the need for integrated diagnostic and therapeutic approaches. Methods: A cross-sectional observational study was conducted through an online survey targeting individuals with lipedema and a control group with lymphedema. The questionnaire assessed symptoms typically associated with HSD, including musculoskeletal, gastrointestinal, urogynecological, vascular, and neuropsychological manifestations. Descriptive statistics were used to evaluate clinical patterns in both groups. Results: Among the lipedema patients, 44% reported joint hypermobility and 60% recalled being hypermobile during childhood. High rates of pediatric overweight (50%), low muscle tone (55%), and exercise-induced fatigue (70%) were observed. Adult symptoms included joint pain (notably in the ankles, knees, cervical spine, sacrum, and feet), digestive issues (50%), and thyroid disorders (24.4%). Compared with the control group, patients with lipedema showed significantly more connective tissue-related motor deficits and systemic symptoms. Conclusions: Connective tissue laxity may play a critical role in the pathogenesis of lipedema, contributing to multisystemic manifestations through vascular, lymphatic, gastrointestinal, and musculoskeletal involvement. The high prevalence of HSD-like features calls for a paradigm shift in the understanding of lipedema as a systemic disorder. Early identification of connective tissue alterations, especially in children with familial predisposition, could enable timely interventions, potentially mitigating disease progression. A multidisciplinary, evidence-based approach is essential for accurate diagnosis and effective management. Full article

Background/Objectives: Sweet’s syndrome (SS), also known as acute febrile neutrophilic dermatosis, is a rare inflammatory skin disorder that may also present with extracutaneous manifestations. Liver involvement is thought to result from sterile neutrophilic infiltration, mirroring the skin pathology and highlighting the syndrome’s systemic inflammatory nature. Timely recognition, exclusion of infectious or autoimmune etiologies, and prompt corticosteroid therapy are critical for favorable outcomes. Methods: Herein, we present the case of a 73-year-old man with hyperuricemia who developed both cutaneous and systemic manifestations of SS seven days after initiating allopurinol treatment. His symptoms included fever, conjunctivitis in the right eye, and painful, non-pruritic erythematous plaques, some with pustules, on the lower limbs, palms, and face. Results: Initial laboratory investigations revealed neutrophilic leukocytosis, elevated inflammatory markers, and renal and hepatic dysfunction. Empirical treatment with antibiotics and antivirals failed to improve his condition. The patient discontinued allopurinol and initiated a high-dose corticosteroid regimen, leading to rapid resolution of fever and improvement in skin lesions. Laboratory parameters gradually normalized, except for persistent high liver enzymes. A comprehensive diagnostic workup ruled out infectious, autoimmune, and malignant causes. Imaging studies, including CT, MRI, and MRCP, showed no structural liver abnormalities. Skin biopsy findings were consistent with SS, demonstrating dense neutrophilic infiltrates in the reticular dermis and papillary dermal edema. After his discharge, he was followed up by the Hepatology unit. The patients’ liver enzyme levels normalized within three months with no recurrence or late complications one year later. Conclusions: In the context of drug-induced SS, persistent hepatic abnormalities, although rare, may occur in patients without underlying liver disease. Full article

Background/Objectives: The therapeutic properties of edible flowers are widely used to improve human health. The phenolic compounds present in edible flowers, such as phenols and flavonoids, among others, play an important role as effective antioxidant compounds against diseases related to oxidative stress. These compounds exhibit biological activities such as anti-ulcerogenic, antimicrobial, neuroprotective, anti-cancer, and anti-inflammatory properties. The objective of this study was to evaluate the in vivo anti-inflammatory activity of hydroethanolic extracts of four Mexican cacti flowers. Methods: A hydroethanolic extract was obtained via maceration for each cactus flower and evaluated using a model of edema induced in mouse ears by 12-O-tetradecanoylphorbol-13-acetate (TPA) as a guide for the anti-inflammatory activity. Compounds in cacti flower extracts were quantified by HPLC. Results: All of the hydroalcoholic flower extracts showed an anti-inflammatory effect. The greatest effect of inhibition of auricular edema (61.2 ± 4.23%) was observed in the group of mice treated with the Cardon extract at a dose of 3 mg/ear. This effect can be attributed to the main compounds detected by HPLC in the extract such as p-coumaric acid, catechin, kaempferol, and quercetin. These compounds are involved in the inhibition of pro-inflammatory mediators and enzymes such as cyclooxygenases and lipoxygenases. Conclusions: This preliminary evidence supports further preclinical evaluation of the Cardon flower. Full article

Background: Acute lung injury (ALI) is a life-threatening respiratory condition and one of the leading causes of mortality worldwide, accounting for approximately 20% of global annual deaths. Despite its high prevalence and severity, effective therapeutic options remain limited. Eupatorium lindleyanum DC., a traditional medicinal herb, has demonstrated therapeutic potential against pulmonary diseases, particularly ALI, in both clinical and experimental settings. However, the protective effects and underlying mechanisms of its characteristic sesquiterpene lactone components against ALI remain unclear. Objective: This study aimed to evaluate the protective effects of sesquiterpene lactones from Eupatorium lindleyanum DC. (SLEL) against lipopolysaccharide (LPS)-induced ALI both in vivo and in vitro. Furthermore, it sought to elucidate the underlying mechanisms by integrating network pharmacology, multi-omics approaches (transcriptomics, metabolomics, and 16S rRNA sequencing), and various molecular biology techniques. Results: SLEL significantly attenuated inflammatory injury in alveolar epithelial cells and alleviated pulmonary edema, hemorrhage, and inflammatory infiltration in rats, accompanied by reduced TNF-α, IL-6, and IL-1β levels and improved lung injury indices. Mechanistically, SLEL exerted dual suppression of the PI3K-Akt and MAPK-NF-κB pathways. Network pharmacology, molecular docking, and UPLC-MS analyses identified Eupalinolide A and Eupalinolide K as potential bioactive constituents, which were further validated to inhibit phosphorylation of key signaling proteins, thereby partially accounting for SLEL’s pharmacological effects. Multi-omics integration further revealed that SLEL restored bile acid metabolism, reshaped gut microbial diversity, and reconstructed the microbiota–metabolite–inflammatory cytokine network, thereby maintaining gut–lung axis homeostasis and enhancing anti-inflammatory effects. Conclusions: SLEL alleviates ALI through multi-component synergistic actions that suppress pro-inflammatory signaling and modulate the gut–lung axis. These findings highlight the potential of SLEL as a promising therapeutic candidate for the treatment of ALI. Full article

Objectives: To evaluate the relationship between hyperreflective dots (HRDs) observed on spectral-domain optical coherence tomography (SD-OCT) and the outcomes following treatment with intravitreal ranibizumab or dexamethasone injections in patients with diabetic macular edema (DME). Methods: This retrospective study focused on individuals suffering from diabetic macular edema (DME) who underwent a sequence of three intravitreal ranibizumab injections. Based on treatment response, the eyes were categorized into two groups: responders and non-responders. The non-responder group subsequently received intravitreal dexamethasone (IVO) implants. Treatment results were evaluated by changes in BCVA, HRD number, and central macular thickness (CMT). Results: This research involved 112 eyes from 78 participants who had been diagnosed with DME. Seventy-three eyes (65%) were identified as ranibizumab responders and 39 eyes (35%) as ranibizumab non-responders. Of the 39 individuals who had suboptimal response to ranibizumab and subsequently received treatment with an intravitreal dexamethasone implant, 26 eyes (66.67%) exhibited a favorable response, while 13 eyes (33.33%) showed an insufficient response. IVR responders demonstrated significantly greater improvements in BCVA (0.54 ± 0.73 to 0.35 ± 0.40 logMAR vs. 0.52 ± 0.61 to 0.47 ± 0.38 logMAR) and CMT (456.53 ± 109.73 μm to 235.47 ± 49.13 μm vs. 468.99 ± 127.10 μm to 427.45 ± 52.91 μm) reduction. Baseline analysis revealed IVR non-responders had higher counts of both inner and outer retinal HRDs compared to responders (9.09 ± 3.38 vs. 7.07 ± 2.32 and 5.46 ± 2.03 vs. 4.27 ± 1.87, p < 0.05, respectively). Eyes with initially higher numbers of inner retinal HRDs, outer retinal HRDs, and subretinal HRDs demonstrated a significantly enhanced response to dexamethasone therapy (9.03 ± 3.18 vs. 7.55 ± 2.72, 6.55 ± 2.46 vs. 4.79 ± 1.88 and 0.27 ± 0.54 vs. 0.21 ± 0.47, p < 0.05, respectively). Conclusions: HRDs could potentially be used as a predictive biomarker to assess the effectiveness of anti-VEGF therapy in treating DME. Patients exhibiting a greater number of retinal HRDs tend to have less favorable reactions to anti-VEGF treatments but experience improved results with dexamethasone. Full article

Clostridium piliforme (Cp) is a pleomorphic spore-forming obligate intracellular bacterium and the causative agent of Tyzzer’s disease. The condition affects multiple species, including rabbits, in which the disease is sporadic in recently weaned animals. This report details a case of disease caused by Cp observed exclusively in breeding rabbits of a commercial farm. The clinical manifestations were a higher mortality rate in does and late-gestation abortions. We performed necropsy and further microbiological, parasitological and histopathological analyses. Anatomopathological lesions were suggestive of Tyzzer’s disease and the presence of Cp was confirmed by PCR. Parasitological analysis tested negative and standard bacteriological examination of intestines revealed a high load of Escherichia coli and Clostridium perfringens, which were considered secondary pathogens. Chlamydophila sp. and Toxoplasma gondii infections were excluded by PCR as causative agents of abortions. Moreover, in the months following the diagnosed outbreak, episodes of subcutaneous edema occurred in multiple does and young breeders born after the resolution of the epidemic. The constant reduction in the use of antimicrobials in recent years could make some neglected diseases emerge again. Therefore, it is crucial to suspect such uncommon pathologies in commercial rabbitries to properly manage them on farms. Full article

Recurrent erysipelas is a common and clinically significant condition that poses challenges for both patients and healthcare systems. Each episode may damage lymphatic vessels, leading to chronic lymphedema, which perpetuates the risk of further relapses. Recurrence rates remain high, ranging from 11% in outpatients during the first year to up to 46% of hospitalized patients within three years. The lower limbs are the most frequent site, although recurrences may also occur in other regions, such as the upper limb after mastectomy with lymph node dissection. This review summarizes current knowledge on risk factors, preventive measures, and chemoprophylaxis in recurrent erysipelas. Modifiable risk factors such as obesity, diabetes, venous insufficiency, tinea pedis, and poor hygiene play an important role, while non-modifiable factors include age, sex, and a history of prior episodes. Non-pharmacological strategies—weight reduction, glycemic control, smoking cessation, compression therapy, and meticulous skin care—form the cornerstone of prevention and may reduce the need for long-term antibiotics. Antibiotic prophylaxis, most commonly with oral penicillin V or intramuscular benzathine penicillin, has been shown to lower recurrence rates. However, efficacy may be reduced in patients with chronic edema or severe obesity. Macrolides serve as alternatives in penicillin-allergic patients, but concerns remain about resistance, adverse effects, and drug–drug interactions. In conclusion, recurrent erysipelas requires a multifaceted approach. While antibiotic prophylaxis is effective, its long-term success depends on simultaneous management of underlying conditions. Further studies are needed to define optimal regimens, treatment duration, and non-antibiotic alternatives. Full article

Methods: Using the most recent pre-COVID National Inpatient Sample (2016–2019), we evaluated inpatient mortality and economic impact after elective primary total hip arthroplasty (THA) across 327,123 cases (1,635,615 weighted discharges).Results: Overall inpatient mortality was 0.04%, but was higher in patients ≥ 80 years (0.15%), with weekend admissions (0.10%), and with surgical delay ≥ 1 day (0.17%). Comorbidities with the greatest mortality association included congestive heart failure and chronic kidney disease (both with markedly elevated odds), and acute in-hospital complications (e.g., pulmonary embolism) carried substantial risk. Complications also increased resource use; for example, heart failure, pulmonary edema, and acute coronary artery disease were each associated with significantly higher costs and prolonged length of stay. Conclusion: These findings provide a contemporary, pre-pandemic national baseline that quantifies high-risk subgroups and the economic footprint of adverse events, supporting targeted perioperative strategies and hospital planning for elective THA. Full article

Background: This study aimed to change the current concept of diabetic macular edema (DME) management through (1) early categorization of our DME patients into either responders or non-responders after the first intravitreal Ranibizumab (IVR) injection, and (2) finding a suitable clinical–biochemical diagnostic panel to identify the possible cause(s) of non-response in each non-responder and changing the treatment plan in each particular patient accordingly. Patients and methods: Our study included 64 eyes of 40 patients with DME (Group A, DME patients) and 40 eyes of 40 healthy individuals matched for age and sex (Group B, controls). Blood and aqueous samples were collected from the study participants before and one month after IVR injection. The DME patients were further subdivided into responders and non-responders according to their response to the first IVR injection. Lymphocyte activation markers, NETosis markers, angiogenic factors, astrocytes, innate immunity, and inflammasome markers were assessed in both groups. Results: Multivariate regression analysis revealed that macular ischemia, aqueous levels of hexokinase 1, SELL CD62L, ELANE, MPO, VEGFA, and SEMA4D were the most significant factors affecting the response to IVR (p < 0.05). Conclusions: defining our DME patients as responders and non-responders after the first IVR injection, combined with potential utilization of a clinical–biochemical panel (macular ischemia- PCR array of combined Hexokinase 1, MPO, and SEMA4D) in each non-responder, may represent a good starting point for changing the current DME management strategy. Full article

Sepsis is a life-threatening condition driven by a dysregulated host response to infection, with high mortality and few treatment options. Decades of failed drug development underscore the urgent need for therapies with novel mechanisms of action. Vimentin, an intermediate filament protein, acts as a network hub that senses and integrates cellular signals. Its involvement in key sepsis pathologies, including infection, hyperinflammation, immunosuppression, coagulopathy and metabolic dysregulation, positions it as a potential therapeutic target. This study evaluated the efficacy of ALD-R491, a novel small-molecule vimentin modulator, in a murine model of polymicrobial sepsis induced by cecal ligation and puncture (CLP). Mice received ALD-R491 prophylactically or therapeutically, alone or with ceftriaxone. The treatment significantly reduced serum levels of key biomarkers of sepsis, including C-reactive protein (CRP), lactate (Lac), tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), and dose-dependently improved the survival of septic mice. Organ-specific analysis confirmed the effects of ALD-R491 in mitigating hyperinflammation and multi-organ injury. The treatment reduced pulmonary edema and inflammation; preserved liver tissue architecture and improved hepatic function with lowered alanine aminotransferase/aspartate aminotransferase (ALT/AST); decreased kidney tubular damage; and improved renal function with lowered creatinine/blood urea nitrogen (BUN). These preclinical findings indicate that the vimentin-targeting agent ALD-R491 represents a promising therapeutic candidate for sepsis and merits further clinical investigation. Full article

Objective: The objective of this study was to clarify the connection between BTX-A injections and local changes in skin temperature and to assess the correlation between post-BTX-A injection facial vascular hyperthermia and subcutaneous adipose tissue thickness (SAT) in the frontal area using thermography. Methods: The study involved 30 patients (mean age 42 ± 0.5 years; 18 women, 12 men). Facial skin temperature was measured via thermography (Thermo GEAR G30) before, immediately after, and 20 min after subcutaneous injection of BTX-A with hemagglutinin complex, gelatin (6 mg), and maltose monohydrate (12 mg). SAT development was graded by combined visual-palpation assessment. Statistical analysis included Student’s t-test and the Mann–Whitney U-test. Results: Biphasic thermal response: immediately post-injection: Significant decrease in min (−1.1 °C) and mean (−0.3 °C) facial temperatures (p < 0.05); 20 min post-injection: pronounced increase in mean (+1.5 °C), max (+1.3 °C), and min (+1.6 °C) temperatures (p < 0.001), attributed to BTX-A-induced vasodilation and local inflammation. Subjects with pronounced SAT exhibited significantly higher baseline temperatures (Me = 33.1 °C vs. 29.8 °C; p < 0.001) and more intense hyperthermic responses (+1.6 °C mean increase vs. +1.1 °C in low-SAT group; p < 0.001). Pronounced SAT was predominantly female (10/15; p < 0.05) and linked to higher BMI (33.3% overweight vs. 0% in low-SAT; *p = 0.036*). Conclusions: SAT thickness is a key determinant of post-BTX-A vascular hyperthermia, with pronounced SAT predicting stronger reactions. Practical Recommendation: Targeted local hypothermia (+4 °C to +8 °C for 5–7 min post-injection, adjustable by SAT thickness) mitigates hyperemia, edema, hematoma risk, and potential toxin diffusion, especially in high-SAT individuals. Full article

Malignant cerebral infarction (MCI) is rare but often fatal. Early identification helps guide monitoring and decompressive surgery. This study evaluated whether serum biomarkers add predictive value beyond clinical and imaging data in severe stroke patients with anterior circulation large vessel occlusion (LVO). In this prospective study, 73 acute severe LVO stroke patients underwent whole-brain CT perfusion (CTP) with rCBV-based core measurement at admission and follow-up MRI at 24 ± 12 h for infarct and edema volume assessment. Serum biomarkers (s100b, NSE, VEGF, ICAM1) were sampled a median of 20.5 h after baseline imaging. Logistic regression models predicted MCI using baseline variables (NIHSS, ASPECTS, rCBV < 30%), adding treatment data (rtPA, mTICI, NIHSS posttreatment), and adding serum biomarkers. Performance was assessed by AUC, accuracy, F1, and cross-validated R². MCI occurred in 18/73 (24%) patients. Baseline models showed an AUC of 0.72; adding treatment improved the AUC to 0.88. Biomarkers slightly increased the AUC (0.90) but did not improve F1. Higher s100b was associated with more severe injury but did not enhance the prediction of MCI. Models with baseline imaging and treatment best explained infarct (R² ≈ 0.27) and edema (R² ≈ 0.58). In conclusion, admission severity, CTP, and early treatment response are the main predictors of MCI and aid early risk stratification of patients. Despite their pathophysiologic relevance, serum biomarkers do not add substantial predictive value. Full article

Cataracts cause vision loss in rabbits, often either spontaneously or as secondary to uveitis. This study considers the ophthalmic presentation, treatment, and outcome of phacoemulsification in seven pet rabbits: six presenting with lens cloudiness and one presenting with a white mass in the iris. Ophthalmic examinations revealed cataracts. The treatment plan was phacoemulsification. Encephalitozoon cuniculi was identified via an enzyme-linked immunosorbent assay technique performed on all rabbits. Ocular ultrasonography was performed to rule out retinal detachment. Phacoemulsification using the one-handed technique without intraocular lens implantation was performed in 8 of the eyes of the 7 rabbits. After surgery, the corneal wounds healed within 2 weeks. All rabbits were comfortable with opening their eyes and had a positive dazzle reflex and a clear visual axis, with no other severe complications (such as retinal detachment, intraocular hemorrhaging, or uncontrolled glaucoma) throughout the post-operative period. Postoperative complications consisted of corneal edema around the surgical wound (2 eyes; 25%); partial anterior synechiae (1 eye; 12.5%); partial posterior synechiae (5 eyes; 3 eyes before surgery and 2 eyes after surgery; 25%); posterior capsular opacities (3 eyes; 37.5%); and lens fiber overgrowths (2 eyes; 25%). In conclusion, successful phacoemulsification was achieved in the seven pet rabbits. Full article

Background and Objectives: Severe complications associated with cervical hyperextension during general anesthesia have been reported. The question is whether some of the cerebral/spinal ischemic complications could be partially related to the position itself. Cerebral oximetric monitoring, combined with optic nerve sheath diameter and cognitive function in non-anesthetized healthy volunteers, should provide more extensive information about the effects of cervical hyperextension, independent of anesthesia. Materials and Methods: 51 healthy volunteers with no vertebrobasilar abnormalities completed the study and were included in statistical analysis. Primary outcomes were cervical blood flow and cerebral relative hemoglobin change. The secondary outcomes were optic nerve sheath diameter and cognitive function assessment. After baseline Doppler ultrasonography of the cervical vessels, Mini-Mental State Examination, Montreal Cognitive Assessment, and optic nerve sheath diameter measurements at T0, volunteers underwent cervical hyperextension > 30°, with assessments repeated at the first and 30th minutes (T1, T30). Relative total, oxi-, and deoxyhemoglobin changes were assessed every 5 min. Results: Peak systolic velocities in the jugular veins at T1 and T30 were significantly lower than those at baseline (p1 and p2 < 0.001). After hyperextension, deoxyhemoglobin changes significantly increased at T1 and T30 (p1 < 0.001). The optic nerve sheath diameter increased at T30 compared to the baseline (p < 0.001). Cognitive scores improved at T30 (p = 0.044 and p < 0.001, respectively). Conclusions: Cervical hyperextension causes a significant increase in relative total and deoxyhemoglobin changes, which are related to acute cerebral congestion by severely impairing cerebral venous flow. A significant change in optic nerve sheath diameter indirectly indicates increased intracranial pressure. Full article

Traumatic brain injury (TBI) disrupts the blood–brain barrier (BBB), resulting in increased permeability, neuronal loss, and cognitive dysfunction. This study investigates the therapeutic potential of thyroid hormone (T4) to reduce BBB dysfunction following moderate fluid percussion injury. T4 injection (intraperitoneal) after TBI restores the levels of pericytes and endothelial cells vital for BBB integrity, reduces edema by downregulating AQP-4 gene expression, and enhances levels of the tight junction protein ZO-1. T4 counteracts the TBI-related increase in MMP-9 and TLR-4, significantly reducing BBB permeability. Furthermore, T4 enhances the neuroprotective functions of astrocytes by promoting the activity of A2 astrocytes. Additionally, T4 treatment increases DHA levels (important for membrane integrity and function), stimulates mitochondrial biogenesis, and leads to a notable improvement in spatial learning and memory retention. These findings suggest that T4 has significant potential to reduce vascular leakage and inflammation after TBI, thereby improving cognitive function and maintaining BBB integrity. Full article