Incidental splenic artery aneurysms: systematic literature review and single-centre study.

Root of Helix Inter Tragus Notch Incision (RHITNI) for open temporomandibular joint surgery: A five-year retrospective cohort study on safety and complications.

Background: Anti-inflammatory medications are classified as either steroidal or non-steroidal. Non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain, lower fever, inhibit blood clot formation, and, at higher doses, reduce inflammation. Their adverse effects vary by drug but commonly include an increased risk of gastrointestinal ulcers and bleeding, as well as potential cardiovascular and kidney complications. Oxidative stress has been recognized as a key pathogenic factor in ulcer development, directly disrupting cellular functions and causing damage to organelles such as mitochondria, lysosomes, and the nucleus. Aims: The aim of this study was to evaluate the anti-inflammatory and antiulcer effects of aqueous extract of fermented seeds of Prosopis africana (okpeye) in Wistar rats. Study Design: The study design monitors the therapeutic potential of aqueous extract of fermented seeds of Prosopis africana by assessing its anti-inflammatory and antiulcer effects on experimentally induced rats. Place and Duration of Study: Department of Biochemistry, University of Nigeria, Nsukka. Between December 2023 and September 2024. Methodology: The induction of gastric ulcer was carried out using the method of Urushidani. Twenty (20) adult rats of both sexes were used, randomly divided into 5 groups of 4 rats each. They were treated orally with normal saline and varying doses of the aqueous extract of fermented seeds of Prosopis africana. Cimetidine was used as the standard anti-ulcer drug. The In vivo anti-inflammatory study was done using fifteen (15) male Wistar rats. They were divided into five (5) groups of three (3) rats each. Diclofenac was used as the standard anti-inflammatory drug. Results: The result showed a significant (P < 0.05) decrease of ulcer formation in group 2 animals treated with 100 mg/kg cimetidine (before induction) with respect to the control group 1. The result also showed a significant (P < 0.05) decrease of ulcer formation in groups 4 and 5 animals treated with 100 mg/kg and 200 mg/kg of extract respectively, when compared with the animals in the control group 1. In the first and second phase of anti-inflammatory study, the result shows that the paw oedema of the rats treated with the extract, decreased significantly (P < 0.05) when compared with the animals in the control group 1. Conclusion: This result shows that aqueous extract of fermented seeds of Prosopis africana (okpeye) aided in the healing of the induced inflammation and chronic ulcer. Hence, the fermented seeds of Prosopis africana (okpeye) has both antiulcer and anti-inflammatory activity.

The present case report aimed to present an immunohistological analysis of newly formed intracanal tissues in a traumatised immature permanent incisor with pulp necrosis and apical periodontitis following RET. A 7-year-old girl sustained a combined traumatic dental injury, an uncomplicated crown fracture and lateral luxation, affecting an immature maxillary central incisor. The tooth subsequently developed pulpal necrosis and apical periodontitis and was treated with RET using calcium hydroxide as an intracanal medicament. A blood clot served as the scaffold, followed by placement of calcium silicate cement (Biodentine®) and a definitive resin composite restoration. During follow-up, the tooth developed ankylosis with progressive infraocclusion. At 13years of age, the tooth was extracted, and prosthetic rehabilitation was completed using a resin-bonded Rochette bridge. Histological and immunohistological analyses revealed a heterogeneous mixture of mineralised and connective tissues within the root canal space. The tissues demonstrated infiltration of fibroblast-like cells, resorptive cells, blood vessels and nerve fibres. Numerous fibrous cystic structures containing cholesterol crystals were identified in the middle third of the root canal. The newly formed intracanal tissues demonstrated limited similarity to intact odontogenic tissues. Both inflammatory root resorption and ankylosis-related replacement resorption, likely associated with the initial luxation injury, were observed. The presence of cholesterol crystal deposits represents a novel finding that may provide new insights into the biological processes occurring after RET. As cellular events following RET cannot be fully controlled clinically, the risk of unfavourable outcomes should be considered carefully, particularly in cases involving luxation injuries.

To evaluate the progression of transplant renal vein stenosis (TRVS) in the early post-operative period and its impact on clinical outcomes. This prospective study enrolled 23 consecutive patients with TRVS detected by contrast-enhanced ultrasound (CEUS). Duplex ultrasound (DUS) was performed on days 1, 30, and 90 after transplantation. The DUS measurements included peak velocity (PV) of stenosis and peak velocity ratio of stenosis to pre-stenosis (PV-ratio). The differences in DUS measurements across different timepoints were evaluated by linear mixed-effects model. The mean serum creatinine (SCr) levels at days 30 and 90 were 131 (range, 46-196) μmol/L, and 103 (range, 70-136) μmol/L, respectively. Two TRVS cases were caused by mural thrombi, the remaining 21 cases were free of any surgical complications. The mean TRVS-PV at days 1, 30, and 90 were 335±92, 221±86, and 134±59 cm/s, respectively. The mean PV-ratio at days 1, 30, and 90 were 9.3±5.0, 3.5±1.9, and 2.0±1.3, respectively. Linear mixed-effects model revealed a significant main effect of timepoint on SCr, TRVS-PV, and PV-ratio (p<0.01 for all), exhibiting a gradually declining trend. There was no significant main effect of timepoint on arterial parameters. TRVS unrelated to thrombotic causes in the early post-operative period is a transient finding not correlating with short-term outcome.

The field of extracellular vesicle (EV) research offers a compelling example of a biological concept refined through continuous methodological innovation. This review traces the historical trajectory of the discipline chronologically, beginning with early observations in haemostasis, from Malpighi's descriptions of blood clots and Chargaff and West's identification of a procoagulant sedimentable plasma fraction, to Wolf's "platelet dust," Crawford's microparticles characterised by electron microscopy, and the seminal work by Stahl and Johnstone demonstrating regulated vesicle biogenesis during reticulocyte maturation via multivesicular bodies. We highlight a pivotal conceptual shift, from viewing EVs as cellular debris to recognising them as regulated "communicasomes," catalysed by Raposo's discovery of antigen-presenting exosomes and subsequent evidence for EV-mediated transfer of functional receptors and nucleic acids, including the influential and sometimes debated model proposed by Ratajczak. By integrating findings from matrix vesicles, plant-derived vesicles, and diverse tissue contexts, we frame EV release as an evolutionarily conserved process with profound implications for immunity, regeneration, oncology, and cardiovascular pathology. A second central aim of this review is practical and methodological. We map how the expansion of biological claims has driven urgent standardisation efforts, notably through the establishment of the International Society for Extracellular Vesicles (ISEV) and the successive MISEV guidelines (2014, 2018, 2023). These are complemented by community resources such as EV-TRACK, MIFlowCyt-EV, and the databases ExoCarta and Vesiclepedia. We summarise core experimental choices across isolation and characterisation techniques, including ultracentrifugation, size exclusion chromatography, density gradients, flow cytometry, nanoparticle tracking analysis, and electron microscopy, while outlining persistent bottlenecks in purity, standardised nomenclature, and experimental reproducibility. Finally, we provide concise biographical sketches of key contributors and an overview of major EV-focused journals and ISEV meetings that anchor consensus-building and the translation of fundamental knowledge into clinical and industrial applications.

We compared three customized nnU-Net models (A: baseline two-dimensional (2D); B: 2D + region-growing; C: three-dimensional (3D) + region-growing) for automated detection and blood clot volume (BCV) quantification of acute pulmonary embolism (PE) on computed tomography pulmonary angiography (CTPA), and to explore the association between BCV and clinical outcome. We retrospectively screened 9,715 CTPA examinations (2015‒2024) to develop a dataset of 874 PE-positive and 339 PE-negative cases. A stratified subset (n = 437) with manually refined ground-truth segmentations was used for model training and internal validation. Region-growing in Models B and C included a 5-voxel negative buffer. Internal testing was performed on 776 cases (Humanitas dataset). External testing was performed on the public RSPECT-RSNA dataset. Performance metrics included accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) at zero-clot and for optimized BCV threshold. Correlations between BCV, survival, and major adverse cardiovascular events (MACE) were analyzed. Model C achieved the highest AUROC on external testing (0.868), outperforming Model A (0.843) and Model B (0.846). On internal testing at ROC-optimized threshold, Model C showed the highest accuracy (85.5%) and AUROC (0.909) compared to Model A (73.4%, 0.784) and Model B (76.0%, 0.816). Model C achieved 83.6% sensitivity and 79.5% accuracy at the zero-clot threshold on external data. BCV was not significantly associated with MACE or survival (p = 0.600). A locally trained 3D nnU-Net with region-growing demonstrated superior performance and generalizability on external data for automated PE detection on CTPA. However, BCV was not predictive of short-term clinical outcomes. A locally developed nnU-Net models integrating volumetric 3D segmentation with region-growing offer robust, clinically acceptable performance for the detection of acute pulmonary embolism without the need for ROC-based thresholds. Our 3D nnU-Net model automates clot detection on CT scans in seconds and shows numerically higher performance than the 2D models. Built on local data, this framework enables institution-specific model training and validation to complement European conformity‒CE-marked tools and assess performance locally. High-sensitivity volumetric quantification reduces missed emboli, paving the way for personalized risk stratification and improved patient outcomes.

Obesity is a major global health issue that significantly raises the risk of cardiovascular disease by connecting metabolic problems, endothelial dysfunction and thrombosis. When fat tissue increases in obesity, it causes ongoing mild inflammation, hypoxia, oxidative stress, and insulin resistance. These changes lead to problems in the blood vessel lining, such as low nitric oxide, more oxidative stress, and higher levels of molecules that promote clotting. As a result, people with obesity are more likely to develop both arterial and venous blood clots. Recent research shows that microRNAs (miRNAs) play an important role in controlling these processes. When miRNAs are not properly regulated, they affect inflammation in fat tissue, nitric oxide production in blood vessels, platelet activity, blood clotting, and clot breakdown. This review brings together current findings on how miRNAs connect obesity, endothelial dysfunction and thrombosis focusing on miR-126, miR-155, miR-223, and other miRNAs that help maintain healthy blood vessels and control inflammation. Learning more about these miRNA pathways can help us understand why obesity leads to heart and blood vessel problems and suggests that miRNAs could be useful as biomarkers and treatment targets to reduce thrombotic risks.

A Case of Deep Cerebral Vein Thrombosis which is a Treatable Type of Dementia.

Background/Objectives: Chronic lower limb ulcers represent a significant clinical challenge, with conventional therapies achieving healing in only 30-40% of complex cases. This study evaluated the comparative effectiveness of autologous blood clot therapy (ActiGraft, delivering platelet- and leukocyte-derived growth factors) and autologous micrograft therapy (Rigenera, containing viable progenitor cells) versus advanced wound dressings for refractory chronic wounds. Methods: This retrospective analysis of a prospectively collected, non-randomized clinical cohort included 132 patients with chronic lower limb ulcers refractory to prior therapy, who were treated between 2019 and 2024 at a single wound care center. The patients received ActiGraft (n = 32), Rigenera (n = 33), or advanced wound dressings (n = 67) based on their choice after informed discussion. The primary outcome was complete wound closure at 52 weeks. Multivariable Poisson regression with robust variance was performed, adjusting for baseline wound area (log-transformed), chronic renal failure, age, and peripheral vascular disease. Cox proportional hazards was used to model time to closure. Bonferroni correction (threshold p < 0.0167) was applied for three pairwise comparisons. This study was not pre-registered, and the results should be considered hypothesis-generating. Results: Unadjusted wound closure rates were 68.8% (ActiGraft; RR = 1.71, 95% CI: 1.17-2.48, p = 0.015), 60.6% (Rigenera; RR = 1.50, 95% CI: 1.01-2.25, p = 0.089), and 40.3% (advanced dressings). After multivariable adjustment, ActiGraft showed attenuated benefit (adjusted RR = 1.38, 95% CI: 0.86-2.21, p = 0.179), while the beneficial effect of Rigenera became non-significant (adjusted RR = 1.19, 95% CI: 0.73-1.94, p = 0.488). However, the adjusted Cox regression revealed significantly faster healing for ActiGraft (HR = 10.67, 95% CI: 4.17-27.30, p < 0.001) and Rigenera (HR = 4.12, 95% CI: 1.75-9.73, p = 0.001). Sensitivity analyses restricted to comparable wound sizes (≤10 cm2) showed a consistent direction of effect (ActiGraft 71.4% vs. Advanced 37.5%). Infection rates were lower in the autologous therapy groups (0-3.0% vs. 11.9%; Fisher's exact p = 0.006). Conclusions: ActiGraft autologous blood clot therapy showed trends toward superior wound closure and demonstrated significantly faster healing compared to advanced dressings in patients with refractory chronic lower limb ulcers, with autologous micrograft therapy (Rigenera) showing intermediate results. Significant baseline imbalances in wound size limit causal inference from the closure rate comparisons. These hypothesis-generating findings from a non-randomized cohort warrant confirmation in adequately powered randomized controlled trials with stratification by wound characteristics.

The diagnosis of cerebral venous thrombosis (CVT) remains challenging due to limited consensus on the optimal imaging modality. MR black-blood thrombus imaging (MRBTI), contrast-enhanced MR imaging (CE-MRI), and noncontrast-enhanced MR venography (NCE-MRV) are promising modalities. This study aims to evaluate the performance of these modalities in diagnosing CVT. PubMed, Web of Science, and Embase databases were systematically searched from inception to March 2025. Studies evaluating the diagnostic accuracy of MRBTI, CE-MRI, and NCE-MRV for CVT were included. A bivariate random-effects model was used to calculate the summary accuracy metrics with 95% confidence intervals (CIs). Sources of heterogeneity were explored through meta-regression, subgroup analysis, and sensitivity analysis. Publication bias was assessed using Deeks' funnel plot. Fifteen studies involving 49 cohorts (1401 patients and 4846 venous segments) were included. MRBTI achieved significantly higher sensitivity, 98% (95% CI: 95-99%), and specificity, 99% (95% CI: 97-100%) than CE-MRI and NCE-MRV (p < 0.05 for both). NCE-MRV (89%; 95% CI: 78-95%) demonstrated higher sensitivity than CE-MRI (76%; 95% CI: 67-83%) (p = 0.045), at the expense of specificity (NCE-MRV: 89%, 95% CI: 79-94%; CE-MRI: 97%, 95% CI: 93-98%; p = 0.04). Study design influenced heterogeneity in both MRBTI and CE-MRI studies, with diagnostic level and scanning mode affecting heterogeneity in MRBTI and CE-MRI, respectively. MRBTI demonstrated superior diagnostic accuracy for CVT compared to CE-MRI and NCE-MRV. Prospective multi-center studies are required to standardize MRBTI protocols and validate its reliability as a standalone diagnostic modality for CVT. Question The diagnostic accuracy for CVT of MRBTI, CE-MRI, and NCE-MRV remains unclear. Findings Pooled data demonstrate that MRBTI exhibits superior diagnostic performance for CVT in comparison with CE-MRI and NCE-MRV. Clinical relevance MRBTI demonstrates high diagnostic accuracy for CVT, facilitating earlier diagnosis and improving patient outcomes. Further studies should standardize MRBTI protocols and validate its reliability as a standalone diagnostic tool for CVT, thereby optimizing workflow, reducing scan time, and improving cost-effectiveness.

Regenerating mineralized tissues under degenerative inflammatory stimuli is challenging, as elevated pro-inflammatory mediators impair the reparative capacity of resident cells. This study developed a chitosan-based scaffold functionalized with calcium hydroxide and simvastatin to modulate inflammation and enhance bone regeneration in inflammatory conditions. Scaffolds were fabricated from 2% chitosan, with or without Ca(OH)₂, and incubated in 1 μM simvastatin, generating four formulations: CH, CH-Ca, CH-SV, and CH-Ca-SV. In vitro, SAOS-2 cells were preconditioned in serum-free medium with or without TNF-α (100 ng/mL) for three days to simulate a degenerative inflammatory microenvironment. Cell metabolic activity, expression of inflammatory genes, alkaline phosphatase activity, mineralized matrix deposition, and osteogenic gene expression were assessed. In vivo, critical-size calvarial defects were created in Wistar rats, with or without TNF-α-induced osteolytic lesions, and filled with blood clot (control), CH-Ca, or CH-Ca-SV. After 14 and 30 days, samples were analyzed by micro-computed tomography, histology, and immunohistochemistry (IL-1β, TNF-α). In vitro, CH-SV and CH-Ca-SV extracts significantly increased cell metabolic activity, enhanced osteogenic differentiation, and downregulated TNF-α, MMP9, and IL-1β under inflammatory challenge. In vivo, CH-Ca-SV scaffolds promoted greater bone formation, reduced inflammatory infiltrate, and improved scaffold integrity compared to CH-Ca. Immunohistochemistry confirmed higher cytokine expression in control defects. Overall, simvastatin-loaded chitosan-calcium scaffolds effectively modulate inflammation and enhance bone regeneration even in a pro-inflammatory environment, supporting their potential for treating inflammatory bone defects.

Long-term neurological and psychiatric outcomes after paediatric arterial ischaemic stroke and cerebral sinovenous thrombosis.

Pediatric cerebral thrombosis is a lifelong neurodevelopmental condition.

Background/Objectives: This study aimed to evaluate the regenerative potential of autologous concentrated growth factor (CGF) combined with residual pulp tissue in immature dog teeth using a histological and histomorphometric analysis. Materials and Methods: Thirty immature anterior and premolar teeth, harvested from four dogs, were randomly assigned to three groups (n = 10 each): group I (negative control, untreated teeth), group II (positive control, complete pulp removal with blood clot in the canal), and group III (experimental, partial pulp removal with 1–4 mm residual pulp and placement of autologous CGF). After 1 and 3 months, animals were euthanized, and samples were processed for histological and histomorphometric assessments. Results: The CGF-treated group exhibited newly formed tissue with morphological characteristics comparable to the negative control group after partial pulp removal. Conclusions: The combination of CGF with 1–4 mm of residual pulp was associated with enhanced tissue organization, representing a promising approach for dentin–pulp complex (DPC) regeneration within this experimental context.

Examining the intricacies of blood flow by means of restricted arteries, this study explores situations in which several stenoses, particularly rotated ellipsoidal stenoses, considerably impair flow and increase cardiovascular risk. A complex Cross-Williamsons model with extra parameters is used to precisely represent the fluid behavior of blood. A novel computational approach that combines the Homotopy Perturbation Method and the Finite Element Method is used to address the continuity, momentum, and energy fundamentals that govern fluid motion and heat transfer. This approach is verified through Computational Fluid Dynamics simulations. The narrowed regions velocity, pressure, and temperature patterns are vividly visualized by the CFD analyses, which also show significant pressure variations (12182 [Formula: see text] − 14450 [Formula: see text]) and increased central flow speeds due to velocity change ange [Formula: see text] at the stenoses. Certain zones are classified as being vulnerable to strong shear rate. Further investigation of hemodynamic parameters such as the Reynolds number (maximum at [Formula: see text]), shear rate (maximum at [Formula: see text], and kinematic velocity provides a better understanding of the complex blood flow dynamics in arteries with numerous constrictions. These discoveries have major therapeutic implications for improving the identification and treatment of vascular stenosis. They can help to establish tailored treatment regimens, improve stent placement, and identify future problems such as blood clot formation and plaque instability. Finally, this study enhances the area of computer modeling in cardiovascular investigations, giving medical practitioners significant insights into tailoring treatment options for patients with complicated artery narrowing.

An ultra-early biliary occlusion caused by a blood clot impaction inside a multi-hole covered self-expandable metal stent.

Blood Clot Classification in Ischemic Stroke Patients using ESAFH-Net with Explainable AI.

A woman in her 50s with Factor V Leiden and recent surgery with history of multiple right-sided deep venous thromboses not on anticoagulation due to a prior bleeding complication presented with acute left groin pain and discolouration. Physical exam was concerning for a condition in which a large blood clot blocks the major deep veins of the legs causing painful swelling and a pale appearance. CT imaging revealed a massive occlusive thrombus. Point of care ultrasound was significant for a completely collapsed inferior vena cava. The patient's presentation progressed, and she subsequently underwent clot removal and was started on Heparin for anticoagulation. She was subtherapeutic on heparin and was started on argatroban. On discharge, she was transitioned to fondaparinux.

A pregnant woman at 32 weeks' pregnancy presented to the Emergency Department with cardiopulmonary arrest requiring active cardiopulmonary resuscitation and perimortem caesarean section. Operative findings revealed a fresh stillborn foetus and a completely detached placenta with 4 L of retroplacental blood and blood clots, suggesting a severe case of placental abruption. An inadvertent posterior uterine wall incision was detected upon uterine closure. A formal exploratory laparotomy was performed after the patient was well-stabilised following the return of spontaneous circulation. The inadvertent posterior uterine wall incision indicated a 135° uterine torsion. The mother survived but suffered severe brain injury.