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Topic Review
Circulating miRNAs and Preeclampsia
miRNAs are single-stranded non-coding RNAs, 20–24 nt long, which control mRNA expression. Changes in miRNA expression can induce a variation in the relative mRNA level and influence cellular homeostasis, and the strong presence of miRNAs in all body fluids has made them useful biomarkers of several diseases. Preeclampsia is a multifactorial disease, but the etiopathogenesis remains unclear. The functions of trophoblasts, including differentiation, proliferation, migration, invasion and apoptosis, are essential for a successful pregnancy.
  • 132
  • 01 Feb 2024
Topic Review
Conventional MRI Characteristics of Peri- and Para-Vascular Spaces
Brain spaces around (perivascular spaces) and alongside (paravascular or Virchow–Robin spaces) vessels have gained significant attention due to the advancements of in vivo imaging tools and to their crucial role in maintaining brain health, contributing to the anatomic foundation of the glymphatic system. In fact, it is widely accepted that peri- and para-vascular spaces function as waste clearance pathways for the brain for materials such as ß-amyloid by allowing exchange between cerebrospinal fluid and interstitial fluid. Visible brain spaces on magnetic resonance imaging are often a normal finding, but they have also been associated with a wide range of neurological and systemic conditions, suggesting their potential as early indicators of intracranial pressure and neurofluid imbalance.
  • 187
  • 01 Feb 2024
Topic Review
Ventilator-Associated Pneumonia
Ventilator-associated pneumonia (VAP) is defined as pneumonia not present or incubating at the time of admission and occurring after more than 48 hours of mechanical ventilation (MV). This is the second-most common healthcare-associated infection (HAI) in neonatal intensive care units (NICUs). VAP is associated with increased morbidity and mortality, an increased length of stay in the NICU and hospital costs.
  • 127
  • 31 Jan 2024
Topic Review
Mitochondrial DNA Deletion/Depletion Disorders Causing Chronic Progressive External Ophthalmoplegia
Chronic progressive external ophthalmoplegia (CPEO) is the most common manifestation of mitochondrial diseases and is characterized by bilateral symmetrical progressive ptosis and reduced ocular motility. CPEO can be isolated or accompanied by a clinical feature of systemic involvement of mitochondrial dysfunction (CPEO plus syndrome). Mitochondrial disorders generally affect tissues with high metabolic demand, such as the central and peripheral nervous systems, heart, adrenal glands, renal tubules, skeletal muscles, and the eye. In CPEO, the ocular findings of ptosis and ophthalmoplegia occur due to the inability of the abnormal mitochondria to supply an adequate amount of ATP due to defective oxidative phosphorylation. The extraocular muscles are particularly susceptible due to their high mitochondrial volume and lower mutational threshold. Their susceptibility is expressed in multiple mitochondrial disorders, highlighting the significance of examining other manifestations in patients with PEO.
  • 167
  • 31 Jan 2024
Topic Review
General Effects of Elevated Blood Pressure on Vasculature
Vascular dysfunction and vascular remodeling are caused by chronically elevated systemic arterial blood pressure (BP), and can be associated with changes in all vessel layers, from the endothelium to the perivascular adipose tissue (PVAT). In HHD, large artery alterations are characterized by increased proximal artery enlargement, arterial wall thickness, the elongation and widening of the aortic arch, and increased arterial stiffness. Small artery alterations are characterized by eutrophic remodeling (defined as increased media-to-lumen ratio with unchanged total wall tissue), increased arterial stiffness, and microvascular rarefaction. It is considered that the progressive course of HHD leads to a reduction in the microcirculatory network, and many bioactive molecules, such as angiotensin-II (Ang-II), endothelin-1 (ET-1), aldosterone, catecholamines, and metalloproteinases (MMP) have an impact on vascular remodeling, particularly because of their capacity to increase oxidative stress and to impair nitric oxide (NO) activity in the vascular wall.
  • 155
  • 31 Jan 2024
Topic Review
Headache and Other Pain Syndromes in Multiple Sclerosis
Multiple sclerosis is a chronic and progressive neurological disease, with an important socio-economic burden. Over time, an increased incidence of headaches like migraines and tension headaches has been observed among these patients. Headaches have not been considered as multiple sclerosis-related symptoms, even representing a red flag for multiple sclerosis diagnosis. 
  • 164
  • 31 Jan 2024
Topic Review
Primary Lateral Sclerosis
Primary lateral sclerosis (PLS) is a rare neurodegenerative disorder which causes the selective deterioration of the upper motor neurons (UMNs), sparing the lower motor neuron (LMN) system. The clinical course is defined by a progressive motor disability due to muscle spasticity which typically involves lower extremities and bulbar muscles. Although classically considered a sporadic disease, some familiar cases and possible causative genes have been reported. Despite it having been recognized as a rare but distinct entity, whether it actually represents an extreme end of the motor neuron diseases continuum is still an open issue. The main knowledge gap is the lack of specific biomarkers to improve the clinical diagnostic accuracy. Indeed, the diagnostic imprecision, together with some uncertainty about overlap with UMN-predominant ALS and Hereditary Spastic Paraplegia (HSP), has become an obstacle to the development of specific therapeutic trials.
  • 258
  • 31 Jan 2024
Topic Review
Hypoxia-Inducible Factor and Oxidative Stress in Tendon Degeneration
Tendinopathy is a debilitating condition marked by degenerative changes in the tendons. Its complex pathophysiology involves intrinsic, extrinsic, and physiological factors. While its intrinsic and extrinsic factors have been extensively studied, the role of physiological factors, such as hypoxia and oxidative stress, remains largely unexplored.
  • 196
  • 31 Jan 2024
Topic Review
The Rationale of Hyperthermic Intraperitoneal Chemotherapy Treatment
Peritoneal metastases (PM) are observed in approximately 8% of patients diagnosed with colorectal cancer, either synchronously or metachronously during follow-up. PM often manifests as the sole site of metastasis. PM is associated with a poor prognosis and typically shows resistance to systemic chemotherapy. Consequently, there has been a search for alternative treatment strategies. For intraperitoneal (IP) therapy to exhibit promise, it either needed to be combined with the removal of larger tumor nodules during cytoreductive surgery or administered as repeated intermittent treatments over an extended duration to affect macroscopic tumor nodules. Cytoreductive surgery, with hyperthermic intraperitoneal chemotherapy (HIPEC) treatment as an adjunct, emerged as a solution for the former situation.
  • 135
  • 31 Jan 2024
Topic Review
Deep Infiltrating Endometriosis in Adolescence
Endometriosis has a prevalence of 10% worldwide in premenopausal women. Probably, endometriosis begins early in the life of young girls, and it is commonly diagnosed later in life. The prevalence of deep infiltrating endometriosis (DIE) in adolescence is currently unknown due to diagnostic limits and underestimation of clinical symptoms. Dysmenorrhea is a common symptom in adolescents affected by DIE, often accompanied by dyspareunia and chronic acyclic pelvic pain. Ultrasonography—either performed transabdominal, transvaginal or transrectal—should be considered the first-line imaging technique despite the potential for missed diagnosis due to early-stage disease. Magnetic resonance imaging should be preferred in the case of virgo patients or when ultrasonographic exam is not accepted. Diagnostic laparoscopy is deemed acceptable in the case of suspected DIE not responding to conventional hormonal therapy. An early medical and/or surgical treatment may reduce disease progression with an immediate improvement in quality of life and fertility, but at the same time, painful symptoms may persist or even recur due to the surgery itself. 
  • 220
  • 31 Jan 2024
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