Background: Cardiovascular disease can be triggered and accelerated by hypertension and the underlying changes in the structure and function of arteries. The purpose of this review is to explore some vascular changes that occur in hypertension as a consequence of the imbalance between cell proliferation and cell death, processes that play an important role in stabilizing the thickness of the arterial wall during vascular remodeling. Methods: The authors conducted research through PubMed and Google Scholar databases using the following search formula: (hypertensive*) AND ((vascular modifications)) OR (vascular changes)) AND (cell death). Results: From 40 articles, only 17 publications were included in this study, taking into account four processes that can be preceded or followed by inflammation and depend on the interaction between local growth factors, vasoactive substances, and hemodynamic stimuli: Cell proliferation and growth; Cell migration; Cell death; Degradation or reorganization of extracellular matrix. Conclusions: To summarize, maladaptive vascular changes in hypertension can represent a major argument for prompt and maximal therapeutic intervention in patients with high cardiovascular risk. Moreover, they can represent an important step in discovering new markers of cardiovascular risk and in the development of new targeted therapies for different pathways of cellular signaling through which the reversibility of abnormal vascular changes could be obtained.
Synovial proliferation is a common intraoperative finding during total knee arthroplasty (TKA) and many studies have proposed synovectomy for the reduction of postoperative pain. We included 180 patients that were split into two groups, one which received a total synovectomy (TS) and the other with partial synovectomy (PS). We measured the amount of intra- and post-operative bleeding as well as perceived pain (using the Visual Analogue Scale) and knee function (using the Knee Society Knee Score) at 4 and 12 weeks. The blood loss during the surgical procedure was 367.77 ± 115.71 mL for TS, while the other group recorded 295.55 ± 106.17 mL (p < 0.05). Regarding postoperative bleeding, the TS group aspirated 533.77 ± 281.65 mL, which was significantly higher than the PS group (404.44 ± 211.55 mL, p < 0.05). No significant differences were recorded between the TS and PS groups regarding pain and knee function at 12 weeks. Total synovectomy demonstrated significantly higher blood loss and lower postoperative hemoglobin levels, even though knee function and pain level did not show improvements. We consider that the decision of performing synovectomy should rely on the clinical indication and, if conditions allow for it, a limited resection should be attempted.
Background. Primary headaches are comprised of three big categories: migraines (with or without aura), the third most common and the 6th most disabling disease worldwide, tension-headaches, and trigeminal autonomic cephalalgias, each with different, complex, and not completely understood pathophysiological, clinical, and neuroimagistic characteristics. Structures like the brain stem, hippocampus, or hypothalamus have been depicted as being the main triggers of these types of headaches, which have a significant impact on the quality of life. Methods. We performed a broad literature review on primary headaches from January 2016 to June 2023, analyzing the latest scientific updates and emphasizing the pathophysiological and neuroimagistic characteristics. Results. We provide a concise review of the main neuroimaging studies that help in differential diagnosis between several types of primary headaches. Conclusions. It is difficult to approach the pathophysiology of these three primary headache categories. Keeping in mind that neuroimagistic methods are rapidly developing (especially in the MRI sphere), the most important endpoint of future studies will be to establish a reliable distinction system for all these types of cephalalgias, thus updating the protocols and guidelines. Currently, imaging studies are indicated only in certain circumstances.
