Extreme neck elongation evolved despite strong developmental constraints in bizarre Triassic reptiles-implications for neck modularity in archosaurs.

The Triassic radiation of vertebrates saw the emergence of the modern vertebrate groups, as well as numerous extinct animals exhibiting conspicuous, unique anatomical characteristics. Among these, members of Tanystropheidae (Reptilia: Archosauromorpha) displayed cervical vertebral elongation to an extent unparalleled in any other vertebrate. Tanystropheids were exceptionally ecologically diverse and had a wide spatial and temporal distribution. This may have been related to their neck anatomy, yet its evolution and functional properties remain poorly understood. We used geometric morphometrics to capture the intraspecific variation between the vertebrae comprising the cervical column among early archosauromorphs, to trace the evolutionary history of neck elongation in these animals. Our results show that the cervical series of these reptiles can be divided into modules corresponding to those of extant animals. Tanystropheids achieved neck elongation through somite elongation and a shift between cervical and thoracic regions, without presacral vertebrae count increase-contrary to crown archosaurs. This suggests a peculiar developmental constraint that strongly affected the evolution of tanystropheids. The data obtained just at the base of the archosauromorph phylogenetic tree are crucial for further studies on the modularity of vertebral columns of not only Triassic reptile groups but extant and other extinct animals as well.

Heart Metastases of Clear Cell Renal Cell Carcinoma.

Renal cell carcinoma (RCC) is a common genitourinary cancer. Of the several histologic types of RCC, clear cell renal cell carcinoma (ccRCC) is the most frequent. Due to the development of imaging methods such as computed tomography (CT) or magnetic resonance imaging (MRI), the incidence of ccRCC diagnosis has increased rapidly. However, up to one third of patients at prime diagnosis of ccRCC are at metastatic stadium of the disease. Metastases of ccRCC are found mostly in the lungs, bones and liver. Metastasis of ccRCC to the heart is an uncommon clinical situation. We present a rare case of metastatic stadium of ccRCC with metastases to heart tissue visualized in transthoracic echocardiography.

Different Types of Vasculitis Complicated by Heparin-Induced Thrombocytopenia-Analysis of Four Cases and Literature Review.

Vasculitis and HIT have different etiologies, although both involve autoimmune mechanisms. Treatment of vasculitis often requires the use of an anticoagulant such as heparin, which can lead to the development of HIT and subsequent life-threatening complications. The analysis covered patients hospitalized in the Department of Internal Medicine, Nephrology and Dialysis in the period from September 2020 to March 2023. After analyzing the data, we selected four patients in whom vasculitis treatment was complicated by HIT. These included two patients with ANCA vasculitis and two patients with anti-GBM disease. We also described similar cases reported in the literature.

The Factors Contributing to Efficiency in Surgical Management of Purulent Infections of Deep Neck Spaces.

Deep neck infections (DNIs) are still emergency conditions in otorhinolaryngology. Due to rapid disease progression and life-threatening complications, the accurate surgical and medical treatment must be promptly applied. In the present study, we analyzed treatment protocols of 46 adults to assess efficacy of the treatment and search for prognostic factors of the outcomes. We performed retrospective analysis of medical data of 46 patients, who underwent surgical treatment in our department due to purulent DNI in the period from 2009 to 2017. Data investigated included age, sex, hospitalization time, duration of symptoms before drainage, comorbidities, selected laboratory tests results, location and the number of abscesses, results of microbiological cultures, and antibiotic treatment options. The study group consisted of 33 (71.7%) men and 13 (28.3%) women. Patients age ranged from 18 to 82 years. The mean duration of hospital stay was 13.2 ± 8.4 days. The most common site involved was submandibular space (43.5%), followed by parapharyngeal space (28.3%). The majority of patients had single abscess (81.2%), the multiple abscesses were revealed in 8 (18.8%) cases. The mean size of the abscesses was 42 mm. C-reactive protein level was increased in 96.7% patients (mean level 155.5  ±  146.7  mg/L), but the white blood cell count exceeded the normal in 60.9% cases (mean level 16.89  ±  5.59 â€Šâ€Š× â€Š109/L). Staphylococcus aureus (20.7%) and Peptostreptococcus (20.7%) were the most common species cultured from swabs. The antibiotic treatment included most commonly a combined ceftriaxone and metronidazole (n = 23). Two patients died due to complications. The correlation between different variables and the duration of hospitalization revealed only the hemoglobin level below 12.5 g/dL, a significant predictor of longer hospitalization (16.23 days vs 12.09 days, P = .017). Patients with purulent DNIs and decreased hemoglobin level are predisposed to prolonged recovery following the surgical drainage.