Regulatory Mechanisms of Muscle Mass: The Critical Role of Resistance Training in Children and Adolescent.

Muscle mass and strength are subjected to several regulations. We found endocrine signals such as growth hormone, insulin-like growth factor 1, testosterone, thyroid hormones, and glucocorticoids among them. Neural inputs also influence muscle development, modulating mass and strength. Among the external stimuli that modulate these muscular features is physical training such as resistance and endurance training. Specifically, resistance training can mediate an increase in muscle mass by hypertrophy in adults, but the effects in children and adolescents are full of myths for most of the population. However, the evidence shows that the impact of resistance training on children and adolescents is clear and provides a wide range of benefits. However, qualified professionals must be available since exercise prescription and subsequent supervision must follow this population's abilities, needs, and interests.

Rathke's cleft cyst infections and pituitary abscesses: case series and review of the literature.

PURPOSE: Pituitary abscesses (PAs) are a rare clinical entity which may arise from normal pituitary tissue or underlying lesions within the gland. Rathke's cleft cysts (RCCs) are not commonly associated with the development of PA. METHODS: Retrospective chart review of three patients with PAs within RCCs at a single university center and review of the literature. RESULTS: Three cases are reported. The first case presented with fever and headache and a history of prior surgery due to RCC and a recent respiratory tract infection. The second case had a history of recent skin infections and presented with sudden onset headache and hypopituitarism. In the third case, chronic visual field impairment prompted an ophthalmologic evaluation resulting in a diagnosis of an adenoma and an infected RCC. In all three cases, an endoscopic endonasal approach was performed to drain infected tissue and allowed microbiological identification of gram-positive cocci, followed by treatment with antibiotics for at least three weeks. Cases in the literature are scarce and the diagnosis is usually made intraoperatively due to non-specific manifestations and imaging. PAs arising from underlying pituitary lesions are less common than primary PAs. Differential diagnosis should include pituitary apoplexy, hypophysitis and other cystic lesions. CONCLUSION: PAs occurring in RCCs are infrequent. Clinical manifestations are commonly subacute, without septic symptoms. Imaging is usually non-specific. Preoperative diagnosis is infrequent and a broad differential diagnosis should be considered. Empirical antimicrobial therapy should be initiated and adjusted after obtaining cultures to reduce the rate of recurrence and improve clinical outcomes.

Preconception use of pegvisomant alone or as combination therapy for acromegaly: a case series and review of the literature.

PURPOSE: Pegvisomant (PEG) is an effective therapy for acromegaly. Its safety in women seeking fertility and during pregnancy has been scarcely reported. METHODS: A retrospective chart review was performed in three patients with acromegaly who received PEG while attempting to conceive. Published studies regarding this topic were analyzed. RESULTS: Four pregnancies in three women with acromegaly are reported. In the first patient, PEG was withdrawn three days before embryo transfer in her first pregnancy and 2 weeks prior to transfer in the second pregnancy. Each transfer resulted in a healthy full-term newborn. In the second and third patients, PEG was withdrawn at diagnosis of pregnancy. No fetal complications occurred during gestations which resulted in three full-term newborns (one single and one twin pregnancy). No abnormalities in development were found in the five live births described. Few cases of pregnancies in women exposed to PEG have been reported and therefore safety cannot be clearly established. In this series, all four pregnancies had good outcomes with discontinuation of the drug before or at first knowledge of conception. A review of the literature reveals no evident drug-related abnormalities in the offspring, even in the few women with continued use of PEG throughout pregnancy. CONCLUSION: Preconception therapy with PEG resulted in successful fertility outcomes. Although few cases have been reported, these four pregnancies with PEG use prior to or at the time of conception were not associated with significant maternal or fetal complications. More studies are needed to establish the safety of PEG preconception.

Tumor-induced osteomalacia: experience from a South American academic center.

The majority of tumor-induced osteomalacia cases have been reported in the Northern Hemisphere and Asia. In this first series of South American patients, we show that the clinical presentation and sensitivity of plasmatic fibroblast growth factor 23 and somatostatin analog-based imaging are similar to those described in other populations. INTRODUCTION: Describe the experience of clinical presentation, diagnostic study, and treatment of patients with tumor-induced osteomalacia (TIO) in a South American academic center in comparison to literature. METHODS: Analysis of the records of patients diagnosed with TIO. The clinical presentation, diagnostic studies, and treatment were analyzed. Fibroblast growth factor 23 (FGF23) was measured by ELISA. RESULTS: Six patients were diagnosed with TIO during the studied period. The patients' median age was 53 years (range 22-64). All patients presented with weakness and pain in the extremities. Four experienced fractures during their evolution. The median time to diagnosis was 4.5 years (1-20). Biochemical studies showed hypophosphatemia, median of 1.4 mg/dL (1.2-1.6), with low maximum rates of tubular reabsorption of phosphate adjusted for glomerular filtration rate. FGF23 was elevated in 4/6 patients and inappropriately normal in the other two. In three patients, the location of the tumor was clinically evident and confirmed with anatomical imaging. In the remaining patients, two tumors were located with 68Ga DOTATATE-PET/CT and one with OctreoScan. The causal tumors were located in the lower extremities in five patients and invading the frontal sinus in one patient. In all patients, tumors were successfully removed. Within 14 days, there was normalization of phosphate and FGF23 levels and resolution of clinical symptoms in all patients. In all cases, the histopathology was compatible with a phosphaturic mesenchymal tumor. CONCLUSIONS: The clinical presentation, delay time to diagnosis, FGF23 diagnostic sensitivity and histopathology in this first series of South American patients is similar to those described in other populations. The success of localization by somatostatin analog-based imaging, suggests this may the optimal imaging modality.

Heart pathologies in dolphins stranded along the northwestern Italian coast.

Nine striped dolphins Stenella coeruleoalba and 1 bottlenose dolphin Tursiops truncatus stranded along the Ligurian Sea coast of Italy were necropsied between February 2011 and April 2012. Macroscopic and histological findings were observed in the hearts of all animals and included saccular aneurysms of the pulmonary trunk (n = 3), cirsoid aneurysms (n = 1), right ventricular dilation (n = 1) associated with hypoplasia of the tricuspid chordae (n = 1), valvular fibrosis (n = 3), mitral leaflet thickening (n = 1), left ventricular hypertrophy (n = 1), lymphocytic myocarditis (n =1), and Lambl's excrescences (n = 4). To our best knowledge Lambl's excrescences, aneurysm of the pulmonary trunk, and cirsoid aneurysms have not previously been described in marine mammals, and some of these findings should be taken into account as possible causes of dolphin morbidity, mortality, and stranding.

Unusual Combination of Multiple Vascular Anomalies in a German Shepherd Puppy with Megaoesophagus.

A 2-months-old male German shepherd puppy was referred for regurgitation and delayed growth. Radiographic and endoscopic investigations revealed a precardiac megaoesophagus and oesophageal constriction at the level of the heart base. At post-mortem examination, a specific form of persistent right aortic arch characterized by an aberrant left subclavian artery in combination with a ligamentum arteriosum originating at the aberrant left subclavian artery (PRAA-SA-LA) was detected. A complete-type persistent left cranial vena cava (PLCVC) was also observed. This is the first report describing the association between PRAA-SA-LA and PLCVC in a dog with megaoesophagus.

Right atrial appendage aneurysms in veal calves and beef cattle: anatomopathological investigations and aetiopathogenetic hypotheses.

OBJECTIVES: Right atrial aneurysms have been reported in bovine species, but a clear aetiopathogenesis has never been elucidated. ANIMALS: One thousand and seventy-nine veal calves (6-9 months old) and 313 beef cattle (10-24 months old) housed in intensive livestock farming systems and regularly slaughtered were included in the present study. METHODS: Hearts were externally examined and the identified right atrial aneurysms were submitted for gross and histopathological investigations. RESULTS: Right atrial aneurysms, which involved the right auricle, were detected in both veal calves (4.63%) and beef cattle (8.63%). Two types of aneurysms were observed: one type showing communications with the atrial lumen, the other one having no connections with it. Aneurysms communicating with the atrial lumen were characterized by endocardial fibrosis, whereas the other ones showed arterial characteristics (intimal fibromuscular hyperplasia and medial elastic fibre and fibrous tissue deposition). CONCLUSIONS: Considering the similarities with the right atrial aneurysms reported in people, the aneurysms communicating with the atrial lumen were considered to be caused by an inherent atrial weakness (so called 'loci minoris resistentiae' areas). On the contrary, the aneurysms with no communications with the atrial lumen, whose localization suggested an origin from the intramural coronary arteries of the pectinate muscles, may be subsequent to systemic hypertension due to intensive livestock farming conditions.

Detection of helicobacter candidatus suis by PCR in oesophagogastric ulcers of swine in Italy.

The aim of this study was to evaluate by PCR the presence of Helicobacter spp. in gastric mucus from the fundic region of the stomach and to investigate its role in oesophagogastric ulcers in swine bred and regularly slaughtered in Piedmont (Northern Italy). Stomachs from 595 regularly slaughtered swine were subjected to gross pathological examination in order to evaluate the presence of gastric ulcers (revealed in 75 cases, 12.6%). Histopathological examination was performed to better characterise erosions and ulcers. DNA extracted from gastric mucus collected from all the ulcer-affected and from 25 normal stomachs was submitted to PCR using Helicobacter spp. 16S rRNA gene target primers. Sixty-three percent (47/75) of the affected stomachs was positive as well as 24% (6/25) of the non-affected ones. Sequence analysis from 5 positive samples showed 99% homology with Helicobacter candidatus suis 16S ribosomal RNA gene.

Maedi-visna virus detection in ovine third eyelids.

Maedi-visna is a systemic disease of sheep caused by a lentivirus, maedi-visna virus (MVV), which mainly affects the lungs and central nervous system but may also affect the mammary glands, joints and other tissues. The aim of the present study was to determine whether the third eyelid was affected in cases of systemic infection. Third eyelid and lung samples from sheep naturally infected with maedi were used. Total DNA was extracted from paraffin-wax-embedded tissues, and a nested polymerase chain reaction (PCR) was performed to amplify MVV proviral DNA. The samples were also tested by in-situ PCR and immunohistochemical methods specific for the detection of MVV proviral DNA and p25, respectively. All sheep showed moderate to severe chronic lymphoproliferative inflammation in the third eyelids. Products of the expected size were obtained by PCR from both lung and third eyelid tissue. In the nictitating membrane, MVV proviral DNA was detected in situ within macrophages, and glandular, ductal and surface epithelia. Immunohistochemistry demonstrated that the infection was productive. Taken together, these results indicate that the third eyelid may represent a target for natural MVV infection and may play a role in disease transmission.

Ultrastructural observations on autolytic changes of atrial specific granules in pig heart.

The progressive autolytic changes of atrial specific granules (ASGS) up to 24 hours after death were studied electron microscopically. Tissue samples taken from the left auricular myocardium of four pig hearts at 0, 0.5, 1.5, 3.5, 6, 12 and 24 hours post mortem were fixed for 24 hours by immersion in 2.5 per cent cacodylate buffered glutaraldehyde (pH 7.4). Two pig hearts were kept at 20 degrees C and two at 4 degrees C. Although typical autolytic changes were seen in many organelles, no remarkable modifications in aspect, distribution, content and diameter of ASGS were observed in all samples. The results of this study indicate that ASGS are not morphologically affected by the autolytic processes, at least during the first 24 hours. Hence, the electron microscopic evaluation of ASGS does not need a particular fixation method such as perfusion. This may eliminate technical problems when slaughterhouse material is used.

Morphological and biochemical investigations of mitral valve endocardiosis in pigs.

Pig endocardiosis is a pathological process affecting cardiac valves that is characterised by the accumulation of glycosaminoglycans (GAG) in the extracellular matrix. To investigate the involvement of GAG in the condition, the morphology of the mitral valves from 23 affected pigs and seven normal controls was studied and qualitative and quantitative biochemical analyses of GAG were made. Gross and histopathological lesions were characterised by valve enlargement, collagen disorganisation and myxoid degeneration. No differences between normal and diseased valves were detected by lectin histochemistry. Electron microscopy revealed myofibroblast differentiation of many fibroblasts. A statistically significant increase of total GAG and hyaluronan was detected in the mitral valves of the pigs with endocardiosis by spectrophotometric, electrophoretic and densitometric analysis of the extracted GAG. Although it is not known whether the change in hyaluronan is a primary event or a result of other changes in the extracellular matrix, its accumulation in association with myofibroblast differentiation suggests that it plays a pathogenetic role in pig endocardiosis.

Histological reactions of porous tip endocardial electrodes implanted in sheep.

The tissue reaction caused by a sintered tip electrode is compared with that of a platinum-iridium tip electrode in a work which employs implantation in sheep and follow-up of the implant for up to 90 days. Clinical tests and anatomo-pathological examination of the histological sections were performed. The results show a remarkably rapid fixation to the heart for the porous electrode with formation of limited inflammatory process, a thin fibrous capsule and modest alteration of the endocardial tissue. Conversely, the platinum-iridium electrode does not fix even in long periods and therefore continuously rubs the endocardial surface. Chronic inflammation and formation of remarkably thick connective capsule results, under which the heart seems mode deeply altered.

Pestivirus infection in small ruminants: virological and histopathological findings.

Pestivirus infection was detected in several flocks of sheep and goats located in the south of Italy by means of serological, virological and histopathological investigations. From four animals, two lambs and two kids, showing enteric symptoms which died during the first week of life, four pestivirus strains were isolated and typed as BVDV-like (three isolates) and "tipic" BDV strains (one isolate). The histopathological lesions consisted of areas of hypomyelination in the brain, and a slight depletion of thymic medullary lymphocytes associated with an increase in reticular cells.

Virological and histological findings in goats infected by caprine herpesvirus 1.

Two adult goats seropositive to caprine herpesvirus 1 were treated with dexamethasone for 6 days to reactivate the virus. The goats shed the virus by the nasal and the vaginal routes. After necropsy, the histologic examinations on vaginal and nasal mucosa and ganglia showed general degenerative and flogistic lesions of the tissues. The findings confirm the respiratory and especially genital tropism of the virus.

[Tuberculosis in animals]. / La tubercolosi negli animali.

Tuberculosis is a well known disease for immemorial time and very diffuse in animals. Today the technological progress of zoo technology decreased the incidence of tuberculosis in animals and at the same time, it modified the epidemiological characteristics in all animal species. We can confirm that in intensive pig- and chicken raising tuberculosis is now quite inexistent. About sanitary reclamation, unfortunately Italy takes a very low position among European countries, since the eradication of bovine tuberculosis is not settled in some provinces. At Piedmont, tubercular lesions in female genital apparatus of regularly slaughtered cows are been shown in about 7% of all examined animals (4500), percentage tantamount to 30-40% of pulmonary tuberculosis. The diagnostic difficulties come from the fact that also in cows tubercular disease can be clinically silent for a long time. In man, animal tuberculosis can be consequent upon an occupational risk. Also in town, the contact with domestic animals proposes as important the problem of a careful antitubercular survey.

The morphology and location of atrial specific granules and the demonstration of atrial natriuretic factor in porcine, lapine and bovine heart by immunoelectronmicroscopy.

The atrial specific granules (ASGs) were studied in samples collected from the right and left auricles of conventionally slaughtered cows (10), pigs (16) and rabbits (8). In addition, the presence of atrial natriuretic factor (ANF) was detected by immunocytochemistry. Mature ASGs, characterized by the presence of highly osmiophilic and electron-dense material surrounded by a membrane, were present in all atrial myoendocrine cells and their diameters ranged from 100 to 470 nm in pigs, from 100 to 235 nm in cattle, and from 125 to 275 nm in rabbits. Immunoelectronmicroscopical studies revealed the presence of ANF in the ASGs of pigs and cattle, whereas anti-ANF polyclonal serum failed to detect any significative reaction in lapine ASGs. The ultrastructural features of the ASGs of pigs, cattle and rabbits described may be useful in comparing the morphological picture of several cardiac endocrine pathological conditions.

[Examination of the brains of slaughtered cattle for the occurrence of BSE in Italy with attention to non-specific neuronal vacuoles]. / Untersuchungen an Gehirnen von Schlachtrindern zum Vorkommen von BSE in Italien unter Beachtung unspezifischer neuronaler Vakuolen.

In order to find out whether BSE exists in Italy 378 brains of normally slaughtered 2-10 years old cattle submitted from slaughterhouses all over the country were examined histologically. None showed the typical lesions of BSE. About 11.5% of the brains contained large vacuoles in the neurons of brain stem nuclei, in particular the red nucleus in the midbrain. They were considered non specific.

[Pathology of cardiac ventricular aneurysms in the horse]. / Sulla patologia degli aneurismi cardiaci ventricolari nel cavallo.

The authors describe pathologic and histopathologic findings of three cardiac aneurysms in horses, two of which in the left ventricle and one in the right ventricle. The aneurysms were always associated with multiple foci of myocardiac fibrosis. A hypothesis concerning histogenesis of the lesion is formulated.

[Myocardial infarction in the cat]. / Infarto miocardico nel gatto.

The authors describe two cases of myocardial infarction evaluated during an anatomo-histopathological study on the cat's cardiovascular system. The authors discuss the pathogenetic hypotheses and their role in comparative pathological studies.