Inflammatory popliteal aneurysm associated with SARS-CoV-2 infection.

BACKGROUND: SARS-CoV-2 infection involves the phase of viral replication and inflammatory response predicting the severity of COVID-19. Vascular involvement in SARS-CoV-2 infection has been well established. Thrombotic complications are common, while only few cases of dilatative diseases have been reported. CASE REPORT: We herein report the case of a 65-year-old male patient with an inflammatory 25-mm saccular popliteal artery aneurysm detected six months after symptomatic COVID-19 (pneumonia, and pulmonary embolism). The popliteal aneurysm was surgically managed with aneurysmectomy, and reversed bifurcated vein graft. Histological examination detected the infiltration of monocytes and lymphoid cells into the arterial wall. CONCLUSIONS: Popliteal aneurysm could be related to inflammatory response related to SARS-CoV-2 infection. The aneurysmal disease should be considered mycotic and surgically managed without prosthetic grafts.

A rare case of mycobacterial pseudoaneurysm of the superficial femoral artery.

OBJECTIVE: Extrapulmonary localization of tuberculosis accounts for about 15-20% of cases. Several cases of Mycobacterium tuberculosis with vascular involvement have been described, but only few cases for limb vessels. CASE REPORT: We report the case of a 33-year-old man from Gambia with a symptomatic pseudoaneurysm of the right superficial femoral artery. Total body positron emission tomography/computed tomography with [18F]FDG revealed an active infection. The patient underwent vascular reconstruction with a straight reversed vein graft. Molecular testing for Mycobacterium tuberculosis was non-diagnostic. Cultures of the pseudoaneurysm wall and thrombus removed during surgery grew Mycobacterium tuberculosis. CONCLUSIONS: The diagnosis of vascular tuberculosis infection due to Mycobacterium tuberculosis is a challenge. Epidemiology remains the primary criterion for maintaining a high index of suspicion.

Listeria abdominal endograft infection miming pseudoaneurysm treated with in-situ aortic reconstruction: a case report.

We report the case of a 72-year old man previously treated with an aortic endograft for an abdominal aortic aneurysm. After 3 years the patient developed a sepsis. Imaging and blood exams detected an endograft infection related to Listeria monocytogenes. Patients underwent endograft removal and in-situ aortic reconstruction with a cryopreserved allograft. A continuous antibacterial therapy has been established. One-month follow-up revealed the absence of clinically relevant infection with patency of the graft and absence of biochemical inflammatory markers.

[Opioid mechanisms for modulating pain: descending pathways. Critical review]. / Meccanismi oppioidi di modulazione del dolore: i circuiti discendenti. Una revisione critica.

This paper presents an extensive review of contributions on opiate controlled descending projections modulating analgesia. While there is a quite definite agreement on the organisation and structure of these projections, their true physiological role remains quite dubious. The hypothesis so far formulated on the modalities of activation of these circuits apparently don't hold a critical re-examination.