Background: Atherosclerosis is a progressive disease that results from endothelial dysfunction, inflammatory arterial wall disorder and the formation of the atheromatous plaque. This results in carotid artery stenosis and is responsible for atherothrombotic stroke and ischemic injury. Low-grade plaque inflammation determines biological stability and lesion progression. Methods: Sixty-seven cases with active perilesional inflammatory cell infiltrate were selected from a larger cohort of patients undergoing carotid endarterectomy. CD68+, iNOS2+ and Arg1+ macrophages and CD31+ endothelial cells were quantified around the atheroma lipid core using digital morphometry, and expression levels were correlated with determinants of instability: ulceration, thrombosis, plaque hemorrhage, calcification patterns and neovessel formation. Results: Patients with intraplaque hemorrhage had greater CD68+ macrophage infiltration (p = 0.003). In 12 cases where iNOS2 predominated over Arg1 positivity, the occurrence of atherothrombotic events was significantly more frequent (p = 0.046). CD31 expression, representing neovessel formation, correlated positively with atherothrombosis (p = 0.020). Conclusions: Intraplaque hemorrhage is often described against the background of an intense inflammatory cell infiltrate. Atherothrombosis is associated with the presence of neovessels and pro-inflammatory macrophages expressing iNOS2. Modulating macrophage polarization may be a successful therapeutic approach to prevent plaque destabilization.

Background and Clinical Significance: Advanced pelvic organ prolapse (POP) associated with perineal herniation of pelvic and abdominal organs is a sporadic occurrence in gynaecological practice. Generally, POP affects up to 50% of multiparous women at some point during their lives. Advanced forms (grade III or IV) represent less than 10% of all cases, with severe grade IV prolapse occurring in fewer than 2% of patients. Case Presentation: We report the case of a 48-year-old nulliparous woman with no prior surgical history and no known medical conditions at presentation. The patient presented with severe grade IV POP (Baden–Walker Classification), characterised by abdominal pain, vaginal bleeding and significant urinary incontinence. A computed tomography scan was performed, revealing an extremely large perineal hernia, containing the uterus, urinary bladder, and small bowel loops—a rare finding with only isolated cases reported in the medical literature. Surgical treatment involved a total intracapsular hysterectomy with right-sided adnexectomy and colpoperineorrhaphy. After the surgery, the overall status of the patient was good. However, less than two months later, she returned, complaining of a recurrence of the initial pathology, and was diagnosed with grade II/III POP recurrence despite having no connective tissue disorders or other classical predisposing factors such as pregnancies, pelvic surgery history or obstetric trauma. The case was further complicated by a femoral neck fracture, stage V chronic kidney disease, COVID-19 pneumonia, and a Clostridium difficile infection. All these complications led to the postponement of the gynaecological reintervention procedure. Conclusions: We emphasise the significant challenges in managing this kind of perineal hernia, under unusual conditions and without common risk factors. A personalised, multidisciplinary approach is required, including careful follow-up to prevent early recurrence.

Background: The first trimester of pregnancy is known for its proinflammatory state, so it is considered a challenging period due to increased maternal vulnerability to viral infections. The main purpose of the current study was to evaluate the incidence trend of early miscarriages and whether there was any possible influence of the COVID-19 pandemic on pregnancy outcomes. Materials and Methods: We conducted a retrospective cohort study in which we included all pregnant women who had been admitted to our hospital between January 2018 and December 2022. Our aim was to compare the percentage of early miscarriages occurring in the pre-pandemic period (January 2018–February 2020) and during the pandemic (March 2020–December 2022). We decided to measure the total number and percentage of early pregnancy outcomes, including all viable pregnancies, ectopic pregnancies, and both medical and spontaneous abortions. Results: The annual incidence of registry-identified early miscarriages declined from 5.4% of 12–46-year-old women in 2018 to 3.6% in 2022 (p = 0.008). An overall incidence rate of 3.66% [95% C.I. 3.26–4.05] was calculated, with 4.25% [95% C.I. 3.35–4.41] in the pre-pandemic period and 3.24% [95% C.I. 2.82–3.57] during the pandemic. The highest incidence rate (p < 0.0001) was identified among nulliparous women (36.9%). Conclusions: To conclude, this study proved that the increase in the early miscarriage incidence rate could be assigned to an advanced maternal age, irrespective of one’s reproductive history. This study proved that no significant increase in the incidence rate of early miscarriage during the COVID-19 pandemic was noted, suggesting that this viral infection does not alter the risk of miscarriages. We hope that these findings help women deal with emotional stress and offer them reassurance about bearing children during pandemic periods.