Fractals are geometric shapes characterized by self-similarity, where patterns repeat at different scales and are common in nature. The box-counting method is used to measure their dimension, but it has a key limitation: it only offers a global and homogeneous characterization, ignoring local variations in density or complexity within the structure. Multifractal analysis solves this problem. Instead of a single dimension, it provides a spectrum of dimensions that maps how regularity varies in different parts of the object, offering a more accurate description of complex and heterogeneous systems. These concepts are relevant to endocrinology and medicine through the study of biological systems with fractal geometry, such as the branching of blood vessels or neurons. Multifractal tools help researchers measure the complexity of these structures and dynamic processes (such as hormonal rhythms), potentially improving the diagnosis and understanding of various pathologies.
This project investigates the emotional, sensory, and physical burden of physical traumas, focusing on the influence of the language in which the trauma is discussed. Using neurolinguistics applied to trauma, we explore how the trauma experience can be modulated when discussed in a language different from the mother tongue or the one in which the trauma occurred. The study aims to understand the effects of this linguistic approach on individuals' emotional and physical responses, with the potential to develop new therapeutic techniques and more effective treatments for trauma
Familial hypercholesterolemia (FH) is a hereditary condition associated with elevated cardiovascular risk, primarily due to increased LDL levels from a young age. In some cases, total cholesterol and triglycerides are also elevated. This case highlights the variable onset of FH within a family, elevated liver enzymes during statin therapy, and the need for a more aggressive treatment approach. Treatment included dose adjustments of statins and the addition of ezetimibe, with close monitoring for adverse events. Personalized management of FH is essential, balancing the need to control hyperlipidemia and reduce cardiovascular risk against potential liver enzyme elevation from statin therapy.
Acromegaly is characterized by progressive somatic deformity and systemic symptoms associated with excessive growth hormone (GH) secretion. The mean age at diagnosis of acromegaly ranges from 40 to 47 years, with a prevalence of 28–137 per million and an incidence of 2–11 new patients per year. Men and women are equally affected. Due to its slow progression and insidious nature, diagnosis is often delayed.
To determine the effects of aging, early onset obesity, and genetic predisposition on the progression of glycemic parameters, groups of congenic male lean, obese, and obese-diabetic rats (n= 5-6 rats/group) that share the same genetic trait for obesity (the -cp trait) were reared under normal laboratory conditions and feed Purina Rodent chow ad libitum throughout. Rats were subjected to measures of fasting glucose, insulin, and amylin and glycated hemoglobin and on the glycemic response to an oral glucose tolerance at 4 and 12 months of age. Obese animals weighed more than their lean littermates. Fasting plasma glucose, insulin, and amylin concentrations of obese > lean, in increased further in T2DM-prone animals, with the greatest increases in the oldest animals.
Dementia states lead to severe medical and social consequences. Most researchers consider Alzheimer's disease to be the most frequent cause of cognitive impairment in elderly people, the second place is occupied by vascular dementia. In the Republic of Belarus, vascular dementia has the largest share in the structure of morbidity of dementia of various genesis among different age groups. The aim of this study was to investigate the epidemiology of dementias in the Republic of Belarus, including dementia with Alzheimer's disease and vascular dementia, characterization of morbidity and disability due to this pathology in dynamics for the period from 2016 to 2023.
Su-al-Qinniya (Anemia) is a condition where there is a decrease in blood volume and alterations in its components, accompanied by a reduction in the number of Kurriyat-e-Hamrah (Red Blood Cells). This condition can arise from various factors, including inadequate dietary intake, low socioeconomic status, persistent illnesses, poor iron absorption, ongoing blood loss, and conditions such as bleeding peptic ulcers, inflammatory bowel disease, hookworm infestation, hemorrhoids, and heavy menstrual bleeding. Specific health situations like pregnancy and rapid growth can also trigger Iron Deficiency Anemia (IDA). In Unani literature, anemia has been described by various names such as Faqr al dam, Sū’-al-Qinniya, Qillatuddam, Kamie khoon, and Fasad’ al dam. The abnormal cold temperament of the liver is attributed to dryness and decreased blood, leading to paleness of the body. Anemia may also develop when the liver becomes functionally weak, causing alterations in temperament. This review paper outlines the etiopathogenesis, clinical presentation, various regimens, and herbal formulations used in the management of Su-al-Qinniya (Anemia).
Osteogenesis imperfecta is a systemic genetic disease of connective tissue with a prevalence of 6 to 7 per 100,000 births, affecting collagen type 1 containing tissues, especially bone tissue. Low bone mass is its main characteristic, which causes fragile bones, susceptible to deformities and recurrent fractures. Approximately 90% of individuals are heterozygous for mutations in the COL1A1 and COL1A2 genes,with a dominant inheritance pattern or sporadic mutations.
Immune thrombocytopenic purpura (ITP) during pregnancy presents significant risks for both mother and fetus, with its management being complex due to its variable etiology and treatment limitations. We report a case of a 27-year-old woman in her fifth pregnancy who, at 26 weeks gestation, exhibited severe thrombocytopenia with a platelet count of 2000 units and spontaneous bruising. Despite corticosteroid therapy, her platelet count improved only marginally, and severe fetal growth restriction was noted. Attempts with eltrombopag were ineffective, leading to the decision to terminate the pregnancy at 35 weeks due to the need for immunoglobulin, which is contraindicated in pregnancy. The infant was born alive and did well, while the mother later required readmission for recurrent thrombocytopenia, which improved with additional immunoglobulin treatment. This case underscores the challenges of managing severe ITP during pregnancy and the need for coordinated care between obstetricians and hematologists.
This case report describes a rare instance of spindle cell neoplasia in the ovaries of a 40-yearold female patient with a history of chronic pelvic pain. The patient presented with bilateral ovarian masses, identified via magnetic resonance imaging and transvaginal ultrasound, which were highly suggestive of malignancy (O-RADS 5). Histological analysis postvideolaparoscopy confirmed spindle cell neoplasia with moderate atypia and a low mitotic index, favoring a diagnosis of high-grade sarcoma in both ovaries. The patient underwent a type 1 hysterectomy, bilateral oophorectomy, and omentectomy, leading to significant postoperative pain relief. Due to the aggressive nature of the tumor, ongoing oncological follow-up was recommended. This report highlights the rarity of spindle cell tumors in the ovaries and underscores the importance of radical surgery combined with adjuvant therapies to manage the potential for recurrence and metastasis
Cancer remains one of the most challenging diseases to treat, demanding innovative approaches to combat its complexity and heterogeneity. In recent years, Pyridoxal kinase (PDXK), a critical enzyme in the vitamin B6 metabolic pathway, has emerged as a promising target in the pursuit of effective cancer therapies. PDXK, responsible for phosphorylating vitamin B6 to its active forms, plays a pivotal role in various cellular processes, including DNA synthesis, amino acid metabolism, and immune regulation. Dysregulation of PDXK expression has been implicated in cancer, contributing to tumorigenesis and progression. Recent advances in small molecule inhibitors and activators targeting PDXK have showcased their potential to alter cancer cell behavior. These molecules hold promise not only as standalone treatments but also as adjuvants to conventional therapies, augmenting their efficacy. Moreover, PDXK modulation has a profound impact on tumor metabolism. By perturbing vitamin B6 homeostasis, it disrupts the bioenergetics and redox balance within cancer cells, rendering them vulnerable to therapeutic intervention. Combining PDXK modulation with existing cancer therapies, such as chemotherapy or immunotherapy, offers the tantalizing prospect of synergistic treatment approaches, potentially enhancing therapeutic outcomes while minimizing side effects. This review explores the therapeutic potential of PDXK modulation as a novel strategy in the battle against cancer.
This review investigates the association between neoadjuvant immunotherapy and the onset of Hashimoto’s disease in patients with neoplastic conditions. With the increasing use of immunotherapy in oncology, understanding potential immune-related adverse events, particularly autoimmune thyroiditis, is crucial for optimizing patient outcomes and managing therapy-related risks. Our findings suggest a notable incidence of Hashimoto’s disease among cancer patients receiving neoadjuvant immunotherapy. The underlying mechanisms may involve immune checkpoint inhibitors disrupting immune tolerance, leading to autoimmune thyroiditis. This review highlights the need for vigilant monitoring of thyroid function in patients undergoing immunotherapy and suggests potential strategies for early detection and management of Hashimoto’s disease in this population. Further research is required to elucidate the precise mechanisms and risk factors involved, which could inform clinical guidelines and improve patient care.
Teriparatide, a recombinant human parathyroid hormone (rhPTH), is primarily used to treat osteoporosis but is also being investigated for its potential to accelerate fracture healing in athletes. This review examines the current evidence supporting Teriparatide’s efficacy in treating stress fractures in athletes. The first reported use of Teriparatide in this context was documented in a 2015 case series, where five athletes with metatarsal stress fractures experienced significant pain reduction and increased bone mineral density after six weeks of treatment. Subsequent studies, including a series involving metatarsal fractures and a randomized controlled trial with tibial fractures, have shown similar benefits, including decreased fracture size and enhanced bone density. However, despite these promising results, there is a need for more extensive research, particularly large, randomized controlled trials, to confirm these findings. A case report of a 43-year-old marathon runner demonstrated complete fracture healing and return to activity after four months of Teriparatide treatment. In conclusion, Teriparatide shows potential as a treatment to accelerate fracture healing in athletes, but further research is necessary to establish its efficacy and safety fully. Athletes considering this treatment should consult with their healthcare providers to understand the risks and benefits
Obesity is a complex metabolic disease1,2 in which several factors concur: genetics, eating habits, low physical activity, sleep abnormalities, medications3 and psychological disturbances, such as eating disorders, addictive behaviors and inattention and hyperactivity disorders. Initially it was considered an aesthetic problem, and its management was aimed at temporary weight loss through calorie restrictions and increased physical activity. After a short period of time, weight regain was observed, even with continued dietary guidelines and physical activity.
The per capita intake of fructose mostly in the form of high fructose corn syrup has increased 4- to 5-fold in recent decades. To determine the impact of dietary fructose on parameters of lipid metabolism in brown adipose tissue in T2DM rats, groups of lean and obese-T2DM rats were fed a nutritionally adequate diet consisting of 54% carbohydrate as either cooked cornstarch (CS) or equal parts CS and fructose (CSF diet) from one until 9 months of age. Measures of initial and final body weight s were recorded. At 9 months of age, measures of interscapular brown adipose tissue mass, and size, number, lipoprotein lipase activity, and lipid content determined. Data were analyzed by ANOVA. The body weights of lean and obese littermates were similar at 4 weeks of age, but the net weight gain of the obese phenotype over the 8 months of observation was twice that of their lean littermates, (p = < 0.01). The IBAT mass of obese rats >> than their lean littermates and was not affected by diet in either phenotype. The IBAT number / depot and lipid content / cell and percent lipid / IBAT depot was greater in obese than lean and was not affected by diet. The IBAT LPL activity of obese >> lean and was greater with the CSF than the CS diet in both phenotypes. In conclusion, these results indicate that the obese phenotype results in marked increases in IBAT mass and cellularity independently of diet. LPL activity of lean >> obese and was increased modestly in both phenotypes with the CSF diet. Thus, long term consumption of an isoenergetic diet high in fructose modulates LPL activity and lipid accumulation in brown adipose tissue in a rodent model of insulin resistance and NIDDM. In addition, the expression of obesity in the obese phenotype is more likely a result of the epigenetic metabolic determinants of obesity rather than the specific type of the dietary carbohydrate consumed per se.
Tsh-oma or Thyrotropinoma is a condition in which there is a pituitary adenoma that secretes TSH in an autonomous fashion, resulting in hyperthyroidism with its clinical aspects and complications. It is a very a rare condition comprising less than 0.1% of pituitary adenomas. The diagnosis and evaluation of Tsh-oma are challenging, as the clinical manifestations and the biochemical profile resemble the thyroid hormone resistance syndromes. Therefore, a high index of suspicion is required. Down syndrome is a chromosomal disease (trisomy 21) manifested in clinical, physical, and developmental impacts on affected persons. It is associated with thyroid autoimmune diseases and thyroid hypoplasia (congenital hypothyroidism) however, to our knowledge, there have been no described cases in the literature where Down syndrome was associated with a TSH-secreting pituitary adenoma. We hereby present a 34-year-old male known to have Down syndrome who was found to have a thyroid disorder (Tsh-oma) different from the known thyroid disorders linked to Down syndrome.
Primary hyperaldosteronism (PA), despite being a common disease, is grossly underdiagnosed and undertreated. Though in primary care prevalence of PA is 4–6% in patients with hypertension, it is much higher in specialized hypertensive clinics, especially in resistant hypertension (RH). PA is associated with higher morbidity rates than matched essential hypertension patients. PA is classified as unilateral and bilateral disease, with adrenalectomy considered for unilateral disease and medical management with mineralocorticoid receptor antagonists (MRA) for bilateral disease. There is gross underdiagnosis of PA across the world with very limited literature on PA from India. We wanted to retrospectively evaluate the profile of patients diagnosed with PA from case records, in outpatient settings in a tertiary care hospital. Primary outcomes of the study will be to evaluate the presenting features of PA patients. This includes clinical, biochemical, radiological aspects in different subgroups like unilateral vs bilateral disease, diabetes/ prediabetes vs non-diabetes, and chronic kidney disease (CKD) vs no significant CKD. We also want to evaluate the treatment preferences (both surgical and medical) and follow-up data (for treatment outcomes / effectiveness if relevant records were available). Our main objective is to highlight the current state of PA presentation and management so that we can develop a pragmatic diagnostic approach to improve screening, case detection and empiric management of PA.
This mini-review describes interactions of hormonal stress mediators and some age-related disorders in a chronobiological mode. In addition, historical aspects of chronobiology, as well as biorhythmological topics related to development and aging are briefly discussed.
This work is focused on describing the most important characteristics of primary hyperparathyroidism and the bone involvement that this pathology produces, based on a clinical case of a patient attended at the Hospital de Clínicas (UDELAR) - Montevideo-Uruguay. Brown tumors (PT) are a rare abnormality of bone tissue caused by chronic hypersecretion of parathyroid hormone (PTH), the pathophysiology of which will be discussed throughout the text. They manifest clinically as tumors, which is of paramount importance since it is necessary to evaluate differential diagnoses. It frequently develops in long bones, which explains its topographic variability. The treatment of these lesions depends fundamentally on the control of hyperparathyroidism and the location of the tumor. Most of them remit when PTH levels are normalized.
