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Unpacking adiposity: a narrative critical appraisal of diverse obesity definitions.

BACKGROUND: Obesity is a complex, multifaceted chronic disease that poses a major global health challenge. Traditionally, population-level screening and follow-up have relied heavily on body mass index (BMI). Although BMI provides a simple, standardized measure for epidemiological studies, it does not account for individual variations in muscle mass, fat distribution, or metabolic health. Consequently, relying solely on weight-to-height ratios-even when supplemented with waist circumference, waist-to-hip ratio, or waist-to-height ratio-limits precise individual diagnosis and comprehensive heal

Adoptive Cell Therapies: Keeping Pace With New and Emerging Advances.

At JADPRO Live 2019, Patricia Mangan, RN, MSN, CRNP, and Edward Stadtmauer, MD, discussed the emerging world of chimeric antigen receptor (CAR) T-cell therapy, including the CAR T-cell process, approved indications and studies in hematologic malignancies, strategies for monitoring and managing emerging toxicities, and future directions in the use of this novel therapy.

A 57-Year-Old Female Presenting With Cardiopulmonary Arrest Secondary to Severe Hypokalemia From a Fanconi-Like Syndrome: A Case Report.

Fanconi syndrome is a multi-factorial disorder that involves diffuse malfunction of the proximal convoluted tubule in the kidney. Renal wasting of potassium, glucose, bicarbonate, amino acids, and phosphorus characterize the condition. We report a case of a 57-year-old female who presented to our emergency department with cardiopulmonary arrest. After successful resuscitation, she had extensive workup to uncover the cause of her cardiac arrest. She had extensive negative workup but was found to have severely low potassium, prompting further evaluation. She was noted to have elevated urine pota

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… An 8 am cortisol level should be measured to exclude Cushing syndrome [ 8 - 10 ]. A notable percentage of people with AIDS present with hypokalemia, thus HIV testing may also be warranted [ 8 - 10 ]. …

Расследование случайной или причинно-следственной связи церебрального венозного тромбоза и миэлина олигодендроцита гликопротеина противомоскитного заболевания: доклад о деле и обзор литературы.

Myelin oligodendrocyte glycoprotein-сопутствующая антителу болезнь (MOGAD) — синдром демиелинирования центральной нервной системы (DS), обычно содержащий оптический неуриит или миелит. Связь между церебральным венозным тромбозом (CVT) и демиелинизирующими заболеваниями, включая множественный склероз (MS), является редкой. В настоящем исследовании 37-летний мужчина столкнулся с сенсорными нарушениями нижних конечностей и недержанием мочевого мозга в соответствии с миелитом. Диагностика MOGAD была подтверждена результатами наблюдений спинного магнитного резонанса и сывороткой антиМОГ с помощью к

Воздействие лирагулитида на инсулиновую аллергию у пациента с глюкокортикоидным диабетом и множественным склерозом.

Глюкокортикоидное применение может вызвать вторичный диабет или усугубить гипергликемию у пациентов с сахарным диабетом (DM). Лираглютид - это глюкагон. peptide-1 (В тыс.GLP-1) рецептор агонист, используемый для лечения пациентов с типом 2 диабет. В нескольких сообщениях лирагулитид упоминается в качестве средства лечения ДМ, вызванного стероидами (SIDM). Здесь мы сообщаем о пациенте с SIDM и множественным склерозом, для которого переход на лирагулитид в сочетании с метформиновой терапией повысил уровень глюкозы и улучшил симптомы инсулиновой аллергии. Лираглютид может быть полезен для лечения

Turning Points in Cross-Disciplinary Perspective of Primary Hyperparathyroidism and Pancreas Involvements: Hypercalcemia-Induced Pancreatitis, MEN1 Gene-Related Tumors, and Insulin Resistance.

We aimed to provide an in-depth analysis with respect to three turning points in pancreas involvement in primary hyperparathyroidism (PHP): hypercalcemia-induced pancreatitis (HCa-P), MEN1 (multiple endocrine neoplasia)-related neuroendocrine tumors (NETs), and insulin resistance (IR). This was a comprehensive review conducted via a PubMed search between January 2020 and January 2024. HCa-P (n = 9 studies, N = 1375) involved as a starting point parathyroid NETs (n = 7) or pancreatitis (n = 2, N = 167). Case report-focused analysis (N = 27) showed five cases of pregnancy PHP-HCa-P and three rep

Immunodeficiencies in Adults: Key Considerations for Diagnosis and Management.

Immunodeficiencies in adults are increasingly recognized yet often remain underdiagnosed, leading to significant morbidity from recurrent infections, autoimmunity, and malignancy. Both primary immunodeficiencies (PIDs), now known as inborn errors of immunity (IEI), and secondary immunodeficiencies (SIDs) contribute to immune dysfunction in adults. Although SIDs are more common in adults due to factors like medications, malignancies, metabolic disorders, chronic conditions, and protein-losing conditions, IEI-particularly common variable immunodeficiency (CVID)-can also manifest in adulthood wit

Rethinking corticosteroids use in oncology.

Corticosteroids (CSs), widely used in oncology for their anti-inflammatory and immunosuppressive properties, help manage cancer-related symptoms and side effects. However, their long-term use may negatively affect patient survival and exacerbate tumor progression. Elevated glucose and glutamine metabolism, disruption of vitamin D levels, and alterations in the microbiome are some of the key factors contributing to these adverse outcomes. Approaches such as ketogenic diets, fasting, sartans, and vitamin D supplementation have shown promise in providing similar benefits to CSs while mitigating t

Kidney failure in the course of focal segmental glomerulonephritis in a patient after alloHSCT - a case study and review of the literature.

Nephrotic syndrome is a rare complication of allogeneic haematopoietic stem cell transplantation (alloHSCT). Its pathogenesis is not fully understood. Membranous nephropathy and minimal change disease are the most common causes of nephrotic syndrome. Nephrotic syndrome occurs more frequently in people with chronic graft-versus-host disease (GvHD). Glucocorticosteroids and cyclosporine are the most common treatments, but their use is associated with the risk of side effects and variable responses. We present a case of a patient after alloHSCT with advanced GvHD who developed nephrotic syndrome

Recognition and management of persistent chylomicronemia: A joint expert clinical consensus by the National Lipid Association and the American Society for Preventive Cardiology.

Extreme hypertriglyceridemia, defined as triglyceride (TG) levels ≥1000 mg/dL, is almost always indicative of chylomicronemia. The current diagnostic approach categorizes individuals with chylomicronemia into familial chylomicronemia syndrome (FCS; prevalence 1-10 per million), caused by the biallelic combination of pathogenic variants that impair the lipolytic action of lipoprotein lipase (LPL), or multifactorial chylomicronemia syndrome (MCS, 1 in 500). A pragmatic framework should emphasize the severity of the phenotype and the risk of complications. Therefore, we endorse the term "persiste

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… Table 2 Categories Examples Hormonal changes Pregnancy, poorly controlled diabetes, central obesity with insulin resistance and metabolic syndrome, hypothyroidism, acromegaly, Cushing syndrome, Lifestyle factors Ethanol consumption, high-fat diet, carbohydrate-rich diet, high fructose intake, sedentary … Categories | Examples Hormonal changes | Pregnancy, poorly controlled diabetes, central obesity with insulin resistance and metabolic syndrome, hypothyroidism, acromegaly, Cushing syndrome, Lifestyle factors | Ethanol consumption, high-fat diet, carbohydrate-rich diet, high fructose intake, sedentary …

Therapeutic efficacy of azathioprine in addition to prednisone-based regimens as first-line chronic graft-versus-host disease treatment.

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Image-Guided Percutaneous Ablation for Primary and Metastatic Tumors.

Image-guided percutaneous ablation methods have been further developed during the recent two decades and have transformed the minimally invasive and precision features of treatment options targeting primary and metastatic tumors. They work by percutaneously introducing applicators to precisely destroy a tumor and offer much lower risks than conventional methods. There are usually shorter recovery periods, less bleeding, and more preservation of organ parenchyma, expanding the treatment options of patients with cancer who may not be eligible for resection. Image-guided ablation techniques are c

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… syndrome who were not surgical candidates [ 126 ]. … RFA has also shown to be promising in patients with severe adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome for which bilateral adrenalectomy is not a suitable option [ 123 , 127 ]. …

Skin manifestations associated with systemic diseases - Part II.

The skin, by reflecting internal processes, externalizes what happens inside the body in many diseases. Thus, the skin, as an organ, extrapolates its functions of protection, barrier and signals the existence of systemic diseases, expanding the importance of the dermatologist beyond the skin surface. Thus, the dermatologist investigates diagnostic hypotheses for conditions related to all systems and refers patients to the appropriate specialty. Combined with examination by a trained eye, the skin, due to its easy access, is still the ideal place for performing biopsies, which often clarify the

Potential Adverse Effects of Dexamethasone Therapy on COVID-19 Patients: Review and Recommendations.

In the context of the coronavirus disease 2019 (COVID-19) pandemic, the global healthcare community has raced to find effective therapeutic agents against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To date, dexamethasone is the first and an important therapeutic to significantly reduce the risk of death in COVID-19 patients with severe disease. Due to powerful anti-inflammatory and immunosuppressive effects, dexamethasone could attenuate SARS-CoV-2-induced uncontrolled cytokine storm, severe acute respiratory distress syndrome and lung injury. Nevertheless, dexamethasone tre

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… Moreover, short-term or protracted dexamethasone therapy might contribute to other potential side effects, such as neuromuscular weakness, psychiatric symptoms and even iatrogenic Cushing syndrome [ 38 – 40 ]. … Hughes JM Hichens M Booze GW Thorner MO Cushing's syndrome from the therapeutic use of intramuscular dexamethasone acetate Arch Intern Med 1986 146 1848 1849 3753129 41. …

Аутоиммунные заболевания у пациентов с различными фенотипами ПХОС.

Полицистический синдром яичников (ПХОС) представляет собой общее разнородное состояние, характеризующееся репродуктивными расстройствами и значительным метаболизмом и другими сопутствующими факторами. Тем не менее взаимосвязь между аутоиммунными расстройствами и ПХОС до сих пор не прояснена. Поэтому цель настоящего исследования состоит в том, чтобы изучить спектр системных и аутоиммунных расстройств органов у большой группы пациентов, страдающих ПХОС, и изучить возможные взаимосвязи между различными фенотипами ПХОС и способностью к аутоиммунным расстройствам. МЕТОДЫ: Всего 1,249 :: женщины с П

International Recommendations for Screening and Preventative Practices for Long-Term Survivors of Transplantation and Cellular Therapy: A 2023 Update.

As hematopoietic cell transplantation (HCT) and cellular therapy expand to new indications and international access improves, the number of HCTs performed annually continues to rise. Parallel improvements in HCT techniques and supportive care entails more patients surviving long term, creating further emphasis on survivorship needs. Survivors are at risk for developing late complications secondary to pretransplantation, peritransplantation, and post-transplantation exposures and other underlying risk factors. Guidelines for screening and preventive practices for HCT survivors were originally p

Management of chimeric antigen receptor T (CAR-T) cell-associated toxicities.

The use of chimeric antigen receptor T (CAR-T) cells is a significant therapeutic improvement increasing the prognosis for patients with a variety of hematological malignancies. However, this therapy has also sometimes life-threatening, complications. Therefore, knowledge of the treatment and management of these complications, especially in treatment centers and intensive care units, respectively, is of outstanding importance. This review provides recommendations for the diagnosis, management, and treatment of CAR-T cell-associated complications such as cytokine release syndrome, immune effect

Sporadic late onset nemaline myopathy with monoclonal gammopathy of undetermined significance: two cases with long term stability.

Monoclonal gammopathy of undetermined significance (MGUS) associated to sporadic late onset nemaline myopathy (SLONM) is a rare and severely disabling condition of quickly progressive limb girdle acquired myopathy. It is believed by some authors to be due to myotoxicity of light chain deposits. Two female patients were diagnosed with MGUS associated SLONM. In the first case, diagnosis was delayed by 6 years thus giving time for a severe generalized myopathy and cardiomyopathy to develop. A single anti-myeloma chemotherapy with lenalidomide markedly improved and stabilized the patient's conditi

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… However, dexamethasone had to be stopped in 2017 due to iatrogenic Cushing syndrome and lenalidomide was discontinued as well one year later. …

Diagnosis, treatment, and follow-up of patients with hypophosphatasia.

INTRODUCTION: Hypophosphatasia is a rare inherited systemic metabolic disorder, with an estimated prevalence in the severe forms of the disease of 1/100.000-1/300.000, that affects the typical architecture of bone, leading to defective mineralization during growth and remodeling. It is characterized by loss-of-function variants in the ALPL gene, resulting in low activity of tissue-nonspecific alkaline phosphatase. In severe cases, it can be fatal. OBJECTIVE: To generate recommendations on the diagnosis, treatment, and follow-up of patients with hypophosphatasia based on available evidence. M

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… Msleny joint disease Benign familial hypophosphatasemia Temporary low Endocrine conditions Cushing syndrome Hypothyroidism Metabolic bone disease Osteogenesis imperfecta, type II Adynamic bone disease Hematological conditions Massive transfusion Perniseous or profound Anemia Multiple myeloma Diet related … Msleny joint disease | Benign familial hypophosphatasemia Temporary low Endocrine conditions Cushing syndrome | Hypothyroidism Metabolic bone disease Osteogenesis imperfecta, type II | Adynamic bone disease Hematological conditions Massive transfusion | Perniseous or profound Anemia Multiple myeloma …

Pituitary metastasis: a clinical overview.

The pituitary gland is an unusual site for metastatic spread and has been associated with a poor prognosis. Clinical presentation is variable but can include visual field defects, cranial nerve palsies, anterior pituitary dysfunction and/ or diabetes insipidus. Management options include surgery or radiotherapy, chemotherapy/immunotherapy or a conservative approach. The pituitary should not be overlooked as a site for metastasis in patients with known cancer and can be the first presentation of neoplastic disease in some patients. Given that patients are now living longer with cancer, clinicia