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Romosuzumab used to treat a 29-year-old patient with anorexia nervosa related osteoporosis - A case report.

Osteoporosis and decreased bone density is a frequent complication of anorexia nervosa (AN). As of yet, there have been no studies of accomplished treatment of AN-related osteoporosis with romosuzumab, a monoclonal antibody to sclerostin. We report the first case of a premenopausal, 29-year old patient in Switzerland with decreased bone density and osteoporotic fractures due to anorexia nervosa, who completed the treatment with romosuzumab. There was a significant increase in bone mineral density (BMD) after 12 months of therapy. No serious side effects were reported. To date, only bisphosphon

Diffuse and Prolonged Bone Pain Revealing Tumor-Induced Osteomalacia: A Case Report.

Tumor-induced osteomalacia should be considered in patients with unexplained bone pain and fractures. Advanced imaging, such as Ga68-DOTATATE PET/CT, enables precise tumor localization, and surgical excision can rapidly normalize phosphate metabolism and resolve symptoms, underscoring the importance of early diagnosis and intervention.

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… Subclinical Cushing syndrome was ruled out by a low‐dose dexamethasone suppression test (morning serum cortisol 1.3 μg/dL; normal: < 1.8) after 1 mg dexamethasone at 11:00 PM. Findings were consistent with an adrenal incidentaloma (Figure 7 ). FIGURE 7 Ga68‐DOTATATE‐PET/CT SCAN. …

The Impact of Educational Interventions on Osteoporosis Knowledge among Korean Osteoporosis Patients.

BACKGROUND: The purpose of this study was to determine the impact of an educational intervention that includes information sharing about absolute fracture risk on the knowledge of osteoporosis and modifiable risk factors among Korean patients with osteoporosis. METHODS: Adults aged >50 years who visited the outpatient clinic for osteoporosis were recruited. Subjects with trauma-related fractures or pathological fractures were excluded. The anthropometric data and clinical risk factors for fracture were collected at baseline. The participants completed the survey questionnaire that measured th

Post-Transplant Cyclophosphamide and Tacrolimus-Mycophenolate Mofetil Combination Governs GVHD and Immunosuppression Need, Reducing Late Toxicities in Allogeneic Peripheral Blood Hematopoietic Cell Transplantation from HLA-Matched Donors.

Combined direct antineoplastic activity and the long-lasting immunological effects of allogeneic hematopoietic cell transplant (HCT) can cure many hematological malignancies, but broad adoption requires non-relapse mortality (NRM) rates and graft-versus-host disease (GVHD) control. Recently, posttransplant cyclophosphamide (PTCy) given after a bone marrow transplant significantly reduced GVHD-incidence, while PTCy given with tacrolimus/mofetil mycophenolate (T/MMF) showed activity following allogeneic peripheral blood stem cell transplantation (alloPBSCT). Here, we report the experience of a l

Potentially fatal complications of new systemic anticancer therapies: pearls and pitfalls in their initial management.

BackgroundVarious types of immunotherapy (i.e. immune checkpoint inhibitors [ICIs], chimeric antigen receptor [CAR] T-cells and bispecific T-cell engagers [BiTEs]) and antibody drug conjugates (ADCs) have been used increasingly to treat solid cancers, lymphomas and leukaemias. Patients with serious complications of these therapies can be presented to physicians of different specialties. In this narrative review we discuss potentially fatal complications of new systemic anticancer therapies and some practical considerations for their diagnosis and initial treatment.ResultsClinical presentation

Involvement of Pruritus, Gut Dysbiosis and Histamine-Producing Bacteria in Paraneoplastic Syndromes.

Background/Objectives: Paraneoplastic syndromes (PNS), characterized by a large diversity of symptoms, may sometimes be the first clinical feature of a severe underlying disorder such as cancer. Methods: We report the case of a middle-aged male patient with no significant previous medical history, a nonsmoker or alcohol heavy drinker, complaining about generalized, recently onset itch. Given no reasonable explanation of pruritus after dermatological consultation and the unsatisfactory response to treatment, the patient was referred to gastroenterology with the suspicion of a cholestatic liver

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… Function of the histology of the lung tumor, the most often reported PNS are the endocrine syndromes such as inappropriate antidiuretic hormone secretion, Cushing syndrome due to ectopic adrenocorticotropic hormone, humoral hypercalcemia, as well as clubbing and hypertrophic pulmonary osteoarthropathy …

Clinical approaches to osteoporosis in patients with chronic kidney disease: A comprehensive review.

Chronic kidney disease (CKD) induces secondary osteoporosis, characterized by an imbalance between bone formation and resorption due to kidney dysfunction; the result is a reduction in both bone mineral density and quality. This condition is compounded by disruption of bone metabolic turnover, abnormalities in bone microstructure and collagen cross-linking, and compromised bone quality, all of which contribute to increased bone fragility. Reduced kidney function is complicated by secondary hyperparathyroidism, which exacerbates bone fragility. Managing osteoporosis in patients with CKD is chal

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… Table 1 Causes of secondary osteoporosis Endocrine disorders | Hyperthyroidism, primary hyperparathyroidism, secondary hyperparathyroidism (uremic and others), Cushing syndrome, Cushing disease, hypogonadism, Type 1 diabetes. …

The Relationship Between Obesity and Cancer: Epidemiology, Pathophysiology, and the Effect of Obesity Treatment on Cancer.

There is growing evidence relating to the risk of cancer in people with obesity. Obesity is already established as one of the strongest predisposing factors to cancer, and 'obesity-related' cancers have been defined in previous studies. In this review article, we examine the epidemiological relationship and describe the potential pathophysiological mechanisms that underpin the association between obesity and cancer. These include hormonal and growth factors that are in abundance in persons living with obesity and thereby increase cancer risk. Additionally, the increased disposition towards chr

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… Patients with paraneoplastic Cushing’s syndrome, for example, may present with weight gain as a key manifestation [ 105 ]. Furthermore, insulinomas (including metastatic insulinomas) may include weight gain as a key symptom that is reported by patients [ 106 ]. … Case-series of paraneoplastic Cushing syndrome in small-cell lung cancer. Endocrinol. Diabetes Metab. Case Rep. 2018;18:0004. doi: 10.1530/EDM-18-0004. 106. Service F., Dale A., Elveback L., Jiang N. Insulinoma: Clinical and diagnostic features of 60 consecutive cases. Mayo Clin. …

Мультикорректный перекрестный анализ показывает механизмы заболеваний и лечебные цели HTLV-1-associated Миэлопатия, забытое нейро-воспалительное расстройство.

HTLV-1 это загадочный ретровирус, вызывающий изнурительное нервно-воспалительное заболевание, HTLV-1-associated Миэлопатия (HAM) с неизвестным патогенезом. Обе HTLV-1 Инфекция и ХАМ затрагивают главным образом женщин и небелые группы населения, которым не уделяется должного внимания. HAM не имеет лечения, которое могло бы привести к изменению болезней, поскольку нынешнее лечение в основном является симптоматическим и вдохновляет либо HIV-1 или множественные терапевтические стратегии склероза. Мы использовали системный биологический анализ новых и общедоступных данных, включая (эпи)геномику, тр

Effects of glucocorticoid replacement therapy in patients with pituitary disease: A new perspective for personalized replacement therapy.

Secondary adrenal insufficiency (SAI) is an endocrine disorder due to impaired secretion of ACTH resulting from any disease affecting the pituitary gland. Glucocorticoid replacement therapy is mandatory to ensure patient survival, haemodynamic stability, and quality of life. In fact, a correct dose adjustement is mandatory due to the fact that inappropriately low doses expose patients to hypoadrenal crisis, while inappropriately high doses contribute to glucose metabolic and cardiovascular deterioration. This review analyses the current evidence from available publications on the epidemiology

Effect of Baduanjin exercise on primary osteoporosis: study protocol for randomized controlled trial.

BackgroundLack of exercise is often a major cause of chronic disease. Osteoporosis (OP) is a chronic disease with multifactorial co-morbidity. Baduanjin (BDJ) exercise may be a powerful tool for modifying risk factors. The aim is to provide more evidence about the effectiveness of BDJ exercise in improving pain and balance ability in patients with OP.MethodsIn the prospective randomized controlled trial, 160 participants will be recruited and randomized to the treatment group (BDJ exercise combined with Calcium carbonate and D3) or the control group (Calcium carbonate and D3) at 1:1 ratio. Par

Acromegaly complications: an update.

CONTEXT: Appropriate diagnosis and treatment of comorbidities is key to managing acromegaly given their adverse clinical impact on quality of life and survival; thus, it is important to increase overall awareness of complications and their individualized management. EVIDENCE: This review examines the current literature on pathophysiology, diagnosis, and clinical presentation of acromegaly complications, as well as impact of acromegaly therapy and current goals for treatment outcomes of these morbidities. CONCLUSION: We focus on the most relevant acromegaly comorbidities including cardiorespi

Magnetic Resonance Imaging in 50 Captive Non-domestic Felids - Technique and Imaging Diagnoses.

Magnetic resonance imaging (MRI) is the recognized gold standard for diagnostic imaging of the central nervous system in human and veterinary patients. Information on the use of this modality and possible imaging abnormalities in captive non-domestic felids is currently limited to individual case reports or small case series. This retrospective study provides information on technique and imaging findings in a cohort of cases undergoing MRI at an academic Veterinary Medical Center. The University of Tennessee College of Veterinary Medicine MRI database was searched for non-domestic felids under

Current drugs for HIV-1: from challenges to potential in HIV/AIDS.

The human immunodeficiency virus (HIV) persists in latently infected CD4+T cells and integrates with the host genome until cell death. Acquired immunodeficiency syndrome (AIDS) is associated with HIV-1. Possibly, treating HIV/AIDS is an essential but challenging clinical goal. This review provides a detailed account of the types and mechanisms of monotherapy and combination therapy against HIV-1 and describes nanoparticle and hydrogel delivery systems. In particular, the recently developed capsid inhibitor (Lenacapavir) and the Ainuovirine/tenofovir disoproxil fumarate/lamivudine combination (

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… Salmeterol, a beta-2-adrenergic drug used to treat asthma, in combination with an anti-HIV-1 drug may cause patients to develop Cushing's syndrome. … Cushing syndrome in a HIV patient using inhaled steroids. Report of one case . Rev. Med. Chil. 144 ( 7 ), 931 – 936 . 10.4067/S0034-98872016000700016 27661558 Gallant J. Moyle G. Berenguer J. Shalit P. Cao H. Liu Y. P. ( 2017 ). …

Review of Hematology-Oncology Emergencies for Internal Medicine Residents.

The prevalence of cancer continues to grow globally every year. With therapeutic advances over the recent decades, the prevalence of individuals living with cancer continues to increase. Internal medicine residents can see patients admitted to the hospital for cancer-related emergencies. Early identification and appropriate management of these emergencies have been shown to improve mortality and morbidity. In this article, we aim to review the recent updates in the management of commonly encountered oncologic emergencies in the practice of internal medicine residents. This review will cover sp

Toxicities of CAR T-cell therapy: a review of current literature.

The chimeric antigen receptor (CAR) design, first invented by Zelig Eshhar, paved the way for the use of genetically modified T-cells in targeted therapy against cancer cells. Since then, it has gone through many generations, especially with the integration of co-stimulation in the second and third-generation CARs. However, it also mounts a hyperactive immune response named as cytokine release syndrome with the release of several cytokines eventually resulting in multiple end-organ toxicities. The severity of cytokine release syndrome depends upon certain factors such as the tumor burden, choi

CNS Toxicity of Immunotherapy.

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Fighting the Host Reaction to SARS-COv-2 in Critically Ill Patients: The Possible Contribution of Off-Label Drugs.

The severe acute respiratory syndrome coronavirus 2 (SARS-COv-2) is the etiologic agent of the 2019 coronavirus disease (COVID19). The majority of infected people presents flu like symptoms and among them 15-20% develops a severe interstitial pneumonitis (IP) that may eventually evolve in acute respiratory distress syndrome (ARDS). IP is caused by the viral glycoprotein spike (S) binding to the angiotensin converting enzyme 2 (ACE2) expressed on the surface of alveolar pneumocytes. The virus is recognized by the "pattern recognition receptors" (PRR) of the immune cells that release cytokines a

Whole genome sequencing in adults with clinical hallmarks of hypophosphatasia negative for ALPL variants.

BackgroundHypophosphatasia (HPP) is a rare disease caused by deficient activity of tissue-nonspecific alkaline phosphatase (ALP), encoded by the ALPL gene. The primary objective was to explore novel ALPL variants by whole genome sequencing (WGS) in patients with HPP who previously tested negative by standard methods for ALPL variants. The secondary objective was to search for genes beyond ALPL that may reduce ALP activity or contribute to HPP symptoms.Methods and resultsWGS was performed in 16 patients clinically diagnosed with HPP who had ALP activity below the normal range and tested negativ

Complete spectrum of adverse events associated with chimeric antigen receptor (CAR)-T cell therapies.

Chimeric antigen receptor (CAR)-T cell therapies have been approved by FDA to treat relapsed or refractory hematological malignancies. However, the adverse effects of CAR-T cell therapies are complex and can be challenging to diagnose and treat. In this review, we summarize the major adverse events, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and CAR T-cell associated HLH (carHLH), and discuss their pathophysiology, symptoms, grading, and diagnosis systems, as well as management. In a future outlook, we also provide an overview of