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Educational Case: Atypical presentation of primary hyperparathyroidism with brown tumor.

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Unraveling the Potential of SGK1 in Osteoporosis: From Molecular Mechanisms to Therapeutic Targets.

Osteoporosis (OP) is a prevalent metabolic bone disease, with several million cases of fractures resulting from osteoporosis worldwide each year. This phenomenon contributes to a substantial increase in direct medical expenditures and poses a considerable socioeconomic burden. Despite its prevalence, our understanding of the underlying mechanisms remains limited. Recent studies have demonstrated the involvement of serum glucocorticoid-regulated protein kinase 1 (SGK1) in multiple signaling pathways that regulate bone metabolism and its significant role in the development of osteoporosis. There

A case of hypercalcemia with double pathology.

Hypercalcemia has many causes including primary hyperparathyroidism, malignancy, and other rare etiologies. In most of the cases, hypercalcemia is secondary to one etiology. In this case, we are reporting hypercalcemia with two causes. The initial workup showed primary hyperparathyroidism due to parathyroid adenoma. But because all features were not fully explained by primary hyperparathyroidism, further work-up revealed multiple myeloma. This case represents coexistence of two different diseases, which was rarely reported in the literature previously. Usually, the co-diagnosis was made subseq

Hyperammonemia: An Unusual Cause of Encephalopathy in Multiple Myeloma.

Multiple myeloma (MM) is a malignancy of plasma cells that commonly presents with kidney dysfunction, hypercalcemia, bone pain, and anemia. Although many patients exhibit these symptoms, other, less obvious presentations can complicate the prognosis. In this case report, we describe a 65-year-old African American female with known IgG Kappa MM, who initially presented with back pain - a common symptom associated with bone involvement in MM. However, during her hospital stay, she developed a profoundly altered mental status, which was later linked to elevated ammonia levels. Hyperammonemia is a

Запоздалая тироидная резистентность к Ормоне после полной тиреоктомии от рака папиллы тироида.

Сопротивление тироидному гормону (РТГ) — это редкое расстройство, характеризующееся ограниченной реакцией клеток на гормоны щитовидной железы, приводящее к дисфункциям в работе щитовидной железы и различным клиническим проявлениям. Мы представляем случай 43-летней кубино-американской пациентки, которая испытывала головокружение, вертиго, неоднократные падения и серьёзную головную боль после небольшого падения. Дополнительные симптомы включали тошноту, рвоту, фотофобию, холодную нетерпимость, общие боли тела и усталость. Ее медицинская история имела большое значение для общей щитовидной эктомии

Infection related membranoproliferative glomerulonephritis secondary to anaplasmosis: A case report.

BACKGROUND: Anaplasmosis is a tick-borne disease with a range of clinical manifestations, from a flu-like illness with fever and myalgias to a severe systemic disease with multisystem organ failure. Although renal involvement is not a common presentation, there have been few cases reporting acute kidney injury from Anaplasmosis. CASE SUMMARY: We present a 55-year-old female with anaplasmosis who developed acute kidney injury due to membranoproliferative glomerulonephritis (MPGN). The patient originally presented with cough and shortness of breath. She was admitted to the hospital with a diagn

Acute respiratory failure as initial manifestation of conventional osteosarcoma rich in giant cells: a case report.

BACKGROUND: Osteosarcoma is a malignant tumor of the bone. The giant cell-rich osteosarcoma (GCRO) is a rare histological variant of the conventional osteosarcoma, accounting for 3% of all osteosarcomas. It has a variable clinical presentation, ranging from asymptomatic to multiple pathological fractures, mainly involving long bones, and less frequently the axial skeleton and soft tissues. CASE PRESENTATION: We present the case of a 25-year-old Hispanic woman, previously healthy, with a 1-month history of dyspnea on exertion, intermittent dry cough, hyporexia, and intermittent unquantified fe

Deep Learning-Based 30-Day Mortality Prediction in Critically Ill Bone and Bone Marrow Metastasis Patients: A Multicenter Retrospective Cohort Study.

Bone and bone marrow Metastasis (BBM) are life-threatening complications of advanced malignancies, frequently requiring intensive care and associated with high short-term mortality. However, prognostic tools specifically tailored to critically ill BBM patients are limited. This multicenter cohort study aimed to develop and validate deep learning models for predicting 30-day mortality using ICU data from MIMIC-IV, eICU-CRD, and the First Affiliated Hospital of Xinjiang Medical University. After univariate screening, XGBoost-Boruta and Lasso regression identified 11 key clinical features within

Обобщение и оценка 6-ариламинобензамидов в качестве позитронных фотографических лигандов для рецептора фингозина-1-фосфата-5.

Спингосин-1-фосфат-5 (S1P5) является одним из пяти мембранных белковых рецепторов G, которые активируются лизофосфолипидом, фосфатом-1, что приводит к регулированию многих клеточных процессов. Рецепторы S1P5 расположены на олигодендроцитах и предлагаются для оказания влияния на физиологию олигодендроцитов. Понимание модуляции S1P5 в ходе таких процессов, как ремиелионация, может иметь потенциальные возможности для демиелионизации расстройств CNS, таких, как множественный склероз (MS). В этой связи мы сообщаем об обобщении и предварительной оценке серии фторированных 6-ариламинобензамидов в кач

Стрессивая симметрия: паралич двустороннего Белла, потенциально вызванный экстремальным стрессом.

Лица с нервыми (FNP) идиопатического происхождения обычно называются параличом Белла. Двусторонний ФНП представляет собой исключительно редкую подгруппу всех дел, связанных с параличом Белла. Она может проявляться либо синхронно, либо последовательно, с одной стороны, с другой стороны, с последующим участием противоположной стороны в течение первых 30 дней с момента возникновения симптома. Обычные этиологии ФНП охватывают такие инфекции, как инфекционный мононуклеоз, грипп, болезнь лайма и менингит. Неинфекционные причины включают в себя новообразования, множественный склероз и синдром Гильен-

Calcitriol Unleashed: A Rare Culprit in Hypercalcemia Associated With Rare Primary Pancreatic Lymphoma - A Case Report.

Hypercalcemia of Malignancy is a complicated condition often linked to parathyroid hormone, parathyroid hormone-related peptide, or bone metastasis. This report presents a unique case of calcitriol-mediated hypercalcemia in an 89-year-old female with primary pancreatic lymphoma, highlighting the rarity and complexity of this presentation. Initially, the patient's condition was thought to be related to sarcoidosis, but the recurrence of hypercalcemia led to the discovery of pancreatic B-cell lymphoma as the underlying cause. It also emphasizes the need to explore new treatment options. Interest

Accidental Ixazomib Overdose in a Patient With Multiple Myeloma.

Multiple myeloma is the second most common hematological malignancy. Ixazomib is the first oral proteasome inhibitor approved in the United States for the management of multiple myeloma who have received at least one prior treatment. The availability of oral chemotherapeutic agents for the management of multiple myeloma has made it easier for patients who do not have to come to the hospital for chemotherapy infusions. However, many barriers are associated with oral chemotherapy, and one of them is a misinterpretation of instruction which can have deleterious effects. In this case report, we pr

Repurposing Drugs for Acute Myeloid Leukemia: A Worthy Cause or a Futile Pursuit?

Acute myeloid leukemia (AML) is a clinically and genetically heterogenous malignancy of myeloid progenitor cells that affects patients of all ages. Despite decades of research and improvement in overall outcomes, standard therapy remains ineffective for certain subtypes of AML. Current treatment is intensive and leads to a number of secondary effects with varying results by patient population. Due to the high cost of discovery and an unmet need for new targeted therapies that are well tolerated, alternative drug development strategies have become increasingly attractive. Repurposing existing d

Association between advanced lung cancer inflammation index levels and ischemic stroke in patients with atrial fibrillation: a propensity score-matching analysis.

IntroductionInflammation is closely associated with atrial fibrillation (AF) complicated by stroke. The Advanced Lung Cancer Index (ALI) is a comprehensive indicator of inflammation; however, its relationship with AF-related stroke is unclear. Therefore, this retrospective study was conducted to explore the correlation between ALI and ischemic stroke in patients with AF.MethodsPatients were divided into two groups according to the optimal cutoff value of ALI: low ALI and high ALI groups. The primary outcome was ischemic stroke in patients with AF. To ensure robustness of the findings, propensi

Management of patients with an electrical storm or clustered ventricular arrhythmias: a clinical consensus statement of the European Heart Rhythm Association of the ESC-endorsed by the Asia-Pacific Heart Rhythm Society, Heart Rhythm Society, and Latin-American Heart Rhythm Society.

Electrical storm (ES) is a state of electrical instability, manifesting as recurrent ventricular arrhythmias (VAs) over a short period of time (three or more episodes of sustained VA within 24 h, separated by at least 5 min, requiring termination by an intervention). The clinical presentation can vary, but ES is usually a cardiac emergency. Electrical storm mainly affects patients with structural or primary electrical heart disease, often with an implantable cardioverter-defibrillator (ICD). Management of ES requires a multi-faceted approach and the involvement of multi-disciplinary teams, but

Совпадение в полном тексте источника
… medications (potassium-sparing diuretics, ACE inhibitors, ARBs, heparin), hypoaldosteronism Transcellular shifts: insulin deficiency, acidosis, medications (BBs, digoxin toxicity) Pseudo-hyperkalaemia: haemolysis, leucocytosis (>75 000 cells per mm 3 ), erythrocytosis, thrombocytosis Management | Oral potassium … chloride: 40–100 mmol i.v. 20–40 mmol/L potassium chloride in 500 mL of saline (not exceed 20 mmol/h; higher rates in emergency situation via central venous catheter) | Potassium <6 mEq/L: stop potassium-elevating drugs, 15–30 g sodium polystyrene sulfonate orally or rectally Potassium >6 mEq/L: insulin …

Hypercalcemia as a Presenting Clinical Manifestation of Adenocarcinoma of the Colon.

Hypercalcemia is rarely associated with colon cancer. It is related to overexpression of parathyroid hormone-related protein (PTH-rp) in malignant cells of the primary colon tumor and metastases. A 44 year old lady presented for evaluation of severe hypercalcemia (15.7 mg/dL) associated with abdominal pain, nausea and constipation. She was diagnosed with metastatic colon cancer involving the liver. Therapy for hypercalcemia consisted of intravenous bisphosphonate and saline hydration. Hypercalcemia remained resistant and refractory to treatment despite resection of the colon tumor. She died so

Sequential Development of Waldenström's Macroglobulinemia After High-Grade Lymphomatoid Granulomatosis.

Lymphomatoid granulomatosis (LYG) is a rare Epstein-Barr virus-driven B-cell lymphoproliferative disease that often progresses to high-grade lymphoma. We describe a case of high-grade LYG causing Pancoast syndrome, diagnosed via transbronchial biopsy after a failed incisional biopsy. Complete remission was achieved with R-CHOP (rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisolone), but 2.5 years later, the patient developed lymphoplasmacytic lymphoma/Waldenström's macroglobulinemia (LPL/WM). Despite bendamustine-rituximab improving LPL/WM, LYG recurred, underscoring its trea

Paradoxical Stress Fracture in a Patient With Multiple Myeloma and Bisphosphonate Use.

Multiple myeloma (MM) is a plasma cell disorder with related organ dysfunction, including hypercalcemia, renal insufficiency, anemia, and bone disease. Osteolytic bone lesions that result in pain and pathologic fractures are a major source of morbidity and the use of bisphosphonates is generally safe and effective treatment in reducing myeloma-related skeletal fractures and associated morbidity. We present a 73-year-old African American woman with MM in remission and on intravenous (IV) bisphosphonate therapy in the past five years who reported gradually worsening bilateral thigh pain of six m

Silent Superior Mesenteric Artery Dissection Discovered During Hypertensive Emergency With Acute Pulmonary Edema in an End-Stage Renal Disease Patient.

Isolated superior mesenteric artery (SMA) dissection is a rare vascular condition that is increasingly recognized due to the widespread use of advanced imaging modalities. It may present with abdominal pain or remain asymptomatic and be detected incidentally. We report the case of a 62-year-old male with end-stage renal disease (ESRD) on hemodialysis who presented with hypertensive emergency and acute pulmonary edema, in whom SMA dissection was incidentally identified on computed tomography angiography (CTA). The patient was successfully managed conservatively with blood pressure control, anti

A case of histiocytic sarcoma presenting with primary bone marrow involvement.

Histiocytic sarcoma (HS) is a very rare neoplasm that often shows an aggressive clinical course and systemic symptoms, such as fever, weight loss, adenopathy, hepatosplenomegaly and pancytopenia. It may present as localized or disseminated disease. We describe here a 63-yr-old male who manifested systemic symptoms, including fever, weight loss and generalized weakness. Abdominal and chest computed tomography failed to show specific findings, but there was suspicion of multiple bony changes at the lumbar spine. Fusion whole body positron emission tomography, bone scan and lumbar spine magnetic