Major Depressive Disorder (MDD) is a leading cause of disability worldwide, creating a high medical and socioeconomic burden. There is a growing interest in the biological underpinnings of depression, which are reflected by altered levels of biological markers. Among others, enhanced inflammation has been reported in MDD, as reflected by increased concentrations of inflammatory markers—C-reactive protein, interleukin-6, tumor necrosis factor-α and soluble interleukin-2 receptor. Oxidative and nitrosative stress also plays a role in the pathophysiology of MDD. Notably, increased levels of lipid peroxidation markers are characteristic of MDD. Dysregulation of the stress axis, along with increased cortisol levels, have also been reported in MDD. Alterations in growth factors, with a significant decrease in brain-derived neurotrophic factor and an increase in fibroblast growth factor-2 and insulin-like growth factor-1 concentrations have also been found in MDD. Finally, kynurenine metabolites, increased glutamate and decreased total cholesterol also hold promise as reliable biomarkers for MDD. Research in the field of MDD biomarkers is hindered by insufficient understanding of MDD etiopathogenesis, substantial heterogeneity of the disorder, common co-morbidities and low specificity of biomarkers. The construction of biomarker panels and their evaluation with use of new technologies may have the potential to overcome the above mentioned obstacles.

Thromboembolic complications (TC) are common in the course of some cancers, such as lung, gastrointestinal, and gynecologic cancers, as well as brain tumors. 1 Surgical treatment of patients with head and neck cancer is an important risk factor for TC. 2,3 However, data on the incidence of TC in nonsurgically treated patients with head and neck cancer are scarce.A 65-year-old patient with low-differentiated carcinoma (FIGURE 1A-1C) of the head and neck region, with multiple bilateral metastatic lymph nodes in the neck (TxN3M0 according to the TNM classification; FIGURE 1D-1F), was hospitalized to undergo megavoltage 3-dimensional radiotherapy (70 Gy/35 fractions delivered in 7 weeks) with 3 courses of concomitant chemotherapy. The comorbidities included type 2 diabetes, arterial hypertension, and obesity. From the beginning of the therapy, the patient showed fluctuating glucose levels; therefore, insulin therapy along with the regulation and close monitoring of blood glucose levels were introduced. Because of persistent vomiting, the patient was administered antiemetic agents, parenteral hydration, and electrolyte supplementation. He remained mobile. After 2 weeks of radiotherapy, he developed a progressive acute inflammatory radiation reaction in the mucous and skin of the head and neck CLINICAL IMAGE

Depression (MDD) is a leading psychiatric entity worldwide, with a high impact on individual life and public health. In recent years, efforts have been made to elucidate its biological underpinnings. MDD biomarker research provides promise for a better understanding of the biochemical processes involved in its pathogenesis. Oxidative and nitrosative stress (O&NS) and lipid disturbances are reported as major factors favoring the occurrence of depression. A total of 29 patients with MDD and 30 healthy volunteers were examined using the Hamilton Depression Scale (HAM-D), the Hamilton Anxiety Scale (HAM-A), and the Beck Depression Inventory (BDI). Blood and urine were collected to search for potential MDD biomarkers. O&NS parameters and β-amyloid were assessed in the urine, while cholesterol fractions were assessed in the blood. The group of depressed patients was characterized by higher concentrations of urine superoxide dismutase (SOD), 3-nitrotyrosine (3-NT), catalase (CAT), reduced glutathione (GSH), tryptophan (TRY), and serum triglycerides (TGA), along with lower levels of serum high-density lipoprotein (HDL). Elevated urine 3-NT and decreased serum HDL, considered together, were found to have the greatest potential as markers of depression. The study supports the importance of oxidative stress and cholesterol disturbances in MDD. Further research is required to assess their clinical usefulness as markers.