Nowadays, chronic kidney disease (CKD) and osteoporosis have become crucial health-related issues globally. CKD-induced osteoporosis is a systemic disease characterized by the disruption of mineral, hormone, and vitamin homeostasis that elevates the likelihood of fracture. Here, we review recent studies on the association of CKD and osteoporosis. In particular, we focus on the pathogenesis of CKD-associated osteoporosis, including the homeostasis and pathways of several components such as parathyroid hormone, calcium, phosphate, vitamin D, fibroblast growth factor, and klotho, as well as abnormal bone mineralization, remodeling, and turnover. In addition, we explore the diagnostic tools and possible therapeutic approaches for the management and prevention of CKD-associated osteoporosis. Patients with CKD show higher osteoporosis prevalence, greater fracture rate, increased morbidity and mortality, and an elevated occurrence of hip fracture. We also rule out that increased severity of CKD is related to a more severe condition of osteoporosis. Furthermore, supplements such as calcium and vitamin D as well as lifestyle modifications such as exercise and cessation of smoking and alcohol help in fracture prevention. However, new approaches and advancements in treatment are needed to reduce the fracture risk in patients with CKD. Therefore, further collaborative multidisciplinary research is needed in this regard.
Coronary artery anomalies (CAAs) are rare congenital cardiovascular defects that can present in various ways depending on the origin, course, and termination of the abnormal coronary artery fistula. It is sometimes detected incidentally during procedures such as coronary angiography or autopsies. While adults with this condition are often asymptomatic, some may experience angina, congestive heart failure, myocardial infarction, cardiomyopathy, ventricular aneurysms, or sudden cardiac death (SCD). In fact, it is the second leading cause of SCD among young athletes and requires more studies to handle such patients efficiently. To illustrate the many possible manifestations of this unusual diagnosis, we present a series of five cases. We have also reviewed the different varieties of this rare congenital anomaly and discussed the latest diagnostic tests and treatment plans.
Thyroid storm, also known as thyrotoxic crisis is an acute, rare life-threatening condition of thyroid gland; possessing 100% mortality when it’s not treated in time. Thyroid storm coexisting with respiratory failure further can contribute to this mortality. Respiratory collapse can be irreversible. This is an endocrine emergency first described in 1926. This is important to recognize it early and treat to reduce mortality. Herein, we review a case of 75 years of male who developed Cardio-respiratory failure while he was manifesting clinical features thyroid storm.
According to WHO, obesity, a global pandemic, is an important cause of cancer. Obesity-induced adipose tissue expansion is associated with infiltration of immune cells which causessecretion of adipokines, chemokines, cytokines like IL-1,2,6,8, TNF-α, etc. The purpose of thisstudy is to provide a comprehensive review of the effects of obesity-induced inflammatorycytokines on breast cancer while discussing available therapeutics & chemotherapy in thetreatment of breast cancer. We discussed the identification of inflammatory biomarkers releasedby adipose tissue, and alterations in their pathway in the pathogenesis of breast cancer. Our studyhelps in improving diagnostic accuracy, identifying targets of therapy, and suggesting usefullifestyle behaviors for this aspect. We conducted our research in PubMed to identify relevantjournal articles published within the last 10 years. We extracted pertinent data and discussedmajor signaling pathways regulated by inflammatory cytokines and adipokines in mediatingbreast cancer. Obesity involves different changes that may contribute to the development ofbreast cancer, such as excess inflammatory cytokines and chronic inflammation,hyperinsulinemia, insulin resistance, and raised leptin and estrogens. It leads to a low-gradechronic inflammatory state in the body, which leads to increased estrogen and aromatase,increased growth proliferation, and angiogenesis. All of these contribute to the development ofbreast cancer, mostly ductal breast cancer and ER-positive breast cancer. Leptin antagonist,Adiponectin agonists, aromatase inhibitors, and lipid-lowering drugs have shown favorable resultsin the treatment of breast cancer. Metformin inhibits the IL-6 mRNA expression and activatesthe IL-1R expression which acts as an anti-inflammatory cytokine. In breast cancer cells,Metformin interferes with mTOR pathway signaling and decreases the expression of HER-2protein. Weight loss with exercise and reduced calorie intake reduces the risk of breast cancer inboth premenopausal and postmenopausal women. Early detection using “biomarkers” shows apromising improvement in the survival rate.
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