Chronic kidney disease and Alzheimer’s disease are chronic conditions highly prevalent in elderly communities and societies, and a diagnosis of them is devastating and life changing. Demanding therapies and changes, such as non-compliance, cognitive impairment, and non-cognitive anomalies, may lead to supplementary symptoms and subsequent worsening of well-being and quality of life, impacting the socio-economic status of both patient and family. In recent decades, additional hypotheses have attempted to clarify the connection between these two diseases, multifactorial in their nature, but even so, the mechanisms behind this link are still elusive. In this paper, we sought to highlight the current understanding of the mechanisms for cognitive decline in patients with these concurrent pathologies and provide insight into the relationship between markers related to these disease entities and whether the potential biomarkers for renal function may be used for the diagnosis of Alzheimer’s disease. Exploring detailed knowledge of etiologies, heterogeneity of risk factors, and neuropathological processes associated with these conditions opens opportunities for the development of new therapies and biomarkers to delay or slow their progression and validation of whether the setting of chronic kidney disease could be a potential determinant for cognitive damage in Alzheimer’s disease.

Brown adipose tissue (BAT) participates in the regulation of whole-body metabolism by producing a variety of adipokines. This study investigates into the BAT pattern and the clinical aspects of overweight and obese (OOB) vs. non-obese (NO) hyperparathyroidism (HPT) patients with the aim of assessing the impact of BAT and obesity on HPT. Parathyroid scans performed on 441 HPT patients between 2015 and 2020 were retrospectively analyzed in order to select the images with active BAT. Based on their BMI, the patients with active BAT were divided into OOB vs. NO. The results showed that BAT was present in cervical and supraclavicular regions, with a single localization especially among NO vs. multiple sites among OOB. The (total counts/pixels)BAT/(total counts/pixels)non-BAT ratio in the right cervical localization showed a significant difference between the groups with higher values in OOB. BMI, PTH, FT4, vitamin D, magnesium, creatinine, and urea had significant correlations with BAT ratios. The predictive values showed that right cervical ratios higher than 1.52 and right supraclavicular ratios lower than 1.15 indicated an increased probability of being OOB. The significant correlations between BAT activation in OOB vs. NO and HPT clinical parameters could be useful for developing potential treatments based on this tissue.

Aim: This paper aims to emphasize the importance of nuclear imaging for cancer patients evolution and personalized treatment. Material and method: A retrospective study comprising 5,670 patients, who performed bone scans, between 2003-2015, at the "Sf. Spiridon" County Clinical Emergency Hospital Iași Nuclear Medicine Laboratory. Studied parameters were demographic data, referral dia gnosis, staging, tumor markers, bone metastases and patient follow-up. Results: Of all, 3,960 were oncological patients. They performed in evolution 3,846 bone scans, between two (21.01%) and 11 (0.05%) explorations. Patients' age varied between 2 and 97 years (with two peaks, at 55 and 65). Gender distribution showed female (61.73%) over male (38.27%) predominance, especially in multiple scans (73.32%). For half of the patients the bone scan showed evolution (worsening), meaning the treatment was only partially effective and r equired modifications. Ethically, for these patients bone scan was irreplaceable. Its absence would have meant undergoing a partially/inefficient treatment, a reserved prognosis and a shorter survival period. The benefits outweigh the risks in terms of radiation exposure. Conclusions: Ethics in oncological nuclear medicine is complex, following the balance between risk and benefit, in the interest of a personalized management. As a result, ethically it is equivalent to maximizing the benefits of this minimally invasive functional investigation, scintigraphy, which is essential for treatment modulation, in order to improve the disease prognosis and increase the patients' survival rate, for precision medicine in cancer.

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Erdheim-Chester Disease (ECD) is a rare form of non-Langerhans' cell histiocytosis (non-LCH). It is characterized by the excessive production of histiocytes. We present the case of a 63 year-old Caucasian woman with ECD, with a history of breast cancer (diagnosed in 2006) and rectal cancer (diagnosed in 2013). Most probably, the initial ECD manifestation occurred within the next 5 years after mastectomy in the soft tissues adjacent to the scar. Recently it became manifest in a different localization (meta-diaphysis of long bones), while the other possible sites like the lungs, central nervous system and pituitary gland show minimal involvement with no specific clinical manifestation yet. Shortly after the bone manifestations were detected, she developed an invasive rectal adenocarcinoma. The ECD diagnosis was based on bone scintigraphy, radiography and immunohistochemistry examination.