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The editorial discusses the controversial relationship between acromegaly, a rare endocrine disorder, and cancer risk. While some studies suggest an increased risk of certain cancers, others do not. Advances in acromegaly treatment have improved disease control and reduced mortality rates. Current data do not support extensive cancer screening beyond standard guidelines, but clinical attention is crucial, especially for elderly patients and those with diabetes mellitus. Further research is needed to understand the impact of acromegaly on cancer risk and refine screening protocols. [Extracted from the article]

Polycystic ovary syndrome (PCOS) is the most complex and common reproductive endocrine disease among reproductive age women. This study aimed to investigate the effects of vitamin D (Vit.D) in a PCOS mouse model induced by low dose DHEA and high-fat diet. Prepubertal female mice were divided into 4 groups randomly: control, PCOS, PCOS with low dose Vit.D(LDVD), and PCOS with high dose Vit.D(HDVD) groups (n = 10 per group). PCOS mice were administrated with high-fat diet and subcutaneous injection with 6 mg/kg/day dehydroepiandrosterone throughout the study. After the first 30 days, 1,25(OH)2D3 was intend to be administered by intraperitoneal injection for 40 consecutive days, 1.3 µg/kg/week in LDVD group, and 13 µg/kg /week in HDVD group. However, the mice in HDVD group appeared to be fatigue and anorexic after the Vit.D injections, then all died within two weeks. The body weights and testosterone levels in PCOS group were significantly higher than those in the control and LDVD groups (P < 0.001). The total cholesterol levels in the control group were lower than those in PCOS and LDVD groups (P < 0.001). Further, the ratio of liver to body weight was different among groups (P < 0.001). Our data illustrates that Vit.D has therapeutic effects on obesity and hyperandrogenemia in PCOS mouse model induced by low dose DHEA and high-fat diet. However, over dose of Vit.D is toxic. Further researches are needed to elucidate the mechanisms. [ABSTRACT FROM AUTHOR]

Introduction: Children diagnosed with endocrine disorders may exhibit atypical development and may encounter challenges in language, academic, and cognitive skills, as well as social–emotional issues. The objective of this study was to identify potential therapeutic requirements in the areas of language, cognition, and mathematical skills among children with endocrine disorders who experience school failure. This will enable an early evaluation of speech and language disorders and the planning of interventions to be possible. Methods: In this study, children with endocrine disorders were compared with their normally developing peers in terms of language, cognition, mathematical skills, and psychosocial characteristics. In this study, 15 children diagnosed with endocrine disorders (8 females, 7 males; mean age: 10, SD: 2) and 15 children with normal development (8 females, 7 males; mean age: 10, SD: 2) participated. The participants were subjected to the Test of Language Development-Primary: Fourth Edition Turkish Revision (TOLDP-4:T), the Turkish Nonword Repetition Test (TNRT), the Turkish Multilingual Sentence Repetition Test (LITMUS-TR), the Wechsler Intelligence Scale for Children (WISC-R), the Problem-Solving Test (PST), the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV), the Coopersmith Self-Esteem Inventory (CSEI), and the Child Behavior Checklist (CBCL). Results: The findings of the study indicate that children with endocrine disease have lower performance in language, cognition, and mathematical skills compared to their healthy peers. Otherwise, they do not differ in terms of social–emotional status assessed by psychological scales. Discussion: These findings suggest that while children with endocrine disorders face challenges in academic and cognitive domains, their social-emotional development remains relatively unaffected. Early identification and intervention in language, cognition, and mathematical skills may help address the academic struggles of these children, potentially improving their school performance and overall well-being. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is defined as a chronic low-grade inflammatory reproductive endocrine disorder. PCOS can induce various metabolic disorders, which are associated with a state of mild and slow-acting inflammation. Nevertheless, the causal relationship between polycystic ovary syndrome and inflammatory factors is uncertain. The causality between inflammatory cytokines and PCOS was analyzed by bidirectional Mendelian randomization (MR) in this current probe. We performed an interactive MR study to assess the causal relationships between 91 inflammatory cytokines and PCOS using Genome Wide Association Study (GWAS) data. We underwent dual-sample MR analysis with inverse variance weights (IVW) as the predominant MR methodology with multiple validity and heterogeneity analyses. MR-Egger, weighted median, simple mode, weighted mode and MR-PRESSO were analyzed as multiple likelihood sensitivity analyses to enhance the final results.The results came out interleukin-1-alpha (IL-1 A) levels (odds ratio [OR] = 1.051, 95% fiducial interval [95% CI] = 1.009–1.095, P = 0.02) and oncostatin-M (OSM) levels ([OR] = 1.041, [95% CI] = 1.001–1.082, P = 0.04) were positively associated with the development of PCOS. Moreover, interleukin-7 (IL-7) levels ([OR] = 0.935, [95% CI] = 0.884–0.989, P = 0.02); interleukin-15 receptor subunit alpha (IL15RA) levels ([OR] = 0.959, [95% CI] = 0.929–0.99, P = 0.01); and C-X-C motif chemokine 11 (CXCL11) levels ([OR] = 0.959, [95% CI] = 0.922–0.996. P = 0.03) were strongly negatively associated with PCOS. However, we did not find any strong positive results in the reverse analysis, suggesting that although inflammatory factors contribute to the pathogenesis of PCOS, PCOS itself does not trigger inflammatory factor production.Our study provides genetic evidence for the connection between systemic inflammatory regulators and PCOS. Treatments targeting specific inflammatory factors may help to mitigate the risk of PCOS. The levels of five of the 91 inflammatory factors included in this study, namely, IL1A and OSM, were associated with PCOS. IL1A and OSM contribute to the progression of PCOS while IL-7, IL15RA, and CXCL11 levels are negatively correlated with the development of PCOS. [ABSTRACT FROM AUTHOR]

Background: Slipped capital femoral epiphysis (SCFE) is usually seen in patients with high body mass index (BMI) and endocrine diseases. SCFE is exceedingly rare among Cerebral palsy (CP) patients due to spasticity present in those patients. Percutaneous in situ fixation is the treatment option for SCFE patients. According to the literature, there's no single case report with SCFE in a spastic CP patient with no prior history of trauma, seizure episodes, or endocrine disease. Case presentation: We report a case of an 11-year-old spastic cerebral palsy (CP) patient with a physical status of level 5 motor function on the gross motor function classification system. He was brought by his mother to the clinic complaining of bilateral hip pain. The mother denied any history of trauma or any seizure episodes. The pain had started spontaneously. Physical examination showed severe spasticity and bilateral hip abduction with external rotation. Drehmann's sign was positive. Bilateral hip radiographs revealed bilateral partial open femoral capital physis with evidence of SCFE bilaterally. Also, the Southwick angle was measured, and it was severe. The patient was taken to the operating room and treated with closed reduction and percutaneous in situ fixation. He was seen multiple times following surgical intervention, reporting pain relief, and showing complete wound healing. Conclusion: This report concludes that paraplegic spastic CP patients may present with SCFE spontaneously without trauma, seizures, or an underlying endocrine disease. Also, severe spasticity might potentially be a risk factor for SCFE, although further investigations would be necessary to establish a conclusive link. [ABSTRACT FROM AUTHOR]

Background: The Developmental Origins of Health and Disease Hypothesis (DOHaD) suggests prenatal alcohol exposure (PAE) should have implications for adult physical and mental health. Since the health profile of older adults with PAE and diagnoses of fetal alcohol spectrum disorder (FASD) is unknown, the current study evaluates self‐reported health problems of midlife adults with and without a history of PAE to describe these outcomes. Methods: Participants (N = 357) recruited from longitudinal cohorts in Atlanta, GA and Seattle, WA completed a health survey assessing a range of physical conditions. Initial analysis compared the frequency of conditions between alcohol‐exposed and nonexposed groups. To identify patterns within groups, 10 problem areas were subjected to latent class analysis (LCA). Finally, the direct effect of PAE on health outcomes was evaluated using multilevel modeling, controlling for effects of other factors. Results: Compared with unexposed controls, individuals with PAE reported significantly higher frequencies of problems with hearing, dentition, heart, cancer, gastritis, kidney stones, bladder, diabetes, thyroid, skin, and seizures. LCA found that controls yielded two classes, with 45% reporting sleep and vision problems and 55% reporting sleep, vision, cardiovascular, endocrine, immune, and dental problems. The PAE group yielded three classes, with 13% endorsing few health problems, 43% reporting sleep, vision, immune, and dental problems, and 43% reporting sleep, vision, cardiovascular, urinary, endocrine, skin, immune, dental, and gastrointestinal problems. With multivariate analysis, controlling for other influences, PAE was associated directly with hearing, urinary, dental, and gastrointestinal problems. A similar pattern was found for alcohol‐exposed individuals who did and did not meet criteria for fetal alcohol syndrome (FAS). Discussion: Patients affected by alcohol may report greater frequency and range of health adversity. That PAE was only uniquely associated with a limited set of problems suggests that many health outcomes in midlife result from an initial vulnerability potentiated by postnatal stress resulting from other associated factors. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most commonly diagnosed cancer among women worldwide, and it is associated with significant number of metabolic and reproductive risk factors. Despite the overlap between hormonal and metabolic factors involved in the development of PCOS and many known risk factors for breast cancer, the relationship between PCOS and breast cancer, the most common type of cancer among women, remains unknown. This study was conducted with the aim of determining the relationship between breast cancer and clinical symptoms of PCOS. Methods: This case-control study was conducted on 285 women with breast cancer and 285 healthy women referred to three centers in Tehran in 2023. Both the case and control groups were matched in terms of age and body mass index. The data collection tool in this study was a researcher-made data registration form, that was completed in person by qualified individuals. A history of PCOS was identified according to the Rotterdam criteria. Women aged 15–49 years who were able to read and write were included in the study. The case group had a history of breast cancer, while the control group did not. Participants who did not consent to having their data use in the analysis were excluded. Data was analyzed using an independent t-test, a chi-square test and a logistic regression model. Results: The mean age of the participants in the case group was 43.05 ± 4.92 years and that of the control group was 42.78 ± 5.06 years. The two groups showed a statistically significant difference in terms of PCOS history (p < 0.001). After adjusting for confounding variables, the logistic regression model showed that women with PCOS had a significantly higher chance of developing breast cancer (0R: 3.677, 95%CI: 1.529–8.840, P = 0.004). Among PCOS symptoms, women with a history of hirsutism had a higher chance of developing breast cancer (OR: 2.188, 95% CI: 1.014–4.720, P = 0.046). Conclusion: The findings of the present study suggest that PCOS is a risk factor for breast cancer. Well-designed further studies are highly recommended to determine the role of PCOS in predicting breast cancer. [ABSTRACT FROM AUTHOR]

Preservation of brain health is a worldwide priority. The traditional view is that the major threats to the ageing brain lie within the brain itself. Consequently, therapeutic approaches have focused on protecting the brain from these presumably intrinsic pathogenic processes. However, an increasing body of evidence has unveiled a previously under-recognized contribution of peripheral organs to brain dysfunction and damage. Thus, in addition to the well-known impact of diseases of the heart and endocrine glands on the brain, accumulating data suggest that dysfunction of other organs, such as gut, liver, kidney and lung, substantially affects the development and clinical manifestation of age-related brain pathologies. In this Review, a framework is provided to indicate how organ dysfunction can alter brain homeostasis and promote neurodegeneration, with a focus on dementia. We delineate the associations of subclinical dysfunction in specific organs with dementia risk and provide suggestions for public health promotion and clinical management. Peripheral organ dysfunction can have considerable effects on brain health, contributing to neurodegeneration and dementia. This Review explores how clinical and subclinical dysfunction of specific organ systems can impact brain health and discusses the implications for dementia prevention. Key points: Brain health is a worldwide priority, and dementia is the biggest threat to healthy brain ageing. The brain requires a supportive environment maintained by healthy organ systems to function optimally and to confer resilience to neurodegenerative diseases such as Alzheimer disease and Parkinson disease. Increasing evidence links subclinical dysfunction of the cardiovascular, pulmonary, renal, gastrointestinal, hepatic and endocrine systems with age-related cognitive decline and dementia. Cardiovascular, renal and hepatic dysfunction as well as changes in the gut microbiome have been associated with the presence of Alzheimer disease biomarkers in human research. Pathways that might lead from organ dysfunction to brain dysfunction include systemic endothelial dysfunction, reduced peripheral clearance of wastes (including amyloid-β and tau), systemic inflammation and alterations in the microbiome. Future research needs to explore mechanisms that link peripheral organ dysfunction to risk of age-related neurodegenerative and cerebrovascular diseases and to elucidate whether improving organ function reduces this risk. [ABSTRACT FROM AUTHOR]

This series of three articles will explore the fundamentals related to anatomy, physiology and pathophysiology in relation to three important topics: the cardiac system, the respiratory system and the endocrine system. The series is intended to provide an informative and evidence-based summary of each topic for both students and clinicians. This third and final paper explores the maternal endocrine system, outlining the key physiological adaptations in pregnancy and summarising the key pathophysiological conditions that may occur. [ABSTRACT FROM AUTHOR]

The article discusses endocrine disorders in adult patients with inherited metabolic diseases, emphasizing the importance of diagnosis and long-term management. It highlights the prevalence of endocrine complications in patients with inherited metabolic diseases, such as diabetes mellitus, hypogonadism, adrenal insufficiency, and thyroid dysfunction. The study conducted at a tertiary referral center for endocrinology and inherited metabolic diseases reveals the need for specialized care and multidisciplinary approaches to address these complex health issues. The authors stress the significance of early detection, appropriate screening, and tailored management strategies for patients with inherited metabolic diseases and associated endocrine disorders. [Extracted from the article]

Female hypogonadism (FH) is a relatively common endocrine disorder in women of premenopausal age, but there are significant uncertainties and wide variation in its management. Most current guidelines are monospecialty and only address premature ovarian insufficiency (POI); some allude to management in very brief and general terms, and most rely upon the extrapolation of evidence from the studies relating to physiological estrogen deficiency in postmenopausal women. The Society for Endocrinology commissioned new guidance to provide all care providers with a multidisciplinary perspective on managing patients with all forms of FH. It has been compiled using expertise from Endocrinology, Primary Care, Gynaecology and Reproductive Health practices, with contributions from expert patients and a patient support group, to help clinicians best manage FH resulting from both POI and hypothalamo‐pituitary disorders, whether organic or functional. [ABSTRACT FROM AUTHOR]

Congenital Adrenal Hyperplasia (CAH) is a group of autosomal recessive endocrine disorders characterized by alteration in adrenal hormonal secretions. The most common form is caused by CYP21A2 mutations that result in 21-hydroxylase deficiency. Clinical features can vary, from salt-wasting forms, characterized by a lack of mineralocorticoid activity with a risk of perinatal-onset adrenal crises, to "simple-virilizing" forms with sufficient aldosterone secretion, up to milder "non-classical" forms, with a variable grade of hyperandrogenism but no severe hormonal deficiencies. During pregnancy, CAH 46,XX fetuses are exposed to elevated androgen levels, leading to a variable grade of virilization and potential central nervous system effects if untreated. These patients are usually (but not always) assigned female at birth, but some cases may be misdiagnosed and assigned male, potentially inducing fertility, gender identity, and sexual behavior issues in adulthood. In these patients, the benefits and risks of a late gender transition should be carefully evaluated. In this paper, we reviewed the literature concerning the most interesting peculiarities of these conditions. [ABSTRACT FROM AUTHOR]

Primary hyperparathyroidism represents the third most prevalent endocrine disease in the general population, consisting of an excessive secretion of parathyroid hormone from one or, more frequently, more of the parathyroid glands, leading to a dysregulation of calcium homeostasis. Schematically, its development occurs primarily by pathophysiological events with genetic mutation, at the germline and/or somatic level, that favor the neoplastic transformation of parathyroid cells and promote their aberrant proliferation, and mutations determining the shift in the PTH "set-point", thus interfering with the normal pathways of PTH secretion and leading to a "resetting" of Ca2+-dependent PTH secretion or to a secretion of PTH insensitive to changes in extracellular Ca2+ levels. Familial syndromic and non-syndromic forms of primary hyperparathyroidism are responsible for approximately 2–5% of primary hyperparathyroidism cases and most of them are inherited forms. The history of the genetic/molecular studies of parathyroid tumorigenesis associated with multiple endocrine neoplasia type 1 syndrome (MEN1) represents an interesting model to understand genetic–epigenetic–molecular aspects underlying the pathophysiology of primary hyperparathyroidism, both in relation to syndromic and non-syndromic forms. This minireview aims to take a quick and simplified look at the MEN1-associated parathyroid tumorigenesis, focusing on the molecular underlying mechanisms. Clinical, epidemiological, and observational studies, as well as specific guidelines, molecular genetics studies, and reviews, have been considered. Only studies submitted to PubMed in the English language were included, without time constraints. [ABSTRACT FROM AUTHOR]

Endocrine-disrupting chemicals (EDCs) are environmental and industrial agents that interfere with hormonal functions. EDC exposure is linked to various endocrine diseases, especially in reproduction, although the mechanisms remain unclear and effects vary among individuals. Neuroinflammation, particularly hypothalamic inflammation, is an emerging research area with implications for endocrine-related diseases like obesity. The hypothalamus plays a crucial role in regulating reproduction, and its inflammation can adversely affect reproductive health. EDCs can cross the blood–brain barrier, potentially causing hypothalamic inflammation and disrupting the reproductive axis. This review examines the existing literature on EDC-mediated hypothalamic inflammation. Our findings suggest that exposure to 2,3,7,8-tetrachloro-dibenzo-p-dioxin (TCDD), polychlorinated biphenyl (PCB), tributyltin (TBT), phthalates, bisphenol A (BPA), and chlorpyrifos (CPF) in animals is linked to hypothalamic inflammation, specifically affecting the hypothalamic centers of the gonadotropic axis. To our knowledge, this is the first comprehensive review on this topic, indicating hypothalamic inflammation as a possible mediator between EDC exposure and reproductive dysfunction. Further human studies are needed to develop effective prevention and treatment strategies against EDC exposure. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in women of reproductive age, and presents a significant challenge to the global population. This review provides comprehensive evidence of interventions, including food and dietary supplements, aimed at reversing PCOS and improving fertility outcomes. Various dietary supplements are known to cause metabolic changes and hormonal regulation and have a potential impact on increasing pregnancy rates. Although some biochemical alterations have been observed, these metabolic changes do not directly reverse the disorder. Moreover, the lack of sufficient evidence does not convince clinicians to standardize dietary supplements as alternatives to medical or pharmacological interventions. This calls for a study of women with PCOS taking dietary supplements. In addition, unbiased studies of combinations of treatment options for supplements, including large cohort clinical trials, will lead to evidence-based medicine. [ABSTRACT FROM AUTHOR]

Background: Carney complex is a rare syndrome characterized by skin pigmentation, endocrine disorders, and myxomas. It is particularly notorious for its tendency to exhibit aggressive cardiac myxomas. Herein, we present a case of a juvenile female patient diagnosed with Carney complex who underwent a right lateral mini-thoracotomy. Case presentation: A 13-year-old girl presented with sudden-onset left hemiplegia and dysarthria. Magnetic resonance imaging revealed multiple areas of restricted diffusion. Echocardiography identified a tumor in the left atrium, suspected to be related to Carney complex based on her medical history and physical examination findings. Surgery was performed via right lateral mini-thoracotomy, which minimized the risk of embolism and ensured a cosmetically favorable outcome. The left atrial wall defect was repaired with autologous pericardium. At 3 years postoperatively, follow-up echocardiography indicated no tumor recurrence and normal cardiac function. Conclusions: Ongoing follow-ups are essential due to the aggressive nature of the Carney complex and its high recurrence rates. Right lateral mini-thoracotomy offers the advantage of avoiding re-sternotomy and minimizing adhesion dissection, making it the optimal choice for this case. [ABSTRACT FROM AUTHOR]

Diabetes mellitus, a high‐morbidity endocrine disease, is typically treated with synthetic hypoglycemic drugs that are costly and have severe side effects. Natural products, like mushrooms, offer a cost‐effective, accessible, and eco‐friendly alternative. Current study intends to examine the antidiabetic potential of mushroom‐based herbal formulation (MHF) on streptozotocin‐induced diabetic rats. For this purpose, five different groups of Wister rats were established including one normal group. Among four diabetic groups, one group served as the diabetic control, while the remaining two groups were administrated with MHF 200 mg/kg and 400 mg/kg, respectively, and the fifth was administered with metformin for 28 days. On the last day of experiment, all rats were sacrificed, and samples were collected for different analysis. The study outcomes revealed that the administration of MHF to diabetic rats resulted in remarkable (p < 0.001) improvements in fasting blood glucose (FBG) levels and glycated hemoglobin along with other biochemical markers. The histopathological examination also showed the protective effect of MHF against diabetic‐induced damage in the pancreas, kidney, and liver. It also helps in the regeneration of β‐cells in the pancreas. These findings suggest MHF is a safer and more effective alternative for managing diabetes. [ABSTRACT FROM AUTHOR]

The article discusses a case of Cushing disease presenting with hypertension in a 33-year-old woman. The patient had a history of easy bruising and a unilateral adrenal adenoma, leading to investigations for hypercortisolism. The diagnosis was confirmed as Cushing disease due to a pituitary microadenoma, which was successfully treated with transsphenoidal surgery. The article emphasizes the importance of accurate diagnosis and appropriate treatment for hypercortisolism and secondary hypertension, highlighting the impact of timely intervention on weight and metabolic health. [Extracted from the article]

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder and metabolic abnormality disease that mainly affects women of reproductive age. LINC00173, a novel long noncoding RNA (lncRNA), has emerged as an important factor in the development of PCOS. However, the role of LINC00173 in PCOS development and its specific upstream and downstream mechanisms remain to be further clarified. Here, we found that LINC00173 was significantly upregulated in granulosa cells (GCs) of PCOS patients, and played a crucial role in promoting apoptosis of GCs. Mechanistically, we observed the activation of endoplasmic reticulum (ER) stress in the GCs of PCOS patients, and the ER stress sensor ATF4 could directly induce LINC00173 expression by binding to its promoter. LINC00173 further upregulated the expression of Harakiri (HRK) and subsequently inhibited downstream PI3K/AKT pathway. In conclusions, our study uncovered that ER stress-induced upregulation of LINC00173 leads to increased HRK expression and inhibition of the PI3K/AKT pathway, thereby promoting the progression of PCOS. These findings provide a new therapeutic strategy for the treatment of PCOS. [ABSTRACT FROM AUTHOR]

Autoimmune adrenal insufficiency (AAI) is a rare disease. This research evaluates three patients with AAI, including autoimmune polyglandular syndrome (APS) type 2. Two patients had APS or AAI during childhood, and one had a history of endocrine autoimmune disease, indicating a possible hereditary basis of the condition. Trio-based exome sequencing and high-resolution HLA typing were employed to analyze patients and their parents. Benign or likely benign variants of the AIRE gene were identified in all participants of the study. These variants, coupled with clinical data and the results of antibody studies to type I interferons, helped to exclude APS-1. Patients with APS-2, in contrast to patient with AAI, inherited distinct variants of unknown significance in the CLEC16A gene, which is associated with autoimmune diseases, including AAI. Various risk alleles in other genes associated with autoimmunity were identified in all patients. HLA typing of class II loci revealed alleles related to APS. Nevertheless, the frequencies of the haplotypes identified are substantial in the healthy Russian population. Immunological tests can detect antibody carriers and assess the risk of autoimmune disease development. In the future, to identify genetic predictors of autoimmune endocrinopathies, it is recommended to analyze the whole genome of patients and their relatives, examining clinically relevant variants in non-coding regions. [ABSTRACT FROM AUTHOR]

Simple Summary: This study explores the effectiveness and safety of a common breast cancer treatment in elderly patients, a group often overlooked in clinical trials. Specifically, it focuses on using CDK4/6 inhibitors with hormone therapy for treating metastatic HR+/HER2- breast cancer in patients aged 70 and older. This research aims to understand how well this treatment works and how tolerable it is for this vulnerable population, which faces unique challenges due to age and other health conditions. The results of this study may provide valuable insights for clinicians, enabling more informed treatment decisions which optimize therapeutic outcomes and enhance the quality of life for elderly patients with breast cancer. Background: Metastatic HR+/HER2- breast cancer is commonly treated with CDK4/6 inhibitors in combination with endocrine therapy. However, the efficacy and safety of this approach in elderly patients (≥70 years) remain unclear, particularly in the context of real-world clinical practice. This study aims to evaluate the clinical outcomes and tolerability of CDK4/6 inhibitor treatments in this fragile population, which is often under-represented in randomized clinical trials. Patients and methods: This retrospective multicenter study included elderly patients with metastatic HR+/HER2-negative breast cancer receiving first-line CDK4/6 inhibitors. The primary endpoint was progression-free survival (PFS). The secondary endpoints focused on the overall survival (OS), safety, and tolerability, considering variables such as tumor subtype, age, comorbidities, and treatment specifics. Results: The median PFS and OS were slightly lower than those reported in clinical trials, reflecting the inclusion of a more fragile population. The luminal B subtype was linked to a poorer PFS, while other factors like age, BMI, and ECOG status did not significantly affect the outcomes. A safety analysis indicated a higher incidence of grade 3 or higher toxicities, especially in frail patients, leading to dose reductions. Despite these challenges, CDK4/6 inhibitors were generally well-tolerated, allowing most patients to continue therapy. Conclusions: CDK4/6 inhibitors with endocrine therapy are effective in elderly patients with metastatic HR+/HER2- breast cancer, though careful management is crucial to balance efficacy and minimize adverse events. [ABSTRACT FROM AUTHOR]

This article provides an updated review of hypopituitarism (HP), an endocrine disorder characterized by a deficiency of one or more pituitary hormones. The various etiologies are reviewed, including pituitary neuroendocrine tumors (PitNETs), hypothalamic lesions, genetic mutations, and acquired factors such as head trauma, medications, neoplasms, and infiltrative diseases. It is noted that PitNETs are responsible for approximately half of the cases in adults, whereas in children the causes are predominantly congenital. Diagnosis is based on clinical evaluation and hormonal testing, with identification of the specific hormonal deficiencies essential for effective treatment. Laboratory tests present challenges and limitations that must be understood and addressed. Hormone replacement therapy is the mainstay of treatment, significantly improving patients' quality of life. It is important to know the possible interactions between hormone replacement therapies in HP. Recent advances in understanding the pathophysiology of HP and the importance of a multidisciplinary approach to the management of associated complications are discussed. This article emphasizes the need for comprehensive evaluation and continuous follow-up to optimize outcomes in patients with HP and highlights the importance of ongoing research to improve diagnostic and treatment strategies. [ABSTRACT FROM AUTHOR]

Simple Summary: This article reviews the molecular factors causing pyometra in domestic cats, a serious uterine infection. While well-studied in dogs, pyometra in cats is less understood. The focus is on hormonal, redox, immunological, and growth factors, aiming to improve the diagnosis and treatment of the disease. Pyometra is a major reproductive disorder affecting female cats. Characterized by the accumulation of purulent exudate in the uterus, it can lead to severe and potentially fatal complications. This pathology primarily occurs in adult cats during diestrus, but can also affect younger felines, often due to inappropriate administration of hormonal medications. While the etiopathogenesis of pyometra is better understood in bitches, few studies have addressed the molecular factors involved in feline pyometra. Therefore, this review aims to provide an up-to-date and comprehensive discussion of pyometra in cats, focusing on the regulation of molecular factors described in this species, including hormonal, redox, immunological, and growth factors. Understanding the regulation of these factors in pyometra is crucial for elucidating its pathogenesis in domestic cats and for improving diagnosis and identifying novel therapeutic approaches. [ABSTRACT FROM AUTHOR]

Polycystic Ovary Syndrome (PCOS) is a widespread and complex hormonal disorder occurs in women of reproductive age, characterized by hormonal imbalances and ovarian dysfunction. Current approaches to treating PCOS often address specific symptoms, highlighting the demand for innovative therapeutic agents that can tackle its multifaceted nature. The present study endeavors to investigate the potential of new chromen‐2‐one derivatives in the management of PCOS. A total of 30 derivatives have been synthesized and evaluated for their in vitro inhibitory effects on 5‐α reductase and antioxidant activities. Based on the promising in vitro activity and acute toxicity profile of 4‐methoxy‐N‐(3‐(4‐methoxyphenyl)‐2‐oxo‐2H‐chromen‐6‐yl) benzamide (29), it was selected for subsequent in vivo investigation in experimental animal models of PCOS. The study also includes molecular interaction analysis through docking and dynamic studies of compound (29). [ABSTRACT FROM AUTHOR]

Objective: Unknown etiology Background: Chylous ascites is defined as the development of lipid-rich ascitic fluid in the peritoneal cavity. The formation of chylous ascites revolves around non-portal-based and portal-based etiologies, and the diagnosis is made via paracentesis revealing an elevated triglyceride level and milky-white appearance. Chylous ascites is often reported as a postoperative complication in surgical procedures, but it has also been documented in cases of cirrhosis, malignancy, and tuberculosis. However, chylous ascites is rarely seen in chronic pancreatitis and noncirrhotic portal hypertension. This report presents the case of a 65-year-old man with a history of necrotizing pancreatitis and portal hypertension amidst an incidental finding of chylous ascites upon elective umbilical hernia repair. Case Report: We present the case of a patient with chylous ascites discovered during hernia repair. A 65-year-old man with no alcohol or tobacco use and a history of recurrent episodes of acute necrotizing pancreatitis was admitted for umbilical hernia repair. However, upon entering the abdominal cavity, an enlarging mass of ascitic fluid was encountered and tracked into the hernia sac. The fluid was drained via paracentesis and cytology revealed chylous ascites. The patient was discharged in stable condition and was advised to consume a high-protein, lowfat diet. Postoperative computed topography (CT) demonstrated an unchanged necrotic mass in the head of the pancreas. Conclusions: This report demonstrates that when dealing with unexpected findings, it is important to consider the existence of multiple pathologies as the driving cause. We describe a complex cause of chylous ascites, along with a review of the literature on the relationship between chylous ascites and chronic pancreatitis. [ABSTRACT FROM AUTHOR]

This document explores the impact of warfare on cardiovascular health, emphasizing the devastating effects it has on individuals, families, communities, and the environment. It discusses how the use of various weapons in warfare can lead to significant human casualties and long-term health implications. Both civilians and veterans are at a higher risk of cardiovascular diseases and related risk factors due to war-related stressors and traumatic injuries. The document also highlights the long-term effects of wartime stress on mental and physical health. The authors advocate for global efforts to de-escalate armed conflicts and prioritize the health of affected populations through comprehensive healthcare systems and peace-building initiatives. [Extracted from the article]

Introduction: Acute pancreatitis (AP) is a common and potentially lethal disease. Approximately 10–20% of the patients progress to necrotizing pancreatitis (NP). The step-up approach is the gold standard approach to managing an infected necrotizing pancreatitis with acceptable morbidity and mortality rates. Video-assisted retroperitoneal debridement (VARD) has been described as a safe and feasible approach with high success rates. Multiple studies in the American, European, and Asian populations evaluating the outcomes of VARD have been published; nevertheless, outcomes in the Latin American population are unknown. This study aims to describe a single-center experience of VARD for necrotizing pancreatitis in Colombia with a long-term follow-up. Methods: A prospective cohort study was conducted between 2016 and 2024. All patients over 18 years old who underwent VARD for necrotizing pancreatitis were included. Demographic, clinical variables, and postoperative outcomes at 30-day follow-up were described. Results: A total of 12 patients were included. The mean age was 55.9 years old (SD 13.73). The median follow-up was 365 days (P25 60; P75 547). Bile origin was the most frequent cause of pancreatitis in 90.1% of the patients. The mean time between diagnosis and surgical management was 78.5 days (SD 22.93). The mean size of the collection was 10.5 cm (SD 3.51). There was no evidence of intraoperative complications. The mean in-hospital length of stay was 65.18 days (SD 26.46). One patient died in a 30-day follow-up. One patient presented an incisional hernia one year after surgery, and there was no evidence of endocrine insufficiency at the follow-up. Conclusion: According to our data, the VARD procedure presents similar outcomes to those reported in the literature; a standardized procedure following the STEP-UP procedure minimizes the requirement of postoperative drainages. Long-term follow-up should be performed to rule out pancreatic insufficiency. [ABSTRACT FROM AUTHOR]

A 34-year-old alcoholic male presented to our outpatient department with a complaint of persistent epigastric pain, radiating to the back with a swelling in the upper abdomen. He had 2 similar episodes in the past for which he was conservatively managed along the lines of acute pancreatitis. Now on physical examination, the patient had a massive lump in the upper abdomen reaching below the umbilicus. Examination findings were confirmed by computed tomography - abdomen (Plain and Contrast), two 13×10×09 cm and 9×8×7.8 cm, cystic lesions (Noncommunicating) were seen abutting the posterior wall of the stomach and into each other, suggestive of mature pseudocysts of the pancreas. The patient was admitted and after necessary investigations, surgical cystogastrostomy was done for the lower pseudocyst and cystocystostomy for the upper pseudocyst. The patient was discharged 5 days later with no complications. This case shows that multiple pseudocysts, a relatively rare complication of acute pancreatitis, are one of the differentials of acute abdomen. The treatment is a therapeutic challenge that depends on location, size, number as well as their relation to one another. Good drainage prevents resection procedures and further complications (exocrine and endocrine insufficiency). [ABSTRACT FROM AUTHOR]

Purpose: Polycystic ovary syndrome (PCOS) is a prevalent and multifaceted metabolic and endocrine disorder that affects a significant number of women in their reproductive years. The purpose of this study is to investigate the relationship between the lifeline diet score (LLDS) and PCOS. Design/methodology/approach: In this study, the authors enrolled 105 women who had recently been diagnosed with PCOS. 105 women without PCOS, matched for age and body mass index (BMI), were selected as the control group. The mean age of the participants was 34.80 ± 5.37 years old. Standardized procedures were used to measure anthropometric indicators and assess the body composition of each participant. To determine the dietary patterns, a validated and reliable 147-item food frequency questionnaire (FFQ) was administered. Based on the responses to the FFQ, the LLDS was calculated using 12 specific components. Multiple and univariate logistic regression analyses were performed to estimate the associations between LLDS and PCOS, considering various factors. Findings: In the control group, the mean LLDS was 45.61 ± 9.67; while in the case group, the mean LLDS was 25.10 ± 7.49, respectively (P = 0.001). After adjusting for socioeconomic status (SES), age, protein, fat, physical activity and BMI, the probability of developing PCOS is 69% lower in the third tertiles of LLDS than in the first tertiles (OR = 0.31, CI 95% = 0.15–0.62), (P < 0.001). Originality/value: The study finds that a higher LLDS correlates with reduced PCOS risk, echoing dietary advice to boost fruits, dairy, vegetables, legumes, poultry and grains while limiting pasta, rice, bread, eggs, red meat, sweets, sugar and hydrogenated fats. [ABSTRACT FROM AUTHOR]

Antiviral therapy such as oseltamivir has been recommended for hospitalized children with suspected and confirmed influenza for almost 20 years. The therapy is officially authorized for newborns two weeks of age or older, however, questions about its safety and effectiveness still surround it. Our goals were to assess the epidemiological features of two consecutive seasonal influenza cases in children following the COVID-19 pandemic; to observe the clinical effectiveness and tolerability of oseltamivir in hospitalized children who were not vaccinated against influenza and had different influenza subtypes, including A(H1N1), A(H3N2), and B; and to identify specific comorbidities associated with influenza in children. We performed an observational study on 1300 children, enrolled between 1 October 2022 and 30 May 2023 and between 1 October 2023 and 4 May 2024, to the IX Pediatric Infectious Diseases Clinical Section of the National Institute of Infectious Diseases "Prof. Dr. Matei Balș". During the 2022–2023 influenza season, 791 pediatric patients tested positive for influenza and received oseltamivir. Of these, 89% (704/791) had influenza A, with 86.4% having subtype A(H1N1) and 13.6% of cases having A(H3N2), and for influenza B, 11% (87/791) of the pediatric patients. Of the total group, 59% were male, and the median age was 2.4 years (1.02–9.28). For the 2023–2024 influenza season, 509 pediatric patients tested positive for influenza, with 56.9% being of the male gender and who were treated with oseltamivir. Of these patients, 81.6% had influenza A and 18.4% had influenza B. Treatment with neuraminidase inhibitors, specifically oseltamivir, 2 mg/kg/dose administered twice daily for 5 days, was well tolerated by the children, and we recorded no deaths. The duration of hospitalization for patients with a fever after the oseltamivir administration was significantly longer for patients with A(H1N1) infection than A(H3N2), during both seasons. We identified more complications in the 2022–2023 season and a decreasing number of influenza B for the 2023–2024 season. Among children with comorbidities, the most common were asthma, gastrointestinal diseases, and metabolic and endocrine diseases. In terms of effectiveness, oseltamivir significantly reduced the intensity of influenza symptoms, thus reducing the number of days of hospitalization (p = 0.001) as well as post-infection complications (p = 0.005) in both groups. In this study, we evaluated the clinical effectiveness of oseltamivir therapy for all influenza types/subtypes in children, and the length of hospitalization. We identified comorbidities associated with the prolonged duration of hospitalization. Influenza vaccination should be the main tool in the prevention of influenza and its complications in children, especially those with comorbidities. [ABSTRACT FROM AUTHOR]

Hyponatremia is a common complication following endoscopic endonasal resection (EER) of pituitary adenomas. We report a single-center, multisurgeon study detailing baseline clinical data, outcomes, and factors associated with postoperative hyponatremia. This was a retrospective cohort study of patients undergoing EER for pituitary adenoma at Tufts Medical Center. Most procedures were performed by the senior author (C.B.H.). Cases were included if at least 1 postoperative sodium value was available and pathology confirmed pituitary adenoma. Hyponatremia was defined as a postoperative sodium level <135 mEq/L. A total of 272 patients underwent 310 EER procedures that met the study inclusion criteria. The mean patient age was 53.3 years, and mean tumor size was 18.8 mm. Postoperative hyponatremia occurred in 12.6% of cases, with 3.6% developing hyponatremia prior to discharge. Lower preoperative sodium level was associated with an increased risk of developing any postoperative hyponatremia. Older age, prolactinoma pathology, and use of selective serotonin reuptake inhibitors were associated with moderate to severe hyponatremia (≤129 mEq/L), and lower preoperative sodium was associated with mild hyponatremia (130–134 mEq/L). Hyponatremia-related readmissions within 30 days occurred in 3.9% of patients. Both African-American race and postoperative hyponatremia were associated with an increased risk of 30-day readmission. The mean nadir sodium for hyponatremic patients was 129.9 mEq/L. Growth hormone–secreting pathology was associated with lower postoperative nadir sodium, whereas higher preoperative sodium was associated with higher postoperative nadir sodium. Hyponatremia is a common postoperative complication of EER for pituitary lesions that can cause significant morbidity, increased readmissions, and increased healthcare costs. [ABSTRACT FROM AUTHOR]

The article examines the intricate relationship between women's health, hormones, and the microbiome. Topics discussed include the biological and structural differences that contribute to health disparities between men and women, the influence of sex hormones on immune function and autoimmune disorders, and the interplay between gut microbiota and hormone regulation, emphasizing how dysbiosis can impact overall health and hormonal balance.

Simple Summary: Hyperadrenocorticism in dogs is a condition characterized by excess cortisol and can disrupt overall health. This study examined its impact on gut bacteria, which is crucial for health. Compared to healthy dogs, the dogs with hyperadrenocorticism had less diverse gut bacteria and an increase in Proteobacteria (Pseudomonadota), Actinobacteria, Bacteroides, Enterococcus, Corynebacterium, Escherichia, and Proteus, alongside a decrease in Firmicutes (Bacillota). These imbalances continued even after treatment, suggesting ongoing health risks. Understanding these gut changes can improve treatments for affected dogs. Hyperadrenocorticism (HAC) is a common endocrine disorder in dogs, which is associated with diverse metabolic abnormalities. We hypothesized that elevated cortisol levels in dogs with HAC disrupt the gut microbiome (GM), and this disruption persists even after trilostane treatment. This study explored GM composition in dogs with HAC. We included 24 dogs, 15 with HAC and 9 healthy controls, and followed up with 5 dogs with HAC who received trilostane treatment. The GM analysis revealed significant compositional changes in dogs with HAC, including reduced microbiome diversity compared to healthy controls, particularly in rare taxa, as indicated by the Shannon index (p = 0.0148). Beta diversity analysis further showed a distinct clustering of microbiomes in dogs with HAC, separating them from healthy dogs (p < 0.003). Specifically, an overrepresentation of Proteobacteria (Pseudomonadota), Actinobacteria, Bacteroides, Enterococcus, Corynebacterium, Escherichia, and Proteus populations occurred alongside a decreased Firmicutes (Bacillota) population. Despite trilostane treatment, gut dysbiosis persisted in dogs with HAC at a median of 41 d post treatment, suggesting its potential role in ongoing metabolic issues. We identified GM dysbiosis in dogs with HAC by examining key bacterial genera, offering insights into potential interventions like probiotics or fecal microbiota transplants for better HAC management. [ABSTRACT FROM AUTHOR]

Lepidium peruvianum—an edible herbaceous biennial plant distributed in the Andes—has been used for centuries as food and as a natural medicine in treating hormonal disorders, as an antidepressant, and as an anti-osteoporotic agent. The presented study aims to prove its beneficial cosmetic and chemopreventive properties by testing the antiradical, whitening, cytotoxic, and anticancer properties of differently colored phenotypes that were extracted using three solvents: methanol, water, and chloroform, with the help of the chemometric approach to provide evidence on the impact of single glucosinolanes (seven identified compounds in the HPLC-ESI-QTOF-MS/MS analysis) on the biological activity of the total extracts. The tested extracts exhibited moderate antiradical activity, with the methanolic extract from yellow and grey maca phenotypes scavenging 49.9 ± 8.96% and 48.8% ± 0.44% of DPPH radical solution at a concentration of 1 mg/mL, respectively. Grey maca was the most active tyrosinase inhibitor, with 72.86 ± 3.42% of the enzyme activity calculated for the water extract and 75.66 ± 6.21% for the chloroform extract. The studies in cells showed no cytotoxicity towards the human keratinocyte line HaCaT in all studied extracts and a marked inhibition of cell viability towards the G361 melanoma cell line, which the presence of pent-4-enylglucosinolate, glucotropaeolin, and glucoalyssin in the samples could have caused. Given all biological activity tests combined, the three mentioned compounds were shown to be the most significant positive contributors to the results obtained, and the grey maca water extract was found to be the best source of the former compound among the tested samples. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a complex and multifactorial endocrine disorder predominantly affecting premenopausal women, characterized by hyperandrogenism, chronic anovulation, and polycystic ovarian morphology. Hyperandrogenism, a central pathogenic factor, negatively influences metabolism through its effects on various tissues and organs, including adipose tissue, skeletal muscle, and the liver. The redistribution of adiposity towards visceral and intraperitoneal fat depots, driven by androgens, is correlated with an increased risk of abdominal obesity and insulin resistance. In skeletal muscles, hyperandrogenism induces a decrease in insulin sensitivity by disrupting insulin signaling and mitochondrial function, thereby contributing to the metabolic dysfunctions associated with PCOS. At the hepatic level, women with PCOS exhibit a higher prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), a relationship largely mediated by chronic inflammation and the proinflammatory effects of androgens. These findings underscore the importance of understanding the molecular mechanisms underlying the relationship between hyperandrogenism and metabolic dysfunctions in PCOS, with significant implications for the development of innovative and personalized therapeutic strategies. Given the high prevalence and significant impact of PCOS on metabolic health, future research should focus on elucidating these mechanisms and identifying more effective therapeutic approaches. [ABSTRACT FROM AUTHOR]

Background: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age, characterized by hyperandrogenism, chronic anovulation, and polycystic ovaries. Obesity often exacerbates the clinical manifestations of PCOS, contributing to insulin resistance, metabolic disturbances, and reproductive issues. This study aims to evaluate the effect of a period of aerobic exercises on sexual hormones and appetite in obese women with Polycystic Ovary Syndrome (PCOS). Methods: This semi-experimental study involved 30 obese women with PCOS, divided into an aerobic exercise group and a control group (15 participants each). The exercise group underwent a supervised 12-week aerobic training program, consisting of three 60-minute sessions per week. Hormonal levels (prolactin, luteinizing hormone [LH], follicle-stimulating hormone [FSH], total testosterone, hydroxyprogesterone, LH/FSH ratio) and appetite scores were measured before and after the intervention. Statistical analyses were performed using ANCOVA to assess the impact of the exercise intervention, adjusting for pre-test scores. Results: Significant improvements were observed in the experimental group postintervention. Prolactin levels decreased from 20.95 ± 2.63 ng/mL to 18.50 ± 1.82 ng/mL (P < 0.001), LH levels from 9.47 ± 2.35 mIU/mL to 6.02 ± 1.45 mIU/mL (P < 0.001), FSH levels from 5.21 ±1.09 mIU/mL to 4.21 ±1.22 mIU/mL (p < 0.001), total testosterone levels from 59.19 ± 20.20 g/mL to 40.62 ± 14.81 g/mL (P < 0.001), and hydroxyprogesterone levels from 4.83 ± 1.65 Mol/L to 3.98 ± 0.95 Mol/L (P < 0.001). The LH/FSH ratio improved from 1.87 ± 0.54 to 1.52 ± 0.47 (p = 0.025), and appetite scores decreased from 7.53 ± 1.50 to 6.33 ± 1.18 (P< 0.001). Conclusion: Aerobic exercise significantly improves hormonal profiles and reduces appetite in obese women with PCOS, highlighting its potential as an effective therapeutic intervention. Regular aerobic training can address both reproductive and metabolic aspects of PCOS, enhancing overall health and quality of life. [ABSTRACT FROM AUTHOR]

Purpose: The Rehabilitation Interventions for Individuals with a Spinal Cord Injury in the Community (RIISC) team aimed to develop and evaluate innovative rehabilitation interventions to identify endocrine metabolic disease (EMD) risk, intending to reduce the frequency and severity of EMD related morbidity and mortality among adults living with chronic spinal cord injury or disease (SCI/D). Materials and Methods: An interprovincial team from Ontario and Quebec reviewed available EMD literature and evidence syntheses and completed an inventory of health services, policies and practices in SCI/D care. The review outcomes were combined with expert opinion to create an EMD risk model to inform health service transformation. Results: EMD risk and mortality are highly prevalent among adults with chronic SCI/D. In stark contrast, few rehabilitation interventions target EMD outcomes. The modelled solution proposes: 1) abandoning single-disease paradigms and examining a holistic perspective of the individual's EMD risk, and 2) developing and disseminating practice-based research approaches in outpatient community settings. Conclusions: RIISC model adoption could accelerate EMD care optimization, and ultimately inform the design of large-scale longitudinal pragmatic trials likely to improve health outcomes. Linking the RIISC team activities to economic evaluations and policy deliverables will strengthen the relevance and impact among policymakers, health care providers and patients. IMPLICATIONS FOR REHABILITATION: Living with a spinal cord injury or disease (SCI/D) increases endocrine metabolic disease (EMD) risk. EMD-related outcomes include fracture; type II diabetes; and cardiovascular disease (myocardial infarction, sudden cardiac death and stroke), directly contributing to higher morbidity and mortality. Single-disease paradigms are not the ideal strategy to address multimorbidity contexts experienced in SCI/D. Practice-based research could be an alternative/adjunct to randomized control trials at generating evidence on current and emerging rehabilitation approaches. [ABSTRACT FROM AUTHOR]

Posterior pituitary ectopia is a very rare entity in the development of the pituitary gland. Several factors and multiple genes are associated with this entity causing both pituitary and extrapituitary abnormalities. Pituitary abnormalities can be various endocrine problems and extrapituitary abnormalities can be optic nerves and cerebellar hypoplasia, heterotopia, and abnormal vessels. This pictorial review represents the imaging manifestations of extrapituitary intracranial anomalies that can be associated with posterior pituitary ectopia. [ABSTRACT FROM AUTHOR]

Diabetes is one of the common endocrine disorders generally characterized by elevated levels of blood sugar. It can originate either from the inability of the pancreas to synthesize insulin, which is considered as an autoimmune disorder, or the reduced production of insulin, considered as insulin resistivity. A wound can be defined as a condition of damage to living tissues including skin, mucous membrane and other organs as well. Wounds get complicated with respect to time based on specific processes like diabetes mellitus, obesity and immunocompromised conditions. Proper growth and functionality of the epidermis gets sustained due to impaired diabetic wound healing which shows a sign of dysregulated wound healing process. In comparison with synthetic medications, phytochemicals like flavonoids, tannins, alkaloids and glycosides have gained enormous importance relying on their distinct potential to heal diabetic wounds. Flavonoids are one of the most promising and important groups of natural compounds which can be used to treat acute as well as chronic wounds. Flavonoids show excellent properties due to the presence of hydroxyl groups in their chemical structure, which makes this class of compounds different from others. Based on the novel principles of nanotechnology via utilizing suitable drug delivery systems, the delivery of bioactive constituents from plant source amplifies the wound-healing mechanism, minimizes complexities and enhances bioavailability. Hence, the encapsulation and applicability of flavonoids with an emphasis on mechanistic route and wound-healing therapeutics have been highlighted in the subsequent study with focus on multiple drug delivery systems. [ABSTRACT FROM AUTHOR]

Hypoglycemia in critical care is a well-documented phenomenon, linking both physiological and clinical evidence to harmful outcomes and an increased risk of mortality. Its implications span medical and non-medical consequences, such as cardiovascular and cerebrovascular complications, and escalated health care expenses and hospitalization duration. Mitigation measures for modifiable risk factors and education for both patients and health care providers on hypoglycemia can effectively prevent the onset of inpatient hypoglycemia. This concise clinical review offers a brief overview of hypoglycemia in critically ill patients, encompassing its pathophysiology, etiology, diagnosis, management, and prevention. [ABSTRACT FROM AUTHOR]

Background: Hypothyroidism and Type 2 Diabetes Mellitus (T2DM) are prevalent endocrine disorders, and their interplay has garnered significant attention due to potential bidirectional relationships. This study investigates the association of hypothyroidism in T2DM patients, focusing on prevalence, clinical correlations, and implications for management. Materials & Methods: A cross-sectional study was conducted at Hind Institute of Medical Sciences, Uttar Pradesh, involving 50 T2DM patients. Clinical assessments, thyroid function tests, and diabetes parameters were collected. Statistical analyses, including descriptive statistics, odds ratios, and correlation coefficients, were employed to explore associations. Results: Among T2DM patients, 20% exhibited hypothyroidism, emphasizing a noteworthy prevalence. Alterations in thyroid function parameters, including elevated TSH and decreased FT4 and FT3, indicated subclinical hypothyroidism. Glycemic control analyses revealed significant differences in FBG and HbA1c levels between euthyroid and hypothyroid individuals. Odds ratios demonstrated associations between hypothyroidism and age, BMI, and T2DM duration. Medication usage patterns highlighted the necessity of thyroid-specific interventions. Conclusion: This study uncovers a substantial prevalence of hypothyroidism in T2DM patients, emphasizing the intricate relationship between these endocrine disorders. Clinical correlations with age, BMI, and T2DM duration suggest the need for tailored therapeutic approaches. Recognizing the impact on glycemic control, screening strategies, and public health measures may enhance patient outcomes in this complex interplay. [ABSTRACT FROM AUTHOR]

Background Severe hypertension in young patients presents a significant diagnostic dilemma, and treatment can often be codified. Therefore, it is crucial to diagnose these cases for probable secondary hypertension. Common causes of secondary hypertension include large vessel vasculitis, renal artery stenosis, coarctation of the aorta, and endocrine disorders. Case summary A 23-year-old Asian male, who was previously in good health, presented with symptoms of chest pain, shortness of breath on exertion grade II, and generalized weakness. On examination, his blood pressure was markedly elevated at 200/110 mmHg. Diagnostic investigations revealed significant vascular involvement, including bilateral renal artery stenosis accompanied by aneurysm formation, celiac trunk disease, and osteal stenosis of the superior mesenteric artery. The patient underwent successful interventional procedure, including renal angioplasty, stenting, and aneurysm coiling. This was followed by tailoring of medical management along with anti-inflammatory and disease-modifying drugs. Discussion The diagnosis of Takayasu arteritis (TAK) in this case is supported by the patients' age, presentation, and imaging according to the new TAK classification criteria by the American College of Rheumatology/European League Against Rheumatism (EULAR) and emphasizes the potential benefits of a pharmaco-invasive approach for optimal outcomes. [ABSTRACT FROM AUTHOR]

Gap junctions are specialized intercellular conduits that provide a direct pathway between neighboring cells, which are involved in numerous physiological processes, such as cellular differentiation, cell growth, and metabolic coordination. The effect of gap junctional hemichannels in folliculogenesis is particularly obvious, and the down‐regulation of connexins is related to abnormal follicle growth. Polycystic ovary syndrome (PCOS) is a ubiquitous endocrine disorder of the reproductive system, affecting the fertility of adult women due to anovulation. Exciting evidence shows that gap junction is involved in the pathological process related to PCOS and affects the development of follicles in women with PCOS. In this review, we examine the expression of connexins in follicular cells of PCOS and figure out whether such communication could have consequences for PCOS women. While along with results from clinical and related animal studies, we summarize the mechanism of connexins involved in the pathogenesis of PCOS. Key Findings: Gap junctional channels contribute to oocyte growth, oocyte maturation, and the proliferation of granulosa cells.Surrounding cumulus cells exerted a restraining effect on oocyte meiosis via functional gap junctions.Gap junction composed of connexin 43 contributes to the differentiation of granulosa cells.Aberrant expression of connexins may contribute to PCOS development and progression.Connexin 43 is involved in PCOS‐relevant pathological processes such as apoptosis of granulosa cells, hyperandrogenism, and IR. [ABSTRACT FROM AUTHOR]

Introduction Early discontinuation of endocrine therapy (ET) is higher among patients with early breast cancer (EBC) compared to patients with metastatic hormone receptor-positive (HR+) breast cancer (MBC). In our clinical experience the reasons for this may include a significant burden of ET side effects impacting quality of life (QOL) in patients with EBC. We hypothesized that QOL is lower in patients with HR + EBC compared to patients with HR + MBC on ET. Methods We conducted a cross-sectional observational study to assess QOL utilizing FACT-ES & EORTC QLQ C30 tools among patients with EBC and MBC receiving ET across 5 Irish hospitals. Results A total of 417 patients were enrolled—EBC (79% n  = 331) and MBC 21% (n  = 86). Using the FACT-ES, we found no difference in overall QOL by stage (139.2 vs 141, P  = .33). Patients with HR + MBC had a lower symptom burden from ET compared to HR + EBC (61.4 vs 54, P  < .01). In adjusted multivariate linear regression models, there was no difference in QOL for patients with EBC and MBC receiving ET. Conclusions There was no significant difference in overall QOL for patients with EBC and MBC. However, patients with EBC experienced more endocrine symptoms. In adjusted multivariate linear regression models, the stage did not predict QOL. Our results suggest that endocrine symptoms are significant contributors to impaired QOL for patients with EBC but the role of other determinants of QOL (eg, stage) is less clear. Future work could include the development of stage-specific QOL tools and utilization of electronic patient-reported outcomes (ePROs) to identify and manage emergent toxicities. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is one of women's most common endocrine disorders that can cause anxiety, psychological distress, and reduced quality of life (QOL). Aims and Objectives: The present study aimed to determine the effectiveness of a 9-week mindfulness-based meditation program on the QOL and general health parameters in young women with PCOS. Materials and Methods: This study was implemented on women diagnosed with PCOS based on Rotterdam criteria. The program was conducted for 9 weeks, beginning with a 15 min session and gradually increasing it to 60 min. The program included techniques on breath focus, body scan, "Om" chanting, mindful breathing, thinking, seeing, and listening. Pre-intervention questionnaires were given to the participants. These were a PCOS questionnaire (PCOSQ), a general health-related QOL questionnaire, and a five-item questionnaire for acne problems. Responses of participants were analyzed using 22 SPSS statistical software. Results: There was a significant difference in the mean of pre- and post-intervention Likert scale response values for the 26-item PCOSQ. There was no significant difference in the mean of pre- and post-intervention Likert scale response values for the acne questionnaire. Prior to the intervention only 8% reported "excellent" health, after the intervention 63% reported "very good." 42% reported a reduction in pain, and 71% reported that they were calm and peaceful "most of the time." Conclusion: Results showed that mindfulness meditation intervention had caused a significant change in general health and QOL of patients with PCOS. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Its prevalence varies with the type of diagnostic criteria used. PCOS is also associated with social stigma and lack of knowledge. Due to its heterogeneous presentation, symptoms and complications of PCOS may vary from person to person. Aims and Objectives: The aim of this study was to determine the prevalence and knowledge regarding PCOS in young college-going girls in Central India. Materials and Methods: This is a questionnaire-based study. The study included 18 questions assessing knowledge and prevalence of PCOS. Results: We included 371 participants in the study with a mean age of 20.77 ± 2.11 years. The mean body mass index of all the participants was around 20.4 kg/m². The prevalence of PCOS as per the Rotterdam criteria was found to be 9.4% in our study. Conclusion: We investigated PCOS prevalence and knowledge among young girls in Central India. Most individuals in our survey understood that lifestyle changes such as exercise, healthy sleep, and diet can help manage and prevent PCOS, but adherence is still low. Lifestyle has a major influence on PCOS's multifactorial pathogenesis. PCOS awareness needs to be raised through more programs. [ABSTRACT FROM AUTHOR]

Multiple changes occur in hormonal regulation with aging and across various endocrine organs. These changes are associated with multiple age-related disorders and diseases. A better understanding of responsible underling biological mechanisms could help in the management of multiple endocrine disorders over and above hormone replacement therapy (HRT). Cellular senescence is involved in multiple biological aging processes and pathologies common in elderly individuals. Cellular senescence, which occurs in many older individuals but also across the lifespan in association with tissue damage, acute and chronic diseases, certain drugs, and genetic syndromes, may contribute to such endocrine disorders as osteoporosis, metabolic syndrome, and type 2 diabetes mellitus. Drugs that selectively induce senescent cell removal, "senolytics,", and drugs that attenuate the tissue-destructive secretory state of certain senescent cells, "senomorphics," appear to delay the onset of or alleviate multiple diseases, including but not limited to endocrine disorders such as diabetes, complications of obesity, age-related osteoporosis, and cancers as well as atherosclerosis, chronic kidney disease, neurodegenerative disorders, and many others. More than 30 clinical trials of senolytic and senomorphic agents have already been completed, are underway, or are planned for a variety of indications. Targeting senescent cells is a novel strategy that is distinct from conventional therapies such as HRT, and thus might address unmet medical needs and can potentially amplify effects of established endocrine drug regimens, perhaps allowing for dose decreases and reducing side effects. [ABSTRACT FROM AUTHOR]

Background: Hypertension is prevalent in the pediatric population, with estimated rates between 2% and 5%, and its incidence is rising globally. This study offers a single-center analysis of hypertension in children. Methods: a retrospective chart review was conducted involving children aged 1 month to 13 years diagnosed with hypertension. Results: The study included a total of 129 children. Secondary hypertension was identified in 103 patients (79.8%), while primary hypertension was noted in 26 patients (20.2%). Primary hypertension was more common among pre-teen children (50.0%), whereas secondary hypertension predominantly affected those aged 1 to 5 years. Renal parenchymal disease emerged as the most frequent etiology of secondary hypertension, followed by endocrine disorders and vascular issues. No significant correlation was found between hypertension and obesity. The primary complications associated with hypertension in these children were cardiovascular, followed by neurological issues. A small proportion (14.7%) managed their hypertension solely through lifestyle modifications, while the majority required additional antihypertensive medications. At the final follow-up, 50% of the children demonstrated improved blood pressure readings. Conclusion: The findings indicate a higher prevalence of secondary hypertension compared to primary hypertension among the studied population. This study underscores the necessity for heightened awareness among pediatricians regarding the early identification and management of hypertension. Larger population-based studies are warranted to further investigate the prevalence, causes, and outcomes of hypertension in this region. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is one of the major endocrine disorders faced by 5-10% of women in their childbearing period. Characterized by raised androgen levels, irregularities in menses and/or polycystic ovaries, the best description that can be linked to PCOS would then be a syndrome including hyperandrogenism, chronic anovulation, and polycystic ovaries. PCOS is a heterogeneous condition associated with many potentially co-occurring disorders, including insulin resistance, obesity and infertility, type 2 diabetes mellitus, cardiovascular disease and even endometrial cancer. The exact causes of this syndrome are yet unknown, though genes, metabolism, malfunction of the endocrine system, and environmental factors are claimed to be involved. Hyperandrogenism manifests itself in the difficulty of follicles to grow and develop, forming small cysts in the ovaries, creating anovulation, contributing to menstrual changes. Modest amounts of weight loss, such as 5%, can be associated with improved endocrine profile and increased likelihood of ovulation and pregnancy. PCOS is treated by means of lifestyle modifications in the form of diet and exercise, medications like clomiphene citrate or metformin, and surgical measures like laparoscopic ovarian drilling only in a few. Diagnosis at an early stage and early institution of treatment are very important to prevent or at least delay the long-term complications of PCOS. With proper management, most women can achieve regularity in menses, ovulation, and finally, successful pregnancy. [ABSTRACT FROM AUTHOR]