Parathyroid cancer — difficult diagnosis — a case report

Parathyroid cancer is a rare disorder of unclear etiology that is difficult to diagnose and treat. It is most often diagnosed incidentally based on multi-organ non-specific symptoms of hypercalcemia as a consequence of parathyroid hormone oversecretion. We present a case of a male with primary hyperparathyroidism who was diagnosed with parathyroid cancer ectopically located in the mediastinum only after the third surgery. However, due to chronic hypercalcemia, problems with localization and a bad clinical condition, the patient was not able to undergo a radical resection and one year after the first pathological fracture died. Taking into consideration the whole clinical picture we want to emphasize the need to apply comprehensive differential diagnosis of hypercalcemia and localization diagnosis of parathyroid tissue with a use of MIBI scintigraphy accompanied by the computed tomography and magnetic resonance imaging, as the most specific diagnostic tools employed in this pathology.Parathyroid cancer is a rare disorder of unclear etiology that is difficult to diagnose and treat. It is most often diagnosed incidentally based on multi-organ non-specific symptoms of hypercalcemia as a consequence of parathyroid hormone oversecretion. We present a case of a male with primary hyperparathyroidism who was diagnosed with parathyroid cancer ectopically located in the mediastinum only after the third surgery. However, due to chronic hypercalcemia, problems with localization and a bad clinical condition, the patient was not able to undergo a radical resection and one year after the first pathological fracture died. Taking into consideration the whole clinical picture we want to emphasize the need to apply comprehensive differential diagnosis of hypercalcemia and localization diagnosis of parathyroid tissue with a use of MIBI scintigraphy accompanied by the computed tomography and magnetic resonance imaging, as the most specific diagnostic tools employed in this pathology

Addison’s disease — symptoms and diagnosis. Case study

Wstęp. Choroba Addisona to zespół objawów klinicznych, wywołanych długotrwałym niedoborem hormonów kory nadnerczy, do którego dochodzi w wyniku autoimmunologicznego uszkodzenia nadnerczy. Najczęściej chorują kobiety, a początek choroby obserwuje się zwykle w 3. lub 4. dekadzie życia. Cel pracy. Przedstawienie trudności diagnostycznych, jakie mogą pojawić się w związku z ustaleniem ostatecznego rozpoznania choroby Addisona. Opis przypadku. Pacjentka 24-letnia z podejrzeniem pierwotnej niedoczynności kory nadnerczy została w trybie nagłym przyjęta do Kliniki Endokry­nologii. Od około pięciu miesięcy chora obserwowała nasilające się ciemnienie skóry, hipotensję, postępujące osłabienie z epizodami zasłabnięć, pogorszenie apetytu wraz z towarzyszącym spadkiem masy ciała. Lekarz rodzinny i dermatolog, do których w pierwszej kolejności zgłosiła się chora, nie brali pod uwagę patologii nadnerczy jako przyczyny zgłaszanych objawów, co opóźniło ustalenie ostatecznego rozpoznania. Wnioski. Ważną rolę w diagnostyce niedoczynności kor y nadnerczy odgrywa dobrze zebrany wywiad chorobowy oraz badanie przedmiotowe, a dokładna znajomość objawów klinicznych może znacznie ułatwić wczesne ustalenie rozpoznania. Choroba Addisona może przebiegać bez charakterystycznych zaburzeń gospodarki elektrolitowej, co może utrudniać jej wczesne rozpoznanie.Introduction. Addison’s disease is a constellation of symptoms triggered by long-term adrenal insufficiency, which is caused by autoimmune adrenal damage. Addison’s disease affects mostly women. The onset of the disease is usually observed in 3rd or 4th decade of life. Aim of the study. In the present paper diagnostic difficulties connected with posting a final diagnosis of Addison’s disease were presented. Case study. A 24-year female patient was admitted to Clinic of Endocrinology as an emergency case with suspected primary adrenal insufficiency. The medical history of the patient indicated progressive darkening of the skin, hypotension, fatigue with episodes of collapse, decreased appetite and weight loss over the last five months. The general practitioner and the dermatologist, who she consulted first, didn’t take into account the adrenal pathology as the cause of reported symptoms, which delayed the posting of final diagnosis. Conclusions. A significant factor in diagnosing adrenal insufficiency is a w ell-gathered medical history and physical examination. A thorough knowledge of signs and symptoms of this disease may be the key to early diagnosis. Addison’s disease may show no characteristic electrolyte metabolism disturbances, which may be a significant problem in posting an accurate early diagnosis

Zapotin, a Polymethoxyflavone, with Potential Therapeutic Attributes

The use of plants as traditional medicines is common and has prevailed in many different cultures over time. Polymethoxyflavones (PMFs) are natural polyphenols from the group of flavonoids. Zapotin, a member of the PMFs, is found mainly in citrus plants and is almost exclusively limited to their peels. The chemical structure of zapotin has been questioned from the very beginning, since the structure of flavonoids with a single oxygen atom in the C2′ position is extremely rare in the plant kingdom. To clarify this, the structural determination and bio-inspired synthesis of zapotin are discussed in detail in this review. Due to the broad biological potential of PMFs, the complication in the isolation process and characterization of PMFs, as well as their purification, have been estimated by adapting various chromatographic methods. According to available data from the literature, zapotin may be a promising curative agent with extensive biological activities, especially as a chemopreventive factor. Apart from that, zapotin acts as an antidepressant-like, anticancer, antifungal, and antioxidant agent. Finally, accessible studies about zapotin metabolism (absorption, distribution, metabolism, excretion, and toxicity) underline its potential in use as a therapeutic substance

In Vitro Screening for Anti-Acetylcholinesterase and Antioxidant Activities of Hottonia palustris L. Extracts and Their Unusual Flavonoids

Hottonia palustris L. is from the genus Hottonia (Primulaceae), and the understanding of its phytochemical and pharmacological properties is limited. In this study, the use of chromatographic techniques led to the isolation of a further eleven compounds, including three new flavonoids: 2′,5-dihydroxyflavone 2′-O-β-glucopyranoside, 5,6-dihydroxyflavone 6-O-(6”-O-glucopyranosyl)-β-glucopyranoside (hottonioside A), and 4′,5,7-trihydroxyflavone 7-O-(2”-O-β-glucuronide)-β-glucopyranoside. Their structures were determined using extensive 1D and 2D NMR data and mass spectrometry (HRMS). The qualitative assessment of the chemical composition of the investigated extracts and fractions was performed using the LC-HRMS technique. Furthermore, the antioxidant potential of extracts, fractions, and compounds and their ability to inhibit acetylcholinesterase were also evaluated. Thus, we may conclude that the observed biological effects are the result of the presence of many biologically active compounds, of which dibenzoylmethane is the most active. Therefore, H. palustris is a source of substances with desirable properties in the prevention and treatment of neurodegenerative diseases

New Flavone C-Glycosides from Scleranthus perennis and Their Anti-Collagenase Activity

Three new flavone glycosides, one known flavone glycoside, and the phenolic derivative apiopaenonside were isolated and identified from the ethyl acetate fraction of the aerial parts of Scleranthus perennis. The planar structures were elucidated through extensive analysis of UV-Vis, IR, and 1H NMR and 13C NMR spectral data, including the 2D techniques COSY, HSQC, and HMBC, as well as ESI mass spectrometry. The isolated compounds were established as 5,7,3′-trihydroxy-4′-acetoxyflavone-8-C-β-d-xylopyranoside-2′′-O-glucoside (1), 5,7,3′-trihydroxy-4′-methoxyflavone-8-C-β-d-xylopyranoside-2′′-O-glucoside (2), 5,7-dihydroxy-3′-methoxy-4′-acetoxyflavone-8-C-β-d-xylopyranoside-2′′-O-glucoside (3), 5,7-dihydroxy-3′-methoxy-4′-acetoxyflavone-8-C-β-d-xylopyranoside-2′′-O-(4′′′-acetoxy)-glucoside (4), and apiopaenonside (5). Moreover, all isolated compounds were evaluated for anti-collagenase activity. All compounds exhibited moderate inhibitory activity with IC50 values ranging from 36.06 to 70.24 µM

Analiza obrazu klinicznego niedoczynności tarczycy u kobiet w okresie menopauzy

The objective of this retrospective study was to analyze the clinical picture of hypothyroidism in women, inrelation to their menopausal status. Materials and methods: A total of 694 female ambulatory patients were divided into 3 groups: group I – 258menstruating patients aged up to 45, group II – 124 perimenopausal patients aged between 46 and 52, group III– 312 postmenopausal patients aged over 52. Medical documentation of the patients with hypothyroidism wasevaluated in terms of the selected features of their medical history and clinical picture of the disease. Results: The main cause of hypothyroidism was the chronic autoimmune thyroid gland inflammation; ingroup I it concerned 62.8% of patients, in the remaining two groups it was 50.0% and 51.6%, respectively. Analysing the prevalence of clinical symptoms it was found that the most frequent ones were: weight gain (18.6%),weakness (16.3%) and drowsiness (14.7%). In group II the prevailing symptoms were: hypertension (37.1%),weight gain (21.8%), drowsiness and weakness (12.1%) whereas in group III hypertension (60.3%), symptoms ofischemic heart disease (24.4%) and weight gain (14.4%) were dominant. Mean daily doses of levothyroxine usedin the 3 groups of patients were 90 μg, 81 μg ,74 μg, respectively. In women from groups II and III, a lipid balancedisorder (hypercholesterolemia) was observed significantly more often than in younger patients. Conclusions: Hyperthyroidism was diagnosed most frequently in postmenopausal women. The main causeof hypothyroidism was the chronic autoimmune thyroid gland inflammation. In postmenopausal women unusualclinical symptoms of hyperthyroidism dominated, which resulted from the coexistence of other diseases,mainly cardiovascular disorders. A 24-hour long-dose of levothyroxine in postmenopausal women was lower ascompared to menstruating women. Hypercholesterolemia was a considerably frequent element of the clinicalpicture of hypothyroidism in postmenopausal women

Determination of Flavonoids in Selected Scleranthus Species and Their Anti-Collagenase and Antioxidant Potential

A new 5,7-dihydroxy-3′-methoxy-4′-acetoxyflavone-8-C-β-d-arabinopyranoside-2″-O-(4‴-acetoxy)-glucoside (6) and three known flavone C-glycosides—5,7,3′,4′-tetrahydroxyflavone-6-C-xyloside-8-C-β-d-glucoside (lucenin-1) (7), 5,7,3′-trihydroxyflavone-6-C-glucoside-8-C-β-d-glucoside (vicenin-2) (8), and 5,7,4′-trihydroxy-3′-methoxyflavone-6-C-β-d-glucopyranoside-8-C-α-arabinopyranoside (chrysoeriol-6-C-β-d-glucopyranoside-8-C-α-arabinopyranoside) (9)—were isolated from aerial parts of Scleranthus perennis L. (Caryophyllaceae). Their structures were determined through the use of comprehensive spectroscopic and spectrometric methods, and a method for the quantification of the major constituents of S. perennis and S. annuus L. was developed. Furthermore, the anti-collagenase and antioxidant activities of all isolated compounds obtained from extracts and fractions from both Scleranthus species were evaluated. The highest percentage of collagenase inhibition (at 400 µg/mL) was distinguished for methanolic extracts (22.06%, 32.04%) and ethyl acetate fractions (16.59%, 14.40%) from S. annuus and S. perennis. Compounds 6–9 displayed moderate inhibitory activity, with IC50 values ranging from 39.59–73.86 µM

New Polymethoxyflavones from Hottonia palustris Evoke DNA Biosynthesis-Inhibitory Activity in An Oral Squamous Carcinoma (SCC-25) Cell Line

Four new compounds, 5-hydroxy-2′,6′-dimethoxyflavone (4), 5-hydroxy-2′,3′,6′-trimethoxyflavone (5), 5-dihydroxy-6-methoxyflavone (6), and 5,6′-dihydroxy-2′,3′-dimethoxyflavone (7), and three known compounds, 1,3-diphenylpropane-1,3-dione (1), 5-hydroxyflavone (2), and 5-hydroxy-2′-methoxyflavone (3), were isolated from the aerial parts of Hottonia palustris. Their chemical structures were determined through the use of spectral, spectroscopic and crystallographic methods. The quantitative analysis of the compounds (1–7) and the zapotin (ZAP) in methanol (HP1), petroleum (HP6), and two chloroform extracts (HP7 and HP8) were also determined using HPLC-PDA. The biological activity of these compounds and extracts on the oral squamous carcinoma cell (SCC-25) line was investigated by considering their cytotoxic effects using the MTT assay. Subsequently, the most active compounds and extracts were assessed for their effect on DNA biosynthesis. It was found that all tested samples during 48 h treatment of SCC-25 cells induced the DNA biosynthesis-inhibitory activity: compound 1 (IC50, 29.10 ± 1.45 µM), compound 7 (IC50, 40.60 ± 1.65 µM) and extracts ZAP (IC50, 20.33 ± 1.01 µM), HP6 (IC50, 14.90 ± 0.74 µg), HP7 (IC50, 16.70 ± 0.83 µg), and HP1 (IC50, 30.30 ± 1.15 µg). The data suggest that the novel polymethoxyflavones isolated from Hottonia palustris evoke potent DNA biosynthesis inhibitory activity that may be considered in further studies on experimental pharmacotherapy of oral squamous cell carcinoma

Rosemary Extract-Induced Autophagy and Decrease in Accumulation of Collagen Type I in Osteogenesis Imperfecta Skin Fibroblasts

Osteogenesis imperfecta (OI) is a heterogeneous connective tissue disease mainly caused by structural mutations in type I collagen. Mutant collagen accumulates intracellularly, causing cellular stress that has recently been shown to be phenotype-related. Therefore, the aim of the study was to search for potential drugs reducing collagen accumulation and improving OI fibroblast homeostasis. We found that rosemary extract (RE), which is of great interest to researchers due to its high therapeutic potential, at concentrations of 50 and 100 µg/mL significantly reduced the level of accumulated collagen in the fibroblasts of four patients with severe and lethal OI. The decrease in collagen accumulation was associated with RE-induced autophagy as was evidenced by an increase in the LC3-II/LC3-I ratio, a decrease in p62, and co-localization of type I collagen with LC3-II and LAMP2A by confocal microscopy. The unfolded protein response, activated in three of the four tested cells, and the level of pro-apoptotic markers (Bax, CHOP and cleaved caspase 3) were attenuated by RE. In addition, the role of RE-modulated proteasome in the degradation of unfolded procollagen chains was investigated. This study provides new insight into the beneficial effects of RE that may have some implications in OI therapy targeting cellular stress

LC-ESI-MS profiling of Potentilla norvegica and evaluation of its biological activities

Potentilla L. species have a long history of use in folk medicine for the management of various human ailments. Despite the tremendous number of studies describing the phytochemical and pharmacological profile of a number of Potentilla species, there is a paucity of scientific data regarding the biological activity of Potentilla norvegica. Thus, the present study endeavored to assess the total phenolic content (TPC), total flavonoid content (TFC), and secondary metabolite composition of this plant using LC-ESI-MS-TOF analysis and determined the biological potential of P. norvegica extracts and fractions. Assessment of the antioxidant potential was performed in vitro by using five standard assays (FRAP, CUPRAC, ABTS, DPPH, and metal chelation assays). Moreover, the inhibition of selected enzymes (alpha-amylase, alpha-glucosidase, acetylcholinesterase (AChE), butyrylcholinesterase (BChE), tyrosinase) was examined. During the study, the following extracts and fractions of aerial parts of P. norvegica were analyzed: water (PN1), 50% MeOH (PN2), MeOH (PN3), Et2O (PN4), EtOAc (PN5), and n-BuOH (PN6). The highest TPC and TFC were found in the PN4 fraction (486.21 14.58 mg gallic acid equivalents (GAE)/g extract and 24.22 +/- 0.93 mg rutin equivalents (RE)/g extract, respectively), which may be attributed to the highest ABTS, CUPRAC and metal chelation activities of this fraction (with values of 3.01 +/- 0.01, 5.90 +/- 0.73 mmol Trolox equivalents (TE)/g extract and 20.15 +/- 0.11 mg EDTA equivalents (EDTAE)/g extract, respectively). Furthermore, the PN5 fraction was found to be the most effective in the phosphomolybdenum, DPPH and FRAP assays (5.06 +/- 0.02, 1.55 +/- 0.01 and 5.19 +/- 0.12 mmol TE/ g extract, respectively). PN2 exhibited the highest inhibitory potential against AChE and BChE (2.58 +/- 0.01 and 2.31 +/- 0.13 mg galantamine equivalents (GALAE)/g extract, respectively), which is probably related to the more complete fingerprint of the analyzed extract. Tyrosinase was inhibited most potently by the PN1 extract (50.33 +/- 1.63 mg kojic acid equivalents (KAE)/g extract). However, all the extracts and fractions exerted mild activity against alpha-glucosidase and alpha-amylase (the highest values were 2.03 +/- 0.02 and 0.30 +/- 0.03 mmol acarbose equivalents (ACE)/g extract for PN4 and PN3, respectively). Furthermore, LC-ESI-MS analysis revealed the predominant presence of polyphenolics, with the presence of acacetin indicated in the Potentilla genus for the second time. These observations highlighted the potential applications of P. norvegica as a valuable source of antioxidants, with interesting activities for the development of new treatment strategies against several human diseases in the pharmaceutical sector. (C) 2021 SAAB. Published by Elsevier B.V. All rights reserved