Case Report and#58; A Rare Case of Central Hyperthyroidism During Pregnancy and#45; Diagnostic And Therapeutic Challenge

Central hyperthyroidism is a rare cause of hyperthyroidism. It causes autonomous TSH secretion and is refractory to the negative feedback of thyroid hormones. Most patients with TSH secreting adenomas are diagnosed around the fifth decade of life. Here we present a case of a TSH secreting adenoma detected during the second trimester of pregnancy. We also present the challenges faced in diagnosing and treating the case because the patient refused neurosurgery till she delivered the baby. She was managed medically and successfully delivered a healthy baby via normal vaginal delivery. She was referred to neurosurgery after delivery.nbs

Absence of intestinal PPARγ aggravates acute infectious colitis in mice through a lipocalin-2-dependent pathway.

To be able to colonize its host, invading Salmonella enterica serovar Typhimurium must disrupt and severely affect host-microbiome homeostasis. Here we report that S. Typhimurium induces acute infectious colitis by inhibiting peroxisome proliferator-activated receptor gamma (PPARγ) expression in intestinal epithelial cells. Interestingly, this PPARγ down-regulation by S. Typhimurium is independent of TLR-4 signaling but triggers a marked elevation of host innate immune response genes, including that encoding the antimicrobial peptide lipocalin-2 (Lcn2). Accumulation of Lcn2 stabilizes the metalloproteinase MMP-9 via extracellular binding, which further aggravates the colitis. Remarkably, when exposed to S. Typhimurium, Lcn2-null mice exhibited a drastic reduction of the colitis and remained protected even at later stages of infection. Our data suggest a mechanism in which S. Typhimurium hijacks the control of host immune response genes such as those encoding PPARγ and Lcn2 to acquire residence in a host, which by evolution has established a symbiotic relation with its microbiome community to prevent pathogen invasion

Alirocumab and cardiovascular outcomes after acute coronary syndrome

BACKGROUN

Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome

BACKGROUN