Gastrointestinal tract carcinoid with carcinoid syndrome in 63-year-old diver – a case report

Introduction: Carcinoid is a tumor that originates from neuroendocrine cells.[1] It was primarily named and described in 1907 by Siegfried Oberndorfer to characterize neoplasms located in GIST with a relatively indolent course.[2] Term “carcinoid” is now used to describe. neuroendocrine neoplasms, a subset of rare tumors, mostly sporadic, which are typically located in gastrointestinal tract but they may also appear beyond it (e.g. in thymus or lungs).[2,3] NET’s are highly differentiated and usually hormonally active. Biochemical proof of their presence can consist of a measurement of the released substances – serotonin, bradykinin, histamine, etc. [3]Carcinoid tumors derive from serotonin-producing enterochromaffin cells.[1] They contain high quantities of tryptophane that is transformed later into serotonin. This biogenic amine is responsible for occurrence of so called- carcinoid syndrome. It manifests with hot flushes, diarrhea, tachycardia, vertigo and excessive sweating.[3] The attacks usually last from 0,5 minutes up to half an hour and they can be triggered by food or alcohol consumption, liver palpation or general anesthesia. Due to excessive serotonin production, long lasting carcinoid might lead to right endocardial fibrosis with tricuspid valve and pulmonary valve dysfunction. [4] Description of the case: The following case describes the clinical history, diagnostic process, imaging studies and treatment applied to 63-year-old male professional diver who was admitted to University Hospital of Zielona Góra with a clinical picture that resembled carcinoid syndrome. The final diagnosis- carcinoid originating from the ileum- was settled after performing multiple studies. The patient was referred to the department of Endocrinology and Neuroendocrine Tumors in Silesian University Center in Katowice. He initiated therapy with Somatuline Autogel. The Tumor Board was conducted in order to determine the optimal treatment for the patient

Anaplastic thyroid cancer with life-threatening symptoms in an older female - a case report

Introduction: Anaplastic thyroid cancer, also called undifferentiated, is an uncommon and highly aggressive thyroid neoplasm that usually occurs in patients above 60 years of age (mean 65 years). Incidence is about 1-2 cases per million persons a year. [11] It accounts for 1-2% of thyroid cancer cases and probably develops from previously differentiated thyroid neoplasms. [1] Mutations of TP53 gene are most common and exist in 17-80% of patients. Other frequently mutated genes are RAS, BRAF and β-catenin. [3] The metastatic spread tends to occur through hematogenous and lymphatic pathways. The neoplasm presents as a rapidly enlarging neck mass that can cause compression on the neck structures giving symptoms such as dysphagia and dyspnea. Patients with established diagnosis of anaplastic thyroid cancer have very poor prognosis. Mean survival time of patients after confirmed diagnosis is 3 to 6 months and 5-year survival rate is estimated to be 5-14%. [2] Aim: The aim of this study is to portray the clinical presentation, course and complications of a patient suffering from anaplastic thyroid cancer. This case report includes performed procedures and implemented treatment. Description of the case: We present a case of an 87-year-old female that was admitted to the hospital with a large thyroid mass, symptoms of dysphagia, dyspnea and significant weight loss. Clinical picture was suspicious of anaplastic thyroid cancer. Further workup included laboratory testing, imaging and FNA biopsy. Surgical procedure of tracheostomy was conducted due to life-threatening dyspnea with consecutive patient’s monitoring in Intensive Care Unit. After achieving clinically stable state the patient was transferred to Clinical Department of Radiotherapy where palliative radiotherapy was initiated

Gastrointestinal tract carcinoid with carcinoid syndrome in 63-year-old diver – a case report

Introduction: Carcinoid is a tumor that originates from neuroendocrine cells.[1] It was primarily named and described in 1907 by Siegfried Oberndorfer to characterize neoplasms located in GIST with a relatively indolent course.[2] Term “carcinoid” is now used to describe. neuroendocrine neoplasms, a subset of rare tumors, mostly sporadic, which are typically located in gastrointestinal tract but they may also appear beyond it (e.g. in thymus or lungs).[2,3] NET’s are highly differentiated and usually hormonally active. Biochemical proof of their presence can consist of a measurement of the released substances – serotonin, bradykinin, histamine, etc. [3]Carcinoid tumors derive from serotonin-producing enterochromaffin cells.[1] They contain high quantities of tryptophane that is transformed later into serotonin. This biogenic amine is responsible for occurrence of so called- carcinoid syndrome. It manifests with hot flushes, diarrhea, tachycardia, vertigo and excessive sweating.[3] The attacks usually last from 0,5 minutes up to half an hour and they can be triggered by food or alcohol consumption, liver palpation or general anesthesia. Due to excessive serotonin production, long lasting carcinoid might lead to right endocardial fibrosis with tricuspid valve and pulmonary valve dysfunction. [4] Description of the case: The following case describes the clinical history, diagnostic process, imaging studies and treatment applied to 63-year-old male professional diver who was admitted to University Hospital of Zielona Góra with a clinical picture that resembled carcinoid syndrome. The final diagnosis- carcinoid originating from the ileum- was settled after performing multiple studies. The patient was referred to the department of Endocrinology and Neuroendocrine Tumors in Silesian University Center in Katowice. He initiated therapy with Somatuline Autogel. The Tumor Board was conducted in order to determine the optimal treatment for the patient

Commotio cordis – a review of a rare cause of sudden death in young athletes

Commotio cordis, from Latin “agitation of the heart” is a potentially fatal sudden disruption and alteration of heart electric activity. It is usually caused by relatively mild blunt non-penetrating trauma to the specific point on anterior part of the chest wall during beginning of the heart muscle repolarization phase. It leads to ventricular fibrillation presenting as a collapse few seconds after the blow. It can be lethal without taking proper steps of management in a short ammount of time

Glucose Monitoring Systems - general rules of use and chances in therapy of type 1 diabetes

Introduction: Glycemic control and maintaining it within the desired range are essential for achieving therapeutic goals in patients with type 1 diabetes. Over the years, patients have gained access to advanced glycemic monitoring technologies that have revolutionized self-monitoring methods. These technologies provide data that was previously unavailable to glucometer users. They allow creating new goals to minimize the risk of diabetic complications. Purpose of the work: The goal of this study was to answer the following questions: What additional information do glycemic monitoring systems offer to patients compared to glucometers? How should this information be utilized to make therapeutic decisions? Do these systems lead to improved glycemic management? Materials and Methods: A literature review was made using PubMed, Springer Link and Google Scholar databases, searching for articles published in English and Polish up to May 2023, focusing on type 1 diabetes and glucose monitoring systems. Summary: The use of glycemic monitoring systems provides additional information compared to relying only on glucometers. Patients equipped with a glucose monitoring system can make more accurate therapeutic decisions based on a larger volume of data. Some continuous glucose monitoring systems offer additional features compatible with personal insulin pumps, preventing or reducing the intensity and duration of hypoglycemia. Patients using glycemic monitoring systems can more frequently achieve therapeutic goals

Treatment methods for patients suffering from acute lymphoblastic leukemia (all) - a brief review

Introduction and purpose: Acute lymphoblastic leukemia is a medical condition with underlying abnormal proliferation of cells of the lymphoid system which are blocked at an early stage of differentiation. As a result of impaired lymphocyte maturation, the proliferation and accumulation of immature blastic cells, derived from tumor-transformed bone marrow precursor cells, develop in the bone marrow. The infiltration of the bone marrow by leukemic cells results in failure of normal hematopoiesis, with subsequent anemia, thrombocytopenia and neutropenia. Acute lymphoblastic leukemia is among the most aggressive proliferative diseases, and survival time is a few to several weeks without appropriate treatment.Materials and methods: The literature available on PubMed was reviewed using the words “acute lymphoblastic leukemia ”, “ALL”, “acute lymphoblastic leukemia treatment”.Summary: Acute lymphoblastic leukemia was managed with a chemotherapeutic drug combination for several years, with median overall survival of approximately 80% for all newly diagnosed cases. Patients with higher-risk relapses receive more intensive treatment, while patients with more favorable outcomes can avoid more toxic effects. Multicenter randomized controlled trials conducted by international collaborative efforts are helping to advance overall survival by exploring novel treatments. Hope for the future of leukemia therapy is defining the underlying molecular trails in the pathogenesis of the disease and clarifying host pharmacogenetic factors further. If successful, these efforts will allow the identification of new genes with candidate proteins for targeted therapies

When diet is not enough - obesity treatment options

Introduction: Obesity and overweight are common diseases affecting both children and adults. They cause a number of health consequences, both physical and mental. The diseases underlying obesity include hypertension, type II diabetes and selected cancers. The etiology is multifactorial, resulting from environmental, behavioral and genetic factors. Aim of the study: The aim of our study is to summarize the therapeutic options available to overweight and obese people. We paid special attention to the available pharmacology and surgical treatment. We compared these methods in terms of effectiveness, possible complications and side effects. Materials and methods: The literature available in the PubMed and Google Scholar databases was reviewed, using the following keywords: "obesity treatment", "obesity pharmacotherapy", "bariatric surgery". Conclusions: There are many treatment options for people who have not improved with diet and increased physical activity alone. The availability of both pharmacotherapy and bariatric surgery enables effective treatment of obesity and overweight tailored to the needs of patients

Influence of selected food in the profilactice and treatment of osteoporosis

Introduction: The proper diet plays an extremely important role in the development of the skeletal system from an early age This is one of the few modifiable factors that we can influence by choosing the right food. In the case of osteoporosis, nutrition is not only important during the period of growth, but also for the rest of life, which allows to reduce pathological changes in bones and counteract the effects of reduced bone mineral density such as fractures or death. Purpose of the work: The aim of the study was to answer the question of which nutrients have a significant impact on bone tissue metabolism and minimize the risk of osteoporosis and its consequences, as well as what substances contained in food may be used in the future by medicine for preventive purposes. Summary: Without a doubt, the provision of adequate recommended doses of nutrients with food is crucial for the prevention and treatment of osteoporosis and its consequences, but it should be remembered that the recommended doses are averaged. As studies show, the absorption of the described substances can vary depending on the food contained in the diet, as well as the age of a person, so the recommended doses of patients should be obtained individually, taking into account dietary preferences and laboratory results. In addition, compounds such as isoflavones, while promising in the prevention of this condition, should not be routinely used as a replacement for estrogen hormone therapy, due to the still small amount of research and their ambiguous results. It is worth remembering that often the diet turns out to be an insufficient preventive measure and should be combined with pharmacotherapy. Materials and methods: Literature review in the database PubMed, Google Scholar, Springer Link, MDPI, using the keywords: Osteoporosis, diet, calcium, phosphorus, vitamin D, Vitamin K, magnesium, isoflavone

Arrhythmogenic Right Ventricular Cardiomyopathy - what do we know? A review of current knowledge state

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is an inherited disorder that is responsible for a considerable number of sudden death cases in young athletes. Its pathological hallmark is a progressive loss of myocytes predominantly in the right ventricle and its simultaneous replacement by fibrous and fat tissue, which in turn leads to an increased risk of potentially lethal ventricular arrhythmias to occur. Over a dozen of mutations have been confirmed as genetic basis of ARVC with most of them affecting genes encoding desmosome proteins, however in up to half of all cases the exact etiology is still unknown. By number of studies, it is implied that physical activity is the most significant environmental factor that impacts the development and course of the disease. The main focus of treatment is to prevent sudden cardiac deaths and additionally to moderate arrhythmic events and heart failure

Pontine and extrapontine myelinolysis associated with rapid correction of hyponatremia - a review

Pontine myelinolysis was first described in 1959 by Adams, Victor and Mancall and reported in alcoholic patients.[1]  It is characterized, above all, by acute non-inflammatory symmetrical lesion of myelin sheath and apoptosis of oligodendrocytes affecting the central part of thebasis pontis.[5] Demyelination may also appear in other parts of central nervous system such as thalamus, basal nuclei and cerebellum. Involvement of the regions beyond pons is called extrapontine myelinolysis. These two manifestations- pontine and extrapontine myelinolysis are combined in one neurological entity- osmotic demyelination syndrome.Pontine and extrapontine myelinolysis are mainly caused by rapid increase in extracellular fluid osmolarity; usually in situation of iatrogenic correction of chronic hyponatremia.[7]The other causes include severe electrolyte disturbances other than hyponatremia (hypokalemia, hypophosphatemia, hypernatremia), anorexia nervosa, AIDS, acute alcoholic hepatitis, liver transplantation, Vernickes syndrome, chemotherapy, chronic renal failure. [11,12] Osmotic demyelination syndrome vary in clinical manifestations. The most common presentations include encephalopathies, pareses, dystonias. The method of choice in diagnostic process is MRI imaging. Treatment of osmotic demyelination syndrome is still in an experimental phase