Insulinoma - review of characteristics, diagnosis and treatment

Introduction and purpose: Insulinoma is one of a group of pancreatic neuroendocrine neoplasms (NENs). This tumor has its origin in the β cells of the pancreatic islets, which are responsible for the production of insulin. Excessive amounts of this hormone in the body manifest hypoglycemic neuroglycopenic and sympathetic-overstimulation symptoms. The purpose of this review is to analyze information on the characteristics, diagnosis and treatment of patients with insulinoma.  Material and methods: This review was based on available data collected in the PubMed database and published between 2017 and 2022. The study was conducted by reviewing keywords as follows: "insulinoma," "NEN," "diagnosis," and "treatment." Results: The diagnosis of insulinoma consists of a typical clinical presentation, biochemical test results indicating hyperinsulinemic hypoglycemia, and presence of a tumor. The treatment targets solutions leading to a complete recovery, usually performing open surgery involving enucleation of the tumor. Conclusions: Despite the characteristic clinical picture, insulinoma is still often a diagnostic problem. It is necessary to work towards improving diagnostic methods and conduct further research into the most effective methods of treating insulinoma

Colonic contained perforation of unknown etiology treated conservatively in a 34 year old female patient: a case report

A colon perforation is defined as a disruption in the continuity of the gastrointestinal wall. A contained perforation is a situation where the perforation is self-limited, usually by adhesion to other structures in the abdominal cavity. Many conditions can cause perforation, including cancer, diverticular disease, or iatrogenic perforation such as during an endoscopy procedure. Less commonly, the cause may be inflammatory bowel disease or the presence of a foreign body in gastrointestinal tract. Furthermore, there are also publications describing situations of spontaneous rupture of the intestinal wall, i.e. spontaneous perforations. This group includes spontaneous perforation caused by fecal stones and idiopathic perforation. In this article we present a case report of a 34 year old woman with perforation of the large intestine without any apparent cause. We discuss the differential diagnosis of patients with conservatively treated perforation with unknown colonoscopy result

The role of chemokines in liver disease

Chemokines are involved in many processes, including the normal immune response to infection, as well as pathological processes such as carcinogenesis, autoimmunity and inappropriate inflammatory responses. These processes represent an important aspect in the context of liver disease, its progression and the possibility of inhibiting fibrosis. Chemokines belong to low molecular weight proteins with a wide range of functions affecting cell migration, involving different physiological and pathological processes. Depending on whether they participate in the maintenance of homeostasis during periods of well-being or represent a type of intervention of the organism to its disorders, their secretion by cells is constitutive or induced. This article focuses on the classification, structure and functions of these molecules and their possible involvement in the pathogenesis of liver diseases, as well as the possibilities of therapeutic application of this knowledge

Graves-Basedow disease treated by complementary medicine leading to severe thyrotoxicosis – a case report

Graves' disease is a common cause of hyperthyroidism. Inadequate treatment or non-compliance can lead to serious complications, including thyroid storm.  We present the case of a 22-year-old woman who had been treated with antithyroid drugs (ATD) for almost 7 years, however decided to suspend conventional treatment and turned towards complementary and alternative medicine methods. Following the bioenergotherapist's advice, she began taking Lugol’s solution (LS) at a dose of 30 drops per day. After about one month of such therapy, the patient was urgently admitted to the Emergency Department with thyrotoxicosis with a high risk of thyroid storm development. With the implementation of intensive thyrostatic treatment and steroid therapy, euthyroidism was successfully restored

Polypharmacotherapy with anti-obesity drugs - case report

Obesity is a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse health consequences. It is diagnosed based on body mass index and waist circumference. In case of severe obesity, bariatric surgery or pharmacotherapy is recommended. We present a case report of a 28 years old man with class III obesity (77,6 kg/m2). In order to qualify the patient for bariatric surgery, a decision to combine two anti-obesity medications has been made. This kind of obesity management is neither recommended, not contraindicated, but has shown good effects on body mass reduction. This case report should initiate the discussion about recommendations modification towards combining anti-obesity medications of different mechanisms of action

Portal vein thrombosis and non-compliance in a high risk patient – a case study

Portal vein thrombosis is a pathological process that refers to the obstruction of blood flow secondary to thrombus formation. It may be caused by a variety of conditions including cancer, cirrhosis, myeloproliferative neoplasms (eg. polycythemia vera) or surgery in the area of the portal vein (eg. splenectomy). Recent studies suggest that patients with a positive history of SARS-CoV-2 infection have a higher risk of thromboembolic incidents. According to current procedures patients with increased thromboembolic risk should receive anticoagulants. Non-compliance to medical recommendations may develop a disease, directly threatening the patient's health and life. We present a case report of a 69 year old woman with a history of polycythemia vera, recent splenectomy, and SARS-CoV-2 infection who developed massive portal vein thrombosis two days after discontinuation of enoxaparin

Vitamin D toxicity – causes, symptoms and diagnosis

Abstract:  Introduction and purpose: This review aims to analyze causes, symptoms and diagnosis of overdosing vitamin D resulting in vitamin D toxicity (VDT).  Material and method: This paper was based on medical articles collected in Pubmed from 2008 to 2021 year. The research has been done by looking through keywords such as “vitamin D” “toxicity”.  Results: The review of studies showed that manifestation of VDT is mainly associated with hypercalcemia and its course can range from asymptomatic to life-threatening, including death. We also draw attention to inappropriate use and widespread of vitamin D products.  Conclusion: There is a high demand for medical health workers to advise patients on possible effects of inappropriate use of vitamin D products and its toxicity. Medical practitioners should be attentive to quickly identify VDT.&nbsp

Multiple myeloma and kidney disease

Abstract   Background: Multiple myeloma is a clonal plasma cell neoplasm which affects 1% of all malignancies. In this article we reviewed epidemiology, symptoms with particular attention to renal failure and its manifestation in multiple myeloma (MM). Material and methods: This paper was based on medical articles collected in PubMed from 2001 to 2022, medical websites and books. The research has been done by looking through key words such as: „multiple myeloma”, „myeloma cast nephropathy”, „bortezomib”, „RANKL” Results: Multiple myeloma has indolent course and many patients present renal disorders at the moment of diagnosis. The use of novel therapies can reverse renal failure. Conclusions: Treatment of the patients with MM and kidney disease is challenging for health care professionals. Doctors have to adjust treatment to provide the best therapeutic effects

Braf protein mutation and its significancy within patients with melanoma

Introduction and purpose:   This review aims to analyze BRAF mutation significancy and its influence on progression and therapy methods within patients with melanoma.  Material and method:  This review was mainly based on articles collected in Pubmed in years 2004-2018. The research was done by looking through keywords as follows “braf kinase”, “braf mutation”, “melanoma” “wemurafenib”.  Results:  The selected studies have demonstrated that it is justified to identify patient with BRAF mutation due to it’s influence on treatment’s method choosing.  Conclusions:  Citied researches have proven BRAF mutation significancy in growth and progressions of many malignant tumors. Further tests are likely to not only prolong life expectancy within patients with melanoma, but also being a source of crucial knowledge about tumors development.&nbsp

Comparison of HPV testing and cervical cytology in prevention of cervical cancer

Introduction and purpose  This article aims to compare two guiding methods of cervical cancer screening: cervical cytology  and HPV testing. The objective is to provide information on which method  is currently more relevant in the early detection of precancerous lesions and and therefore should  be more frequently used.        Materials and method  This review was mainly based on articles from around the world collected in Pubmed in 2003-2022, medical books and websites. The research was done by looking through keywords as follows: “cervical cancer”, “cytology”, “HPV testing”.  Results  All selected studies have demonstrated that HPV testing is a more appropriate indicator for initial  high-grade CIN (cervical intraepithelial neoplasia) than cytology.  Conclusions  According to the cited researches, the public health system should definitely pay more attention  to HPV testing as the first stage of cervical cancer screening. Moreover,  it should clarify by comparing all advantages and disadvantages of methods, which further diagnostic pathway is the most effective and has the best outcomes for the patients.   Keywords  cervical cancer, cervical screening, cytology, HPV primary screening, HPV testing  &nbsp