Folia medica最新文献

Introduction: Thyroid hormones exert pleiotropic effects on lipid and glucose metabolism, blood pressure regulation, and energy expenditure. Thyroid dysfunction is a known risk factor for cardiovascular disease. The association between thyroid pathology and the components of metabolic syndrome (MetS) has emerged as a significant clinical focus, as both conditions contribute to increased morbidity and mortality. Studies indicate that patients with overt and subclinical hypothyroidism have a higher risk of developing MetS. Even in euthyroid individuals, TSH levels in the upper normal range (>2.5 mIU/L) are significantly associated with increased MetS prevalence.

Non-invasive prenatal testing (NIPT) has transformed prenatal screening, offering high sensitivity and specificity in the detection of common fetal aneuploidies. However, discordant results-where NIPT findings do not align with those of confirmatory diagnostics-pose challenges for clinical interpretation and patient counseling.

Chronic granulomatous disease (CGD) is a primary immunodeficiency disorder that is either X-linked or autosomal recessive and is characterized by recurrent infections. The diagnosis is primarily based on the nitroblue tetrazolium dye reduction test. Here, we present the case of a 28-year-old pregnant woman with CGD who was diagnosed before marriage and who presented with recurrent subcutaneous skin and ocular infections. Following treatment with multiple antibacterial agents, including meropenem, her infections resolved, and she gave birth to a healthy baby girl at term. However, the newborn has now started to exhibit similar symptoms to those experienced by her mother. This case highlights the need for further studies on the potential impact of maternal chemotherapy on CGD.

Introduction: Rupture of the free ventricular wall is a rare and catastrophic complication of acute myocardial infarction (AMI).

Q fever is a systemic zoonotic infection with a wide range of clinical presentations leading to a laborious diagnosis. We present a case of a 28-year-old man who was diagnosed with acute Q fever with typical hepatic and bone marrow involvement, characterized by acute hemolytic anemia, which is not commonly associated with this disease. This underscores the importance of including Q fever in the differential diagnosis when facing unexplained systemic or hematologic abnormalities.

Introduction: Peripheral vestibular disorders (PVDs) are associated with the inner ear or vestibular nerve and can occur as acute, episodic, or persistent vestibular syndromes. The symptoms are mainly vertigo and dizziness, which significantly affect kinesiophobia, quality of life, and balance.

Methotrexate, administered in high doses, is utilized in the treatment of a range of childhood cancers. Despite the implementation of routine supportive measures, including intensive hydration, urine alkalinization, and antidote therapy, nephrotoxicity remains a significant problem. The literature suggests a range of frequencies from 1.8% to 36%, depending on the diagnostic method employed. The primary pathogenetic mechanism of its occurrence is the precipitation of methotrexate and its metabolites in the renal tubules, clinically manifesting as crystalline nephropathy, which leads to delayed excretion of the medication. The risk factors, long-term renal prognosis, and safety of re-administration of high-dose methotrexate after an episode of acute kidney injury remain unclear. In the event of nephrotoxicity, restriction of its further use and substitution with another cytostatic drug are often considered. The following clinical case is presented: a 13-year-old girl with osteosarcoma was administered high-dose methotrexate, resulting in fourth-degree acute kidney injury. This necessitated a renal replacement therapy. Given its pivotal role in osteosarcoma treatment, subsequent courses were planned with gradually increasing doses. Four additional courses of high-dose methotrexate were administered at doses of 3 g/m2, 8 g/m2, and 12 g/m2, until the maximum tolerable dose of 20 grams was reached. These courses were well tolerated, with no evidence of toxicity, and the medication was eliminated in a timely manner.

Introduction: Natural ingredients have grown in popularity in recent years, surpassing synthetic alternatives. Among them, orange essential oil (EO) stands out as one of the most widely used essential oils (EOs) globally, primarily due to its significant health benefits. Traditionally incorporated into the human diet, orange EO is now extensively utilized in the perfumery, cosmetic, pharmaceutical, and food industries for its antioxidant, antimicrobial, anti-inflammatory, and immunostimulatory properties. Orange EO is mainly extracted from the peels of Citrus sinensis L. through cold pressing.

Thyroid dysfunction is typically associated with systemic metabolic disturbances and may also present as thyroid myopathy. Understanding this relationship is crucial for recognizing its clinical manifestations and guiding appropriate management. This report describes the case of a 29-year-old male who presented with unusual swelling in his right leg along with persistent stiffness in his calf muscles. Physical examination revealed striking diffuse pseudo-hypertrophy of the calf muscles, accompanied by a positive Gowers' sign, indicating underlying muscular weakness. Laboratory investigations confirmed classic features of hypothyroidism, including markedly low triiodothyronine (T3) and thyroxine (T4) levels, elevated thyroid-stimulating hormone (TSH), and increased muscle enzyme levels. Remarkably, following the initiation of levothyroxine therapy, the patient exhibited a dramatic and progressive improvement in symptoms. The clinical picture was consistent with Hoffman syndrome, a rare manifestation of hypothyroid myopathy marked by visibly enlarged calf muscles and progressive muscle weakness. This rapid response underscores the importance of early diagnosis and timely treatment, which can lead to a full recovery even in cases with such rare presentations. Overall, this case serves as a reminder that thyroid disorders may occasionally manifest in unexpected ways, and with prompt intervention, patients can achieve significant clinical improvement.

Intradural disc herniation is a rare complication that, despite the precision of modern diagnostic tools, is usually confirmed intraoperatively. Therefore, we aimed to present a case of intradural disc herniation, reviewing the incidence, pathogenesis, clinical presentation, diagnostic options, and management.