Chemotherapy and Metabolic Syndrome: A Comprehensive Review of Molecular Pathways and Clinical Outcomes.

Cancer therapies, notably chemotherapy, have significantly improved survival rates and quality of life for many patients. However, chemotherapy's cytotoxic effects also impact normal cells, leading to adverse effects, including metabolic disturbances. This paper explores the link between chemotherapy and metabolic syndrome, a cluster of metabolic abnormalities that increase the risk of cardiovascular diseases and type 2 diabetes. Understanding the predictors, such as specific chemotherapy regimens, patient characteristics, comorbid conditions, lifestyle factors, and genetic variations, is crucial for formulating personalized care plans and preventive strategies. Research indicates that older age, female gender, pre-existing diabetes, and baseline obesity are significant predictors of metabolic syndrome in cancer patients. Chemotherapy-induced molecular changes, including insulin resistance, dyslipidemia, chronic inflammation, oxidative stress, and tissue fibrosis, contribute to the development of this syndrome. Effective management strategies require a multidisciplinary approach, incorporating lifestyle interventions, pharmacological treatments, and regular monitoring. This paper underscores the importance of personalized medicine in mitigating the risks associated with metabolic syndrome and improving long-term health outcomes for cancer survivors. Future research directions include longitudinal studies to track metabolic health over time, mechanistic studies to uncover the molecular pathways involved, and the development of integrative therapies. By adopting comprehensive care models, healthcare providers can enhance the overall quality of life for cancer survivors, addressing both cancer and metabolic health challenges.

Muir-Torre Syndrome: A Case Report and a Literature Review of Genetic Insights and Cancer Surveillance.

Muir-Torre syndrome (MTS) is a rare autosomal dominant genetic disorder that manifests through the co-occurrence of sebaceous skin tumors and internal malignancies, primarily due to mutations in mismatch repair (MMR) genes such as MSH2, MLH1, and MSH6. This paper presents a detailed case report of a 57-year-old female diagnosed with MTS, highlighting her extensive medical history and the critical role of genetic testing and multidisciplinary management. The patient's dermatological and oncological assessments revealed multiple sebaceous carcinomas and recurrent urothelial carcinoma, confirmed by a pathogenic MSH2 mutation. Through comprehensive preventive surgeries and rigorous follow-up, this case underscores the necessity of proactive cancer surveillance. The discussion integrates findings from key genetic studies and emphasizes the importance of immunohistochemistry in diagnosis. Recommendations for clinical practice include routine genetic testing, stringent surveillance, and multidisciplinary management, underscoring the need for ongoing research to understand better and manage this complex syndrome.

Copper Deficiency Mimicking Myelodysplastic Syndrome: A Case Report.

Copper deficiency can mimic myelodysplastic syndrome, a group of heterogeneous hematopoietic disorders characterized by peripheral cytopenias, with potential progression to bone marrow failure and acute myeloid leukemia. We present the case of an 83-year-old female with a history of Graves' disease, early-stage hormone receptor-positive breast cancer, hypertension, and glaucoma, who presented with fatigue and progressive lower extremity weakness. Laboratory tests revealed macrocytic anemia, neutropenia, and lymphopenia, with normal platelet counts. Bone marrow biopsy showed trilineage hematopoiesis, dyserythropoiesis, ring sideroblasts, and vacuoles in erythroid precursors, indicating copper deficiency. The patient had been using zinc oxide paste for dentures and had increased her zinc intake during the COVID-19 pandemic, leading to severe copper deficiency. Treatment with intravenous and oral copper supplementation resulted in marked improvement in hematologic indices and symptoms. This case underscores the importance of considering copper deficiency in the differential diagnosis of cytopenias and myeloneuropathy in elderly patients, particularly those with a history of excessive zinc intake.

Aryl Hydrocarbon Receptor Signaling in Prostate Cancer Therapy: A Review of Implications for Anti-androgen Treatment Strategies and Resistance.

Prostate cancer is a leading cause of cancer-related morbidity and mortality in men, frequently exhibiting resistance to conventional anti-androgen therapies. This review investigates the emerging significance of the aryl hydrocarbon receptor (AhR) in prostate cancer, focusing on its role in modulating androgen receptor (AR) signaling and its potential as a therapeutic target. AhR, traditionally known for detoxifying harmful compounds, has been increasingly recognized for its dual capacity to either enhance or inhibit AR activity based on cellular context and specific coactivators. Furthermore, AhR influences tumor progression independently of AR by regulating genes involved in cell cycle control and apoptosis. This narrative review synthesizes current research on AhR's multifaceted roles in prostate cancer, evaluates its potential as a biomarker, and discusses the therapeutic implications of targeting AhR, particularly for hormone-refractory prostate cancer. Our findings underscore the necessity for personalized AhR-targeted therapies and advocate for continued clinical research to fully leverage AhR's therapeutic potential.

A Diagnostic Dilemma: A Case of Complicated Pneumonia With Pyelonephritis and Subclinical Myocarditis.

A 41-year-old woman presented with a 3.5-month history of fever, weakness, productive cough, and burning micturition along with generalized weakness and significant weight loss. Chest X-ray revealed bilateral infiltrates and bilateral pleural effusion, and the workup suggested community-acquired pneumonia (CAP). However, the course was complicated by persistent fevers, elevated inflammatory markers, elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP), and pelvic fluid collection. Extensive investigations, including bronchoscopy and lung biopsy, failed to identify a specific pathogen. Pulmonary vasculitis and lymphoma were ruled out. Antibiotic and corticosteroid therapy resulted in clinical improvement. While the cause remains unknown, brucellosis and aspergillosis were considered but ruled out with advanced testing. The underlying etiology remains elusive, highlighting the diagnostic challenges in CAP with atypical presentations.

Integrating whole genome sequencing, methylation, gene expression, topological associated domain information in regulatory mutation prediction: A study of follicular lymphoma.

A major challenge in human genetics is of the analysis of the interplay between genetic and epigenetic factors in a multifactorial disease like cancer. Here, a novel methodology is proposed to investigate genome-wide regulatory mechanisms in cancer, as studied with the example of follicular Lymphoma (FL). In a first phase, a new machine-learning method is designed to identify Differentially Methylated Regions (DMRs) by computing six attributes. In a second phase, an integrative data analysis method is developed to study regulatory mutations in FL, by considering differential methylation information together with DNA sequence variation, differential gene expression, 3D organization of genome (e.g., topologically associated domains), and enriched biological pathways. Resulting mutation block-gene pairs are further ranked to find out the significant ones. By this approach, BCL2 and BCL6 were identified as top-ranking FL-related genes with several mutation blocks and DMRs acting on their regulatory regions. Two additional genes, CDCA4 and CTSO, were also found in top rank with significant DNA sequence variation and differential methylation in neighboring areas, pointing towards their potential use as biomarkers for FL. This work combines both genomic and epigenomic information to investigate genome-wide gene regulatory mechanisms in cancer and contribute to devising novel treatment strategies.

A targeted review on fate, occurrence, risk and health implications of bisphenol analogues.

Due to its widespread applications and its ubiquitous occurrence in the environment, bisphenol A (BPA) and its alternatives have gained increasing attention, especially in terms of human safety. Like BPA, alternatives such as bisphenol S (BPS), bisphenol F (BPF), and bisphenol AF (BPAF) have also been identified to be endocrine-disrupting chemicals (EDCs). Hence, in this study, we reviewed the literature of BPA and its alternatives mainly published between the period 2018-2020, including their occurrences in the environment, human exposure, and adverse health effects. The review shows that bisphenols are prevalent in the environment with BPA, BPS, and BPF being the most ubiquitous in the environment worldwide, though BPA remains the most abundant bisphenol. However, the levels of BPS and BPF in different environmental media have been constantly increasing and their fates and health risks are being evaluated. The studies show that humans and animals are exposed to bisphenols in many different ways through inhalation and ingestion and the exposure can have serious health effects. Urinary bisphenols (BPs) levels were frequently reported to be positively associated with different health problems such as cancer, infertility, cardiovascular diseases, diabetes and neurodegenerative diseases. Our literature study also shows that BPs generate reactive oxygen species and disrupt various signalling pathways, which could lead to the development of chronic diseases. Activated carbon-based and chitosan-based sorbents have been widely utilized in the removal of BPA in aqueous solutions. In addition, enzymes and microorganisms have also been getting much attention due to their high removal efficiencies.

Alcohol Withdrawal Mimicking Neuroleptic Malignant Syndrome.

Long-standing, heavy alcohol use can lead to alcohol dependence, which predisposes to alcohol withdrawal if alcohol consumption is suddenly decreased or stopped. Alcohol withdrawal syndrome is characterized by a hyperadrenergic response, with symptoms ranging from mild tremulousness to delirium tremens. We report a 55-year-old male presenting with hyperthermia, tachycardia, tachypnea, altered consciousness, tremors, rigidity, diaphoresis, elevated creatinine kinase, and myoglobinuria. The diagnosis of alcohol withdrawal was made due to a history of alcohol use disorder with the last drink two days ago and no history of any medication or drug intake prior to admission. He was treated with benzodiazepines with an improvement in his condition.