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Background: Huemul (Hippocamelus bisulcus) an endangered endemic cervid of Chile and Argentina, is currently confined year-round mainly to their historic summer range in the Andean mountains, with complete loss of migratory behavior due to anthropogenic activity. Trace mineral deficiencies, such as selenium and iodine, in the soils of their current year-round home range have been hypothesized to explain the lack of the species’ recovery. This hypothesis has been supported by osteopathy of numerous skeletal remains, particularly in the cranium and dentary bones, with prevalent loss of teeth even at a young age. Such lesions negatively affect foraging, the ability to avoid predators, and thus contribute to the low average adult age and lack of population recovery. Low iodine levels in the Andean mountain region is causing a high frequency of associated disease in both humans and livestock. Prenatal iodine deficiency in livestock, for instance, is causing frequent perinatal mortality and neonates with congenital anomalies. Here we document results of the first-ever analysis of the iodine status in a huemul deer. Methods: Serum was used to analyze Thyrotropin via chemiluminescence immulite, Thyroxine via chemiluminescence, and Triiodothyronine via electrochemiluminescence. Results: Blood tests revealed <0,01 ng/mL for Thyrotropin, 6,9 ug/dL for Thyroxine, and 83,5 ng/dL for Triiodothyronine. Conclusions: Compared to several studies on other Odocoiline deer, the huemul was clearly deficient in iodine.

Significant advancements in understanding the need of glycemic control in physically active individuals with diabetes contributed to the development of exercise-specific nutritional and life-style recommendations ensuring the optimal performance and recovery. The main aim of this article is to review and present the update guidance for endurance athletes with certain metabolic disturbance, particularly diabetes type 1. post-exercise recovery in athletes with diabetes, particularly type 1 diabetes, who are often left to develop their own strategies or rely on guidelines designed for individuals without diabetes. Evidence to date indicated that employing nutritional strategies along the life-style habits can enhance sport performance in individuals with diabetes, while facilitating post-exercise recovery and glycemic management. Consequently, optimizing exercise protocols is essential for efficient recovery and appropriate training adaptations. The post-exercise period is particularly critical, as it presents challenges due to altered insulin sensitivity, post-exercise hyperglycemia, and other metabolic disturbances observed. Therefore, the key nutritional considerations include carbohydrate intake to replenish glycogen stores, fluid management to maintain hydration and thermoregulation, protein intake to promote muscle repair and glycogen synthesis, and caffeine intake to potentially mitigate exercise-associated hypoglycemia. Furthermore, it is emphasized that specific recommendations for carbohydrate intake, including timing, quantity, and quality, as well as exercise duration and intensity, are crucial for managing glycemic responses. The inclusion of fiber is also recommended. Additionally, fluid management, protein intake, and caffeine consumption play significant roles in optimizing post-exercise recovery for athletes with diabetes. Future research should aim to define optimal nutritional interventions tailored to the unique needs of this population, taking into account individual variations in glycemic responses and metabolic profiles. Future research should focus on defining optimal nutritional interventions tailored to this population's unique needs, considering individual variations in glycemic responses and metabolic profiles.

In this research discovery we reference abstract key points and manuscript on Neurobiology, Psychiatry, and Trauma Medicine. We apply a scientific research method to a Trauma Case were a patient recovered 65 percent of cognitive functions, and Central Nervous system with mobility, and cognitive development. The patient presented with dysexecutive disorder with injury to frontol lobe manifestations psychological issues, and Trauma Center research center scored the case as Level V, Trauma/or Urgent Care for Neurological Disorder and/or Psychological Disorder.

Introduction: Type 2 diabetes is a multifactorial disease whose hyperglycemia is linked to a reduction in insulin secretion and insulin sensitivity, combined with lipid metabolism disorders. Management of the disease requires not only exploration of carbohydrate metabolism, but also measurement of certain lipid parameters. Materials and Methods: This study was carried out in 100 patients with type 2 diabetes. In these patients, venous blood samples were taken after a minimum 12 hours fast. Parameters such as insulin, fasting blood glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides (TG) were measured using the ARCHITECT plus Ci4100 automated system. Results: The mean age of patients was 55.1 ± 12.1 years; 43 patients were aged under 55 and 57 patients were aged 55 or over, respectively 43.% and 57%. We noted 61 women and 39 men, or 61% and 39% respectively, with a sex ratio 0.63. The results also showed that 75% of patients had an insulin level ˂ 11mUI/l and 25% a level ≥ 11 mUI/l. Some of the patients had total hypercholesterolemia, hyperLDLaemia, hypoHDLaemia, hypertriglyceridemia with percentages of 90, 67, 95 and 22 respectively. A statistically significant negative correlation between insulin and blood glucose was found (p-value < 0.05). On the other hand, the correlation between insulin and lipid parameters was not statistically significant. Conclusion: Our study shows that insulin resistance plays an important role in the pathophysiology of dyslipidemia in type 2 diabetes.

Introduction: Darier-Ferrand dermatofibrosarcoma (DFS) is a rare cutaneous mesenchymal tumour, the extent of tumour spread of which is often underestimated. It is distinguished by its local aggressiveness and its significant potential for recurrences, the prognosis of which is contingent on the quality of the patient's care. The management of localized forms is based on broad surgery, with meticulous evaluation of the margins. Treatment is based on surgery. Objective: To describe the management of frontal Darier-Ferrand dermatofibrosarcoma. Observation: This is a 23-year-old patient, with no medical or surgical history, who had consulted the Department of Stomatology and Maxillofacial Surgery of the CHUO for frontal swelling that had been evolving for two months. The clinical examination revealed a swelling resting on an indurated surface. A biopsy was performed under local anaesthesia, and the anatomo-pathological result was a Darier-Ferrand dermatofibrosarcoma. Subsequent to this, a broad excision with substance loss coverage (PDS) from a thin skin graft on the inner side of the thigh was performed. Conclusion: Dermato fibrosarcoma is a skin tumor whose frontal location is unusual and very rare. Surgery with significant margins for resection in healthy areas, covering the loss of substance by skin grafting is the solution.

Positive treatment outcomes with the usage of CBCT were bolstered with certain treatment challenges faced by the general practitioner when faced specifically with RCT of maxillary molar teeth, such as calcified canals, difficulty detecting and/or navigating the second mesiobuccal canal (MB2), detection of vertical fractures, determination of root morphology, assessment of fill density, presence of internal or external root resorption, and presence of any pathology. Conversely, there were also contradictions present with a subset of studies, which showed flaws in the use of CBCTs as a diagnostic tool. Case studies will be presented which highlight the use of CBCT as an adjunct when traditional therapy with use of PAs has failed. Maxillary molars present unique challenges for the general practitioner, and these cases demonstrate the positive impact of selective CBCT when sub-standard results are achieved during or after initial RCT for the benefit of the patient.

Ocimum Grattissimum is used to treat several infectious and non-infectious diseases. Antimicrobial resistance (AMR) among bacteria to conventional antimicrobials becomes a serious challenge and threat worldwide. However, the medicinal plants of Ocimum Grattissimum, which are used for two Gram-positive (Staphylococcus aureus and Enterococcus faecalis) and two Gram-negative (Escherichia coli, and Pseudomonas aeruginosa) bacteria, was collected from Jimma town of Ethiopia. Therefore, the antibacterial activity of leaf extracts of selected plants was determined in vitro, using disc diffusion and minimum inhibitory concentration (MIC) determined against selected zoonotic pathogenic bacteria. Aqueous extraction, ethanol, and methanol were the extraction solvents used in this study. The means inhibition zone among three, methanolic and ethanolic crude extract, were higher and aqueous was lowest extract while compared using analysis of significant difference test. The antimicrobial assay showed that the zones of inhibition produced using the disc diffusion method ranged from 2±0.26mm lower to 30±0.34 mm highest for the three extraction methods, with the highest value of 30±0.34 mm obtained with methanol extraction. The zones of inhibition for dried Ocimum grattissimum methanol extract were 15±0.26mm lowest to 30±0.34mm highest and for were 15±0.26 to 28±0.11, Ethanol extract from dried leaf Ocimum grattissimum was 10±0.22mm lowest to 26±0.34mm highest and 7±0.11mm to 24±0.26mm respectively. Regarding ethanol, methanol extract, and hot and cold aqueous extract, there was a significant difference (P<0.05) seen for all tested bacteria. This study's results suggest that Ocimum grattissimum extracts may be useful in the search for an antibacterial agent to help create novel medications that combat animal pathogenic bacteria that cause life-threatening illnesses.

Background: Light-chain amyloidosis (AL amyloidosis) is a rare, debilitating, heterogeneous, and multisystemic disorder that is often fatal in the absence of treatment. This is because of the conversion of light chains (LCs) produced by plasma cell dyscarasia from their soluble state into organized fibrillar aggregates, resulting in progressive organ damage and dysfunction. The clinical features of the disease are nonspecific and depend on the type of organ affected. Overall prognosis depends on several clinical, laboratory, and pathological parameters. Case presentation: A young Algerian man presenting with the diagnostic challenge of atypical extensive systemic amyloidosis initially presenting with severe neurological manifestations despite a lower burden light chain level and undetected plasma cell dyscarasia that developed over 10 years. Conclusion: Atypical clinical presentation, undetectable plasma cell dyscarasia, and unusual disease evolution led to delayed diagnosis and devastating complications in the patient at the time of diagnosis. A very high clinical suspicion with a combination of several laboratory and histopathological tests is required to confirm the diagnosis. Although biopsy is the gold standard for the diagnosis of AL amyloidosis and confirmation of the involvement of each organ, noninvasive techniques with high sensitivity and specificity have been used.

Hematopoietic stem cell transplantation (HSCT) is an essential therapy for malignant and non-malignant hematologic, autoimmune, and genetic disorders. However, post-transplant complications, particularly pulmonary infections, remain a leading cause of morbidity and mortality. Case report: We present the case of a 70-year-old male with chronic lymphocytic leukemia (CLL) who underwent allogeneic HSCT several years ago. Post-transplant, he received intravenous immunoglobulin (IVIG) every six weeks for immune support. Despite this, he developed chronic obstructive pulmonary disease (COPD) without any smoking history and has experienced recurrent pneumonia requiring frequent hospitalizations. Extensive microbiologic and imaging evaluations repeatedly failed to identify a causative organism. The patient remains on chronic antibiotic therapy, nebulized bronchodilators, and antiviral prophylaxis with valacyclovir. This case underscores the vulnerability of post-HSCT patients to recurrent, often unexplained pulmonary infections despite ongoing prophylactic and supportive measures. Management focuses on infection prevention and treatment through broad-spectrum antimicrobials, immunoglobulin replacement, and respiratory support, while addressing physical, psychological, and nutritional needs. Discussion: In patients with CLL and T-cell-depleted HSCT, persistent immunodeficiency can lead to refractory pulmonary complications, significantly reducing quality of life and survival. Early recognition, aggressive management, and multidisciplinary care are essential to improving outcomes in this high-risk population.

Guyton proposed the physiology of venous return and its characteristic curves nearly seven decades ago. This article aims to understand their relevance today—particularly the bedside application—by reviewing the literature. His concepts and experiments have withstood the test of time and profoundly influenced our physiological understanding of both normal and pathological states. Researchers have built upon these principles to further elucidate venous circulation under various clinical conditions. However, unlike the arterial circulation—which lies at the heart of hemodynamic monitoring and shock management—Guyton’s venous return curves have not translated into bedside utility. Central venous pressure (CVP) remains integral to hemodynamic monitoring, though its concept did not emerge from Guyton’s framework. Further studies are warranted to explore the clinical utility of Guyton’s theory at the bedside.

Copper deficiency is an uncommon but clinically significant etiology of cytopenias that can closely resemble myelodysplastic syndrome (MDS), particularly when ring sideroblasts and multilineage dysplasia are observed. This morphological overlap presents a diagnostic challenge and may lead to misclassification, unnecessary treatments, and delays in appropriate management. Here, we report the case of a 60-year-old woman who presented with progressive fatigue and was found to have severe neutropenia. Bone marrow examination demonstrated hypercellularity with marked multilineage dysplasia and ring sideroblasts, initially raising concern for MDS with sideroblastic features. Nevertheless, initially exhaustive molecular testing, including an MDS next-generation sequencing panel, SF3B1 mutation analysis, and standard myelodysplastic syndrome fluorescence in situ hybridization (MDS FISH) studies, all yielded negative findings, prompting further evaluation for other reversible causes of dysplasia. Following comprehensive laboratory studies, profound copper deficiency was revealed. The patient started receiving copper repletion, resulting in rapid hematologic recovery, sustained improvement in neutrophil counts, and near-complete resolution of dysplastic morphology on repeat marrow evaluation. The case emphasizes the importance of early consideration of nutritional deficiencies in diagnostic differentials, particularly copper deficiency, in the differential diagnosis of unexplained cytopenias and dysplasia. Early recognition is critical to avoid inappropriate initiation of disease-modifying therapy and to ensure timely, effective, and reversible management and treatment.

Paroxetine is a selective serotonin reuptake inhibitor (SSRI). It is used to treat several diseases, including major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, and premenstrual dysphoric disorder. Anaesthesia or surgery may exacerbate the cardiac effects of the drug. Its interaction with anaesthetic drugs may also have an effect on the heart rhythm. In this case report, the mechanism of such an arrhythmia is elucidated upon. We report a case of acquired QT prolongation in a patient receiving paroxetine who underwent lumbar spinal fusion surgery under general anaesthesia. The potential mechanisms, perioperative implications, and management strategies for acquired QT prolongation are discussed.

Albendazole is a broad-spectrum anthelmintic drug generally regarded as safe. Rarely, it may cause acute toxic hepatitis. We report a case of severe hepatotoxicity following albendazole use in a pediatric patient. Other causes of acute hepatitis were excluded, and the Roussel Uclaf Causality Assessment Method (RUCAM) score was 8, indicating a highly probable drug-induced liver injury.