The Involvement of miRNAs in Pituitary Adenomas Pathogenesis and the Clinical Implications

Pituitary adenomas (PAs) account for the top three primary intracranial tumors in terms of total incidence rate. PAs can cause severe endocrine disorders and even malignant features, such as invasion, metastasis, and recurrence. Therefore, the early diagnosis and accurate prognosis would be greatly beneficial for clinical treatment of PAs. MicroRNAs (miRNAs) are small, protein-noncoding RNAs that regulate gene expression posttranscriptionally. They regulate essential physiological processes, including proliferation, growth, and apoptosis, and also they involve in the invasion and metastasis of malignant tumors. At the tissue level, differential miRNA expression in endocrine malignancies including PAs has been reported. When miRNAs have been successfully detected in various biofluids and cell-free environments, their important roles as potential screening or prognostic biomarkers have been extensively investigated. The current work reviews recent studies on the emerging roles of miRNAs in PAs and the clinical significance.

Characteristics and pharmacological treatment options of delirium patients treated at Sanglah Central General Hospital

Delirium is a syndrome characterized by disturbances of consciousness and cognition that occur acutely and fluctuate. Delirium can be caused by general medical conditions, drug users, sensory disturbances, polypharmacy, etc. The etiology of delirium is diverse and non-specific. The preference of pharmacological therapy in delirium is still a debate. Descriptive research with the retrospective cross-sectional method, using secondary data in medical records at the Sanglah Central General Hospital Denpasar for the period January 1, 2020, to December 31, 2020. Patients who were consulted were 166 people, with sex 57 people (34.3%) and 109 women (65.7%). The incidence of delirium in adults (20-59 years old) and elderly (age 60 years) is the highest with 51.2% and 45.1% respectively. One-third of 45 people (37.2%) had overlapping dementia. Most of the 142 people (85.5%) were experiencing significant life stress. The most common type of delirium was hyperactive delirium (74%). The underlying disease of delirium varies such as the cause of infection (24.1%), intracranial process (19%), malignancy 18.1%, cardiovascular (10.1%), endocrine disorders,(7.8%), kidney disorders (6%), and others in small percentages.

Management of Medically Compromised Prosthodontic Patients

The medical evaluation of patients considering prosthodontic treatment is a vital step in the treatment planning. The prosthodontist should be able to assess the inherent risks associated with the treatment of patients with systemic conditions. Many factors are associated with evaluating the patient’s health status and risk including the patient’s current and past medical and dental history, current and past use of medications, type of treatment, length of treatment, invasiveness of treatment, and degree of urgency of treatment. In this article, some of the systemic diseases like arthritis, cardiovascular diseases, endocrine disorders, hematologic and oncologic disease, neurologic disorders, bone disorders, pulmonary diseases, liver diseases, and chronic kidney disease that commonly affect aged individuals are reviewed. The prosthodontic considerations that should be taken care of while managing patients with these systemic conditions will also be discussed.

Dependent and independent causes of hypercalcemia

Previous clinical studies show that the condition is significantly associated with mortality and increased cardiovascular morbidities. Accordingly, it is essential to conduct adequate diagnosis and evaluation to assess these cases properly. Studies show that different etiologies have been associated with hypercalcemia development with variable prevalence rates among different populations. Reduced PTH levels among patients with hypercalcemia indicate the presence of a non-PTH-dependant etiology for hypercalcemia. We have discussed various causes of hypercalcemia, including dependant and non-dependant causes. We found that malignancy-induced hypercalcemia is the commonest non-PTH-dependant etiology of hypercalcemia. Many malignancies were reported in the literature to attribute to the development of hypercalcemia. Vitamin D-mediated hypercalcemia was also reported as another common etiology for the condition. It might occur secondary to overdosing, immobilization, endocrine disorders, and granulomatous diseases. Other familial and congenital causes were also reported in the literature and discussed.

Yoga for Preventive Health: A Holistic Approach

Yoga has been prevalent for over 5000 years; it originated in India and has become an essential lifestyle ingredient for achieving optimal health. The goal of this article in lifestyle modification is to increase awareness about the benefits of yoga and how its practice can reduce the overall risk of chronic diseases. Yoga has been proven to be therapeutic for enhancing immunity and support management of chronic diseases such as cardiovascular, respiratory, endocrine disorders, obesity, cancer, and metabolic syndrome. Yoga techniques called asanas, such as pranayama for breathing regulation and dhyana for meditation, boost innate immune response, interrupt inflammation, and thereby prevent the manifestation of chronic diseases. Yoga also provides symptomatic relief for chronic arthritis by increasing joint flexibility and microcirculation. Yoga and meditation regulate neurotransmitters, neuropeptides, hormones, and cytokines that mediate interactions between the central nervous system and the immune system. These techniques reduce the psychological and physiological effects of chronic stress. Serotonin, oxytocin, and melatonin released directly due to practicing yoga have been shown to better manage anxiety and fear, especially during the pandemic. We believe the current trends of chronic disease management will become more effective with the implementation of lifestyle changes using yoga.