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Infertility is generally defined as the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. premature ovarian failure (POF) is a cause of female infertility, being estimated to affect 1% of the general population. This condition represents a loss of hormonal and germinative activity of the ovaries due to a lack in the number of active follicles in women under 40 years old. Regenerative medicine represents a complex therapeutic option and it consists of technologies such as the use of stem cells, tissue engineering, and gene therapy alone or in different combinations. Although the boundaries of regenerative medicine are not clearly outlined at present, this paper is aiming to review its possibility of treatment in the future in what concerns POF, focusing more on the use of stem cell therapy. Stem cell therapy could be a feasible therapeutic approach for POF as the cells can be easily obtained. However, additional clinical studies are needed because until now the majority of the literature focuses on animal models for the evaluation of the role of stem cells on treating POF. Additionally, the platelet-rich plasma (PRP) approach for POF should be kept in mind as it was shown to be useful in the regeneration of multiple types of tissue. [ABSTRACT FROM AUTHOR]

Introduction. Scleroderma induces heterogeneous skin changes due to collagen anomalies including facial. The recommended therapy is. among others, topic cortisol derived products so an issue of diagnosis differential regarding the etiological type of Cushing's syndrome (CS) is raised if a patient develops a suggestive phenotype. Case presentation. This is a 64-year female presenting since the last few months red face, high blood pressure. central obesity. She has a 6-year history of scleroderma, intermittently treated with local corticotherapy. On admission, she associated metabolic disturbances as lipid profile anomalies, high uric acid, insulin resistance and increased number of white blood cells (which were not connected with a relapse of scleroderma, neither to an inflammatory syndrome). Low baseline plasma ACTH and morning serum cortisol level (not high yet detectable) with abnormal diurnal rhythm suggested an adrenal source of CS. A 3 cm right adrenal tumor was found on computer tomography and later removed through a classical intervention. Two weeks after, the patient voluntarily reduced her prednisone dose causing an adrenal crisis which required re-admission as an emergency. After discharge daily oral adrenal replacement therapy is needed for the moment. Conclusions. Scleroderma, especially with skin involvement, and some of associated therapies may mask an endogenous CS as adrenal tumor derivate thus delaying the adequate diagnosis and therapy. Patient's education regarding a potential life threatening condition as chronic adrenal insufficiency is necessary since post-operatory recovery of adrenal function is expected within 6 to 24 months. [ABSTRACT FROM AUTHOR]

Introduction. 5-hydroxytryptamin (serotonin) represents a monoamine with different functions. Central neurotransmitter is related to mood, food and energy regulation and indirect positive effects on bone mass via leptin and sympathetic system. Gut-derived 5-hydroxytryptamine directly influences the skeleton through Wnt/Lrp5/beta catenin signalling with opposite actions to the central pool. Method. This is a mini-review regarding serotonin- related bone changes. Results and discussions. All the bone cells have receptors for 5-hydroxytryptamine while skeleton may have an intrinsic ability to locally generate it. The monoamine displays paracrine and autocrine actions, some incompletely described. One practical point is the potential bone loss in clinical situations with serotonin excess as seen in carcinoid syndrome. Up to this moment, non-bone metastatic neuroendocrine tumours are not listed as cause of secondary osteoporosis. Another practical aspect is the use of circulating 5-hydroxytryptamine as bone turnover marker surrogate for assessing the future fragility fracture probability. Despite some correlations with classical bone remodelling markers, no clear cut conclusion has been established yet. Conclusion. 5-hydroxytryptamine displays complex effects on skeleton status, whether direct, indirect or local but there are data still unknown thus future need to connect the dots in this particular inter-disciplinary field. [ABSTRACT FROM AUTHOR]

Introduction. Bariatric surgery, regardless the type of approach, has aggressively extended nowadays. The procedure saves lives due to substantial improvement of severe cardio-metabolic co-morbidities but the influence of nutritional status might not be completely harmless including bone and muscle changes. Our purpose is to introduce data regarding skeleton after bariatric surgery. This is a narrative mini-review including papers from PubMed. A selection of 33 papers has been done. General data. Longitudinal better than cross-sectional studies confirmed an annual rate of losing bone mineral density at lumbar and femoral neck of 3-10% starting with first year after surgery and continuing within the third year; low vitamin D and calcium absorption with associated secondary hyperparathyroidism is described; others anomalies include elevated bone remodelling markers, damage of bone microarchitecture, fracture healing disturbances and sarcopenia. Conclusion. Overall, despite spectacular results after bariatric surgery, the bone and muscle are expected to suffer a level of deterioration which should be taken into account for assuring an adequate quality of life and an immediate and distant good post-operatory prognosis. [ABSTRACT FROM AUTHOR]