Immune checkpoint inhibitors are antineoplastic drugs associated with adverse events that result from unleashing the immune system against self-antigens while attacking neoplastic cells. Endocrinopathies are among the most common associated adverse events and hypophysitis is a frequent endocrine side effect of this treatment. We conducted a systematic search of the literature in 2 databases: PubMed and Medline. Articles that reported endocrine adverse events of immune checkpoint inhibitors were reviewed. Hypophysitis is most commonly seen with cytotoxic T-lymphocytes associated protein 4 (CTLA-4) inhibitors and can result in different anterior pituitary hormones deficiencies. Monitoring for this complication is of particular interest due to the life-threatening nature of secondary adrenal insufficiency and thyroid dysfunction if not promptly recognized and treated. Hypophysitis is the most common endocrinopathy seen and is usually treated by adequate hormonal replacement. The use of high dose corticosteroids has not been established as a treatment of this endocrine toxicity. Hormonal screening should be a part of baseline laboratory testing of all patients undergoing treatment with immune checkpoint inhibitors.

Diabetes has become a global pandemic which imparts a financial burden on the patients as well as on healthcare system. Researches all over the world have shown that more than 200 plants, possess antidiabetic properties. Members of cucurbit family are the most important one. Experimental studies in animal and human models have depicted the hypoglycemic effect of cucurbit family. These studies also stated that cucurbit promote regeneration of beta-cells of pancreas. The selected pumpkin (Cucurbitaceous) seeds were also shown to contain globulins with significant anti hyperglycaemic activity. Administering pumpkin seed powder and seed oil can reduce the side effects of diabetes; improve insulin levels and diabetic’s health status. Pumpkin seeds are generally regarded as waste, recently gained significant attention due to their nutritional value and health benefits. Due to the emerging different active components with nutraceutical properties of pumpkin (Cucurbita sp.) powder, seed, extracts, and oil. The aim of this analysis is to recognize the nutraceutical potential of pumpkin (Cucurbita sp.) seed powder, extracts, and oil on diabetic patients. The component of pumpkin seed is easily available, palatable and cost-effective therapy.

Background: The impact of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome-coronavirus 2 (SARS-Cov-2) on testicular function is unclear. Objective: To clarify the effects of COVID-19 on male gonadal function. Methods: Pubmed search up to February 24, 2021. Search terms included COVID-19, testicles, testosterone, spermatogenesis, hypogonadism. Case reports, retrospective, prospective and autopsy studies are included. Results: Prevalence of patients hospitalized with COVID-19 having scrotal pain varies from 0-19%. Orchitis and/or epididymitis were demonstrated by scrotal ultrasound (US) in approximately 22-42% of men with COVID-19 admitted to the hospital and can be frequently asymptomatic. Circulating testosterone levels are reduced in men admitted with COVID-19 with concomitant elevation of luteinizing hormone (LH) suggesting testicular dysfunction. Men affected with COVID-19 exhibit abnormal semen parameters. Most, but not all, studies failed to detect SARS-CoV-2 in semen. Autopsy studies showed extensive damage of testicular tissues of men who died from severe COVID-19. Conclusion: COVID-19 negatively affects almost all aspects of male gonadal function. Physicians should evaluate testicular function during and after recovery from COVID-19 to preserve normal fertility.

Objective: To describe the tumor response and adverse events in patients with advanced medullary thyroid carcinoma (MTC) treated with vandetanib at the National Cancer Institute in Bogotá, Colombia. Materials and Methods: Case series including five patients with advanced MTC treated with vandetanib from April 2011 to August 2018 and a minimum follow-up of 6 months. Results: 5 patients met the inclusion criteria, including 3 women. The mean age was 49 years. A total of 4 patients underwent total thyroidectomy prior to starting vandetanib. The main indication for vandetanib was progression of liver metastasis (4 patients). Regarding treatment response, 3 patients presented stable disease, 1 patient showed partial response, and 1 had disease progression. The mean treatment duration was 16.5 months. Grade 3 or 4 adverse events were observed in three patients, 1 with diarrhea, 1 with hypertension, and 1 with rash. All symptoms improved with dose reduction or temporary suspension of vandetanib. Conclusions: The management of advanced MTC with vandetanib allows for prolonged disease control (stable disease or partial response). Although adverse events are frequent, most are mild and severe cases are manageable.

Diabetes mellitus is a group of metabolic disorder characterize by and absolute or partial insulin deficiency. Diabetic hyperglycemia is produce by the effect of homeostasis between proteolytic enzymes, their inhibitors and the antioxidants defense that protect and repair vital tissues and molecular components. Bone consist of both component and trabecular bone tissue. Organic matrix and albumin form part of noncollagenous of bone .Initiation of mineralization and collagen fibrils form the phase of mineral matrix. Calcium flux into and out of bone depend of osteoclastic and osteoblastic activity. The remodeling is initiated by resorption and new bone formation at the resorption site. Diabetic complication is a critical factor for bone pathology and could start early inflammatory stage even before hyperglycemia. Diabetic produces bone loss from reduce osteoblast activity. Partly insulin deficiency produce defective bone remodeling indirect by oxidative stress. The current treatment for defective bone in diabetes state include biophosphonate and cinaciguat. Biphosphonate inhibit bone resorption, but may worsen bone quality. A novel type of activation of sGMP is cinaciguat an NO independent activator of oxidative GC, increase c GMP synthesis on diabetic and restore proliferation and survival of osteoblasts. Chronic hyperglycemia interferes with the oseointegration of implants in diabetics. Both diabetic and aging plays a role in abnormal differentiation of osteroblasts. In diabetic patients may improve the oral health to have a positive impact if optimal glycemic control is emphasized. However with cinaciguat present as a novel paradigm enhancing bone formation under hyperglycemia and protect bone implants.