PubMed, Scopus and Web of Science Core Collection databases were systematically searched for studies reporting synchronous double or multiple pituitary adenomas (MPA), a rare clinical condition, with a vague pathogenesis. Multiple adenomas of the pituitary gland are referred to as morphologically and/or immunocytochemically distinct tumors that are frequently small-sized and hormonally non-functional, to account for the low detection rate. There is no general agreement on how to classify MPA, various criteria such as tumor contiguity, immunoreactivity and clonality analysis are being used. Among the component tumors, prolactin (PRL)-immunopositive adenomas are highly prevalent, albeit mute in the majority of cases. The most frequent clinical presentation of MPA is Cushing’s syndrome, given the fact that in more than 50% of reported cases at least one lesion stains for adrenocorticotrophic hormone (ACTH). Plurihormonal hyperactivity may be diagnosed in a patient with MPA when more than one tumor is clinically active (e.g. ACTH and PRL) or in cases with at least one composite tumor (e.g. GH and PRL), to complicate the clinical scenario. Specific challenges associated with MPA include high surgical failure rates, enforcing second-look surgery in certain cases, and difficult preoperative neuroradiological imaging evaluation, with an overall sensitivity of only 25% for magnetic resonance imaging (MRI) to detect distinct multiple tumors. Alternatively, minor pituitary imaging abnormalities may raise suspicion, as these are not uncommon. Postoperative immunohistochemistry is mandatory and in conjunction to electron microscopy scanning and testing for transcription factors (i.e. Pit-1, T-pit, and SF-1) accurately define and classify the distinct cytodifferentiation of MPA.

Edible insects such as the black soldier fly Hermetia illucens L. represent a potential and sustainable source of nutrients for food and feed due to their valuable nutritional composition, which can be modulated through dietary enrichment. The high content of saturated fatty acid (FA) of Hermetia illucens larvae fats can be modulated through dietary enrichment as a result of adding vegetable oils in the rearing substrate. Therefore, the present research aims to highlight the effects of a 10% addition of vegetable oils from five dietary fat sources (linseed oil, soybean oil, sunflower oil, rapeseed oil, and hempseed oil) on the growth, development, reproductive performance, and the fat and fatty acids profile of H. illucens. Oil inclusion in the larval diet improved (p < 0.05) the weight of larvae, prepupae, pupae, and imago without influencing (p > 0.05) the egg clutch weight and the number of eggs in the clutch. In addition, the larvae fatty acid profile was different (p < 0.001) according to the oil type, because the unsaturated FAs (UFA) increased from 11.23 to 48.74% of FAME, as well as according to the larvae age, because the saturated FAs decreased from 85.86 to 49.56% of FAME. Linseed oil inclusion led to the improvement of the FA profile at 10 days age of larvae, followed by hempseed and rapeseed oil. These three dietary treatments recorded the highest concentrations in UFA (29.94–48.74% of FAME), especially in polyunsaturated FA (18.91–37.22% of FAME) from the omega-3 series (3.19–15.55% of FAME) and the appropriate n–6/n–3 ratio. As a result, the degree of the lipid polyunsaturation index increased (17.76–41.44) and the value of the atherogenic (3.22–1.22) and thrombogenic (1.43–0.48) indices decreased. Based on the obtained results, it can be concluded that enriching the larval diet with these oils rich in UFA can modulate the larvae FA profile, making them suitable sources of quality fats for feed and indirectly for food.

Objective: There is plenty of evidence that osteoprotegerin (OPG) is linked to subclinical vascular damage and predicts cardiovascular disease in high-risk populations. Our aim is to investigate the relationships of OPG/free soluble receptor activator of nuclear factor κB ligand (sRANKL) to insulin resistance, brachial artery flow-mediated vasodilation (FMD), and the carotid artery intima-media thickness (CIMT) in polycystic ovary syndrome (PCOS), a disorder characterized by hyperandrogenism, impaired glucose control, and endothelial injury.Design: A cross-sectional, observational study.Methods: Hormonal and metabolic profiles, FMD, CIMT, serum OPG, and ampli-sRANKL were assessed in 64 young PCOS patients and 20 controls of similar age. Body composition was measured by dual energy X-ray absorptiometry.Results: OPG was significantly lower in PCOS and related negatively to free testosterone and positively to estradiol (E₂) levels. In multivariate analysis, OPG but not ampli-sRANKL correlated positively to fasting insulin, insulin sensitivity indices, and FMD. Neither OPG nor ampli-sRANKL was associated with CIMT. Significantly lower adjusted FMD values were demonstrated in women in the upper OPG quartile group (>2.65 pmol/l) compared with all other quartile groups together (P=0.012). In PCOS, multiple regression analysis retained E₂/sex hormone-binding globulin ratio, fat mass, and homeostasis model assessment of insulin resistance as independent predictors of OPG.Conclusions: In PCOS, circulating OPG is related to both endothelial dysfunction and insulin resistance, independent of obesity and androgen excess, suggesting OPG as a useful biomarker of these effects. Further studies are needed to evaluate OPG in relation to cardiovascular events and cardiovascular mortality in PCOS.

Two-thirds of differentiated thyroid cancer (DTC) patients with distant metastases would be classified as radioactive iodine-refractory (RAIR-DTC), evolving into a poor outcome. Recent advances underlying DTC molecular mechanisms have shifted the therapy focus from the standard approach to targeting specific genetic dysregulations. Lenvatinib and sorafenib are first-line, multitargeted tyrosine kinase inhibitors (TKIs) approved to treat advanced, progressive RAIR-DTC. However, other anti-angiogenic drugs, including single targeted TKIs, are currently being evaluated as alternative or salvage therapy after the failure of first-line TKIs. Combinatorial therapy of mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K) signalling cascade inhibitors has become a highly advocated strategy to improve the low efficiency of the single agent treatment. Recent studies pointed out targetable alternative pathways to overcome the resistance to MAPK and PI3K pathways’ inhibitors. Because radioiodine resistance originates in DTC loss of differentiation, redifferentiation therapies are currently being explored for efficacy. The present review will summarize the conventional management of DTC, the first-line and alternative TKIs in RAIR-DTC, and the approaches that seek to overcome the resistance to MAPK and PI3K pathways’ inhibitors. We also aim to emphasize the latest achievements in the research of redifferentiation therapy, immunotherapy, and agents targeting gene rearrangements in advanced DTC.