Cancer stem cells (CSCs) are a rare cancer cell population, responsible for the facilitation, progression, and resistance of tumors to therapeutic interventions. This subset of cancer cells with stemness and tumorigenic properties is organized in niches within the tumor microenvironment (TME) and presents altered regulation in a variety of metabolic pathways, including glycolysis, oxidative phosphorylation (OXPHOS), as well as lipid, amino acid, and iron metabolism. CSCs exhibit similarities as well as differences when comparedto normal stem cells, but also possess the ability of metabolic plasticity. In this review, we summarize the metabolic characteristics of normal, non-cancerous stem cells and CSCs. We also highlight the significance and implications of interventions targeting CSC metabolism to potentially achieve more robust clinical responses in the future.
Background: Post-thyroidectomy hypocalcemia is a common complication, yet the optimal perioperative markers for identifying high-risk patients and guiding supplementation remain debated. This study aimed to evaluate factors associated with hypocalcemia at 24 h after total thyroidectomy, identify independent predictors, and assess the reliability of early PTH measurement in determining supplementation needs. Methods: We conducted a single-center prospective cohort study including 200 patients undergoing total thyroidectomy at Genesis Hospital, Thessaloniki, between November 2022 and March 2025. PTH was measured preoperatively, 10 min post-resection, and at 24 and 72 h; calcium and phosphorus were measured preoperatively and postoperatively. Results: Independent predictors of hypocalcemia at 24 h were female sex, preoperative calcium, and PTH at 10 min. Age, pathology, incidental parathyroid excision, and extent of surgery were not significantly associated with hypocalcemia. ROC analysis showed that a preoperative calcium cutoff of 9.47 mg/dL yielded an AUC of 0.73, with 70.1% sensitivity and an NPV of 82%. PTH at 10 min with a cutoff of 24.6 pg/mL yielded an AUC of 0.66, with 70.1% sensitivity and an NPV of 79%. For supplementation needs, PTH at 10 min demonstrated excellent discrimination, with a cutoff of 16.3 pg/mL at 24 h and 14.1 pg/mL at 72 h. Conclusions: Preoperative calcium and PTH measured 10 min after thyroid removal are useful markers for predicting hypocalcemia after total thyroidectomy, with early PTH also accurately identifying supplementation needs.
The COVID-19 pandemic has highlighted intricate associations between SARS-CoV-2 infection and autoimmune skin diseases (ASDs). This review examines the bidirectional relationship between COVID-19 and ASDs including hidradenitis suppurativa, psoriasis, atopic dermatitis, alopecia areata, autoimmune bullous diseases, cutaneous and systemic lupus erythematosus, systemic sclerosis, dermatomyositis, and lichen planus. Current evidence indicates that SARS-CoV-2 may precipitate or worsen ASDs via mechanisms such as molecular mimicry, dysregulated cytokine signaling, and enhanced Th1/Th17 immune responses, leading to loss of self-tolerance and autoantibody production. Epidemiological studies have identified increased incidence and flares of psoriasis, hidradenitis suppurativa, and other ASDs following both COVID-19 infection and vaccination, with mRNA vaccines associated with a higher risk of flare in hidradenitis suppurativa compared with non-mRNA vaccines. Notably, severe COVID-19 is associated with a greater risk of new-onset autoimmune disease, and patients with pre-existing inflammatory skin conditions may have increased susceptibility to SARS-CoV-2 infection but experience less severe COVID-19 courses. These findings underscore the need for ongoing surveillance and mechanistic studies to clarify the immunopathogenic links between SARS-CoV-2 and ASDs and inform management strategies for affected patients in the context of both infection and vaccination.