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Parathyroid hormone (PTH) is a single-chain 84 amino acid peptide produced by the parathyroid gland in response to a decrease in the extracellular concentration of ionized calcium. Its main role is to increase the level of calcium in the serum. It does this by stimulating the release of calcium from the bones and renal reabsorption in the distal tubules. In the proximal tubules, PTH stimulates the synthesis of calcitriol, which in turn increases the absorption of calcium in the intestines and creates an endocrine feedback loop on PTH secretion at the level of the parathyroid gland. Parathyroid hormone also reduces phosphate reabsorption in the proximal tubules of the kidneys, thereby reducing the amount of phosphate in the serum.Disorders of the parathyroid gland lead to an increase or decrease in blood calcium levels (hypercalcemia or hypocalcemia), which is caused by a change in parathyroid gland secretion.Excessive production of parathyroid hormone is called hyperparathyroidism.Types include:• Primary hyperparathyroidism: Often caused by a benign tumor (adenoma) on one of the parathyroid glands. Other causes include enlarged glands (hyperplasia) or, rarely, parathyroid gland cancer.• Secondary hyperparathyroidism: Occurs as a response to low blood calcium levels due to chronic renal failure, vitamin D deficiency, or extremely high levels of phosphate. The parathyroid glands produce excess PTH, attempting to restore calcium balance.• Tertiary hyperparathyroidism: Develops when secondary hyperparathyroidism continues for a long time, leading to autonomous hyperactivity of the glands, even when calcium levels return to normal.Underproduction of parathyroid hormone is called hypoparathyroidism.The causes of hypoparathyroidism are:• Damage, accidental removal, or destruction of the parathyroid glands during neck or thyroid surgery• Autoimmune diseases• Low magnesium levels• Radiation therapy to the head or neck• Rarely, congenital absence of glands or functional defectsSymptoms of hyperparathyroidism are:• Fatigue and general weakness (the most common symptom)• Bone and joint pain, osteoporosis, brittle bones, and fractures• Muscle weakness• Kidney stones and possible kidney disease or renal failure• Memory problems, difficulty concentrating, depression, anxiety, and mood swings• Increased thirst and frequent urination• Gastrointestinal problems such as nausea, vomiting, loss of appetite, constipation, and abdominal pain• Insomnia or difficulty sleeping• Headaches• Heart-related symptoms such as high blood pressure, arrhythmias, and atrial fibrillationSymptoms of hypoparathyroidism are:• A tingling or burning sensation in the fingers, toes, lips, and around the mouth (paresthesia)• Muscle aches, spasms, and cramps, sometimes affecting the hands, feet, face, and throat• Fatigue, weakness, exhaustion• Headaches and problems with memory or concentration• Abdominal pain• Dry skin, brittle nails, dry hair, brittle teeth• Cataracts• Anxiety, irritability, and mood swings• In severe cases, convulsionsSometimes the symptoms are mild or absent, and parathyroid gland problems are detected through routine blood tests.

Obesity is not just excess weight, but is considered a chronic disease that over time leads to serious complications. According to the WHO, obesity is a global epidemic that affects both physical and psychological health. Main causes of obesity • Poor diet – abuse of fats, sweets, and high-calorie foods. • Lack of physical activity – a sedentary lifestyle reduces energy expenditure. • Hormonal disorders – for example, hypothyroidism, Cushing's syndrome. • Genetic predisposition – some genes affect metabolism and appetite. • Psychological factors – stress, depression, loneliness, which often lead to excessive food consumption. The hidden dangers of obesity Excess weight can become the basis for numerous health problems. The consequences of obesity include a high risk of type 2 diabetes, cardiovascular diseases (heart attack, stroke), atherosclerosis, and joint diseases (arthrosis, gonarthrosis). It can also cause respiratory disorders (sleep apnea, asthma) and hormonal disorders. In addition, obesity is associated with a high risk of oncological diseases (breast, uterine, colon, and other cancers), as well as skin problems (dermatitis, fungal infections). Prevention The prevention of obesity is based on a healthy lifestyle: • A healthy and balanced diet, limiting fats and simple carbohydrates. • Regular physical activity, at least 150 minutes of moderate-intensity exercise per week. • Periodic monitoring of weight and body mass index. • Hormonal and metabolic tests for those at risk. Treatment Obesity treatment is individualized and includes a comprehensive approach: • Diet therapy – calorie control, diet adjustment. • Physical activity – workouts and motor activity. • Treatment of accompanying diseases – diabetes, hypertension, hormonal disorders. • Bariatric surgery – indicated when the BMI is over 40 and diet and physical activity have not given a satisfactory result. Obesity is not just an aesthetic problem, but a serious medical condition. By consulting an endocrinologist in time and undergoing hormonal and metabolic tests, it is possible to prevent severe complications and maintain a healthy life.

Polycystic ovary syndrome (PCOS) is considered one of the most common hormonal disorders among women, affecting both the reproductive system and metabolism. In this condition, numerous small, immature follicles form in the ovaries, which can disrupt the natural process of ovulation. Why is it important to recognize polycystic ovary syndrome? PCOS can go on for years without obvious symptoms, but it can lead to the following complications: • Infertility or complications during pregnancy • Irregular menstrual cycle • Skin and hair problems: acne, hirsutism • Insulin resistance and a high risk of type 2 diabetes • Psychological complications: depression, stress, low self-esteem How is a diagnosis confirmed? PCOS diagnosis is made by combining a number of data points: • Detailed medical interview • Menstrual cycle analysis • Ultrasound examination (sonography) • Blood hormonal and metabolic tests How is treatment carried out? PCOS is treated with a combined approach, depending on the woman's age, goals (e.g., getting pregnant or regulating the cycle), and the severity of the symptoms. The main directions of treatment are: 1. Regulation of diet and lifestyle 2. Cycle regulation: hormonal treatment 3. Treatment of hirsutism and skin acne 4. Assisted conception: medication or, if necessary, the use of reproductive technologies 5. Medications that increase insulin sensitivity Polycystic Ovary Syndrome and a Healthy Lifestyle Even a mild weight loss (5-10%) can significantly improve hormonal balance, restore ovulation, and regulate menstruation. • Balanced nutrition • Regular physical activity • Good quality of sleep • Stress management methods Remember, you are not alone. There are many women with PCOS, and with proper management, it is possible to live a full, feminine life with a healthy reproductive system. Pay attention to your body's signals, and do not hesitate to consult a specialist.

Aspirin (active ingredient: acetylsalicylic acid) is a medicine used to reduce pain, fever, and inflammation. However, it also plays a very important role in the prevention of heart diseases (Cardiomagnyl, Aspirin cardio). Why is Aspirin important for heart patients? Aspirin has blood-thinning properties. Many heart diseases start because the blood becomes thick and can form clots (thrombi), which hinder the natural flow of blood. These clots can block the vessels of the heart or brain, causing myocardial infarction or stroke. Aspirin reduces the risk of cardiovascular diseases by preventing the formation of clots in people who are at risk of developing cardiovascular diseases. Who should use Aspirin (as directed by a doctor)? • Those who have already had a myocardial infarction or a cerebral stroke. • Those who have ischemic heart disease (narrowing of the heart vessels). • Those who have undergone stenting of the coronary arteries (vessels that supply the heart). • High-risk individuals: those with diabetes, who are overweight, or who are smokers. It is important to know that Aspirin should be taken only as directed by a doctor, as it can have side effects. For example, in people with high blood pressure, it can increase the risk of intracerebral hemorrhage (hemorrhagic stroke). Possible side effects Aspirin can also cause the following problems: • Stomach pain • Bleeding (e.g., from gums or intestines) • Allergic reaction Inform your doctor if: • You are taking other medications. • You have bleeding or stomach ulcers, gastritis. • You are preparing for surgery. How and when is the medication taken? For primary and secondary prevention of cardiovascular diseases, aspirin is used in a low dose of 75–150 mg per day (as directed by a doctor). It is taken every day (Cardiomagnyl: after eating, Aspirin cardio: before eating). Do not stop taking aspirin without consulting a doctor, even if you feel well. Reminder to the patient Aspirin does not cure; it prevents the development of dangerous conditions. It should be taken every day, at the right time. Keep it away from children. Talk to your doctor if you are also taking other medicines. While using aspirin, it is necessary to regularly monitor blood pressure to avoid complications, especially the risk of bleeding or stroke. Remember, the medication can help, but real heart protection starts with a healthy lifestyle.

A white, radiant smile is not only about aesthetics but also a reflection of self-care. Today, it is possible to quickly and effectively whiten teeth, but it is important to remember that teeth whitening is a medical procedure, not a cosmetic service. If done incorrectly, it can harm your health. Why You Should Only Trust a Specialist In a clinical setting, teeth whitening is performed by dentists who have received professional training. They use safe, certified materials and select the gel concentration individually for each patient. The doctor considers the condition of the enamel, gums, and the presence of fillings or restorations. Attempts to whiten teeth at home on your own, especially with kits from the internet or stores, can lead to serious problems: • burns to the oral mucosa; • damage and thinning of the enamel; • increased tooth sensitivity; • gum inflammation. No online kit can replace the experience and knowledge of a dentist. Even if the procedure seems simple, without a medical diagnosis, it is impossible to determine if it is safe for you. Types of Whitening Clinical Whitening. This is performed in a dentist's office and takes 1-1.5 hours. Gels based on hydrogen peroxide or carbamide are used, activated by a special lamp or laser. The result is noticeable immediately, and the doctor controls the process from beginning to end. At-Home Whitening Under a Doctor's Supervision. The doctor creates custom trays and provides a gel with the optimal concentration. The patient undergoes a 1-3 week course at home, but under the regular supervision of a dentist. Who is Whitening Not Suitable For? The procedure is not recommended during pregnancy, with tooth decay, gum inflammation, or increased tooth sensitivity. In these cases, the doctor first performs treatment and only then returns to the question of whitening. How to Maintain the Results The whitening effect lasts from 6 months to 3 years. To make it last longer: • avoid frequent consumption of coffee, strong tea, and red wine; • do not smoke; • get a professional cleaning from a dentist every 6 months. Remember: tooth health is more important than an instant result. Home whitening experiments can cost you not only the whiteness but also the health of your smile. At Dalimed Medical Center, teeth whitening is performed by experienced doctors, ensuring maximum safety and long-lasting results. Book your consultation today — trust your smile to the professionals!

Seborrheic keratosis (or seborrheic keratoma) is one of the most common benign skin growths. It usually develops in adults and is considered a natural sign of aging. Who gets Seborrheic Keratoses? Seborrheic keratoses are often found in individuals over 60, but they can appear as early as 30-40, regardless of gender or race. They are rare in young people (under 20). Causes Although the name "seborrheic keratosis" suggests a connection to sebaceous glands, the growths do not actually originate from them. They arise from the abnormal proliferation of immature keratinocytes in the epidermis. Prevalence Seborrheic keratosis is extremely common. Studies show that: • By age 40, about 30% of people have at least one seborrheic keratosis. • In individuals over 60, the prevalence reaches nearly 75%. Contributing Factors Contributing factors include: • Genetic predisposition. • Prolonged exposure to sunlight. • Possible, but less likely, viral influence (e.g., HPV). • Genetic mutations: FGFR3, PIK3CA, RAS. Appearance Seborrheic keratoses can have various appearances: • Shape — they can be flat or raised nodules. • Surface — often scaly, sometimes fissured. • Color — ranges from skin-colored to yellowish, brown, or black. • Size — from 1 mm to several centimeters. • Location — almost anywhere on the body, except the palms and soles. • They often appear in clusters, especially on the chest, back, scalp, and in skin folds. On the back, they sometimes arrange themselves in a "Christmas tree-like" pattern, which is related to their spread along the lines of Blaschko. Complications A seborrheic keratosis is a benign growth and is not cancer or a precancerous condition. However, in some cases, its appearance can mimic malignant growths, such as: • Basal cell carcinoma. • Squamous cell carcinoma. • Melanoma. Additionally, the sudden and massive eruption of seborrheic keratoses (especially in older individuals) can be a sign of an internal malignancy, such as gastric adenocarcinoma. This phenomenon is known as the sign of Leser-Trélat. Diagnosis 1. Clinical examination — in many cases, a diagnosis can be made based on a visual inspection. 2. Dermoscopy — a non-invasive method that helps differentiate seborrheic keratosis from malignant growths. Characteristic dermoscopic features include: • Comedo-like openings. • Milia-like cysts. • Gyri and sulci ("brain-like" structure). • Hairpin-like vessels. 3. Biopsy and histological examination — performed in suspicious cases where dermoscopic or clinical data are not conclusive. Differential Diagnosis Seborrheic keratosis must be differentiated from the following growths: • Common warts (verruca vulgaris). • Actinic keratosis. • Pigmented basal cell carcinoma. • Squamous cell carcinoma. • Melanoma — rare, but important to rule out. Treatment Seborrheic keratosis doesn't require treatment, but it can be removed in the following situations: • Aesthetic discomfort. • Itching or irritation. • Injury from clothing or shaving. Treatment methods: • Cryodestruction (freezing). • Electrocoagulation. • Laser therapy. • Shave biopsy. The choice of treatment method is based on the size and location of the growth, as well as the patient's overall health. When choosing the best method, all indications and contraindications should be considered. Prevention and Prognosis Since the exact causes of its occurrence are not fully understood, there are no specific preventive measures known. However, it is recommended to: • Use sunscreen. • Undergo regular dermatological examinations. • Avoid excessive sun exposure. Some seborrheic keratoses can disappear on their own over time. In suspicious cases, you should always consult a specialist.

Rheumatoid arthritis is a chronic autoimmune disease that primarily affects the joints, causing inflammation, pain, swelling, and gradual joint damage. The disease can affect not only the joints but also internal organs like the heart, lungs, and blood vessels. The causes of rheumatoid arthritis are not yet fully understood, but it's believed that genetic predisposition, environmental factors like viral infections and smoking, and immune system disorders can contribute to the disease's development. The immune system mistakenly begins to attack its own tissues, especially the synovial membranes of the joints, causing inflammation and damage. The disease is more common in women, especially between the ages of 30 and 60, but it can also begin in childhood, starting as early as age 2. Initial symptoms include joint pain, morning stiffness, swelling, redness, and restricted movement. Generally, the earlier the onset of the disease, the more aggressive its course, leading to irreversible deformities and even the development of joint contractures. Rheumatoid arthritis that begins in childhood is called Juvenile Rheumatoid Arthritis, which can manifest as rheumatoid vasculitis (inflammation of blood vessels), leading to internal organ damage. The disease usually starts in the small joints of the wrists and feet and can spread to other joints. Involvement of the spine is not typical in rheumatoid arthritis, although the atlantoaxial joint in the neck can be affected. Diagnosis of rheumatoid arthritis is made through clinical symptoms, laboratory blood tests (e.g., rheumatoid factor, anti-CCP antibodies, C-reactive protein), and X-ray or ultrasound examinations. Early diagnosis of the disease is very important, as the earlier treatment begins, the better the chances of achieving stable remission. If a patient’s complaints have been present for less than 5-6 months, an X-ray is not informative; in this case, a joint ultrasound and anti-CCP antibody test are recommended. Treatment is primarily aimed at reducing inflammation and preventing joint damage. Non-steroidal anti-inflammatory drugs, corticosteroids, and disease-modifying drugs such as methotrexate, leflunomide, and biological therapies like TNF inhibitors and IL-6 inhibitors are used. Although rheumatoid arthritis cannot be completely cured, modern therapy makes it possible to control the disease, keep it in a mild phase, and improve the patient's quality of life. Biological therapy can free the patient from long-term corticosteroid use and prevent the development of drug side effects. A healthy lifestyle, physical exercises, and joint care are also important in the treatment process.

Conjunctivitis is the inflammation of the conjunctiva, the outer membrane of the eye. The conjunctiva is a transparent membrane that covers the white part of the eyeball and the inner eyelid. When this membrane becomes inflamed, the eye turns red, and itching, discharge, and sometimes burning occur. Many people know it as "pink eye". Conjunctivitis is a very common and usually not serious illness, but some forms can be contagious and require special attention. Conjunctivitis can be caused by various factors: • Viral conjunctivitis: This is the most common form, often associated with upper respiratory tract infections and colds. The eye becomes red and watery, and often both eyes are affected. It is very contagious and easily transmitted. • Bacterial conjunctivitis: The cause is bacteria. A thick yellow or greenish discharge comes from the eye, and in the morning, the eyelids may stick together. It can also be contagious but is treated with antibacterial drops. • Allergic conjunctivitis: This is an eye reaction to allergens (dust, pollen, animal hair, etc.). Both eyes itch, turn red, and are watery. It is not contagious to others. • Chemical or irritant conjunctivitis: This is eye irritation from smoke, chemicals, or perfumes. You should wash your eye and consult a doctor. What are the symptoms? • Redness of the eye • Watery or purulent discharge • Itching or burning • Sticky eyelids in the morning • Slightly blurred vision (usually temporary) • Sensitivity to light (only in some cases) If vision suddenly worsens, the eye is very painful, or you feel there is a problem in the center of your vision, you should immediately consult an ophthalmologist. Viral and bacterial conjunctivitis can spread easily through: • Hands, when we touch our eyes • Public items (towels, pillows, eye cosmetics) • Kindergartens, schools, and workplaces How to protect yourself and treat it • Wash your hands frequently with soap. • Do not try to share towels or pillows. • Do not use other people's eye cosmetics or contact lenses. • Replace cosmetics with new ones during an infection. Treatment approach: • Viral conjunctivitis usually resolves on its own within a few days or weeks. Artificial tears and cold compresses are used to alleviate the symptoms. • Bacterial conjunctivitis is treated with antibacterial drops or ointment. • Allergic conjunctivitis is treated with antiallergic drops, and sometimes with antihistamines. • In the case of chemical or irritant forms, the eye should be washed well with clean water, and a doctor should be visited as soon as possible. Remember, self-treatment can be dangerous, especially if the symptoms worsen or last for a long time. If you have a red eye, burning, or discharge, don't wait. Consult an ophthalmologist for a correct diagnosis and treatment.