Gastrointestinal Manifestations of Diabetes Mellitus

Elsayes, Khaled M.; Menias, Christine O.; Sierra, Lina M.; Dillman, Jonathan R.; Platt, Joel F.

doi:10.1097/rct.0b013e3181626871

Cited by 11 publications

(5 citation statements)

References 8 publications

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“… 16 Other studies have also noted a higher rate of upstaging in patients with axillary disease and recommended that metastatic workup should not be performed in a patient with a clinically negative axilla. 16 , 17 …”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic Features Predictive of Distant Metastasis in Patients Diagnosed With Invasive Breast Cancer

Ali

Mubarik

Zahid

et al. 2020

JCO Global Oncology

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PURPOSE National Comprehensive Cancer Network and European Society for Medical Oncology guidelines suggest screening for distant metastasis (M1) in symptomatic patients or those with locally advanced breast cancer. These guidelines are based on studies that often used pathologic staging for analysis. Physician variability in screening for M1 has also resulted in overuse of diagnostic tests. We sought to identify clinicopathologic features at diagnosis that could guide testing for metastatic disease. METHODS Patients diagnosed with invasive breast cancer between January 2014 and December 2015 were identified from our institutional database. Demographic and clinical variables were collected, including receptor profiles and clinical TNM staging. Rates of upstaging for each clinical stage and rates of concordance of pathologic and clinical staging were analyzed. Univariate analysis and multivariate regression analysis ( P < .05) identified predictors of upstaging to stage IV disease. RESULTS A total of 370 patients met the inclusion criteria. Seventy patients (18.9%) had metastatic disease at diagnosis. The rate of upstaging for stages I, IIA, IIB, and III were 0%, 5.6%, 18.8%, and 36.6%, respectively. Advancing clinical stage, tumor size, and nodal status resulted in a significantly higher rate ( P < .001) of upstaging to M1 disease. Age and hormone receptor status were not associated with upstaging to stage IV disease. Clinical stages I-III were concordant with pathologic staging in 65(42.8%) of 152 patients (kappa’s index, 0.197; P < .000). CONCLUSION Advancing clinical stage, tumor size, and nodal status at diagnosis were predictive of upstaging to M1 disease in patients with breast cancer. Distant metastatic workup should be considered in patients with clinical stage IIB disease or higher.

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Section: Discussionmentioning

confidence: 99%

Clinicopathologic Features Predictive of Distant Metastasis in Patients Diagnosed With Invasive Breast Cancer

Ali

Mubarik

Zahid

et al. 2020

JCO Global Oncology

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“…It usually affects elderly men (2:1), and it is associated with diabetes mellitus and arteriosclerosis. Vascular compromise of the cystic artery is thought to play a significant role in the evolution of the emphysematous form of this disease, likely explaining its male predilection 1,2,7 . In comparison with all cases of acute cholecystitis, EC is associated with an increased prevalence of acalculous disease and gallbladder perforation.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous Cholecystitis

Ala-Ketola¹,

Pyhtinen²,

Hulkko³

2015

Diagnostic Imaging: Gastrointestinal

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“…It usually affects elderly men (2:1), and it is associated with diabetes mellitus and arteriosclerosis. Vascular compromise of the cystic artery is thought to play a significant role in the evolution of the emphysematous form of this disease, likely explaining its male predilection 1,2,7 . In comparison with all cases of acute cholecystitis, EC is associated with an ABCDDV/680 Lupinacci RM increased prevalence of acalculous disease and gallbladder perforation.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous cholecystitis

Lupinacci¹,

Chafaı̈²,

Tiret³

2009

ABCD, arq. bras. cir. dig.

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BACKGROUND: Emphysematous cholecystitis is life-threatening condition characterized by gas-forming infection of the gallbladder. It is mostly seems in old male patients with systemic, specially diabetes and vascular diseases. CASE REPORT: - A 30-year-old man without previous diseases was admitted because of right upper quadrant pain and nausea. On admission the patient was febrile (38.7o) with normal bilirubin levels. The white blood count was 26700/µl and reactive protein C was 470. Axial sections of single slice computed tomography imaging (section thickness 5 mm), revealed gallbladder wall enhancement after i.v. contrast, as well as dilatation of the gallbladder with intraluminal air. The patient underwent open cholecystectomy. The culture of the bile showed clostridium perfringes. The postoperative course of the patient was uneventful. CONCLUSION: This is a rare form of cholecystitis that carries a high mortality and usually present insidious clinical signs. CT is the most accurate imaging technique. Antibiotic therapy should begin quickly and include coverage of common pathogens, particularly Clostridia. Surgical intervention should take place as early as possible.

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Gastrointestinal Manifestations of Diabetes Mellitus

Cited by 11 publications

References 8 publications

Clinicopathologic Features Predictive of Distant Metastasis in Patients Diagnosed With Invasive Breast Cancer

Clinicopathologic Features Predictive of Distant Metastasis in Patients Diagnosed With Invasive Breast Cancer

Emphysematous Cholecystitis

Emphysematous cholecystitis

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