Choix entre une gliptine et une gliflozine chez le patient âgé avec un diabète de type 2

Object. The results of two longitudinal studies of growth rates of vestibular schwannomas (VSs) in patients with neurofibromatosis Type 2 (NF2) differ as to whether VS growth rates decrease or increase with increasing patient age. The authors undertook this study to assess the relationship between VS growth rates and patient age and type of constitutional NF2 mutation; they also examined variability in VS growth rates among multiple patients in families with NF2. Methods. Gadolinium-enhanced magnetic resonance images obtained in 18 patients with inherited NF2 from 11 unrelated families were retrospectively analyzed. The patients had been observed for a median of 4 years. Volumes of the VSs were measured using a two-component box model (intrameatal and extrameatal parts measured separately). Single-strand conformation polymorphism analysis and Southern blot analysis were used to identify constitutional NF2 mutations. Growth rates of the VSs were highly variable, but tended to decrease with increasing patient age both at onset of signs or symptoms of NF2 (r2 = 0.35, p = 0.026) and at diagnosis (r2 = 0.33, p = 0.012). The VS growth rates did not vary significantly with the type of constitutional NF2 mutation or the number of non-VS cerebral or spinal tumors. The VS growth rates were highly variable within families and did not correspond to clinical indices of NF2 disease severity, such as patient age at symptom onset and the number of non-VS cerebral and spinal tumors. Conclusions. The growth rates of VSs in patients with NF2 are highly variable, but tend to decrease with increasing patient age. Clinical treatment of multiple patients in families with NF2 cannot be based on the expectations of similar VS growth rates, even when other clinical aspects of disease severity are similar.

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Diabetes Onset at 31–45 Years of Age is Associated with an Increased Risk of Diabetic Retinopathy in Type 2 Diabetes

Scientific Reports ◽

10.1038/srep38113 ◽

2016 ◽

Vol 6 (1) ◽

Cited By ~ 7

Author(s):

Wenjun Zou ◽

Lisha Ni ◽

Qianyi Lu ◽

Chen Zou ◽

Minjie Zhao ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Onset Age ◽

Patient Age ◽

Diabetes Onset ◽

Type 2 Dm ◽

Patient Âgé ◽

Increased Risk ◽

Department Of Ophthalmology

Abstract This hospital-based, cross-sectional study investigated the effect of age of diabetes onset on the development of diabetic retinopathy (DR) among Chinese type 2 diabetes mellitus (DM) patients. A total of 5,214 patients with type 2 DM who were referred to the Department of Ophthalmology at the Shanghai First People’s Hospital from 2009 to 2013 was eligible for inclusion. Diabetic retinopathy status was classified using the grading system of the Early Treatment Diabetic Retinopathy Study (ETDRS). Logistic and hierarchical regression analyses were used to identify independent variables affecting the development of DR. Upon multiple logistic regression analysis, patient age at the time of diabetes onset was significantly associated with development of DR. Further, when the risk of retinopathy was stratified by patient age at the onset of diabetes, the risk was highest in patients in whom diabetes developed at an age of 31–45 years (odds ratio [OR] 1.815 [1.139–2.892]; p = 0.012). Furthermore, when patients were divided into four groups based on the duration of diabetes, DR development was maximal at a diabetes onset age of 31–45 years within each group. A diabetes onset age of 31–45 years is an independent risk factor for DR development in Chinese type 2 DM patients.

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Clinicopathological profile of primary ovarian carcinomas

IP Archives of Cytology and Histopathology Research ◽

10.18231/j.achr.2021.018 ◽

2021 ◽

Vol 6 (2) ◽

pp. 70-75

Author(s):

Hareesh Chandran

Keyword(s):

Progression Free Survival ◽

Ovarian Carcinomas ◽

Patient Age ◽

Free Survival ◽

Immunohistochemical Markers ◽

Post Surgery ◽

Patient Âgé ◽

Significant Difference

Ovarian cancer is the sixth most common cancer worldwide and seventh most common cause of cancer mortality. Latest WHO classification (2014) classified ovarian carcinomas into serous, mucinous, endometrioid, clear cell, Brenner, poorly differentiated / undifferentiated carcinomas and carcinosarcomas. Shih and Kurman had first proposed classifying epithelial ovarian carcinomas into Type 1 and Type 2 based on the 2 main pathways of tumorigenesis. To classify primary ovarian carcinomas into type 1 and type 2 based on morphology and assessment of IHC expression in different types of ovarian carcinomas. To correlate the 2 subtypes with clinical parameters and prognosis. Retrospective observational cohort analysis of 96 cases diagnosed as primary ovarian carcinomas was done including pathologically proven primary ovarian carcinoma between April 2013 and March 2016. We collected data from hospital information system, used 5 immunohistochemical markers to classify the tumors & then followed up the patients. We found statistical significant difference for patient age, patient stage, CA125, type of surgery (IDS/PDS)between type 1 and type 2 tumors. There was a significant reduction in mean overall and progression free survival for patients with type 2 carcinomas, residual disease post surgery, higher stage & those which underwent debulking (p<0.05). From our study we would like to conclude that, the classification of primary ovarian carcinomas into type 1 and 2 can be done based on morphological features and immunohistochemical markers comprising ER, PR, WT1, p53 & Napsin A. Frequency data of types of tumors, stage in our population concords with that of other studies in world literature. Type 2 carcinomas showed higher patient age, more advanced stage, higher CA125 levels & comprised higher proportion of cases that underwent interval debulking (post NACT) than type 1 carcinomas. Type 2 carcinomas have both lower overall and progression free survival in our study population.

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