Compllicaciones en pacientes de 5 años o más de padecer de diabetes mellitus tipo 2, Hospital Monte España, Abril 2009

Tesis (Doctor en Medicina)--Universidad Americana, Managua, 2012Este estudio pretende demostrar cómo las complicaciones de la diabetes mellitus tipo 2 afecta mucho al paciente, para así sensibilizar a los altos funcionarios de la salud de este país y motivarlos a implementar una base de datos actualizada a nivel nacional acerca de cuáles son las complicaciones más frecuentes que afectan a los diabéticos de nuestro país, para así tener una mejor idea de cómo estas afectan el estilo de vida de los nicaragüenses y así poder formar estrategias de salud para la prevención de las mismas cómo del incremento en la calidad de vida de estos pacientes. Identificando las principales complicaciones en todos aquellos pacientes de 5 años o más de padecer de diabetes mellitus tipo 2 atendidos en el Hospital Monte España, abril 2009

A Case Report with Severe Thrombocytopenia Induced by Axitinib

Axitinib is an oral, second-generation tyrosine kinase inhibitor that is selective for vascular endothelial growth factor receptors (VEGFR). This agent is approved as monotherapy or in combination with immune checkpoint inhibitors for the treatment of metastatic renal cell carcinoma. Axitinib is associated with a safety profile very similar to other anti-VEGFR inhibitors but usually with fewer hematologic adverse events, due to the selectivity for VEGF. In this report, we presented a rare case of grade 4 axitinib-induced thrombocytopenia, not observed with other antiangiogenic therapies. We discuss the differential diagnostic work-up, the necessary multidisciplinary approach, and the successful management of the case

Obesity and adverse breast cancer risk and outcome: Mechanistic insights and strategies for intervention

Answer questions and earn CME/CNE Recent decades have seen an unprecedented rise in obesity, and the health impact thereof is increasingly evident. In 2014, worldwide, more than 1.9 billion adults were overweight (body mass index [BMI], 25-29.9 kg/m ), and of these, over 600 million were obese (BMI ≥30 kg/m ). Although the association between obesity and the risk of diabetes and coronary artery disease is widely known, the impact of obesity on cancer incidence, morbidity, and mortality is not fully appreciated. Obesity is associated both with a higher risk of developing breast cancer, particularly in postmenopausal women, and with worse disease outcome for women of all ages. The first part of this review summarizes the relationships between obesity and breast cancer development and outcomes in premenopausal and postmenopausal women and in those with hormone receptor-positive and -negative disease. The second part of this review addresses hypothesized molecular mechanistic insights that may underlie the effects of obesity to increase local and circulating proinflammatory cytokines, promote tumor angiogenesis and stimulate the most malignant cancer stem cell population to drive cancer growth, invasion, and metastasis. Finally, a review of observational studies demonstrates that increased physical activity is associated with lower breast cancer risk and better outcomes. The effects of recent lifestyle interventions to decrease sex steroids, insulin/insulin-like growth factor-1 pathway activation, and inflammatory biomarkers associated with worse breast cancer outcomes in obesity also are discussed. Although many observational studies indicate that exercise with weight loss is associated with improved breast cancer outcome, further prospective studies are needed to determine whether weight reduction will lead to improved patient outcomes. It is hoped that several ongoing lifestyle intervention trials, which are reviewed herein, will support the systematic incorporation of weight loss intervention strategies into care for patients with breast cancer. CA Cancer J Clin 2017;67:378-397. © 2017 American Cancer Society