Breast cancer with diabetes insipidus

Diabetes insipidus (DI) is a rare clinical condition, which is usually caused by neurohypophyseal or pituitary stalk infiltration in cancer patients. Case report: we present a 62-year old metastatic breast cancer woman with DI. She admitted to the hospital because of nausea, vomiting, polyuria and polydipsia, while she was on no cytotoxic medication. She had no electrolyte imbalance except mild hypernatremia. The CT scan of the brain yielded a suspicious area in pituitary gland. A pituitary stalk metastasis was found on magnetic resonance imaging (MRI) of pituitary. Water deprivation test was compatible with DI. A clinical response to nasal vasopressin was achieved. Conclusions: Cancer patients who have symptoms such as nausea, vomiting, polyuria and polydipsia while they are not on chemotherapy should be evaluated for not only metabolic complications like hypercalcemia but also posterior pituitary or stalk metastasis MRI could be the choice of imaging for pituitary metastasis.Несахарный диабет (DI) — редкое клиническое состояние, вызываемое инфильтрацией нейрогипофизарной ножки или ножки гипофиза у онкологических больных. Описание случая: в исследовании рассмотрен случай выявления DI у 62-летней женщины, у которой был выявлен рак молочной железы с наличием метастазов. Она поступила в больницу с симптомами тошноты, рвоты, полиурии и полидипсии, хотя не проходила курса химиотерапии. У больной не выявлено дисбаланса электролитов, кроме небольшой гипернатриемии. Компьютерная томография мозга показала подозрительную область в мозговом придатке. На магнитно-резонансном изображении выявлен метастаз в ножке гипофиза. Обезвоживание также соответствовало диагнозу DI. Получен клинический ответ на назальный вазопрессин. Выводы: онкологические больные с симптомами тошноты, рвоты, полиурии и полидипсии, не проходящие курса химиотерапии, должны быть обследованы не только на предмет метаболических осложнений, таких как гиперкальциемия, но и на возможное наличие метастазов в ножке и задней части гипофиза с помощью магнитно-резонансного изображения. Ключевые слова: рак, несахарный диабет, метастаз в гипофизе

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3�6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55 of the global rise in mean BMI from 1985 to 2017�and more than 80 in some low- and middle-income regions�was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing�and in some countries reversal�of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. © 2019, The Author(s)

The role of computerized tomography in the assessment of perivesical invasion in bladder cancer

Background: The aim of the present study was to identify the contrast patterns of a tumor, and to evaluate the possibility of assessing the invasion of the perivesical fatty tissue in bladder cancer. Material/Methods: In this study, 26 patients with bladder cancer were included. Multiphasic CT examination was performed to determine the stage of the disease before radical cystectomy. Results: There were statistically significant differences in tumor and perivesical fatty tissue densities between pre- and post-contrast phases (p<0.05). Conclusions: Increases in focal density suspected of being invasion of the perivesical fatty tissue can show perivesical invasion with high specificity. © Pol J Radiol

The Adrenal Gland Volume Measurements in Manifestation of the Metabolic Status in Type-2 Diabetes Mellitus Patients

Objectives. The aim of our study was to investigate the differences in adrenal gland volume between nondiabetic controls and Type-2 diabetic patients and to examine the influence of glycemic control in diabetes mellitus on adrenal gland volume. Methods. From March 2 to November 25, 2015, 62 consecutive patients with Type-2 DM along with 62 nondiabetics matched by age, gender, and BMI were enrolled in this prospective study. Our diabetes patients were categorized into two groups, well-controlled and poorly controlled diabetes groups. Adrenal volumetric measurements were performed by two radiologists, prospectively and independently, with semiautomatic software. Interobserver reliability was studied using the interobserver correlation coefficient (ICC). Results. The total adrenal volume (TAV) was significantly higher in Type-2 diabetic patients when compared with nondiabetic patients (p < 0.05). When we investigated diabetic patients according to glycemic controls, the TAVs in controlled diabetic patients were significantly higher than in those of the poorly controlled or uncontrolled diabetic patients (p < 0.05). Nondiabetic control patients have significantly smaller TAVs when compared to controlled and poorly or noncontrolled diabetic patients (p < 0.05). Conclusion. Our study suggests that adrenal gland volume measurement may be used as an indirect marker of glycemic control in patients with diabetes. © 2016 Ismail Serifoglu et al

Ewing's Sarcoma: Dural metastases after intracranial hemorrhage

Ewing's sarcoma (ES) is a primary malignant tumor of the mesenchymal tissue of bone in children and young adults. Central nervous system metastases of ES are rarely seen. In this paper, we report a case of ES that progressed with dural metastases after spontaneous intracerebral hemorrhage. © 2015 S. Karger AG, Basel

Cerebellar infarction in childhood: Delayed-onset complication of mild head trauma

Objective Cerebellar ischemic infarction is a rare complication of minor head trauma. Vertebral artery dissection, vasospasm or systemic hypo perfusion can cause infarct. However, underlying causes of the ischemic infarct cannot be explained in nearly half of cases. The accurate diagnosis is essential to ensure appropriate treatment. Here we report a five yr old boy patient of cerebellar infraction after minor head trauma, admitted to emergency serves of Bulent Ecevit University, Turkey in 2013. We aimed to remind minor head trauma that causes cerebellar infarction during childhood, and to review the important points of the diagnosis, which should be keep in mind. © 2016, Iranian Child Neurology Society. All rights reserved

Comparison of Drug-Eluting Balloon and Standard Balloon Angioplasty for Infrapopliteal Arterial Diseases in Diabetic Patients

Objective: To consider the clinical outcomes and restenosis rates of drug-eluting balloons (DEBs) and percutaneous transluminal angioplasty (PTA) in diabetic patients with infrapopliteal (IP) arterial disease. Materials and Methods: This retrospective, single-center study included 51 patients (37 males; mean age: 63.43 ± 9.81 years) with diabetes mellitus having IP arterial disease, from October 2012 to September 2014. Twenty-two patients were treated with PTA, and 29 patients were treated with DEBs. After intervention, the patients were evaluated in the first week and every 3 months, clinically and radiologically. Univariate and multivariate analyses were used to evaluate the clinical outcomes of diabetic patients with IP arterial disease who were treated with either DEBs or PTA. Results: There were no statistically significant differences between the groups in terms of age and gender, risk factors, characteristics of lesions, or the diameters or length of the balloons (P >.05). Primary patency was higher in the DEB group than in the PTA group (97.8% vs 81.1%, P =.020) in the first 3 months. However, there was no statistically significant difference at 1-year follow-up (68.2% vs 48.5%, P =.131). At the 12-month follow-up, there was no difference in clinical improvement between the groups (P =.193). Conclusion: The findings of this study reveal that DEB is a safe alternative treatment method for IP arterial disease in diabetic patients. © The Author(s) 2016

Magnetic resonance imaging findings in spinal hemangioblastoma case

[No abstract available

Effects of erythropoiesis-stimulating agents on intestinal flora in peritoneal fibrosis

Introduction. This study aimed to investigate the effects of erythropoiesis-stimulating agents (ESAs) on intestinal flora in peritoneal fibrosis. Methods and Methods. Twenty-four Wistar albino rats were divided into 3 groups as the control group, which received 0.9% saline (3 mL/d) intraperitoneally; the chlorhexidine gluconate (CH) group, which received 3 mL/d injections of 0.1% CH intraperitoneally, and the ESA group, which received 3 mL/d injections of 0.1% CH intraperitoneally and epoetin beta (3 doses of 20 IU/kg/wk) subcutaneously. On the 21st day, the rats were sacrificed and the visceral peritoneum samples were obtained from left liver bowel. Blood samples were obtained from abdominal aorta and intestinal flora samples were obtained from transverse colon. Results. Histopathologically, the CH, ESA, and control groups had peritoneal thickness of 135.4 ± 22.2 µm, 48.6 ± 12.8 µm, and 6.0 ± 2.3 µm, respectively. Escherichia coli was the predominant bacterium in the intestinal flora in the control group. Significant changes in microbial composition of intestinal flora towards Proteus species and Enterobacter species was seen among the groups (P < .001). There was no significant difference between the ESA and CH groups regarding the isolates from blood cultures. However, the bacterial isolates from cultures of intestinal flora among these groups were significantly different (P < .05). Conclusions. Erythropoiesis-stimulating agents change intestinal flora by a clinically significant amount in experimental peritoneal fibrosis. We consider that ESAs achieve this via regulating intestinal peristaltism. © 2017, Iranian Society of Nephrology. All rights reserved

Congenital absence of internal carotid artery with intercavernous anastomosis: Case report and systematic review of the literature

The absence of an internal carotid artery is a rare congenital anomaly. In the absence of the internal carotid artery, collateral circulations develop through the circle of Willis, persistent embryonic arteries or transcranial collaterals of the external carotid artery. Six pathways of collateral circulation have been described. Intercavernous anastomosis is between cavernous segments of the bilateral internal carotid arteries and is rarely seen. Patients with an absence of the internal carotid artery can be completely asymptomatic. However, these patients can present with subarachnoid hemorrhage or stroke accompanying cerebral aneurysm or abnormal collateral. We combined our case with 33 previous publications to form a retrospective series including 35 cases of unilateral internal carotid artery agenesis with intercavernous anastomosis. © The Author(s) 2016