BACKGROUND
Adiponectin has been reported to have a prohibitory effect on prostate cancer. The goal of this study was to evaluate the diagnostic value of adiponectin multimers for prostate cancer.
METHODS
Total adiponectin, high- and low molecular weight (HMW, LMW), ratios of these measures, and body mass index (BMI) were compared in a prospective prostate cancer screened cohort. Multivariable logistic regression was used to assess the association between adiponectin measures, their interaction with BMI, and risk of prostate cancer and Gleason score upgrading from biopsy to prostatectomy.
RESULTS
228 prostate cancer cases and 239 controls were analyzed: 72 (31.6%) of the cancer cases were high-grade (Gleason grade ≥7). Only percent HMW had a statistically significant relationship with prostate cancer [p = 0.04]. Among normal and overweight men, the risk of prostate cancer increased as percent HMW increased (OR = 1.24 for a doubling of percent HMW, 95% confidence interval [0.41,3.75] and 1.81[1.02,3.20], respectively), whereas among obese men, the risk of prostate cancer decreased (OR = 0.62, [0.32,1.18]). Among 97 patients who underwent radical prostatectomy, there was no association between Gleason score upgrading and any of the adiponectin multimers.
CONCLUSION
This study was unable to confirm the utility of total adiponectin as a biomarker for prostate cancer risk. For the adiponectin multimers, only HWM showed increases with prostate cancer but not in all weight classes.
IMPACT
While adiponectin may play a role in the pathogenesis of prostate cancer, our results do not support adiponectin multimers as biomarkers of detection.
We present the case of a 45 year old female patient with an incidental diagnosis of a cystic pancreatic lesion corresponding to a serous cystadenoma of 14 mm. During a 5-year follow-up (CT and MRT) the lesion tripled in size and a surgical intervention was decided upon. The lesion was thought to have a benign pathology and, in an attempt to preserve the spleen and a major portion of pancreatic tissue, a central pancreatectomy with a diversion of the remaining distal pancreas was carried out. The authors reviewed national and international publications.
Background: Jejunostomy for enteral feeding is excellent for patients who cannot manage oral intake, with a low complication rate. A Foley catheter, Ryle tube, Kerh tube or needle-catheter (Jejuno-Cath ® ) are commonly used. It is a safe procedure but it can lead to severe complications.Case report: We present two cases: firstly, an 80 year old male who was admitted to the Emergency Room with a bowel perforation secondary to Jejuno-Cath ® for enteral feeding after a subtotal gastrectomy with Roux-en-Y reconstruction; and secondly, a 53 year old male who was admitted to the Emergency Room due to gastric perforation developing multiple complications, including bowel necrosis and enteral feeding impaction.Discussion: We have reviewed the recent literature with regard to this rare complication.
We present the case of a 69 year old woman with a history of cholecystitis, who consulted for severe abdominal pain, nausea and vomiting. Abdominal CT showed duodenal obstruction caused by a gallstone, cholecystoduodenal fistula and pneumobilia, what is known as Bouveret's syndrome, a rare form of gallstone ileus. Additionally, she presented free duodenal and vesicular perforation to retroperitoneum at the same level of the cholecystoduodenal transit point. The patient underwent a difficult cholecystectomy, enterolithotomy, repair of the duodenal defect, extensive washing and drainage of the retroperitoneum. The postoperative course was uneventful except for a laparotomy infection.
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