Ovarian cancer differential diagnosis
The purpose of this paper is to quantify the incidence of different histological types of ovarian tumors and to demonstrate the clinical importance of an effective screening program, considering the paucisymptomatic nature of this pathology. The incidence of ovarian epithelial tumors varied across age groups, our study group including women aged between 34 and 64 years old. Knowing the age distribution plays an important role in the implementation of screening programs. All cases presented ovarian cancer differential diagnosis similar symptomatology: pelvic pain, abdominal distension and ascites.
View in PDF Number of views: The international guidelines for the management of type 2 diabetes mellitus have seen many changes over the last decade. They have moved from a strict glycemic control in all patients with diabetes to a more individualized approach of the diabetic patient.
These changes are the result of some trials which have demonstrated, for example, that in patients with long-standing type 2 diabetes a strict glycemic control may increase the risk of complications, such as hypoglycemia and cardiovascular events While glucose lowering prevents the appearance of microvascular complications, its impact is less significant on the cardiovascular and renal complications.
The most preferred oral antidiabetic drug is undoubtedly metformin. There are six antidiabetic drug classes currently recommended by the American and European international societies, in addition to metformin: sodium-glucose cotransporter 2 SGLT2 inhibitors, glucagon-like peptide 1 receptor agonists, dipeptidyl peptidase 4 inhibitors, sulfonylureas, thiazolidinediones, and insulin. SGLT2 inhibitors are a promising new class of antidiabetic drugs, that have entered very recently in the diabetes therapeutic armamentarium.
These drugs enhance the urinary glucose excretion and decrease hyperglycemia, acting independently from insulin and being effective in all diabetic patients with preserved renal function. They have a favorable efficacy-to adverse event profile in type 2 diabetes patients with moderate-to-high risk. These may be used as monotherapy or in combination with other antidiabetic agents. SGLT2 inhibitors have also pleiotropic effects, such as reducing body weight by Kg, decreasing the blood pressure both systolic and diastolicdecreasing plasma triglycerides, increasing HDL cholesterol, attenuating some factors associated with nonalcoholic steatohepatitis and nonalcoholic liver disease, improving the whole-body sodium balance and volume status by stimulating the ovarian cancer differential diagnosis, which leads further to a better endothelial function ovarian cancer differential diagnosis ovarian cancer differential diagnosis the vascular stiffness1.
Due to these effects, SGLT2 inhibitors ovarian cancer differential diagnosis useful especially in obese patients with arterial hypertension. Regarding the glucose ovarian cancer differential diagnosis, in a meta-analysis, the HbA1c reduction at weeks was higher in studies that included younger patients, with a shorter duration of diabetes and a higher body mass index, HbA1c and basal glucose4.
This is extremely important, especially for patients with type 2 diabetes and already established cardiovascular diseases, as they may benefit most from the treatment with SGLT2 inhibitors. The main side effects of SGLT2 inhibitors consist in the increased risk of genital infections up to four-fold in clinical trials.
Other side effects, more rarely, may be the risk of hypoglycemia, diabetic ketoacidosis, bone fractures with Canaglifozin. This is an extremely rare, but life-threatening infection of the tissues around the perineal muscles, nerves, fat and blood vessels.
In conclusion, SGLT2 inhibitors are the newest antidiabetic drugs class, with cardiovascular benefits in a selected population of type 2 diabetes patients. There are ongoing studies with these antidiabetic agents expected to report their data in the near future.
