Hippokratia
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To describe a case of primary granulocytic sarcoma. ⋯ Although chloromas usually manifest in patients with a hematologic malignancy, isolated cases may occur. The low specificity of imaging and, occasionally, microscopic examination is challenging for the right diagnosis. The role of immunohistochemistry in conjunction with the clinical, imaging and laboratory findings is crucial to reach the correct diagnosis.
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De novo malignancies have become one of the leading causes of late mortality after renal transplantation, with their incidence being 2-15 fold higher than in general population. We present herein a unique case of ovarian carcinosarcoma in a renal transplant recipient. ⋯ Ovarian Carcinosarcoma is a rare and aggressive neoplasia, comprising 1-2 % of all ovarian tumors. Radical surgical approach, as well as appropriate chemotherapy are the cornerstone of treatment. In the presented case, where immunosuppression is involved, further evaluation should be made as far as immunosuppression dose reduction or switch is concerned.
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In type 2 diabetes mellitus (T2DM), therapies to maintain blood glucose control usually fail after several years. The aim of this study was to estimate the time to insulin initiation, the glycemic burden that patients are exposed prior to conversion to insulin and their HbA1c level at that time and a year later. ⋯ Healthcare professionals delay the initiation of insulin in patients with type 2 diabetes until their HbA1c exceeds 10%. As a result, patients are exposed to a significant glycemic burden. Change in treatment improves their glycemic control for the next 12 months. Hippokratia 2014; 18 (4): 306-309.