Subject(s)
Adenocarcinoma of Lung/drug therapy , Diabetes Mellitus/chemically induced , Diabetic Ketoacidosis/chemically induced , Hyperglycemic Hyperosmolar Nonketotic Coma/chemically induced , Immune Checkpoint Inhibitors/adverse effects , Lung Neoplasms/drug therapy , Nivolumab/adverse effects , Abdominal Pain/physiopathology , Acute Kidney Injury/physiopathology , Adenocarcinoma of Lung/secondary , Aged , Autoantibodies/metabolism , Confusion/physiopathology , Diabetes Mellitus/drug therapy , Diabetes Mellitus/metabolism , Diabetes Mellitus/physiopathology , Diabetic Ketoacidosis/drug therapy , Diabetic Ketoacidosis/metabolism , Diabetic Ketoacidosis/physiopathology , Female , HLA-DRB1 Chains/genetics , Humans , Hyperglycemic Hyperosmolar Nonketotic Coma/drug therapy , Hyperglycemic Hyperosmolar Nonketotic Coma/metabolism , Hyperglycemic Hyperosmolar Nonketotic Coma/physiopathology , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Lung Neoplasms/pathology , Male , Middle Aged , Polydipsia/physiopathology , Polyuria/physiopathologyABSTRACT
INTRODUCTION: Skeletal-related events (SRE) are common in patients with bone metastatic lung cancer and have a negative impact on quality of life and survival. The objective of this study is to identify predictive factors for SRE occurrence among this population. METHODS: We conducted a 3-year retrospective study including 100 lung cancer patients with bone metastasis. RESULTS: Eighty-two patients presented at least one SRE (69.5% at baseline). The median occurrence for SRE was 4.5 months and severe bone pain was the most common SRE (56%). The alkaline phosphatase serum level>120IU/L (hazard ratio [sHR]=2.8; 95% confidence interval (CI) [1.5-5.4]; P=0.002) and calcemia>2.6mmol/L ([sHR]=9.7; 95% CI [5.1-18.4]; P<0.001) were identified as risk factors for SRE occurrence while the presence of an initial SRE was associated with a decrease of this risk ([sHR]=0.2; 95% CI [0.1-0.4]; P<0.001). CONCLUSION: The elevated alkaline phosphatase serum level and hypercalcemia are risk factors for SRE occurrence in bone metastatic lung cancer patients and should be used as biomarkers to adapt current medical practice for these patients.
Subject(s)
Bone Neoplasms/etiology , Bone Neoplasms/secondary , Carcinoma, Bronchogenic/pathology , Lung Neoplasms/pathology , Aged , Bone Neoplasms/diagnosis , Bone Neoplasms/epidemiology , Carcinoma, Bronchogenic/diagnosis , Carcinoma, Bronchogenic/epidemiology , Carcinoma, Bronchogenic/therapy , Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/epidemiology , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Non-Small-Cell Lung/therapy , Comorbidity , Female , France/epidemiology , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Lung Neoplasms/therapy , Male , Middle Aged , Prognosis , Quality of Life , Retrospective Studies , Risk Factors , Treatment OutcomeABSTRACT
Doege-Potter syndrome is a paraneoplastic syndrome characterized by non-islet cell tumor hypoglycemia secondary to a solitary fibrous tumor. These tumors are rare and usually asymptomatic. The syndrome of hypoglycemia is seen in less than 5% of the cases, and the associated tumors are large with a high mitotic rate. The cause of hypoglycemia is related to insulin-like growth factors produced by these tumors called "big" IGF-2. Several biological tests can demonstrate the increase of "big" IGF-2 plasma levels confirming the diagnosis of non-islet cell tumor induced hypoglycemia. The diagnosis is suggested by imaging but diagnostic confirmation is provided by the surgery, which remains the treatment of choice. Resection in many cases is the cure leading to hypoglycemia resolution. Recurrences and malignant transformations are possible which imposes a long-term monitoring. We report a case with relapsed malignant pleural fibrous tumor for which the pathophysiological mechanism of hypoglycemia could be documented as a paraneoplastic syndrome.
Subject(s)
Hypoglycemia/etiology , Paraneoplastic Syndromes/etiology , Pleural Neoplasms/complications , Sarcoma/complications , Aged , Documentation , Humans , Hypoglycemia/blood , Hypoglycemia/pathology , Insulin-Like Growth Factor II/metabolism , Male , Medical Records , Paraneoplastic Syndromes/blood , Paraneoplastic Syndromes/pathology , Pleural Neoplasms/blood , Pleural Neoplasms/pathology , Sarcoma/metabolism , Sarcoma/pathologyABSTRACT
This study described elite football (soccer) goalkeepers' activity and performance in critical game situations. The 11 best French players (M age = 15.5 yr., SD = 0.5) participated in the study. Interviews focused on goalkeepers' experiences were conducted to identify meaningful events involved in failed actions. Players formulated 23 critical game situations. Verbatim encoding using a thematic analysis indicated that four main categories (coming off the line, goal-line clearance, one-on-one, and diving) represented the most critical situations encountered during matches. The relations among experience and action, inner states, background, attention contents, and intentions were elucidated. The discussion is grounded on the properties of such critical game situations and their implications for improving goalkeepers' performance.
