Diabetes and work at sea: has everything been already settled? Article for discussion

Along with increased worldwide incidence of diabetes, the frequency of its occurrence among persons employed on seagoing vessels has also grown (12). According to the current regulations, persons treated with insulin are not admitted to work at sea, and those treated with oral drugs have a markedly limited access to such a work. This may lead to concealing the fact of being a diabetic, thus enhancing the existing hazards. Current improved methods of glycemia self-control and treatment of diabetes have radically improved vital abilities of diabetics. Having this in mind, a question arises whether the binding regulations on the fitness of diabetics for work at sea should be verified

Epic battles in endocrinology — malignant pheochromocytoma: a case report

The rarity of malignant pheochromocytoma coupled with the lack of definitive predictors of malignancy and the variability of clinical course, poses a significant diagnostic and therapeutic challenge. Since data on treatment is so scarce, case reports are a valuable source of knowledge for clinicians. This case report describes the medical history of a woman, aged 51 at the time of initial diagnosis and adrenalectomy. Within over 5 years she presented with recurrent relapse of tumour in adrenal gland bed and multiple distant metastases to descending colon, abdominal wall, postoperative scars, and the peritoneum. Neither before diagnosis nor during the whole follow-up were symptoms associated with pheochromocytoma present. The treatment administered to our patient consisted of numerous debulking surgeries along with administration of both hot and cold somatostatin analogues. We believe that debulking surgeries played a substantial role in enabling the patient to survive nearly 6 years despite aggressive clinical course of pheochromocytoma. She passed away in 2012 as a result of postlaparotomy complications. We stress the role of debulking surgery in the treatment of malignant pheochromocytoma and summarise currentliterature