Primary hyperparathyroidism can generate recurrent pancreatitis and secondary diabetes mellitus – A case report

Introduction. Acute or recurrent pancreatitis may be a complication of primary hyperparathyroidism and patients with previous episodes of pancreatitis may develop secondary diabetes mellitus. Case report. We describe the clinical case of a 52-year old Caucasian man diagnosed with chronic recurrent pancreatitis in 2007. The first episode of acute pancreatitis occurred in 2002, followed by another 4 episodes in 2004 and 2007. In 2004, papilosfincterectomy was implemented with a stent mount that was removed one month later. In 2005, the patient underwent a surgical intervention for the diagnosis of chronic lithiasis, and cholecystectomy was performed. Additional investigations on the etiology of recurrent chronic pancreatitis, initially diagnosed as idiopathic, revealed elevated values of total serum calcium, serum parathormone, and the presence of a parathyroid adenoma in the right lower pole of the thyroid. In September 2007, parathyroidectomy was performed with a favorable evolution and the remission of the acute pancreatitis episodes. The patient had not had any family history of diabetes; in 2017 he was diagnosed with diabetes. Conclusion. In cases of recurrent pancreatitis, screening for hyperparathyroidism is recommended. Metabolic evaluation is required, because the risk of developing diabetes in patients with recurrent pancreatitis is high

Serum markers of bone fragility in type-2 diabetes mellitus

Patients with type-2 diabetes mellitus (T2DM) have normal or increased bone mineral density (BMD) but despite that, they are characterized by an increased hip and vertebral fracture risk that involves the alteration of bone quality and not the reduction in bone mass. BMD is utilized for the diagnosis and evaluation of osteoporosis, but BMD itself cannot provide an accurate diagnosis of the individuals at increased risk of fracture and, therefore, studies have focused on identifying other risk factors that are partially or fully independent of BMD. The fracture risk score tool-FRAX® models provide information about a 10-year probability of osteoporotic fractures, but do not include risk factors specific to illness such as diabetes duration, diabetes drug therapy, glycemic control, or the presence of micro-vascular complications. Multiple markers have been investigated to provide information on the risk of fractures in patients with T2DM such as: advanced glycation end products (AGEs), insulin-like growth factor-I (IGF-I), osteocalcin (OC), adiponectin, and sclerostin, but epidemiological studies did not provide homogeneous information regarding the link between these markers and bone fragility in T2DM subjects. Markers that increase the accuracy of fracture risk estimation in patients with T2DM need to be identified and employed in current medical practice

Primary hyperparathyroidism can generate recurrent pancreatitis and secondary diabetes mellitus – A case report

Introduction. Acute or recurrent pancreatitis may be a complication of primary hyperparathyroidism and patients with previous episodes of pancreatitis may develop secondary diabetes mellitus. Case report. We describe the clinical case of a 52-year old Caucasian man diagnosed with chronic recurrent pancreatitis in 2007. The first episode of acute pancreatitis occurred in 2002, followed by another 4 episodes in 2004 and 2007. In 2004, papilosfincterectomy was implemented with a stent mount that was removed one month later. In 2005, the patient underwent a surgical intervention for the diagnosis of chronic lithiasis, and cholecystectomy was performed. Additional investigations on the etiology of recurrent chronic pancreatitis, initially diagnosed as idiopathic, revealed elevated values of total serum calcium, serum parathormone, and the presence of a parathyroid adenoma in the right lower pole of the thyroid. In September 2007, parathyroidectomy was performed with a favorable evolution and the remission of the acute pancreatitis episodes. The patient had not had any family history of diabetes; in 2017 he was diagnosed with diabetes. Conclusion. In cases of recurrent pancreatitis, screening for hyperparathyroidism is recommended. Metabolic evaluation is required, because the risk of developing diabetes in patients with recurrent pancreatitis is high

Oral pathology induced by excess or deficiency of glucocorticoids in adults

Oral manifestations are present both in Cushing\u27s syndrome and in adrenal insufficiency. Possible oro-dental pathology in patients with Cushing\u27s syndrome include jawbone loss, tooth loss, and periodontal diseases. Professional societies did not include Cushing\u27s syndrome as being part of systemic diseases associated with loss of periodontal supporting tissues. The comorbidities of Cushing\u27s syndrome such as obesity, osteoporosis, and diabetes are conditions that influence periodontal attachment apparatus. In patients with adrenal primary insufficiency, the most specific sign is the melanic pigmentation of the skin and mucosal surfaces due to increments of corticotropin and pro-opiomelanocortin peptide levels that occur as a result of decreased cortisol feedback. The oral mucosa develops black plaques that can also be present on the gums, palate, tongue, and lips. The pallor may occur in patients with adrenocortical insufficiency secondary to corticotropin deficiency. Patients with primary adrenal insufficiency need to increase their glucocorticoid doses during physical activity, intercurrent illnesses, surgery, and medical procedures. Current evidence indicates that routine, nonsurgical, or minor surgical procedures do not need supplemental glucocorticoids in diagnosed patients who are in a stable condition. However, for major oral surgery, glucocorticoid supplementation is necessary for the surgery day and for at least one postoperative day

Serum markers of bone fragility in type-2 diabetes mellitus

Patients with type-2 diabetes mellitus (T2DM) have normal or increased bone mineral density (BMD) but despite that, they are characterized by an increased hip and vertebral fracture risk that involves the alteration of bone quality and not the reduction in bone mass. BMD is utilized for the diagnosis and evaluation of osteoporosis, but BMD itself cannot provide an accurate diagnosis of the individuals at increased risk of fracture and, therefore, studies have focused on identifying other risk factors that are partially or fully independent of BMD. The fracture risk score tool-FRAX® models provide information about a 10-year probability of osteoporotic fractures, but do not include risk factors specific to illness such as diabetes duration, diabetes drug therapy, glycemic control, or the presence of micro-vascular complications. Multiple markers have been investigated to provide information on the risk of fractures in patients with T2DM such as: advanced glycation end products (AGEs), insulin-like growth factor-I (IGF-I), osteocalcin (OC), adiponectin, and sclerostin, but epidemiological studies did not provide homogeneous information regarding the link between these markers and bone fragility in T2DM subjects. Markers that increase the accuracy of fracture risk estimation in patients with T2DM need to be identified and employed in current medical practice

Serum markers of bone fragility in type-2 diabetes mellitus

Patients with type-2 diabetes mellitus (T2DM) have normal or increased bone mineral density (BMD) but despite that, they are characterized by an increased hip and vertebral fracture risk that involves the alteration of bone quality and not the reduction in bone mass. BMD is utilized for the diagnosis and evaluation of osteoporosis, but BMD itself cannot provide an accurate diagnosis of the individuals at increased risk of fracture and, therefore, studies have focused on identifying other risk factors that are partially or fully independent of BMD. The fracture risk score tool-FRAX® models provide information about a 10-year probability of osteoporotic fractures, but do not include risk factors specific to illness such as diabetes duration, diabetes drug therapy, glycemic control, or the presence of micro-vascular complications. Multiple markers have been investigated to provide information on the risk of fractures in patients with T2DM such as: advanced glycation end products (AGEs), insulin-like growth factor-I (IGF-I), osteocalcin (OC), adiponectin, and sclerostin, but epidemiological studies did not provide homogeneous information regarding the link between these markers and bone fragility in T2DM subjects. Markers that increase the accuracy of fracture risk estimation in patients with T2DM need to be identified and employed in current medical practice

Uncommon Manifestation of Hypoglycemia in a Patient with Insulinoma – A Case Report

Insulinoma are insulin-secreting tumors of pancreatic origin that generates hypoglycemia by excessive secretion of insulin. Insulinoma is a rare disease ant the most tumors are benign, solitary and occur at intrapancreatic sites

INTERNALLY DISPLACED PERSONS AND HEALTH EFFECTS CAUSED BY THE FLOODS THAT AFFECTED ROMANIA DURING 2006-2007

The heavy rainfall between late 2005 and early 2006 in South Romania caused severe flooding, as to environmental, social and economic consequences. The event was unique in the last 3 decades in Romania, and among the most severe flooding events in the WHO-European region, in the last decade, next to the floods registered in Rusia, Turkey and Great Britain. Large household damages, requiring internal displacement of persons, part of which being sheltered in camps, for up to 17 months occured in 6 counties, 5 of them located along the Danube river and 1 county in the hill-mountain region. Our study aimed to quantify people displacement, camp sheltering and morbidity profile among the sheltered people, during the existence of the camps. We present an observational study, using data collected by the surveillance system that ran in the affected territory, under the management of the National Institute of Public Health. The calculated values of the target indicators showed the following results: people displacement rate of 316 %000 inhabitants, camp sheltering rate of 100 %000 inhabitants; sheltering in tents represented 84%, for 2-25 weeks, of the total 68 weeks. “Communicable diseases” was the diagnosis category registered in each of the 6 counties, representing less than 30% of all the diagnosis categories.The category “injuries” did not exceed 5%, in 5 of the 6 counties, while “psychological trauma” did not exceed 1.2%, in only 3 of the 6 counties. The acute respiratory infections, of upper tract, followed by those of lower tract contributed more than 85% to all communicable disesses. Acute eye inflamations, acute watery diarrhoea, other rushes than measles and pediculosis contributed each less than 5%. Only 2 cases of clinical measles and 1 case of scab were registered. Most of the communicable diseases occured in children and adults. Neither death, nor disease outbreak were registered. Conclusions. The flood event generated internally displaced persons, some of which needed shelter in long term camps. Tents were the preponderant category of shelters. The communicable diseases, injuries and psychological trauma were not prevailing categories among the camp sheltered persons. The acute respiratory infections were preponderant among infections. Neither deaths, nor disease outbreaks occurred for the duration of camps