Pancreatogenic type 3C diabetes

Background. The relationship between chronic pancreatitis and diabetes is well established. This form of diabetes is secondary to exocrine pancreatic disorder and is known as diabetes mellitus type 3c (T3cDM). Materials and Methods. In this retrospective study we included 261 patients, 59 patients being diagnosed with chronic pancreatitis and secondary diabetes mellitus, and admitted in the Fundeni Clinical Institute, 2nd Department of Gastroenterology or N.C. Paulescu Institute/ Carol Davila University of Medicine and Pharmacy. Results and Discussions. Patients were 22.2% women and 77.8% men, with an average age of 56.8 years and 53.4 years respectively. 63% came from urban areas. The mean duration of chronic pancreatitis was six years. Non-diabetic patients were compared with patients who were previously diagnosed with T3cDM and who had been analyzed for body mass index (BMI). Imaging investigations were also performed to confirm pseudotumors or pancreatic tumours. Patients already considered non-diabetic had basal blood glucose values and were mostly overweight and obese. In this context, insulin resistance cannot be excluded for this group of patients. Conclusions. T3cDM is a new pathological entity that needs to be explored more deeply, and that should benefit from both a diagnostic stratification and treatment

Along-Path Evolution of Biogeochemical and Carbonate System Properties in the Intermediate Water of the Western Mediterranean

A basin-scale oceanographic cruise (OCEANCERTAIN2015) was carried out in the Western Mediterranean (WMED) in summer 2015 to study the evolution of hydrological and biogeochemical properties of the most ubiquitous water mass of the Mediterranean Sea, the Intermediate Water (IW). IW is a relatively warm water mass, formed in the Eastern Mediterranean (EMED) and identified by a salinity maximum all over the basin. While it flows westward, toward and across the WMED, it gradually loses its characteristics. This study describes the along-path changes of thermohaline and biogeochemical properties of the IW in the WMED, trying to discriminate changes induced by mixing and changes induced by interior biogeochemical processes. In the first part of the path (from the Sicily Channel to the Tyrrhenian Sea), respiration in the IW interior was found to have a dominant role in determining its biogeochemical evolution. Afterward, when IW crosses regions of enhanced vertical dynamics (Ligurian Sea, Gulf of Lion and Catalan Sea), mixing with surrounding water masses becomes the primary process. In the final part of the investigated IW path (the Menorca-Mallorca region), the role of respiration is further masked by the effects of a complex circulation of IW, indicating that short-term sub-regional hydrological processes are important to define IW characteristics in the westernmost part of the investigated area. A pronounced along-path acidification was detected in IW, mainly due to remineralization of organic matter. This induced a shift of the carbonate equilibrium toward more acidic species and makes this water mass increasingly less adequate for an optimal growth of calcifying organisms. The carbonate buffering capacity also decreases as IW flows through the WMED, making it more exposed to the adverse effects of a decreasing pH. The present analysis indicates that IW evolution in the sub-basins of the WMED is currently driven by complex hydrological and biogeochemical processes, which could be differently impacted by coming climate changes, in particular considering expected increases of extreme meteorological events, mainly due to the warming of the Mediterranean basin

Improvement of acromegaly control with multimodal therapy in Romania

Introduction: In Romania, there is no acromegaly national register and there are no nationwide data available. However, some studies have reported the control rates in the country’s main referral centres. Our aim was to assess the overall control rate in our tertiary referral centre. Also, we assessed the control rate in the last three years, and we compared the results with our previous reports. Material and methods: We reviewed the charts of 186 patients with acromegaly assessed in our department between January 1st, 2012 and May 31st, 2019. We also compared the control rates for patients treated between April 1st, 2016 and May 31st, 2019 with historical controls (assessed between January 1st, 2012 and March 31st, 2016). Results: Primary analysis: There were 19 untreated and 167 treated patients, mean age 52.46 years, surgery being the most commonly used treatment. The surgical cure rate was 14.8%, and disease control with medical treatment was 35.3%. Secondary analysis: In the first group there were 45 patients, surgery also being the most commonly used treatment. The surgical cure rate was 26.9%, and disease control was 30.4%. In the second group (historical controls) there were 42 patients, surgery being the most commonly used treatment. The surgical cure rate was 9.7%, and disease control with medical treatment was 15.4%. Random GH and IGF-1 after surgery were lower in the first group (p < 0.05) Conclusions: Changes in the Romanian protocol and highly specialised pituitary centres has improved the cure rate and disease control in patients with acromegaly.

Pancreatogenic type 3C diabetes

Background. The relationship between chronic pancreatitis and diabetes is well established. This form of diabetes is secondary to exocrine pancreatic disorder and is known as diabetes mellitus type 3c (T3cDM). Materials and Methods. In this retrospective study we included 261 patients, 59 patients being diagnosed with chronic pancreatitis and secondary diabetes mellitus, and admitted in the Fundeni Clinical Institute, 2nd Department of Gastroenterology or N.C. Paulescu Institute/ Carol Davila University of Medicine and Pharmacy. Results and Discussions. Patients were 22.2% women and 77.8% men, with an average age of 56.8 years and 53.4 years respectively. 63% came from urban areas. The mean duration of chronic pancreatitis was six years. Non-diabetic patients were compared with patients who were previously diagnosed with T3cDM and who had been analyzed for body mass index (BMI). Imaging investigations were also performed to confirm pseudotumors or pancreatic tumours. Patients already considered non-diabetic had basal blood glucose values and were mostly overweight and obese. In this context, insulin resistance cannot be excluded for this group of patients. Conclusions. T3cDM is a new pathological entity that needs to be explored more deeply, and that should benefit from both a diagnostic stratification and treatment