The benefits of insulin therapy following acute myocardial infarction revisited.
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Biomedical subjects
Publications and source records attributed to H Soran.
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A 72-year-old lady presented with recurrent hypoglycaemia and a large pelvic mass. Hypoglycaemia was accompanied by undetectable serum insulin and c-peptide and high insulin-like growth factor II (IGFII) to IGFI ratio. She had undergone successful resection of a large bladder haemangiopericytoma 7 years earlier. A core biopsy was performed, and histology confirmed the recurrence of the haemangiopericytoma. Local palliative radiotherapy resulted in the reduction of IGFII level and IGFII to IGFI ratio and increased insulin, c-peptide and growth hormone (GH) level with long-term amelioration of hypoglycaemic episodes. Clinically and biochemically, radiotherapy was more effective than GH therapy.
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Erectile dysfunction (ED) is one of the commonest disorders of male sexual function. Penile erection depends on a complex interaction of psychological, neural, vascular and endocrine factors. Testosterone has an important role in both central and peripheral domains of this process. In this article we discuss the role of testosterone in male sexual function and endocrine causes of ED.
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Diabetes is a major public health problem that is approaching epidemic proportions globally. There is an urgent need for strategies to curb the rising prevalence of this disease, and prevention appears a logical approach. Lifestyle modifications with weight loss and moderate exercise can reduce the incidence of diabetes by >50% in patients with impaired glucose tolerance (IGT). The use of metformin, acarbose and other agents have been shown in randomized prospective trials to prevent type 2 diabetes in high-risk subjects with IGT. Other pharmacological interventions are currently being examined in large prospective studies. It is likely that one or a combination of these approaches could make diabetes prevention a reality in the near future.
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A case of bleeding from angiodysplasia in association with aortic stenosis is presented. The particular interest in this patient is that the bleeding ceased immediately after the insertion of a bioprosthetic valve and recurred when the valve restenosed. Furthermore, the bleeding again promptly resolved when the valve was exchanged for a metallic prosthesis despite long-term anticoagulation. The implications of these observations are discussed.
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Inflammatory pseudotumours of the liver are rare benign tumours of unknown origin, usually mistaken for malignant lesions. Two patients with Type 2 diabetes presented separately, unwell with fever, weight loss and hepatomegaly. Ultrasonography revealed 3-4 cm multiple lesions in the liver of the first case and a solitary 5 cm mass in the right lobe of the liver in the second. Biopsies revealed inflammatory pseudotumours in both cases. Both patients were treated with intravenous antibiotics and fluids. The clinical outcome was good and both patients had an uneventful recovery. We believe these to be the first two cases of inflammatory liver pseudotumours to be described in patients with diabetes mellitus.