[Ultrasonographic findings and integration with computerized tomography in pathology of the abdominal wall]. / Rilievi ecografici e integrazione con Tomografia Computerizzata nella patologia della parete addominale.

Ultrasonography (US) plays a major role in the study of the anterior and lateral abdominal wall. Our experience refers to 150 patients examined over a 5-year period, who were divided into two groups according to disease etiology: 72 patients suffered from iatrogenic and 78 from non-iatrogenic conditions. The first group was mainly composed of alterations caused by anticoagulation therapy, e.g., hematomas, and recent or previous surgery, i.e., 19 incisional hernias and 19 inflammatory-abscess processes. The second group included above all 32 cases of abdominal wall hernia, 18 neoplasms, 13 traumas with abdominal wall involvement only and 12 inflammatory processes. US yielded valuable pieces of information to diagnose iatrogenic conditions, even for small or non-relevant conditions. Moreover, US allowed non-iatrogenic conditions to be located and identified, accurately demonstrating abdominal wall layers involvement. US was also very useful in the patients whose physical examination is of no use or difficult, e.g., in the patients with much pain and trauma or obese patients. CT was used in selected cases only, as a complement to US, when a more detailed spatial assessment of wide or deep lesions was necessary.

Blood glucose control and insulin secretion improved with combined therapy in type 2 diabetic patients with secondary failure to oral hypoglycaemic agents.

The influence of combined therapy using insulin and oral hypoglycaemic agents on blood glucose control and on insulin secretion in Type 2 diabetic patients with secondary failure to oral hypoglycaemic agents was evaluated. Type 2 diabetic patients (n = 180) (98 normal-weight, 82 over-weight), at least 3 years from diagnosis, and having poor blood glucose control on oral hypoglycaemic agents for at least 3 months (fasting plasma glucose greater than 10.0 mmol l-1) despite intensive efforts at improvement, were included in the study. A single daily insulin injection (human ultralente), at a dose of 0.22 +/- 0.07 U kg-1 d-1 in normal-weight and 0.33 +/- 0.10 U kg-1 d-1 in over-weight patients, was added to the previous dietary and drug treatment for 6 months. A progressive and significant (2p less than 0.001) reduction of the mean daily blood glucose was observed during the first 3 months of combined therapy (from 13.2 +/- 3.2 to 8.1 +/- 2.1 mmol l-1 in normal-weight and from 13.4 +/- 3.1 to 8.8 +/- 2.3 mmol l-1 in over-weight patients), with no further significant changes thereafter. A significant increase (2p less than 0.001) in the mean daily C-peptide concentration (from 0.50 +/- 0.30 to 0.71 +/- 0.29 nmol l-1 in normal-weight and from 0.78 +/- 0.36 to 1.00 +/- 0.41 nmol l-1 in over-weight patients) took place during combined therapy. No changes of body weight (+ 1.5 +/- 1.2 kg in normal-weight and + 1.0 +/- 1.0 kg in over-weight patients) were observed.

Long-term results in preventive medicine for type II diabetes.

The authors report the results of a 12-year screening for type II diabetes in their Health District (Emilia-Romagna, Northern Italy). The method consisted of two steps, following Pavel and Sdrobici, for early diagnosis of clinical diabetes and IGT. The authors found 1.03% of clinical diabetes and 2.65% of IGT cases in the population examined (200,000 subjects). Statistically significant correlations existed with regard to the various risk factors (familiarity, obesity, fetal macrosomia, occupation). Follow-up after 6 years for IGT subjects showed a 25.5% return to normal of OGTT values, 21.7% improvement, 19% unchanged, 33.8% deterioration. There was a correlation between these results and life-style (diet, reduction in calorie intake, weight loss). Twelve years after these screenings, a 2.7% drop in incidence was observed for type II diabetes in this Health District.

Pavel's "dynamic screening" for diabetes type 2: 14 years results in a district of northern Italy.

The AA. report the results of 14 years' screening for diabetes type 2 in their Health District (Emilia Romagna, North Italy), according to Pavel's method, for early diagnosis of clinical diabetes and impaired glucose tolerance (IGT). The AA. found in a first screening 1.03% of clinical diabetes and 2.65% of IGT cases in the population examined (200,000 subjects). Statistically significant correlations existed in relation to the various risk factors (hereditary factors, obesity, fetal macrosomia, job). The follow-up after 6 years for IGT subjects showed a 25.5% return to normal oral glucose tolerance test (OGTT) values, 21.7% improvement, 19% unchanged, 33.8% impairment. There was a correlation between these results and life-style (diet, physical exercise, weight loss). Fourteen years after these screening, a 2.7% negative incidence was observed for diabetes type 2 in this Health District.

[Insulin microinfusors in diabetes of the elderly]. / I microinfusori per insulina nel diabete dell'anziano.

Clinical experience over three years of insulin microinfusors in the treatment of diabetes is reported. The instable insuline dependent diabetes in the elderly very often represents a field of useful application for these devices, owing to the characteristics of the illness and to some psychological aspects of these patients.