Prevalence of microangiopathic complications in hyperglycemia secondary to pancreatic disease.

Diabetes secondary to pancreatic disease (PD) represents a useful model for the study of the effects of chronic hyperglycemia on microangiopathic complications in the absence of those genetic factors predisposing to Type I diabetes. Our aim was to evaluate the prevalence of nephropathy and retinopathy in a group of 86 patients with PD. The genetic pattern, assessed by the determination of HLA antigens, was different than in patients with Type I diabetes. A family history of diabetes was present in 53% of the patients. The prevalence of retinopathy was 37%. Eighteen percent of the patients with duration of diabetes less than 10 years showed an albumin excretion rate (AER) greater than 40 mg/24 hr. The prevalence of pathologic microalbuminuria (greater than 40 mg/24 hr) was found in 29% of the patients with duration of diabetes greater than 10 years. The prevalence of pathologic microalbuminuria is related to the duration of diabetes. Both diastolic and systolic blood pressure is positively correlated to albumin excretion rate (p less than 0.02), suggesting a possible role of hypertension in the evolution of nephropathy. Sixty-one percent of the patients with AER greater than 40 mg/24 h had retinopathy, thus confirming the close association between renal and ocular complications. Abnormal microalbuminuria and retinopathy were not influenced by a family history of diabetes. We conclude that the prevalence of microangiopathic complications is similar to that seen in Type I diabetes, and the metabolic abnormalities of diabetes can play a direct role in the development of diabetic microangiopathy.

[Pseudoaneurysm of the peroneal artery caused by a non-penetrating injury]. / Pseudo aneurisma dell'arteria peronea da trauma non penetrante.

The rareness of false arterial aneurysm, a consequence of a non-penetrating injury of a limb, induced the Authors, on the basis of the most recent literature, to review its physiopathologic, clinical and therapeutical aspects, with the purpose to hasten its diagnosis and prevent its complications through the adoption of the most suitable surgical treatment.

[Importance of combined surgical and heparin treatment of peripheral embolism]. / Importanza del trattamento chirurgico ed eparinico combinato nell'embolia periferica.

The authors dwell upon the physiopathologic and diagnostical aspects of the peripheral embolism, and emphasize the effectiveness of the surgical treatment if associated to the anticoagulative one: the valid results obtained should be ascribed to a prompt diagnosis, a stronger surgical aggressiveness and a constant combination of heparinic and surgical therapy.

[Cystic dilatation of intrahepatic bile ducts (Caroli's disease)]. / Dilatazione cistica delle vie biliari intraepatiche (morbo di Caroli).

The AA, report two cases of congenital cystic dilation of intrahepatic biliary ducts. They consider the difficulties in diagnosis and show the ways to follow to demonstrate the pathology. They discuss the therapy and point out that resections are necessary, whereas bilio-digestive bypasses are ineffective.

[Biliary peritonitis]. / Le peritoniti biliari.

The Authors contribute to the definition of the diagnosis and treatment of biliary peritonitis (PB) by showing 12 cases of it. They appraise the etiopathogenetic aspects of this pathology, point out the peculiarities of its precocious radiological and echographic picture, and emphasize its high mortality in patients not subjected to adequate emergency therapy.

[Epidermoid cyst of the spleen with a picture of acute abdomen]. / Cisti epidermoide della milza con quadro di addome acuto.

A case of epidermoid cyst of the spleen in an 8-yr-old boy presented as acute abdomen secondary to rupture of the cyst. The lesion is classified and the relevant literature surveyed. Particular reference is made to the pathogenetic mechanism responsible for the picture of acute abdomen.