[Paraneoplastic Cushing's syndrome, a real diagnostic and therapeutic challenge: A case report and literature review].

Introduction: Paraneoplastic Cushing's syndrome is a rare cause of endogenous hypercortisolism attributable to ectopic ACTH secretion by non-pituitary tumors. Imaging and biochemical results are often inconclusive and differential diagnosis with Cushing's disease can then be challenging. Moreover, these tumors may be occult and difficult to find and thus the need of new imaging tools such as (18)FDG-PET scan and (18)DOPA-PET scan.

Hypoglycaemia and dementia in diabetic patients.

Diabetes and dementia, which have a complex relationship between them, are undergoing extensive growth in their fields. The occurrence of hypoglycaemia, the potential severity of which has just been pointed out in some recent studies, must be included in these relationships. In fact, diabetes is the cause of decline in cognitive functions and most certainly is involved in the occurrence of vascular dementia.

Diabetes and inflammation: fundamental aspects and clinical implications.

Aim: The aim of this paper is to provide the fundamental background of the inflammation theory associated with type 2 diabetes, to discuss the clinical consequences of low-grade inflammation, particularly in terms of cardiovascular risk, and to infer some clinical therapeutic strategies deriving from drugs that already exist or are in development.

Methods: This non-exhaustive work is the result of a Pubmed(®) research, based on requests including the following keywords: diabetes, inflammation, innate immunity, obesity, reticulum endoplasmic stress, cytokines, endothelial dysfunction.

Results: Obesity and type 2 diabetes are linked with a low-grade inflammation state that reflects the activation of innate immunity where metabolic, environmental and genetic factors are implicated.

A new simple method for assessing sudomotor function: relevance in type 2 diabetes.

Aim: The current sudomotor function tests are too time-consuming to be used for diabetic patients in daily practice. EZSCAN is a new, patented technology that measures electrochemical skin conductance (ESC) through reverse iontophoresis and chronoamperometry. The aim of the present study was to assess the sensitivity, specificity and reproducibility of the method in type 2 diabetic patients in comparison to control subjects with no risk of diabetes.

[Uncommon complication of anticoagulant therapy: pituitary hemorrhage].

Pituitary apoplexy is well known as the first manifestation of pituitary tumour. Conversely, haemorrhage of a pituitary adenoma, revealed by anticoagulant therapy, is very uncommon. Two weeks after initiation of anticoagulant therapy for a deep venous thrombosis, an 83-year-old woman presented with intracranial hypertension and blindness.

[Thyroid metastasis of kidney cancer].

Thyroid metastasis of solid tumors is rare and often asymptomatic. Differential diagnosis with malignant thyroid tumor is difficult. We report a 65-year-old man who presented with a solitary intrathoracic thyroid nodule of the left lobe, inaccessible to fine needle biopsy.

[Hyperparathyroidism during pregnancy: dangerous association for the mother and her infant].

Hypercalcaemia during pregnancy is rare but requires a systematic approach for its diagnosis and its treatment. We report a 32-year-old pregnant female at 32 weeks of gestation who presented a severe hypercalcaemia, due to primary hyperparathyroidism. The delivery allowed the birth of a healthy child who had a serum calcium level in the normal range.

[Type 2 diabetes mellitus associated with pancreatic and renal malformations].

A 55-year-old woman presented with a recent diabetes mellitus associated with pancreatic and renal malformations. This atypical diabetes raised the possibility of maturity onset diabetes of the young (MODY) and a genetic research was performed. These malformations led to MODY5 diagnosis that was confirmed by the presence of HNF1beta gene mutation.

[Obesity and the metabolic syndrome: a new epidemic].

The disorder now known as the "metabolic syndrome "was first recognized 50 years ago, but the use of various definitions led to confusion over its real nature. The metabolic syndrome is directly linked to android obesity, which reflects insulin resistance; it lies at the root of all associated risk factors and is a forerunner of type 2 diabetes. Screening is based on systematic waist measurement, taking ethnic origin into account.

[Acromegaly in the elderly].

Unlabelled: Multicentric registers such as The French Acromegaly Register provide data on rare disorders that are otherwise difficult to obtain, so avoiding extrapolation from limited data sets. This study focuses on clinical, hormonal and therapy characteristics of acromegaly in people over 70 years old. The objective was to compare this population with the youngest to disclose if the medical management was similar.

Military community: a privileged site for clinical research: Epidemiological Study of Metabolic Syndrome Risk Factors in the Military Environment.

The metabolic syndrome is considered to be an important public health problem. The Epidemiological Study of Metabolic Syndrome Risk Factors in the Military Environment is a prospective epidemiological study that is designed to identify clinical and laboratory parameters of metabolic syndrome and cardiovascular risk factors with an initial 1-year cross-sectional study followed by a 10-year follow-up and patient care. One hundred eight-five (9%) of 2,045 military personnel subjects presented at least three of the five National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) criteria.

[Seizure and Bourneville tuberous sclerosis: think about insulinoma].

Bourneville tuberous sclerosis is a phacomatosis characterized by skin, neurological and ophthalmological lesions. At first, seizure can reveal cerebral lesions, but other causes may be suspected. We report a case of a Bourneville tuberous sclerosis in a 41-year-old-man with hypoglycemia leading to seizures, resulting from an insulinoma.

Is hyperhomocysteinemia an additional risk factor of the metabolic syndrome?

The aim of this study was to ascertain if hyperhomocysteinemia is associated with the metabolic syndrome. The metabolic syndrome is a cluster of cardiovascular risk factors. Hyperhomocysteinemia is an obvious independent risk factor for atheroma, and thrombosis morbidity and mortality.

What is the role of computed tomographic coronary angiography in diabetic patients?

Unlabelled: All diabetes specialists are aware of the frequency and severity of coronary disease in diabetics. Non-invasive diagnostic tests perform well, but they could be better.

Aim: To assess the role of computed tomographic coronary angiography in diabetics.

Use of Ni electrodes chronoamperometry for improved diagnostics of diabetes and cardiac diseases.

Low DC active current through Nickel electrodes applied on skin in places like hands, forehead and feet provides a novel non invasive diagnostic tool using reverse iontophoresis. This work describes the electrochemistry reactions involved and some medical applications, such as diagnostics of neuropathy, diabetes and cardiac diseases. Finally we provide evidence for the utility of this method through large clinical studies.

[Modifications of 24-h blood pressure profile associated with reduction of the heart rate variability in type 1 diabetic patients].

Unlabelled: The purpose of this study was to assess the blood pressure modifications in type 1 diabetic patients who present reduction of heart rate variability.

Patients And Methods: This study included 70 type 1 diabetic patients (mean age: 42 +/- 13 years, diabetes duration: 13.2 +/- 9 years.

[Role of nocturnal blood pressure in the onset of diabetic nephropathy].

Unlabelled: The aim of this study was to assess the responsibility of night-time blood pressure in the onset of nephropathy in diabetic patients.

Patients And Methods: This study included 98 diabetic patients (mean age: 54 +/- 15 years, diabetes duration: 15 +/- 10 years). An evaluation of diabetes and a 24-h ambulatory blood pressure were performed at the initial evaluation (Y0) and about five years later (Y5).

[Hypertension and acromegaly in the elderly: French Registry Data].

Unlabelled: Multi centre registries such as the French Acromegaly Registry created in 1999 provide data on rare disorders that are otherwise difficult to obtain. This study focuses on the characteristics of high blood pressure in people aged of over 70 years old.

Patients And Methods: The data were obtained from the thirty centres where patients had been recorded on the Acromegaly Registry since 1999.

[Recommendations of the French National Health Authority for management of high blood pressure in clinical practice].

Unlabelled: The new recommendations of the French national authority for health (or Haute Autorité de Santé: HAS) concerning management of high blood pressure (HBP) deserve to be compared with real clinical practices in a large population.

Material And Methods: [corrected] EPIMIL is a prospective epidemiological study designed to assess the prevalence of the metabolic syndrome and the risk factors in a 2045 French male military personnel coming from Paris area. The different recommendations of the HAS have been applied to these subjects, and the aim of this work is to compare these theoretical objectives to what is done in real practice.

Should we have more definitions of metabolic syndrome or simply take waist measurement?

The disorder now known as metabolic syndrome has been recognized for 50 years, but its multiple definitions have led to some confusion and even doubt about its very nature. Metabolic syndrome is directly linked to the presence of android obesity, which indicates insulin resistance and lies at the root of all risk factors and early indications of type 2 diabetes. It is diagnosed by systematic measurements of waist size and its direct interpretation taking ethnic origin into account.

[Nelson's syndrome management: current knowledge].

Purpose: Nelson's syndrome is a severe complication of bilateral adrenalectomy performed in the treatment of some Cushing's diseases, and its management remains difficult. Trough the observation of a patient suffering from a severe form of Nelson's syndrome for more than 10 years, the authors review the literature and discuss the main current therapeutic possibilities.

Current Knowledge And Key Points: Many molecules have been used with variable results.

[Inappropriate ADH secretion-induced hyponatremia and associated with paroxetine use].

Introduction: Selective serotonin reuptake inhibitors (SSRI) are the most common antidepressants prescribed for elderly people. Although they are generally better tolerated than other antidepressant treatment classes, they can be responsible for potentially life-threatening hyponatremia, related to syndrome of inappropriate antidiuretic hormone secretion (SIADH).

Observation: A 64 years-old woman was hospitalized for cognitive function alteration and vomiting after introduction of paroxetine for depressive symptoms.

[Silent thyroiditis in a patient under lithium therapy].

While hypothyroidism secondary to treatments by lithium are well known, cases of hyperthyroidism are less common. A 48 years old patient under lithium carbonate from about 10 years ago presents hyperthyroidism without any auto-immunity biological markers, associated with a very low thyroid tracer uptake on scintigraphy. Treatments by anti thyroid agents will be necessary during months in order to normalize the hormone level, whereas lithium is maintained.

[Influence of blood pressure level on urinary albumin excretion rate and erythropoietin production in diabetic patients].

Unlabelled: The purpose of this study was to investigate blood pressure variations during diabetic incipient nephropathy and to evaluate theirs consequences for erythropoietin (EPO) production.

Patients And Methods: This study included 94 diabetic patients (mean age: 59.9 +/- 15.