Severe sulfonylurea-induced hypoglycemia: a problem of uncritical prescription and deficiencies of diabetes care in geriatric patients.

Objective: Severe sulfonylurea-induced hypoglycemia (SH) remains a life-threatening and under-reported condition. We investigated the incidence of SH and clinical characteristics of patients with type 2 diabetes mellitus (T2DM) to demonstrate typical risk constellations.

Methods: In a prospective population-based observational study, all consecutive cases of SH in the period 2000 - 2009 in a German area with 200,000 inhabitants were registered.

Recommendations for adult and paediatric cardiologists on obtaining additional qualification in "Adults with Congenital Heart Disease" (ACHD).

Background: The number of adult congenital heart disease (ACHD) patients will be larger in the medium to long term than that of children and adolescents with congenital heart disease. The present structures for the medical care of ACHD patients are not sufficient and need to be improved. Therefore the Task Force aimed at developing recommendations for adult and paediatric cardiologists to acquire the additional qualification "Adults with Congenital Heart Disease" (ACDH).

Lipoatrophy associated with the use of insulin analogues: a new case associated with the use of insulin glargine and review of the literature.

Importance Of The Field: Any insulin formulation can in principle cause lipoatrophy; even cases associated with recombinant human insulin have been reported. An increasing number of case reports have been published indicating that lipoatrophy also develops after treatment with various insulin analogues.

Areas Covered In This Review: In this review, we summarise the literature on lipoatrophy associated with the use of insulin analogues published to date.

Intraperitoneal splenosis: a simple diagnosis if you remember to think of it.

A 72-year old man presented with clinical signs of small bowel obstruction. The medical history revealed an asymptomatic retrogastric tumor 5 cm in diameter with impression of the gastric fundus that was found 10 years ago and showed no progression. This diagnosis was made endoscopically, by endosonography and abdominal computed tomography.

The management of chronic total coronary occlusions.

Although recent consensus has clearly defined chronic total occlusions (CTO), attempted percutaneous coronary intervention (PCI) remains low. Histopathologically, CTOs are characterized by fibrous caps, varying degrees of plaques, and neovascularization, with both increasing with the age of the CTO. Multiple registries and studies show that successful PCI of CTOs can improve symptoms, left ventricular function, and mortality.