Endokrynol Pol
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Randomized Controlled Trial
Comparison of metformin and insulin in the control of hyperglycaemia in non-diabetic critically ill patients.
It is accepted that preventing hyperglycaemia during critical illness while assuring adequate caloric intake can reduce mortality and morbidity. The aim of this study was to compare the metabolic effects of metformin and insulin on hyperglycaemia in ICU patients. ⋯ Both metformin and intensive insulin therapy significantly decreased hyperglycaemia in ICU patients. Insulin caused a greater reduction in blood glucose concentration but required more attention and trained personnel.
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'Silent' somatotropinomas are defined as GH-immunopositive pituitary adenomas without clinical symptoms of acromegaly and GH elevation in peripheral blood. Such tumours used to be considered as rare. However, recent data has indicated that they are more frequent than previously thought. The present paper shows that pituitary adenomas, diagnosed before surgery as nonfunctioning, often display GH immunopositivity. ⋯ GH-immunopositivity occurs in nearly half of 'clinically' nonfunctioning pituitary adenomas. Because of that, IGF-1 determination in blood before the surgery, and immunohistochemical examination of adenoma for GH after the surgery, should be performed as standard in all patients suffering from pituitary tumours, irrespective of the presence or absence of acromegaly symptoms.
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Gastroenteropancreatic (GEP) and bronchopulmonary (BP) neurendocrine neoplasms (NENs) are rare and slowly growing tumours. Matrix metalloproteinases (MMPs) degrade extracellular matrix and are responsible for invasion and metastasis. Tissue inhibitors of matrix metalloproteinases (TIMPs) affect the invasiveness of tumour cells and the formation of distant metastases. The aim of this study was to evaluate selected MMPs (MMP2 and MMP9) and their tissue inhibitors (TIMP1 and TIMP2) depending on the pTNM classification, grading, and the occurrence of metastases. ⋯ Patients with NENs secreted larger quantities of MMP2 and TIMP1. TIMP1 may be considered a marker of metastases in patients with GEP NENs.