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Elsdai I, Elsdai T. Marked reduction in the hospital admission rate of a man with nonislet cell tumor hypoglycemia after starting steroids: a case report. Ann Med Surg (Lond) 2023; 85:2007-2009. [PMID: 37228993 PMCID: PMC10205264 DOI: 10.1097/ms9.0000000000000537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/18/2023] [Indexed: 05/27/2023] Open
Abstract
Nonislet cell tumor hypoglycemia (NICTH) is a rare cause of hypoglycemia. It results from the secretion of insulin-like growth factor 2 from various tumors, which acts on insulin receptors, increasing glucose utilization by the tumor. Among the treatment options for patients with NICTH, steroids have the best palliative effects. Case presentation The authors present the case of a man with metastatic lung cancer who had multiple hospitalizations for hypoglycemia and associated anorexia, weight loss, and depression. After receiving steroids, the patient's hospital admission rate due to hypoglycemia reduced, depression improved, and weight loss reversed. Clinical discussion Steroids, diazoxide, octreotide, glucagon infusion, and recombinant growth hormone have shown good results in treating NICTH. Steroids have many advantages: they are easy to administer and relatively inexpensive. In our patient, steroids had the added benefit of improving the appetite with subsequent weight gain and controlling depression. They also significantly reduced the readmission rate. Conclusion NICTH is a rare cause of hypoglycemia. Glucocorticoids show better palliative effects than other medical treatments. In our patient, steroids dramatically reduced the number of hospitalizations due to hypoglycemia while improving the appetite, weight, and depression.
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Affiliation(s)
- Ibrahim Elsdai
- Department of Internal Medicine, Misurata Medical Center, Misurata University, Misurata, Libya
| | - Taher Elsdai
- Department of Endocrinology, Conemaugh Memorial Medical Center, Johnstown, Pennsylvania, USA
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Liotta G, Madaro O, Scarcella P, Inzerilli MC, Frattini B, Riccardi F, Accarino N, Mancinelli S, Terracciano E, Orlando S, Marazzi MC. Assessing the Impact of A Community-Based Pro-Active Monitoring Program Addressing the need for Care of Community-Dwelling Citizens aged more than 80: Protocol for a Prospective Pragmatic Trial and Results of the Baseline Assessment. Transl Med UniSa 2021. [PMID: 34447708 PMCID: PMC8370536 DOI: 10.37825/2239-9747.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this paper is to describe the protocol of a study assessing the impact of a Community-based pro-Active Monitoring Program, by measuring the effect in counteracting the adverse outcomes related to frailty. Methods a prospective pragmatic trial will be carried out to describe the impact of an intervention on people aged>80, adjusted for relevant parameters: demographic variables, comorbidities, disability and bio-psycho-social frailty. They have been assessed with the Functional Geriatric Evaluation questionnaire that is a validated tool. Mortality, Acute Hospital Admission rates, Emergency Room Visit rates and Institutionalization rates are the main outcomes to be evaluated annually, over three years. Two groups of patients, made up by 578 cases (undergoing the intervention under study) and 607 controls have been enrolled and interviewed. Results at baseline the two groups are quite similar for age, living arrangement, comorbidity, disability and cognitive status. They differ in education, economic resources and physical status (that are better in the control group) and in social resources (that is better in the case group). The latter was expected since the intervention is focused on increasing social capital at individual and community level and aimed at improving survival among the cases as well as reducing the recourse to hospital and residential Long Term Care. Conclusion The proposed study addresses a crucial issue: assessing the impact of a bottom up care service consisting of social and health interventions aimed at reducing social isolation and improving access to health care services.
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Affiliation(s)
- G Liotta
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - O Madaro
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - P Scarcella
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - M C Inzerilli
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - B Frattini
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - F Riccardi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - N Accarino
- Community of Sant'Egidio, "Long Live the Elderly!" program, Via San Gallicano 25, 00153, Rome, Italy
| | - S Mancinelli
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - E Terracciano
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - S Orlando
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00173, Rome, Italy
| | - M C Marazzi
- LUMSA University, Via della Traspontina 21, 00193, Rome, Italy
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