No abstract

ObjectiveHyperintensity signal in T2‐weighted magnetic resonance imaging (MRI) has been related to better therapeutic response during pasireotide treatment in acromegaly. The aim of the study was to evaluate T2 MRI signal intensity and its relation with pasireotide therapeutic effectiveness in real‐life clinical practice.Design, Patients and MeasurementsRetrospective multicentre study including acromegaly patients treated with pasireotide. Adenoma T2‐weighted MRI signal at diagnosis was qualitatively classified as iso‐hyperintense or hypointense. Insulin‐like growth factor (IGF‐I), growth hormone (GH) and tumour volume reduction were assessed after 6 and 12 months of treatment and its effectiveness evaluated according to baseline MRI signal. Hormonal response was considered ‘complete’ when normalization of IGF‐I levels was achieved. Significant tumour shrinkage was defined as a volume reduction of ≥25% from baseline.ResultsEighty‐one patients were included (48% women, 50 ± 1.5 years); 93% had previously received somatostatin receptor ligands (SRLs) treatment. MRI signal was hypointense in 25 (31%) and hyperintense in 56 (69%) cases. At 12 months of follow‐up, 42/73 cases (58%) showed normalization of IGF‐I and 37% both GH and IGF‐I. MRI signal intensity was not associated with hormonal control. 19/51 cases (37%) presented a significant tumour volume shrinkage, 16 (41%) from the hyperintense group and 3 (25%) from the hypointense.ConclusionsT2‐signal hyperintensity was more frequently observed in pasireotide treated patients. Almost 60% of SRLs resistant patients showed a complete normalization of IGF‐I after 1 year of pasireotide treatment, regardless of the MRI signal. There was also no difference in the percentage tumour shrinkage over basal residual volume between the two groups.

No abstract

BackgroundDiabetes is a chronic pathology of high prevalence and a large number of associated comorbidities that have an impact on patients’ quality of life. In the hospital environment, poor insulin adherence may lead to episodes of hyperglycaemia or severe hypoglycaemia, increasing long-term complications, as well as morbidity and mortality.PurposeTo evaluate the clinical results obtained after the implantation of the insulinisation protocol in non-critical patients in our hospital. This protocol recommends the suspension of oral antidiabetic drugs (OADs) at admission, and if blood glucose >150 mg/dl, baseline insulin control is recommended along with control of preprandial glycaemias by administering rapid-acting insulin.Material and methodsOn 25 November 2015, a cross-sectional study (submitted to the Ethical Committee for Clinical Research) was carried out. In this study, all patients diagnosed with diabetes who were hospitalised and who had undergone validation of pharmacological treatment were located.The Electronic Clinical History (SELENE®) and the Pharmacy Service Managing Software (FARMATOOLS®) were used for the location and collection of clinical data.ResultsA total of 132 patients were evaluated. Sixty-four per cent and 36% of them were males and females respectively, with an average age of 69 years (range 29–93) and an average weight of 80 kg at admission. Fifty per cent of patients’ weight was not registered and this is a vital fact for the evaluation of the patients’ nutritional status and the calculation of the dose of insulin.Ninety per cent of patients had type-2 diabetes and 3% of them were diagnosed during their hospital admission. 46.4% of patients were treated with OADs in monotherapy, 15.2% with OADs plus insulin and 10.4% under a basal-bolus pattern.The overall compliance rate of the treatment to the basal-bolus pattern was very low (32%). These results are in line with the rest of the studies carried out in hospitalised diabetic patients.ConclusionIn spite of gaining better glycaemic control with the basal-bolus regimen, the adherence to it was low. In the future, the suspension of the OADs, or their change to insulin after admission, will be a difficult target that we have to reach.References and/or AcknowledgementsI would like to express my very great appreciation to the staff of the service.No conflict of interest

No abstract