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Osteoporosis is a disease that affects over 40 percent of women over the age of 50. The diabetes-osteoporosis relationship is complex and still incompletely elucidated, despite numerous studies conducted in recent decades. The influence of diabetes on bone tissue (1) differs, however, between the forms of type 1 and type 2 diabetes. The purpose of this paper is to highlight the main aspects of the physical therapy in the prophylaxis and treatment of diabetic osteoporosis in females, in the context of proper guidance and an appropriate exercise program. After 35 years of age, the bone continuously loses its substance, a normal and natural phenomenon with the aging. However, this loss can become a serious problem if the initial "bone reserve" was too low or if the bone loss is done too quickly, and especially after the menopause. The result is an increased risk of fracture, either by a normal fall, like in the wrist or hip, or by a moderate lifting effort, as in the case of the vertebrae. Insufficient physical activity, sedentarism, obesity or low body weight, metabolic disorders with absorption deficits lead to demineralization and bone marrow scarring. So, an appropriate exercise program under the auspices of: resistance, posture, balance, are targets that can activate osteoblast in the process of deposition and collagen construction in the bone matrix. A good exercise program in the prophylaxis and treatment of osteoporosis consists of exercise, posture and balance exercises designed for both upper and lower limbs, but also for abdominal and pelvic belts. [ABSTRACT FROM AUTHOR]

The aim of our study was to determine the relationship between two well known cardiovascular risk factors (subclinical atheroclerosis and hypertension) and nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus. The study group was represented by 92 patients with type 2 diabetes mellitus who were treated with antidiabetic drugs or diet. Abdominal ultrasonography and Doppler ultrasonography were used to assess the severity of hepatic steatosis and subclinical atherosclerosis, evaluated using intima-media thickness of the carotid artery (CIMT). The average age of the study group was 60,38 ± 10,37 years. More than 90% of the subjects presented different degrees of hepatic fat load. 61% of the patients had CIMT values above the normal range. 75% of the subjects presented high blood pressure (BP) values. A direct statistically significant correlation between the degree of hepatic steatosis and CIMT (r =0.3636, p =0.0004) was found. Also, we found a positive correlation between the degree of hepatic fat load and the value of systolic blood pressure (SBP). These results sustain the hypothesis that NAFLD can be a predictor of cardiovascular risk due to its direct connection with CIMT and SBP. [ABSTRACT FROM AUTHOR]

Diagnosing peripheral neuropathy is essential for the majority of clinical specialties, as it often reveals systemic underlying diseases that are rarely purely neurological. The patient's history and thorough clinical examination represent the foundation of an early diagnosis. For internal medicine practitioners, it is important to consider common causes at first and search for diabetes, alcoholism or vitamin B12 deficiency, whilst following a diagnosis algorithm that encompasses cues to less popular aetiologies such as systemic vasculitis or paraproteinemia. Prior to requesting nerve conduction studies or further investigations, a few characteristics of peripheral neuropathy should be sought: onset, symmetry, distribution and function impairment (either sensory or motor). Given its interdisciplinary nature, peripheral neuropathies are managed via tight collaboration between the specialist and the internist. Although symptomatic treatment for painful neuropathy is available, treating the underlying disease is fundamental. [ABSTRACT FROM AUTHOR]

Cushing's syndrome (CS) is a clinical condition resulting from chronic exposure to glucocorticoid excess. Hypercortisolism contributes significantly to the early development of systemic disorders by direct and/or indirect effects. Complications such as obesity, hypertension, diabetes, dyslipidemia, and hypercoagulability cause premature atherosclerosis and increase cardiovascular mortality. These associated abnormalities increase cardiovascular risk not only during the active phase of the disease but also long after the remission of hypercortisolism. Clinical management of these patients should be particularly careful and control of cardiovascular risk factors is necessary for a long period. [ABSTRACT FROM AUTHOR]

Insulin resistance is a determinant factor for the increased prevalence of hypertension and dyslipidemia in type 2 diabetes patients. In this study we determined those modifications of clinical and biochemical parameters associated with insulin resistance in the diabetic patient, these alterations can offer us indications concerning the pathophysiological mechanisms that lead to the diabetes development in the case of most patients. Also we determined a correlation between insulin resistance and cardiovascular risk, through the combined effect of age and insulin resistance on this risk. [ABSTRACT FROM AUTHOR]

We are presenting the case of a 50 year-old patient whose symptoms started over an year ago with hiposmia and epistaxis. Multiple ENT surgeries were performed for a frontal maxillary sinusitis. The patient also developed polydipsia, reaching up to 15 liters of liquid intake per day and, soon after, inflammatory and migratory arthralgia, Raynaud phenomenon, conjunctivitis and eyelid edema. The biological and imagistic investigations showed intense inflammatory syndrome, c-ANCA antibodies, nodular cavitary lesions in both lungs, pericarditis, pituitary micro adenoma. Infectious and neoplastic causes were excluded. The final diagnosis was granulomatosis with polyangiitis with upper and lower airway, cardiac, skeletal, and endocrinological involvement. Remission of induction therapy with cyclophosphamide and pulse glucocorticoids was started with a good clinical and biological outcome and a gradual decrease of fluid intake. The presence of pituitary granuloma leading to central diabetes insipidus is a rare clinical manifestation of granulomatosis with polyangiitis, and it is reversible if the treatment is prompt, before pituitary necrosis. [ABSTRACT FROM AUTHOR]