E. Rota, P. Varese, L. Arena, L. Celli, I. Pappalardo, N. Morelli
Literature on antiepileptic induced iatrogenic hypoglycemia is scanty. Due to its broad spectrum of activity and mechanisms of action, valproic acid (VPA), a fatty acid, is the most widely prescribed epilepsy treatment worldwide. Herein, we describe an adult epileptic patient, where persistent, otherwise unexplained hypoglycemia, was most likely induced by VPA, as suggested by the VPA time course and glucose blood levels. Indeed, no further hypoglycemic episodes occurred after VPA discontinuation and the diagnostic work-up ruled out other possible causes of hypoglycemia. This case supports the hypothesis that VPA may induce hypoglycemia, due to still not well-defined metabolic mechanisms of action. Moreover, it emphasizes the fact that an iatrogenic pathogenesis should be considered if an apparently unexplained hypoglycemia occurs in a patient on chronic therapy with antiepileptics, even at a therapeutical dosage.
{"title":"Iatrogenic Hypoglycemia Induced by Valproic Acid in an Adult Patient","authors":"E. Rota, P. Varese, L. Arena, L. Celli, I. Pappalardo, N. Morelli","doi":"10.7175/CMI.V15I1.1487","DOIUrl":"https://doi.org/10.7175/CMI.V15I1.1487","url":null,"abstract":"Literature on antiepileptic induced iatrogenic hypoglycemia is scanty. Due to its broad spectrum of activity and mechanisms of action, valproic acid (VPA), a fatty acid, is the most widely prescribed epilepsy treatment worldwide. Herein, we describe an adult epileptic patient, where persistent, otherwise unexplained hypoglycemia, was most likely induced by VPA, as suggested by the VPA time course and glucose blood levels. Indeed, no further hypoglycemic episodes occurred after VPA discontinuation and the diagnostic work-up ruled out other possible causes of hypoglycemia. This case supports the hypothesis that VPA may induce hypoglycemia, due to still not well-defined metabolic mechanisms of action. Moreover, it emphasizes the fact that an iatrogenic pathogenesis should be considered if an apparently unexplained hypoglycemia occurs in a patient on chronic therapy with antiepileptics, even at a therapeutical dosage.","PeriodicalId":40270,"journal":{"name":"Clinical Management Issues","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42635065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This case report describes a male patient born in 1953 presenting an occasional increase in serum amylase and lipase forty years ago. The monitoring of enzymes was accompanied by radiological investigations, which did not reveal pancreatic pathology. In his family, including 10 siblings, half were carriers of this isolated anomaly; multiple cysts in pancreas, kidneys, and liver were present in some family members, in addition to a pancreatic neoplasia in a sister who did not carry the enzymatic abnormality. Our patient developed colon adenocarcinoma at the age of 67. Here we examine the characteristics of non-pathological chronic pancreatic hyperenzymemia defined as such by the main Italian pioneer Professor Gullo.
{"title":"Familial Gullo’s Syndrome: a clinical case report","authors":"M. Turrin, L. Fornasiero","doi":"10.7175/CMI.V15I1.1493","DOIUrl":"https://doi.org/10.7175/CMI.V15I1.1493","url":null,"abstract":"This case report describes a male patient born in 1953 presenting an occasional increase in serum amylase and lipase forty years ago. The monitoring of enzymes was accompanied by radiological investigations, which did not reveal pancreatic pathology. In his family, including 10 siblings, half were carriers of this isolated anomaly; multiple cysts in pancreas, kidneys, and liver were present in some family members, in addition to a pancreatic neoplasia in a sister who did not carry the enzymatic abnormality. Our patient developed colon adenocarcinoma at the age of 67. Here we examine the characteristics of non-pathological chronic pancreatic hyperenzymemia defined as such by the main Italian pioneer Professor Gullo.","PeriodicalId":40270,"journal":{"name":"Clinical Management Issues","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48571833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Giuffrida, M. Mangia, A. Lavagna, E. Morello, M. Cosimato, R. Rocca, M. Daperno
Colorectal cancer (CRC) is slightly increased in inflammatory bowel disease (IBD) patients, with roughly a 2.5-fold increase compared to the general population. Clinical features associated to CRC risks are extent and severity of colonic involvement, disease duration, concomitant primary sclerosing cholangitis (PSC) and/or familial history of CRC in first-degree relatives. Colonic Crohn’s disease (CD) and ulcerative colitis (UC) share similar risks when similar colonic extent is affected. Risk stratification affects outcomes and surveillance programs. Newer endoscopic techniques substantially ameliorated diagnostic performance of endoscopy, and nowadays the standard for CRC surveillance in IBD patients is high-definition endoscopy, with dye-spray or virtual colonoscopy, oriented at targeted (+ random) colonic biopsies. Visible dysplastic lesions should be considered for endoscopic resection, while invisible dysplasia is still a mandatory proctocolectomy indication. Newer endoscopic interventional techniques (endoscopic mucosa resection, EMR, and endoscopic submucosal dissection, ESD) are appropriate therapeutic techniques to be delivered, but long-term risks of cancer should be balanced towards proctocolectomy.
{"title":"Risk of Colorectal Cancer in Inflammatory Bowel Disease: Prevention and Monitoring Strategies According With Risk Factors","authors":"E. Giuffrida, M. Mangia, A. Lavagna, E. Morello, M. Cosimato, R. Rocca, M. Daperno","doi":"10.7175/CMI.V15I1.1464","DOIUrl":"https://doi.org/10.7175/CMI.V15I1.1464","url":null,"abstract":"Colorectal cancer (CRC) is slightly increased in inflammatory bowel disease (IBD) patients, with roughly a 2.5-fold increase compared to the general population. Clinical features associated to CRC risks are extent and severity of colonic involvement, disease duration, concomitant primary sclerosing cholangitis (PSC) and/or familial history of CRC in first-degree relatives. Colonic Crohn’s disease (CD) and ulcerative colitis (UC) share similar risks when similar colonic extent is affected. Risk stratification affects outcomes and surveillance programs. Newer endoscopic techniques substantially ameliorated diagnostic performance of endoscopy, and nowadays the standard for CRC surveillance in IBD patients is high-definition endoscopy, with dye-spray or virtual colonoscopy, oriented at targeted (+ random) colonic biopsies. Visible dysplastic lesions should be considered for endoscopic resection, while invisible dysplasia is still a mandatory proctocolectomy indication. Newer endoscopic interventional techniques (endoscopic mucosa resection, EMR, and endoscopic submucosal dissection, ESD) are appropriate therapeutic techniques to be delivered, but long-term risks of cancer should be balanced towards proctocolectomy.","PeriodicalId":40270,"journal":{"name":"Clinical Management Issues","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46237842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.22394/2304-3369-2021-3-80-92
E. Pastukhova, A. Mukhachyova, O. Kochneva
{"title":"Rates, dynamics, and factors of absolute and relative poverty: regional aspect","authors":"E. Pastukhova, A. Mukhachyova, O. Kochneva","doi":"10.22394/2304-3369-2021-3-80-92","DOIUrl":"https://doi.org/10.22394/2304-3369-2021-3-80-92","url":null,"abstract":"","PeriodicalId":40270,"journal":{"name":"Clinical Management Issues","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73461752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.22394/2304-3369-2021-4-151-165
E. Popov, V. Simonova, I. Chelak
{"title":"Classification of the factors of an enterprise innovation ecosystem development","authors":"E. Popov, V. Simonova, I. Chelak","doi":"10.22394/2304-3369-2021-4-151-165","DOIUrl":"https://doi.org/10.22394/2304-3369-2021-4-151-165","url":null,"abstract":"","PeriodicalId":40270,"journal":{"name":"Clinical Management Issues","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84378845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.22394/2304-3369-2021-5-37-50
I. Ushakov, D. Skopich
{"title":"Target management map as an instrument of strategic development of regional economy","authors":"I. Ushakov, D. Skopich","doi":"10.22394/2304-3369-2021-5-37-50","DOIUrl":"https://doi.org/10.22394/2304-3369-2021-5-37-50","url":null,"abstract":"","PeriodicalId":40270,"journal":{"name":"Clinical Management Issues","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85197915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.22394/2304-3369-2021-4-166-178
A. Fedorova, E.B. Vlasova
{"title":"Management of university personnel capacity: competitive procedure for a faculty staff","authors":"A. Fedorova, E.B. Vlasova","doi":"10.22394/2304-3369-2021-4-166-178","DOIUrl":"https://doi.org/10.22394/2304-3369-2021-4-166-178","url":null,"abstract":"","PeriodicalId":40270,"journal":{"name":"Clinical Management Issues","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88352100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.22394/2304-3369-2021-3-49-60
E. Sandoyan, A. B. Egiazaryan, M. Voskanyan, A. Galstyan, G. Grigoryan, Grigoryan, Partners Llc
{"title":"The Great Depression of 1929–1933: development of approaches to macroeconomic regulation during crisis","authors":"E. Sandoyan, A. B. Egiazaryan, M. Voskanyan, A. Galstyan, G. Grigoryan, Grigoryan, Partners Llc","doi":"10.22394/2304-3369-2021-3-49-60","DOIUrl":"https://doi.org/10.22394/2304-3369-2021-3-49-60","url":null,"abstract":"","PeriodicalId":40270,"journal":{"name":"Clinical Management Issues","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86666491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.22394/2304-3369-2021-4-62-77
A. Mokronosov, E. Zaytseva
{"title":"Ways to improve the balanced scorecard system applied to the evaluation of management effectiveness in small and medium-sized businesses","authors":"A. Mokronosov, E. Zaytseva","doi":"10.22394/2304-3369-2021-4-62-77","DOIUrl":"https://doi.org/10.22394/2304-3369-2021-4-62-77","url":null,"abstract":"","PeriodicalId":40270,"journal":{"name":"Clinical Management Issues","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85797532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.22394/2304-3369-2021-3-135-147
V. Mortikov
{"title":"The role of budget constraints in human resources management of organization","authors":"V. Mortikov","doi":"10.22394/2304-3369-2021-3-135-147","DOIUrl":"https://doi.org/10.22394/2304-3369-2021-3-135-147","url":null,"abstract":"","PeriodicalId":40270,"journal":{"name":"Clinical Management Issues","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86603121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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