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The structural abnormalities of the genitourinary tract and cervical/vaginal infections are common in patients with diabetes mellitus. The objective was to determine the prevalence of gynecological abnormalities in diabetic women and to investigate its association with different variables. Diabetic women, aged 20 years and older who were attending the diabetic outpatient clinic, were randomly selected. All patients underwent a clinical and gynecological examination and a urianalysis, and papanicolaou. Smear were obtained. A total of 98 women, 84.7% type 2 diabetics, with a mean age of 57 +/- 13 years were included. Uretherocele, cystocele and/or rectocele were present in 19% and cervicitis in 22% of the patients. Urinary incontinence (OR 3.1, p = 0.03) and the history of multiparity (OR 4.2, p = 0.03) were statistically associated with these structural abnormalities. The symptom of vaginal discharge (OR 3.8, p = 0.01) was the only one variable that correlated with cervicitis. By comparing patients with and without cervicitis or gynecologic abnormalities, no significant differences were observed related to the type, duration or treatment of diabetes, blood glucose control or the evidence of leukocyturia in the urine sample. There is an elevated prevalence (31%) of gynecological abnormalities (cervicitis and/or structural abnormalities) in diabetic women, and are mostly asymptomatic.

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The testosterone:dihydrotestosterone ratio (T:DHT) and the antigenic marker CA 19-9 were studied in the serum of 21 male patients with pancreatic cancer and 62 controls with other gastrointestinal malignancies or benign pancreatobiliary disease. Specificity of the T:DHT ratio was 98%, significantly better than the specificity of CA 19-9 at both a 37 U/ml cutoff level (61%) and at 100 U/ml (79%). Sensitivity of the T:DHT ratio was 67%, and that of CA 19-9, 71% and 90% at the upper and lower cutoff levels, respectively. False-negative results of the T:DHT ratio were found predominantly in cases of advanced pancreatic cancer, whereas all four stage I patients had an abnormal (less than 5) T:DHT ratio. These results suggest that the T:DHT ratio is a useful marker for pancreatic cancer in males. It can be used alone or in combination with CA 19-9, and should be further evaluated in the differential diagnosis of patients with the early stages of this disease.

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Intrapancreatic air has been considered a reliable sign of pancreatic abscess (PA), although it can also be associated with other pancreatic diseases. We report here the clinical outcome of two patients with acute pancreatitis with gas in the retrogastric region suggestive of an abscess. Both patients exhibited a good clinical course with no evidence of sepsis. They were treated with analgesics and one of them with antibiotics. Control CT scans showed disappearance of liquid collections and intrapancreatic gas. In one case an endoscopy disclosed a gastric ulcer with changes suggesting a pancreatic fistula. This report shows that intrapancreatic air may mimic PA in cases with acute pancreatitis without septic complications.

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There is strong evidence indicating that the pancreas is under the influence of sex steroid hormones, and that it may even participate in their biosynthesis and metabolism. In the present study, [3H]testosterone was perfused into the isolated canine pancreas, and measured in the effluent with several of its metabolites (5 alpha-dihydrotestosterone, androstenedione, and estradiol). Results show that testosterone is readily transformed by the canine pancreas. The main product found in the effluent is androstenedione. The testis and spleen were also perfused with [3H]testosterone and used as controls. In both cases, this hormone appeared mostly unchanged in the effluent as compared to the pancreatic perfusion (p less than 0.0001). From our data, we conclude that the canine pancreas has the capacity to transform sex steroid hormones, and could be considered an extragonadal site of sex steroid biosynthesis.

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A 67-year-old woman was admitted to the hospital because of intermittent pain in the upper left quadrant of the abdomen. Ultrasound and computed tomography (CT) scan revealed a mass in the body of the pancreas, and angiography demonstrated encasement of the celiac trunk and splenic vein thrombosis. She was thought to have a pancreatic carcinoma and was surgically explored to obtain tissue for diagnosis. A hard and irregular tumor was found, and biopsies revealed granulomatous inflammation with caseous necrosis. The final diagnosis was tuberculosis, and treatment with rifampicin, isoniazid, and ethambutol was undertaken. One year later the patient is asymptomatic and new CT scan shows disappearance of the pancreatic mass.

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Serum androstenedione and testosterone levels were measured in 39 male patients with pancreatic cancer, and compared with the values obtained from 37 male patients with chronic pancreatitis or benign obstructive jaundice, and with those from 36 male patients with other gastrointestinal malignancies. Mean androstenedione values were significantly higher in the pancreatic cancer patients when compared to both control groups, and mean testosterone levels were significantly lower. The testosterone/androstenedione ratio was calculated and was also found to be significantly lower in the patients with pancreatic cancer. There was no difference in this ratio or in the androstenedione or testosterone levels when comparing both control groups. In two patients with stage I pancreatic cancer, serum androstenedione and testosterone levels were significantly altered, and returned to normal values after successful resection. These results confirm previous findings indicating that there is significant derangement in the androgen profile of patients with pancreatic cancer.

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The papillary cystic neoplasm of the pancreas is a rare tumor. Two cases are presented, one of a 38-year-old man and the other of a 23 year-old woman. Both had mild upper abdominal symptoms and were successfully resected with a distal pancreatectomy. Forty-five well documented cases informed in the literature are reviewed. The neoplasm has a striking preference for young women and a relatively benign course with only 10% of the reported cases presenting recurrence or distant metastases.

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The incidence, etiology, clinical characteristics, and long-term outcome of patients with chronic pancreatitis (CP) studied at the Instituto Nacional de la Nutrición in a 12-year period were retrospectively analyzed. One hundred fifty cases were identified, with an overall incidence of 4.4 per 1,000 hospital admissions and of 5.4 per 1,000 in the last 6 years. In 68% of the cases, CP was secondary to alcoholism, in 29% it was idiopathic, and in the rest it was secondary to other causes. Overall, 74% of patients had pancreatic calcifications at time diagnosis was established, and 21% were asymptomatic regarding pain. Patients with idiopathic CP had an earlier age of onset than did patients with alcoholic CP, and in addition the former developed symptoms of diabetes or pancreatic exocrine insufficiency less frequently than alcoholic patients did (p less than 0.05). The sex ratio was different in both groups, with a marked male predominance in alcoholic CP and an equal distribution in the idiopathic group. A 30% actuarial mortality was found in the first 10 years after the onset of the disease, which remained the same at 20 years with a tendency to better survival in nonalcoholic patients. Five patients developed pancreatic cancer throughout the study period.

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Se revisan en este trabajo los aspectos de dinamica hormonal mas sobresalientes que acontecen a la mujer durante el climaterio y la menopausia, con el objeto de aclarar los mecanismos que influyen en el decaimento de la actividad ovaria y la trascendencia que este supuesto deterioro ejerce en la homeostasis corporal en funcion del tiempo

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