Propofol-induced acute pancreatitis.

WHAT IS KNOWN AND OBJECTIVE: Drug-induced acute pancreatitis comprises only 0.5%-2% of all cases of acute pancreatitis. Propofol is a potentially dangerous drug that can cause acute pancreatitis, but this complication is extremely rare. CASE SUMMARY: A 57-year-old patient developed acute pancreatitis after a planned thyroidectomy. As the common causes of acute pancreatitis were excluded, we believe that the pancreatitis was drug-induced, in this case by a single dose of propofol administered to the patient during the surgery. WHAT IS NEW AND CONCLUSION: We present a rare case of propofol-induced acute necrotising pancreatitis, which is to the best of our knowledge the first fatal case reported in an adult patient.

Improvement of hypertension after parathyroidectomy of patients suffering from primary hyperparathyroidism.

Background. Primary hyperparathyroidism (PHPT) is one of the most common endocrine conditions and is accompanied by hypertension and increased cardiovascular mortality. The purpose of this study was to evaluate the effect of parathyroidectomy on systolic and diastolic blood pressure (BP) in hypertensive patients with PHPT and whether hypertension occurs more frequently in PHPT than in control group. Methods. A total of 1020 patients with proved PHPT who underwent surgery were compared with with 1020 age, sex, BMI, and smoking status matched controls. We evaluated changes in serum calcium, parathyroid hormone (PTH), uric acid, and BP before and 6 months after surgery. Results. Parathyroidectomy corrected PHPT and resulted in a substantial fall in both mean systolic (150 ± 3.8 to 138 ± 3.6 mmHg) and mean diastolic pressures (97 ± 3 to 88 ± 2.8 mmHg) of the hypertensive subjects; P < .01. In these patients, PTH, calcium, and uric acid normalized. 726 patients from 1020 with PHPT (69.8%) were found to be hypertensive whilst only 489 (47.8%) from 1020 of our control group. Conclusion. Parathyroidectomy in hypertensive patients reduces systolic and diastolic BP. PHPT is accompanied by a variety of metabolic complications, which are a risk factor for hypertension, and parathyroidectomy can improve these metabolic complications.

Raloxifen prevents bone loss in castrated male mice.

Raloxifen is a selective estrogen receptor modulator which prevents bone loss in ovariectomized female mice in a fashion similar to estrogens. Since testosterone-deficient male mice also lose bone mass, we were interested in testing the effects of raloxifen on bones in intact and castrated male mice. Bone density was significantly reduced in castrated animals (1.36+/-0.04 g/ml) as compared to intact animals (1.42+/-0.03 g/ml) (p<0.01). When castrated mice with extraordinarily low concentrations of testosterone and with reduced weight of seminal vesicles were treated with raloxifen, the changes in bone density and bone minerals resulting from castration (1.36+/-0.04 g/ml) were entirely prevented (1.40+/-0.01 g/ml). Cortical bone was lost in orchidectomized mice, and this decrease in cortical thickness of the femur was prevented by raloxifen administration. Raloxifen in a dose used in humans for treatment of osteoporosis decreased the weight of seminal vesicles, an organ which is highly sensitive to the androgenic effect, decreased the concentration of testosterone (12.5+/-2.8 micromol/l) (p<0.01) but not to the same level as in the case of castrated animals (0.6+/-0.3 micromol/l), and did not have any effect on bone density or mineral content in intact mice. The results of the present study may thus be interpreted as supporting the hypothesis that raloxifen is an effective agent against the deleterious effects of castration-induced osteopenia in male mice and also support the hypothesis that estrogens may have physiological skeletal effects in male mice.

Progestagens androgenic action on the bone of male castrated mice.

It has been suggested that some progestagens could have an androgenic stimulatory effect on bone formation. The androgenic effects of progestagens were tested in vivo in the absence of androgens and estrogens in the castrated male mice, species extraordinary responsive to the withdrawal or administration of androgens. Three progestagens (norethisterone, uterogestan and medroxyprogesterone acetate were compared as to their androgenic activity. Tissues especially sensitive to androgens, the seminal vesicles and kidney of the mice fell significantly after castration and all three progestagens did not affect their weights. The present results confirm the well known fact that castration leads to osteopenia in mice. Uterogestan micronized progesterone and MPA have no effect on the bone density or mineral content of the tibia of tested mice. Only in the case of NETA we observed slight statistically significant (p < 0.05) increase in bone density. Progestagens do not appear to have the androgenic effect on the skeleton and NETA has been suggested as one of the exception. Our results indicate that only NETA at the dose which is used in hormonal therapy for prevention of osteoporosis has a slight protective effect against bone mineral loss in castrated mice.