The paper describes an exceptionally unusual case of a conjunctival form of microangiopathy in a young patient suffering from type 1 diabetes. The patient, who was experiencing a long-term poor compensation of his disease with a serious form of ischaemia of the retina and deficient treatment of proliferate diabetic retinopathy, sought doctor’s advice when suffering from watering of the eyes and extreme eye pressure. An eversion of the tarsus of the conjuntivae of both eyes showed extensive hemangiomatose forms which did not exhibit the usual character of conjunctival papillae. The largest were excised, examined to ascertain the presence of coilcytes and benign papilloma viruses. The latter, however, were not confirmed even following repeated tests. Surprisingly the indications regressed spontaneously following the improvement of the compensation of diabetes and on the completion of panretinal photocoagulation. This case also demonstrates the need for patients to cooperate with doctors.

Key words: type 1 diabetes mellitus, conjunctival microangiopathy

CSII – a continuous subcutaneous infusion of insulin by insulin pump is a frequent method of therapy used in diabetes patients with long-term insufficient compensation, in particular in cases when the alternatives of intensified insulin treatment resulted in unsatisfactory results. Another frequent indication is an effort to stop the development of complications in different organs. The treatment with insulin pump is normally started in patients admitted to hospital for a period of 3-5 days, i.e. at hospital wards of diabetology centres. In selected patients we successfully started the treatment with insulin pump in the conditions of our outpatient clinic, i.e. without hospital admission. In cases of patients who received a thorough preliminary information and training the adjustment of the treatment and its start under the conditions of outpatient clinic was smooth, with rapid effect, trouble free and without any further complications.

Key words: diabetes mellitus, CSII, insulin pump, treatment adjustment in outpatient clinic

The case is described of a non-obese patient suffering from type 2 diabetes with a stealthy development of heart failure due to an ischemic left ventricular dysfunction. Intensified treatment, however, repeatedly improved the patient’s condition and lately there was an enhancement by one functional level of NYHA classification due to resynchronisation therapy of heart failure.

Key words: ischaemic dysfunction of the heart, resynchronisation treatment, aorto-coronary bypass

Cardiovascular complaints account for the main causes of morbidity and mortality among patients suffering from diabetes. A number of cases occur quite asymptomatically. The American Diabetic Association recommends undertaking suitable severe load cardio-vascular tests on patients where several risk factors are at stake. In our paper we present a procedure for the detection of asymptomatic cardiovascular complaints in the case of a type 2 diabetic patient which ranges from arteriosclerosis markers, via severe load cardio-vascular tests to invasive examinations.

Key words: silent ischaemia, type 2 diabetes, scintigraphy myocardium, arteriosclerosis markers

The case of an obese diabetes type 2 patient treated in a podiatric out-patients clinic for recurring ulcers on his legs. A combination of antibiotic treatment, local treatment with modern bandages and polyurethane foam (Inadine, Ialugen, Ialugen Plus and Allevyn foam) as well as antimycotic treatment (Clotrimazol) combined with enlightening the patient, alleviating pains in the legs and presenting suitable shoes led to the healing of the wounds. The paper discusses the principles of a comprehensive care for the diabetic leg and the need to treat patients at risk in a podiatric clinic.

Key words: polyneuropathy, diabetic leg, podiatric care

The report describes a case of gradual progressive muscle slackness displaying a neurological similarity to a spastic case. Surprisingly, following a fairly long process of diagnosing the finding was a hyperparatyreosis of an adenoma in the proximity of the thyroid gland. Special emphasis is therefore placed on EMG findings in this type of muscle weakness.

Key words: electromyography, hyperparatyreosis, spasticity

The case is described of a woman who at the age of 66 was diagnosed as suffering from thyroid-related orbitopathy due to the presence of unilateral exophthamos and a struma nodosa. At the time when this diagnosis was adopted there were no other signs of thyroid-related ophthalmopathy, neither according to clinical findings, nor in the course of CT examinations. After 3 years the patient underwent endocrinological examinations because of progressive eye complaints. Considering that the clinical finds were ambiguous and there were signs of an impediment of cognitive functions, CT examinations of the brain were undertaken which proved the existence of a large meningeom in the spheno-occipital area on the left. Subsequently the patient was successfully operated on. She is without any signs of a relapse.

Key words: thyroid-related orbitopathy, meningeom

The occurrence of node changes in the thyroid gland is frequent and increases in prevalence as women grow older and in areas which suffer from an iodine deficiency.
Most node changes are benign, but at all times it is important to differentiate malignant processes – a differentiation of a carcinoma thyroid gland, a malignant lymphoma, anaplastic carcinoma or metastasis. It is vital to verify the functional state of the node, to ascertain its morphology (sonographic image) or undertake an FNAB (fine-needle aspiration biopsy) and then decide on subsequent treatment – whether we choose observation, medication, a surgical solution or the administration of radioiodine.
Demonstration of 2 cases of patients suffering from struma nodosa

Key words: struma nodosa, follicular adenoma, papillocarcinoma