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https://www.readbyqxmd.com/read/29155695/citrobacter-endogenous-endophthalmitis-a-case-report-and-review-of-the-literature
#1
Daniel H T Wong, Candice C H Liu, Justin M K Tong, Wei-Kwang Luk, Kenneth K W Li
PURPOSE: We present a case of endogenous endophthalmitis because of an unusual bacterium, Citrobacter koseri. PATIENT: A 57-year-old woman without previous history of eye surgery or trauma presented with diabetic ketoacidosis and a painful right eye with the reduction of vision. C. koseri was identified in blood culture; thus, a diagnosis of right eye endogenous endophthalmitis was made. Intravenous and intravitreal antibiotics were both started, and vitreous culture further confirmed C...
November 16, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/29135618/pathway-for-the-management-of-hyperglycemia-in-the-cardiac-care-unit
#2
Seyed Hamed Hosseini Dehkordi, Jeanine Albu, Emad F Aziz, Eyal Herzog
Inpatient hyperglycemia has been associated with increased morbidity and mortality in critically ill patients. Optimal control of blood glucose (BG) levels using insulin infusion protocols has been shown to improve clinical outcomes. Protocols have been developed to prescribe a safe and effective rate of insulin infusion for optimal control of BG levels; however, a major obstacle in their implementation is their complexity. We have revised and updated our previously published pathway for the management of hyperglycemia, which introduces the "wheel" concept for insulin dosing...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29118847/starvation-ketoacidosis-treatment-pitfalls
#3
Henry Hammerbeck, Michael R Holland
No abstract text is available yet for this article.
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29113868/a-case-of-influenza-type-a-myocarditis-that-presents-with-st-elevation-mi-cardiogenic-shock-acute-renal-failure-and-rhabdomyolysis-and-with-rapid-recovery-after-treatment-with-oseltamivir-and-intra-aortic-balloon-pump-support
#4
Eleni Geladari, Vasilios Papademetriou, Hans Moore, David Lu
We present a 59-year-old black male with history of type-1 diabetes and alcohol abuse. Patient became critically ill after a 5-day period of burning throat discomfort. On arrival patient was lethargic, in cardiogenic shock with a blood pressure of 81/47mmHg. Immediate diagnoses included diabetic ketoacidosis, acute renal failure, and possible septic shock. He was intubated, resuscitated with intravenous fluids, maintained on three inotropic agents, and given empiric wide spectrum antibiotics. An ECG showed a new ST elevation MI and an echocardiogram showed severe LV dysfunction...
May 2, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29111277/resolution-of-ketoacidosis-in-children-with-new-onset-diabetes-evaluation-of-various-definitions
#5
Julia E von Oettingen, Erinn T Rhodes, Joseph I Wolfsdorf
AIMS: Data are sparse concerning use of serum electrolyte parameters as compared to venous blood gas (VBG) measurements to monitor acid-base status during treatment of diabetic ketoacidosis (DKA). We explored the utility of various parameters to define DKA resolution by investigating the relationship of venous pH (vpH), anion gap (AG), serum bicarbonate (HCO3), and glucose concentration during management of DKA in children with new onset diabetes mellitus (NODM). METHODS: We included all patients with NODM presenting with DKA to Boston Children's Hospital from 10/1/07-7/1/13...
October 27, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29109609/end-stage-renal-disease-increases-rates-of-adverse-glucose-events-when-treating-diabetic-ketoacidosis-or-hyperosmolar-hyperglycemic-state
#6
Caitlin M Schaapveld-Davis, Ana L Negrete, Joanna Q Hudson, Jagannath Saikumar, Christopher K Finch, Mehmet Kocak, Pan Hu, Megan A Van Berkel
IN BRIEF Treatment guidelines for diabetic emergencies are well described in patients with normal to moderately impaired kidney function. However, management of patients with end-stage renal disease (ESRD) is an ongoing challenge. This article describes a retrospective study comparing the rates of adverse glucose events (defined as hypoglycemia or a decrease in glucose >200 mg/dL/h) between patients with ESRD and those with normal kidney function who were admitted with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)...
October 2017: Clinical Diabetes: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29105262/evaluation-of-novorapid-infusion-as-a-treatment-option-in-the-management-of-diabetic-ketoacidosis
#7
Raylene Kwok, Shoshana Sztal-Mazer, Ria E Hopkins, Susan G Poole, Louise Grannell, John Coutsouvelis, Duncan J Topliss
This study evaluates the clinical efficacy and safety of NovoRapid (insulin aspart) compared to Actrapid™ (human neutral insulin) for diabetic ketoacidosis (DKA). In this retrospective study involving 40 patients, no statistically significant differences were observed between biochemical variables, infusion duration or complications in patients treated with insulin aspart or human neutral insulin. These results support the use of insulin aspart as an effective and safe alternative to human neutral insulin in DKA...
November 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29101821/pharmacodynamics-and-pharmacokinetics-of-insulin-aspart-assessed-by-use-of-the-isoglycemic-clamp-method-in-healthy-cats
#8
H N Pipe-Martin, J M Fletcher, C Gilor, M A Mitchell
The objective of this study was to determine the pharmacodynamics (PD) and pharmacokinetics (PK) of insulin aspart in healthy cats following intramuscular (IM) and subcutaneous (SC) injection. Eight healthy, purpose-bred cats were used in a randomized, crossover study design. Each cat had 2 isoglycemic clamps performed, one after receiving 0.25 IU/kg of insulin aspart by IM injection and one after receiving the same dose by SC injection. The two isoglycemic clamps were performed on different days, at least 48 h apart...
September 21, 2017: Domestic Animal Endocrinology
https://www.readbyqxmd.com/read/29081625/sodium-glucose-transporter-2-inhibitors-and-diabetic-ketoacidosis-in-three-patients-with-diabetes-underlying-causation
#9
Jordan L Kelley, Matthew Strum, Daniel M Riche, Andrew M Chandler
Sodium glucose transporter 2 inhibitors (SGLT2i) inhibit the reabsorption of glucose in the renal tubules reducing glycemia and increasing glucosuria. The increased glucosuria causes a shift in normal flora and colonization of pathogenic microorganisms leading to an increase in mycotic genital infections. Recent Food and Drug Administration reported cases of diabetic ketoacidosis (DKA) after initiation of SGLT2i probes the question of safety with such agents. The mechanisms of ketoacidosis and the breakdown of lipids are often misunderstood, and blame is placed on lack of insulin or on medications used to treat diabetes...
July 2017: Journal of Pharmacology & Pharmacotherapeutics
https://www.readbyqxmd.com/read/29079259/endoscopic-endonasal-transsphenoidal-drainage-of-a-spontaneous-candida-glabrata-pituitary-abscess-case-report-intraoperative-video
#10
Ben A Strickland, Martin Pham, Joshua Bakhsheshian, John Carmichael, Martin Weiss, Gabriel Zada
Noniatrogenic pituitary abscesses remain a rare clinical entity, and are the indication for surgery in <1% of transsphenoidal approaches. Correct diagnosis of this rare entity is often delayed. Without timely treatment, morbidity and mortality are high. Of the 200 cases reported, less than half have identified a causative organism. We report the second case of a pituitary abscess caused by Candida species, and further provide intraoperative video of endoscopic management of this pathology. A 33-year-old woman presented with headache, hypopituitarism, and vision loss in the setting of diabetic ketoacidosis, and was found to have multiple abscesses in the liver, lung, kidney, and uterus...
October 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29074329/degree-of-ketonaemia-and-its-association-with-insulin-resistance-after-dapagliflozin-treatment-in-type-2-diabetes
#11
S H Min, T J Oh, S-I Baek, D-H Lee, K M Kim, J H Moon, S H Choi, K S Park, H C Jang, S Lim
BACKGROUND: Euglycaemic ketoacidosis has been reported after sodium-glucose cotransporter 2 (SGLT2) inhibitor treatment. However, the degree of ketonaemia and its metabolic effects have not been well investigated. Our study examined the degree of ketonaemia induced by SGLT2 inhibition and its association with metabolic profiles in type 2 diabetes mellitus (T2DM). METHODS: Biochemical parameters, including insulin, glucagon, free fatty acid (FFA), β-hydroxybutyrate (BHB) and acetoacetate (ACA) levels, were measured in 119 T2DM patients after dapagliflozin treatment for>3 months, and compared with a matched control group...
October 23, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29073302/potential-clinical-benefits-of-a-two-bag-system-for-fluid-management-in-pediatric-intensive-care-unit-patients-with-diabetic-ketoacidosis
#12
Jacqueline P Velasco Md, Joshua Fogel PhD, Robert L Levine Md PhD, Peter Ciminera Md, David Fagan Md, Renee Bargman Md
INTRODUCTION: Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM) that requires appropriate treatment with insulin and intravenous fluids. Both one-bag and two-bag systems of fluid management are used to treat pediatric diabetic ketoacidosis. AIM OF THE STUDY: We compare the one-bag and two-bag systems of fluid managementwith regard to incidence of hypoglycemia, serum bicarbonate correction, pH correction and discharge from the pediatric intensive care unit (PICU)...
2017: Pediatric Endocrinology, Diabetes, and Metabolism
https://www.readbyqxmd.com/read/29068709/altered-patterns-of-early-metabolic-decompensation-in-type-1-diabetes-during-treatment-with-a-sglt2-inhibitor-an-insulin-pump-suspension-study
#13
Neha S Patel, Michelle A Van Name, Eda Cengiz, Lori R Carria, Stuart A Weinzimer, William V Tamborlane, Jennifer L Sherr
BACKGROUND: Enthusiasm for the benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2i) as an adjunctive treatment in type 1 diabetes (T1D) has been offset by the possible increased risk of diabetic ketoacidosis (DKA). Since pump-treated T1D patients are susceptible to DKA due to infusion site problems, this study was undertaken to assess how treatment with SGLT2i affects patterns of early metabolic decompensation following suspension of basal insulin. METHODS: Ten T1D participants (age 19-35 years, duration 10 ± 8 years, A1c 7...
November 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29068248/diabetic-ketoacidosis-in-the-cat-recognition-and-essential-treatment
#14
Elke Rudloff
Practical relevance: Diabetic ketoacidosis (DKA) is a not uncommon emergency in both newly diagnosed and poorly regulated diabetic cats. When there is a heightened metabolic rate and energy requirement due to concurrent illness, an increase in the release of glucose counter-regulatory hormones causes insulin receptor resistance, lipolysis, free fatty acid release and ketogenesis. This necessitates not only treatment to eliminate the ketosis and control blood glucose, but also investigation of concurrent illnesses...
November 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/29058835/-diabetes-and-ramadan-consequences-of-fasting-and-practical-aspects-of-management
#15
S Bessemans, N Paquot
A lot of diabetic Muslims choose to fast during Ramadan, despite recommendations that advise some patients to abstain according to established risk factors. Fasting exposes the diabetic subject to acute major complications, including diabetic ketoacidosis and severe hypoglycaemia. Patients with diabetes, therefore, had to benefit from individualized care already before Ramadan, including a risk assessment, a specific education integrating in particular the adaptation of the pharmacological treatment in order to limit the occurrence of these acute complications...
October 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29049584/association-of-insulin-pump-therapy-vs-insulin-injection-therapy-with-severe-hypoglycemia-ketoacidosis-and-glycemic-control-among-children-adolescents-and-young-adults-with-type-1-diabetes
#16
COMPARATIVE STUDY
Beate Karges, Anke Schwandt, Bettina Heidtmann, Olga Kordonouri, Elisabeth Binder, Ulrike Schierloh, Claudia Boettcher, Thomas Kapellen, Joachim Rosenbauer, Reinhard W Holl
Importance: Insulin pump therapy may improve metabolic control in young patients with type 1 diabetes, but the association with short-term diabetes complications is unclear. Objective: To determine whether rates of severe hypoglycemia and diabetic ketoacidosis are lower with insulin pump therapy compared with insulin injection therapy in children, adolescents, and young adults with type 1 diabetes. Design, Setting, and Participants: Population-based cohort study conducted between January 2011 and December 2015 in 446 diabetes centers participating in the Diabetes Prospective Follow-up Initiative in Germany, Austria, and Luxembourg...
October 10, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29039237/sglt2-inhibitors-are-they-safe
#17
Sebastian Filippas-Ntekouan, Theodosios D Filippatos, Moses S Elisaf
Sodium-glucose linked transporter type 2 (SGLT2) inhibitors are a relatively new class of antidiabetic drugs with positive cardiovascular and kidney effects. The aim of this review is to present the safety issues associated with SGLT2 inhibitors. Urogenital infections are the most frequently encountered adverse events, although tend to be mild to moderate and are easily manageable with standard treatment. Although no increased acute kidney injury risk was evident in the major trials, the mechanism of action of these drugs requires caution when they are administered in patients with extracellular volume depletion or with drugs affecting renal hemodynamics...
October 27, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/29034415/a-diabetic-ketoacidosis-in-a-context-of-hyperglycemia-addiction
#18
Guillaume Rousseau, Cristian Palmiere, Vincent Dupont, Marion Verschoore, Caroline Savary, Nathalie Jousset, Clotilde Rougé-Maillart
We herein present a case of a 20-year-old woman who suffered from type I diabetes mellitus and died from a diabetic ketoacidosis in a context of addiction to hyperglycemia. Diabetic ketoacidosis is a lethal complication of insulin-dependent diabetes mellitus, which can result from insulin therapy stoppage. This can occur voluntarily with suicidal intent or involuntarily due to treatment inaccessibility, forgotten injections, or material deficiency. A new possibility is investigated in our case study: hyperglycemia addiction...
October 15, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28994854/alkoholketoacidos-%C3%A3-r-en-v%C3%A3-l-dokumenterad-men-t%C3%A3-mligen-ok%C3%A3-nd-diagnos-m%C3%A3-jlig-orsak-till-d%C3%A3-dsfall-bland-personer-med-alkoholproblem
#19
Jonas Höjer
Alcoholic ketoacidosis - a review A chronic alcoholic with severe metabolic acidosis presents a difficult diagnostic problem in the emergency room. Over and above methanol- and ethylene glycol intoxication, alcoholic ketoacidosis is a common but less recognized etiology. The disorder occurs in alcoholics who have had a recent binge drinking followed by the abrupt cessation of alcohol consumption because of abdominal pain and vomiting, with resulting dehydration, starvation, and then a β-hydroxybutyrate dominated ketoacidosis...
October 3, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28977090/use-of-sglt-2-inhibitors-in-the-treatment-of-type-2-diabetes-mellitus
#20
REVIEW
Leyna Leite Santos, Fernando José Camello de Lima, Célio Fernando de Sousa-Rodrigues, Fabiano Timbó Barbosa
INTRODUCTION: Diabetes mellitus is one of the most common chronic diseases in the world, with high morbidity and mortality rates, resulting in a greatly negative socioeconomic impact. Although there are several classes of oral antidiabetic agents, most of the patients are outside the therapeutic goal range. OBJECTIVE: To review the use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus, focusing on their favorable and unfavorable effects, as well as on cardiovascular profile...
July 2017: Revista da Associação Médica Brasileira
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