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Ketoacidosis in childs

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https://www.readbyqxmd.com/read/30285427/urine-metabolic-signatures-of-multiple-environmental-pollutants-in-pregnant-women-an-exposome-approach
#1
Léa Maitre, Oliver Robinson, David Martinez, Mireille B Toledano, Jesús Ibarluzea, Loreto Santa Marina, Jordi Sunyer, Cristina M Villanueva, Hector C Keun, Martine Vrijheid, Muireann Coen
Exposure to environmental pollutants, particularly during pregnancy, can have adverse consequences on child development but little is known about the effects of pollutant mixtures on endogenous metabolism in pregnant women. We aimed to identify urinary metabolic signatures associated with low level exposure to multiple environmental pollutants in pregnant women from the INMA (INfancia y Medio Ambiente) birth cohort (Spain, N = 750). 35 chemical exposures were quantified in first trimester blood samples (organochlorine pesticides, PCBs, PFAS), in cord blood (mercury), and twice in urine at 12 and 32 weeks of pregnancy (metals, phthalates, bisphenol A)...
October 30, 2018: Environmental Science & Technology
https://www.readbyqxmd.com/read/30217366/a-mixed-method-approach-to-understanding-the-factors-surrounding-delayed-diagnosis-of-type-one-diabetes
#2
TeriSue Smith-Jackson, Mary V Brown, Matthew Flint, Merilee Larsen
AIMS: This study examined delayed type one diabetes (T1D) diagnosis, along with the associated severity markers, in the United States. Qualitative reflection was explored to add depth of understanding. METHODS: 975 parents of a minor child with T1D were recruited through snowball, social media requests to complete a 55-question online survey on the experience of diagnosis. RESULTS: 34% of children with T1D had a delayed diagnosis. When compared to those without a delayed diagnosis, these children were more likely to have an Emergency Room diagnosis (39...
November 2018: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/30130252/successful-treatment-of-life-threatening-severe-metabolic-acidosis-by-continuous-veno-venous-hemodialysis-in-a-child-with-diabetic-ketoacidosis
#3
Osman Yesilbas, Ela Cem, Emine Ayca Cimbek
No abstract text is available yet for this article.
August 21, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/30033649/effectiveness-of-continuous-subcutaneous-insulin-infusion-on-parental-quality-of-life-and-glycemic-control-among-children-with-t1d-meta-analysis
#4
REVIEW
Anita Yuk-Ling Li, Winnie Kwok-Wei So, Doris Yin-Ping Leung
BACKGROUND: Type 1 diabetes (T1D) is one of the most common chronic diseases in childhood. Daily diabetes management poses a major challenge for parents. Intensive insulin therapy using continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) are recommended for patients with T1D, but evidence for their effectiveness on parental quality of life (QOL) and glycemic control among children with T1D is inconclusive. OBJECTIVES: A systematic review was conducted to determine the best available evidence regarding the effectiveness of CSII compared to MDI on parental QOL and glycemic control among children with T1D...
October 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29958183/diazoxide-toxicity-in-a-child-with-persistent-hyperinsulinemic-hypoglycemia-of-infancy-mixed-hyperglycemic-hyperosmolar-coma-and-ketoacidosis
#5
Pragya Mangla, Khalid Hussain, Sian Ellard, Sarah E Flanagan, Vijayalakshmi Bhatia
BACKGROUND: Persistent hyperinsulinemic hypoglycemia of infancy (PHHI), also known as congenital hyperinsulinism, has been known to go into spontaneous remission, with patients developing diabetes in later life. A temporary phase of hyperglycemia is, however, rarely reported. CASE PRESENTATION: We describe a 16-month-old child, a known case of diazoxide responsive PHHI, presenting with mixed hyperglycemic hyperosmolar coma and ketoacidosis with rhabdomyolysis while on diazoxide treatment...
August 28, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29922355/ischaemic-haemorrhagic-stroke-in-a-child-with-new-onset-type-1-diabetes-mellitus
#6
Noor Shafina Mohd Nor, Choong Yi Fong, Kartini Rahmat, Wan Mun Vanessa Lee, Azriyanti Anuar Zaini, Muhammad Yazid Jalaludin
Cerebral oedema is the most common neurological complication of diabetic ketoacidosis (DKA). However, ischaemic and haemorrhagic brain injury has been reported infrequently. A 10-year old girl who was previously well presented with severe DKA. She was tachycardic with poor peripheral perfusion but normotensive. However, two fast boluses totalling 40 ml/kg normal saline were given. She was transferred to another hospital where she was intubated due to drowsiness. Rehydration fluid (maintenance and 48-hour correction for 7...
April 2018: European Endocrinology
https://www.readbyqxmd.com/read/29897851/clinical-trial-of-fluid-infusion-rates-for-pediatric-diabetic-ketoacidosis
#7
RANDOMIZED CONTROLLED TRIAL
Nathan Kuppermann, Simona Ghetti, Jeff E Schunk, Michael J Stoner, Arleta Rewers, Julie K McManemy, Sage R Myers, Lise E Nigrovic, Aris Garro, Kathleen M Brown, Kimberly S Quayle, Jennifer L Trainor, Leah Tzimenatos, Jonathan E Bennett, Andrew D DePiero, Maria Y Kwok, Clinton S Perry, Cody S Olsen, T Charles Casper, J Michael Dean, Nicole S Glaser
BACKGROUND: Diabetic ketoacidosis in children may cause brain injuries ranging from mild to severe. Whether intravenous fluids contribute to these injuries has been debated for decades. METHODS: We conducted a 13-center, randomized, controlled trial that examined the effects of the rate of administration and the sodium chloride content of intravenous fluids on neurologic outcomes in children with diabetic ketoacidosis. Children were randomly assigned to one of four treatment groups in a 2-by-2 factorial design (0...
June 14, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29852520/a-longitudinal-observational-study-examining-the-relationships-of-patient-satisfaction-with-services-and-mental-well-being-to-their-clinical-course-in-young-people-with-type-1-diabetes-mellitus-during-transition-from-child-to-adult-health-services
#8
S Gray, T Cheetham, H McConachie, K D Mann, J R Parr, M S Pearce, A Colver
AIM: We hypothesized that participant well-being and satisfaction with services would be positively associated with a satisfactory clinical course during transition from child to adult health care. METHODS: Some 150 young people with Type 1 diabetes mellitus from five diabetes units in England were recruited to a longitudinal study of transition. Each young person was visited at home four times by a research assistant; each visit was 1 year apart. Satisfaction with services (Mind the Gap; MTG) and mental well-being (Warwick-Edinburgh Mental Well-being Scale; WEMWBS) were captured...
May 31, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29784696/why-are-we-failing-to-address-the-issue-of-access-to-insulin-a-national-and-global-perspective
#9
David Beran, Irl B Hirsch, John S Yudkin
Insulin was discovered in 1921 and soon became widely available in high-income countries. However, many people currently in need of this life-saving medicine are unable to access it. This is a global phenomenon, impacting not only populations of low- and middle-income countries but low-income populations in the U.S. In the U.S., the rate of diabetic ketoacidosis remains high in certain subpopulations, the cost of insulin being the main precipitating factor. On a global level the main cause of mortality for a child with type 1 diabetes is a lack of access to insulin, and in sub-Saharan Africa the life expectancy of a child with type 1 diabetes can be as low as 1 year...
June 2018: Diabetes Care
https://www.readbyqxmd.com/read/29531931/thrombotic-thrombocytopenic-purpura-in-a-child-with-diabetic-ketoacidosis
#10
Neda Mostofizadeh, Serajaddin Arefnia, Mahin Hashemipour, Elham Hashemi Dehkordi
Thrombotic thrombocytopenic purpura (TTP) secondary to diabetic ketoacidosis has been rarely reported and is considered as a rare complication. If left untreated, this condition could be life threatening with considerable morbidity and mortality. Herein, we report a 6-year-old girl with reduced consciousness and respiratory distress with a history of polydipsia and polyuria in the 2 weeks before hospitalization. The patient was initially diagnosed as diabetic ketoacidosis based on clinical and laboratory findings and treated accordingly...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29500601/clinical-study-of-pregnancy-associated-fulminant-type-1-diabetes
#11
COMPARATIVE STUDY
Lan Liu, Wenjuan Jia, Ruike Liu, Jie Shen
BACKGROUND: Studies reported that fulminant type 1 diabetes (fT1DM) can occurred during pregnancy or within 2 weeks after delivery, and was defined as pregnancy-associated fulminant type 1 diabetes (PF). In PF patients, plasma glucose (PG) levels have an abrupt rise while glycated hemoglobin (HbA1C ) levels are not markedly elevated, resulting in a sharply increased PG/HbA1C ratio. METHODS: We studied 30 PF patients, 21 non-pregnant fulminant type 1 diabetes (NPF) patients, and 26 female patients of child-bearing age (13-49 years) with diabetic ketoacidosis (DKA), all from China...
May 2018: Endocrine
https://www.readbyqxmd.com/read/29217500/peripheral-neuropathy-as-a-complication-of-diabetic-ketoacidosis-in-a-child-with-newly-diagnosed-diabetes-type-1-a-case-report
#12
Marta Baszyńska-Wilk, Marta Wysocka-Mincewicz, Anna Świercz, Jolanta Świderska, Magdalena Marszał, Mieczysław Szalecki
Neurological complications of diabetic ketoacidosis are considered to be a serious clinical problem. The most common complication is cerebral edema. However, these neurological complications also include less common entities such as ischemic or hemorrhagic stroke, cerebral venous and sinus thrombosis or peripheral neuropathy. We present a case of a 9-year old girl admitted to our intensive care unit with new onset type 1 diabetes, diabetic ketoacidosis, cerebral edema, multifocal vasogenic brain lesions and bilateral lower limb peripheral paresis...
July 31, 2018: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/29212386/efficacy-and-safety-of-sotagliflozin-in-treating-diabetes-type-1
#13
REVIEW
Marc S Rendell
Sotagliflozin is the first dual SGLT1/SGLT2 inhibitor developed for use in diabetes. Sotagliflozin blocks SGLT2 in the kidneys and SGLT1 in the intestines resulting in reduced early phase glucose absorption and increased blood levels of GLP-1 and PYY. Urinary glucose excretion is lower than with other agents as a result of decreased glucose absorption. The primary development effort to date has been in Type 1 diabetes. Areas covered: The published information on sotagliflozin is reviewed, along with the recent results of several pivotal Type 1 diabetes trials...
February 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29181745/salicylate-intoxication-in-an-infant-a-case-report
#14
Rita Espírito Santo, Sara Vaz, Filipa Jalles, Leonor Boto, Francisco Abecasis
In children, the most common cause of an elevated anion gap (AG) with ketonemia, ketonuria, hyperglycemia, and glycosuria is diabetic ketoacidosis. However, when the clinical history is not clear, other causes must be considered. A 9-month-old girl was transferred to our pediatric intensive care unit (PICU) because of severe metabolic acidosis. On admission, she presented with Kussmaul breathing, tachycardia, irritability, and fever. Blood gasses revealed metabolic acidosis with superimposed respiratory alkalosis and elevated AG...
November 27, 2017: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/29156484/-perioperative-intravenous-fluid-therapy-in-children
#15
Robert Sümpelmann
The objective of this consensus-based S1 Guideline for perioperative fluid therapy in children is to maintain or re-establish the child's homeostasis. Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. For the intraoperative background infusion a physiologically composed balanced isotonic electrolyte solution (BS) with 1 - 2.5% glucose is recommended to maintain normal glucose concentrations and to avoid hyponatremia, hyperchloremia, and lipolysis...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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/28970664/diabetic-ketoacidosis-with-extreme-hypernatremia-in-a-4-year-old-girl
#17
Manish Kumar Arya, Sheikh Minhaj Ahmed, Krishnakumar N Shah, Uma S Ali
A 4-year-old girl admitted with altered mental status, new-onset diabetes mellitus, and diabetic ketoacidosis (DKA) had a rapid rise in serum sodium from 158 mEq/L (corrected sodium 165 mEq/L) at the admission to 204 mEq/L within 18 hours of admission despite standard fluid and insulin therapy recommended for the treatment of DKA. During her illness, she developed arterial and deep vein thrombosis (DVT), bloodstream infection with Candida species, and extensive skin blistering and denudation. The child needed mechanical ventilation, insulin infusion, careful fluid titration to bring down the sodium gradually, and low-molecular weight heparin for her DVT...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28924478/a-rare-cause-of-metabolic-acidosis-ketoacidosis-in-a-non-diabetic-lactating-woman
#18
Gordon Sloan, Amjad Ali, Jonathan Webster
Ketoacidosis occurring during lactation has been described infrequently. The condition is incompletely understood, but it appears to be associated with a combination of increased metabolic demands during lactation, reduction in carbohydrate intake and acute illness. We present a case of a 27-year-old woman, 8 weeks post-partum, who was exclusively breastfeeding her child whilst following a low carbohydrate diet. She developed gastroenteritis and was unable to tolerate an oral diet for several days. She presented with severe metabolic acidosis on admission with a blood 3-hydroxybutyrate of 5...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28905317/healthcare-resource-utilization-and-costs-associated-with-ketosis-events-in-pediatric-and-adult-patients-with-type-1-diabetes-mellitus-in-the-uk
#19
Nandu Thalange, Natalie Valerie Jane Aldhouse, Helen Kitchen, Daniel Howard, Deniz Tutkunkardas, Jonas Håkan-Bloch
INTRODUCTION: Ketosis is a metabolic state associated with insulin deficiency. Untreated, it develops into diabetic ketoacidosis, a significant contributor to mortality and morbidity in people with type 1 diabetes mellitus (T1DM). Little is understood about how patients utilize healthcare resources during ketosis events. This study aimed to identify and quantify healthcare resource utilization and provide estimates of associated costs of ketosis events in T1DM, treated unaided or with healthcare professional (HCP) assistance in the UK...
October 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28858101/usefulness-of-end-tidal-carbon-dioxide-as-an-indicator-of-dehydration-in-pediatric-emergency-departments-a-retrospective-observational-study
#20
Hee Won Yang, Woochan Jeon, Young Gi Min, Ji Sook Lee
Physician assessment of hydration status is one of the most important factors in the management of dehydration in the pediatric emergency department (ED). Overestimating dehydration may lead to overtreatment with intravenous fluids or unnecessary hospitalization, whereas underestimation may lead to delayed therapy and aggravation of symptoms. Various methods to estimate hydration status have been proposed, including use of physical findings, body weight, and laboratory results. These methods are subjective, invasive, or inappropriate for application in the ED...
September 2017: Medicine (Baltimore)
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