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https://www.readbyqxmd.com/read/27592119/diabetic-ketosis-during-hyperglycemic-crisis-is-associated-with-decreased-all-cause-mortality-in-patients-with-type-2-diabetes-mellitus
#1
Ivan Kruljac, Miroslav Ćaćić, Petra Ćaćić, Vedran Ostojić, Mario Štefanović, Aljoša Šikić, Milan Vrkljan
Patients with type 2 diabetes mellitus have impaired ketogenesis due to high serum insulin and low growth hormone levels. Evidence exists that ketone bodies might improve kidney and cardiac function. In theory, improved ketogenesis in diabetics may have positive effects. We aimed to assess the impact of diabetic ketosis on all-cause mortality in patients with type 2 diabetes mellitus presenting with hyperglycemic crisis. We analyzed 486 patients with diabetic ketosis and 486 age and sex-matched patients with non-ketotic hyperglycemia presenting to the emergency department...
September 3, 2016: Endocrine
https://www.readbyqxmd.com/read/27057898/ventricular-tachycardia-and-resembling-acute-coronary-syndrome-during-pheochromocytoma-crisis-a-case-report
#2
Shi-Jun Li, Tao Wang, Lin Wang, Zhan-Qi Pang, Ben Ma, Ya-Wen Li, Jian Yang, He Dong
Pheochromocytomas are neuroendocrine tumors, and its cardiac involvement may include transient myocardial dysfunction, acute coronary syndrome (ACS), and even ventricular arrhythmias.A patient was referred for evaluation of stuttering chest pain, and his electrocardiogram showed T-wave inversion over leads V1 to V4. Coronary angiography showed 90% stenosis in the mid-left anterior descending coronary artery (LAD), which was stented. Five days later, the patient had ventricular tachycardia, and severe hypertension, remarkable blood pressure fluctuation between 224/76 and 70/50 mm Hg...
April 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27010266/intraperitoneal-dextrose-administration-as-an-alternative-emergency-treatment-for-hypoglycemic-yearling-california-sea-lions-zalophus-californianus
#3
RANDOMIZED CONTROLLED TRIAL
Vanessa A Fravel, William Van Bonn, Frances Gulland, Carlos Rios, Andreas Fahlman, James L Graham, Peter J Havel
The Marine Mammal Center (TMMC) cares for malnourished California sea lion (CSL) (Zalophus californianus) pups and yearlings every year. Hypoglycemia is a common consequence of malnutrition in young CSLs. Administering dextrose during a hypoglycemic crisis is vital to recovery. Traditional veterinary approaches to treat hypoglycemia pose therapeutic challenges in otariids, as vascular access and catheter maintenance can be difficult. The current approach to a hypoglycemic episode at TMMC is to administer dextrose intravenously (i...
March 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/26866521/glucose-control-in-acute-brain-injury-does-it-matter
#4
Daniel A Godoy, Réza Behrouz, Mario Di Napoli
PURPOSE OF REVIEW: Alterations of blood glucose levels are secondary insults with detrimental consequences for the injured brain. Here, we review various aspects of brain glucose metabolism and analyze the evidence on glycemic control during acute brain injury. RECENT FINDINGS: An essential component in the overall management of acute brain injury, especially during the acute phase, is maintaining adequate and appropriate control of serum glucose. This is one of the few physiological parameters that is modifiable...
April 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26862997/a-transient-metabolic-recovery-from-early-life-glucose-intolerance-in-cystic-fibrosis-ferrets-occurs-during-pancreatic-remodeling
#5
Yaling Yi, Xingshen Sun, Katherine Gibson-Corley, Weiliang Xie, Bo Liang, Nan He, Scott R Tyler, Aliye Uc, Louis H Philipson, Kai Wang, Manami Hara, Katie Larson Ode, Andrew W Norris, John F Engelhardt
Cystic fibrosis (CF)-related diabetes in humans is intimately related to exocrine pancreatic insufficiency, yet little is known about how these 2 disease processes simultaneously evolve in CF. In this context, we examined CF ferrets during the evolution of exocrine pancreatic disease. At 1 month of age, CF ferrets experienced a glycemic crisis with spontaneous diabetic-level hyperglycemia. This occurred during a spike in pancreatic inflammation that was preceded by pancreatic fibrosis and loss of β-cell mass...
May 2016: Endocrinology
https://www.readbyqxmd.com/read/26733088/pyruvate-dehydrogenase-activity-is-decreased-in-emergency-department-patients-with-diabetic-ketoacidosis
#6
Lars W Andersen, Katherine M Berg, Sophia Montissol, Christopher Sulmonte, Julia Balkema, Michael N Cocchi, Richard E Wolfe, Ashok Balasubramanyam, Xiaowen Liu, Michael W Donnino
OBJECTIVES: The pyruvate dehydrogenase complex (PDH) is an essential enzyme in aerobic metabolism. Ketones are known to inhibit PDH activity, but the extent of this inhibition is unknown in patients with diabetic ketoacidosis (DKA). METHODS: We enrolled adult patients presenting to the emergency department in hyperglycemic crisis. Patients were classified as DKA or hyperglycemia without ketoacidosis based on laboratory criteria. Healthy controls were also enrolled...
June 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/26554509/autophagy-the-missing-link-in-diabetic-neuropathy
#7
Veera Ganesh Yerra, Chayanika Gundu, Pragna Bachewal, Ashutosh Kumar
Autophagy is a dynamic process which plays an important role in cellular homeostasis through recycling of damaged proteins and organelles. Chronic hyperglycemia associated with diabetes is known to impair the cellular autophagic pathways to a varied extent in some of the diabetic complications. But the role of autophagy driven quality control of proteins and the cellular organelles has been understudied in diabetic complications including neuropathy (DN). The present article hypothesizes that enhancing autophagy in neuronal cells may help them to get rid of bioenergetic crisis, necrosis, apoptosis associated with DN...
January 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/26524498/who-will-deliver-comprehensive-healthy-lifestyle-interventions-to-combat-non-communicable-disease-introducing-the-healthy-lifestyle-practitioner-discipline
#8
Ross Arena, Carl J Lavie, Marie-France Hivert, Mark A Williams, Paige D Briggs, Marco Guazzi
Unhealthy lifestyle characteristics (i.e., physical inactivity, excess body mass, poor diet, and smoking) as well as associated poor health metrics (i.e., dyslipidemia, hyperglycemia, and hypertension) are the primary reasons for the current non-communicable disease crisis. Compared to those with the poorest of lifestyles and associated health metrics, any movement toward improving lifestyle and associated health metrics improves health outcomes. To address the non-communicable disease crisis we must: 1) acknowledge that healthy lifestyle (HL) interventions are a potent medicine; and 2) move toward a healthcare system that embraces primordial as much as, if not more than, secondary prevention with a heavy focus on HL medicine...
2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/26466492/-perioperative-blood-glucose-control-in-patients-with-diabetic-mellitus
#9
Moritoki Egi
Current criteria used for the diagnosis of diabetic mellitus are (1) HbA(1c) level > 6.5% (National Glycohemoglobin Standardization Program certified methods), (2) fasting glucose concentration > 126 mg x dl(-1) (7.0 mmol x l(-1)), (3) 2-h plasma glucose concentration > 200 mg x dl(-1) (11.1 mmol x l(-1)) during an oral glucose tolerance test, or (4) classic symptoms of hyperglycemia or hyperglycemic crisis with a random plasma glucose concentration > 200 mg x dl(-1) (11.1 mmol x l(-1)). It is reported that 15-20% of perioperative patients were with the presence of diabetic mellitus...
September 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26349512/submerged-culture-mycelia-and-broth-of-the-maitake-medicinal-mushroom-grifola-frondosa-higher-basidiomycetes-alleviate-type-2-diabetes-induced-alterations-in-immunocytic-function
#10
Ya-Hui Chen, Chien-Hsing Lee, Tai-Hao Hsu, Hui-Chen Lo
Type 2 Diabetes mellitus (T2DM), a disease with impaired glucose, protein and lipid metabolism, low-grade chronic inflammation, and immune dysfunction, is a global public health crisis. We previously demonstrated that Grifola frondosa has bioactivities in improving glycemic responses in diabetic rats. Herein, we investigated the immunomodulatory effects of the submerged-culture mycelia and broth of G. frondosa on the peripheral blood cells (PBL) and splenocytes. Male Wistar rats were administered with saline (normal rats) or streptozotocin plus nicotinamide (T2DM rats) and were intragastrically administered with placebo, fermented mycelia, broth, or mycelia plus broth (1 g kg-1 day-1) for two weeks...
2015: International Journal of Medicinal Mushrooms
https://www.readbyqxmd.com/read/26273667/recent-trends-in-therapeutic-approaches-for-diabetes-management-a-comprehensive-update
#11
REVIEW
Pragya Tiwari
Diabetes highlights a growing epidemic imposing serious social economic crisis to the countries around the globe. Despite scientific breakthroughs, better healthcare facilities, and improved literacy rate, the disease continues to burden several sections, especially middle and low income countries. The present trends indicate the rise in premature death, posing a major threat to global development. Scientific and technological advances have witnessed the development of newer generation of drugs like sulphonylureas, biguanides, alpha glucosidase inhibitors, and thiazolidinediones with significant efficacy in reducing hyperglycemia...
2015: Journal of Diabetes Research
https://www.readbyqxmd.com/read/25748960/onset-of-reversible-flaccid-quadriplegia-during-treatment-of-thyrotoxic-crisis
#12
Tetsuya Mizokami, Takuko Fukui, Hirofumi Imoto, Hiroki Fujii, Yuichi Sato, Kiyohide Nunoi, Ken Okamura
Two unrelated women were hospitalized for thyrotoxic crisis complicated by multiple organ failure. Both patients were treated with antithyroid drugs and hydrocortisone, as well as insulin for hyperglycemia, and underwent mechanical ventilation with sedation. Flaccid quadriplegia became apparent after each patient completely recovered their level of consciousness once sedation was discontinued on days 6 and 15, respectively. Three to six months of rehabilitation was required for the muscle strength to fully improve in both cases...
2015: Internal Medicine
https://www.readbyqxmd.com/read/25611000/anesthetic-management-of-emergent-laparoscopic-bilateral-adrenalectomy-in-a-patient-with-a-life-threatening-cortisol-crisis
#13
Ankur Sharma, Rajeshwari Subramaniam, Mahesh Misra, Bandi Joshiraj, Gopi Krishnan, Prerna Varma, Shyam Kishore
Cushing syndrome may rarely present with life-threatening hypercortisolism, manifested by hypertension, hypokalemia, hyperglycemia, and edema. If medical treatment proves ineffective in ameliorating the symptoms, emergent rescue adrenalectomy may be the only way to relieve the crisis. We describe the anesthetic management of a patient with an ectopic adrenocorticotropic hormone-secreting tumor, whose condition was rapidly deteriorating due to severe cortisol excess, and emergent adrenalectomy was the only available therapeutic modality...
January 15, 2015: A & A Case Reports
https://www.readbyqxmd.com/read/25177530/physical-activity-and-pre-diabetes-an-unacknowledged-mid-life-crisis-findings-from-nhanes-2003-2006
#14
Kathryn Farni, David A Shoham, Guichan Cao, Amy H Luke, Jennifer Layden, Richard S Cooper, Lara R Dugas
The prevalence of pre-diabetes (PD) among US adults has increased substantially over the past two decades. By current estimates, over 34% of US adults fall in the PD category, 84% of whom meet the American Diabetes Association's criteria for impaired fasting glucose (IFG). Low physical activity (PA) and/or sedentary behavior are key drivers of hyperglycemia. We examined the relationship between PD and objectively measured PA in NHANES 2003-2006 of 20,470 individuals, including 7,501 individuals between 20 and 65 yrs...
2014: PeerJ
https://www.readbyqxmd.com/read/25097323/aldosterone-and-cortisol-co-secreting-bifunctional-adrenal-cortical-carcinoma-a-rare-event
#15
Puskar Shyam Chowdhury, Prasant Nayak, Srinivasan Gurumurthy, Deepak David
Adrenocortical carcinoma (ACC) co-secreting aldosterone and cortisol is extremely rare. We report the case of a 37-yearold female who presented with paresis and facial puffiness. Evaluation revealed hypertension, hyperglycemia, severe hypokalemia and hyperaldosteronemia with elevated plasma aldosterone to renin ratio (ARR). Urinary free cortisol estimation showed elevated levels. Computed tomography scan revealed a right adrenal mass. Radical adrenalectomy specimen revealed ACC (T3N1). Post-operatively, the patient became normotensive and euglycemic with normalization of urinary cortisol and ARR...
July 2014: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/25044235/the-association-of-oxidative-stress-and-pro-inflammatory-cytokines-in-diabetic-patients-with-hyperglycemic-crisis
#16
Juan Li, Minglian Huang, Xingping Shen
AIMS: To investigate the relationship between oxidative stress and serum levels of pro-inflammatory cytokines in diabetic patients with hyperglycemic crisis. METHODS: Seventy-three patients presenting to hospital with diabetic ketoacidosis or non-ketotic hyperglycemia were studied. Superoxide dismutase (SOD) activity, malondialdehyde (MDA) content, total antioxidant capacity (TAC), 8-iso-prostaglandin F2α (8-iso-prostaglandinF2α, 8-iso-PGF2α), tumor necrosis factor receptor-I (TNF-RI), interleukin -1β (IL-1β), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels were measured in all patients...
September 2014: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/24868152/efficacy-of-treatment-for-hyperglycemic-crisis-in-elderly-diabetic-patients-in-a-day-hospital
#17
COMPARATIVE STUDY
D Benaiges, J J Chillarón, M J Carrera, F Cots, J Puig de Dou, E Corominas, J Pedro-Botet, J A Flores-Le Roux, C Claret, A Goday, J F Cano
BACKGROUND: The purpose of this prospective cohort study was to compare the costs of day hospital (DH) care for hyperglycemic crisis in elderly diabetic patients with those of conventional hospitalization (CH). Secondary objectives were to compare these two clinical scenarios in terms of glycemic control, number of emergency and outpatient visits, readmissions, hypoglycemic episodes, and nosocomial morbidity. METHODS: The study population comprised diabetic patients aged >74 years consecutively admitted to a tertiary teaching hospital in Spain for hyperglycemic crisis (sustained hyperglycemia [>300 mg/dL] for at least 3 days with or without ketosis)...
2014: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/24739034/presumptive-cocaine-toxicosis-in-19-dogs-2004-2012
#18
Emily K Thomas, Kenneth J Drobatz, Deborah C Mandell
OBJECTIVE: To characterize the incidence, signalment, presenting complaint, history, clinical signs, diagnostic test results, complications, treatment, length of hospitalization, and outcome of dogs presenting with presumptive cocaine toxicosis. DESIGN: Retrospective study from March 1, 2004 to March 1, 2012. SETTING: Twenty-four hour urban university veterinary teaching hospital. ANIMALS: Nineteen dogs presenting with clinical signs consistent with cocaine toxicosis and having a positive urine cocaine test...
March 2014: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/24738668/changes-in-diabetes-related-complications-in-the-united-states-1990-2010
#19
Edward W Gregg, Yanfeng Li, Jing Wang, Nilka Rios Burrows, Mohammed K Ali, Deborah Rolka, Desmond E Williams, Linda Geiss
BACKGROUND: Preventive care for adults with diabetes has improved substantially in recent decades. We examined trends in the incidence of diabetes-related complications in the United States from 1990 through 2010. METHODS: We used data from the National Health Interview Survey, the National Hospital Discharge Survey, the U.S. Renal Data System, and the U.S. National Vital Statistics System to compare the incidences of lower-extremity amputation, end-stage renal disease, acute myocardial infarction, stroke, and death from hyperglycemic crisis between 1990 and 2010, with age standardized to the U...
April 17, 2014: New England Journal of Medicine
https://www.readbyqxmd.com/read/24282823/the-impact-of-hyperglycemic-emergencies-on-the-kidney-and-liver
#20
Feng Bai, Fang-fang Jiang, Jun-jie Lu, Shao-gang Ma, Yi-gen Peng, Yue Jin, Wei Xu, Jian-ping Cheng, Hai-feng Wu
Studies on the alterations of liver and kidney function parameters in patients with diabetic ketoacidosis (DKA) and diabetic ketosis (DK) were limited. Participants with DKA, DK, non-DK, and healthy controls were enrolled in the current study. Parameters of liver and kidney function were measured and evaluated. The patients with DKA had higher levels of plasma glucose, hemoglobin A1c (HbA1c), uric acid, and creatinine but lower levels of transferases and protein compared with the other three groups (P < 0...
2013: Journal of Diabetes Research
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