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M P De Carolis, G Pinna, C Cocca, S A Rubortone, C Romagnoli, I Bersani, S Salvi, A Lanzone, S De Carolis
BACKGROUND: Infants born at 34 to 36 weeks of gestation (late preterm) are at greater risk for adverse outcomes than those born at 37 weeks of gestation or later. Aim of this paper is to examine risk factors for late preterm births and to investigate the complications of the transition period in late preterm infants (LPIs). METHODS: All consecutive late preterm deliveries, excluded stillbirths, were included. Maternal and neonatal data, need for delivery room resuscitative procedures, temperature at birth (T1) and two hours after the admission (T2) were analyzed in all LPIs stratified by Gestational Age (GA) and divided into three groups (34, 35 and 36 weeks)...
2016: Italian Journal of Pediatrics
Matteo Monami, Sara Aleffi
Diabetes mellitus is one of the most important causes of cardiovascular morbidity and mortality; the incidence of chronic complications of diabetes appears to be closely related to the degree of hyperglycaemia. However, results of clinical trials showed that intensive treatment of hyperglycaemia prevents microvascular complications, but has little or no effect on the incidence of cardiovascular events. Different hypoglycaemic drugs show different effects on cardiovascular risk. However, those trials have shown a neutral effect on cardiovascular mortality...
2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
José Sampaio-Neto, Alcides José Branco-Filho, Luis Sérgio Nassif, André Thá Nassif, Flávia David João De Masi, Daniele Rezende Ximenez
BACKGROUND: Hyperinsulinemic hypoglicemia with severe neuroglycopenic symptoms has been identified as a late and rare complication in patients submitted to Roux-en-Y gastric bypass. However, the potential gravity of its manifestations requires effective treatment of this condition. The absence of treatment makes it necessary to develop more effective clinical or surgical methods. AIM: To present one surgical option to revisional surgery in the treatment of hyperinsulinemic hypoglicemia Methods : The procedure consists in reconstituting alimentary transit through the duodenum and proximal jejunum, while keeping the restrictive part of the gastric bypass...
November 2015: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Félix Ignacio Téllez-Ávila, Gladys Yolanda Acosta-Villavicencio, Carlos Chan, Jorge Hernández-Calleros, Luis Uscanga, Francisco Valdovinos-Andraca, Miguel Ángel Ramírez-Luna
BACKGROUND AND OBJECTIVES: Noninvasive imaging techniques have shown limitations to identify insulinomas. In few studies reported so far, endoscopic ultrasound (EUS) has proven to be able to locate lesions. The aim of this study was to compare the performance of computed tomography versus EUS for the detection of insulinomas. MATERIALS AND METHODS: In a retrospective manner prospectively collected data were analyzed. Patients with hypoglucemia and hyperinsulinemia were included...
January 2015: Endoscopic Ultrasound
Melissa Pitrowsky, Cassia Righy Shinotsuka, Márcio Soares, Jorge Ibrain Figueira Salluh
Glucose control is a major issue in critical care since landmark publications from the last decade leading to widespread use of strict glucose control in the clinical practice. Subsequent trials showed discordant results that lead to several questions and concerns about benefits and risks of implementing an intensive glucose control protocol. In the midst of all recent controversy, we propose that a new glycemic target -150mg/dl) should be aimed. This target glucose level could offer protection against the deleterious effects of hyperglycemia and at the same time keep patient's safety avoiding hypoglicemia...
August 2009: Revista Brasileira de Terapia Intensiva
Martín de Santibañes, Agustín Cristiano, Oscar Mazza, Luis Grossenbacher, Eduardo de Santibañes, Rodrigo Sánchez Clariá, Enrique Sivori, Ricardo García Mónaco, Juan Pekolj
BACKGROUND: The endogenous hyperinsulinemic hypoglicemia syndrome (EHHS) can be caused by an insulinoma, or less frequently, by nesidioblastosis in the pediatric population, also known as non insulinoma pancreatic hypoglycemic syndrome (NIPHS) in adults. The aim of this paper is to show the strategy for the surgical treatment of ehhs. MATERIAL AND METHODS: A total of 19 patients with a final diagnosis of insulinoma or NIPHS who were treated surgically from january 2007 until june 2012 were included...
October 2014: Cirugía Española
Liiljana Baloš, Silvija Sajić, Vera Zdravković
INTRODUCTION: Diabetes mellitus type 1 (T1DM) in children is characterized by unstable course. A significant number of studies shows that introduction to insulin analogues treatment aims towards better control of the disease. OBJECTIVE: The assessment of metabolic control in children with T1DM that were introduced to insulin analogue treatment after many years of treatment with classic (human) insulin. METHODS: The study included 59 patients 2-19 years old (12...
September 2011: Srpski Arhiv za Celokupno Lekarstvo
Alia Ramírez-Camacho, Silvia Meavilla, Natalia Catalán, Alejandra Gutiérrez, Jaume Campistol
INTRODUCTION: Epilepsy is a disease where most patients have a good control with pharmacological antiepileptic treatment. Nevertheless, 25% of the patients have a refractory epilepsy to usual antiepileptic drugs. Ketogenic diet is one of the treatment options for this type of epilepsy. In spite of the increased popularity of it as an antiepileptic treatment, it does not exist an international consensus of its indications and management. AIM: To evaluate the response, tolerance and adverse effects of the patients with refractory epilepsy at our hospital during the last 20 years...
November 1, 2011: Revista de Neurologia
Alicia Martínez, Titania Pasqualini, Mirta Stivel, Juan Jorge Heinrich
Adrenal insufficiency is defined by impaired secretion of adrenocortical hormones. It is classified upon the etiology in primary and secondary. Rapid recognition and therapy of adrenocortical crisis are critical to survival. Patients often have nonspecific symptoms: anorexia, vomiting, weakness, fatigue and lethargy. They are followed by hypotension, shock, hypoglicemia, hyponatremia and hyperkalemia. All patients with adrenal insufficiency require urgent fluid reposition, correction of hypoglycemia and glucocorticoid replacement, in order to avoid serious consequences of adrenal crisis...
April 2010: Archivos Argentinos de Pediatría
D Andronesi, A Andronesi, A Tonea, S Andrei, V Herlea, I Lupescu, C Ionescu-Târgovişte, M Coculescu, S Fica, M Ionescu, C Gheorghe, I Popescu
UNLABELLED: Insulinoma is the most frequent neuroendocrine pancreatic tumor and is the main cause for hypoglicemia due to endogenous hyperinsulinism. We performed an analysis of a clinical series in order to study the clinical and biological spectrum of presentation, the preoperatory imagistic diagnosis and results of the surgical approach. Between 1986-2009, 30 patients with symptoms suggesting an insulinoma were hospitalized in our department. Preoperatory localization of insulinomas was possible in 16 patients...
November 2009: Chirurgia
Ilaria Bo, Nicola Carano, Aldo Agnetti, Bertrand Tchana, Valentina Allegri, Marcello Sommi, Umberto Squarcia
BACKGROUND AND AIM OF THE WORK: Syncope occurs frequently in childhood and adolescence. It generally is benign, but may be a sign of pathology. The purpose of this study is to determine the incidence of syncope in children and adolescents in the Parma area, analyse the frequency of syncope due to cardiac, neurological or metabolic diseases, to identify a diagnostic procedure based on careful review, clinical features, and results of investigations. METHODS: The records of 156 children (age 1 to 18 years, mean age 10...
April 2009: Acta Bio-medica: Atenei Parmensis
Cynthia de Almeida Brandão Meirelles, Maria Inês do Couto Oliveira, Rosane Reis de Mello, Maria Angélica Bonfim Varela, Vânia de Matos Fonseca
The Baby-Friendly Hospital Initiative recommends not giving newborn infants any food or drink other than breast milk unless medically indicated. This study investigated the prevalence and alleged reasons for giving formula supplementation to rooming-in newborns at a Baby-Friendly Hospital. Participants were 300 formula-supplemented, exclusively rooming-in newborns at a Baby-Friendly Hospital in Rio de Janeiro, Brazil. Reasons for formula supplementation were classified as acceptable or unacceptable in accordance with the WHO/UNICEF Baby-Friendly Hospital Initiative guidelines...
September 2008: Cadernos de Saúde Pública
Mônica de A Lima Gabbay
Since Diabetes Control and Complications Trial (DCCT), intensive therapy has been directed at achieving glucose and glycosylated hemoglobin (HbA1c) values as close to normal as possible regarding safety issues. However, hyperglycemia (especially postprandial hyperglycemia) and hypoglicemia continue to be problematic in the management of type 1 diabetes. The objective of associating other drugs to insulin therapy is to achieve better metabolic control lowering postprandial blood glucose levels. Adjunctive therapies can be divided in four categories based on their mechanism of action: enhancement of insulin action (e...
March 2008: Arquivos Brasileiros de Endocrinologia e Metabologia
R Baldelli, G Ettorre, G Vennarecci, G Pasimeni, F Carboni, R Lorusso, A Barnabei, M Appetecchia
Insulin-secreting tumors are the commonest hormone-producing neoplasm of the gastrointestinal tract. They occur with an incidence of 4 cases per million per year. About 10% of them are metastatic and malignant insulinomas very rarely observed in children and in elderly. We report a rare case of very large malignant insulinoma in a 71-year-old woman admitted in our Oncological Institute on October 2005. She presented with fasting hypoglicemia (blood glucose 35 mg/dl) and high serum insulin levels (insulin 115...
December 2007: Journal of Experimental & Clinical Cancer Research: CR
Manoel Reginaldo Rocha de Holanda, Aurea Nogueira de Melo
OBJECTIVE: To determine whether the seizure clinical type is predictive of etiology. METHODS: This is a prospective study from 9 neonatal and pediatric intensive care units. Neonatal seizures were defined clinically as described by Volpe. The seizures etiology was defined by positive clinical date, cranial sonogram and laboratory investigation routinely obtained in all neonates with seizures. Correlation between seizures type and etiologies was determined by Odds ration (OR)...
2005: Acta Cirúrgica Brasileira
Raquel R Costa, Frederico F R Maia, Levimar R Araújo
Persistent Hyperinsulinemic Endogenous hypoglycemia in adults is, in most cases, due to Insulinoma. Nesidioblastosis, a peculiar functional hyperinsulinemia from hypertrophic beta cells, has been described mainly in newborns. This article describes a 34-year-old patient who presented hyperinsulinemic endogenous hypoglycemia clinical and laboratorial situation (Fasting glycemia: 54 mg/dl / Reference Interval (RI): 60-99 mg/dl; Serum insulin: 70.9 mcU/ml / RI: < 29.1 mcU/ml; e C peptide: 7.1 ng/ml / RI: 1...
February 2007: Arquivos Brasileiros de Endocrinologia e Metabologia
Jacek Sein Anand, Zygmunt Chodorowski, Marek Wiśniewski
A 31-year-old female bodybuilder who was admitted to the Clinic because of deep coma and hypoglycaemia was presented. For last six weeks she had been preparing for a competition doing aerobic and anaerobic exercises, ingesting rich-protein and low-carbohydrate diet and administering a low dose of somatotropin every day. Even for the regional competitions there is a need for exact doping check among young athletes. Growth hormone in a small dosage taken together with low-carbohydrate and rich-protein diet can provoke deep hypoglicemia among people who use it for doping purposes...
2005: Przegla̧d Lekarski
Svjetlana Maglajlić, Milos Jesić, Svetislav Necić, Marija Lukac, Sanja Sindjić, Maja Jesić, Dragana Vujović
Persistent hyperinsulinemic hypoglicemia of the neonate is a rare heterogenous disease (clinically, histologically, metabolically and genetically), which is characterized by inadequatly high insuline rates in the presence of severe hypoglicemia. Hyperinsulinism, rather a syndrome than a disease, of which the main metabolic feature is hypoglicemia and decreased concentration of free fatty acids and ketones in serum (insulin inhibits lypolisis and synthesizes ketonic bodies), presents a major diagnostic and therapeutic chalenge...
October 2004: Srpski Arhiv za Celokupno Lekarstvo
Aneta Malinowska-Polubiec, Krzysztof Czajkowski, Agnieszka Sotowska
OBJECTIVES: The aim of the study was to assess mother and fetal outcome in gestational diabetic women. MATERIALS AND METHODS: The study covered 689 patients with gestational diabetes mellitus. All women had been taken care of II Department of Obstetrics and Gynecology Warsaw Medical University in 1997-2001 years. The following parameters were analyzed: the patients ages, past obstetric experience, gestational age of GDM diagnosis, pregnancy complications, delivery course and neonatal outcomes...
October 2003: Ginekologia Polska
A M Gerelli, M A Soares, M A Almeida
This study tries to identify Nursing Diagnoses and Interventions. It was done with a patient who was in critical health condition: multiple organs failure, in an Intensive Care Unit of a general hospital in Porto Alegre. The Case Study was the methodology used. Nursing Diagnoses is described mostly using NANDA Taxonomy. They are: Risk for Aspiration, Disuse Syndrome, Diarrhea, Risk for Infection, Impaired Tissue Integrity; and a Collaborative Problem was identified: Hypoglicemia. We have elaborated 34 Nursing Interventions for those diagnoses...
July 1999: Revista Gaúcha de Enfermagem
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