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Neuropathy and acute renal failure

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https://www.readbyqxmd.com/read/29745916/fournier-s-gangrene-a-rare-complication-of-diabetes-mellitus-case-report
#1
Sh Muharremi
The presented case reports on 54-years old patient with T2 Diabetes mellitus who, due to hypoglycemic episodes on Insulin therapy, was treated with oral anti-hyperglycemic medications. Patient was on hemodialysis due to the stage 5 chronic kidney failure and had various comorbid conditions: arterial hypertension, history of acute myocardial infarction, dilative cardiomyopathy, amaurosis and peripheral neuropathy. Besides his complicated medical history, patient developed an early stage of Fournier's gangrene...
April 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29559406/working-party-approved-by-the-french-society-of-anaesthesia-and-intensive-care-medicine-sfar-and-the-french-society-for-the-study-of-diabetes-sfd
#2
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastroparesis creates a risk of stasis and aspiration of gastric content at induction of anaesthesia requiring the use of a rapid sequence induction technique. Cardiac involvement can be divided into several types...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29341834/improvement-in-overall-survival-with-carfilzomib-lenalidomide-and-dexamethasone-in-patients-with-relapsed-or-refractory-multiple-myeloma
#3
David S Siegel, Meletios A Dimopoulos, Heinz Ludwig, Thierry Facon, Hartmut Goldschmidt, Andrzej Jakubowiak, Jesus San-Miguel, Mihaela Obreja, Julie Blaedel, A Keith Stewart
Purpose In the ASPIRE study of carfilzomib, lenalidomide, and dexamethasone (KRd) versus lenalidomide plus dexamethasone (Rd) in patients with relapsed or refractory multiple myeloma, progression-free survival was significantly improved in the carfilzomib group (hazard ratio, 0.69; two-sided P < .001). This prespecified analysis reports final overall survival (OS) data and updated safety results. Patients and Methods Adults with relapsed multiple myeloma (one to three prior lines of therapy) were eligible and randomly assigned at a one-to-one ratio to receive KRd or Rd in 28-day cycles until withdrawal of consent, disease progression, or occurrence of unacceptable toxicity...
January 17, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29276608/lithium-one-drug-five-complications
#4
Jeremy Zaworski, Pierre-Yves Delannoy, Nicolas Boussekey, Damien Thellier, Hugues Georges, Olivier Leroy
Background: Lithium poisoning could trigger multiple complications. We report the case of a lithium poisoning with five complications that are described for the first time together. Case report: A 60-year-old woman was admitted in our intensive care unit for altered consciousness. Severe lithium intoxication was diagnosed (lithium plasmatic level 8.21 mmol/l) associated with acute oliguric kidney failure. Continuous renal replacement therapy was started immediately...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29232246/the-role-of-fdg-pet-in-diabetic-myonecrosis-a-rare-and-underrecognized-complication-of-diabetes
#5
Guillaume Chaussé, Gad Abikhzer
A 66-year-old man with poorly controlled type 2 diabetes was admitted for acute bilateral calf pain in the context of coronary artery disease, chronic renal failure, and peripheral neuropathy. Lower-extremity Doppler ultrasound excluded deep vein thrombosis. FDG-PET was performed to exclude a suspected infection because of elevated white blood cells and inflammatory markers but normal creatinine kinase levels. PET scan demonstrated intense bilateral calf muscle and left thigh muscle uptake, which in combination with the patient's history was consistent with diabetic myonecrosis, a rare end-stage complication of diabetes...
February 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28944153/sequential-development-of-non-arteritic-anterior-ischemic-optic-neuropathy-in-a-patient-on-hemodialysis
#6
Mukesh Jain, Renuka Srinivasan, K Ramesh Babu, M Swapnil Parchand
Purpose: Non-arteritic anterior ischemic optic neuropathy (NA-AION) is typically a disorder of patients 50 years and older predisposed to the vascular and structural optic disc risk factors. We present an interesting case of sequential development of NA-AION in a 45-year-old patient with end-stage renal disease undergoing hemodialysis. Methods: Observational case report. Results: A 45-year-old female on hemodialysis for chronic renal failure complained of sequential acute onset sudden painless gross diminution of vision in right eye followed by the left eye...
2017: GMS Ophthalmology Cases
https://www.readbyqxmd.com/read/28779862/neurological-complications-of-renal-disease
#7
REVIEW
Jorge H Baluarte
Neurological manifestations related to electrolyte disorders, drug toxicity, and uremia are common in chronic kidney disease (CKD). Seizures and coma are frequent complications of acute renal insufficiency (uremia), whereas peripheral neuropathy and encephalopathy, observed in progressive uremia, are terminal events. Failure to excrete metabolic products causes their accumulation and can lead to severe intoxication. Clinically, the signs and symptoms of uremia can vary widely, depending on the biological characteristics of the patient, the specific type of renal disease, and the time of the uremic intoxication...
February 2017: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/27982422/update-review-of-the-acute-porphyrias
#8
REVIEW
Penelope E Stein, Michael N Badminton, David C Rees
Acute porphyrias are rare inherited disorders due to deficiencies of haem synthesis enzymes. To date, all UK cases have been one of the three autosomal dominant forms, although penetrance is low and most gene carriers remain asymptomatic. Clinical presentation is typically with acute neurovisceral attacks characterised by severe abdominal pain, vomiting, tachycardia and hypertension. Severe attacks may be complicated by hyponatraemia, peripheral neuropathy sometimes causing paralysis, seizures and psychiatric features...
February 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/27583583/predictive-model-for-estimating-the-cost-of-incident-diabetes-complications
#9
Jia Zhu, Peter Kahn, Janine Knudsen, Sanjeev N Mehta, Robert A Gabbay
BACKGROUND: The cost of diabetes care accounts for a significant proportion of healthcare expenditures. Cost models based on updated incident complication rates and associated costs are needed to improve financial planning and quality assessment across the U.S. healthcare system. We developed a cost model using published data to estimate the direct medical costs of incident diabetes-related complications in a U.S. population of adults. MATERIALS AND METHODS: A systematic literature review of MEDLINE, EMBASE, and TRIP databases was conducted on studies reporting the incidence and/or cost of diabetes-related complications (cardiovascular disease, neuropathy, nephropathy, ophthalmological disease, and acute metabolic events)...
October 2016: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/26921807/beyond-what-the-eye-can-see
#10
REVIEW
Kate E Ahmad, Clare L Fraser, Carolyn M Sue, Jason J S Barton
A 45-year-old woman presented with acute sequential optic neuropathy resulting in bilateral complete blindness. No significant visual recovery occurred. Past medical history was relevant for severe preeclampsia with resultant renal failure, diabetes mellitus, and sudden bilateral hearing loss when she was 38 years old. There was a family history of diabetes mellitus in her mother. Testing for common causes of bilateral optic neuropathy did not reveal a diagnosis for her illness. The maternal and personal history of diabetes and deafness prompted testing for mitochondrial disease...
September 2016: Survey of Ophthalmology
https://www.readbyqxmd.com/read/26615382/diagnosing-mitochondrial-disorder-without-sophisticated-means
#11
Josef Finsterer, Marlies Frank
Mitochondrial disorders (MIDs) require biochemical or genetic investigations for being diagnosed. In some cases, however, the diagnosis can be suspected upon the syndromic phenotype or upon clinical presentation and family history, as in the following case. The patient was a 74-year-old male admitted for worsening of pre-existing left-sided ptosis and ophthalmoparesis after a birthday party. The history was positive for arterial hypertension, hypertrophic cardiomyopathy with systolic dysfunction, diabetes-type 2, mild renal insufficiency, thyroiditis, and polyneuropathy...
October 2015: Acta Medica Iranica
https://www.readbyqxmd.com/read/26558370/ertapenem-induced-acute-reversible-peripheral-neuropathy-in-chronic-kidney-disease-3-case-reports
#12
Ekrem Kara, Osman Zikrullah Sahin, Teslime Ayaz, Safak Yildirim, Tuncay Sahutoglu, Ahmet Tufekci
BACKGROUND: Ertapenem is a broad-spectrum and long-acting carbapenem which is predominantly eliminated by the kidneys, and it requires dose adjustment in renal failure. Although it is known that excessive doses of ertapenem can cause neurotoxicity, there are very few case reports of ertapenem-induced reversible peripheral neuropathy in the literature when used with renal adjusted doses. STUDY DESIGN AND METHODS: We report 3 patients with a history of stage 4 or 5 chronic kidney disease (CKD) who developed acute reversible peripheral neuropathy proven with electroencephalography (EEG) and electromyography (EMG)...
December 2015: Clinical Nephrology
https://www.readbyqxmd.com/read/26538786/bilateral-abducent-palsy-in-leptospirosis-an-eye-opener-to-a-rare-neuro-ocular-manifestation-a-case-report
#13
Mahadevaiah Mahesh, Mamatha Shivanagappa, Chilkunda Raviprakash Venkatesh
Leptospirosis, a disease of great significance in tropical countries, presents commonly as a biphasic illness with acute febrile episode in the first phase followed by a brief afebrile period and then by the second phase of fever with or without jaundice and renal failure. However, it has varied manifestations and unusual clinical features ascribed to immunological phenomena can occur due to the additional involvement of pulmonary, cardiovascular, and neurological systems. Among the various neurological features, aseptic meningitis is the most common myeloradiculopathy, myelopathy, cerebellar dysfunction, transverse myelitis, Guillain-Barre syndrome, optic neuritis, peripheral neuropathy hare also described...
November 2015: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/26281892/kidney-brain-crosstalk-in-the-acute-and-chronic-setting
#14
REVIEW
Renhua Lu, Matthew C Kiernan, Anne Murray, Mitchell H Rosner, Claudio Ronco
Patients with kidney disease often exhibit multiple organ dysfunction that is caused, in part, by marked connectivity between the kidney and other organs and tissues. Substantial crosstalk occurs between the kidney and the brain, as indicated by the frequent presentation of neurological disorders, such as cerebrovascular disease, cognitive impairment, and neuropathy during the natural history of chronic kidney disease. The underlying pathophysiology of such comorbid neurological disorders in kidney disease is governed by shared anatomic and vasoregulatory systems and humoral and non-humoral bidirectional pathways that affect both the kidney and the brain...
December 2015: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/26229472/acute-multiple-focal-neuropathies-and-delayed-postanoxic-encephalopathy-after-alcohol-intoxication
#15
Wei-Che Wang, Hsiu-Chun Yang, Yao-Jen Chen
Acute-onset alcohol-associated neuropathy is only occasionally reported, and delayed postanoxic encephalopathy is rare. Here, we report a male who developed acute multiple focal neuropathies and later delayed postanoxic encephalopathy after alcohol intoxication. He had hypoxia and rhabdomyolysis, presenting with acute renal failure initially, and cardiopulmonary support, including mechanical ventilation, led to improvement of the patient at the acute stage. He suffered from bilateral hand numbness and mild weakness of the right lower limb thereafter...
2015: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/26005946/-rhabdomyolysis-from-gabapentin-a-case-report
#16
Daniela Falconi, Fabio Tattoli, Carlo Brunetti, Ornella De Prisco, Maurizio Gherzi, Federico Marazzi, Marita Marengo, Ilaria Serra, Michela Tamagnone, Marco Formica
Gabapentin (GBP) is a drug with different indications.Is not metabolized and is excreted by the kidney. The common side effects are: arthralgia, myalgia, fatigue, dizziness and ataxia. Rhabdomyolysis is an extremely rare side effect. This latter, that can be caused by trauma, strenuous exercise, infections, drugs and toxins, is a syndrome characterized by loss of skeletal muscle resulting in the release of myocyte components in the circulation. Following a case of rhabdomyolysis caused by GBP in patient with chronic renal failure (CRF)...
March 2015: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/25849583/paraptosis-cell-death-induction-by-the-thiamine-analog-benfotiamine-in-leukemia-cells
#17
Naomi Sugimori, J Luis Espinoza, Ly Quoc Trung, Akiyoshi Takami, Yukio Kondo, Dao Thi An, Motoko Sasaki, Tomohiko Wakayama, Shinji Nakao
Benfotiamine is a synthetic thiamine analogue that stimulates transketolase, a cellular enzyme essential for glucose metabolism. Currently, benfotiamine is used to treat diabetic neuropathy. We recently reported that oral benfotiamine induced a temporary but remarkable recovery from acute myeloid leukemia in an elderly patient who was ineligible for standard chemotherapy due to dementia and renal failure. In the present study we present evidences that benfotiamine possess antitumor activity against leukemia cells...
2015: PloS One
https://www.readbyqxmd.com/read/25374958/bilateral-psoas-haematomata-complicating-renal-transplantation
#18
Jacob A Akoh, Tahawar A Rana, Daniel Higgs
Background. The challenge in managing patients undergoing renal transplantation is how to achieve optimum levels of anticoagulation to avoid both clotting and postoperative bleeding. We report a rare case of severe postoperative retroperitoneal bleeding including psoas haematomata complicating renal transplantation. Case Report. SM, a 55-year-old female, had a past history of aortic valve replacement, cerebrovascular event, and thoracic aortic aneurysm and was on long-term warfarin that was switched to enoxaparin 60 mg daily a week prior to her living donor transplantation...
2014: Surgery Research and Practice
https://www.readbyqxmd.com/read/25332554/pure-motor-axonal-neuropathy-organomegaly-impaired-glucose-tolerance-m-protein-skin-changes-multiple-plasmacytomas-acute-interstitial-nephritis-in-osteolytic-myeloma-beyond-poems
#19
Partha Pal, Sayantan Ray, Pradipta Guha, Sisir Kumar Patra, Kaushik Kumar Das
The authors describe a case of 52-year-old male who presented with sudden onset deterioration of weakness of both lower limbs and retention of urine. He had 1 month history of gradually progressive weakness of legs. On examination, there were lower motor neuron signs in lower extremity, digital clubbing and a lump over left iliac fossa. Routine blood tests showed impaired glucose tolerance, confirmed by oral glucose tolerance test while renal parameters were normal. Magnetic resonance imaging of spine documented osteolytic lesions, long segment epidural mass in thoracic spine and a mass overlying the left iliac bone, both were revealed to be plasmacytoma following cytology...
September 2014: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/25307332/profile-and-long-term-prognosis-of-glucose-tight-control-in-intensive-care-unit-patients-a-cohort-study
#20
Márcia Inês Boff, Márcio Pereira Hetzel, Daniele Munaretto Dallegrave, Roselaine Pinheiro de Oliveira, Claúdia da Rocha Cabral, Cassiano Teixeira
OBJECTIVES: Stress-induced hyperglycemia is frequent in critically ill patients and has been associated with increased mortality and morbidity (both in diabetic and non-diabetic patients). This study objective was to evaluate the profile and long-term prognosis of critically ill patients undergoing tight glucose-control. METHODS: Prospective cohort. All patients admitted to the intensive care unit over 1-year were enrolled. We analyzed demographic data, therapeutic intervention, and short- (during the stay) and long-term (2 years after discharge) mortality...
December 2009: Revista Brasileira de Terapia Intensiva
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