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Case report a diabetic patient

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https://www.readbyqxmd.com/read/28222414/urinary-steroid-metabolites-in-a-case-of-florid-ectopic-cushing-s-syndrome-and-clinical-correlations
#1
Angelos Kyriacou, Karolina G Stepien, Basil Issa
A 51-year old woman was admitted with multiple cerebral, pulmonary and intra-abdominal abscesses. The combination of apparent immunosuppression, obesity, diabetes mellitus, hypertension, hypokalaemia, osteoporotic fractures and bilateral shoulder avascular necrosis led to a clinical diagnosis of Cushing's syndrome (CS). This was biochemically confirmed as follows: midnight serum cortisol 4275 nmol/L (60-250), non-suppressed overnight dexamethasone suppression test, raised salivary cortisol 716 nmol/L (5-46) and ACTH 639 ng/L (0-46)...
October 2016: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28219414/severe-skull-base-osteomyelitis-caused-by-pseudomonas-aeruginosa-with-successful-outcome-after-prolonged-outpatient-therapy-with-continuous-infusion-of-ceftazidime-and-oral-ciprofloxacin-a-case-report
#2
Cristina Conde-Díaz, Jara Llenas-García, Mónica Parra Grande, Gertrudis Terol Esclapez, Mar Masiá, Félix Gutiérrez
BACKGROUND: Skull base osteomyelitis is an uncommon disease that usually complicates a malignant external otitis with temporal bone involvement. It affects predominantly diabetic and immunocompromised males and has a high mortality rate. Pseudomonas aeruginosa is the most common causative organism. Currently, there is no consensus about the best therapeutic option. Here we describe a case of severe skull base osteomyelitis caused by Pseudomonas aeruginosa with progressive palsy of cranial nerves that was successfully managed with prolonged outpatient continuous infusion of ceftazidime plus oral ciprofloxacin...
February 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28214312/update-treatment-of-necrobiosis-lipoidica
#3
REVIEW
Melanie Peckruhn, Jörg Tittelbach, Peter Elsner
Necrobiosis lipoidica (NL) is a rare granulomatous disease of hitherto unclear etiology frequently seen in patients with diabetes. Characterized by its potential for ulcerations, it often presents a serious burden for those affected. There are currently neither German nor European guidelines for the treatment of NL. At the same time, standard treatment with topical or intralesional corticosteroids does not always show satisfactory results. We therefore set out to evaluate whether the various treatment regimens published since 2000 have actually expanded the therapeutic armamentarium in a relevant manner...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28211788/hemolytic-uremic-syndrome-complicated-by-clostridium-septicum-bacteremia-and-new-onset-type-1-diabetes-mellitus-report-of-a-case%C3%A2
#4
Anna C Iddings, Asha N Shenoi, Alba Morales Pozzo, Stefan G Kiessling
We report the unusual case of a 5-year-old male hospitalized for management of diabetic ketoacidosis (DKA) and new-onset type 1 diabetes mellitus (T1DM) who developed acute renal injury secondary to hemolytic uremic syndrome (HUS). He was diagnosed with Shiga toxin-producing entero-hemorrhagic Escherichia coli (EHEC) 0157:H7-positive HUS 48 hours after being diagnosed with new-onset T1DM/DKA. His hospital course was complicated by Clostridium septicum sepsis with colonic perforation. This patient's diagnosis of new-onset T1DM just prior to HUS is novel...
February 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28211041/a-granulomatous-conundrum-concurrent-necrobiosis-lipoidica-cutaneous-sarcoidosis-and-erythema-nodosum-in-a-nondiabetic-patient
#5
Nishant Valecha, Genevieve Bennett, Leona Yip
Necrobiosis lipoidica (NL) and cutaneous sarcoidosis are granulomatous disorders with a largely unknown aetiopathogenesis. Evidence of co-existing NL and sarcoidosis in the same patient may suggest a degree of overlap between these entities through shared granulomatous inflammatory pathways. Occasionally, one condition can mimic the other, making their distinction difficult. We report a novel case of a non-diabetic woman who presented with concurrent NL, cutaneous sarcoidosis and erythema nodosum. We discuss some of the complexities distinguishing these entities and propose that they may represent different stages of the same granulomatous process linked through yet unknown pathomechanisms...
February 17, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28210522/acute-hyperglycemia-associated-with-psychotic-symptoms-in-a-patient-with-type-1-diabetes-mellitus-a-case-report
#6
Swapnajeet Sahoo, Aseem Mehra, Sandeep Grover
Although psychiatric manifestations in the form of delirium, confusional states, and psychosis have been commonly reported in relation to hypoglycemia, association of hyperglycemia with psychiatric manifestations has been less commonly reported. In this case report, we present the case of a 36-year-old woman suffering from Type 1 diabetes mellitus who developed recurrent episodes of psychosis following poor adherence to her insulin therapy, leading to significantly high levels of blood glucose. Adequate control of blood glucose levels by improving the adherence with insulin led to lack of recurrence of psychosis...
November 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/28210456/severe-odontogenic-infection-an-emergency-case-report
#7
Marcelo Guzmán-Letelier, Claudia Crisosto-Jara, Camilo Diaz-Ricouz, Miguel Peñarrocha-Diago, David Peñarrocha-Oltra
Odontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. However, some OI can spread to vital and deep structures, overcome the host immune system - especially in diabetic, immunocompromised or weakened patients - and even prove fatal. Ludwig's angina is a severe form of diffuse cellulitis that can have an acute onset and spread very rapidly, bilaterally affecting areas of the head and neck, and may prove life threatening...
February 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28206705/erysipelothrix-rhusiopathiae-bloodstream-infection-a-22-year-experience-at-mayo-clinic-minnesota
#8
E M Tan, J R Marcelin, N Adeel, R J Lewis, M J Enzler, P K Tosh
Erysipelothrix rhusiopathiae is a facultatively anaerobic Gram-positive bacillus found mostly in swine, fish and sheep. E. rhusiopathiae classically causes cutaneous eruptions in butchers, fish handlers and veterinarians. Based solely on case reports, 90% of E. rhusiopathiae bloodstream infections (BSI) have been associated with infective endocarditis (IE). To assess the true frequency of IE in E. rhusiopathiae BSI as well as other clinical associations, we performed a retrospective cohort analysis of E...
February 16, 2017: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28202871/the-dramatic-recovery-of-a-patient-with-biguanide-associated-severe-lactic-acidosis-following-thiamine-supplementation
#9
Shigeo Godo, Yoshitaro Yoshida, Motoo Fujita, Daisuke Kudo, Ryosuke Nomura, Hiroaki Shimokawa, Shigeki Kushimoto
Biguanides are a drug of choice for the treatment of type 2 diabetes mellitus. Although they can cause lactic acidosis in susceptible patients with predisposing risk factors, the incidence of lactic acidosis is reported to be very low when they are used properly. We herein present a case of biguanide-associated severe lactic acidosis complicated with thiamine deficiency that was provoked without predisposing factors for thiamine deficiency. Diabetic patients taking biguanide may be predisposed to thiamine deficiency, even when there is no evidence of risk factors, and the high-dose administration of thiamine may be essential in the treatment of this otherwise under-recognized disorder...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28202829/-treatment-strategy-and-results-of-carotid-endarterectomy-in-chronic-renal-failure-patients
#10
Takeo Murahashi, Kenji Kamiyama, Toshiaki Osato, Toshiichi Watanabe, Tatsuya Ogino, Hironori Sugio, Hideki Endo, Kazuki Takahira, Koichiro Shindo, Shuhei Takahashi, Hirohiko Nakamura
INTRODUCTION: The number of patients receiving chronic dialysis treatment in Japan currently exceeds 300,000 people. Few reports have described carotid endarterectomy(CEA)for chronic renal failure patients because of the unacceptable rate of perioperative stroke and other morbidities. A strategy for and treatment results of CEA for chronic renal failure patients in our hospital are described herein. METHODS: The present study included 6 patients who underwent CEA while receiving dialysis treatment between April 2011 and November 2014...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28202297/delayed-onset-diabetic-striatopathy-hemichorea-hemiballism-one-month-after-a-hyperglycemic-episode
#11
Chiu-Jung Lin, Poyin Huang
Diabetic striatopathy is an uncommon and life threatening manifestation of diabetes mellitus. It has a tendency to occur in the elderly, female and people of Asian descent. Patients usually present with hemichorea-hemiballism caused by non-ketotic hyperglycemia. However, patients could develop diabetic striatopathy weeks after the hyperglycemic event, even when blood sugar has been well controlled. Herein, we report a case of delayed onset diabetic striatopathy and discuss the importance of detailed history and brain magnetic resonance imaging for making prompt and accurate diagnosis...
February 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28201828/add-on-exenatide-treatment-is-beneficial-in-poorly-controlled-obese-type-2-diabetics-under-intensive-insulin-regimens
#12
Alper Sönmez, Mustafa Dinç, Abdullah Taşlıpınar, Aydogan Aydoğdu, Coskun Meriç, Yalcin Başaran, Cem Haymana, Orhan Demir, İlker Yılmaz, Ömer Azal
Background: Intensive insulin treatment is bothersome in obese patients with type 2 diabetes mellitus. High insulin dosages further increase weight gain and the risk of hypoglycemia. Glucagon like peptide-1 receptor agonists decrease the insulin need, cause weight loss and reduce the risk of hypoglycemia. There is limited data about the effect of exenatide on obese diabetics under intensive insulin regimens. Methods: This retrospective case series report the clinical outcomes of 23 obese (13 morbidly obese) patients with uncontrolled type 2 diabetes mellitus (Age=59±10...
February 15, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28199805/bariatric-surgery-versus-intensive-medical-therapy-for-diabetes-5-year-outcomes
#13
Philip R Schauer, Deepak L Bhatt, John P Kirwan, Kathy Wolski, Ali Aminian, Stacy A Brethauer, Sankar D Navaneethan, Rishi P Singh, Claire E Pothier, Steven E Nissen, Sangeeta R Kashyap
Background Long-term results from randomized, controlled trials that compare medical therapy with surgical therapy in patients with type 2 diabetes are limited. Methods We assessed outcomes 5 years after 150 patients who had type 2 diabetes and a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 27 to 43 were randomly assigned to receive intensive medical therapy alone or intensive medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy. The primary outcome was a glycated hemoglobin level of 6...
16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28195447/safety-tolerability-and-efficacy-of-lixisenatide-as-monotherapy-in-japanese-patients-with-type-2-diabetes-mellitus-an-open-label-multicenter-study
#14
Yutaka Seino, Yasuo Terauchi, Xiangling Wang, Daisuke Watanabe, Elisabeth Niemoeller
AIM/INTRODUCTION: To assess overall safety of lixisenatide monotherapy in Japanese patients with type 2 diabetes mellitus. MATERIALS AND METHODS: Patients with type 2 diabetes mellitus, previously treated with ≤1 oral antidiabetic drugs, were enrolled in an uncontrolled, open-label, single-arm study over 24 and 52 weeks. Any oral antidiabetic drug treatment was stopped at the start of the 6-week run-in period. From baseline, patients received once-daily lixisenatide monotherapy (10 μg for 1 week, 15 μg for 1 week, 20 μg thereafter) for 52 weeks (first 140 patients enrolled) or 24 weeks (subsequently enrolled patients)...
February 13, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28193286/tropical-diabetic-hand-syndrome-a-case-report
#15
Eugene Vernyuy Yeika, Jacques Cabral Tchoumi Tantchou, Joyce Bei Foryoung, Paul Nkemtendong Tolefac, Derrick Tembi Efie, Siméon Pierre Choukem
BACKGROUND: Tropical diabetic hand syndrome describes a complex hand sepsis affecting patients with diabetes across the tropics and often results from a trivial hand trauma. The clinical presentation of this syndrome is variable and ranges from localised swelling and cellulitis, with or without ulceration of the hand to progressive fulminant hand sepsis, and gangrene affecting the entire limb which may be fatal. Tropical diabetic hand syndrome could lead to permanent disability and death as a result of delay in presentation, late diagnosis and late medical and surgical intervention...
February 13, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28191374/klebsiella-pneumoniae-liver-abscess-a-case-report-and-review-of-literature
#16
Faisal Kamal, George Williams, Hina Akbar, Muhammad Ali Khan, Dipen Kadaria
Klebsiella pneumoniae (K.pneumoniae) is a known cause of pyogenic liver abscess (PLA) in the absence of hepatobiliary disease. In settings of hepatic infection, it has also been known to cause disseminated infections including meningitis and endopthalmitis. Several groups of patients are particularly susceptible to infection, including patients with diabetes mellitus, those from Southeast Asia and those with the preexisting hepatobiliary disease. We present a case of K.pneumoniae PLA with bacteremia. A 39-year-old Vietnamese male with no previous medical history who presented with complaints of abdominal pain, nausea, vomiting, diarrhea and fever...
January 10, 2017: Curēus
https://www.readbyqxmd.com/read/28190720/endarterectomy-versus-stenting-in-patients-with-prior-ipsilateral-carotid-artery-stenting
#17
Isibor J Arhuidese, Besma Nejim, Susruth Chavali, Satinderjit Locham, Tammam Obeid, Caitlin W Hicks, Mahmoud B Malas
OBJECTIVE: In-stent restenosis is a recognized complication of carotid angioplasty and stenting (CAS), and it is associated with an increased risk of stroke. Few case series have reported outcomes separately following carotid endarterectomy (CEA) and CAS for the treatment of in-stent restenosis. In this study, we perform an evaluation of redo-CAS vs CEA in a large contemporary cohort of patients who underwent prior ipsilateral CAS. METHODS: We studied all patients in the Vascular Quality Initiative (VQI) database, who underwent CEA or CAS between January 1, 2003, and April 30, 2016, after prior ipsilateral CAS...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190377/collaborative-approach-to-the-creation-of-an-arteriovenous-fistula-on-a-us-navy-hospital-ship
#18
Kimberly A Thompson, Amrish Krishnan, Charles Stehman, Steven Hanling, Kevin Casey
Early creation of arteriovenous fistulas (AVFs) decreases morbidity and mortality in patients with end-stage renal disease and is the standard of care in the United States. However, this procedure is frequently not accessible in low- and middle-income countries (LMICs). We present the first reported case of successful AVF creation as part of a humanitarian assistance mission. The patient was a 51-year-old male with diabetes, hypertension, and end-stage renal disease on hemodialysis via a temporary dialysis catheter...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28184273/hemoptysis-during-general-anesthesia-in-a-diabetic-patient-with-healed-tuberculosis-a-case-report
#19
Mee Young Chung, Hyeon-Do Jeong, Seul-Gi Kim, Chang Jae Kim
Hemoptysis is a common complication of pulmonary tuberculosis. Most of the cases of hemoptysis originate from hypertrophied bronchial arteries. Also, diabetes induces pulmonary vascular abnormalities such as endothelial dysfunction, inflammatory infiltration and pulmonary vascular remodeling. A 27-year-old male, with diabetes and a history of tuberculosis, underwent the procedure of pars plana vitrectomy under general anesthesia. After an uneventful intra-operative period, he had hemoptysis prior to extubation...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28183578/a-case-of-central-diabetes-insipidus-after-ketamine-infusion-during-an-external-to-internal-carotid-artery-bypass
#20
Sharib Gaffar, Jonathan P Eskander, Burton D Beakley, Brian P McClure, Peter Amenta, Nakeisha Pierre
STUDY OBJECTIVE: We report the first teenage case of ketamine-induced transient central diabetes insipidus. CASE SUMMARY: The patient was an 18-year-old woman with moyamoya disease undergoing an external carotid to internal carotid bypass and given a low-dose ketamine infusion. After approximately 2 hours in the supine position, with 0.5 Minimum Alveolar Concentration (MAC) of sevoflurane, a propofol infusion at 50 μg/kg/min, a remifentanil infusion at 0.5 μg/kg/min, and a ketamine infusion at a dose of 10 μg/kg/min, this patient had an excessive urine output...
February 2017: Journal of Clinical Anesthesia
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