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Diabetic coma

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https://www.readbyqxmd.com/read/29922355/ischaemic-haemorrhagic-stroke-in-a-child-with-new-onset-type-1-diabetes-mellitus
#1
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
#2
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/29865917/twenty-four-hour-blood-pressure-variability-plays-a-detrimental-role-in-the-neurological-outcome-of-hemorrhagic-stroke
#3
Huan-Xin Zhang, Qun-Xiong Fan, Shi-Zhen Xue, Min Zhang, Ji-Xian Zhao
Background Blood pressure variability (BPV) is a modifiable risk factor for stroke. This study was performed to determine the prognostic role of BPV in patients with acute hemorrhagic stroke. Methods The data of 131 hospitalized hypertensive patients with spontaneous intracerebral hemorrhage (sICH) were collected. All patients underwent examinations using several neurological scales (Glasgow Coma Scale, National Institutes of Health Stroke Scale, and modified Rankin scale [mRS]) and BP measurements at different time points...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29780121/risk-factors-for-hypoglycemic-coma-a-study-of-33-patients-on-insulin-therapy-who-were-transported-to-the-hospital-by-ambulance
#4
Takashi Otsuka, Yosuke Okada, Keiichi Torimoto, Yoshiya Tanaka
Objective Patients on outpatient insulin therapy are at a high risk of severe hypoglycemia and a high incidence of hypoglycemic coma. However, only a few studies have explored the risk factors for hypoglycemic coma in such patients. We retrospectively analyzed the clinical characteristics of diabetic patients who had developed hypoglycemic coma during outpatient insulin therapy. Methods This study included 33 diabetic patients on insulin therapy who were transported to the hospital by ambulance for severe hypoglycemia...
May 18, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29773640/health-care-utilization-and-burden-of-diabetic-ketoacidosis-in-the-u-s-over-the-past-decade-a-nationwide-analysis
#5
Dimpi Desai, Dhruv Mehta, Priyanka Mathias, Gopal Menon, Ulrich K Schubart
OBJECTIVE: Diabetes is one of the most common chronic diseases and a leading cause of morbidity and mortality in the U.S. Although our ability to treat diabetes and its associated complications has significantly improved, presentation with uncontrolled diabetes leading to ketoacidosis remains a significant problem. RESEARCH DESIGN AND METHODS: We aimed to determine the incidence and costs of hospital admissions associated with diabetic ketoacidosis (DKA). We reviewed the National Inpatient Sample Database for all hospitalizations in which DKA (ICD-9 codes 250...
May 17, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29770221/risperidone-induced-type-2-diabetes-presenting-with-diabetic-ketoacidosis
#6
Clarissa Ern Hui Fang, Mohammed Faraz Rafey, Aine Cunningham, Sean F Dinneen, Francis M Finucane
A 28-year-old male presented with 2 days of vomiting and abdominal pain, preceded by 2 weeks of thirst, polyuria and polydipsia. He had recently started risperidone for obsessive-compulsive disorder. He reported a high dietary sugar intake and had a strong family history of type 2 diabetes mellitus (T2DM). On admission, he was tachycardic, tachypnoeic and drowsy with a Glasgow Coma Scale (GCS) of 10/15. We noted axillary acanthosis nigricans and obesity (BMI 33.2 kg/m2 ). Dipstick urinalysis showed ketonuria and glycosuria...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29732423/predicting-critical-care-unit-level-complications-after-long-segment-fusion-procedures-for-adult-spinal-deformity
#7
Rafael De la Garza-Ramos, Jonathan Nakhla, Yaroslav Gelfand, Murray Echt, Aleka N Scoco, Merritt D Kinon, Reza Yassari
Background: To identify predictive factors for critical care unit-level complications (CCU complication) after long-segment fusion procedures for adult spinal deformity (ASD). Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database [2010-2014] was reviewed. Only adult patients who underwent fusion of 7 or more spinal levels for ASD were included. CCU complications included intraoperative arrest/infarction, ventilation >48 hours, pulmonary embolism, renal failure requiring dialysis, cardiac arrest, myocardial infarction, unplanned intubation, septic shock, stroke, coma, or new neurological deficit...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29685363/fulminant-type-1-diabetes-mellitus-with-remarkable-elevation-of-serum-pancreatic-enzymes
#8
Mikio Nakajima, Masamitsu Shirokawa, Tomotsugu Nakano, Hideaki Goto
Fulminant type 1 diabetes mellitus progresses extremely rapidly and is accompanied by ketoacidosis. Patients with the disease present at emergency departments with non-specific symptoms, including fever, nausea, vomiting, and abdominal pain. Here, we present a case of fulminant type 1 diabetes mellitus where the patient was initially misdiagnosed with gastroenteritis and acute pancreatitis. A 50-year-old Japanese woman was referred to our hospital with coma and shock. She had presented with nausea, vomiting, abdominal pain and thirst from 5 days before admission, and had been misdiagnosed with gastroenteritis by her primary care physician...
April 14, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29672561/rich-table-but-short-life-diffuse-idiopathic-skeletal-hyperostosis-in-danish-astronomer-tycho-brahe-1546-1601-and-its-possible-consequences
#9
Sacha Kacki, Petr Velemínský, Niels Lynnerup, Sylva Kaupová, Alizé Lacoste Jeanson, Ctibor Povýšil, Martin Horák, Jan Kučera, Kaare Lund Rasmussen, Jaroslav Podliska, Zdeněk Dragoun, Jiří Smolík, Jens Vellev, Jaroslav Brůžek
The exhumation of Danish astronomer Tycho Brahe (1546-1601) was performed in 2010 to verify speculative views on the cause of his death. Previous analyses of skeletal and hair remains recovered from his grave refuted the presumption that he died from poisoning. These studies also outlined the possibility that he actually died from an acute illness, echoing the rather vague and inaccurate testimony of some historical records. We performed a detailed paleopathological analysis of Tycho Brahe's skeletal remains, along with a reconstruction of his diet based on carbon and nitrogen stable isotopes analysis and an estimate of his physical status (relative body fat) based on medullar and cortical dimensions of the femoral shaft...
2018: PloS One
https://www.readbyqxmd.com/read/29606344/agraphia-with-reversible-splenial-corpus-callosum-lesion-caused-by-hypoglycemia
#10
Yukari Miyakawa, Tatsuo Fuchigami, Masako Aoki, Yusuke Mine, Junichi Suzuki, Tatsuhiko Urakami, Shori Takahashi
BACKGROUND: Neurological manifestations caused by hypoglycemia range from reversible focal deficits and transient encephalopathy to irreversible coma or death. Recently, high signal intensity lesions in the splenium of the corpus callosum on diffusion-weighted magnetic resonance imaging were reported in adults experiencing hypoglycemia. However, patients presenting with agraphia are rare. SUBJECT AND METHODS: We examined a 17-year-old left-handed female patient with type 1 diabetes who exhibited transient left agraphia with a reversible splenium lesion of the corpus callosum on diffusion-weighted imaging caused by hypoglycemia, which was improved with blood glucose management alone...
March 29, 2018: Brain & Development
https://www.readbyqxmd.com/read/29577222/-establishment-of-comprehensive-prediction-model-of-acute-gastrointestinal-injury-classification-of-critically-ill-patients
#11
Yan Wang, Jianrong Wang, Weiwei Liu, Guangliang Zhang
OBJECTIVE: To develop the comprehensive prediction model of acute gastrointestinal injury (AGI) grades of critically ill patients. METHODS: From April 2015 to November 2015, the binary channel gastrointestinal sounds (GIS) monitor system which has been developed and verified by the research group was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of Chinese PLA General Hospital. Also, the AGI grades (Grande I(-IIII(, the higher the level, the heavier the gastrointestinal dysfunction) were evaluated...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29555548/postoperative-period
#12
(no author information available yet)
Follow on from continuous intravenous administration of insulin with an electronic syringe (IVES) is an important element in the postoperative management of a diabetic patient. The basal-bolus scheme is the most suitable taking into account the nutritional supply and variable needs for insulin, reproducing the physiology of a normal pancreas: (i) slow (long-acting) insulin (=basal) which should immediately take over from IVES insulin simulating basal secretion; (ii) ultra-rapid insulin to simulate prandial secretion (=bolus for the meal); and (iii) correction of possible hyperglycaemia with an additional ultra-rapid insulin bolus dose...
March 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29486630/diabetic-ketoacidosis-among-pregnant-and-non-pregnant-women-a-comparison-of-morbidity-and-mortality
#13
Michelle Rougerie, Nicholas Czuzoj-Shulman, Haim A Abenhaim
PURPOSE: Diabetic ketoacidosis (DKA) is a critical diagnosis that can cause severe morbidity and mortality in the diabetic population. Although it is rare in pregnancy, the aim of this study is to compare DKA in pregnant women with age-matched non-pregnant women to determine if outcomes are influenced by pregnancy. MATERIALS AND METHODS: A population-based age-matched retrospective cohort was carried out using data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 1999 to 2013...
February 27, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29484801/brain-injury-markers-s100-calcium-binding-protein-b-neuron-specific-enolase-and-glial-fibrillary-acidic-protein-in-children-with-diabetic-ketoacidosis
#14
Gönül Çatlı, Ahmet Anık, Sezer Acar, Tuncay Küme, Melike Karabulut, Özlem Gürsoy Çalan, Bumin Nuri Dündar, Ayhan Abacı
BACKGROUND: To investigate serum levels of brain injury markers in diabetic ketoacidosis (DKA) and the relation of these markers with clinical and radiological findings of brain injury and laboratory results. METHODS: Twenty-nine patients with DKA, 30 with type 1 diabetes mellitus (T1DM), and 35 healthy children were included. Clinical and laboratory findings, and the Glasgow Coma Scale (GCS) were recorded. In the DKA group, neuron-specific enolase (NSE), S100 calcium-binding protein B (S100B) and glial fibrillary acidic protein (GFAP) levels were measured at baseline and 6 and 12 hours after treatment...
February 27, 2018: Pediatric Diabetes
https://www.readbyqxmd.com/read/29449530/the-type-2-diabetes-associated-hmg20a-gene-is-mandatory-for-islet-beta-cell-functional-maturity
#15
Jose M Mellado-Gil, Esther Fuente-Martín, Petra I Lorenzo, Nadia Cobo-Vuilleumier, Livia López-Noriega, Alejandro Martín-Montalvo, Irene de Gracia Herrera Gómez, Maria Ceballos-Chávez, Laura Gómez-Jaramillo, Antonio Campos-Caro, Silvana Y Romero-Zerbo, Júlia Rodríguez-Comas, Joan-Marc Servitja, Gemma Rojo-Martinez, Abdelkrim Hmadcha, Bernat Soria, Marco Bugliani, Piero Marchetti, Francisco J Bérmudez-Silva, Jose C Reyes, Manuel Aguilar-Diosdado, Benoit R Gauthier
HMG20A (also known as iBRAF) is a chromatin factor involved in neuronal differentiation and maturation. Recently small nucleotide polymorphisms (SNPs) in the HMG20A gene have been linked to type 2 diabetes mellitus (T2DM) yet neither expression nor function of this T2DM candidate gene in islets is known. Herein we demonstrate that HMG20A is expressed in both human and mouse islets and that levels are decreased in islets of T2DM donors as compared to islets from non-diabetic donors. In vitro studies in mouse and human islets demonstrated that glucose transiently increased HMG20A transcript levels, a result also observed in islets of gestating mice...
February 15, 2018: Cell Death & Disease
https://www.readbyqxmd.com/read/29431405/hyperosmolar-hyperglycemic-state
#16
Gregg D Stoner
Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. Although there are multiple precipitating causes, underlying infections are the most common. Other causes include certain medications, nonadherence to therapy, undiagnosed diabetes mellitus, substance abuse, and coexisting disease. In children and adolescents, hyperosmolar hyperglycemic state is often present when type 2 diabetes is diagnosed. Physical findings include profound dehydration and neurologic symptoms ranging from lethargy to coma...
December 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29405355/cortisol-evaluation-during-the-acute-phase-of-traumatic-brain-injury-a-prospective-study
#17
Meriem Bensalah, Malcolm Donaldson, Yamina Aribi, Malek Iabassen, Lyes Cherfi, Mustapha Nebbal, Meriem Medjaher, ElMehdi Haffaf, Benaissa Abdennebi, Kamel Guenane, Adel Djermane, Zahra Kemali, Samia OuldKablia
BACKGROUND: Biochemical diagnosis of adrenal insufficiency (AI) is difficult in the context of traumatic brain injury (TBI). AIM: To assess the frequency and predictive factors of AI in victims of TBI from Algiers. METHODS: Between November 2009 and December 2013, TBI victims had a single 8-9 am serum cortisol measurement during the acute postinjury period (0-7 days). AI was defined according to basal cortisol levels of 83, 276 and 414 nmol/L...
May 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29400569/the-value-of-the-identification-of-predisposing-factors-for-post-traumatic-amnesia-in-management-of-mild-traumatic-brain-injury
#18
George Fotakopoulos, Demosthenes Makris, Eleni Tsianaka, Polikceni Kotlia, Paulos Karakitsios, Charalabos Gatos, Alkiviadis Tzannis, Kostas Fountas
OBJECT: To identify the risk factors for post-traumatic amnesia (PTA) and to document the incidence of PTA after mild traumatic brain injuries. METHODS: This was a prospective study, affecting mild TBI (mTBI) (Glasgow Coma Scale 14-15) cases attending to the Emergency Department between January 2009 and April 2012 (40 months duration). Patients were divided into two groups (Group A: without PTA, and Group B: with PTA, and they were assessed according to the risk factors...
2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29396187/diabetes-care-and-dementia-among-older-adults-a-nationwide-3-year-longitudinal-study
#19
Matthieu Wargny, Adeline Gallini, Hélène Hanaire, Fati Nourhashemi, Sandrine Andrieu, Virginie Gardette
OBJECTIVES: To compare diabetes monitoring and the incidence of acute diabetic complications between patients with and without incident Alzheimer's Disease and Related Syndromes (ADRS). DESIGN: Longitudinal observational study from 2010 to 2014. SETTING: Data from the French national health system database. PARTICIPANTS: The France-Démence cohort: individuals aged 65 years or older suffering from incident ADRS, based on long-term disease registry, hospitalization for dementia, or antidementia drug delivery...
January 25, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29301583/which-factor-is-the-most-effective-one-in-metabolic-sydrome-on-the-outcomes-after-coronary-artery-bypass-graft-surgery-a-cohort-study-of-5-years
#20
Lijuan Wang, Xiangyang Qian, Mingya Wang, Xinran Tang, Hushan Ao
BACKGROUND: Metabolic Syndrome and diabetes mellitus are risk factors for cardiovascular disease. However, the effects of Metabolic Syndrome with or without diabetes on perioperative and long-term morbidity and mortality after Coronary Artery Bypass Graft remain unclear. METHODS: An retrospective study was performed on 1166 patients who received isolated primary Coronary Artery Bypass Graft in Fuwai hospital. They were divided into three groups: control, Metabolic Syndrome of three factors together with diabetes and Metabolic Syndrome of three factors without diabetes (n = 868, 76 and 222 respectively)...
January 4, 2018: Journal of Cardiothoracic Surgery
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