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Diabetic coma

S Gibiino, A Trappoli, B Balzarro, A R Atti, D De Ronchi
A 71-year-old man developed coma with severe respiratory failure, hypotension, and tachycardia induced by the intentional ingestion of quetiapine fumarate extended release (XR) 20 g. At the time, he had been treated for bipolar depression with venlafaxine 75 mg/day, lamotrigine 100 mg/day, pregabalin 75 mg/day, and quetiapine XR 400 mg/day for approximately 1 year. Comorbidities were hypertension treated with metoprolol, diabetes mellitus type 2 treated with metformin, and benign prostatic hyperplasia treated with silodosin...
December 2015: Drug Saf Case Rep
Cornelius Kürten, Mladen Tzvetkov, Volker Ellenrieder, Harald Schwörer
History and clinical findings | We report about a 79 year old non-diabetic patient who was admitted to the emergency room with severe hypoglycemia (blood glucose level: 36 mg / dl and Glasgow Coma Scale Score: 3). After the infusion of G40 % her blood glucose level stabilised. The patient reported to have taken 50 mg of Tramadol during the night to treat her headache. Investigations and diagnosis | No other differential diagnosis for hypoglycemia (i.e. diabetes, insulinoma, severe liver or kidney disease) could be established...
September 2016: Deutsche Medizinische Wochenschrift
Simin Babaie Kafaki, Kamaledin Alaedini, Ashkan Qorbani, Leila Asadian, Kaveh Haddadi
OBJECTIVES: Management of hyperglycemia during an acute sickness in adults is accompanied by improved outcomes. We have designed a prospective study with meticulous attention to exclude all diabetes patients by checking hemoglobin A1c (HbA1c or glycated hemoglobin) to avoid the ill-effects of hyperglycemia in patients with traumatic head injury admitted to the intensive care unit (ICU). METHODS: This prospective study included adults with traumatic primary brain injury with a Glasgow coma score of ≤8 necessitating mechanical ventilation treated in the period 2012-2015...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
Leonardo Méndez Boo, Ermengol Coma, Manuel Medina, Eduardo Hermosilla, Manuel Iglesias, Carmen Olmos, Sebastian Calero Muñoz, Johanna Caro Mendivelso
BACKGROUND: To determine the effectiveness of reminders compared to no reminders in improving adherence to multiple clinical recommendations measured as the resolution of the clinical condition that motivated the reminder, in a primary care setting with a well-established feedback system. METHODS/DESIGN: A 12-month, cluster-randomized, controlled clinical trial was designed (randomized by primary care team) to evaluate the impact of computerized reminders. All study participants will continue to receive the usual feedback from the electronic health records system...
2016: SpringerPlus
David Krahulik, Darina Aleksijevic, Vratislav Smolka, Eva Klaskova, Petra Venhacova, Miroslav Vaverka, Vladimir Mihal, Jirina Zapletalova
BACKGROUND AND AIMS: Retrospective studies of TBI have found a neuroendocrine dysfunction following traumatic brain injury in 23 to 60% of adults and 15 to 21% of children. Our aims were to determine the prevalence of hypothalamo-hypophyseal dysfunction in children following brain injury, assess its relationship to the type of injury and the course of the acute post-traumatic phase. PATIENTS AND METHODS: Body development (growth, pubertal development, and skeletal maturity) were evaluated in 58 patients (21 girls) after a brain injury rated 3 to 12 on the Glasgow Coma Scale (GCS)...
September 19, 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Severina Haugvik, David Beran, Pamela Klassen, Akhtar Hussain, Ane Haaland
AIMS: To explore and describe perceptions and experiences of living with type 1 Diabetes Mellitus among children/youths in Tajikistan. METHODS: Qualitative methods were employed. Participants were recruited through purposive and snowball samplings. Data were collected using a semi-structured interview guide with children/youths having diabetes, their parents as well as health professionals. Data were analyzed according to Malterud's systematic text condensation...
September 10, 2016: Chronic Illness
Jinlu Yu, Yongjie Yuan, Wei Li, Kan Xu
Multiple simultaneous intracerebral hemorrhages (MSIH) caused by Moyamoya disease (MMD) is extremely rare. To date, the clinical manifestations, imaging characteristics and mechanism of MMD-induced MSIH have not yet been elucidated. In order to improve the understanding on such cases, the present study described a rare case of MSIH caused by MMD. A 40-year-old female patient with no history of hypertension or diabetes mellitus experienced a sudden headache followed by coma. Cranial computed tomography (CT) examination revealed MSIH in the left frontal area, temporal lobe and basal ganglia...
September 2016: Experimental and Therapeutic Medicine
Laura Brugnara, Serafín Murillo, Anna Novials, Gemma Rojo-Martínez, Federico Soriguer, Albert Goday, Alfonso Calle-Pascual, Luis Castaño, Sonia Gaztambide, Sergio Valdés, Josep Franch, Conxa Castell, Joan Vendrell, Roser Casamitjana, Anna Bosch-Comas, Elena Bordiú, Rafael Carmena, Miguel Catalá, Elias Delgado, Juan Girbés, Alfonso López-Alba, Maria Teresa Martínez-Larrad, Edelmiro Menéndez, Inmaculada Mora-Peces, Gemma Pascual-Manich, Manuel Serrano-Ríos, Ramon Gomis, Emilio Ortega
Low physical activity (PA), or sedentary lifestyle, is associated with the development of several chronic diseases. We aimed to investigate current prevalence of sedentariness and its association with diabetes and other cardiovascular risk factors. PA was evaluated in a population-based, cross-sectional, randomly sampled study conducted in 2009-2010 in Spain. International Physical Activity Questionnaire (SF-IPAQ) was used to assess PA. 4991 individuals (median age 50 years, 57% women) were studied. Prevalence of sedentariness was 32...
2016: PloS One
Roland Faigle, Elisabeth B Marsh, Rafael H Llinas, Victor C Urrutia, Rebecca F Gottesman
BACKGROUND: Intracerebral hemorrhage (ICH) carries high risk for short-term mortality. We sought to identify race-specific predictors of mortality in ICH patients. METHODS AND RESULTS: We used 2 databases, the Johns Hopkins clinical stroke database and the Nationwide Inpatient Sample (NIS). We included 226 patients with the primary diagnosis of spontaneous ICH from our stroke database between 2010 and 2013; in the NIS, 42 077 patients met inclusion criteria. Logistic regression was used to assess differences in predictors of mortality in blacks compared to whites...
August 2016: Journal of the American Heart Association
Chin-Ming Chen, Khee-Siang Chan, Wen-Liang Yu, Kuo-Chen Cheng, Hui-Chun Chao, Chiu-Yin Yeh, Chih-Cheng Lai
Outcomes of adult patients with dengue infections requiring intensive care unit (ICU) admissions remain unclear. We assessed the clinical manifestations and prognostic factors of patients critically ill with severe dengue.This retrospective study was done in a tertiary referral hospital with 96 adult ICU beds. All of the patients with laboratory-confirmed severe dengue infections and admitted to the ICU were enrolled between July 31 and November 31, 2015, during the large outbreak period. The medical records of all the recruited patients were reviewed for the following information: age, gender, clinical manifestations, disease severity scores, underlying conditions, laboratory examinations, and outcomes...
August 2016: Medicine (Baltimore)
Carlos Calvo Gómez, Ricardo Gómez-Huelgas, Joan Lima Ruiz, Lluis Masmiquel Comas, Alfredo Michán Doña, Antonio Zapatero Gaviria
BACKGROUND: Type 2 diabetes mellitus (DM2) is a disease of epidemic proportions. In the adult Spanish population, prevalence of DM2 is nearly 14%, which makes its monitoring and treatment imperative. Liraglutide has achieved relevance due to its efficacy and safety in DM treatment. The aim of this study is to gather expert opinion on diabetes to assess the current role of liraglutide in DM2. MATERIALS/METHODS: The survey was performed by 57 internal medicine specialists using the Delphi method...
November 2016: International Journal of Clinical Pharmacology and Therapeutics
Hormuzdiyar H Dasenbrock, Robert F Rudy, William B Gormley, Timothy R Smith, Kai U Frerichs, Mohammad Ali Aziz-Sultan, Rose Du
INTRODUCTION: While obliteration of unruptured aneurysms reduces the risk of subarachnoid hemorrhage, perioperative complications impact the risk-benefit ratio of aneurysm repair, and additional data are needed to optimally risk-stratify patients preoperatively. METHODS: Patients who underwent craniotomy for microsurgical clipping of an unruptured aneurysm were extracted from the prospective National Surgical Quality Improvement Program (NSQIP) registry (2007-2014)...
August 2016: Neurosurgery
E Tas, S Atlanoglu, K T Onbasi, B Tas, A O Harmanci
Hypotension, hypoxia or hypotension and hypoxia together may proceed to ischaemic hepatitis; hypotension is often as a result of cardiovascular diseases. Ischaemic hepatitis not due to cirrhotic process or malignancy but due to acute thrombosis of the portal venous system is rare. In this article, we present a case of acute ischaemic hepatitis due to an acute thrombus developing after a ketoacidosis coma which was thought to have triggered this event. Other reasons which could be have triggered this event, such as a thrombophilia and cirrhosis or malignancy, were excluded...
December 16, 2015: West Indian Medical Journal
Fu-Chao Liu, Jr-Rung Lin, Hsiu-Pin Chen, Yung-Fong Tsai, Huang-Ping Yu
The aim of the present nationwide population-based cohort study was to explore the prevalence, risk factors, and survival outcome of new-onset diabetes (NOD) in recipients after liver transplantation.The National Health Insurance Research Database of Taiwan was searched for ICD-9-codes, 2248 patients who had received liver transplant without pretransplant diabetes from July 1, 1998 to December 31, 2012 were included in the study. The preoperative risks factors were considered and analyzed using logistic regression analysis, following adjustments for age and sex...
June 2016: Medicine (Baltimore)
Hossein Moravej, Alireza Salehi, Zahra Razavi, Mahmood Reza Moein, Hamed Etemadfard, Forough Karami, Forough Ghahremani
BACKGROUND: Walnut hydrosol (WH) is used extensively by Iranian people with diabetes in order to control blood sugar (BS). There are few data regarding the effect of walnut on controlling diabetes. OBJECTIVES: A pilot study to determine the efficacy and safety of WH in patients with type 1 diabetes. MATERIALS AND METHODS: Eight patients with diabetes mellitus (DM) type 1 were enrolled in the study. They did not use any medicine except insulin...
January 2016: International Journal of Endocrinology and Metabolism
Alexandra M G Larsen, David J Cote, Aditya V Karhade, Timothy R Smith
OBJECTIVE: The American College of Surgeons National Surgical Quality Improvement Program database aims to reduce 30-day postoperative complications. Reduction of postoperative stroke and coma can decrease length and cost of hospitalization, improve patient functional status, and decrease morbidity and mortality. METHODS: We performed a search of the American College of Surgeons National Surgical Quality Improvement Program database for all patients from 2006 to 2013 undergoing an operation with a surgeon whose primary specialty was neurologic surgery...
September 2016: World Neurosurgery
Anneke Kramer, Maria Pippias, Vianda S Stel, Marjolein Bonthuis, José Maria Abad Diez, Nikolaos Afentakis, Ramón Alonso de la Torre, Patrice Ambuhl, Boris Bikbov, Encarnación Bouzas Caamaño, Ivan Bubic, Jadranka Buturovic-Ponikvar, Fergus J Caskey, Pablo Castro de la Nuez, Harijs Cernevskis, Frederic Collart, Jordi Comas Farnés, Maria de Los Ángeles Garcia Bazaga, Johan De Meester, Manuel Ferrer Alamar, Patrik Finne, Liliana Garneata, Eliezer Golan, James G Heaf, Marc Hemmelder, Kyriakos Ioannou, Nino Kantaria, Mykola Kolesnyk, Reinhard Kramar, Mathilde Lassalle, Visnja Lezaic, Frantisek Lopot, Fernando Macário, Angela Magaz, Eduardo Martín-Escobar, Wendy Metcalfe, Mai Ots-Rosenberg, Runolfur Palsson, Celestino Piñera Celestino, Halima Resić, Boleslaw Rutkowski, Carmen Santiuste de Pablos, Viera Spustová, Maria Stendahl, Ariana Strakosha, Gültekin Süleymanlar, Marta Torres Guinea, Anna Varberg Reisæter, Evgueniy Vazelov, Edita Ziginskiene, Ziad A Massy, Christoph Wanner, Kitty J Jager, Marlies Noordzij
BACKGROUND: This article provides a summary of the 2013 European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report (available at, with a focus on patients with diabetes mellitus (DM) as the cause of end-stage renal disease (ESRD). METHODS: In 2015, the ERA-EDTA Registry received data on renal replacement therapy (RRT) for ESRD from 49 national or regional renal registries in 34 countries in Europe and bordering the Mediterranean Sea...
June 2016: Clinical Kidney Journal
Katja Konrad, Thomas Kapellen, Eggert Lilienthal, Nicole Prinz, Maria Bauer, Angelika Thon, Ernst Rietschel, Dagobert Wiemann, Reinhard W Holl
OBJECTIVE: Research on β-cell autoimmunity in cystic fibrosis (CF)-related diabetes (CFRD) is still rare. We aimed to analyze the frequency of β-cell autoimmunity and the influence on age at diabetes onset, insulin requirement, type of insulin therapy, and hypoglycemic or ketoacidotic events in patients with CFRD compared with antibody-negative patients with CFRD in the Diabetes Patienten Verlaufsdokumentation (DPV) registry. RESEARCH DESIGN AND METHODS: We analyzed data of 837 patients with CFRD in the German/Austrian DPV database by multivariable mixed-regression modeling...
August 2016: Diabetes Care
Juan Wang, De-Xian Li, Chao-Xian Yu, Su Huang, Yan-Qiong Liang
OBJECTIVE: To explore the risk factors of ventilator-associated pneumonia (VAP) in patients admitted in an intensive care unit (ICU) for pulmonary tuberculosis (TB). METHODS: The clinical data of 143 patients admitted in the ICU at our center between January, 2014 and June, 2015 were reviewed. The patients with VAP and those without VAP were analyzed for risk factors of VAP in the setting of an ICU for pulmonary TB and compared for the duration of ventilation and hospital stay...
May 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Christian Arndt, Hinnerk Wulf
Hypernatremia is a common electrolyte disorder that reflects an imbalance in the water balance of the body, often resulting from an increased loss of free water compared to sodium excretion. It is rarely based on excessive sodium intake. The clinical presentation is often characterized by a central nervous system dysfunction (confusion, coma) and pronounced thirst (in awake patients). In addition to medical history, the volume status of the patient and the osmolality of urine are leading in the differential diagnosis...
May 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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