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diabetic ketoacidosis diagnosis

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https://www.readbyqxmd.com/read/29037929/severe-sepsis-and-acute-myocardial-dysfunction-in-an-adolescent-with-chlamydia-trachomatis-pelvic-inflammatory-disease-a-case-report
#1
Ashley M Morgan, R Claire Roden, Steven C Matson, Grant M Wallace, Hannah L H Lange, Andrea E Bonny
BACKGROUND: Although generally asymptomatic, severe Chlamydia trachomatis (C. trachomatis) infections have been documented. C. trachomatis has been associated with both myocarditis and sepsis. CASE: A 19-year-old female with type 1 diabetes mellitus developed sudden-onset mental status change and shock after resolution of diabetic ketoacidosis. Abdominal and pelvic imaging demonstrated uterine and adnexal inflammation, and pelvic exam confirmed a diagnosis of pelvic inflammatory disease...
October 13, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/29028140/report-of-12-cases-with-tracheobronchial-mucormycosis-and-a-review
#2
Ruoxi He, Chengping Hu, Yongjun Tang, Huaping Yang, Liming Cao, Ruichao Niu
OBJECTIVES: Tranchobronchial mucormycosis is a rare and invasive pulmonary mucormycosis involving the tracheobronchial tree. DATA SOURCE: at a 3500-bed tertiary care center. STUDY SELECTION: This was a retroactive study of 12 cases of tranchobronchial mucormycosis diagnosed in our hospital, and 48 cases that were previously reported in the English literature. RESULTS: Rhizopus was the predominant species of pathogen (66...
October 13, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29026710/factors-associated-with-c-peptide-levels-after-diagnosis-in-children-with-type-1-diabetes-mellitus
#3
Jung Won Hwang, Min Sun Kim, Dae-Yeol Lee
C-peptide is the best indicator of endogenous insulin secretion in patients with diabetes. This study investigated the relationship between C-peptide levels and clinical/laboratory parameters of children with type 1 diabetes mellitus (T1DM), as measured at 6-month intervals after diagnosis. We retrospectively reviewed the data of 34 children with newly diagnosed T1DM. The study subjects were subdivided into a rapid progression group with C-peptide levels <0.6 ng/mL at 36 months (n=27; Group A) and a slow progression group with C-peptide levels >0...
September 2017: Chonnam Medical Journal
https://www.readbyqxmd.com/read/29026609/ketosis-prone-diabetes-and-sle-co-presenting-in-an-african-lady-with-previous-gestational-diabetes
#4
S Hussain, S Keat, S V Gelding
We describe the case of an African woman who was diagnosed with ketosis-prone diabetes with diabetes-associated autoantibodies, after being admitted for diabetic ketoacidosis (DKA) precipitated by her first presentation of systemic lupus erythematosus (SLE). She had a seven-year history of recurrent gestational diabetes (GDM) not requiring insulin therapy, with return to normoglycaemia after each pregnancy. This might have suggested that she had now developed type 2 diabetes (T2D). However, the diagnosis of SLE prompted testing for an autoimmune aetiology for the diabetes, and she was found to have a very high titre of GAD antibodies...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28989879/root-cause-analysis-of-diabetic-ketoacidosis-admissions-at-a-tertiary-referral-pediatric-emergency-department-in-north-india
#5
Muralidharan Jayashree, Rohit Sasidharan, Sunit Singhi, Karthi Nallasamy, Mullai Baalaaji
OBJECTIVES: To identify system-based factors contributing to Emergency Department (ED) admissions of children with diabetic ketoacidosis (DKA) and related complications with emphasis on parental and physician awareness and prereferral management. MATERIALS AND METHODS: A prospective observational root cause analysis study of all consecutive admissions of children with DKA to pediatric ED of a tertiary care referral hospital in northern India over a period of 1 year (July 2010-June 2011)...
September 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28989569/clinical-profile-of-diabetes-at-diagnosis-among-children-and-adolescents-at-an-endocrine-clinic-in-ghana
#6
Emmanuel Ameyaw, Serwah B Asafo-Agyei, Sumithira Thavapalan, Angela C Middlehurst, Graham D Ogle
AIM: To determine the clinical features of diabetes in children and adolescents in Ghana. METHODS: Retrospective review of clinical features of all children and adolescents with new-onset diabetes seen at the paediatric endocrinology clinic of Komfo Anokye Teaching Hospital in Kumasi, from February 2012 to Auguest 2016. RESULTS: One hundred and six subjects presented with diabetes. Ninety (84.9%) were diagnosed by clinical features and family history as type 1, and 16 (15...
September 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/28984788/concurrent-diabetic-ketoacidosis-in-hypertriglyceridemia-induced-pancreatitis-how-does-it-affect-the-clinical-course-and-severity-scores
#7
Yuchen Wang, Bashar M Attar, Keiki Hinami, Palashkumar Jaiswal, John Erikson Yap, Radhika Jaiswal, Kalpit Devani, Carlos Roberto Simons-Linares, Melchor V Demetria
OBJECTIVES: Concurrent diabetic ketoacidosis (DKA) is highly prevalent in patients with hypertriglyceridemia-induced pancreatitis (HP). Diabetic ketoacidosis could potentially complicate the diagnosis, management, and prognosis of HP. This study aimed to directly compare the clinical course of HP with and without DKA and assess the outcomes of frequently used severity-prediction scores in such population. METHODS: We retrospectively analyzed 140 patients with HP; 37 patients (26...
November 2017: Pancreas
https://www.readbyqxmd.com/read/28978581/anti-pd-l1-therapy-and-the-onset-of-diabetes-mellitus-with-positive-pancreatic-autoantibodies
#8
Jennifer Way, Alexandra Drakaki, Andrew Drexler, Matthew Freeby
An 84-year-old woman with metastatic squamous cell carcinoma of the nasopharynx and no history of diabetes was started on the antiprogrammed cell death ligand-1 (anti-PD-L1) antibody durvalumab. Four months later, she presented in diabetic ketoacidosis with glucose 488 mg/dL, anion gap 16, positive serum ketones and A1C9.1%. Antiglutamic acid decarboxylase 65 (GAD) antibody was 13 U/mL (normal, <0.5 U/mL), c-peptide 0.4 ng/dL (normal, 1.1-4.3 ng/mL) and glucose 142 mg/dL. A man with metastatic papillary urothelial carcinoma was treated with the PD-L1 inhibitor atezolizumab...
October 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28951345/diabetic-ketoacidosis-in-acromegaly-a-rare-complication-precipitated-by-corticosteroid-use
#9
REVIEW
Jeremy Weiss, Anna J Wood, Jeffrey D Zajac, Mathis Grossmann, Sofianos Andrikopoulos, Elif I Ekinci
Diabetic ketoacidosis has been described in the literature as a rare possible initial presentation of acromegaly before a diagnosis of acromegaly is eventually made. Indeed, diabetic ketoacidosis is a recognised complication of acromegaly. There are a number of factors that can predispose patients with acromegaly to diabetes as well as to diabetic ketoacidosis. These include high levels of growth hormone and insulin-like growth factor 1 in acromegaly and the effect on glycaemia by medications used in the management of acromegaly...
September 19, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28943512/prevalence-of-znt8-antibody-in-turkish-children-and-adolescents-with-new-onset-type-1-diabetes
#10
Selin Elmaoğulları, Seyit Ahmet Uçaktürk, Şehri Elbeg, Esra Döğer, Meltem Tayfun, Fatih Gürbüz, Aysun Bideci
OBJECTIVE: Zinc transporter 8 protein (ZnT8) is a transmembranic protein organizing the zinc transfer to insulin vesicles. Antibodies formed against ZnT8 (ZnT8A) are regarded as an independent autoimmunity demonstrator in type 1 diabetes (T1D) diagnosis Investigation of ZnT8ab prevalence in Turkish children with new onset T1D was planned in this study. METHODS: 84 patients between 1-18 years of age diagnosed with T1D between February 2015- March 2016 and the control group consisting of 50 healthy children without any autoimmune diseases were included in the study...
September 25, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28936086/diabetes-mellitus-as-the-presenting-feature-of-friedreich-s-ataxia
#11
Meenal Garg, Shilpa D Kulkarni, Krishnakumar N Shah, Anaita Udwadia Hegde
Patients with Friedreich's ataxia (FA) are at an increased risk of developing diabetes mellitus and glucose intolerance. Diabetes usually develops many years after the initial presentation. We report an 8-year-old girl who initially presented with diabetic ketoacidosis and was treated as a case of insulin-dependent diabetes mellitus. Around a year later, she developed gait problems and ataxia. Cardiac involvement was detected on echocardiography. Genetic testing confirmed the diagnosis of FA. FA should be a diagnostic consideration in children presenting with diabetes and neurological issues, even with early presentation of the former...
August 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28924481/euglycemic-diabetic-ketoacidosis-a-diagnostic-and-therapeutic-dilemma
#12
Prashanth Rawla, Anantha R Vellipuram, Sathyajit S Bandaru, Jeffrey Pradeep Raj
Euglycemic diabetic ketoacidosis (EDKA) is a clinical triad comprising increased anion gap metabolic acidosis, ketonemia or ketonuria and normal blood glucose levels <200 mg/dL. This condition is a diagnostic challenge as euglycemia masquerades the underlying diabetic ketoacidosis. Thus, a high clinical suspicion is warranted, and other diagnosis ruled out. Here, we present two patients on regular insulin treatment who were admitted with a diagnosis of EDKA. The first patient had insulin pump failure and the second patient had urinary tract infection and nausea, thereby resulting in starvation...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28924478/a-rare-cause-of-metabolic-acidosis-ketoacidosis-in-a-non-diabetic-lactating-woman
#13
Gordon Sloan, Amjad Ali, Jonathan Webster
Ketoacidosis occurring during lactation has been described infrequently. The condition is incompletely understood, but it appears to be associated with a combination of increased metabolic demands during lactation, reduction in carbohydrate intake and acute illness. We present a case of a 27-year-old woman, 8 weeks post-partum, who was exclusively breastfeeding her child whilst following a low carbohydrate diet. She developed gastroenteritis and was unable to tolerate an oral diet for several days. She presented with severe metabolic acidosis on admission with a blood 3-hydroxybutyrate of 5...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28904676/-gestational-diabetes-revealed-by-inaugural-diabetic-ketoacidosis-about-a-case
#14
Serge Irie Bi Gohi, Pete Yaich, Koffi N'guessan, Bernard Ogondon, Yapo Brouh
Ketoacidosis complicating gestational diabetes is rare and responsible for severe maternal-fetal mortality. It is an acute metabolic emergency whose management is multidisciplinary. Early diagnosis and treatment affect the vital prognosis of both the mother and the fetus. We report the case of a 27-year old pregnant woman at term, with a family history of diabetes, admitted to the emergency obstetric care with alertness problems associated with dyspnoea. The diagnosis of inaugural ketoacidosis decompensated due to severe malaria associated with gestational diabetes was retained on the basis of patient's medical history, of clinical examination and paraclinical assessment...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28883232/severe-hypertriglyceridemia-possibly-masked-acute-pancreatitis-and-led-to-a-difficult-diagnosis-in-an-obese-patient-with-ketoacidosis-onset-type-2-diabetes
#15
Midori Fujishiro, Akiko Horita, Hiroshi Nakagawara, Takayuki Mawatari, Yoshifusa Kishigami, Yoshiteru Tominaga, Mitsuhiko Moriyama, Hisamitsu Ishihara
A young obese man with ketoacidosis-onset type 2 diabetes mellitus, associated with severe hypertriglyceridemia, was admitted to a local hospital complaining of abdominal pain. Although the abdominal pain worsened, his serum amylase level remained normal with persistent severe hypertriglyceridemia until the second day of hospitalization. The next day, computed tomography showed severe acute pancreatitis (AP) with serum amylase elevation, while the patient's triglyceride level decreased to 558 mg/dL. He was transferred to our hospital and recovered after intensive care...
October 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28860211/excess-all-cause-mortality-before-age-30-in-childhood-onset-type-1-diabetes-data-from-the-brecon-group-cohort-in-wales
#16
Diana R Wasag, John W Gregory, Colin Dayan, John N Harvey
BACKGROUND: Long-term outcomes in young people with type 1 diabetes continue to be of interest, and may help evaluate the effects of changes to the clinical care of children that have occurred in recent decades. AIMS: To identify mortality and its causes before age 30 years in patients developing type 1 diabetes before age 15 years. METHODS: Since 1995, paediatricians in Wales have compiled a prospective register of incident cases of type 1 diabetes occurring before age 15 years in Wales (the Brecon Cohort)...
August 31, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28858101/usefulness-of-end-tidal-carbon-dioxide-as-an-indicator-of-dehydration-in-pediatric-emergency-departments-a-retrospective-observational-study
#17
Hee Won Yang, Woochan Jeon, Young Gi Min, Ji Sook Lee
Physician assessment of hydration status is one of the most important factors in the management of dehydration in the pediatric emergency department (ED). Overestimating dehydration may lead to overtreatment with intravenous fluids or unnecessary hospitalization, whereas underestimation may lead to delayed therapy and aggravation of symptoms. Various methods to estimate hydration status have been proposed, including use of physical findings, body weight, and laboratory results. These methods are subjective, invasive, or inappropriate for application in the ED...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28810113/an-unusual-presentation-of-an-unusual-disease-spontaneous-pneumomediastinum
#18
Kalyan Chakravarthy Potu, Maheedhar Gedela, Kashif Abbas Shaikh, Sujithasree Ketineni, Eric Larson
We report a case of spontaneous pneumomediastinum with unusual clinical presentation. The most common symptoms of spontaneous mediastinum are chest pain and shortness of breath. Our patient presented with neck swelling and change in voice, an unusual presentation for spontaneous pneumothorax. A 30-year-old previously healthy man presented with complaints of neck swelling and hoarseness of voice beginning after an intense coughing spell. He had no other complaints. He denied any trauma to the chest, nausea, vomiting, recent air travel, scuba diving or recreational drug use...
November 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28807726/the-value-of-venous-blood-gas-analysis-in-the-diagnosis-of-diabetic-ketoacidosis
#19
Jawad Ibrahim Rasheed, Manal Khudder Abdul Razak, Ahmed Amer Abdul Hussein
BACKGROUND & AIM: Newer blood gas analyzers have the ability to report electrolyte values and glucose in addition to pH, so this diagnostic process could be condensed in diagnosing diabetic ketoacidosis (DKA). We aimed to assess the accuracy of the venous blood gas (VBG) analysis with electrolytes for diagnosing DKA. METHODS: This study prospectively identified a convenience sample of (60 patients) presented with DKA and tested their VBG and serum electrolytes. The diagnosis of DKA was made according to American Diabetes Association criteria...
June 15, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#20
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large, detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to 160 US adult ICUs from 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV-based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
October 2017: Chest
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