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hyperosmolar coma

Mazhar Muslum Tuna, Faruk Kilinc, Zafer Pekkolay, Hikmet Soylu, Alpaslan Kemal Tuzcu
Mediastinitis is a serious infection involving mediastinal spaces after cervical infections spread along the facial planes. A late diagnosis of mediastinitis may result in death. Here we present a diabetic patient suffered from mediastinit accompanied with hyperosmolar nonketotic coma. A 61 years old male patient with type 2 diabetes was admitted to our hospital, with complaint of generalized worsening and fever. A diagnosis of nonketotic hyperosmolar coma was done and proper treatment started immediately. Neck tomography revealed abscess formation in the upper mediastinum...
June 2016: Turkish Journal of Emergency Medicine
Jessita S Natasha Albert Messiah Dhas, Raghad Hussein, Mohammed Mogri, Lokendra Thakur
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Zachary D Threlkeld, Mohan Kottapally, Aimee Aysenne, Nerissa Ko
Intracranial pressure (ICP) monitoring frequently guides key decisions in the management of diseases causing intracranial hypertension. Although typically measured by invasive means, contraindications may leave the clinician with little recourse for dynamic ICP evaluation-particularly when the patient's mental status is compromised. We describe here a healthy 18-year-old woman who subacutely progressed to coma due to diffuse cerebral venous sinus thrombosis. Heparinization precluded the use of invasive ICP monitoring, and electroencephalography (EEG) was used novelly as a surrogate ICP monitor...
October 2016: Neurohospitalist
Rebecca R Dixon, Maryalice Nocera, Adam J Zolotor, Heather T Keenan
OBJECTIVE: To examine the use of intracranial pressure monitors and treatment for elevated intracranial pressure in children 24 months old or younger with traumatic brain injury in North Carolina between April 2009 and March 2012 and compare this with a similar cohort recruited 2000-2001. DESIGN: Prospective, observational cohort study. SETTING: Twelve PICUs in North Carolina. PATIENTS: All children 24 months old or younger with traumatic brain injury, admitted to an included PICU...
November 2016: Pediatric Critical Care Medicine
Sekar Arunkumar, Bhagavatula Indira Devi, Dhaval Shukla, Madhusudhan Reddy
BACKGROUND: Intracranial pressure monitoring (ICP) is considered as optional for management of severe traumatic brain injury (TBI) in children. AIMS: This study was performed to determine whether ICP monitoring is beneficial in the managing severe TBI in children. SETTINGS AND DESIGN: Neurosurgical intensive care unit (ICU) of a tertiary care referral center; prospective observational study. MATERIALS AND METHODS: Children aged 16 years or less with severe TBI defined as "postresuscitation Glasgow Coma Scale (GCS) score of 8 or less admitted to an ICU" were enrolled...
September 2016: Neurology India
Nadia Roumeliotis, Christian Dong, Géraldine Pettersen, Louis Crevier, Guillaume Emeriaud
OBJECTIVES: The objectives of the study are to describe the use of hyperosmolar therapy in pediatric traumatic brain injury (TBI) and examine its effect on intracranial pressure (ICP) and cerebral perfusion pressure (CPP). DESIGN: A retrospective review of patients with severe TBI admitted to the pediatric intensive care unit (PICU) was conducted. Inclusion criteria were ICP monitoring and administration of a hyperosmolar agent (20 % mannitol or 3 % hypertonic saline) within 48 h of PICU admission; for which dose and timing were recorded...
December 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Michael Grabner, Xiaomei Peng, Caroline Geremakis, Jay Bae
BACKGROUND: Canagliflozin is the first sodium-glucose co-transporter-2 (SGLT-2) inhibitor-a new class of oral antidiabetic (OAD) medication-approved for type 2 diabetes mellitus (T2DM) treatment in the United States. Approved less than 2 years ago, use of canagliflozin is largely uncharacterized. OBJECTIVE: To investigate and compare baseline demographic, clinical, and economic characteristics of patients initiating canagliflozin and dipeptidyl peptidase-4 (DPP-4) inhibitors in the real-world setting...
December 2015: Journal of Managed Care & Specialty Pharmacy
Mikhael Giabicani, Pierre-Gildas Guitard, Dominique Guerrot, Steven Grangé, Lauranne Teule, Bertrand Dureuil, Benoît Veber
Extreme hypernatremia in intensive care unit are frequently associated with a poor prognosis and their treatment, when associated with acute renal failure, is not consensual. We report the case of a 39-year-old man admitted in our intensive care unit for coma who presented extreme hyperosmolar hypernatremia (sodium 180 mmol/L, osmolarity 507 mOsm/L) associated with acute renal failure (urea 139.3 mmol/L, creatinine 748 μmol/L) and many other metabolic abnormalities. He was treated with hypotonic fluid administration and continuous renal replacement therapy (veno-venous hemodiafiltration) using an industrial dialysate fluid...
November 2015: Néphrologie & Thérapeutique
Ivan Kruljac, Goran Rinčić, Hrvoje Ivan Pećina
No abstract text is available yet for this article.
April 2016: Endocrine
Yuqian Li, Zhihong Li, Min Li, Yanlong Yang, Bao Wang, Li Gao, Xingye Zhang, Hongyu Cheng, Wei Fang, Bo Zhao, Boliang Wang, Guodong Gao, Lihong Li
BACKGROUND: Elevated intracranial pressure is one of the most common problems in patients with diverse intracranial disorders, leading to increased morbidity and mortality. Effective management for increased intracranial pressure is based mainly on surgical and medical techniques with hyperosmolar therapy as one of the core medical treatments. The study aimed to explore the effects of continuous micro-pump infusions of 3% hypertonic saline combined with furosemide on intracranial pressure control...
2015: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Naifa L Busaidy, Patricia LoRusso, Kristie Lawhorn, Kenneth R Hess, Mohammed Amir Habra, Siqing Fu, David S Hong, Helen X Chen, Lawrence A Doyle, Razelle Kurzrock, Aung Naing
BACKGROUND: Cixutumumab (a humanized monoclonal antibody against insulin-like growth factor-1 receptor [IGF-1R]) and the mammalian target of rapamycin (mTOR) inhibitor temsirolimus were combined in a phase I study of patients with advanced cancer. We investigated the prevalence of metabolic toxicities, their management, and impact on outcome. METHODS: The temsirolimus dose was 25 mg or 37.5 mg i.v. weekly with escalating doses of cixutumumab (3, 5, or 6 mg/kg i...
July 2015: Oncologist
Said Azzoug, Souad Mahgoun, Farida Chentli
Worldwide, the proportion of people above 60 years old represents 15% of the whole population. Diabetes mellitus is more frequent in this age group, and is associated with increased risk of morbidities and premature mortality. Aged Muslim people with diabetes insist on fasting during Ramadan, for many reasons. Elderly people, especially frail patients, who fast are at increased risk for many complications such as hypoglycaemia, hyperglycaemia and metabolic decompensation including hyperosmolar coma, diabetic ketoacidosis, dehydration and thrombosis...
May 2015: JPMA. the Journal of the Pakistan Medical Association
S-T Yan, C-X Li, C-L Li, J Li, Y-H Shao, Y Liu, W-W Zhong, F-S Fang, B-R Sun, H Tian
The aim of this study was to evaluate the control of blood glucose and glycosylated hemoglobin A1c (HbA1c) and its influencing factors, in elderly type 2 diabetic mellitus (T2DM) patients undergoing comprehensive management. After years of comprehensive prevention of and control measures for diabetes, elderly T2DM patients who were receiving long-term health care were comprehensively evaluated through an annual physical examination. In addition to routine health examination, the patients were required to undergo HbA1c measurement...
2015: Genetics and Molecular Research: GMR
Darlene Vigil, Kavitha Ganta, Yijuan Sun, Richard I Dorin, Antonios H Tzamaloukas, Karen S Servilla
A man with past lithium use for more than 15 years, but off lithium for two years and not carrying the diagnosis of diabetes mellitus or nephrogenic diabetes insipidus (NDI), presented with coma and hyperglycemic hyperosmolar state (HHS). Following correction of HHS, he developed persistent hypernatremia accompanied by large volumes of urine with low osmolality and no response to desmopressin injections. Urine osmolality remained < 300 mOsm/kg after injection of vasopressin. Improvement in serum sodium concentration followed the intake of large volumes of water plus administration of amiloride and hydrochlorothiazide...
May 6, 2015: World Journal of Nephrology
Christoph Henzen
No abstract text is available yet for this article.
January 28, 2015: Revue Médicale Suisse
Jian Zhou, Xiaopeng Yuan, Weiqiang Ju, Zhiyong Guo, Qiang Tai, Linwei Wu, Xiaoping Wang, Ming Han, Xingyuan Jiao, Xiaofeng Zhu, Jiefu Huang, Xiaoshun He
No abstract text is available yet for this article.
December 2014: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Faraz Khan Luni, Abdur Rahman Khan, Youngsook Yoon, Deepak Malhotra, Sandeep Vetteth
Disequilibrium syndrome (DS) is a central nervous system disorder described in hemodialysis (HD) patients. The authors present 4 cases of elevated blood urea nitrogen (BUN); the first patient passed away from suspected DS, whereas the other 3 patients were identified as having a high risk of developing DS on the basis of their BUN. The authors tried to lower their BUN slowly and prevent rapid correction by different methods. This is the first study in which DS has been studied in patients who are not on HD, and methods are described to identify and prevent DS in such patients...
May 2015: American Journal of the Medical Sciences
B J Piper, P W Harrigan
We describe the protocolised use of 23.4% hypertonic saline solution (HTS) for intracranial hypertension in the context of traumatic brain injury in the paediatric population. This study represents the largest published data on the use of 23.4% HTS in the paediatric population. In this retrospective cohort, we focus on the efficacy, biochemical and metabolic consequences of 23.4% HTS administration in a Level 1 paediatric trauma centre. Mortality in the first seven days was 6% (2/32) with a mean intensive care unit length-of-stay of ten days (range 2 to 25, standard deviation [SD] 6)...
March 2015: Anaesthesia and Intensive Care
Karla Victoria Rodríguez-Velver, Analy J Soto-Garcia, María Azucena Zapata-Rivera, Juan Montes-Villarreal, Jesús Zacarías Villarreal-Pérez, René Rodríguez-Gutiérrez
Osmotic demyelination syndrome (ODS) is a life-threatening demyelinating syndrome. The association of ODS with hyperosmolar hyperglycemic state (HHS) has been seldom reported. The aim of this study was to present and discuss previous cases and the pathophysiological mechanisms involved in ODS secondary to HHS. A 47-year-old man arrived to the emergency room due to generalized tonic-clonic seizures and altered mental status. The patient was lethargic and had a Glasgow coma scale of 11/15, muscle strength was 4/5 in both lower extremities, and deep tendon reflexes were diminished...
2014: Case Reports in Neurological Medicine
Zhen-qiang Ma, Monica A Fisher
OBJECTIVES: To evaluate the characteristics driving higher diabetes-related hospitalization charges. METHODS: Hospital discharge data on 216,858 hospitalizations from 2001 to 2011 with primary discharge diagnosis of diabetes were linked to the Pennsylvania death registry. Multiple linear regression analysis was used to evaluate the association between inpatient hospitalization charges and complications, sociodemographic status, comorbidities, readmission, length of stay, admission type, region, procedures, payer type, and hospitalization misadventures...
September 2014: American Journal of Managed Care
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