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Hyperosmolar hyperglycemic state

Chin-Li Lu, Hsin-Hui Chang, Hua-Fen Chen, Li-Jung Elizabeth Ku, Ya-Hui Chang, Hsiu-Nien Shen, Chung-Yi Li
This study aimed to investigate the association of admissions for diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) with ambient temperature and season, respectively in patients with diabetes mellitus (DM), after excluding known co-morbidities that predispose onset of acute hyperglycemia events. This was a time series correlation analysis based on medical claims of 40,084 and 33,947 episodes of admission for DKA and HHS, respectively over a 14-year period in Taiwan. These episodes were not accompanied by co-morbidities known to trigger incidence of DKA and HHS...
September 2016: Environment International
Tetsuyuki Yasuda
No abstract text is available yet for this article.
April 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Ichiro Hirayama, Takahiro Hiruma, Yoshihiro Ueda, Kent Doi, Susumu Nakajima
No abstract text is available yet for this article.
March 17, 2016: American Journal of Emergency Medicine
Ju Hyun Seo, Jin Ah Kim, Bomi Choi, Kyo Hee Kim, Ha Neul Park, Hannah Seok, Tae Seo Sohn
No abstract text is available yet for this article.
March 10, 2016: Korean Journal of Internal Medicine
Yashwant Agrawal, Kiran Lingala, Hemasri Tokala, Jagadeesh K Kalavakunta
Atypical antipsychotics are very widely used for various psychiatric ailments because of their less extrapyramidal side effects. Various reports of disturbances in glucose metabolism in the form of new onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, diabetic ketoacidosis, hyperosmolar nonketotic coma, acute pancreatitis, and increased adiposity have been reported. We present a case of new onset diabetic ketoacidosis in a patient without a history of glucose intolerance who was being treated with olanzapine for bipolar disorder...
January 6, 2016: American Journal of Therapeutics
E Geuna, D Roda, S Rafii, B Jimenez, M Capelan, K Rihawi, F Montemurro, T A Yap, S B Kaye, J S De Bono, L R Molife, U Banerji
BACKGROUND: PI3K-AKT-mTOR inhibitors (PAMi) are promising anticancer treatments. Hyperglycaemia is a mechanism-based toxicity of these agents and is becoming increasingly important with their use in larger numbers of patients. METHODS: Retrospective case-control study comparing incidence and severity of hyperglycaemia (all grades) between a case group of 387 patients treated on 18 phase I clinical trials with PAMi (78 patients with PI3Ki, 138 with mTORi, 144 with AKTi and 27 with PI3K/mTORi) and a control group of 109 patients treated on 10 phase I clinical trials with agents not directly targeting the PAM pathway...
December 1, 2015: British Journal of Cancer
Tigestu Alemu Desse, Tesfahun Chanie Eshetie, Esayas Kebede Gudina
BACKGROUND: Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) commonly known as hyperglycemic emergencies are the two most common life-threatening acute metabolic complications of diabetes. The objective of this study is to assess predictors and treatment outcome of hyperglycemic emergencies (HEs) among diabetic patients admitted to Jimma University Specialized Hospital (JUSH). METHODS: It is a three year retrospective review of medical records of patients admitted with HEs at JUSH...
2015: BMC Research Notes
Alyssa Milano, Ara Tadevosyan, Regina Hart, Anthony Luizza, Mary Eberhardt
No abstract text is available yet for this article.
February 2016: American Journal of Emergency Medicine
Michelle Samson Maust, Russ S Muramatsu, Kathryn Egan, Iqbal Ahmed
No abstract text is available yet for this article.
August 2015: Journal of Clinical Psychopharmacology
Yuan Kao, Chien-Chin Hsu, Shih-Feng Weng, Hung-Jung Lin, Jhi-Joung Wang, Shih-Bin Su, Chien-Cheng Huang, How-Ran Guo
Hyperglycemic crisis episodes (HCEs)-diabetic ketoacidosis and the hyperosmolar hyperglycemic state-are the most serious acute metabolic complications of diabetes. We aimed to investigate the subsequent mortality after HCE in the non-elderly diabetic which is still unclear. This retrospective national population-based cohort study reviewed, in Taiwan's National Health Insurance Research Database, data from 23,079 non-elder patients (≤65 years) with new-onset diabetes between 2000 and 2002: 7693 patients with HCE and 15,386 patients without HCE (1:2)...
January 2016: Endocrine
Jaroslav Rybka, Jerguš Mistrík
The hyperglycemic hyperosmolar state (HHS) is a serious acute complication of diabetes decompensation, especially in type 2 diabetes (T2DM), and with critical prognosis. Primary characteristics of HHS include extreme hyperglycemia, severe dehydration (with prerenal hyperazotaemia), plasma hyperosmolarity, frequent disorders of consciousness, absent or minimum ketoacidosis (with higher values, only found in combined forms). Both DKA and HHS have a common pathogenetic mechanism, but both states are opposite extreme deviations, and the boundaries between them are not entirely clear...
May 2015: Vnitr̆ní Lékar̆ství
Georgeanna J Klingensmith, Crystal G Connor, Katrina J Ruedy, Roy W Beck, Craig Kollman, Heidi Haro, Jamie R Wood, Joyce M Lee, Steven M Willi, Eda Cengiz, William V Tamborlane
OBJECTIVE: Type 2 diabetes (T2D) in youth is recognized as a pediatric disease, but few reports describe the characteristics during diagnosis. We describe the clinical presentation of 503 youth with T2D. METHODS: The Pediatric Diabetes Consortium (PDC) T2D Clinic Registry enrolled T2D participants from eight pediatric diabetes centers in the USA. Clinical and laboratory characteristics at the time of diagnosis were analyzed. RESULTS: In total 67% presented with symptoms of diabetes and confirming laboratory data, but 33% were identified by testing at risk children, 11% presented with diabetic ketoacidosis (DKA), and 2% with hyperglycemic hyperosmolar state (HHS)...
June 2016: Pediatric Diabetes
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
Akinyele Taofiq Akinlade, Anthonia Okeoghene Ogbera, Olufemi Adetola Fasanmade, Michael Adeyemi Olamoyegun
INTRODUCTION: HE are common acute complications of diabetes mellitus (DM) and include diabetic ketoacidosis (DKA), normo-osmolar hyperglycemic state (NHS) and hyperosmolar hyperglycemic state (HHS). They contribute a lot to the mortality and morbidity of DM. The clinical features include dehydration, hyperglycemia, altered mental status and ketosis. The basic mechanism of HE is a reduction in the net effective action of circulating insulin, resulting in hyperglycemia and ketonemia (in DKA) causing osmotic diuresis and electrolytes loss...
2014: International Archives of Medicine
Christoph Henzen
No abstract text is available yet for this article.
January 28, 2015: Revue Médicale Suisse
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
Francisco J Pasquel, Guillermo E Umpierrez
The hyperosmolar hyperglycemic state (HHS) is the most serious acute hyperglycemic emergency in patients with type 2 diabetes. von Frerichs and Dreschfeld described the first cases of HHS in the 1880s in patients with an "unusual diabetic coma" characterized by severe hyperglycemia and glycosuria in the absence of Kussmaul breathing, with a fruity breath odor or positive acetone test in the urine. Current diagnostic HHS criteria include a plasma glucose level >600 mg/dL and increased effective plasma osmolality >320 mOsm/kg in the absence of ketoacidosis...
November 2014: Diabetes Care
Maria Luraschi, Hidenobu Shigemitsu, Matthew Schreiber
Outcomes/Quality Control Posters ISESSION TYPE: Original Investigation PosterPRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PMPURPOSE: Hyperglycemic states, such as diabetic ketoacidosis (DKA) and the hyperosmolar hyperglycemic state (HHS), are common acute complications of diabetes mellitus. Epidemiologic studies demonstrate that more that 50% of these cases are admitted to the intensive care unit. The utilization of intensive care resources is costly and often requires selective application...
October 1, 2014: Chest
Gerald Beltran
Diabetic emergencies are common presentations to the emergency department. It is estimated that diabetes affects 25.8 million people in the United States, at an annual total cost of over $174 billion. There are 2 general categories of diabetic emergencies: hyperglycemic and hypoglycemic. The hyperglycemic emergencies include diabetic ketoacidosis and hyperosmolar hyperglycemic state. Management of these conditions requires a careful hydration strategy to restore volume and improve perfusion, intravenous insulin therapy, and electrolyte monitoring...
June 2014: Emergency Medicine Practice
Chia-Hung Yo, Meng-Tse Gabriel Lee, Weng-Tein Gi, Shy-Shin Chang, Kuang-Chau Tsai, Shyr-Chyr Chen, Chien-Chang Lee
OBJECTIVES: The objective of the study is to describe the epidemiology and outcome of community-acquired bloodstream infection (BSI) in type 2 diabetic patients in emergency department (ED). METHODS: All patients admitted to the ED of the university hospital from June 2010 to June 2011 with a history of type 2 diabetes mellitus and microbiologically documented BSI were retrospectively enrolled. Demographic characteristics, Charlson comorbidity index, antibiotic therapy, clinical severity, microbiological etiology, and diabetes-related complications were recorded in a standardized form...
December 2014: American Journal of Emergency Medicine
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