Read by QxMD icon Read

hyperosmolar hyperglycaemic state

Lucy-Anne Frank, Andrew Solomon
No abstract text is available yet for this article.
September 2, 2016: British Journal of Hospital Medicine
Usha Devi Appalsawmy, Habib Akbani
A 56-year-old man who was a Jehovah's Witness with an advanced directive against autologous procedures developed acute kidney injury needing renal replacement therapy while he was intubated and ventilated on the intensive care unit. He was being treated for hyperosmolar hyperglycaemic state. He also had a healing laparotomy wound, having undergone a splenectomy less than a month ago following a road traffic accident. His hyperkalaemia and metabolic acidosis were refractory to medical treatment. As he became oligoanuric, decision was taken to carry out acute peritoneal dialysis (PD) by inserting a Tenckhoff catheter in his abdomen using peritoneoscopic technique...
2016: BMJ Case Reports
A W MacEwen, D M Carty, A McConnachie, G A McKay, J G Boyle
BACKGROUND: Evidence suggests that junior doctors lack the confidence and skills to manage acute/inpatient diabetes. We investigated the impact of the introduction of a "Diabetes Acute Care Day" on undergraduate medical students' knowledge and confidence in acute/inpatient diabetes. METHODS: Participants attended four short lectures on the basics of diabetes, diabetic emergencies, inpatient diabetes management and peri-operative/procedure care followed by case-based learning tutorials on diabetic ketoacidosis (DKA), hyperosmolar hyperglycaemic state (HHS) and hypoglycaemia using capillary blood glucose charts to interpret and practice subsequent insulin prescription and adjustment...
2016: BMC Medical Education
Guillermo Umpierrez, Mary Korytkowski
Diabetic ketoacidosis (DKA), hyperglycaemic hyperosmolar state (HHS) and hypoglycaemia are serious complications of diabetes mellitus that require prompt recognition, diagnosis and treatment. DKA and HHS are characterized by insulinopaenia and severe hyperglycaemia; clinically, these two conditions differ only by the degree of dehydration and the severity of metabolic acidosis. The overall mortality recorded among children and adults with DKA is <1%. Mortality among patients with HHS is ~10-fold higher than that associated with DKA...
April 2016: Nature Reviews. Endocrinology
Alexander Spyridoulias, Muhammad Shakeel Riaz
Decompensated hypothyroidism is a rare endocrine emergency but a differential that should be considered in patients presenting critically unwell with systemic illness. We report a case of myxoedema coma in a woman presenting with respiratory failure, hypotension, hypothermia and a reduced level of consciousness, all of which are poor prognostic features in decompensated hypothyroidism. The patient was admitted to critical care for mechanical ventilation and cardiovascular support and treated with a combination of insulin, liothyronine and levothyroxine, making a good recovery...
2016: BMJ Case Reports
Krishna Chinthapalli, Allison Newey, Martin Krause
We present an 89-year-old man with new onset of left-sided hemiballismus affecting his face, arm and leg. He was found to have hyperglycaemia with a glucose level of 20.2 mmol/l and had started prednisolone 3 months earlier for polymyalgia rheumatica. A T 2-weighted magnetic resonance scan of the brain showed a hypointense lesion of the right lentiform nucleus. At follow-up, his symptoms had improved with treatment for diabetes mellitus. To our knowledge, this is the first patient to develop hemiballismus after starting corticosteroids...
September 2015: Oxford Medical Case Reports
Asmah Hassan Syed, Joanna Shak, Ali Alsawaf
An 84-year-old lady was treated for hyperosmolar hyperglycaemia with IV insulin, fluids and catheterisation for fluid balance monitoring. Trial without catheter failed as the patient complained of new-onset urinary incontinence and lack of awareness of bladder filling. In light of her breast cancer history, we excluded cauda equina. Ultrasound KUB showed an enlarged bladder. Whole-body MRI revealed a lesion in the pons which was highly suggestive of central pontine myelinolysis (CPM). Her electrolytes were normal throughout her admission; thus, the rapid fluctuation in osmolality, secondary to her hyperglycaemic state, was the likely cause of CPM...
September 2015: Age and Ageing
A R Scott
No abstract text is available yet for this article.
April 2016: Diabetic Medicine: a Journal of the British Diabetic Association
G Frontino, R Bonfanti, A Rigamonti, R Battaglino, V Favalli, C Bonura, F Meschi, G Barera
No abstract text is available yet for this article.
April 2016: Diabetic Medicine: a Journal of the British Diabetic Association
A R Scott
Hyperglycaemic hyperosmolar state (HHS) is a medical emergency, which differs from diabetic ketoacidosis (DKA) and requires a different approach. The present article summarizes the recent guidance on HHS that has been produced by the Joint British Diabetes Societies for Inpatient Care, available in full at HHS has a higher mortality rate than DKA and may be complicated by myocardial infarction, stroke, seizures, cerebral oedema and central pontine myelinolysis and there is some evidence that rapid changes in osmolality during treatment may be the precipitant of central pontine myelinolysis...
June 2015: Diabetic Medicine: a Journal of the British Diabetic Association
Francesca Ruth Harrington, Helen Wolfenden, Tafadzwa Makaya
Hyperglycaemic hyperosmolar state (HHS) is a life-threatening condition rarely seen in paediatrics. It is becoming increasingly recognised with the growing incidence of childhood type 2 diabetes mellitus (T2DM). We present a 16-year-old boy with Bardet-Biedl syndrome, with comorbidities including chronic renal impairment requiring renal transplant, isolated growth hormone (GH) deficiency and obesity, who presented on routine follow-up with new onset T2DM and in HHS. Investigations revealed hyperglycaemia (45...
2015: BMJ Case Reports
Yi-Chen Wang, Li-Chao Gao, Hui Xu, Xiao-Zhang Qu, Ye Wang, Xiao-Qian Lou, Hui Guo
INTRODUCTION: This study aimed to report a rare case of hypopituitarism complicated with hyperosmolar hyperglycaemic state and rhabdomyolysis. CASE PRESENTATION: Hypopituitarism is a clinical syndrome in which there is a deficiency in hormone production by the pituitary gland. It often leads to hypoglycaemia, but in this case the patient was complicated with hyperosmolar hyperglycaemic state. The patient received prompt medical treatment, which effectively prevented the occurrence of possible acute kidney failure and other complications...
May 2015: Scottish Medical Journal
Nikhil M Bhagwat, Ameya S Joshi, Gururaja Rao, Premlata K Varthakavi
Hyperosmolar hyperglycaemic state (HHS) an acute complication of diabetes mellitus, can be associated with neurological involvement ranging from seizures, involuntary movements to reversible focal neurological deficits without any structural lesions. We report a 71-year-old woman, a known case of type 2 diabetes mellitus who presented with the sudden onset of hemichorea-hemiballismus. On investigations she had hyperglycaemia and urinary tract infection. Achievement of euglycemia with insulin therapy resolved the involuntary movements completely...
2013: BMJ Case Reports
Maria del Carmen Garcia-Pascual, John Kidby
Two of the most common acute and potentially life-threatening complications of diabetes mellitus are diabetic ketoacidosis and hyperosmolar hyperglycaemic state. Both conditions are characterised by hyperglycaemic states, but nurses should be aware of important differences so the correct condition and treatment can be identified. Treatment includes immediate referral to specialist diabetes teams and possible transfer to intensive care. This article outlines the similarities and differences in the symptoms and treatment of the conditions, and discusses prevention strategies...
December 2012: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Mohamed Osama Hegazi, Anant Mashankar
OBJECTIVE: To report a rare association of central pontine myelinolysis (CPM) with hyperosmolar hyperglycaemic state (HHS). CLINICAL PRESENTATION AND INTERVENTION: A diabetic female presented with HHS and prolonged severe hypernatraemia. The metabolic derangement was adequately treated with proper correction of both hyperglycaemia and hypernatraemia. Lack of improvement in the presenting confusional state and the development of a fresh neurological deterioration led to the suspicion of CPM that was confirmed with magnetic resonance imaging...
2013: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Feng-Chih Kuo, Yi-Jen Hung, Chang-Hsun Hsieh, Fone-Ching Hsiao
Aldosterone-producing adenoma (APA), one of the most common causes of primary hyperaldosteronism, is clinically characterized by hypertension, increased sodium retention, increased potassium excretion and altered glucose metabolism. APA can also manifest in the form of hyperosmolar hyperglycaemic state (HHS), which is a life-threatening acute diabetic complication. Infection and inadequate fluid replacement are the common precipitating and predisposing factors for the occurrence of HHS. Here, we report a case of occult APA with the initial presentation of HHS, in which an unusually rapid correction of diabetes was observed after correct diagnosis and surgical resection of the APA...
September 2012: Annals of Clinical Biochemistry
M Y Ahmedani, M S Haque, A Basit, A Fawwad, S F D Alvi
AIMS: To observe the effects of active glucose monitoring, alteration of drug dosage and timing, dietary counselling and patient education in the occurrence of acute diabetic complications in fasting individuals with diabetes during the month of Ramadan. METHODS: This prospective study was conducted at the outpatient department of the Baqai Institute of Diabetology and Endocrinology. Two educational sessions, one about drug dosage and timing alteration and glucose monitoring, and the other about dietary and lifestyle modifications, were given to the patients by a doctor and a dietician, respectively...
June 2012: Diabetic Medicine: a Journal of the British Diabetic Association
Hanisah Abd Hamid, Nor-Aini Umar, Hanita Othman, Srijit Das
Hyperosmolar hyperglycaemic state (HHS) is a medical emergency which needs immediate medical intervention. A 37-year-old Chinese woman with a history of hypertension attended the Emergency Department. She had a two-day history of involuntary movement, i.e. chorea of the upper limbs, preceded by a one-week history of upper respiratory tract infection. She also had polyuria and polydipsia, although she was never diagnosed as diabetic. The main aim of reporting the present case was to highlight the importance of biochemical investigations involved in the diagnosis of involuntary movements...
December 2010: Archives of Medical Science: AMS
C O Ekpebegh, B Longo-Mbenza, A Akinrinmade, E Blanco-Blanco, M Badri, N S Levitt
OBJECTIVES: To describe the frequencies, presenting characteristics (demographic, clinical and biochemical) and outcomes (duration of admission and mortality rates) for various types of hyperglycaemic crisis. METHODS: Retrospective review of medical records of patients with hyperglycaemic crisis admitted to Nelson Mandela Academic Hospital, Mthatha, E Cape, from 1 January 2008 to 31 December 2009. Outcome measures were duration of admission and mortality. RESULTS: Data were available for 269 admissions (response rate 81...
December 2010: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Shanying Mao, Zhirong Liu, Meiping Ding
Central pontine myelinolysis (CPM) is a demyelinating disorder, which is associated most commonly with the rapid correction of hyponatraemia and other abrupt changes in physiological osmotic conditions. This includes the treatment of hyperosmolar hyperglycaemia in diabetes mellitus (DM) sufferers. Herein, we report a case of CPM in a 55-y-old patient with new-onset DM who presented with partial focal seizures and a sudden-onset right-sided hemiplegia. Magnetic resonance imaging revealed a lesion in the central pons...
January 2011: Annals of Clinical Biochemistry
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"