scholarly journals Characteristic Renal Histology of a 81-Year-Old Patient with a 30-Year History of Diabetes Mellitus: A Case Report

2020 ◽  
Vol 9 (4) ◽  
pp. 338-343
Author(s):  
Natsuki Shima ◽  
Naoki Sawa ◽  
Masayuki Yamanouchi ◽  
Hiroki Mizuno ◽  
Masahiro Kawada ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Immunofluorescence Microscopy ◽  
Antihypertensive Agents ◽  
Diabetic Glomerulopathy ◽  
Normal Range ◽  
Salt Diet ◽  
Protein Excretion ◽  
Renal Histology ◽  
History Of ◽  
Arteriolar Hyalinosis

Abstract A renal histology of an 81-year-old man with a 30-year history of diabetes mellitus (DM), as well as diabetic retinopathy and neuropathy, was examined. The patient’s blood pressure was controlled within the normal range (less than 140/75 mmHg) using antihypertensive agents including angiotensin receptor blocker. Edematous management was achieved by a strict salt diet (less than 6 g/per day). However, this patient’s glycemic control was poor with HbA1c 8–10%. Serum creatinine was 0.87 mg/dL and estimated globular filtration rate (eGFR) was 64 ml/min/1.73m2. Urinary protein excretion was 1.5 g/day. This patient’s renal biopsy showed linear staining for IgG along the GBM by immunofluorescence microscopy, but light microscopy showed almost intact glomeruli, and the GBM was not thickened as revealed by electron microscopy with a width of 288–368 nm (< 430 nm). While arteriolar hyalinosis was severe, and polar vasculosis was observed around the glomerular vascular pole. This case indicates that long-standing hyperglycemia may induce polar vasculosis by the mechanism of angiogenesis, but diabetic glomerulopathy can become minor change, only when hypertension and edematous management could be controlled strictly.

Transfer of Brown Norway Rat Chromosome 13 into Dahl S Genomic Background Confers Protection from High Salt Diet

Hypertension ◽  
2000 ◽  
Vol 36 (suppl_1) ◽  
pp. 717-717
Author(s):  
Allen W Cowley ◽  
Richard J Roman ◽  
Mary L Kaldunski ◽  
Peter J Tonellato ◽  
Pierre Dumas ◽  
...  
Keyword(s):  
Complex Traits ◽  
Salt Intake ◽  
High Salt ◽  
Brown Norway ◽  
High Salt Diet ◽  
Salt Diet ◽  
Chromosome 13 ◽  
Protein Excretion ◽  
High Salt Intake ◽  
Renal Histology

P132 Consomic rats (SS BN13 ) were bred in which chromosome 13 from normotensive inbred Brown Norway (BN/Mcw) rats was introgressed into the background of Dahl salt-sensitive (SS/Mcw) rats. The present studies determined the mean arterial pressure (MAP) responses to salt; renal and peripheral vascular responses to norepinephrine (NE) and angiotensin II (AngII); and protein excretion and renal histology in rats that received a high salt (4% NaCl) for 3 weeks. Indwelling arterial catheters were implanted in the 2 nd week of high salt and MAP was recorded for 3 days during the 3 rd week of high salt, and again 36 hours after 10mg/kg Lasix and return to a low salt (0.4%) diet. Results: High salt MAP of SS/Mcw rats averaged 183+4 mmHg, SS BN13 averaged 124+3 mmHg, and BN/Mcw averaged 132+4 mmHg. The reduction in MAP with sodium depletion averaged 31.8+3 mmHg in SS/Mcw rats but was significantly less in SS BN13 rats (14.7+1.6 mmHg) and BN/Mcw rats (13.9+2 mmHg). Protein excretion of SS/Mcw rats on high salt averaged 270+31 mg/24hr compared to 55+22 mg/24hr in SS BN13 rats, and 19+7 mg/24hr in BN/Mcw rats. Reduction of renal blood flow to iv administration of NE and AngII, was significantly greater SS/Mcw rats compared to SS BN13 and BN/Mcw rats. Severe medullary interstitial fibrosis and tubular necrosis was consistently seen in SS/Mcw rat kidneys but not in the SS BN13 or BN/Mcw rats following 3 weeks of high salt intake. These results demonstrate the power of functional mapping of complex traits using chromosomal transfer techniques and reveal a powerful gene (or set of genes) within BN/Mcw chromosome 13 that confers protection from the detrimental effects of a high salt diet to the Dahl salt-sensitive rat (SS/Mcw). It remains to be determined if the renoprotective effect is secondary to the reduction in blood pressure with chromosomal transfer, or a direct protective effect.

Hereditary Heparin Cofactor II Deficiency and the Risk of Development of Thrombosis

1987 ◽  
Vol 57 (02) ◽  
pp. 196-200 ◽  
Author(s):  
R M Bertina ◽  
I K van der Linden ◽  
L Engesser ◽  
H P Muller ◽  
E J P Brommer
Keyword(s):  
Liver Disease ◽  
Venous Thrombosis ◽  
Healthy Volunteers ◽  
Mean Value ◽  
Age Group ◽  
Normal Range ◽  
Heparin Cofactor Ii ◽  
History Of ◽  
Group 2 ◽  
Hereditary Nature

SummaryHeparin cofactor II (HC II) levels were measured by electroimmunoassay in healthy volunteers, and patients with liver disease, DIC, proteinuria or a history of venous thrombosis. Analysis of the data in 107 healthy volunteers revealed that plasma HC II increases with age (at least between 20 and 50 years). HC II was found to be decreased in most patients with liver disease (mean value: 43%) and only in some patients with DIC. Elevated levels were found in patients with proteinuria (mean value 145%). In 277 patients with a history of unexplained venous thrombosis three patients were identified with a HC II below the lower limit of the normal range (60%). Family studies demonstrated hereditary HC II deficiency in two cases. Among the 9 heterozygotes for HC II deficiency only one patient had a well documented history of unexplained thrombosis. Therefore the question was raised whether heterozygotes for HC II deficiency can also be found among healthy volunteers. When defining a group of individuals suspected of HC II deficiency as those who have a 90% probability that their plasma HC II is below the 95% tolerance limits of the normal distribution in the relevant age group, 2 suspected HC II deficiencies were identified among the healthy volunteers. In one case the hereditary nature of the defect could be established.It is concluded that hereditary HC II deficiency is as prevalent among healthy volunteers as in patients with thrombotic disease. Further it is unlikely that heterozygosity for HC II deficiency in itself is a risk factor for the development of venous thrombosis.

The Prevalence of Hereditary Antithrombin-III Deficiency in Patients with a History of Venous Thromboembolism

1985 ◽  
Vol 54 (04) ◽  
pp. 744-745 ◽  
Author(s):  
R Vikydal ◽  
C Korninger ◽  
P A Kyrle ◽  
H Niessner ◽  
I Pabinger ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Antithrombin Iii ◽  
Positive Family History ◽  
Normal Range ◽  
The Family ◽  
History Of ◽  
Antithrombin Iii Deficiency ◽  
Recurrent Venous Thrombosis ◽  
Antithrombin Iii Activity ◽  
Slight Deficiency

SummaryAntithrombin-III activity was determined in 752 patients with a history of venous thrombosis and/or pulmonary embolism. 54 patients (7.18%) had an antithrombin-III activity below the normal range. Among these were 13 patients (1.73%) with proven hereditary deficiency. 14 patients were judged to have probable hereditary antithrombin-III deficiency, because they had a positive family history, but antithrombin-III deficiency could not be verified in other members of the family. In the 27 remaining patients (most of them with only slight deficiency) hereditary antithrombin-III deficiency was unlikely. The prevalence of hereditary antithrombin-III deficiency was higher in patients with recurrent venous thrombosis.

Omental Infarction: A Case Treated with Laparoscopic Surgery

2019 ◽  
pp. 1-3
Author(s):  
Bertrand Ng ◽  
Arafat Yasser
Keyword(s):  
Diabetes Mellitus ◽  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Inflammatory Markers ◽  
Acute Onset ◽  
Laparoscopy Surgery ◽  
History Of ◽  
Background History ◽  
The Right

Omental infarct is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Here, we present a case of omental infarct in a 67-year-old gentleman with background history of diabetes mellitus who present unusually with a severe acute onset right hypochondrium pain. Examination revealed that he was tender to touch at the right and was having localized guarding. His inflammatory markers were normal. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day. Omental infarct cases with right hypochondrium pain can sometimes mimicked acute cholecystitis and management includes laparoscopic surgery which can hasten symptoms resolution and reduces hospital stay, however recommendation for surgery has to be balanced with anesthetics risk and complication of the surgery itself.

Eksplorasi Kesadaran Diri, Persepsi Dan Sikap Pada Individu Yang Memiliki Riwayat Keluarga Diabetes Melitus Tipe 2

2019 ◽  
Vol 1 (1) ◽  
pp. 52-62
Author(s):  
Mulia Mayangsari
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Family History ◽  
Diabetes Type 2 ◽  
Diabetes Type ◽  
Self Awareness ◽  
Perceptions And Attitudes ◽  
History Of ◽  
Diabetes Melitus

 Individuals who have a family history oftype 2 diabetes mellitus (DM) have a highrisk for type 2 diabetes. Type 2 diabetescan be prevented by improving modifiablerisk factors, supported by self-awareness,perceptions and attitudes of individualswho have a high family history of DM. Thisstudy used a qualitative phenomenologicaldesign. A Purposive Sampling techiniquewas applied to determine individuals whohad parents with type 2 diabetes. Nineindividuals participated in this study. AQualitative content analysis with Collaiziapproach used as a data analysis method.The main themes depicted individuals selfawareness,perceptions, & attitudes were:denials that diabetes caused by heredityfactors; misperception about diabetes;“traditional modalities” as a preventionmeasurement toward type 2 diabetes; andDM is perceived as a “threatening disease”.Further study is needed to examine indepth the themes that have been identifiedon the number of participants are morenumerous and varied.

Glucose Levels and Outcome After Primary Intraventricular Hemorrhage

2019 ◽  
Vol 16 (1) ◽  
pp. 40-46
Author(s):  
Rui Guo ◽  
Ruiqi Chen ◽  
Chao You ◽  
Lu Ma ◽  
Hao Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Incidence Rate ◽  
Glucose Level ◽  
Intraventricular Hemorrhage ◽  
Laboratory Data ◽  
History Of ◽  
Poor Outcomes ◽  
The Impact

Background and Purpose: Hyperglycemia is reported to be associated with poor outcome in patients with spontaneous Intracerebral Hemorrhage (ICH), but the association between blood glucose level and outcomes in Primary Intraventricular Hemorrhage (PIVH) remains unclear. We sought to identify the parameters associated with admission hyperglycemia and analyze the impact of hyperglycemia on clinical outcome in patients with PIVH. Methods: Patients admitted to Department of Neurosurgery, West China Hospital with PIVH between 2010 and 2016 were retrospectively included in our study. Clinical, radiographic, and laboratory data were collected. Univariate and multivariate logistic regression analyses were used to identify independent predictors of poor outcomes. Results: One hundred and seventy patients were included in the analysis. Mean admission blood glucose level was 7.78±2.73 mmol/L and 10 patients (5.9%) had a history of diabetes mellitus. History of diabetes mellitus (P = 0.01; Odds Ratio [OR], 9.10; 95% Confidence Interval [CI], 1.64 to 50.54) was independent predictor of admission critical hyperglycemia defined at 8.17 mmol/L. Patients with admission critical hyperglycemia poorer outcome at discharge (P < 0.001) and 90 days (P < 0.001). After adjustment, admission blood glucose was significantly associated with discharge (P = 0.01; OR, 1.30; 95% CI, 1.06 to 1.59) and 90-day poor outcomes (P = 0.03; OR, 1.27; 95% CI, 1.03 to 1.58), as well as mortality at 90 days (P = 0.005; OR, 1.41; 95% CI, 1.11 to 1.78). In addition, admission critical hyperglycemia showed significantly increased the incidence rate of pneumonia in PIVH (P = 0.02; OR, 6.04; 95% CI 1.27 to 28.80) even after adjusting for the confounders. Conclusion: Admission blood glucose after PIVH is associated with discharge and 90-day poor outcomes, as well as mortality at 90 days. Admission hyperglycemia significantly increases the incidence rate of pneumonia in PIVH.

scholarly journals Incidence of diabetes mellitus and associated risk factors in the adult population of the Basque country, Spain

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Inés Urrutia ◽  
◽  
Alicia Martín-Nieto ◽  
Rosa Martínez ◽  
J Oriol Casanovas-Marsal ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Basque Country ◽  
Adult Population ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Family History Of Diabetes ◽  
History Of ◽  
Incident Cases

AbstractThe aim of this study was to estimate the incidence of diabetes mellitus in the Basque Country and the risk factors involved in the disease by reassessing an adult population after 7 years of follow-up. In the previous prevalence study, 847 people older than 18 years were randomly selected from all over the Basque Country and were invited to answer a medical questionnaire, followed by a physical examination and an oral glucose tolerance test. In the reassessment, the same variables were collected and the resulting cohort comprised 517 individuals of whom 43 had diabetes at baseline. The cumulative incidence of diabetes was 4.64% in 7 years and the raw incidence rate was 6.56 cases/1000 person-years (95%CI: 4.11–9.93). Among the incident cases, 59% were undiagnosed. The most strongly associated markers by univariate analyses were age > 60 years, dyslipidaemia, prediabetes and insulin resistance. We also found association with hypertension, obesity, family history of diabetes and low education level. Multivariate analysis adjusted for age and sex showed that a set of risk factors assessed together (dyslipidaemia, waist-to-hip-ratio and family history of diabetes) had great predictive value (AUC-ROC = 0.899, 95%CI: 0.846–0.953, p = 0.942), which suggests the need for early intervention before the onset of prediabetes.

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