Hyperinsulinemic hypoglycemia in adults. Case reports and a short review

2008 ◽  
Vol 149 (35) ◽  
pp. 1659-1664 ◽  
Author(s):  
Erzsébet Kovács ◽  
Hajnalka Németh ◽  
Éva Pásztor ◽  
György Pfliegler
Keyword(s):  
Case Reports ◽  
Short Review ◽  
Hyperinsulinemic Hypoglycemia

A nem insulinoma eredetű tartós (perzisztáló) hyperinsulinaemiával járó hypoglykaemia oka a felnőttek körében ritkán előforduló nesidioblastosis. A nesidioblastosis hátterében álló inzulinszekréciós zavar molekuláris eltéréseken alapul. Morfológiailag különböző pancreassziget-, illetve béta-sejt-eltérések jellemzik, az inzulinhiperszekréció hátterében azonban körülhatárolható térfoglalás nem mutatható ki. A diagnózis alappillére az alacsony vércukorszint, a normoglykaemia intravénásan alkalmazott glükóz adásával történő fenntarthatósága, illetve az emelkedett inzulin- és C-peptid-szint. A hormontermelő tumor kizárásához mind invazív, mind nem invazív képalkotó módszerek szükségesek. A tartós, illetve ismétlődő hypoglykaemia káros hatásai gyógyszeres és/vagy sebészi kezeléssel előzhetők meg. Esetismertetés: A szerzők két betegük esetét ismertetik, akiknél felnőttkorban jelentkeztek a súlyos tünetekkel járó hypoglykaemiás epizódok. Nőbetegük „klasszikus” hypoglykaemiás tünetei 34 éves korban léptek fel: izzadás, szédülés, remegés, idegesség, illetve életveszélyes neuroglycopeniás jelek. Második, férfi betegük 22 éves, akinek fő panasza a hypoglykaemia ritka és szokatlan tünete, a nagyfokú éhségérzet mellett jelentkező puffadás volt. Az éhezési próbák mindkét esetben pozitívak voltak, vagyis hypoglykaemiás tünetek miatt fel kellett azokat függeszteni. Az inzulin- és a C-peptid-szintek magasak voltak, vénás inzulinszint-meghatározás az a. lienalis több pontjából és a képalkotó eljárások (komputertomográfia, mágneses rezonancia, pozitronemissziós tomográfia, angiográfia) nem tudtak igazolni térfoglalást. Az adatok alapján – szövettan hiányában is – a legvalószínűbb a felnőttkori nesidioblastosis diagnózisa. Diazoxid adásával mindkét esetben majdnem teljes tünetmentességet értek el, és neuroglycopeniás esemény a kezelés kezdete óta nem fordult elő. Következtetések: Ismeretlen eredetű hypoglykaemia esetén, ha a képalkotó eljárásokkal nincs körülírt képlet, a laboratóriumi adatok viszont egyértelműen emelkedett inzulinszekrécióra utalnak, gondolni kell nesidioblastosis lehetőségére. A sebészi beavatkozás veszélye pancreaselégtelenség éppúgy lehet, mint a betegség fennmaradása a hasnyálmirigy reszekciója miatt. Diazoxid adásával viszont tartós tünetmentesség érhető el ezen ritka kórképben, ezért érdemes elsőként ezt megkísérelni.

Bedside Cardiac Pocus in Emergency Setting: A Practice Review

2020 ◽  
Vol 15 ◽  
Author(s):  
Christian Zanza ◽  
Yaroslava Longhitano ◽  
Marco Artico ◽  
Gianmaria Cammarota ◽  
Andrea Barbanera ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Core Curriculum ◽  
Case Reports ◽  
Short Review ◽  
Rapid Identification ◽  
Cochrane Library ◽  
Emergency Setting ◽  
Holistic View ◽  
Questions And Answers ◽  
The Usa

Background: in the last years, ultrasound technology has entered in clinical practice as a tank and today, it has also allowed to no-cardiologists to extend and to deep their medical examination without the needing to call the consultant and having a good profile of diagnostic accuracy. The ultrasound bedside does not replace the consultant but it allows not to perform inappropriate consultations with more savings for hospitals. Objective: The aim was to review recently published literature to inform the clinician about the most up to date management of use bedside echography in emergency setting. In this short review we focused on two types of syndromes, no traumatichypotension and dyspnea, common to the three holistic disciplines of medicine, showing the main and basic questions and answers that ultrasound can give us for rapid identification of the problem Methods: We conducted a systematic review using Pubmed/Medline, Ovid/Willey and Cochrane Library, combining key terms such as “cardiac ultrasound, “cardiac diseases”,“emergency medicine”,“pocus”, “dyspnea”,“ hypotension”. We selected the most relevant clinical trials and review articles (excluding case reports) published in the last 19 years and in our opinion 59 publications appeared the best choice according to the PRISMA statement. In additional papers identified from individual article reference lists were also included. Conclusion: Recent studies have shown promise in establishing best practices for evaluation of heart, lung abdomen and deep vessels At the moment bedside US is widely used in an integrated ultrasound vision just like the holistic view have internal medicine, intensive care and emergency medicine and many medical schools in Europe and the USA are inserting ultrasonography into the core curriculum but we still have to find a standard method for the training program for minimum competence acquisition.

scholarly journals Introducing a New Feature to Allergy and Rhinology

2014 ◽  
Vol 5 (1) ◽  
pp. 215265671400500
Keyword(s):  
Case Reports ◽  
Short Review ◽  
Final Diagnosis ◽  
Open Access Journal ◽  
Original Research ◽  
Tissue Samples ◽  
Case Presentation ◽  
New Type ◽  
New Feature ◽  
Case Data

In this issue of Allergy and Rhinology, we are pleased to introduce a new type of article, “Pathology Quiz Case,” to complement the original research articles, case reports, and reviews that we currently publish. This special submission should consist of a case presentation that includes the following elements – 1) patient history, exam and initial case data, 2) pathological description of tissue samples, 3) differential diagnosis, 4) final diagnosis, and 5) a short review of the disease entity and the patient course. This feature should be educational for all trainees and practicing otolaryngologists. In particular, we welcome medical student, resident, and fellow submissions from otolaryngology training programs. Allergy and Rhinology is an open access journal cited in PubMed.

scholarly journals Symptomatic Thoracic Intramedullary Arachnoid Cyst: “A Rare Entity” Report of Two Cases with Short Review of Literature

2019 ◽  
Vol 10 (02) ◽  
pp. 306-311 ◽  
Author(s):  
Naresh Panwar ◽  
Devendra Kumar Purohit ◽  
Somnath Sharma ◽  
Sanjeev Chopra
Keyword(s):  
Arachnoid Cyst ◽  
Case Reports ◽  
Adult Population ◽  
Short Review ◽  
Arachnoid Cysts ◽  
Rare Entity ◽  
Review Of Literature ◽  
Benign Lesions ◽  
Clinicopathological Profile ◽  
Compressive Myelopathy

ABSTRACTSpinal arachnoid cysts are uncommon benign lesions of spine axis and most commonly present as compressive myelopathy. Intramedullary arachnoid cyst is uncommonly seen, hence, not much discussed in literature. Due to rarity of this entity, many questions are yet to be answered and should be addressed properly, particularly related to etiopathogenesis, accustomed course, behavior, differential diagnosis, and the best treatment modality. We report the clinicopathological profile of thoracic intramedullary arachnoid cysts in two adult patients, and present a detailed review of available literature on the spinal intramedullary arachnoid cyst. Most of the literature concerning with intramedullary arachnoid cysts are in the form of case reports from pediatrics population. As far to the best of our knowledge, only a few cases excluding our two were found in both pediatrics and adult population.

scholarly journals Retrieval of displaced implants inside the maxillary sinus: two case reports and a short review

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Maria Gnigou ◽  
Lampros Goutzanis ◽  
Stavros Sarivalasis ◽  
Vasilios Petsinis
Keyword(s):  
Maxillary Sinus ◽  
Case Reports ◽  
Short Review

scholarly journals Successful Treatment of Genitofemoral Neuralgia Using Ultrasound Guided Injection: A Case Report and Short Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Harsha Shanthanna
Keyword(s):  
Case Report ◽  
Pain Relief ◽  
Groin Pain ◽  
Case Reports ◽  
Young Male ◽  
Short Review ◽  
Therapeutic Procedure ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Genitofemoral Nerve

A young male patient developed chronic, severe, and disabling right sided groin pain following resection of his left testicular cancer. Since there is considerable overlap, ultrasound guided, selective diagnostic nerve blocks were done for ilioinguinal, iliohypogastric, and genitofemoral nerves, to determine the involved nerve territory. It was revealed that genitofemoral neuralgia was the likely cause. As a therapeutic procedure, it was injected with local anesthetic and steroid using ultrasound guidance. The initial injection led to pain relief of 3 months. Subsequent blocks reinforced the existing analgesia and were sufficient to allow for maintenance with the use of analgesic medications. This case report describes the successful use of diagnostic selective nerve blocks for the assessment of groin pain, subsequent to which an ultrasound guided therapeutic injection of genitofemoral nerve led to long term pain relief. As a therapeutic procedure, genitofemoral nerve block is done in patients with genitofemoral neuralgia. Ultrasound allows for controlled administration and greatly enhances the technical ability to perform precise localization and injection. There are very few case reports of such a treatment in the published literature. Apart from the case report, we also highlight the relevant anatomy and a brief review of genitofemoral neuralgia and its treatment.

scholarly journals Anxiety and depression in post-Menopausal women: A short review

2021 ◽  
Vol 8 (2) ◽  
pp. 38-41
Author(s):  
Neema Acharya ◽  
Sparsh Madaan ◽  
Arpita Jaiswal ◽  
Deepika Dewani ◽  
Kanan Kotdawala
Keyword(s):  
Mental Health ◽  
Vitamin D ◽  
Case Reports ◽  
Psychological Disorders ◽  
The Elderly ◽  
Short Review ◽  
Cross Sectional ◽  
Vitamin D Levels ◽  
Menopausal Women ◽  
Post Menopausal

Anxiety, Depression and stress are one of the most prevalent psychological problems witnessed in post-menopausal women. These complaints are mostly neglected by the females and ignored due to social stigmas and lack of awareness amongst the elderly population regarding the same. It often affects the quality of life and is thus essential to diagnose and treat on time. Reduced Vitamin D and estrogen levels are one of the proposed culprits behind these psychological disorders in post-menopausal women which will be discussed in this review.Systematic literature review was done with the help of data search domains such as Pubmed, Scopus, Web of science and google scholar. Case reports, observational studies and cross-sectional studies were included in this review.Depression and anxiety are common problems for the post-menopausal women. Various factors such as reduced Vitamin D levels and Estrogen levels as well as increased stress can contribute to development of these psychological complaints. Though these problems might look benign to the patients, they can severely impact the mental health and require more awareness amongst the patients to improve the mental as well as physical health in post-menopausal women.Women in the post-menopausal stage have increased predisposition towards developing psychological disorders and hence the assessment of mental health is essential in these females which should be a vital part of the evaluation done of these females.

scholarly journals Coffee Consumption and Cardiovascular Disease Risk: What Should We Tell Our Patients?

2016 ◽  
Vol 30 (1&2) ◽  
pp. 34
Author(s):  
Krysthel Engstrom
Keyword(s):  
Cardiovascular Disease ◽  
Retrospective Studies ◽  
Disease Risk ◽  
Case Reports ◽  
Cardiovascular Disease Risk ◽  
Coffee Consumption ◽  
Short Review ◽  
Supporting Evidence ◽  
Randomized Controlled ◽  
The Past

The association between coffee and the risk of cardiovascular disease has been studied over the past 20 years. Given the complexity of conducting large, randomized, controlled trials to prove causality, conclusions are based on case reports, retrospective studies, and small physiologic trials. Surveys determine that most physicians advise discontinuing or reducing consumption of caffeine in patients with known heart disease, yet this recommendation lacks strong supporting evidence. The following is a short review of the effects of coffee and caffeine on the cardiovascular system that aims to provide objective advice to physicians and patients based on the published literature. 

Mirizzi Syndrome—Two Case Reports and a Short Review of the Literature

2011 ◽  
Vol 96 (3) ◽  
pp. 228-232 ◽  
Author(s):  
Petar B. Petricevic ◽  
Olga M. Kontic ◽  
Miomira Z. Petricevic ◽  
Marko M. Kontic ◽  
Geza Smit
Keyword(s):  
Bile Duct ◽  
Comparative Study ◽  
Preoperative Diagnosis ◽  
Ultrasound Examination ◽  
Case Reports ◽  
Short Review ◽  
Mirizzi Syndrome ◽  
Review Of The Literature ◽  
Operative Cholangiography ◽  
Significant Difference

Abstract The authors have analyzed the problem of Mirizzi syndrome (MS) and found in the literature that it was reported in 0.3% to 3% of patients undergoing cholecystectomy. Anatomic disorder, especially the presence of cholecystocholedochal fistula, increases the risk of bile duct injury during cholecystectomy, albeit more often during laparoscopic than laparotomic cholecystectomy. A comparative study was performed regarding the incidence of MS in two groups of patients: 332 patients in Zrenjanin in the year 2009, and 531 patients in Belgrade in the year 2005, with an incidence of MS found in 2 patients in Zrenjanin (0.63%) and 4 patients in Belgrade (0.75%). The incidence rate was 6% in Zrenjanin and 7.5% in Belgrade, but there was no statistically significant difference between the two groups. All patients with MS were diagnosed during the operative period using operative cholangiography. During preoperative diagnosis, patients underwent laboratory ultrasound examination, and those who were suspected of having an anatomic disorder underwent operative cholangiography, although patients today more often undergo choledochoscopy then cholangiography. MS according to classification by Csendes was found in all 6 patients undergoing operation.

Sign in / Sign up

Export Citation Format

Share Document