scholarly journals Pulmonary Mucormycosis as the Leading Clinical Type of Mucormycosis in Western China

2021 ◽  
Vol 11 ◽  
Author(s):  
Junyan Qu ◽  
Xijiao Liu ◽  
Xiaoju Lv
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Clinical Outcomes ◽  
Amphotericin B ◽  
Clinical Laboratory ◽  
Histopathological Examination ◽  
Clinical Manifestations ◽  
Western China ◽  
Pulmonary Mucormycosis ◽  
Clinical Type

The aim was to better understand the clinical characteristics of patients with mucormycosis in western China. We retrospectively investigated the clinical, laboratory, radiological and treatment profiles of mucormycosis patients during a 10-year period (2010–2019). As a result, 59 proven mucormycosis were enrolled in this study. It was found that 52.5% of patients had worse clinical outcomes. Pulmonary mucormycosis (PM) was the most common clinical manifestation. The most frequent risk factor was diabetes mellitus (38, 64.4%) for mucormycosis patients. Cough (43, 93.5%), fever (24, 52.2%) and hemoptysis/bloody phlegm (21, 45.7%) were the most common manifestations of PM. There were no differences in clinical manifestations, risk factors and laboratory tests between different clinical outcome groups (P>0.05). Lymph node enlargement (30, 65.2%), patchy shadows (28, 60.9%), cavitation (25, 53.3%) and bilateral lobe involvement (39, 84.8%) were the most common on chest CT. Nodule was more common in good outcome group (P <0.05). A total of 48 cases (81.4%) were confirmed by histopathological examination, 22 cases (37.3%) were confirmed by direct microscopy. PM patients were treated with amphotericin B/amphotericin B liposome or posaconazale had better clinical outcomes (P <0.05). In conclusion, PM was the most common clinical type of mucormycosis in China. Diabetes mellitus was the most common risk factor. PM has diverse imaging manifestations and was prone to bilateral lobes involvement. Early diagnosis and effective anti-mucor treatment contribute to successful treatment.

scholarly journals Review on mucormycosis in the oro-facial region: an overview

2021 ◽  
Vol 8 (10) ◽  
pp. 5060
Author(s):  
Yogashree Sonawane ◽  
Ankeeta Ahire ◽  
Ananya Saha
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Amphotericin B ◽  
Clinical Manifestation ◽  
Clinical Manifestations ◽  
Predisposing Factor ◽  
Facial Region ◽  
Drug Of Choice ◽  
Orofacial Region

The study aims to identify the clinical manifestation of mucormycosis in the oro-facial region to distinguish the role of meticulous intraoral examination for early and timely diagnosis based on the review of reported cases, to propose the role of diabetes mellitus as a predisposing risk factor for mucormycosis in the oro-facial region, to propose the association of traumatic incidents like tooth extraction as a risk factor for mucormycosis in immune-compromised individuals and to perceive the use of amphotericin-B in its treatment. A systematic review was conducted on an electronic database, Google Scholar to analyze the existing data for the clinical manifestation of mucormycosis in the orofacial region. Out of the existing literature on this topic for various timelines, a period of 10 years from 2011 to 2021 was selected for the study. The sample size was calculated taking into consideration the 99.99% confidence interval. The data was extracted from these relevant articles in Microsoft Excel, showing remarkable conclusions. Mucormycosis does not show stereotypical clinical manifestations and thus the diagnosis of mucormycosis has to be confirmed through culture studies and histopathological or radiological ways. Diabetes Mellitus serves as a predisposing factor for mucormycosis in the oro-facial region other than the COVID-19 infection and immune-compromised conditions. Amphotericin-B was a drug of choice for the treatment of mucormycosis by many practitioners. The only hindrance to its usage being its nephrotoxicity.

scholarly journals Erectile dysfunction in men with diabetes (literature review) Part 1

2021 ◽  
Vol 17 (5) ◽  
pp. 426-434
Author(s):  
E.V. Luchytskyy ◽  
V.Ye. Luchytskiy
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Risk Factor ◽  
Erectile Dysfunction ◽  
Rating Scale ◽  
Sexual Experience ◽  
Clinical Manifestations ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Patients With Diabetes

The first part of the review article highlights modern views on the prevalence, etiology and features of the pathogenesis of erectile dysfunction (ED) in men with diabetes mellitus. Google Scholar and PubMed databases were used to search for literature sources. The role of comorbid diseases in the development of ED in men with diabetes mellitus has been shown. The generalized data on the main clinical manifestations of erectile dysfunction, methods of its diagnosis and treatment are given. A number of epidemiological studies over the past 20 years have found that erectile dysfunction in men with diabetes may be an early marker of cardiovascular complications. Thus, in the algorithm for ED diagnosis in patients with diabetes it is necessary to conduct a thorough examination of the cardiovascular system. Numerous literature sources indicate an important role in the correction of androgen deficiency in men with type 2 diabetes, in order to enhance the effectiveness of phosphodiesterase type 5 inhibitors. Erectile dysfunction involves a change in any of the components of an erectile response. ED can negatively affect a man’s quality of life because most patients experience symptoms of depression and anxiety related to their sexual capabilities. These symptoms also affect a partner’s sexual experience and the couple’s quality of life. Clinical features of ED have many key features in the anamnesis, including some physical signs during examination depending on a type of diabetes. With age, comorbid conditions play an increasing role in the development of ED. Diabetes mellitus, cardiovascular diseases, obesity can lead to the development of ED before accelerated deterioration of erectile function and disorders at the molecular level of the mechanisms underlying erection. Patients with diabetes and ED have higher scores on the depression rating scale, and poorer overall health and quality of life. Early detection of ED in individuals with diabetes can improve the overall health and quality of life of patients. Patients with diabetes with poor glycemic control and older age are more likely to develop severe ED, which further exacerbates an already compromised health and quality of life. According to the National Health and Nutrition Examination Survey (2001–2002), diabetes mellitus is a modified risk factor independently associated with the development of ED (odds ratio (OR) 2.69), obesity (OR 1.60), smoking (OR 1.74) and hypertension (OR 1.56). Erectile dysfunction is a common complication of diabetes, and diabetes is a risk factor for ED; men with diabetes are three times more likely to have ED.

scholarly journals Clinical Characteristics and Prognostic Factors in Pediatric Vascular Tumors

2020 ◽  
Author(s):  
Piya Rujkijyanont ◽  
Chanchai Traivaree ◽  
Nucharin Supakul ◽  
Kantang Satayasoontorn ◽  
Apichat Photia ◽  
...  
Keyword(s):  
Risk Factor ◽  
Prognostic Factors ◽  
Clinical Outcomes ◽  
Clinical Characteristics ◽  
Independent Risk Factor ◽  
Clinical Manifestations ◽  
Age At Diagnosis ◽  
Vascular Tumors ◽  
P Value ◽  
Treatment Approaches

Abstract Background: Vascular tumor is a specific entity of vascular anomalies with variable clinical manifestations and outcomes. Although surgical intervention is the gold standard to establish diagnosis and treatment, the procedure also carries certain risk especially in cases with large and inoperable tumors. Determinant factors to predict clinical outcomes among those patients were not well studied. The study aimed to explore clinical characteristics including investigational and treatment approaches as well as associated prognostic factors of vascular tumors specifically in pediatric populations. Methods: Pediatric patients with confirmed diagnosis of vascular tumors between January 1, 2005 and December 31, 2017 were enrolled in this study. Clinical data including initial clinical manifestations with associated complications, diagnostic studies used to establish diagnosis, treatment modalities provided and final outcomes were retrospectively reviewed and analyzed. Results: In all, 50 patients with confirmed diagnosis of vascular tumors were enrolled. The median age at diagnosis was 11.5 years with equal gender distribution. The most common type of vascular tumors was hemangioma (n=41, 82%), followed by pyogenic granuloma (n=4, 8%), kapasiform hemangioendothelioma with Kasabach-Merritt phenomenon (n=2, 4%), infantile hepatic hemangioma (n=2, 4%) and juvenile nasal angiofibroma (n=1, 2%). The median age at diagnosis among patients with cutaneous vascular tumors (12.4 years) was significantly older than the age of those with visceral vascular tumors (1.3 years) with p-value of 0.009. The mean size among patients with visceral tumors (7.46±4.84 cms) was significantly greater than the size among patients with cutaneous tumors (3.21±3.7 cms) with p-value of 0.023. Size of the tumor was the only independent risk factor associated with clinical outcomes.Conclusion: Clinical characteristics of vascular tumors are heterogenous. Diagnosis can be made using clinical manifestations combined with radiological and histopathological examination. Treatment approaches consist of close observation, medications and surgery. Clinical outcomes are favorable among most patients and size of the tumor is an independent risk factor associated with outcomes. This study was registered at www.clinicaltrials.in.th under the title, “Vascular tumors in pediatric hematology-oncology settings” with registration number: TCTR20190917001.

scholarly journals Pulmonary Mucormycosis: A Case Report of a Rare Infection with Potential Diagnostic Problems

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Salwa O. Mekki ◽  
Amal A. Hassan ◽  
Afnan Falemban ◽  
Nashwa Alkotani ◽  
Salem M. Alsharif ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Hematological Malignancies ◽  
Histopathological Examination ◽  
Past History ◽  
Early Management ◽  
Pulmonary Mucormycosis ◽  
Life Threatening ◽  
History Of

Pulmonary mucormycosis is a relatively rare pulmonary fungal disease, which is difficult to diagnose early and lacks effective treatment. It is seen in patients with hematological malignancies, diabetes mellitus, and immunocompromised states. The diagnosis depends primarily on the detection of fungi in lung tissue. Here, we present a case of a 52-year-old male who has type 2 diabetes mellitus and a past history of treated pulmonary tuberculosis. Clinical diagnosis is difficult in pulmonary mucormycosis, and early diagnosis is needed for this life-threatening infection. Histopathological examination of a resected cavity confirmed the diagnosis of pulmonary mucormycosis. This report highlights the difficulty of diagnosis and the importance of histological examination in detecting mucormycosis which will help for early management.

scholarly journals serum 25(oH)D level in patients with CoVID-19

2020 ◽  
Vol 12 (3) ◽  
pp. 21-27 ◽  
Author(s):  
T. L. Karonova ◽  
А. Т. Andreeva ◽  
М. А. Vashukova
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Risk Factor ◽  
Vitamin D Deficiency ◽  
Fatal Outcome ◽  
Clinical Manifestations ◽  
Obese People ◽  
Coronavirus Infection ◽  
Severity Of The Disease ◽  
Disease Analysis

Recently, vitamin D deficiency is considered as a risk factor for the incidence and severity of new coronavirus infection. The aim of this work was to evaluate the vitamin D level of patients with COVID-19 hospitalized with communityacquired pneumonia and compare the value of 25(OH)D in blood serum with the clinical manifestations of the disease. Results. Included are 80 patients aged 18 to 94 years (mean age 53,2 ± 15,7 years), 43 (53,8%) men; with severe course – in 25 (31,3%) patients (12 males), and moderate – in 55 people (68,7%) (31 males). Half of the severely ill patients were obese, and among the deceased patients, the number of obese people was 61,5%, which was significantly higher than the discharged ones – 14,9% (p<0,001). Diabetes mellitus and cardiovascular diseases occurred with the same frequency, regardless of the severity of the disease. Analysis of the outcomes of coronavirus infection in these patients showed mortality in 52,0% of cases in severe patients. Serum 25(OH)D level ranged from 3,0 to 88,8 ng / ml (16,7 ± 12,7 ng / ml). It was found that in patients with severe course, the level of 25(OH)D blood was significantly lower (11.9 ± 6.4 ng / ml) and vitamin D deficiency was more common than in patients with moderate to severe course of the disease (18,5 ± 14,0 ng / ml, p = 0,027). The same pattern was revealed in patients with a fatal outcome, where the level of 25(OH)D was 10,8 ± 6,1 ng / ml, compared with this indicator in patients discharged from the hospital (17,8 ± 13,4 ng / ml) (p = 0,02). Conclusions. Vitamin D deficiency and obesity have been found to increase the risk of severe course and death of coronavirus infection.

scholarly journals Clinical, Laboratory and Ultrasonographic Findings of Diabetic Dog with Emphysematous Cystitis

2019 ◽  
Vol 47 ◽  
Author(s):  
Francisco Felipe De Magalhães ◽  
Francisco Jucélio Correia Canuto ◽  
Gisele De Oliveira Matos Gomes ◽  
Marília Lídia Maia Rôla ◽  
Roméria Rodrigues Barbosa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Urinary Bladder ◽  
Clinical Laboratory ◽  
Urine Culture ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Diagnostic Tools ◽  
Emphysematous Cystitis ◽  
History Of ◽  
Diabetic Dog

Background: Emphysematous cystitis is a rare inflammatory disease of the lower urinary tract characterized by the accumulation of gas within the wall and lumen of the urinary bladder. The clinical manifestations of emphysematous cystitis resemble those of bacterial cystitis, often hindering the differentiation between the two. In this work, we report a case of emphysematous cystitis in a diabetic dog. The diagnosis of cystitis was followed by ultrasonography for the early detection of emphysematous cystitis, which showed the presence of multifocal and irregular hyperechoic interfaces forming a distal reverberation artifact.                                                                                       Case: A 9-year-old female dog was referred to VETCLINIC Veterinary Hospital 24 hours with a history of urinary incontinence, polydipsia, polyuria, and diabetes mellitus. At first, the blood glucose was measured and found to be 376 mg/dL. Blood count, biochemical measurements of alkaline phosphatase (AF), urea, creatinine, and alanine aminotransferase (AAT), urinalysis, urine culture with antimicrobial susceptibility testing, and abdominal ultrasonography were performed. The hematological exams showed that the serum was lipemic and with hemolysis; the values of AAT, AF, and total plasma proteins were above the reference values; hematocrit was below the normal level; erythrocyte rouleaux and thrombocytosis with platelet aggregates were present. Urinalysis showed the presence of traces of proteins, glucose, and occult blood as well as granular and hyaline cylinders and transitional epithelial cells. In urine culture, growth of the aerobic bacteria Klebsiella pneumoniae was observed, being sensitive to most of the antimicrobials. Ultrasonography showed the presence of gas in the wall of the urinary bladder, besides a discrete thickening of the wall, compatible with the diagnosis of emphysematous cystitis.                                                                                                   Discussion: The first report of emphysematous cystitis in dogs was made in 1926 in a diabetic dog. Emphysematous cystitis is complicated, characterized by the presence of gas in the wall and lumen of the urinary bladder. It is usually reported in patients with diabetes mellitus. The patient presented with a very high glycemic index (376 mg/dL), in addition to having a history of urinary obstruction and presence of bladder stones, which may have acted as predisposing factors for the onset of emphysematous cystitis. In the present case, ultrasonography was the examination of choice. Hyperechoic reverberation-forming lines, identified as gas present in the topography of the urinary bladder, were easily visualized, as described in the literature. For the treatment of this condition, adequate management of the diet and the correct use of antimicrobials are of fundamental importance since the presence of diabetes mellitus in this patient can present serious complications in the future. This report shows the importance of the use of a combination of diagnostic tools to arrive at the correct diagnosis of the patient.

scholarly journals CASE OF POST COVID PULMONARY MUCORMYCOSIS

2021 ◽  
pp. 51-53
Author(s):  
Chetan Prajapati ◽  
Jagruti Ahir ◽  
Ghanshyam Borisagar ◽  
Madhavi Dhameliya
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Hematological Malignancies ◽  
Histopathological Examination ◽  
Past History ◽  
Early Management ◽  
Pulmonary Mucormycosis ◽  
Life Threatening ◽  
History Of

Pulmonary mucormycosis is a relatively rare pulmonary fungal disease, which is difficult to diagnose early and lacks effective treatment. It is seen in patients with hematological malignancies, diabetes mellitus, and immunocompromised states. The diagnosis depends primarily on the detection of fungi in lung tissue. Here, we present a case of a 54-year-old male who has type 2 diabetes mellitus and a past history of treated covid positive LRTI. Clinical diagnosis is difficult in pulmonary mucormycosis, and early diagnosis is needed for this life-threatening infection. Histopathological examination of a resected cavity confirmed the diagnosis of pulmonary mucormycosis. This report highlights the difficulty of diagnosis and the importance of histological examination in detecting mucormycosis which will help for early management.

Impact of Diabetes Mellitus on Percutaneous Coronary Intervention in Chinese Patients: A Large Single-Center Data

Angiology ◽  
2017 ◽  
Vol 69 (6) ◽  
pp. 540-547 ◽  
Author(s):  
Huanhuan Wang ◽  
Zhan Gao ◽  
Ying Song ◽  
Xiaofang Tang ◽  
Jingjing Xu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Percutaneous Coronary Intervention ◽  
Risk Factor ◽  
Clinical Outcomes ◽  
Independent Risk Factor ◽  
Coronary Intervention ◽  
Chinese Patients ◽  
Diabetic Patients ◽  
Percutaneous Coronary

Aim: To investigate the impact of diabetic status on 2-year clinical outcomes in Chinese patients undergoing contemporary percutaneous coronary intervention (PCI) treatment. Methods and Results: A total of 10 724 consecutive patients underwent PCI at Fu Wai Hospital were prospectively collected. Two-year clinical outcomes were compared between patients with and without diabetes mellitus (DM). Diabetic patients had more baseline clinical risks and more extensive coronary disease. During 2-year follow-up, the rates of all-cause death, myocardial infarction (MI), revascularization, and major adverse cardiac events (MACE) were significantly higher in DM group. After multivariable-adjusted Cox regression analysis, DM was an independent risk factor for MACE but not for the individual components of MACE. After performing propensity score matching, rates of all-cause death, MI, revascularization, stroke, stent thrombosis, and MACE were not significantly different between the 2 groups, and DM was not predictive of MACE and any clinical adverse outcomes. Conclusions: Diabetic patients who underwent PCI had worse prognosis including death and repeat revascularization during 2-year follow-up, but DM was not an independent risk factor for adverse clinical outcomes.

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