scholarly journals Clinical Reasoning: Myokymia, Dysautonomia, and Uveitis Researching a Common Denominator

2020 ◽  
Vol 3 (1) ◽  
pp. 22-24
Author(s):  
Mikhail M ◽  
Maurice C
Keyword(s):  
Avascular Necrosis ◽  
Limbic Encephalitis ◽  
Diabetes Type 2 ◽  
Common Denominator ◽  
Shortness Of Breath ◽  
Steroid Use ◽  
Night Sweats ◽  
History Of ◽  
Artery Disease

A 56-year old man, originally from Pakistan, presented with bilateral avascular necrosis of the hips on a background of emphysema, pulmonary fibrosis, coronary artery disease, diabetes type 2 and psoriasis. The cause of the avascular necrosis was unclear, with no recent trauma or steroid use. During his preoperative consultation, he presented dysautonomia requiring an inpatient investigation; the surgery was canceled. He reported a thirty-pound weight loss and a three-week history of night sweats and shortness of breath. While hospitalized, this gentleman presented subacute confusion and fluctuation of his sensorium, compatible with limbic encephalitis. Furthermore, he developed diffuse myokymia involving the axial and appendicular musculature, confirmed by EMG.

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.

scholarly journals Neuroinflammation as a Common Denominator of Complex Diseases (Cancer, Diabetes Type 2, and Neuropsychiatric Disorders)

2021 ◽  
Vol 22 (11) ◽  
pp. 6138
Author(s):  
Serena Asslih ◽  
Odeya Damri ◽  
Galila Agam
Keyword(s):  
Cell Activation ◽  
Neuronal Degeneration ◽  
Complex Diseases ◽  
Diabetes Type 2 ◽  
Neuropsychiatric Disorders ◽  
Diabetes Type ◽  
Common Denominator ◽  
Cancer Type ◽  
Complex Disorders

The term neuroinflammation refers to inflammation of the nervous tissue, in general, and in the central nervous system (CNS), in particular. It is a driver of neurotoxicity, it is detrimental, and implies that glial cell activation happens prior to neuronal degeneration and, possibly, even causes it. The inflammation-like glial responses may be initiated in response to a variety of cues such as infection, traumatic brain injury, toxic metabolites, or autoimmunity. The inflammatory response of activated microglia engages the immune system and initiates tissue repair. Through translational research the role played by neuroinflammation has been acknowledged in different disease entities. Intriguingly, these entities include both those directly related to the CNS (commonly designated neuropsychiatric disorders) and those not directly related to the CNS (e.g., cancer and diabetes type 2). Interestingly, all the above-mentioned entities belong to the same group of “complex disorders”. This review aims to summarize cumulated data supporting the hypothesis that neuroinflammation is a common denominator of a wide variety of complex diseases. We will concentrate on cancer, type 2 diabetes (T2DM), and neuropsychiatric disorders (focusing on mood disorders).

Possible GoLytely-Associated Cardiac Arrest: A Case Report and Literature Review

2019 ◽  
Vol 33 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Yoonsun Mo ◽  
Shiv Gandhi ◽  
Jose Orsini
Keyword(s):  
Cardiac Arrest ◽  
Abdominal Pain ◽  
Sudden Cardiac Arrest ◽  
Lower Abdominal Pain ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
Artery Disease ◽  
Possible Cause

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.

Systematic Review of the Epidemiology and Natural History of the Metabolic Vascular Syndrome and its Coincidence with Type 2 Diabetes Mellitus and Cardiovascular Diseases in Different European Countries

2017 ◽  
Vol 50 (03) ◽  
pp. 201-208 ◽  
Author(s):  
Caroline Kwasny ◽  
Ulf Manuwald ◽  
Joachim Kugler ◽  
Ulrike Rothe
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
United Kingdom ◽  
Cardiovascular Diseases ◽  
Natural History ◽  
European Countries ◽  
History Of ◽  
Artery Disease ◽  
The Many

AbstractThe objectives of this systematic review were to estimate the incidence, prevalence and natural history of the metabolic (vascular) syndrome (MVS) among adults in different European countries. Furthermore, we assessed its co-incidence with type 2 diabetes (T2DM) and cardiovascular diseases (CVD). PubMed, MedLine, and EMBASE (via Ovid) were searched for relevant studies. After reading 116 full-text articles to find eligible ones, 66 publications met our inclusion criteria. Data for the incidence are based on a study from Portugal, in which the incidence rate for the MVS was 47.2/1000 person-years. Prevalence varied strongly depending on country and definition. The lowest was found in the United Kingdom (3%), the highest in Finland (71.7%). No article that deals with the natural history of the MVS was found. Considering the co-existence of MVS and T2DM, it ranged between 2% (United Kingdom) and 74.4% (Spain). The co-occurrence of MVS and CVD ranged from 2.8% (Italy) up to 52% (Netherlands). Coronary heart disease (CHD) varied between 1.2% and 44.2%. With regard to peripheral artery disease (PAD), values between 3.3% and 59.8% were found. Due to the many different definitions of the MVS, a comparison is very difficult. Overall prevalence ranged between 3% and 71.7% depending on definition, age, and country. An association between MVS and T2DM as well as several CVD can be assumed.

scholarly journals Potential risk factors for developing diabetes mellitus type 2

2010 ◽  
Vol 63 (3-4) ◽  
pp. 231-236 ◽  
Author(s):  
Dusica Zivanovic ◽  
Sandra Sipetic ◽  
Marina Stamenkovic-Radak ◽  
Jelena Milasin
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Family History ◽  
Physical Inactivity ◽  
Positive Family History ◽  
Diabetes Type 2 ◽  
Diabetes Type ◽  
Family History Of Diabetes ◽  
History Of

Introduction Type 2 diabetes mellitus is a common multifactorial genetic syndrome, which is determined by several genes and environmental factors. The aim of the present study was to investigate the presence of risk factors for developing diabetes type 2 among diabetic individuals and to compare the presence of risk factors among diabetic individuals with and without positive family history for type 2 diabetes. Material and methods This study was conducted in Cuprija during the period from February to June 2002. The case group included 137 individuals having diagnosis type 2 diabetes. The control group included 129 subjects having the following diagnoses: hypertension, angina pectoris, chronic obstructive lung disease, gastric ulcer or duodenal ulcer. All participants were interviewed at the Medical Center Cuprija using structural questionnaire. The data were collected regarding demographic characteristics, exposure to various chemical and physical agents, stress, smoking, obesity, physical inactivity and family history of diabetes. In the statistical analysis chi square test was used. Results The diabetic individuals were statistically significantly older (40 and more years old) (p=0,000), and they came from rural areas more frequently (p=0,006) than the individuals without diabetes. Significantly more diabetics had lower educational level (p=0,000) and they were agriculture workers and housewives significantly more frequently (p=0,000) than nondiabetic individuals. Furthermore, obesity (p=0,000) and physical inactivity (p=0,003) were significantly more frequent among the diabetic individuals than the nondiabetics. The diabetic individuals had significanly (p=0,000) more numbers of relatives with diabetes mellitus type 2 than the nondiabetics. The diabetic individuals with positive family history of diabetes were significantly older (p=0,021) and more frequently from urban areas (p=0,018) than the diabetic individuals without the positive family history of diabetes. Also they were significantly less exposed to physical agents (p=0,004). Discussion In our study, like in many others, age, place of residence, education, occupation, obesity, physical inactivity, positive family history of diabetes type 2 and exposure to physical agents were identified as potential risk factors for diabetes type 2. Conclusion Different risk factors are probably responsible for developing type 2 diabetes among individuals with and without positive family history of type 2 diabetes.

scholarly journals Obesity and Covid-19: A Major Mortality Risk in Patients Hospitalized With Covid-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A53-A53
Author(s):  
Giovanna Rodriguez ◽  
Eunice Kim ◽  
Fausto Cabezas ◽  
Paulomi Dave ◽  
Jefferson Li ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Normal Weight ◽  
Health Crisis ◽  
City Community ◽  
Patients With Diabetes ◽  
History Of ◽  
Artery Disease

Abstract The coronavirus disease 2019 COVID-19 pandemic is a major public health crisis. Obesity has emerged as a significant comorbidity for COVID-19 severity. To study the association of both pandemics, we conducted an observational, retrospective cohort study involving 521 patients admitted with Covid-19 to an inner city, community hospital in Brooklyn, NY in the period March 20 to May 2, 2020. Of the cohort, 57.6% was men, mean age was 61.6±17.2 years, and mean BMI was 29.0 ± 8.2 kg /m2. 11% had BMI > 40 kg/m2. 53.9% was Hispanic, 33.3% was African American, 7.1% was White, with a predominance of type 2 diabetes (99%). Diabetes, hypertension, coronary artery disease and chronic kidney disease were found in 45%, 41.5%, 15%, and 20.1% cases, respectively. Mean HbA1c was 5.8%± 1.1 in patients with no history of diabetes, 3% presented with diabetic ketoacidosis, mortality rate was 30.6%. Non-survivors were significantly older (median age 68 vs 56, p < 0.03) and had higher rate of microvascular and macrovascular diseases. In patients with diabetes, mortality rate was 40.1%. HbA1c was similar between survivors and non-survivors. Older age and hyperglycemia on admission were the risk factors for mortality. Only 30% of the cohort had normal weight (BMI<25), 30% was overweight and 40% was obese. In univariate analysis, the characteristics at admission significantly associated with mortality were age, BMI, hyperglycemia, diabetes and DKA in patients with or without diabetes. In age- and sex-adjusted multivariable analysis only BMI 30–39 kg/m2 (OR = 1.63; 95% CI, 1.10, 2.43; p = 0.015), BMI >40 kg/m2 (OR = 2.05; 95% CI, 1.22, 3.44; p = 0.007) and DKA (OR = 1.77; 95% CI, 1.18, 2.64; p = 0.005) remained positively associated with higher mortality. In summary, BMI, and DKA but not diabetes, were positively and independently associated with mortality in patients hospitalized with Covid-19. Reference: (1) Popkin et al., Obesity Reviews 2020 August;21(11):e13128. (2) Cariou et al., Diabetologia 2020 May;63(8): 1500–1515.

Intravenous fosfomycin as salvage therapy for osteomyelitis caused by multidrug-resistant Pseudomonas aeruginosa

2021 ◽  
Author(s):  
Maggie Wong ◽  
Davie Wong ◽  
Sangita Malhotra
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Salvage Therapy ◽  
Wound Care ◽  
Multidrug Resistant ◽  
Wound Culture ◽  
History Of ◽  
Artery Disease ◽  
Oral Ciprofloxacin ◽  
Oral Metronidazole

Abstract Purpose A case of osteomyelitis caused by multidrug-resistant (MDR) Pseudomonas aeruginosa is reported. Summary An 84-year-old Caucasian male with an underlying history of type 2 diabetes, peripheral vascular disease, and coronary artery disease had chronic nonhealing wounds on his right foot. Wound care and a course of intravenous (IV) ertapenem with oral ciprofloxacin were ineffective. His initial wound culture grew Staphylococcus aureus, group G streptococcus and P. aeruginosa; the Pseudomonas was susceptible to multiple agents. The patient eventually required midtarsal amputation and angioplasties to his right leg. Twenty days after the operation, 2 openings were discovered at the surgical site, 1 of which was probed to the bone. He was readmitted 5 weeks after the operation. A repeat wound swab grew MDR P. aeruginosa and Finegoldia magna. The Pseudomonas was susceptible to gentamicin and colistin. The patient had revision of the infected amputation site with the goal of salvaging his right lower limb. The patient developed acute renal failure after 26 days of IV gentamicin, IV ceftriaxone, and oral metronidazole. Additional susceptibility testing was performed to identify alternatives. The bacteria were considered susceptible to IV fosfomycin, the last resort, by our microbiology laboratory. This was combined with ceftolozane/tazobactam followed by meropenem to treat the residual infection. After 2 weeks of IV fosfomycin, the patient’s wound improved and further amputation was avoided. Conclusion Our case demonstrates that IV fosfomycin may provide an effective salvage therapy when combined with β-lactams for the treatment of severe diabetic foot infection or osteomyelitis caused by MDR P. aeruginosa.

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