1,196 results match your criteria Hyperosmolar Coma


Decompression Hemicraniectomy for Refractory Intracranial Hypertension in Reversible Cerebral Vasoconstriction Syndrome.

J Neurosci Rural Pract 2019 Apr-Jun;10(2):355-359

Division of Neurocritical Care, Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Reversible cerebral vasoconstriction syndrome (RCVS) is a disorder of dysregulation of cerebrovascular tone resulting in transient segmental vasoconstriction which resolves in 1-3 months. Cerebral edema is an underrecognized complication in RCVS. It is likely multifactorial. Read More

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http://dx.doi.org/10.4103/jnrp.jnrp_334_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454955PMC

Bihemispheric Cerebral Oximetry Monitoring's Functionality in Suspected Cerebral Edema Diabetic Ketoacidosis With Therapeutic 3% Hyperosmolar Therapy in a Pediatric Emergency Department.

Pediatr Emerg Care 2019 Apr 4. Epub 2019 Apr 4.

Division of Biostatistics ACHRI, Department of Pediatrics, Arkansas Children's Hospital Research Institute, College of Medicine, University of Arkansas, Little Rock, AR.

Background: Suspected cerebral edema diabetic ketoacidosis (SCEDKA) is more common than perceived with symptoms including altered mentation, headache with vomiting, depressed Glasgow coma scale (GCS), abnormal motor or verbal responses, combativeness, and neurological depression. Suspected cerebral edema diabetic ketoacidosis has been associated with initial diabetic ketoacidosis (DKA) presentation and at start of DKA therapy.Cerebral oximetry (bihemispheric regional cerebral oxygen saturation [rcSO2] and cerebral blood volume index [CBVI]) can detect increased intracranial pressure (ICP)-induced altered bihemispheric cerebral physiology (rcSO2) (Crit Care Med 2006;34:2217-2223, J Pediatr 2013;163: 1111-1116, Curr Med Chem 2009;16:94-112, Diabetologia 1985;28:739-742, Pediatr Crit Care Med 2013;14:694-700). Read More

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http://dx.doi.org/10.1097/PEC.0000000000001774DOI Listing
April 2019
2 Reads

Characteristics of hyperglycemic crises in an adult population in a teaching hospital in Colombia.

J Diabetes Metab Disord 2018 Dec 19;17(2):143-148. Epub 2018 Sep 19.

3Universidad Pontificia Bolivariana, Calle 78b #72a-159, Antioquia, Colombia.

Background: Hyperglycemic crisis are the most serious forms of acute decompensation of diabetes mellitus and require urgent medical attention. The epidemiological data of these conditions in Latin America are scarce and in Colombia unknown, that is why we decided to describe the clinical characteristics and factors associated with the mortality of adults who presented with hyperglycemic crises in a teaching hospital in Colombia.

Materials And Methods: Retrospective cohort study of all episodes of hyperglycemic crisis treated in Pablo Tobón Uribe Hospital in a three-year period. Read More

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https://jdmdonline.biomedcentral.com/articles/10.1007/s40200
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http://dx.doi.org/10.1007/s40200-018-0353-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405398PMC
December 2018
3 Reads

Subclinical cerebral edema in diabetic ketoacidosis in children.

Authors:
Hemant S Agarwal

Clin Case Rep 2019 Feb 18;7(2):264-267. Epub 2018 Dec 18.

Department of Pediatrics University of New Mexico Health Sciences Center Albuquerque New Mexico.

Subclinical cerebral edema in diabetic ketoacidosis tends to manifest with subtle neurological symptoms including headache, lethargy, or disorientation and a Glasgow Coma Scale of 14-15. Treatment of subclinical cerebral edema with hyperosmolar therapy for persistent symptoms is associated with good outcomes. Read More

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http://dx.doi.org/10.1002/ccr3.1960DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389473PMC
February 2019
4 Reads

Management of Pediatric Severe Traumatic Brain Injury: 2019 Consensus and Guidelines-Based Algorithm for First and Second Tier Therapies.

Pediatr Crit Care Med 2019 Mar;20(3):269-279

Division of Pediatric Neurology, University of Washington, Seattle Children's Hospital, Seattle, WA.

Objectives: To produce a treatment algorithm for the ICU management of infants, children, and adolescents with severe traumatic brain injury.

Data Sources: Studies included in the 2019 Guidelines for the Management of Pediatric Severe Traumatic Brain Injury (Glasgow Coma Scale score ≤ 8), consensus when evidence was insufficient to formulate a fully evidence-based approach, and selected protocols from included studies.

Data Synthesis: Baseline care germane to all pediatric patients with severe traumatic brain injury along with two tiers of therapy were formulated. Read More

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http://dx.doi.org/10.1097/PCC.0000000000001737DOI Listing
March 2019
5 Reads

Improvement in renal prognosis with prompt hemodialysis in hyperosmolar hyperglycemic state-related rhabdomyolysis: A case report.

Medicine (Baltimore) 2018 Dec;97(50):e13647

Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, Taiwan.

Rationale: Acute kidney injury is common and correctable in patients with a hyperosmolar hyperglycemic state (HHS). Nevertheless, hyperglycemic crisis may also contribute to the development of rhabdomyolysis, which can worsen renal function and lead to high mortality in such patients.

Patient Concerns: Herein, we report a case of hyperosmolar hyperglycemic state-related rhabdomyolysis and acute renal failure with an excellent outcome. Read More

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http://dx.doi.org/10.1097/MD.0000000000013647DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319979PMC
December 2018
3 Reads

Short-term Effect of Ambient Air Pollution on Emergency Department Visits for Diabetic Coma in Seoul, Korea.

J Prev Med Public Health 2018 Nov 29;51(6):265-274. Epub 2018 Oct 29.

Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Korea.

Objectives: A positive association between air pollution and both the incidence and prevalence of diabetes mellitus (DM) has been reported in some epidemiologic and animal studies, but little research has evaluated the relationship between air pollution and diabetic coma. Diabetic coma is an acute complication of DM caused by diabetic ketoacidosis or hyperosmolar hyperglycemic state, which is characterized by extreme hyperglycemia accompanied by coma. We conducted a time-series study with a generalized additive model using a distributed-lag non-linear model to assess the association between ambient air pollution (particulate matter less than 10 μm in aerodynamic diameter, nitrogen dioxide [NO2], sulfur dioxide, carbon monoxide, and ozone) and emergency department (ED) visits for DM with coma in Seoul, Korea from 2005 to 2009. Read More

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http://dx.doi.org/10.3961/jpmph.18.153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283743PMC
November 2018
3 Reads

Acid-base and electrolyte disturbances in patients with diabetes mellitus.

Acta Clin Belg 2019 Feb 23;74(1):28-33. Epub 2018 Nov 23.

a Departments of Nephrology , Universitair Ziekenhuis Brussel , Brussels , Belgium.

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http://dx.doi.org/10.1080/17843286.2018.1546983DOI Listing
February 2019
1 Read

Hyperglycemia crisis in head and neck cancer patients with platinum-based chemotherapy.

J Chin Med Assoc 2018 Dec 9;81(12):1060-1064. Epub 2018 Aug 9.

Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan, ROC. Electronic address:

Background: The development of a hyperglycemic crisis in platinum-based chemotherapy-treated head and neck cancer patients, such as hyperosmolar hyperglycemic state (HHS), has been reported. Hyperglycemic crises are associated with a high risk of comorbidity and may delay cancer treatment if not promptly managed.

Methods: This is a retrospective study using cancer registry data from a tertiary medical center. Read More

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http://dx.doi.org/10.1016/j.jcma.2018.05.008DOI Listing
December 2018
11 Reads

Pediatric Diabetic Ketoacidosis With Hyperosmolarity: Clinical Characteristics and Outcomes.

Endocr Pract 2018 08 7;24(8):726-732. Epub 2018 Aug 7.

Objective: Studies of hyperglycemic emergencies with hyperosmolality, including hyperglycemic hyperosmolar state (HHS) and "mixed presentation" with features of diabetic ketoacidosis (DKA) and HHS, are lacking in children. Objectives were to determine the incidence of DKA, HHS, and mixed presentation in a pediatric population, to characterize complications, and to assess accuracy of associated diagnosis codes.

Methods: Retrospective cohort study of 411 hyperglycemic emergencies in pediatric patients hospitalized between 2009 and 2014. Read More

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http://dx.doi.org/10.4158/EP-2018-0120DOI Listing
August 2018
24 Reads

Osmotic demyelination syndrome due to hyperosmolar hyperglycemia.

Cleve Clin J Med 2018 Jul;85(7):511-513

Chairman, Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, Japan.

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http://dx.doi.org/10.3949/ccjm.85a.17020DOI Listing
July 2018
4 Reads

Diazoxide toxicity in a child with persistent hyperinsulinemic hypoglycemia of infancy: mixed hyperglycemic hyperosmolar coma and ketoacidosis.

J Pediatr Endocrinol Metab 2018 Aug;31(8):943-945

Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Background: Persistent hyperinsulinemic hypoglycemia of infancy (PHHI), also known as congenital hyperinsulinism, has been known to go into spontaneous remission, with patients developing diabetes in later life. A temporary phase of hyperglycemia is, however, rarely reported.

Case Presentation: We describe a 16-month-old child, a known case of diazoxide responsive PHHI, presenting with mixed hyperglycemic hyperosmolar coma and ketoacidosis with rhabdomyolysis while on diazoxide treatment. Read More

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http://dx.doi.org/10.1515/jpem-2018-0112DOI Listing
August 2018
13 Reads

Risperidone-induced type 2 diabetes presenting with diabetic ketoacidosis.

Endocrinol Diabetes Metab Case Rep 2018 10;2018. Epub 2018 May 10.

Bariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, Galway, Ireland.

A 28-year-old male presented with 2 days of vomiting and abdominal pain, preceded by 2 weeks of thirst, polyuria and polydipsia. He had recently started risperidone for obsessive-compulsive disorder. He reported a high dietary sugar intake and had a strong family history of type 2 diabetes mellitus (T2DM). Read More

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http://dx.doi.org/10.1530/EDM-18-0031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5948194PMC
May 2018
21 Reads

Pediatric Major Head Injury: Not a Minor Problem.

Emerg Med Clin North Am 2018 May 10;36(2):459-472. Epub 2018 Feb 10.

Department of Emergency Medicine, The University of Arizona, PO Box 245057, Tucson, AZ 85724-5057, USA; Department of Pediatrics, The University of Arizona, PO Box 245057, Tucson, AZ 85724-5057, USA.

Traumatic brain injury is a highly prevalent and devastating cause of morbidity and mortality in children. A rapid, stepwise approach to the traumatized child should proceed, addressing life-threatening problems first. Management focuses on preventing secondary injury from physiologic extremes such as hypoxemia, hypotension, prolonged hyperventilation, temperature extremes, and rapid changes in cerebral blood flow. Read More

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http://dx.doi.org/10.1016/j.emc.2017.12.012DOI Listing
May 2018
5 Reads

Spectrum of hyperosmolar hyperglycaemic state in neurology practice.

Indian J Med Res 2017 Nov;146(Supplement):S1-S7

Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Background & Objectives: Hyperosmolar hyperglycaemic state (HHS) is a medical emergency, but there is a paucity of studies reporting the spectrum of neurological manifestations of HHS. We, therefore, report the neurological spectrum, triggering factors and outcome of HHS in general neurology practice.

Methods: The records of the patients with HHS were extracted from computerized hospital information system and those managed currently were prospectively included. Read More

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http://dx.doi.org/10.4103/ijmr.IJMR_57_15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890590PMC
November 2017
13 Reads

Role of CHADS-VASc score in predicting new-onset atrial fibrillation in patients with type 2 diabetes mellitus with and without hyperosmolar hyperglycaemic state: real-world data from a nationwide cohort.

BMJ Open 2018 03 22;8(3):e020065. Epub 2018 Mar 22.

Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.

Purpose: The objective of the current study was to explore the role of CHADS-VASc score in predicting incidence of atrial fibrillation (AF) in patients with type 2 diabetes mellitus (DM). Furthermore, the use of the CHADS-VASc score for stratifying new-onset AF risk in patients with DM and with/without hyperosmolar hyperglycaemic state (HHS) was also compared.

Methods: The study subjects were identified from Longitudinal Health Insurance Database provided by the National Health Research Institutes. Read More

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http://dx.doi.org/10.1136/bmjopen-2017-020065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875622PMC
March 2018
3 Reads

Hyperglycemic Hyperosmolar State: A Pragmatic Approach to Properly Manage Sodium Derangements.

Curr Diabetes Rev 2018 ;14(6):534-541

Department of Translational Medicine, Universita del Piemonte Orientale, Novara, Italy.

Introduction: Although hypovolemia remains the most relevant problem during acute decompensated diabetes in its clinical manifestations (diabetic ketoacidosis, DKA, and hyperglycemic hyperosmolar state, HHS), the electrolyte derangements caused by the global hydroelectrolytic imbalance usually complicate the clinical picture at presentation and may be worsened by the treatment itself.

Aim: This review article is focused on the management of dysnatremias during hyperglycemic hyperosmolar state with the aim of providing clinicians a useful tool to early identify the sodium derangement in order to address properly its treatment.

Discussion: The plasma sodium concentration is modified by most of the therapeutic measures commonly required in such patients and the physician needs to consider these interactions when treating HHS. Read More

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http://www.eurekaselect.com/160560/article
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http://dx.doi.org/10.2174/1573399814666180320091451DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237920PMC
February 2019
11 Reads

Perioperative management of adult diabetic patients. Postoperative period.

Anaesth Crit Care Pain Med 2018 Jun 16;37 Suppl 1:S27-S30. Epub 2018 Mar 16.

Service d'anesthésie - réanimation chirurgicale, hôpitaux universitaires Paris-Sud, AP-HP, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France. Electronic address:

Follow on from continuous intravenous administration of insulin with an electronic syringe (IVES) is an important element in the postoperative management of a diabetic patient. The basal-bolus scheme is the most suitable taking into account the nutritional supply and variable needs for insulin, reproducing the physiology of a normal pancreas: (i) slow (long-acting) insulin (=basal) which should immediately take over from IVES insulin simulating basal secretion; (ii) ultra-rapid insulin to simulate prandial secretion (=bolus for the meal); and (iii) correction of possible hyperglycaemia with an additional ultra-rapid insulin bolus dose. A number of schemes are proposed to help calculate the dosages for the change from IV insulin to subcutaneous insulin and for the basal-bolus scheme. Read More

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http://dx.doi.org/10.1016/j.accpm.2018.02.023DOI Listing
June 2018
13 Reads

[Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State].

Dtsch Med Wochenschr 2018 Mar 15;143(6):384-391. Epub 2018 Mar 15.

Background:  Diabetic ketoacidosis and the hyperosmolar hyperglycemic state are the most serious diabetic emergencies. Before the discovery of insulin in 1921 by Banting and Best the diagnosis of type 1 diabetes was fatal ending in diabetic ketoacidosis equivalent to a torturous death. Today, mortality from diabetic ketoacidosis is low at approximately 2 %. Read More

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http://dx.doi.org/10.1055/s-0043-114493DOI Listing
March 2018
6 Reads

Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations.

Intensive Care Med 2018 04 2;44(4):449-463. Epub 2018 Mar 2.

School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.

Objective: To report the ESICM consensus and clinical practice recommendations on fluid therapy in neurointensive care patients.

Design: A consensus committee comprising 22 international experts met in October 2016 during ESICM LIVES2016. Teleconferences and electronic-based discussions between the members of the committee subsequently served to discuss and develop the consensus process. Read More

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http://dx.doi.org/10.1007/s00134-018-5086-zDOI Listing
April 2018
33 Reads

Hyperosmolar Hyperglycemic State.

Authors:
Gregg D Stoner

Am Fam Physician 2017 Dec;96(11):729-736

University of Illinois College of Medicine, Peoria, IL, USA.

Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. Although there are multiple precipitating causes, underlying infections are the most common. Other causes include certain medications, nonadherence to therapy, undiagnosed diabetes mellitus, substance abuse, and coexisting disease. Read More

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December 2017
9 Reads

Copeptin levels and commonly used laboratory parameters in hospitalised patients with severe hypernatraemia - the "Co-MED study".

Crit Care 2018 02 9;22(1):33. Epub 2018 Feb 9.

Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.

Background: Hypernatraemia is common in inpatients and is associated with substantial morbidity. Its differential diagnosis is challenging, and delayed treatment may have devastating consequences. The most important hormone for the regulation of water homeostasis is arginine vasopressin, and copeptin, the C-terminal portion of the precursor peptide of arginine vasopressin, might be a reliable new parameter with which to assess the underlying cause of hypernatraemia. Read More

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http://dx.doi.org/10.1186/s13054-018-1955-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806470PMC
February 2018
17 Reads

New onset diabetes after nivolumab treatment.

BMJ Case Rep 2018 Jan 29;2018. Epub 2018 Jan 29.

Department of Endocrinology, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.

The authors describe a case of a life-threatening diabetic emergency 25 days after initiation of nivolumab (3 mg/kg) for stage 4 lung adenocarcinoma. She was admitted to the emergency department, with hyperglycaemia-related signs and symptoms, such as polyuria, polydipsia, weight loss, confusion, asthenia, dehydration, hypotension and Kussmaul respiratory pattern. Her body mass index was 21. Read More

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http://dx.doi.org/10.1136/bcr-2017-220999DOI Listing
January 2018
8 Reads

Effect of Hyperosmolar Therapy on Outcome Following Spontaneous Intracerebral Hemorrhage: Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study.

J Stroke Cerebrovasc Dis 2018 Apr 3;27(4):1061-1067. Epub 2018 Jan 3.

Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Purpose: We aimed to identify the effect of hyperosmolar therapy (mannitol and hypertonic saline) on outcomes after intracerebral hemorrhage (ICH) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study.

Methods: Comparison of ICH cases treated with hyperosmolar therapy versus untreated cases was performed using a propensity score based on age, initial Glasgow Coma Scale, location of ICH (lobar, deep, brainstem, and cerebellar), log-transformed initial ICH volume, presence of intraventricular hemorrhage, and surgical interventions. ERICH subjects with a pre-ICH modified Rankin Scale (mRS) score of 3 or lower were included. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2017.11.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845468PMC
April 2018
13 Reads

Association between continuous hyperosmolar therapy and survival in patients with traumatic brain injury - a multicentre prospective cohort study and systematic review.

Crit Care 2017 12 28;21(1):328. Epub 2017 Dec 28.

Intensive Care Unit, Anaesthesia and Critical Care Department, Hôtel Dieu - HME, CHU Nantes, Nantes, France.

Background: Intracranial hypertension (ICH) is a major cause of death after traumatic brain injury (TBI). Continuous hyperosmolar therapy (CHT) has been proposed for the treatment of ICH, but its effectiveness is controversial. We compared the mortality and outcomes in patients with TBI with ICH treated or not with CHT. Read More

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http://dx.doi.org/10.1186/s13054-017-1918-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745762PMC
December 2017
20 Reads

Altered Mental Status in an Elderly Male.

J Emerg Med 2018 Feb 11;54(2):232-237. Epub 2017 Dec 11.

Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts.

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http://dx.doi.org/10.1016/j.jemermed.2017.11.025DOI Listing
February 2018
12 Reads

Thrombocytopenia-associated multi-organ failure secondary to hyperglycemic, hyperosmolar non-ketotic syndrome: A case report.

Pediatr Diabetes 2018 05 22;19(3):574-577. Epub 2017 Nov 22.

Pediatric Nephrology, Baylor College of Medicine, Houston, Texas.

Thrombocytopenia associated multi-organ failure (TAMOF) is a clinical syndrome with features of new onset thrombocytopenia, increased lactate dehydrogenase, and multi-organ failure in critically ill patients. TAMOF can be the initial presentation of an underlying disease process or can develop during the course of illness either during the hospital stay. TAMOF has a high mortality rate if not treated; therefore, early detection is critical. Read More

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http://dx.doi.org/10.1111/pedi.12608DOI Listing
May 2018
8 Reads

The Impact of Hyperosmolarity on Long-Term Outcome in Patients Presenting with Severe Hyperglycemic Crisis: A Population Based Study.

Exp Clin Endocrinol Diabetes 2018 Sep 17;126(9):564-569. Epub 2017 Nov 17.

Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Center "Sestre Milosrdnice", University of Zagreb School of Medicine, Zagreb, Croatia.

Aims: We compared characteristics of patients with hyperglycemic hyperosmolar state (HHS) and patients with severe hyperglycemia without the signs of hyperosmolarity and ketoacidosis; analyzed long-term all-cause mortality and potential prognostic factors.

Methods: The studied population included 261 749 adults. HHS was diagnosed in patients with plasma glucose >33. Read More

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http://dx.doi.org/10.1055/s-0043-117416DOI Listing
September 2018
12 Reads

Hyperglycemic Hyperosmolar State During Induction Chemotherapy for Acute Lymphoblastic Leukemia.

Pediatr Emerg Care 2017 Dec;33(12):e172-e174

We present the case of a 16-year-old boy who presented with fatigue, polyuria, and polydipsia while on chemotherapy for his relapsed acute lymphoblastic leukemia (ALL). Blood gas examination confirmed the diagnosis of hyperosmolar hyperglycemic state. The etiology for his hyperglycemia was most likely a result of oral glucocorticoid therapy combined with asparaginase therapy-both are a cornerstone of induction chemotherapy for ALL. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001331DOI Listing
December 2017
13 Reads

Severe complications after initial management of hyperglycemic hyperosmolar syndrome and diabetic ketoacidosis with a standard diabetic ketoacidosis protocol.

J Pediatr Endocrinol Metab 2017 Oct;30(11):1141-1145

.

Hyperglycemic hyperosmolar syndrome (HHS) is a clinical entity not identical to diabetic ketoacidosis (DKA), and with a markedly higher mortality. Children with HHS can also present with concomitant DKA. Patients with HHS (with or without DKA) are profoundly dehydrated but often receive inadequate fluid resuscitation as well as intravenous insulin therapy based on traditional DKA protocols, and this can lead to devastating consequences. Read More

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http://www.degruyter.com/view/j/jpem.2017.30.issue-11/jpem-2
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http://dx.doi.org/10.1515/jpem-2017-0183DOI Listing
October 2017
6 Reads

Acute Management of Traumatic Brain Injury.

Surg Clin North Am 2017 Oct;97(5):1015-1030

Division of Trauma, Surgical Critical Care, and Emergency General Surgery, Department of Surgery, Section of Surgical Sciences, Center for Health Services Research, Vanderbilt Brain Institute, Vanderbilt University Medical Center, 1211 21st Avenue South, Medical Arts Building, Suite 404, Nashville, TN 37212, USA; Surgical Services, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, 1310 24th Avenue South, Nashville, TN 37212, USA. Electronic address:

Traumatic brain injury (TBI) is a leading cause of death and disability in patients with trauma. Management strategies must focus on preventing secondary injury by avoiding hypotension and hypoxia and maintaining appropriate cerebral perfusion pressure (CPP), which is a surrogate for cerebral blood flow. CPP can be maintained by increasing mean arterial pressure, decreasing intracranial pressure, or both. Read More

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http://dx.doi.org/10.1016/j.suc.2017.06.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5747306PMC
October 2017
13 Reads

Effectiveness of levodopa treatment for diabetic chorea with reduced striatal accumulation in dopamine transporter SPECT: a case report.

Rinsho Shinkeigaku 2017 10 28;57(10):591-594. Epub 2017 Sep 28.

Department of Neurology, Kasugai City Hospital.

We report the case of a 77-year-old woman with diabetic chorea, which presented as hemiballism of the right limbs. Initial blood examination revealed that sugar and hemoglobin A1c levels were 732 mg/dl and 12.2%, respectively. Read More

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http://dx.doi.org/10.5692/clinicalneurol.cn-001041DOI Listing
October 2017
7 Reads

COBI (COntinuous hyperosmolar therapy for traumatic Brain-Injured patients) trial protocol: a multicentre randomised open-label trial with blinded adjudication of primary outcome.

BMJ Open 2017 Sep 24;7(9):e018035. Epub 2017 Sep 24.

Anaesthesia Intensive Care Unit, Centre Hospitalier Universitaire, Nantes, France.

Introduction: Traumatic brain injury (TBI) is a major cause of death and severe prolonged disability. Intracranial hypertension (ICH) is a critical risk factor of bad outcomes after TBI. Continuous infusion of hyperosmolar therapy has been proposed for the prevention and the treatment of ICH. Read More

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http://dx.doi.org/10.1136/bmjopen-2017-018035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623466PMC
September 2017
103 Reads

[Endocrine and diabetic emergencies].

Authors:
H Lehnert M Reincke

Internist (Berl) 2017 10;58(10):1009-1010

Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336, München, Deutschland.

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http://dx.doi.org/10.1007/s00108-017-0319-8DOI Listing
October 2017
5 Reads

Background characteristics and clinical features of elderly patients with hyperglycemic hyperosmolar syndrome.

Nihon Ronen Igakkai Zasshi 2017 ;54(3):349-355

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital.

Aim: Few reports have described the characteristics of hyperglycemic hyperosmolar syndrome (HHS) in the elderly. We investigated the background characteristics and clinical features of 14 elderly patients with HHS.

Methods: HHS was diagnosed based on a blood glucose level of >600 mg/dL and an effective plasma osmolality [2 (Na) + glu/18] of >320 mOsm/kg. Read More

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http://dx.doi.org/10.3143/geriatrics.54.349DOI Listing
January 2019
57 Reads

[Diabetic emergencies : Hypoglycemia, ketoacidotic and hyperglycemic hyperosmolar nonketotic coma].

Internist (Berl) 2017 Oct;58(10):1020-1028

Präsidium der Universität zu Lübeck, Universität zu Lübeck, Lübeck, Deutschland.

The diabetic emergencies diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS) and hypoglycemia represent severe and potentially life-threatening complications of diabetes mellitus that require prompt diagnostics and treatment. Absolute or relative insulin insufficiency is characteristic of DKA und HHS along with severe dehydration. They differ by the prevalence of ketone bodies and the severity of acidosis; however, the treatment regimens are similar. Read More

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http://dx.doi.org/10.1007/s00108-017-0317-xDOI Listing
October 2017
15 Reads

[Acute diabetic complications attended in a hospital emergency department: a descriptive analysis].

Emergencias 2017 07;29(4):245-248

Servicio de Endocrinología Hospital Universitario Río Hortega, Valladolid, España.

Objectives: To analyze the characteristics of acute diabetic complications attended in a hospital emergency department.

Material And Methods: Cross-sectional, descriptive, retrospective study of patients with hyper- and hypoglycemic emergencies attended in a tertiary-care university hospital emergency department.

Results: We included 237 patients with a mean (SD) age of 61 (26) years. Read More

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July 2017
7 Reads

Emergency Department Management of Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State in Adults: National Survey of Attitudes and Practice.

Can J Diabetes 2018 Jun 19;42(3):229-236. Epub 2017 Jul 19.

The University of Ottawa, Ottawa, Ontario, Canada; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Objectives: In 2013, the Canadian Diabetes Association, now Diabetes Canada, published national clinical practice guidelines for the effective management of diabetic ketoacidosis and hyperosmolar hyperglycemic states in adults. We sought to determine emergency physician compliance rates and attitudes toward these guidelines and to identify potential barriers to their use in Canadian emergency departments.

Methods: An online survey consisting of questions related to the awareness and use of the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada was distributed to 500 randomly selected members of the Canadian Association of Emergency Physicians. Read More

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http://dx.doi.org/10.1016/j.jcjd.2017.05.005DOI Listing
June 2018
34 Reads

A Comparison of Pharmacologic Therapeutic Agents Used for the Reduction of Intracranial Pressure After Traumatic Brain Injury.

World Neurosurg 2017 Oct 14;106:509-528. Epub 2017 Jul 14.

Division of Neurological Surgery, Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA. Electronic address:

Objective: In neurotrauma care, a better understanding of treatments after traumatic brain injury (TBI) has led to a significant decrease in morbidity and mortality in this population. TBI represents a significant medical problem, and complications after TBI are associated with the initial injury and postevent intracranial processes such as increased intracranial pressure and brain edema. Consequently, appropriate therapeutic interventions are required to reduce brain tissue damage and improve cerebral perfusion. Read More

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http://dx.doi.org/10.1016/j.wneu.2017.07.009DOI Listing
October 2017
21 Reads

Effect of different blood glucose intervention plans on elderly people with type 2 diabetes mellitus combined with dementia.

Eur Rev Med Pharmacol Sci 2017 06;21(11):2702-2707

Department of Endocrinology, Fujian Institute of Endocrinology, Union Hospital of Fujian Medical University Fuzhou, Fujian Province, China.

Objective: We analyzed the effects of intensive and mitigatory blood glucose control strategy on elderly people with type 2 diabetes mellitus (T2DM) combined with Alzheimer disease (AD).

Patients And Methods: We enrolled 90 elderly patients with T2DM combined with AD to participate in this study. They were randomly divided into 3 groups: the control group, the strength group and the mitigation group with 30 cases in each group. Read More

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June 2017
8 Reads

A case report of hyperosmolar hyperglycemic state in a 7-year-old child: An unusual presentation of first appearance of type 1 diabetes mellitus.

Medicine (Baltimore) 2017 Jun;96(25):e7369

Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

Rationale: A hyperosmolar hyperglycemic state (HHS) is a rare presentation of a hyperglycemic crisis in children with diabetes mellitus. As this condition can be fatal and has high morbidity, early recognition and proper management are necessary for a better outcome. Here, we report a rare case of HHS as the first presentation of type 1 diabetes mellitus (T1DM) in a 7-year-old girl. Read More

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http://dx.doi.org/10.1097/MD.0000000000007369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484263PMC
June 2017
11 Reads

[Epidural Emphysema Associated with Diabetic Nonketotic Hyperosmolar Coma].

Brain Nerve 2017 Jun;69(6):671-672

Department of Neurology, Tochigi Medical Center Shimotsuga.

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http://dx.doi.org/10.11477/mf.1416200800DOI Listing
June 2017
6 Reads

Endocrine Emergencies With Neurologic Manifestations.

Authors:
Makoto Ishii

Continuum (Minneap Minn) 2017 06;23(3, Neurology of Systemic Disease):778-801

Purpose Of Review: This article provides an overview of endocrine emergencies with potentially devastating neurologic manifestations that may be fatal if left untreated. Pituitary apoplexy, adrenal crisis, myxedema coma, thyroid storm, acute hypercalcemia and hypocalcemia, hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state), and acute hypoglycemia are discussed, with an emphasis on identifying the signs and symptoms as well as diagnosing and managing these clinical entities.

Recent Findings: To identify the optimal management of endocrine emergencies, using formal clinical diagnostic criteria and grading scales such as those recently proposed for pituitary apoplexy will be beneficial in future prospective studies. Read More

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http://dx.doi.org/10.1212/CON.0000000000000467DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902332PMC
June 2017
12 Reads

Severe Traumatic Brain Injury at a Tertiary Referral Center in Tanzania: Epidemiology and Adherence to Brain Trauma Foundation Guidelines.

World Neurosurg 2017 Sep 27;105:238-248. Epub 2017 May 27.

Weill Cornell Brain and Spine Center, Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.

Background: Severe traumatic brain injury (TBI) is a major cause of death and disability worldwide. Prospective TBI data from sub-Saharan Africa are sparse. This study examines epidemiology and explores management of patients with severe TBI and adherence to Brain Trauma Foundation Guidelines at a tertiary care referral hospital in Tanzania. Read More

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http://dx.doi.org/10.1016/j.wneu.2017.05.101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5575962PMC
September 2017
37 Reads

Evaluation of glycated albumin (GA) and GA/HbA1c ratio for diagnosis of diabetes and glycemic control: A comprehensive review.

Crit Rev Clin Lab Sci 2017 06 10;54(4):219-232. Epub 2017 Apr 10.

b Marquette University School of Dentistry , Milwaukee , WI , USA.

Diabetes Mellitus (DM) is a group of metabolic diseases characterized by chronic high blood glucose concentrations (hyperglycemia). When it is left untreated or improperly managed, it can lead to acute complications including diabetic ketoacidosis and non-ketotic hyperosmolar coma. In addition, possible long-term complications include impotence, nerve damage, stroke, chronic kidney failure, cardiovascular disease, foot ulcers, and retinopathy. Read More

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http://dx.doi.org/10.1080/10408363.2017.1299684DOI Listing
June 2017
47 Reads

Management of Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State.

Med Clin North Am 2017 May;101(3):587-606

Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, 69 Jesse Hill Jr. Drive Southeast, 2nd Floor, Atlanta, GA 30303, USA. Electronic address:

Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are the most serious and life-threatening hyperglycemic emergencies in diabetes. DKA is more common in young people with type 1 diabetes and HHS in adult and elderly patients with type 2 diabetes. Features of the 2 disorders with ketoacidosis and hyperosmolality may coexist. Read More

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http://dx.doi.org/10.1016/j.mcna.2016.12.011DOI Listing
May 2017
41 Reads

Treatment of Diabetic Ketoacidosis (DKA)/Hyperglycemic Hyperosmolar State (HHS): Novel Advances in the Management of Hyperglycemic Crises (UK Versus USA).

Curr Diab Rep 2017 05;17(5):33

Division of Endo, Metabolism & Lipids, Emory University School of Medicine, Atlanta, GA, USA.

Purpose Of Review: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies that cause high morbidity and mortality. Their treatment differs in the UK and USA. This review delineates the differences in diagnosis and treatment between the two countries. Read More

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http://dx.doi.org/10.1007/s11892-017-0857-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375966PMC
May 2017
42 Reads

Ascariasis and hyperosmolar hyperglycemic state: a surprising ultrasound finding in the emergency department.

Int J Emerg Med 2017 Dec 21;10(1):12. Epub 2017 Mar 21.

Emergency Department, Centre Hospitalier Universitaire de Kigali, University of Rwanda, Butare, Rwanda.

Background: We report the ultrasound finding of ascariasis in a patient with hyperosmolar hyperglycemic state (HHS). Although ascariasis is common in low-resource settings, there has been no previous report associating ascariasis with HHS.

Case Presentation: A 26-year-old Rwandan man was admitted to the emergency department in coma, with a glycemia of 600 mg/dl. Read More

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http://dx.doi.org/10.1186/s12245-017-0138-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360740PMC
December 2017
18 Reads

[Acute necrotising oesophagitis associated with hyperosmolar diabetic coma].

Semergen 2017 Sep 18;43(6):e57-e59. Epub 2017 Mar 18.

Hospital Regional Universitario de Málaga, Málaga, España.

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http://dx.doi.org/10.1016/j.semerg.2017.01.006DOI Listing
September 2017
4 Reads