1,303 results match your criteria Hyperosmolar Coma


Reversible global hypoperfusion in an adult patient with a mixed diabetic ketoacidosis/hyperglycemic hyperosmolar coma: A case report.

Clin Case Rep 2022 Apr 4;10(4):e05576. Epub 2022 Apr 4.

University Institute of Diagnostic and Interventional Neuroradiology, Inselspital Bern University Hospital, and University of Bern Bern Switzerland.

Diabetic ketoacidosis is a severe complication of diabetes mellitus. We report a case of global hypoperfusion in an elderly patient on CT, with complete resolution shown on early MRI follow-up. Metabolic causes have always to be included in the differential diagnosis of diffuse hypoperfusion in the appropriate clinical setting. Read More

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Investigation of Antioxidant Markers in Diabetic Patients.

Arch Razi Inst 2021 Nov 30;76(5):1453-1460. Epub 2021 Nov 30.

Chemistry Department, College of Science, University of Kirkuk, Kirkuk, Iraq.

Hyperglycemia is a characteristic of diabetes mellitus, one of the most common metabolic illnesses in the world, and is caused by either reduced insulin secretion or insulin resistance. Diabetes mellitus in adults has been on the rise in recent decades, and it is now the world's fifth-biggest cause of mortality. Diabetes mellitus will affect 592 million people worldwide by 2035, according to the International Diabetes Mellitus Federation, and diabetic complications are divided into two groups of acute and chronic types. Read More

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November 2021

Comparison of Intracranial Pressure Measurements Before and After Hypertonic Saline or Mannitol Treatment in Children With Severe Traumatic Brain Injury.

JAMA Netw Open 2022 03 1;5(3):e220891. Epub 2022 Mar 1.

Department of Pediatrics, Children's National Hospital, Washington, DC.

Importance: Hyperosmolar agents are cornerstone therapies for pediatric severe traumatic brain injury. Guideline recommendations for 3% hypertonic saline (HTS) are based on limited numbers of patients, and no study to date has supported a recommendation for mannitol.

Objectives: To characterize current use of hyperosmolar agents in pediatric severe traumatic brain injury and assess whether HTS or mannitol is associated with greater decreases in intracranial pressure (ICP) and/or increases in cerebral perfusion pressure (CPP). Read More

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Hospitalizations and inpatient mortality for hyperosmolar hyperglycemic state over a decade.

Diabetes Res Clin Pract 2022 Mar 3;185:109230. Epub 2022 Feb 3.

Department of Internal Medicine, Central Michigan University, Saginaw, MI, USA; Department of Medicine, Samaritan Medical Center, Watertown, NY, USA.

Objectives: This study aimed to describe rates and trends in hospitalizations, inpatient mortality, total hospital charges, and mean lengths of stay among adult patients hospitalized for hyperosmolar hyperglycemic state (HHS).

Methods: The study included NIS databases 2008, 2010, 2012, 2014, 2016, and 2018. These databases were searched for hospitalizations with a principal discharge diagnosis of HHS in patients with T2DM using ICD codes (25020, 25022, and E110). Read More

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Hyperosmolar hyperglycaemic state as a stroke cause or stroke mimic: an illustrative case and review of literature.

Clin Med (Lond) 2022 01;22(1):83-86

Great Western Hospital, Swindon, UK.

Hyperosmolar hyperglycaemic state (HHS) is a life-threatening metabolic complication of type 2 diabetes (T2DM) that often presents with neurological symptoms. A 74-year-old man with known T2DM presented to the emergency department with collapse, left-sided weakness and slurred speech (National Institutes of Health Stroke Scale (NIHSS) 3) and a biochemical profile consistent with HHS. When he further deteriorated (NIHSS 20), he was managed for concurrent ischaemic stroke. Read More

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January 2022

New strategies of diagnostic and therapeutic approach to emergencies in the evolution of patients with diabetes mellitus (Review).

Exp Ther Med 2022 Feb 28;23(2):178. Epub 2021 Dec 28.

Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

Diabetes mellitus, known as the most widespread disease in the world, along with four other chronic diseases, involves major expenditures and significant human resources for care, thus representing a burden on any type of health care system especially due to its rapid evolution of acute and chronic complications. For the emergency department (ED), the requirements of patients with acute complications of diabetes, determine expenses which are three times higher than those for non-diabetic patients and their hospitalizations are four times more frequent. The acute complications for which patients with diabetes most frequently require the ED are hypoglycemic, hyperosmolar, or ketoacidosis coma as well as alterations of the general condition that is typical of hypoglycemia, diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state and new-onset hyperglycemia. Read More

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February 2022

Dramatic recovery without steroid therapy and withdrawal from insulin therapy in a subject with hyperglycemic and hyperosmolar syndrome and depletion of insulin secretory capacity induced by type 2 autoimmune pancreatitis: A case report.

Medicine (Baltimore) 2022 Jan;101(2):e28609

Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Japan.

Introduction: Autoimmune pancreatitis (AIP) is characterized by the involvement of autoimmune mechanisms and is classified as type 1, together with infiltration of IgG4-positive cells, and type 2 with poor serological abnormal findings. In clinical practice, AIP is often treated with steroid therapy.

Patient Concerns: An 81-year-old Japanese woman had thirst and appetite loss in the previous 5 days; thus, she visited a local doctor. Read More

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January 2022

Hyperosmolar hyperglycaemic state causing atypical status epilepticus with hippocampal involvement.

Pract Neurol 2022 Apr 13;22(2):117-119. Epub 2021 Dec 13.

Chalfont Centre for Epilepsy, London, UK.

Diabetes mellitus may arise abruptly and decompensate suddenly, leading to a hyperglycaemic hyperosmolar state. Coma often ensues, although this usually reverses after the metabolic abnormalities have resolved. Acute symptomatic seizures can also occur in patients who are conscious, although these usually resolve after osmolarity and glycaemia have normalised. Read More

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Time trend in excess mortality in children with type 1 diabetes from 1987 to 2016 in mainland France.

Pediatr Diabetes 2022 02 19;23(1):38-44. Epub 2021 Dec 19.

Pediatric Diabetology, University Hospital, Angers, France.

Background: Mortality risk for children with type 1 diabetes (T1D) is unknown in France and their causes of death are not well documented.

Aim: To determine the standardized mortality ratios (SMRs) and causes of death in children aged 1-14 years with T1D from 1987 to 2016.

Methods: The French Center for Epidemiology on Medical Causes of Death collected all death certificates in mainland France. Read More

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February 2022

[Severe Candida sepsis in a 28-year-old female patient with initial diagnosis of diabetes mellitus and marked hyperosmolar coma].

Anaesthesist 2022 02 24;71(2):117-122. Epub 2021 Nov 24.

Klinik für Intensivmedizin, Lehrkrankenhaus der Universitätsmedizin Mainz, Gemeinschaftsklinikum Mittelrhein, Standort Kemperhof Koblenz, Koblenzer Straße 115-155, 56073, Koblenz, Deutschland.

We report on a 28-year-old female patient who had no history of diseases and who was brought to our intensive care unit in a comatose state by the ambulance service. The clinical picture corresponded to sepsis with a massively increased blood sugar concentration (> 2000 mg/dl) as well as a pronounced skin mycosis in the groin region of the very obese patient (body mass index [BMI]: 33.7 kg/m) in the physical examination. Read More

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February 2022

Transient Antidiuretic Hormone Insufficiency Caused by Severe Hyperosmolar Hyperglycemic Syndrome Based on Nephrogenic Diabetes Insipidus.

AACE Clin Case Rep 2021 Nov-Dec;7(6):372-375. Epub 2021 Jun 18.

Department of Nephrology, Our Lady of the Snow Social Medical Corporation, St. Mary's Hospital, Kurume, Japan.

Background: The hyperosmolar hyperglycemic state (HHS), an acute complication of diabetes mellitus with plasma hyperosmolarity, promotes the secretion of anti-diuretic hormone (ADH) and reduces the storage of ADH. Magnetic resonance T1-weighted imaging reflects ADH storage in the posterior pituitary lobe, which disappears when the storage is depleted. Whether the HHS induces ADH depletion leading to clinical manifestations has been unclear. Read More

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Hyperosmolar hyperglycemic coma in an infant with neonatal diabetes mellitus.

Am J Emerg Med 2022 Apr 22;54:327.e5-327.e6. Epub 2021 Oct 22.

Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States of America.

Neonatal diabetes mellitus (NDM) is a rare disease distinct from type 1 diabetes mellitus (T1DM). While T1DM results from autoimmune destruction of pancreatic beta cells, NDM arises from genetic mutations to insulin production and secretion pathways. We present a case of an infant presenting to the emergency department with shock and poor responsiveness, found to have neonatal DM with hyperosmotic hyperglycemic syndrome (HHS). Read More

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Profile and outcomes of patients admitted with hyperglycemic emergencies in the Buea Regional Hospital in Cameroon.

Pan Afr Med J 2021 27;39:274. Epub 2021 Aug 27.

Douala General Hospital, Douala, Cameroon.

Introduction: hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state) are the most common serious acute metabolic complications of diabetes which result in significant morbidity and mortality. There is paucity of data on hyperglycemic emergencies in Cameroon. The objective of this study was to investigate the precipitants and outcomes of patients admitted for hyperglycemic emergencies in the Buea Regional Hospital in the South West Region of Cameroon. Read More

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November 2021

Hyperosmolar diabetic ketoacidosis-- review of literature and the shifting paradigm in evaluation and management.

Diabetes Metab Syndr 2021 Nov-Dec;15(6):102313. Epub 2021 Oct 21.

Division of Endocrinology and Diabetes, Department of Pediatrics, New York University Grossman School of Medicine, New York, USA.

Background: Hyperosmolar diabetic ketoacidosis (H-DKA), a distinct clinical entity, is the overlap of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS).

Aim: We describe the clinical presentation, metabolic aberrations, and associated morbidity/mortality of these cases with H-DKA. We highlight the problem areas of medical care which require particular attention when caring for pediatric diabetes patients presenting with H-DKA. Read More

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Continuous Electroencephalogram and Antiseizure Medication Use in an International Pediatric Traumatic Brain Injury Population.

Neurocrit Care 2022 04 22;36(2):573-583. Epub 2021 Sep 22.

Medical College of Wisconsin, 9000 W. Wisconsin Ave, Milwaukee, WI, 53226, USA.

Background: Electrographic seizures are frequent and associated with worse outcomes following traumatic brain injury (TBI). Despite this, the use of continuous electroencephalogram (cEEG) remains low. Our study describes cEEG usage and treatment dosing antiseizure medications (ASMs) in an international pediatric TBI population, hypothesizing that children monitored with cEEG have an increased rate of treatment ASMs because of electrographic seizure detection, compared with children who are not monitored with cEEG. Read More

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Some characteristics of hyperglycaemic crisis differ between patients with and without COVID-19 at a safety-net hospital in a cross-sectional study.

Ann Med 2021 12;53(1):1642-1645

Section of Endocrinology, Diabetes, and Metabolism, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.

Objective: To compare patients with DKA, hyperglycaemic hyperosmolar syndrome (HHS), or mixed DKA-HHS and COVID-19 [COVID (+)] to COVID-19-negative (-) [COVID (-)] patients with DKA/HHS from a low-income, racially/ethnically diverse catchment area.

Methods: A cross-sectional study was conducted with patients admitted to an urban academic medical center between 1 March and 30 July 2020. Eligible patients met lab criteria for either DKA or HHS. Read More

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December 2021

New-Onset Pediatric Diabetes Complicated By Diabetic Ketoacidosis and Invasive Rhinocerebral Mucormycosis With Internal Carotid Artery Occlusion.

J Emerg Med 2022 01 9;62(1):95-100. Epub 2021 Sep 9.

Boston University School of Medicine, Boston, Massachusetts; Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts.

Background: Diabetic ketoacidosis (DKA) has increased in prevalence in the emergency department (ED) in recent years. The complications of DKA are life threatening and necessitate rapid identification and management. Pediatric complications include cerebral edema, venous thrombosis, acute kidney injury, and severe infections including necrotizing fasciitis and mucormycosis. Read More

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January 2022

Diagnosis and Management of the Critically Ill Adult Patient with Hyperglycemic Hyperosmolar State.

J Emerg Med 2021 10 10;61(4):365-375. Epub 2021 Jul 10.

Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois.

Background: Hyperglycemic hyperosmolar state is a life-threatening complication of diabetes mellitus. Therefore, it is important for emergency physicians to be aware of this unique diagnosis and treatment considerations.

Objective: This manuscript reviews the emergency department evaluation and management of the adult patient with hyperglycemic hyperosmolar state. Read More

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October 2021

COVID-19 and Combined Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic Coma: Report of 11 Cases.

J Investig Med High Impact Case Rep 2021 Jan-Dec;9:23247096211021231

Saint Joseph's University Medical Center, Paterson, NJ, USA.

We report 11 cases of combined diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic coma (HHNK) in coronavirus 2019 patients who presented to our institution in New Jersey, USA. The median age was 47 years (range 12-88 years). Out of the 11 patients, 7 were male and 4 were female. Read More

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Multidisciplinary management of a traumatic posterior meningeal artery pseudoaneurysm: A case report and review of the literature.

Int J Surg Case Rep 2021 May 29;82:105933. Epub 2021 Apr 29.

Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA; University of South Florida, Tampa, FL, USA.

Background: Meningeal arterial injuries represent <1% of all blunt traumatic brain injuries (TBIs). Middle meningeal artery (MMA) lesions comprise the majority. However, there is little clinical data on posterior meningeal artery (PMA) injuries. Read More

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An extremely high blood glucose level in a child with hyperglycemic hyperosmolar state and type 1 diabetes.

J Pediatr Endocrinol Metab 2021 Aug 3;34(8):1045-1048. Epub 2021 May 3.

Department of Emergency Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia.

Objectives: Hyperglycemic hyperosmolar state (HHS) is one of the most severe acute complications of diabetes mellitus (DM) characterized by severe hyperglycemia and hyperosmolality without significant ketosis and acidosis. What is new? Since HHS in the pediatric population is rare and potentially life-threatening, every reported case is very valuable for raising awareness among healthcare professionals.

Case Presentation: A 7-year-old boy with previously diagnosed Joubert syndrome was admitted due to vomiting, polydipsia and polyuria started several days earlier. Read More

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Hospitalization for Short-Term Diabetes-Related Complications: Focus on Patients Aged over 85 Years.

Healthcare (Basel) 2021 Apr 14;9(4). Epub 2021 Apr 14.

Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy.

(1) : The prevalence of diabetes in elderly people is frequently high. When occurring in the elderly, diabetes is often accompanied by complications and comorbidities, at least one in 60% and four or more in 40% of older people with diabetes. As far as short-term complications among the elderly are concerned, hypoglycemia and hyperglycemic crises prove to be frequent. Read More

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Posterior reversible encephalopathy syndrome complicating hyperosmolar hyperglycemic syndrome.

Am J Emerg Med 2021 Nov 21;49:438.e5-438.e6. Epub 2021 Apr 21.

Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan.

Hyperosmolar hyperglycemic syndrome is a life-threatening diabetic emergency that manifests as altered mental status. An otherwise healthy 40-year-old man presented to our emergency department with headache and severe hypertension. Brain magnetic resonance imaging showed evidence of posterior reversible encephalopathy syndrome, a usually reversible neurological syndrome characterized by subcortical vasogenic oedema. Read More

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November 2021

Acute and extremely severe necrotic esophagitis accompanied by hyperglycemic hyperosmolar syndrome in a subject with type 2 diabetes mellitus.

J Diabetes Investig 2021 Oct 10;12(10):1925-1926. Epub 2021 Apr 10.

Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki, Japan.

Acute necrotic esophagitis is characterized by blacking in the esophageal mucosa and is rarely accompanied by diabetes mellitus, especially under severe hyperglycemic conditions. Here we show a very rare case of a patient who had acute and extremely severe necrotic esophagitis accompanied by hyperglycemic hyperosmolar syndrome. Read More

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October 2021

Implementation of Multimodality Neurologic Monitoring Reporting in Pediatric Traumatic Brain Injury Management.

Neurocrit Care 2021 08 31;35(1):3-15. Epub 2021 Mar 31.

Department of Neurosciences, Barrow Neurological Institute At Phoenix Children's Hospital, 1919 E. Thomas Road, Ambulatory Building B, 3rd floor, Phoenix, AZ, 85016, USA.

Background/objective: Multimodality neurologic monitoring (MMM) is an emerging technique for management of traumatic brain injury (TBI). An increasing array of MMM-derived biomarkers now exist that are associated with injury severity and functional outcomes after TBI. A standardized MMM reporting process has not been well described, and a paucity of evidence exists relating MMM reporting in TBI management with functional outcomes or adverse events. Read More

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A Complicated Case of COVID-19 and Hyperglycemic Hyperosmolar Syndrome in an Adolescent Male.

Horm Res Paediatr 2021 31;94(1-2):71-75. Epub 2021 Mar 31.

Division of Endocrinology & Diabetes, Department of Pediatrics, Riley Hospital for Children at IU Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Emerging data demonstrate that comorbid conditions and older age are contributing factors to COVID-19 severity in children. Studies involving youth with COVID-19 and diabetes are lacking. We report the case of a critically ill adolescent male with obesity, type 2 diabetes, and COVID-19 who presented with hyperglycemic hyperosmolar syndrome (HHS). Read More

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[Hyperosmolar Hyperglycemic State (HHS) with extreme hyperglycemia and hyperglycemia-induced hyponatremia in a patient with previously known diabetes mellitus type 2].

Lakartidningen 2021 03 26;118. Epub 2021 Mar 26.

överläkare, VO internmedicin, Visby lasarett.

This case report covers a patient presenting unconscious to the emergency department with a serum glucose level of 125.6 mmol/L and an associated hyperglycemia-induced hyponatremia with a sodium level of 101 mmol/L. The glucose level is, to our knowledge, one of the most extreme values described in medical literature. Read More

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Capecitabine-induced hyperosmolar hyperglycaemic state.

BMJ Case Rep 2021 Mar 24;14(3). Epub 2021 Mar 24.

Medicine, Division of Endocrinology, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada

An elderly woman with metastatic breast cancer was admitted with hyperglycaemic hyperosmolar state (HHS) and an elevated haemoglobin A1C. For 1 week, she had experienced confusion, nausea and frequent urination. Preceding this, she had completed seven cycles of capecitabine chemotherapy for her breast cancer. Read More

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Neurological Complications of Endocrine Emergencies.

Curr Neurol Neurosci Rep 2021 03 11;21(5):21. Epub 2021 Mar 11.

Department of Neurology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA.

Purpose Of Review: Endocrine disorders are the result of insufficient or excessive hormonal production. The clinical course is long, and the manifestations are nonspecific due to the systemic effect of hormones across many organs and systems including the nervous system. This is a narrative review of the recent evidence of the diagnosis and treatment approach of these medical and neurological emergencies. Read More

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