1,226 results match your criteria Hyperosmolar Coma


Hemichorea-Hemiballismus as an Unusual Presentation of Hyperosmolar Hyperglycemic Syndrome.

Am J Med Case Rep 2020 5;8(6):159-161. Epub 2020 Apr 5.

Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203 USA.

Diabetes mellitus can lead to a diverse array of systemic complications. Poorly managed hyperglycemia can result in serious neurological consequences ranging from peripheral neuropathy to seizures and coma. A rare neurologic disorder seen in acute decompensated type 2 diabetes mellitus (T2DM) is hemichorea-hemiballismus (HCHB). Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236990PMC

Acute Hyperglycemic Crises with Coronavirus Disease-19: Case Reports.

Diabetes Metab J 2020 04;44(2):349-353

Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.

Since the first case was contracted by coronavirus disease-19 (COVID-19) in Daegu, Korea in February 2020, about 6,800 cases and 130 deaths have been reported on April 9, 2020. Recent studies have reported that patients with diabetes showed higher mortality and they had a worse prognosis than the group without diabetes. In poorly controlled patients with diabetes, acute hyperglycemic crises such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) also might be precipitated by COVID-19. Read More

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http://dx.doi.org/10.4093/dmj.2020.0091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188962PMC

Salty, Sweet and Difficult to Treat: A Case of Profound Hypernatremia in the Setting of Hyperosmotic Hyperglycemic State.

Cureus 2020 Mar 15;12(3):e7278. Epub 2020 Mar 15.

Pulmonology and Critical Care, State University of New York (SUNY) Upstate Medical University Hospital, Syracuse, USA.

Hyperosmolar hyperglycemic state (HHS) is a disorder that occurs most frequently in type 2 diabetics and is associated with high mortality - up to 50%. Hypernatremia, when associated with HHS, worsens the prognosis. Encephalopathy is evident at a serum sodium level greater than 160 mOsm/kg. Read More

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http://dx.doi.org/10.7759/cureus.7278DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7158592PMC

[The Management of Blood Glucose Should be Emphasized in the Treatment of COVID-19].

Sichuan Da Xue Xue Bao Yi Xue Ban 2020 Mar;51(2):146-150

Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China.

Based on the higher mortality and the higher proportion of critically ill adults in coronavirus disease 2019 (COVID-19) patients with diabetes, good inpatient glycemic control is particularly important in the comprehensive treatment of COVID-19. Individualized blood glucose target goals and treatment strategies should be made according to specific circumstances of COVID-19 inpatients with diabetes. For mild patients, a strict glycemic control target (fasting plasma glucose (FPG) 4. Read More

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http://dx.doi.org/10.12182/20200360606DOI Listing

[A case of Langerhans cell histiocytosis with hyperosmolar hyperglycemic syndrome].

Zhonghua Nei Ke Za Zhi 2020 Mar;59(3):232-234

Department of Endocrinology, Hainan General Hospital, Haikou 570311, China.

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http://dx.doi.org/10.3760/cma.j.issn.0578-1426.2020.03.014DOI Listing

Assessing the Impact of 3% Hypertonic Saline Hyperosmolar Therapy on Intubated Children With Isolated Traumatic Brain Injury by Cerebral Oximetry in a Pediatric Emergency Setting.

Pediatr Emerg Care 2020 Feb 26. Epub 2020 Feb 26.

Arkansas Children's Hospital.

Background: Intubated pediatric patients with isolated traumatic brain injury (TBI) are a diagnostic challenge for early detection of altered cerebral physiology instigated by trauma-induced increased intracranial pressure (ICP) while preventing secondary neuronal damage (secondary insult detection) and assessing the effects of increased ICP therapeutic interventions (3% hypertonic saline [HTS]). Invasive brain tissue oxygen monitoring is guiding new intensive care unit TBI management but is not pediatric emergency department (PED) readily accessible. Objective measurements on pediatric isolated TBI-altered bihemispheric cerebral physiology and treatment effects of 3% HTS are currently lacking. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001959DOI Listing
February 2020
0.923 Impact Factor

Mild traumatic brain injuries with minor intracranial hemorrhage: Can they Be safely managed in the community? - A cohort study.

Int J Surg 2020 Apr 17;76:88-92. Epub 2020 Feb 17.

Department of Surgery, Massachusetts General Hospital, Boston, MA, USA. Electronic address:

Background: Patients with mild traumatic brain injury (mTBI) are frequently transferred to level 1 trauma centers (L1TC) if they have minor findings on a computerized tomographic scan of the head due to the absence of continuous neurosurgical coverage in community hospitals (CH). We hypothesized that such patients can be safely managed at community hospitals with a qualified Trauma team.

Methods: This is a multicentered Retrospective Cohort Study. Read More

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http://dx.doi.org/10.1016/j.ijsu.2020.02.016DOI Listing

Cytomegalovirus Colitis Followed by Colonic Pseudolipomatosis and Gastric Emphysema in a Post-resuscitation Patient.

Intern Med 2020 Feb 24;59(4):519-525. Epub 2019 Oct 24.

Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan.

A 64-year-old Japanese man suffered cardiopulmonary arrest, which may have resulted from sepsis and/or hyperosmolar hyperglycemic non-ketonic coma, and was admitted after successful resuscitation. He had watery diarrhea on day 18 and was diagnosed with cytomegalovirus enterocolitis. In addition, computed tomography performed on day 27 and colonoscopy revealed gastric emphysema and intestinal pseudolipomatosis, respectively. Read More

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http://dx.doi.org/10.2169/internalmedicine.3633-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7056364PMC
February 2020
1 Read

Trends in Hyperglycemic Crisis Hospitalizations and in- and out-of-Hospital Mortality in the Last Decade Based on Korean National Health Insurance Claims Data.

Endocrinol Metab (Seoul) 2019 09;34(3):275-281

Division of Endocrinology and Metabolism, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Background: Hyperglycemic crisis is a metabolic emergency associated with diabetes mellitus. However, accurate epidemiologic information on cases of hyperglycemic crisis in Korea remains scarce. We evaluated trends in hyperglycemic crisis hospitalizations and in- and out-of-hospital mortality in Korea. Read More

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http://dx.doi.org/10.3803/EnM.2019.34.3.275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769342PMC
September 2019
3 Reads

The authors reply.

Crit Care Med 2019 10;47(10):e851

Department of Pharmacy Services, University of California, Davis Health, Sacramento, CA University of California, Davis Health, Sacramento, CA.

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http://dx.doi.org/10.1097/CCM.0000000000003952DOI Listing
October 2019

The "Underwater Part of the Iceberg" of Insulin Administration for Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State: Electrolytics Disorders.

Crit Care Med 2019 10;47(10):e850-e851

Intensive Care Unit, Poissy Saint Germain Hospital, 9-10 rue du champ Gaillard, Poissy, France, INSERM U-1018, CESP, Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, Villejuif, France, and French Intensive Renal Network (FIRN), Poissy, France Intensive Care Unit, Poissy Saint Germain Hospital, 9-10 rue du champ Gaillard, Poissy, France French Intensive Renal Network (FIRN), Poissy, France, Renal Intensive Care Unit and Kidney Transplantation, Tenon Hospital, Assistance Publique Hôpitaux de Paris, Paris, France, and Medicine Faculty, Sorbonne University, Paris, France French Intensive Renal Network (FIRN), Poissy, France, and Nephrology and Renal Transplantation, Conception Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France.

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http://dx.doi.org/10.1097/CCM.0000000000003923DOI Listing
October 2019
6 Reads

A pilot study evaluating the effect of mannitol and hypertonic saline solution in the treatment of increased intracranial pressure in 2 cats and 1 dog naturally affected by traumatic brain injury.

J Vet Emerg Crit Care (San Antonio) 2019 Sep 26;29(5):578-584. Epub 2019 Aug 26.

Department of Veterinary Medicine, Veterinary Teaching Hospital, Via Vienna SNC, Sassari, Italy.

Objective: To evaluate the effects of iso-osmolar doses of 18% mannitol and 3% sodium chloride (NaCl) solutions in decreasing intracranial pressure (ICP) in animals with severe traumatic brain injury (TBI).

Design: Prospective uncontrolled interventional study.

Setting: Veterinary university teaching hospital. Read More

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http://dx.doi.org/10.1111/vec.12880DOI Listing
September 2019
2 Reads

Care of Children and Adolescents with Diabetes Mellitus and Hyperglycemia in the Inpatient Setting.

Curr Diab Rep 2019 08 23;19(10):85. Epub 2019 Aug 23.

Weill Cornell Medicine, Division of Pediatric Endocrinology, NY Presbyterian Hospital, 505 East 70 Street, New York, NY, 10021, USA.

Purpose Of Review: Children and adolescents with acute hyperglycemia and diabetes mellitus frequently have acute, potentially life-threatening presentations which require high-acuity care in an inpatient and often intensive care setting. This review discusses the evaluation and care of hyperglycemia and diabetes mellitus in hospitalized children in both critical and non-critical care settings, highlighting important differences in their care relative to adults.

Recent Findings: Diabetic ketoacidosis remains highly prevalent at diagnosis among children with type 1 diabetes, and hyperglycemic hyperosmolar state is increasingly prevalent among children with type 2 diabetes. Read More

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http://dx.doi.org/10.1007/s11892-019-1205-7DOI Listing
August 2019
3 Reads

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Crit Care Med 2019 09;47(9):e793-e794

Department of Pharmacy Services, University of California, Davis Health, Sacramento, CA.

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http://dx.doi.org/10.1097/CCM.0000000000003885DOI Listing
September 2019
2 Reads

"High-Intensity" May Not Be the Intent of "Low-Dose" Insulin: Request for Full Protocol.

Crit Care Med 2019 09;47(9):e793-e795

Department of Pharmacy, HSHS St. John's Hospital, Springfield, IL.

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http://dx.doi.org/10.1097/CCM.0000000000003845DOI Listing
September 2019
1 Read

Hyperosmolar hyperglycaemic state (HHS) as the first manifestationof type 2 diabetes in a child.

Pediatr Endocrinol Diabetes Metab 2019 ;25(2):85-89

Department of Endocrinology and Diabetology for Children and Adolescents, Wrocław Medical University, Poland.

Hyperglycaemic hyperosmolar state (HHS) may occur in young patients with type 1 and type 2 diabetes and in infants with hyperglycaemia. Hyperglycaemic hyperosmolar state is characterised by extremely high glucose concentration, which, by increasing osmotic diuresis, intensifies dehydration. Hyperglycaemic hyperosmolar state criteria include the following: plasma glucose > 600 mg/dl, venous pH > 7. Read More

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http://dx.doi.org/10.5114/pedm.2019.85819DOI Listing
February 2020
2 Reads

Intracranial pressure monitoring in patients with spontaneous intracerebral hemorrhage.

J Neurosurg 2019 May 31:1-11. Epub 2019 May 31.

4Neurology, and.

Objective: The utility of ICP monitoring and its benefit with respect to outcomes after ICH is unknown. The aim of this study was to compare intracerebral hemorrhage (ICH) outcomes in patients who underwent intracranial pressure (ICP) monitoring to those who were managed by care-guided imaging and/or clinical examination alone.

Methods: This was a retrospective analysis of data from the Ethnic/Racial variations of Intracerebral Hemorrhage (ERICH) study between 2010 and 2015. Read More

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http://dx.doi.org/10.3171/2019.3.JNS19545DOI Listing
May 2019
28 Reads

Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients.

BMJ 2019 05 29;365:l1114. Epub 2019 May 29.

Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome (HHS) are life threatening complications that occur in patients with diabetes. In addition to timely identification of the precipitating cause, the first step in acute management of these disorders includes aggressive administration of intravenous fluids with appropriate replacement of electrolytes (primarily potassium). In patients with diabetic ketoacidosis, this is always followed by administration of insulin, usually via an intravenous insulin infusion that is continued until resolution of ketonemia, but potentially via the subcutaneous route in mild cases. Read More

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http://dx.doi.org/10.1136/bmj.l1114DOI Listing
May 2019
9 Reads

Correction of neurological deficiency in patients with acute ischemic stroke by application of different qualitative composition of infusion solutions.

Wiad Lek 2019 ;72(4):543-547

National Pirogov Memorial Medical University, Vinnytsya, Ukraine.

Objective: Introduction: Infusion therapy is an important component in the treatment of patients with acute ischemic stroke (AIS). The aim: Compare the dynamics of changes neurological deficiency in the application of solutions: 0.9% NaCl, HES 130, HAES-LX-5% and mannitol 15% in patients with AIS. Read More

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August 2019
8 Reads

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
April 2019
4 Reads

[Treatment of acute diabetic metabolic crises in adults (Update 2019) : Hyperglycemic hyperosmolar state and ketoacidotic metabolic disorders].

Wien Klin Wochenschr 2019 May;131(Suppl 1):196-199

Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.

Diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state (HHS) represent potentially life-threatening situations in adults. Therefore, rapid comprehensive diagnostic and therapeutic measures with close monitoring of vital and laboratory parameters are required. The treatment of DKA and HHS is essentially the same and replacement of the mostly substantial fluid deficit with several liters of a physiological crystalloid solution is the first and most important step. Read More

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http://link.springer.com/10.1007/s00508-018-1423-z
Publisher Site
http://dx.doi.org/10.1007/s00508-018-1423-zDOI Listing
May 2019
20 Reads

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 2020 Mar 6. Epub 2020 Mar 6.

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
March 2020
33 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
Publisher Site
http://dx.doi.org/10.1007/s40200-018-0353-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405398PMC
December 2018
11 Reads

Non-ketotic hyperosmolar hyperglycemic chorea.

Rev Assoc Med Bras (1992) 2019 Feb;65(2):127-129

Professor of Neurology, Movement Disorders Division, Irmandade Santa Casa de Misericórdia of Porto Alegre, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brasil.

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http://dx.doi.org/10.1590/1806-9282.65.2.127DOI Listing
February 2019
4 Reads

Moderate-Intensity Insulin Therapy Is Associated With Reduced Length of Stay in Critically Ill Patients With Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State.

Crit Care Med 2019 05;47(5):700-705

Department of Pharmacy Services, University of California Davis Medical Center, Sacramento, CA.

Objectives: Insulin infusion therapy is commonly used in the hospital setting to manage diabetic ketoacidosis and hyperosmolar hyperglycemic state. Clinical evidence suggests both hypoglycemia and glycemic variability negatively impact patient outcomes. The hypothesis of this study was that moderate-intensity insulin therapy decreases hospital length of stay and prevalence of hypoglycemia in patients with diabetic ketoacidosis and hyperosmolar hyperglycemic state. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003709DOI Listing
May 2019
7 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
16 Reads

Guidelines for the Management of Pediatric Severe Traumatic Brain Injury, Third Edition: Update of the Brain Trauma Foundation Guidelines, Executive Summary.

Pediatr Crit Care Med 2019 03;20(3):280-289

Herman and Faye Sarkowsky Endowed Chair, Head, Division of Pediatric Neurology, University of Washington, Seattle Children's Hospital, Seattle, WA.

Objectives: The purpose of this work is to identify and synthesize research produced since the second edition of these Guidelines was published and incorporate new results into revised evidence-based recommendations for the treatment of severe traumatic brain injury in pediatric patients.

Methods And Main Results: This document provides an overview of our process, lists the new research added, and includes the revised recommendations. Recommendations are only provided when there is supporting evidence. Read More

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http://dx.doi.org/10.1097/PCC.0000000000001736DOI Listing
March 2019
62 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 03;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
32 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
12 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
13 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
12 Reads

Incidence and Outcomes of Non-ST Elevation Myocardial Infarction in Patients Hospitalized with Decompensated Diabetes.

Am J Cardiol 2018 10 17;122(8):1297-1302. Epub 2018 Jul 17.

Division of Cardiology, West Virginia University, Morgantown, West Virginia. Electronic address:

Single center studies suggested that non-ST elevation myocardial infarction (NSTEMI) in patients admitted with acute decompensated diabetes is associated with poor long-term prognosis. We hypothesize that acute decompensated diabetes is also associated with worse early morbidity and mortality in patients admitted with NSTEMI. Adult patients with a primary discharge diagnosis of diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) were identified in the national inpatient sample. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029149183141
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http://dx.doi.org/10.1016/j.amjcard.2018.07.004DOI Listing
October 2018
18 Reads

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
16 Reads
0.889 Impact Factor

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
45 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
14 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
49 Reads

ISPAD Clinical Practice Consensus Guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state.

Pediatr Diabetes 2018 10;19 Suppl 27:155-177

Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile.

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http://doi.wiley.com/10.1111/pedi.12701
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http://dx.doi.org/10.1111/pedi.12701DOI Listing
October 2018
131 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
51 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
13 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
25 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
10 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
31 Reads

Perioperative management of adult diabetic patients. Postoperative period.

Anaesth Crit Care Pain Med 2018 06 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
30 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
25 Reads

Clinical Features and Prognosis of Type 2 Myocardial Infarction in Acutely Decompensated Diabetic Patients.

Am J Med 2018 07 5;131(7):820-828. Epub 2018 Mar 5.

Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisc; University of Wisconsin School of Medicine and Public Health, Milwaukee.

Background: After the introduction of the universal definition of myocardial infarction, the incidence and diagnosis of type 2 myocardial infarction have risen dramatically, yet there are no clear guidelines on clinical management. Diabetic patients are at high risk for developing type 2 myocardial infarction when admitted in a decompensated state, and they are also at high risk for future cardiovascular events.

Methods: We performed a retrospective analysis of 1058 patients admitted with diabetic ketoacidosis or hyperosmolar hyperglycemic state between 2011 and 2016. Read More

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http://dx.doi.org/10.1016/j.amjmed.2018.02.007DOI Listing
July 2018
16 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
59 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
18 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
53 Reads