scholarly journals Bilateral Diabetic Knee Neuroarthropathy in a Forty-Year-Old Patient

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Patrick Goetti ◽  
Nicolas Gallusser ◽  
Olivier Borens
Keyword(s):  
Joint Destruction ◽  
Young Patients ◽  
Joint Disease ◽  
Diabetic Patients ◽  
Type I ◽  
Bilateral Involvement ◽  
Satisfactory Outcome ◽  
History Of ◽  
Diabetes Type I ◽  
Low Incidence

Diabetic osteoarthropathy is a rare cause of neuropathic joint disease of the knee; bilateral involvement is even more exceptional. Diagnosis is often made late due to its unspecific symptoms and appropriate surgical management still needs to be defined, due to lack of evidence because of the disease’s low incidence. We report the case of a forty-year-old woman with history of diabetes type I who developed bilateral destructive Charcot knee arthropathy. Bilateral total knee arthroplasty was performed in order to achieve maximal functional outcome. Follow-up was marked by bilateral tibial periprosthetic fractures treated by osteosynthesis with a satisfactory outcome. The diagnosis of Charcot arthropathy should always be in mind when dealing with atraumatic joint destruction in diabetic patients. Arthroplasty should be considered as an alternative to arthrodesis in bilateral involvement in young patients.

scholarly journals Modulation of Insulin Gene Expression with CRISPR/Cas9-based Transcription Factors

2021 ◽  
Vol 9 (A) ◽  
pp. 876-881
Author(s):  
Bakhytzhan Alzhanuly ◽  
Zhussipbek Y. Mukhatayev ◽  
Dauren M. Botbayev ◽  
Yeldar Ashirbekov ◽  
Nurlybek D. Katkenov ◽  
...  
Keyword(s):  
Embryonic Stem ◽  
Cell Types ◽  
Diabetic Patients ◽  
Type I ◽  
Transcription Activator ◽  
New Approach ◽  
Donor Cells ◽  
Diabetes Type I ◽  
Promising Solution ◽  
Insulin Gene Expression

Background: The discovery and use of CRISPR/Cas9 technology have enabled researchers throughout the globe to continuously edit genomes for the benefit of science and medicine. Diabetes type I is one field of medicine where CRISPR/Cas9 has a strong potential for cell therapy development. The long-lasting paucity of healthy cells for clinical transplantation into diabetic patients has led to the search of new methods for producing β-cells from other human cell types. Embryonic stem cells are being studied worldwide as one most promising solution of this need. Aim: The aim of the study is to to check the feasibility of modulating human insulin transcription using CRISPR/Cas9-based synthetic transcription regulation factors. Results: A new approach for creating potential therapeutic donor cells with enhanced and suppressed insulin production based on one of the latest achievements of human genome editing was developed. Both synthetic transcription activator (VP64) and transcription repressor (KRAB) proteins were shown to function adequately well as a part of the whole CRISPR/Cas9-based system. We claim that our results have a lot to offer and can bring light to many studies where numerous labs are struggling on to treat this disease.

scholarly journals A Rarely Seen Multilevel Thoracic Vertebral Fracture after a Nocturnal Hypoglycemic Convulsion Attack

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Ebru Atalar ◽  
Cuneyd Gunay ◽  
Hakan Atalar ◽  
Tugba Tunc
Keyword(s):  
Back Pain ◽  
Thoracic Spine ◽  
Type I Diabetes ◽  
Compression Fracture ◽  
Diabetic Patients ◽  
Type I ◽  
Rare Injury ◽  
Compression Fractures ◽  
History Of ◽  
Insulin Dependent Diabetic

A 49-year-old male presented with acute midthoracic severe back pain following a witnessed nocturnal convulsion attack. There was no history of trauma and the patient had a 23-year history of Type I diabetes mellitus. MRI scans of the thoracic spine revealed compression fractures at T5, T6, T7, and T8 vertebrae. The patient was treated conservatively. At 17 months after the initial diagnosis, the complaints of back pain had been resolved and the patient was able to easily undertake daily living activities. Hypoglycaemia is a common problem in diabetic patients treated with insulin. Convulsions may occur as a consequence of insulin-induced hypoglycemia. Nontraumatic compression fractures of the thoracic spine following seizures are a rare injury. Contractions of strong paraspinal muscles can lead to compression fracture of the midthoracic spine. Unrecognized hypoglycaemia should be considered to be a possible cause of convulsions in insulin-dependent diabetic patients. The aim of this report is to point out a case of rarely seen multilevel consecutive vertebrae fractures in a diabetic patient after a nocturnal hypoglycaemic convulsion attack.

scholarly journals High Prevalence of Toxoplasma gondii Infection in Type I Diabetic Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Qasem Asgari ◽  
Mohammad Hossein Motazedian ◽  
Amir Khazanchin ◽  
Davood Mehrabani ◽  
Shahrbanou Naderi Shahabadi
Keyword(s):  
Family History ◽  
Type I Diabetes ◽  
Positive Family History ◽  
Control Group ◽  
Diabetic Patients ◽  
Type I ◽  
Toxoplasma Infection ◽  
Family History Of Diabetes ◽  
History Of ◽  
Toxoplasma Gondii Infection

Background. Type I diabetes (TΙDM) is a genetic or autoimmune disorder, which may be stimulated by induced immune system components due to the underlying infectious diseases. This study was undertaken to find out any possible association between Toxoplasma gondii infection and TIDM. Materials and Methods. One hundred and eighty-two blood samples were taken from individuals who were referred to outpatient clinics in Shiraz city, Southern Iran, during a 6-month period. The age of type I diabetic subjects ( n = 91 ) and the control group ( n = 91 ) was identical, which were less than 30 years. The sera were examined for IgG and IgM antibodies by ELISA and correlated with epidemiological factors such as age, sex, and family history of diabetes. Results. Out of 91 diabetic patients, 54 (59.3%) were female and 37 (40.7%) were male. The highest frequency of diabetes belonged to 6-10- and 11-15-year groups ( P = 0.17 ). Toxoplasma infection prevalence in diabetic and control groups was 28.6% and 7.7%, respectively ( P = 0.001 ). A significantly positive family history of diabetes was observed between diabetic patients (31 cases, 34.1%) and the control group (3 cases, 3.3%) ( P = 0.01 ). Interestingly, IgG positivity was seen in 13 cases (41.9%) of patients with positive family history of type I diabetes and 13 cases (21.7%) of subjects with no positive family history of type I diabetes ( P = 0.04 ). Conclusion. Our study showed a higher prevalence of Toxoplasma infection in type I diabetes patients. It is likely that the prevalence of TIDM decreases by increasing hygiene and preventing toxoplasmosis.

scholarly journals Management of Diabetic Ketoacidosis in Patients with Diabetes Type I

2019 ◽  
Author(s):  
Basam Zuhaer Sindi ◽  
Naif Mishkhas Alazwari ◽  
Abdulaziz Mohammed Khateeb ◽  
Aqil Abdulmonem Alzaher ◽  
Mohammad Abdulaziz M Alkhawajah ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Fluid Replacement ◽  
Diabetic Patients ◽  
Type I ◽  
Care Providers ◽  
Patients With Diabetes ◽  
Type One Diabetes ◽  
Diabetes Type I ◽  
Comprehensive Search ◽  
Health Complications

Background: DKA is the leading cause of mortality among pediatric age and young adults with T1D, responsible for almost 50% of all fatalities in diabetic patients younger than 24 years of age. Goals of DKA management include optimization of volume status, hyperglycemia and ketoacidosis, electrolyte abnormalities, and potential precipitating factors. Methodology: we conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1987, through February 2017. The following search terms were used: ketoacidosis, management of diabetic ketoacidosis, type I diabetic patients’ emergency complication, fluid replacement in DKA, insulin therapy approach. Aim: in this review, we aim at evaluating the various ways of approaching patients who suffer from type-one diabetes during ketoacidosis and keto-acidotic coma. We will try to understand the triggers and pathophysiology behind this condition, and explore ways to prevent them. Conclusion: prompt diagnoses, aggressive treatment, and education of patient and their care providers about prevention strategies must be implemented. Also, more studies are required in the area of preventing health complications due to these types of diseases to effectively manage DKA in the future.

Diabetic hip arthropathy is associated with a higher prevalence of femoral head chondromalacia: a case-controlled study

2018 ◽  
Vol 29 (5) ◽  
pp. 527-534
Author(s):  
T David Luo ◽  
Alejandro Marquez-Lara ◽  
Austin V Stone ◽  
Sandeep Mannava ◽  
Elizabeth A Howse ◽  
...  
Keyword(s):  
Femoral Head ◽  
Clinical Symptoms ◽  
Joint Disease ◽  
Controlled Study ◽  
Diabetic Patients ◽  
Duration Of Symptoms ◽  
Diabetic Status ◽  
Patients With Diabetes ◽  
History Of ◽  
Outerbridge Grade

Introduction: No previous studies have characterised hip joint disease in diabetic patients undergoing hip arthroscopy. The purpose of our study was to evaluate intra-articular hip pathology and surgical variables in patients with diabetes compared to matched, non-diabetic controls. We hypothesised that diabetic patients would demonstrate a higher prevalence and severity of hip chondral pathology. Methods: We retrospectively reviewed 795 consecutive hip arthroscopies performed by a single surgeon between 2010 and 2015. Patients ⩾18 years of age without a history of diabetes served as controls and were matched based on age, sex, body mass index, duration of symptoms, and operative side. Clinical symptoms, preoperative physical examination, and radiologic and intraoperative findings were assessed. The primary outcomes were the acetabular and femoral head chondromalacia index (CMI), calculated as the product of the Outerbridge chondromalacia grade and surface area (mm2*severity). Results: 15 diabetic patients were matched to 137 non-diabetic controls. Diabetic patients demonstrated a higher prevalence of femoral head chondromalacia compared to controls both on magnetic resonance imaging (45.5% vs. 7.5%, p = 0.002) and during arthroscopy (100% vs. 75.9%, p = 0.042). Femoral head chondromalacia in diabetic patients had higher Outerbridge grade (2.4 vs. 2.0, p = 0.030) but similar CMI (513.0 vs. 416.4, p = 0.298) compared to controls. Discussion: Femoral head chondral pathology was more prevalent and of higher severity grade in diabetic patients. The prevalence, size, and severity of acetabular chondral disease were similar between diabetic and non-diabetic patients. Multivariate analysis demonstrated that diabetic status was independently associated with the presence of femoral head chondromalacia.

scholarly journals Natural History of Anterior Shoulder Instability

2017 ◽  
Vol 11 (1) ◽  
pp. 909-918 ◽  
Author(s):  
Eduardo Palma Carpinteiro ◽  
Andre Aires Barros
Keyword(s):  
Surgical Treatment ◽  
Natural History ◽  
Age Of Onset ◽  
Young Patients ◽  
The Body ◽  
Joint Disease ◽  
First Episode ◽  
Anterior Shoulder Instability ◽  
Bone Lesions ◽  
History Of

Background:The shoulder is the most complex joint in the body. The large freedom of motion in this joint is the main cause of instability. Instability varies in its degree, direction, etiology and volition and there is a large spectrum of conditions.Methods:Based on literature research and also in our own experience, we propose to elucidate the reader about the natural history of instability and its importance for the appropriate management of this pathology, by answering the following questions:What happens in the shoulder after the first dislocation? Which structures suffer damage? Who are the patients at higher risk of recurrence? How does the disease evolve without treatment? Will surgical treatment avoid future negative outcomes and prevent degenerative joint disease? Who should we treat and when?Results:80% of anterior-inferior dislocations occur in young patients. Recurrent instability is common and multiple dislocations are the rule. Instability is influenced by a large number of variables, including age of onset, activity profile, number of episodes,delay between first episode and surgical treatment.Conclusion:Understanding the disease and its natural evolution is determinant to decide the treatment in order to obtain the best outcome. It is crucial to identify the risk factors for recurrence. Delay in surgical treatment, when indicated, leads to worse results. Surgical technique should address the type and severity of both soft tissue and bone lesions, when present.

Semi-quantitative assessment of cerebral blood flow with 99m Tc-HMPAO SPET in type I diabetic patients with no clinical history of cerebrovascular disease

1997 ◽  
Vol 24 (12) ◽  
pp. 1507-1513 ◽  
Author(s):  
Remedios Quirce ◽  
José M. Carril ◽  
Julio F. Jiménez-Bonilla ◽  
José A. Amado ◽  
Ceferino Gutiérrez-Mendiguchí ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cerebrovascular Disease ◽  
Quantitative Assessment ◽  
Clinical History ◽  
Diabetic Patients ◽  
Type I ◽  
History Of

Septic Arthritis and Osteomyelitis

2016 ◽  
Author(s):  
Melissa Leber
Keyword(s):  
Antibiotic Therapy ◽  
Septic Arthritis ◽  
Vertebral Body ◽  
Joint Destruction ◽  
Vertebral Osteomyelitis ◽  
Initial Evaluation ◽  
Joint Disease ◽  
Diabetic Patients ◽  
Posttraumatic Osteomyelitis ◽  
Neuropathic Ulcers

Septic arthritis is an inflammatory condition within the joint in reaction to bacterial infection in the joint space. Emergent diagnosis and initiation of therapy are necessary to prevent joint destruction and, in some cases, serious systemic illness. This review covers the epidemiology, assessment and stabilization, diagnosis, treatment and disposition, and outcomes of septic arthritis. Figures show the pathophysiology of bone infection; an algorithm for the initial evaluation and management of a suspected septic joint; a magnetic resonance image of vertebral body osteomyelitis; a cutaneous sinus in a patient with underlying chronic posttraumatic osteomyelitis at the site of a previous tibial fracture; the probe-to-bone test for diagnosing osteomyelitis in the diabetic foot; an algorithm for the initial evaluation and management of suspected vertebral body osteomyelitis; nonsurgical treatment of osteomyelitis of the foot in a patient with diabetes; and algorithms for the evaluation and management of osteomyelitis in diabetic patients with neuropathic ulcers and no or mild foot infection, osteomyelitis in diabetic patients with neuropathic ulcers and moderate or severe foot infection, and chronic posttraumatic osteomyelitis. Tables list supportive findings for diagnosis of chronic osteomyelitis, risk factors for the development of septic arthritis in patients with underlying joint disease, microbiology in septic arthritis, empirical antibiotic therapy for septic arthritis, microbiology in vertebral osteomyelitis, antibiotic therapy for vertebral osteomyelitis awaiting culture results, representative studies with likelihood ratios for diagnostic tests used in the evaluation of native joint septic arthritis, antibiotic therapy for vertebral osteomyelitis with unknown or established microbiology, and antibiotic therapy for diabetic pedal osteomyelitis with unknown or established microbiology.   Key words: osteomyelitis, probe-to-bone test, septic arthritis, septic joint, vertebral osteomyelitis This review contains 10 highly rendered figures, 9 tables, and 110 references.

Vascularized Bone Grafting for the Treatment of Capitate Avascular Necrosis

2021 ◽  
Author(s):  
Jorge I. Quintero ◽  
Maria C. Herrand ◽  
Rodrigo Moreno
Keyword(s):  
Avascular Necrosis ◽  
Young Patients ◽  
Rare Condition ◽  
Type I ◽  
Carpal Collapse ◽  
History Of ◽  
Surgical Options ◽  
Revascularization Procedures ◽  
Capitate Bone ◽  
Vascularized Bone

AbstractAvascular necrosis (AVN) of the capitate bone is a rare condition and it can be related to major trauma or idiopathy. Different treatments are available including soft tissue interposition and intercarpal arthrodesis including lunocapitate, scaphocapitate, four corner, and carpometacarpal fusions. Other surgical options are resection of the proximal pole and revascularization procedures. The main purpose of this article is to present two cases of AVN of the capitate treated with a revascularization procedure using the 4th–5th extensor compartment artery (4th–5th ECA). Two female patients with capitate AVN are reported with an average age of 30.5 years. Both cases were classified as type-I according to Milliez classification. The major complaint in each case was wrist pain that increased during activity. In both cases there was no history of trauma, smoking, diabetes, or hematologic diseases. Both patients had a diminished range of motion, grip, and strength. The definitive diagnosis was made with magnetic resonance imaging. Both patients underwent treatment revascularization of the capitate using a vascularized bone graft based on the 4th–5th ECA. At average follow-up of 12 months, each patient had improved with regards to pain and had increased grip strength. The literature does not describe a specific algorithm treatment for capitate AVN. We recommend revascularization of the capitate using the 4th–5th ECA in type-I Milliez classification in young patients without signs of carpal collapse.

scholarly journals Management of Diabetic Ketoacidosis in Patients with Diabetes Type I

2019 ◽  
Author(s):  
Basam Zuhaer Sindi ◽  
Naif Mishkhas Alazwari ◽  
Abdulaziz Mohammed Khateeb ◽  
Aqil Abdulmonem Alzaher ◽  
Mohammad Abdulaziz M Alkhawajah ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Fluid Replacement ◽  
Diabetic Patients ◽  
Type I ◽  
Care Providers ◽  
Patients With Diabetes ◽  
Type One Diabetes ◽  
Diabetes Type I ◽  
Comprehensive Search ◽  
Health Complications

Background: DKA is the leading cause of mortality among pediatric age and young adults with T1D, responsible for almost 50% of all fatalities in diabetic patients younger than 24 years of age. Goals of DKA management include optimization of volume status, hyperglycemia and ketoacidosis, electrolyte abnormalities, and potential precipitating factors. Methodology: we conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1987, through February 2017. The following search terms were used: ketoacidosis, management of diabetic ketoacidosis, type I diabetic patients’ emergency complication, fluid replacement in DKA, insulin therapy approach. Aim: in this review, we aim at evaluating the various ways of approaching patients who suffer from type-one diabetes during ketoacidosis and keto-acidotic coma. We will try to understand the triggers and pathophysiology behind this condition, and explore ways to prevent them. Conclusion: prompt diagnoses, aggressive treatment, and education of patient and their care providers about prevention strategies must be implemented. Also, more studies are required in the area of preventing health complications due to these types of diseases to effectively manage DKA in the future.

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