scholarly journals Diabetic Myonecrosis: A Diagnostic and Treatment Challenge in Longstanding Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Lima Lawrence ◽  
Oscar Tovar-Camargo ◽  
M. Cecilia Lansang ◽  
Vinni Makin
Keyword(s):  
Diabetes Mellitus ◽  
Rare Complication ◽  
Acute Onset ◽  
Muscular Pain ◽  
Uncontrolled Diabetes ◽  
Long Term Prognosis ◽  
The Right ◽  
High Index Of Suspicion ◽  
Microvascular And Macrovascular Complications

Objective. Diabetes mellitus is associated with microvascular and macrovascular complications; the most commonly recognized ones include diabetic nephropathy, retinopathy, and neuropathy. Less well-known complications are equally important, as timely recognition and treatment are essential to decrease short- and long-term morbidity. Methods. Herein, we describe a case of a 41-year-old female with longstanding, uncontrolled type 2 diabetes, who presented with classical findings of diabetic myonecrosis. Results. Our patient underwent extensive laboratory and imaging studies prior to diagnosis due to its rarity and similarity in presentation with other commonly noted musculoskeletal conditions. We emphasize the clinical presentation, laboratory and imaging findings, treatment regimen, and prognosis associated with diabetic myonecrosis. Conclusion. Diabetic myonecrosis is a rare complication of longstanding, poorly controlled diabetes mellitus. The diagnosis requires a high index of suspicion in the right clinical setting: acute onset nontraumatic muscular pain with associated findings on clinical exam, laboratory studies, and imaging. While the short-term prognosis is good, the recurrence rate remains high and long-term prognosis is poor given underlying uncontrolled diabetes and associated sequelae.

Hospital and long-term prognosis of patients with non-ST-segment elevation myocardial infarction

2008 ◽  
Vol 149 (45) ◽  
pp. 2115-2119 ◽  
Author(s):  
András Jánosi ◽  
Dániel Várnai ◽  
Zsófia Ádám ◽  
Adrienn Surman ◽  
Katalin Vas
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Long Term Prognosis

A szerzők 139, nem ST-elevációs infarktus miatt kezelt betegük adatait elemzik. Vizsgálják a betegek kórházi és késői prognózisát, egyes echokardiográfiás adatok prognózissal való összefüggését, valamint a kórházból elbocsátott betegek esetén a szekunder prevenció szempontjából ajánlott gyógyszeres kezelés gyakoriságát. Az utánkövetés a betegek 98%-ában sikeres volt, a bekövetkezett eseményekről, illetve az utánkövetés idején alkalmazott gyógyszeres kezelésről postai kérdőív útján szereztek adatokat. A nők átlagéletkora 78,6, a férfiaké 71,4 év volt. A kezelt betegeknél gyakori volt a társbetegségek (hypertonia, diabetes mellitus, korábbi ischaemiás szívbetegség) előfordulása. A kórházi kezelés időszakában 30 betegnél (22%) történt koronarográfia, és 29 betegnél revascularisatiós beavatkozásra is sor került. A kórházi halálozás 15% volt, az utánkövetés háromnegyed éve alatt 17%-os halálozást észleltek. A kórházban, illetve az utánkövetési idő alatt meghalt betegek szignifikánsan idősebbek voltak azoknál, akik életben maradtak. Egyes echokardiográfiás adatok (ejekciós frakció, végszisztolés átmérő, szegmentális falmozgászavar és a mitralis insufficientia nagysága) prognosztikus jelentőségűnek bizonyultak, mivel szignifikánsan különböztek az életben maradt és a meghalt betegek esetén. A kórházból elbocsátott betegek igen magas arányban részesültek a másodlagos prevenció szempontjából fontosnak ítélt gyógyszeres kezelésben (aszpirin, béta-blokkoló, ACE-gátló, statin). Az utánkövetés idején sem csökkent ezen gyógyszerek használatának aránya, ami a betegek jó compliance-ét igazolja.

Omental Infarction: A Case Treated with Laparoscopic Surgery

2019 ◽  
pp. 1-3
Author(s):  
Bertrand Ng ◽  
Arafat Yasser
Keyword(s):  
Diabetes Mellitus ◽  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Acute Cholecystitis ◽  
Inflammatory Markers ◽  
Acute Onset ◽  
Laparoscopy Surgery ◽  
History Of ◽  
Background History ◽  
The Right

Omental infarct is a rare cause of an acute abdomen that arises from an interruption of blood supply to the omentum. Here, we present a case of omental infarct in a 67-year-old gentleman with background history of diabetes mellitus who present unusually with a severe acute onset right hypochondrium pain. Examination revealed that he was tender to touch at the right and was having localized guarding. His inflammatory markers were normal. He was successfully treated with laparoscopy surgery and he was subsequently discharged the following day. Omental infarct cases with right hypochondrium pain can sometimes mimicked acute cholecystitis and management includes laparoscopic surgery which can hasten symptoms resolution and reduces hospital stay, however recommendation for surgery has to be balanced with anesthetics risk and complication of the surgery itself.

P1836Constrictive pericarditis after open heart surgery: a 20-year case controlled study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A E Moreyra ◽  
Y Yang ◽  
S Zinonos ◽  
N M Cosgrove ◽  
J Cabrera ◽  
...  
Keyword(s):  
Constrictive Pericarditis ◽  
Heart Surgery ◽  
Rare Complication ◽  
Open Heart Surgery ◽  
Controlled Study ◽  
Robert Wood Johnson Foundation ◽  
Open Heart ◽  
Significant Difference ◽  
Long Term Prognosis

Abstract Background Constrictive pericarditis (CoPe) after open-heart surgery (OHS) is a rare complication. Information on the incidence, determinants, and prognosis of this condition has been scarcely reported. Purpose To investigate the long term prognosis of CoPe after OHS. Methods Using the Myocardial Infarction Data Acquisition System database, we analyzed records of 144,902 patients that had OHS in New Jersey hospitals between 1995 and 2015. CoPe was identified in 79 patients after discharge. Differences in proportions were analyzed using chi square. Cases and controls were matched for demographics and comorbidities. Cox proportional hazard models were used to evaluate outcome risks. Log-rank test was used to assess differences in the Kaplan-Meier survival curves. Results Patients with CoPe were more likely to have history of valve disease (HVD) (p<0.0001), atrial fibrillation (AF) (p=0.0006) and chronic kidney disease (CKD) (p=0.012). Significant predictors of CoPe were AF (HR 1.62, 95% CI 1.02–2.59), CKD (HR 2.70, 95% CI 1.53–4.76), diabetes (HR 1.73, 95% CI 1.08–2.80) and HVD (HR 3.11, 95% CI 1.88–5.15). Patients with CoPe compared to matched controls had a higher 10-year mortality (p<0.0001). This became a statistically significant difference at 6 years after surgery (Figure). Survival Curve Conclusion Constrictive pericarditis is a rare complication of OHS and occurs more frequently in patients with AF, CKD, diabetes and HVD. It is associated with an unfavorable long-term prognosis. The data highlight the need for strategies to help prevent this complication. Acknowledgement/Funding Robert Wood Johnson Foundation

scholarly journals Role of comorbidities in heart failure prognosis Part I: Anaemia, iron deficiency, diabetes, atrial fibrillation

2020 ◽  
Vol 27 (2_suppl) ◽  
pp. 27-34
Author(s):  
Stefania Paolillo ◽  
Angela B Scardovi ◽  
Jeness Campodonico
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Chronic Heart Failure ◽  
Iron Deficiency ◽  
Prognostic Impact ◽  
Heart Failure Patients ◽  
Cardiovascular Comorbidities ◽  
Long Term Prognosis

Cardiovascular and non-cardiovascular comorbidities are frequently observed in heart failure patients, complicating the therapeutic management and leading to poor prognosis. The prompt recognition of associated comorbid conditions is of great importance to optimize the clinical management, the follow-up, and the treatment of patients affected by chronic heart failure. Anaemia and iron deficiency are commonly reported in all heart failure forms, have a multifactorial aetiology and are responsible for reduced exercise tolerance, impaired quality of life, and poor long-term prognosis. Diabetes mellitus is highly prevalent in heart failure and a poor glycaemic control is associated with worst outcome. Two specific heart failure forms are usually observed in diabetic patients: an ischaemic cardiomyopathy or a typical diabetic cardiomyopathy. The implementation of use of sodium-glucose cotransporter-2 inhibitors will much improve in the near future the long-term prognosis of patients affected by heart failure and diabetes. Among cardiovascular comorbidities, atrial fibrillation is the most common arrhythmic disease of heart failure patients and it is still not clear whether its presence should be considered as a prognostic indicator or as a marker of advanced disease. The aim of the present review was to explore the clinical and prognostic impact of anaemia and iron deficiency, diabetes mellitus, and atrial fibrillation in patients affected by chronic heart failure.

scholarly journals An unusual presentation of acute onset Charcot arthropathy

2020 ◽  
Vol 2020 (5) ◽  
Author(s):  
Ammar Al-Najjar ◽  
Julien Al Shakarchi ◽  
Melwyn Pereira ◽  
Richard Downing
Keyword(s):  
Rare Complication ◽  
Major Amputation ◽  
Acute Onset ◽  
Lower Limbs ◽  
Charcot Foot ◽  
Charcot Arthropathy ◽  
Plantar Aspect ◽  
Patients With Diabetes ◽  
Fracture Dislocations ◽  
High Index Of Suspicion

Abstract Charcot arthropathy is a progressive condition primarily affecting the lower limbs in patients with diabetes mellitus. It is a rare complication of diabetic neuropathy and if left untreated can lead to severe limb destruction necessitating major amputation. Here, we report the case of a 41-year-old female who presented with rapidly progressive Charcot foot over a 10-day period, necessitating open reduction and internal fixation of Lisfranc-type fracture dislocations. Her presentation with a rapidly progressing red, swollen foot with a blister on the plantar aspect prompted initial treatment on the basis of a diabetic foot infection. The report will therefore serve as a useful reminder to maintain a high index of suspicion for Charcot foot, which may present in an atypical manner.

Displacement of an Ununited Medial Humeral Condylar Ossification Centre in the Cat

2018 ◽  
Vol 31 (02) ◽  
pp. 153-157
Author(s):  
Kerstin Erles ◽  
Thomas Maddox ◽  
Andy Morris
Keyword(s):  
Weight Bearing ◽  
Distal Humerus ◽  
Acute Onset ◽  
Outcome Evaluation ◽  
Ossification Centre ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Similar Appearance ◽  
The Right

AbstractA 2-year-old cat was presented with the complaint of acute-onset non–weight-bearing lameness of the right forelimb. When examined, the cat was of short stature and had multiple joint and cartilaginous abnormalities suggestive of chondrodysplasia. The cause of the acute lameness was radiographically identified as a displaced osseous fragment from the medial portion of the right humeral condyle. The features of the osseous fragment were consistent with an ununited medial condylar ossification centre of the distal humerus. Furthermore, a nondisplaced ununited ossified fragment of similar appearance and size was present in the contralateral elbow. Surgical treatment by excision of the displaced fragment resulted in a preinjury level of limb function in the long-term outcome evaluation.

scholarly journals Two cases of six-chambered hearts

2020 ◽  
Vol 40 (6) ◽  
pp. 496-500
Author(s):  
Naseer Choh ◽  
Saika Amreen ◽  
Amber Bashir ◽  
Tariq Gojwari ◽  
Akshit Kumar
Keyword(s):  
Female Child ◽  
The Other ◽  
Resonance Imaging ◽  
Management Guidelines ◽  
Patient Demographics ◽  
Septal Defects ◽  
Unusual Combination ◽  
Long Term Prognosis ◽  
The Right

ABSTRACT Double-chambered right ventricles (DCRV) and left ventricles are rare entities on their own. We present two cases with an unusual combination of double-chambered right as well as left ventricles. One was discovered in a 28-year-old female, while the other was found at birth in a female child. The differing nature of both the patient demographics as well as the presentation with a common morphological background is shown on both computed tomography and magnetic resonance imaging. The oldest description of an obstructive muscular band within the right ventricle was given in 1867. In the literature, there is ample description of the long-term prognosis and management guidelines for DCRV, but no inheritance patterns or risk factors have been identified except for associations with septal defects, tetralogy of Fallot and transposition of the great arteries. A combination of both double-sided left as well as right ventricles has been published in literature a few times with little details about management and prognosis. SIMILAR CASES PUBLISHED: Although many cases of DCRV and DCLV have been published, to our knowledge only 3 cases of combined DCRV and DCLV have been published in literature.

Sign in / Sign up

Export Citation Format

Share Document