Bilateral pulmonary hydathidic cyst with fatal outlet: a case report

Hydatidosis is a parasitic zoonosis caused by Echinococcus Granulosus, its life cycle includes dogs, sheep and others; liver involvement is the most frequent (65%-75%), followed by the lung (10%-25%), in Peru the pulmonary location is 60%. Its signs and symptoms are produced by the mass effect, its superinfection or anaphylactic reactions secondary to its rupture. We present the case of a 24-year-old insulin-dependent patient with type I diabetes mellitus, hypertension and diabetic retinopathy with bilateral pulmonary hydatidosis. A cystectomy was performed without complications and a lobectomy that was complicated with admission to the ICU until the death of the patient. Diabetes mellitus causes a state of immunosuppression which caused the advanced state of the patient's parasitosis, as well as being related to multiple intra- and postoperative complications and even leading to the death of the patient.

Stability of shared appraisal: The role of attachment and implications for relationships and health

In the context of coping with chronic illness, shared appraisal refers to one person’s perception that the illness is a shared issue. Despite increasing research linking shared appraisal to positive relationship and health outcomes, whether it is static or fluctuates across time has not yet been investigated. Fluctuations in shared appraisal may affect patient and spouse well-being and influence disease management. We investigated the association of daily shared appraisal fluctuations (operationalized as intraindividual standard deviations) to relationship satisfaction, psychological well-being, and diabetes-specific well-being over 2 weeks among 199 couples in which one person had type 1 diabetes. In addition, we examined attachment insecurity as a correlate of shared appraisal fluctuations. Individuals higher in anxiety or avoidance may more frequently reevaluate their relationship. Thus, their shared appraisal may be more reactive to daily events. Actor–partner interdependence models showed greater fluctuations in spouse appraisal were associated with lower patient relationship satisfaction (partner effect) but not with spouse relationship satisfaction and with greater spouse psychological distress (actor effect) but not patient psychological distress. There were no actor or partner effects of patient appraisal fluctuations on these outcomes. In terms of diabetes outcomes, regression analyses showed that greater fluctuations in patient and spouse appraisal were each associated with higher patient diabetes distress, and greater fluctuations in spouse appraisal were associated with lower patient self-care. Higher attachment anxiety was related to greater appraisal fluctuations in the spouse but not the patient. These findings highlight the importance of spouse appraisal stability for spouse relationships and well-being and for patient diabetes outcomes and suggest that attachment insecurity may be implicated in the instability of shared appraisal.

Bigdata and Deep Learning: Using Python Keras Predict Patient Diabetes and Employee‟s Wages per Hour

In this paper we analyze big data analytic & Deep Learning is not supposing as two entire various concept. BigData mean extreme simple larger data into set in that may be analyzes as finding into pattern, trend. The first techniques in that may useful with data analyzed therefore in capable to helping to finding abstract pattern into Big Data is DeepLearning. It is applying into DeepLearning into Big Data, it can be find out nameless & useful pattern in that not possible up to now. This is technique as present into extra active areas into researches in the medical sciences. From increases sizes & complex into medical data’s such as X-ray, deeplearning gain into small success to prediction as several diseases such as pneumonia, diabetes. The project is proposed into two deeplearning model used to Keras & too we can be building in a regression models in to predicted as employee pay per hour, & we are builds in a classifications models in predict when it is na patient have been diabetes.

Salvage of thrombosed arteriovenous fistulae of patients on hemodialysis: report on the experience of a Brazilian center

ABSTRACT Introduction: Hemodialysis vascular access thrombosis is an acute event that can interrupt the dialytic treatment. A timely management can restore access patency, avoiding the use of central venous catheters and their complications. Objective: To present the experience from a Brazilian Interventional Nephrology Center (INC) in the salvage of arteriovenous fistula (AVF) and grafts for hemodialysis. Methods: A retrospective study was performed to evaluate the primary and secondary patencies of 41 hemodialysis accesses with thrombosis confirmed by ultrasound and submitted to endovascular salvage procedures. We considered clinical success the use of the access for at least 3 subsequent hemodialysis sessions. The procedures were done in an outpatient center by interventional nephrologists. Patients were followed for up to 18 months with Doppler every 3 months. Results: Forty-five salvage procedures were performed in 41 accesses of 40 hemodialysis patients with native AVF or grafts. Of these, 90% were AVF, mostly upper arm, and 10% were grafts. Clinical success rate was 60% (27 procedures). Primary patency at 12 months was 39% and secondary was 52%. Gender of the patient, diabetes, and location of the access did not correlate statistically with outcomes. There were 3 major complications (anastomosis rupture, grade 3 hematoma, and anaphylactic shock). Conclusion: The majority of thrombosed accesses can be successfully treated, maintaining its long-term patency. The need of repeated intervention is frequent.

BODY IMAGE PASIEN DIABETES MILLITUS YANG MENGALAMI GANGGREN

AbstactDiabetes mellitus causes a DM complication where the wound complication are hard to recover, red to black, spoiled smell so there is amputation must be done in the end. This condition clearly disturbs body image which causes the patient feel embarrassed, low, and rejects this body condition. This purpose of this research is to know body image of gangrene diabetes mellitus patient in Dr. Sayidiman Magetan hospital.This research design is descriptive. The sampling technique is purposive sampling, with 589 populations. The sample is 49 respondents. The data collecting technique is questionnaire with T Score as data analysis technique.The result of this research is 25 respondents (51%) have positive body image, and 24 respondents (49%) has negative body image. This depends on gender, age, time of DM and gangrene suffer, living together, kind of dysfunction, education.Based on this research, it is hoped the patients can increase good body image in order to help the healing process, for next researcher suggested not to stop doing research about body image of gangrene diabetes mellitus with wider populations so reach optimal carefulness.Keyword : Body Image, Patient, Diabetes Mellitus, Gangrene. AbstrakPenyakit DM mengakibatkan salah satu komplikasi DM dimana komplikasi pada luka sukar sembuh, luka berwarna merah kehitaman, berbau busuk yang akhirnya dilakukan amputasi kondisi ini jelas mengganggu body image yang mengakibatkan pasien merasa malu, rendah diri, dan tidak menerima keadaan tubuhnya. Penelitian ini diuntukkan mengetahui body image pasien DM yang mengalami ganggren di RSUD dr.Sayidiman Magetan. Desain penelitian yang digunakan adalah deskriptif. Teknik sampling yang digunakan adalah Purposive Sampling, dengan populasi 589 orang, sampel berjumlah 49 responden, teknik pengumpulan data dengan kuisioner, teknik analisa menggunakan skor T. Hasil penelitian dari 49 responden didapatkan hasil 25 responden (51%) memiliki body image positif, dan 24 responden (49%) memiliki body image negatif. Hal ini dipengaruhi jenis kelamin, usia, lama menderita DM, lama menderita ganggren, tinggal bersama, jenis gangguan fungsi, pendidikan. Berdasarkan hasil penelitian diharapkan pasien dapat meningkatkan body image yang baik agar membantu proses penyembuhan dengan cepat, bagi peneliti selanjutnya disarankan untuk tidak berhenti melakukan penelitian tentang body image pasien DM yang mengalami ganggren dengan populasi yang lebih banyak agar tercapai ketelitian penelitian optimal.Kata Kunci : Body Image, Pasien, Diabetes Mellitus, Gangren

Paraproteinemia associated Peripheral Neuropathy

Peripheral Neuropathy can be acute or gradual over the years turning severe and quite debilitating to the patient. Diabetes, Alcohol or Drugs are some of the common causes of neuropathies however a small percentage of patients can present with paraproteinemia. The cause of paraproteinemia in these patients range from benign to serious malignant disorders such as Multiple Myeloma. We here report a case of an elderly patient who had to visit multiple center for over 4 months for his chronic neuropathy. Following extensive workup, he was started on an immunomodulating agent and glucocorticoids. Patient has remained free of disease and symptom free throughout treatment and thereafter.