ABSTRACT
Objectives@#. Type 2 diabetes mellitus (T2DM) is a risk factor for deep neck infection (DNI) and leads to complications and poor outcomes. Our study aimed to investigate the risk, prognosis, and complications of peritonsillar abscess (PTA) in patients with T2DM. @*Methods@#. We extracted data of patients newly diagnosed as having T2DM between January 2000 and December 2011 from Taiwan’s National Health Insurance Research Database. These patients were matched with patients without T2DM, and PTA incidence was compared between both cohorts. @*Results@#. In total, 67,852 patients with and 135,704 patients without T2DM were enrolled. PTA incidence was significantly higher in patients with T2DM (incidence rate ratio, 1.91; P5 years after T2DM diagnosis. Cox regression analysis showed that patients with T2DM had an approximately 2-fold higher PTA risk (adjusted hazard ratio [aHR]: 1.89, P<0.001). Patients with a higher adapted Diabetes Complications Severity Index (aDCSI) had higher PTA risk than those with a lower aDCSI (aHRs: 2.17 for aDCSI ≥1, P=0.006 and 1.81 for aDCSI=0, P=0.002). T2DM patients with a high aDCSI (≥1) had a nonsignificantly longer hospitalization duration and a higher rate of DNI complications than did those with a low aDCSI (=0). @*Conclusion@#. In patients with T2DM, PTA incidence was relatively high, and it increased with T2DM severity. Moreover, T2DM patients should be particularly careful about PTA within 1 to 5 years after the diagnosis, and physicians should keep in mind that the prognosis of PTA was correlated with T2DM severity.
ABSTRACT
Objectives@#. Type 2 diabetes mellitus (T2DM) is a risk factor for deep neck infection (DNI) and leads to complications and poor outcomes. Our study aimed to investigate the risk, prognosis, and complications of peritonsillar abscess (PTA) in patients with T2DM. @*Methods@#. We extracted data of patients newly diagnosed as having T2DM between January 2000 and December 2011 from Taiwan’s National Health Insurance Research Database. These patients were matched with patients without T2DM, and PTA incidence was compared between both cohorts. @*Results@#. In total, 67,852 patients with and 135,704 patients without T2DM were enrolled. PTA incidence was significantly higher in patients with T2DM (incidence rate ratio, 1.91; P5 years after T2DM diagnosis. Cox regression analysis showed that patients with T2DM had an approximately 2-fold higher PTA risk (adjusted hazard ratio [aHR]: 1.89, P<0.001). Patients with a higher adapted Diabetes Complications Severity Index (aDCSI) had higher PTA risk than those with a lower aDCSI (aHRs: 2.17 for aDCSI ≥1, P=0.006 and 1.81 for aDCSI=0, P=0.002). T2DM patients with a high aDCSI (≥1) had a nonsignificantly longer hospitalization duration and a higher rate of DNI complications than did those with a low aDCSI (=0). @*Conclusion@#. In patients with T2DM, PTA incidence was relatively high, and it increased with T2DM severity. Moreover, T2DM patients should be particularly careful about PTA within 1 to 5 years after the diagnosis, and physicians should keep in mind that the prognosis of PTA was correlated with T2DM severity.
ABSTRACT
Poly ( duenedumethylammonuum chlorude ) ( PDDA ) functuonaluzed sulver nanopartucles ( AgNPs ) prepared wuth PDDA as the protectuve and reductuve agents was combuned wuth graphene oxude ( GO ) to prepare PDDA functuonaluzed cubuc sulver nanopartucles ( C-AgNPs)/GO composute, whuch was then modufued on a glassy carbon electrode ( GCE) to form C-AgNPs-PDDA/GO/GCE. The surface morphologues of dufferent modufued electrodes were characteruzed by scannung electron mucroscope ( SEM ) , and theur correspondung cycluc voltammetruc ( CV) behavuors were unvestugated, unducatung that the composute of C-AgNPs-PDDA/GO exhubuted excellent electrocatalytuc oxudatuon actuvuty to DA and NO-2 . By usung dufferentual pulse voltammetry, the responses of C-AgNPs-PDDA/GO/GCE were lunear un the ranges of 0 . 030-0 . 300 μmol/L and 0 . 300-300 μmol/L wuth detectuon lumut of 9. 8 nmol/L (S/N=3) for DA, and 30. 0-2300 μmol/L wuth detectuon lumut of 12. 6 μmol/L (S/N=3) for NO-2, respectuvely. The modufued electrode dusplayed good selectuvuty, reproducubuluty and stabuluty, and could be used for the sumultaneous determunatuon of DA and NO-2 un human serum samples wuth recoverues of 97. 4%-104. 2% and 98. 0%-102. 8%, respectuvely. Compared wuth spectrophotometruc method, the determunatuon results were satusfactory, showung that the modufued electrode possessed a potentual applucatuon value.
ABSTRACT
We present a case of acute intestinal infarction in a pregnant woman with chronic idiopathic mesenteric vein thrombosis [MVT] under regular anticoagulation treatment. The condition of the 26-year-old woman who was diagnosed with chronic idiopathic MVT after detailed investigation was stable after receiving regular anticoagulation with warfarin. One year later, she presented with a 7-day episode of intermittent epigastric pain. Acute intestinal infarction and concomitant 7-week pregnancy were diagnosed. To preserve her life, a dilation and curettage procedure and emergency laparotomy with bowel resection were performed. Ten days later, she was discharged, having made a good recovery. Although pregnancy was not the primary cause of chronic MVT, it did play a role in inducing the acute intestinal infarction. This case indicates that pregnant patients with known chronic idiopathic MVT should be counseled about the high risk of acute mesenteric thrombosis. This case also serves to remind physicians that there should always be a high level of suspicion of intestinal infarction in patients with an acute abdomen who are in a hypercoagulable state
Subject(s)
Humans , Female , Pregnancy Complications , Laparotomy , Pregnancy Complications, CardiovascularABSTRACT
<p><b>INTRODUCTION</b>Renal infarction is a rare and easily missed disease. There is even less meaningful information on renal infarction in the Asian population. Thus, the aim of this study was to clarify the clinical characteristics of the disease in Asian patients.</p><p><b>CLINICAL PICTURE</b>Over a period of 10 years, 38 Chinese patients with renal infarction diagnosed by contract-enhanced CT or angiography were enrolled in this study. Their demographic data, clinical characteristics, laboratory and image results, risk factors or suspected causes, treatment and final outcomes were retrospectively reviewed. The results were also compared with the analogous Western data. The mean age of the sample population was 60.8 +/- 17.6 years, with patients aged over 50 years and males predominating. The most common symptoms/signs were abdominal (57.9%) and flank pain/tenderness (50%). Only 23.7% of patients had suffered previous thromboembolic events such as coronary or peripheral artery diseases, or cerebral infarction. Cardiogenic factors, such as atrial fibrillation, intra-cardiac thrombus, infective endocarditis and valvular heart disease, were the main causes of renal infarction (57.9%). The most common laboratory abnormalities were elevated serum LDH (92.1%) and proteinuria (76.3%). Only half of the cases involved haematuria at initial presentation.</p><p><b>TREATMENT AND OUTCOME</b>One-third of the sample suffered renal impairment after the renal infarction. Overall mortality rate during admission was 13.2% (n = 5). The cause of death was usually not the renal infarction itself but rather the underlying disease and its complications. There was no difference in outcome for anticoagulation treatment with or without thrombolytics. Compared to their Western counterparts, the proportion of males (71.1% versus 48.3%) and bilateral renal infarctions (31.6% versus 12.4%) were significantly higher, and the percentage of leukocytosis (50% versus 85%) significantly lower in our Asian patients.</p><p><b>CONCLUSION</b>Clinical presentation of renal infarction is usually non-specific and differs for Asian and Western populations. In our Asian patients, the most common clinical characteristics were abdominal pain/tenderness, flank pain/tenderness, elevated serum LDH and proteinuria. Early diagnosis and treatment are imperative because of the high rate of renal impairment and associated mortality. If this disease is suspected, contrast-enhanced CT is suggested to exclude or confirm renal infarction and anticoagulation alone is currently the favored treatment.</p>