ABSTRACT
Fluid resuscitation is vital in the resuscitation of diabetic ketoacidosis patients. The purpose of this narrative review is to analyze the role of Plasmalyte in fluid resuscitation of adult diabetic ketoacidosis patients. A thorough search was conducted in PUBMED, EMBASE and MEDLINE. Studies conducted between 1st January 2010 and 31st March 2023 were collected. Of 123 results, 5 pertinent randomized controlled trials were included. The close resemblance of Plasmalyte's electrolyte composition to human plasma and its role in the prevention of hyperchloremic metabolic acidosis are some of its vital benefits in patients with diabetic ketoacidosis. Results on the role of Plasmalyte in length of stay, time to resolution of diabetic ketoacidosis and mortality in diabetic ketoacidosis patients are varied. Hence, further research on these topics is needed.
Subject(s)
Osteomyelitis/diagnostic imaging , Pubic Bone/diagnostic imaging , Staphylococcal Infections/diagnostic imaging , Diagnosis, Differential , Groin , Humans , Magnetic Resonance Imaging , Male , Osteomyelitis/microbiology , Pain Measurement , Staphylococcal Infections/microbiology , Young AdultABSTRACT
Electronic databases of MEDLINE, EMBASE, CINAHL, and the Cochrane Library as well as the Google Scholar search engine were used. Studies written in the English language highlighting the use of magnetic resonance imaging (MRI) and computed tomography in diagnosing occult proximal femoral fractures despite negative or equivocal plain radiographs were included. Two reviewers independently extracted data from each article. Raw frequencies for each of the details investigated were calculated. 15 prospective and 7 retrospective studies from 1989 to 2009 were included in this systematic review. A total of 996 patients (mean age, 75 years; standard deviation, 5 years) with suspected occult proximal femur fractures underwent MRI for further assessment. 350 (35%) of the patients tested positive for proximal femoral fractures, of whom 295 (84%) underwent further treatment/surgical interventions. MRI also detected other fractures and soft-tissue injuries. MRI was superior to other imaging modalities in diagnosing occult proximal femoral fractures and should be performed within 24 hours of injury. Early diagnosis and management may avoid substantial displacement and complications, and improve overall mortality and morbidity.
Subject(s)
Fractures, Closed/diagnosis , Hip Fractures/diagnosis , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Diagnosis, Differential , Humans , Reproducibility of ResultsABSTRACT
Recurrence of gastric carcinoma most frequently involves abdominal distension and usually occurs with in 5 years of primary surgery. Recurrence more than 8 years after surgery is extremely rare and bony metastasis occurs only in 0-17% cases of gastric carcinoma. We present a case of metastasis to the second toe which occurred 12 years after the initial surgery. The case highlights the importance of high index of suspicion of pedal metastasis in patients presenting with swelling or bony tenderness with history of carcinoma.
Subject(s)
Adenocarcinoma/pathology , Adenocarcinoma/secondary , Bone Neoplasms/diagnosis , Bone Neoplasms/secondary , Toe Phalanges/pathology , Adenocarcinoma/surgery , Amputation, Surgical , Bone Neoplasms/surgery , Diagnosis, Differential , Female , Humans , Middle Aged , Osteomyelitis/diagnosis , Stomach Neoplasms/pathology , Toe Phalanges/surgeryABSTRACT
A 75-year-old man was referred to hospital with a 24 hour history of severe neck pain, associated with fever, rigors and mild confusion. The pain radiated into his arms and was exacerbated by neck movements. Eight days prior to admission he had developed loose stools for 3 days. There was no history of trauma, and no other features of meningism. He gave a past history of ischemic heart disease and atrial fibrillation for which he was taking warfarin. Examination revealed a pyrexia of 38.3°C. There was tenderness over the cervical spine but no other positive findings. Neurological examination was unremarkable.
ABSTRACT
The MRI scan reveals a shallow anterior epidural abscess at C5 / C6 level without cord compression. The recent history of diarrhea is suggestive of salmonella enteritidis.
