ABSTRACT
Factitious hypoglycemia (FH) in a diabetic patient represents a difficult diagnostic and costly management problem. An adolescent diabetic with FH is reported. A literature search revealed 10 adolescent and 45 adult diabetic patients with FH. Tests currently available for diagnosis are evaluated. The role of psychiatric therapy in relation to overall management and prognosis is stressed.
Subject(s)
Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/drug therapy , Factitious Disorders/chemically induced , Hypoglycemia/chemically induced , Insulin/adverse effects , Adolescent , Blood Glucose/metabolism , C-Peptide/blood , Child , Factitious Disorders/blood , Humans , Hypoglycemia/blood , Insulin/therapeutic use , MaleABSTRACT
Does regular consumption of alcohol protect against coronary artery disease but not against sudden death? In this article, Dr Sheehy examines several theories that have been proposed to explain the cardioprotective effect of ethanol and also reviews the factors related to sudden death in alcoholics.
Subject(s)
Ethanol/pharmacology , Heart/drug effects , Cardiomyopathy, Alcoholic , Coronary Circulation/drug effects , Coronary Disease/chemically induced , Coronary Disease/prevention & control , Ethanol/adverse effects , Humans , Vasodilation/drug effectsABSTRACT
Gustatory sweating is an unusual entity that may occur as an idiosyncratic reaction to certain foods, as a localized reaction to trauma or infection, or as the result of diabetic neuropathy. This report deals with a severe case of diabetic gustatory sweating, discusses the various types of gustatory sweating, and reviews the English literature dealing with the diabetic form.
Subject(s)
Diabetic Neuropathies/complications , Sweating, Gustatory/etiology , Adult , Humans , MaleSubject(s)
Cholera/therapy , Fluid Therapy/history , History, 19th Century , Humans , Russia (Pre-1917)Subject(s)
Hypothermia/diagnosis , Adolescent , Adult , Aged , Body Temperature Regulation , Critical Care/methods , Humans , Hypothermia/therapy , Middle AgedSubject(s)
Sprue, Tropical/diagnosis , Adult , Alabama , Female , Humans , Sprue, Tropical/etiology , Syndrome , TravelSubject(s)
Tuberculosis, Pulmonary/diagnosis , Adult , Aged , Humans , Middle Aged , Tuberculosis, Pulmonary/drug therapyABSTRACT
Only one of eight previously described patients with sickle cell intrahepatic cholestasis (SCIH) survived. Death usually resulted from liver failure and/or a hemorrhagic diathesis. This report deals with the successful treatment of SCIH by partial blood-plasma exchange transfusion. This treatment led to regression of hepatic encephalopathy, impending bleeding diathesis, and noticeable clinical improvement withn 48 hours. Within six days, the serum bilirubin level decreased from 146 to 16 mg/dL. Partial blood-plasma exchange transfusion may be valuable for the treatment of SCIH.
Subject(s)
Anemia, Sickle Cell/therapy , Cholestasis, Intrahepatic/etiology , Adult , Anemia, Sickle Cell/complications , Exchange Transfusion, Whole Blood , Humans , MaleSubject(s)
Aged , Surgical Procedures, Operative , Age Factors , Cardiovascular Diseases/complications , Gastrointestinal Diseases/complications , Humans , Hypertension/complications , Hypotension/complications , Middle Aged , Nutrition Disorders/complications , Respiratory Insufficiency/complications , Risk , Urologic Diseases/complicationsSubject(s)
Alcoholism/blood , Blood/drug effects , Ethanol/adverse effects , Alcoholism/metabolism , Anemia/blood , Anemia/etiology , Anemia, Hemolytic/etiology , Blood Platelets/drug effects , Folic Acid/metabolism , Granulocytes/drug effects , Hematopoiesis/drug effects , Humans , Iron/metabolism , Tissue DistributionABSTRACT
Alcoholism and tuberculosis often coexist, and patients with this combination have the most frequent failures of therapy. Several intriguing alternatives to standard outpatient chemotherapy are now available. The brief MAST interview (a shortened version of the Michigan Alcoholism Screening Test) has been demonstrated to be effective in identifying alcoholism in public health clinics for tuberculosis in New Orleans and Birmingham, Ala., with scores indicating populations of alcoholic patients of 25% and 28%, respectively. The test could be administered without interrupting the routine of the clinic. We believe that the problem of inadequate therapy in the alcoholic patient with tuberculosis is significant and widespread and is not being handled well is most places. Identification of the potential problem patient at first contact will be most helpful in choosing candidates for specialized forms of therapy, including short-term and supervised treatment, begun before failure of therapy ensues.
