Medicine
-
Case Reports
Euglycemic diabetic ketoacidosis after the initiation of dulaglutide in patient with type 2 diabetes.
Diabetic ketoacidosis is rarely observed when the blood glucose level is <250 mg/dL. This is referred to as euglycemic diabetic ketoacidosis (EDKA). EDKA can present diagnostic and management challenges for physicians, especially when dealing with unusual triggers such as glucagon-like peptide 1 (GLP1) receptor agonists and sodium-glucose co-transporter 2 inhibitors. With this case report, we wanted to raise the knowledge and understanding of EDKA and its triggering factors. ⋯ In this case report describes the use of GLP1 receptor agonists along with Sodium-glucose co-transporter 2 inhibitors in type 2 diabetes patients whose extreme restriction of carbohydrate intake may have triggered EDKA. Therefore, physicians should use diabetes medications in a stepwise manner and advise their patients not to over-restrict their carbohydrate intake while they are being treated with GLP1 receptor agonists.
-
This project sought to explore the potential association between medical history and the development of multiple sclerosis (MS) by conducting a retrospective study. This population-based case-control study included 200 MS cases and 2 control groups of 200 patients and healthy individuals each. Data was collected through face-to-face interviews, medical file reviews, and an electronic checklist. ⋯ The adjusted MS odds for autoimmune disease including 4.63; 95% CI: 0.35 to 60.6 for psoriasis and 7.15; 95% CI: 1.87 to 27.2 for myasthenia gravis. On the other hand, the calculated adjusted odds of MS occurrence were 0.14; 95% CI: 0.03 to 0.69 for seizure and 0.17; 95% CI: 0.02 to 1.49 for epilepsy. This study suggested that individuals with autoimmune diseases should be monitored more closely, as they may be at an increased risk of developing other autoimmune conditions, particularly MS.
-
Oral propranolol has not been shown to impact physical development, such as weight and height. The impact of children's intellectual development has received relatively little attention from researchers. The effects of propranolol on the growth and development of children with proliferative infantile hemangiomas during treatment were analyzed retrospectively. ⋯ No significant difference was detected in DQ 3 months posttreatment and pretreatment (P = .19), while it decreased at 6 and 9 months posttreatment (P < .05). Oral propranolol does not have an impact on physical development (height and weight). No short-term effect was found on intellectual development, but a decrease was noted over 6 months, which needs to be investigated further.
-
To compare the quality and interobserver agreement in the evaluation of lumbar spinal stenosis (LSS) on computed tomography (CT) images between deep-learning reconstruction (DLR) and hybrid iterative reconstruction (hybrid IR). This retrospective study included 30 patients (age, 71.5 ± 12.5 years; 20 men) who underwent unenhanced lumbar CT. Axial and sagittal CT images were reconstructed using hybrid IR and DLR. ⋯ Subjective image noise, depictions of structures, and overall image quality were significantly better with DLR than with hybrid IR (P < .006, Wilcoxon signed-rank test). Interobserver agreements in the evaluation of LSS (with 95% confidence interval) were 0.732 (0.712-0.751) and 0.794 (0.781-0.807) for hybrid IR and DLR, respectively. DLR provided images with improved quality and higher interobserver agreement in the evaluation of LSS in lumbar CT than hybrid IR.
-
Observational Study
Sex-dependent difference in the relationship between thyroid hormones and gallstone disease in euthyroid subjects.
The relationship between thyroid dysfunction and gallstone disease (GSD) has been examined by some observational studies. However, evidence about the relationship between thyroid function and GSD among euthyroid subjects was scarce. The aim of this study was to investigate the association between thyroid function and the presence of GSD in a large-sample euthyroid subjects. ⋯ Subgroup analyses showed that the relationship between thyroid function and GSD was different according to gender, with negative association for ln (TT3/TT4) and (odds ratio:0.551, 95% CI: 0.306-0.992, P = .047) and positive association for TT4 (odds ratio:1.077, 1 95% CI: .001-1.158, P = .046) in men. None of the thyroid function parameters was significantly associated with GSD in women. Our findings indicated that low levels of TT3-to-TT4 ratio and high levels of TT4 were significantly and independently associated with GSD among euthyroid male subjects, but not female subjects.