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Interleukin-6 and the Lung
Published in Jason Kelley, Cytokines of the Lung, 2022
Ralph J. Zitnik, Jack A. Elias
Insulin-dependent diabetes mellitus (IDDM) is thought to be caused by autoimmune destruction of insulin-producing pancreatic beta-cells. Insulitis, the characteristic lesion of IDDM, is characterized by the accumulation of T lymphocytes and macrophages around pancreatic islets (Botazzo et al., 1985). Pancreatic beta-cells produce IL-6 protein and mRNA after in vitro stimulation with TNF and interferon gamma (Campbell et al., 1989). Campbell and coworkers, using a well-established mouse model of autoimmune IDDM, demonstrated that islet cells isolated during the induction of autoimmune diabetes produce markedly increased amounts of IL-6, but not IFN-γ, TNF, or IL-1. Treatment with antibody to IFN-γ significantly reduced the incidence of diabetes as well as pancreatic inflammation in these animals. In contrast, treatment with anti-IL-6 antibody decreased the incidence of IDDM, but not the degree of pancreatic inflammation (Campbell et al., 1991). These studies provide evidence that IL-6 is involved in the pathogenesis of diabetes.
Adherence to Treatment in Children
Published in Lynn B. Myers, Kenny Midence, Adherence to Treatment in Medical Conditions, 2020
The daily management of insulin-dependent diabetes mellitus involves daily insulin injections, often several times per day. These injections may comprise more than one type of insulin and, therefore, require skilled preparation. Blood glucose monitoring by finger prick between two and four times per day is necessary as insulin requirements vary throughout the day. A minimum of daily exercise is necessary to reduce insulin requirements, and dietary restrictions are also imposed (Johnson et al., 1992; Reid and Appleton, 1991). For a review of diabetes in adults, see Warren and Hixenbaugh, Chapter 16.
Hepatobiliary Surgery
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
Clinical Features➢ Recurrent or chronic abdominal pain.Typically epigastric radiating to back, worse after food and alcohol.➢ Fat malabsorption resulting in steatorrhoea and malabsorption of fat soluble vitamins.➢ Weight loss and anorexia.Due to protein malabsorption.➢ Insulin dependent diabetes mellitus.secondary to loss of Beta cell function.
Reconstruction of necrotizing soft tissue infection in the auricle and temporal region: a case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2023
Junpei Saito, Shoichi Ishikawa, Shigeru Ichioka
During the first hospital visit, skin and subcutaneous tissue necrosis and pus drainage were mainly observed on the posterior surface of the right auricle. The right auricle and the surrounding temporal area were erythematous and swollen (Figure 1). Vital signs were as follows: clear consciousness, heart rate of 118/min, blood pressure of 151/103 mmHg, a body temperature of 37.1 °C, and respiratory rate of 20/min. Blood tests showed leukocytes of 26,490/μl; CRP, 40.97 mg/dl; Hb, 14.7 g/dl; Na, 127 mEq/l; creatinine, 0.43 mg/dl; blood glucose, 475 mg/dl; HbA1c, 12.1%; high inflammatory response; and poor glucose control. The laboratory risk indicator for necrotizing fasciitis score was 9 points. The patient reported that she had no history of diabetes mellitus, but a slowly progressing insulin-dependent diabetes mellitus was diagnosed; during hospitalization, the diabetologist administered insulin to control her blood glucose level. Blood and pus cultures revealed methicillin-susceptible Streptococcus aureus. Antibiotic treatment was started with meropenem and daptomycin. Meropenem was administered for 6 days and daptomycin for 4 days. This regimen was subsequently de-escalated to cefazolin. Antibiotics were administered for 22 days, at which point acute signs of infection had subsided.
Functional impairment assessed by the Barthel Index influenced outcomes after transcatheter aortic valve implantation
Published in Scandinavian Cardiovascular Journal, 2020
Mohammad El Garhy, Tamer Owais, Mohamed Abdulrahman, Torsten Schreiber, Christian Schulze, Bernward Lauer, Thomas Kuntze
In our previous study [8], we missed to assess the role of functional impairment in the failure of the fast track protocol [8]. In the current study, a BI <80 was an independent predictor of the failure of fast track protocol, which mainly caused by decompensated heart failure, postoperative strokes, delirium and anemia. These complications are expected in this group of patients with advanced age and insulin dependent diabetes mellitus. Puls et al. [4] showed that functional status measured by the Katz Index represents a powerful predictor of adverse early and late outcome after TAVI but not on of the success of early discharge. In the study by Puls et al., the rate of early discharge was very low 5%, as the concept of fast track TAVI was not yet well established in 2014 and 53% of study patients were operated through transapical approach [4]. Nevertheless, the incidence of prolonged hospital stay >14 days was more common in patients with Katz index <6 (32% vs. 22%, p = .047). According to our experience, the success of fast track protocol improved patient’s, families’ and team’s satisfaction and reduced the overall health care costs. But this needs a precise patient’s selection to exclude patients who had negative predictors of the success of fast track protocol.
Myeloid-Related Protein-14/MRP-14/S100A9/Calgranulin B is Associated with Inflammation in Proliferative Diabetic Retinopathy
Published in Ocular Immunology and Inflammation, 2018
Ahmed M. Abu El-Asrar, Kaiser Alam, Mohammad M. Siddiquei, Kathleen Van den Eynde, Ghulam Mohammad, Gert De Hertogh, Ghislain Opdenakker
Undiluted vitreous fluid samples (0.3–0.6 mL) were obtained from 16 patients with PDR during pars plana vitrectomy, for the treatment of tractional retinal detachment, and/or non-clearing vitreous hemorrhage. The control subject group consisted of 16 patients who had undergone vitrectomy for the treatment of rhegmatogenous retinal detachment with no proliferative vitreoretinopathy (PVR). Control subjects were free from diabetes or other systemic disease. Vitreous samples were collected undiluted by manual suction into a syringe through the aspiration line of vitrectomy, before opening the infusion line. The samples were centrifuged (2000 rpm for 10 min, 4ºC) and the supernatants aliquoted and frozen at –80ºC until assay. Epiretinal fibrovascular membranes were obtained from 20 patients with PDR during pars plana vitrectomy for the repair of tractional retinal detachment. The diabetic patients were 12 males and 8 females, whose ages ranged from 25 to 68 years (mean 50.15 ± 9.87 years). The duration of diabetes ranged from 8 to 33 years (mean 15.55 ± 6.9 years). Nine patients had insulin-dependent diabetes mellitus, and 11 patients had non-insulin-dependent diabetes mellitus. For comparison, epiretinal membranes were obtained from 10 patients without diabetes undergoing vitreoretinal surgery for the treatment of retinal detachment complicated by PVR. Membranes were fixed for 2 h in 10% formalin solution and embedded in paraffin.