Diabetic Ketoacidosis, Hypertriglyceridemia and Abdominal Pain due to Acute Pancreatitis Complicated by Non-immune Haemolytic Anaemia.

Unlabelled: The triad of diabetic ketoacidosis, acute pancreatitis and hypertriglyceridemia is a rare phenomenon, with mortality rates of up to 80%. A unique characteristic of the described case is the co-occurrence of non-immune haemolytic anaemia (NIHA) with the complex triad. It is suggested that this presentation is secondary to hyperlipidemia which leads to increased fragility of erythrocytes due to destabilization of red cell membranes.

Goodpasture's Syndrome with Negative Anti-glomerular Basement Membrane Antibodies.

Unlabelled: A young male patient with rapidly progressive and life-threatening pulmonary haemorrhage due to anti-glomerular basement membrane (anti-GBM) antibody disease without renal involvement repeatedly tested negative for serum anti-GBM antibodies. Although rare, anti-GBM antibody disease should be considered in the differential diagnosis in patients with life-threatening pulmonary haemorrhage due to isolated diffuse alveolar haemorrhage. Enzyme-linked-immunosorbent assay (ELISA) testing for anti-GBM antibodies in anti-GBM antibody disease can give false-negative results.

Coma caused by Shigella toxin-producing in the absence of haemorrhagic uraemic syndrome (HUS).

Unlabelled: Shigella toxin-producing (STEC) is well known for its complications such as haemolytic uraemic syndrome (HUS), but neurological symptoms have also been reported. While most cases of infection with STEC occur with concurrent HUS, we describe a patient with severe neurological symptoms in the absence of HUS.

Learning Points: Shigella toxin producing (STEC) are bacteria that cause haemorrhagic colitis.

Splenic artery rupture during pregnancy concealed by a pancreatic lymphangioma: a rare co-occurrence.

A pregnant woman presented to a local hospital with abdominal pain and hemorrhagic shock. Emergency caesarean section ruled out an obstetric cause and revealed a large mass, interpreted as a hematoma, with active bleeding of unknown origin. Because of her poor clinical condition, the patient was admitted to our hospital.

[A marine with acute dyspnea].

A 29-year-old male marine presented with acute dyspnea and abdominal discomfort. The complaints were caused by a diaphragmatic rupture with an intrathoracic stomach and spleen probably due to an explosion during a military mission a year earlier. Subsequent operative intervention was initiated.

Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics.

Background: For the treatment of depression in diabetes patients, it is important that depression is recognized at an early stage. A screening method for depression is the patient health questionnaire (PHQ-9). The aim of this study is to validate the 9-item Patient Health Questionnaire (PHQ-9) as a screening instrument for depression in diabetes patients in outpatient clinics.

The decision not to drive during hypoglycemia in patients with type 1 and type 2 diabetes according to hypoglycemia awareness.

Objective: In recent years, there has been an ongoing discussion on the relationship between diabetes and driving. As driving performance will inevitably decline at lower levels of glycemia, patients' decisions concerning driving or taking corrective action when hypoglycemia occurs immediately before or during driving seems paramount.

Research Design And Methods: Twenty-four type 1 diabetic patients with normal awareness of hypoglycemia (T1Norm group), 21 type 1 diabetic patients with impaired awareness of hypoglycemia (T1Imp group), and 20 type 2 diabetic patients with normal awareness of hypoglycemia (T2 group) were studied.

A practical insulin infusion algorithm for the establishment of euglycaemia in both lean and obese patients with type 1 and type 2 diabetes.

Background: Both in research and in various clinical situations, prolonged euglycaemia can be desirable. In recent years, its benefit in (critically) ill patients and patients with acute myocardial infarction has been established. The objective of this study was to assess safety and efficacy of a practical, bodyweight-dependent algorithm to establish euglycaemia in both lean and obese patients with type 1 and type 2 diabetes.

Comparison of the accuracy of the HemoCue glucose analyzer with the Yellow Springs Instrument glucose oxidase analyzer, particularly in hypoglycemia.

Objective: We aimed to assess the accuracy of the HemoCue Beta-glucose analyzer (HemoCue) and its correlation with the Yellow Springs Instrument (YSI 2300 STAT; YSI) glucose oxidase analyzer, in particular for hypoglycemic values.

Design And Methods: Samples were taken from 24 volunteers during hyperinsulinemic glucose clamp studies. Glucose concentrations were determined immediately with the HemoCue in whole blood and with the YSI in plasma from the same sample.

Human albumin and starch administration in critically ill patients: a prospective randomized clinical trial.

Objective: To determine whether intravenous infusion of either human albumin or hydroxyethyl-starch (HES) in hypo-albuminemic critically ill may lead to an increase in colloid osmotic pressure and to a better clinical outcome, i.e. lower mortality and fewer complications, compared to fluid replacement with normal saline.