Recurrent diabetic myonecrosis –An under-diagnosed cause of acute painful swollen limb in long standing diabetics

Publication date: Available online 13 September 2018Source: Annals of Medicine and SurgeryAuthor(s): Sonali Gupta, Pradeep Goyal, Pranav Sharma, Priti Soin, Puneet S. KocharAbstractDiabetic myonecrosis (DMN) is an under-diagnosed complication of long-standing poorly controlled diabetes mellitus. It presents as abrupt pain and swelling of the extremity, mostly lower limbs. Diagnosis is often delayed as it mimics a number of clinical entities such as deep vein thrombosis (DVT), cellulitis, necrotizing fasciitis and malignancy. Failure to properly identify this condition can result in increased morbidity through exposure to unnecessary tests and biopsy. A 56-year-old male with a history of complicated type 2 diabetes mellitus, hypertension presented to emergency with gradually worsening left calf pain for last 2 weeks. A lower-extremity venous Doppler was negative for DVT. Magnetic resonance imaging (MRI) was suggestive of muscle edema likely of inflammatory etiology. Muscle biopsy revealed myonecrosis with ischemic myopathy and was negative for vasculitis or inflammatory myopathy. He was managed conservatively and his symptoms resolved in 4 weeks. After 6 months he had recurrence in right thigh which was managed conservatively too. Given these findings, a diagnosis of recurrent diabetic myonecrosis was made. Myonecrosis is a less known microvascular complications of diabetes and should always be keep in mind when evaluating a diabetic patient with muscle pain. Diagnosis can be ...
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research

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Conclusions: The DC-TAV program is an ambitious, civilian-military, nationwide and long-term program, based on a harmonised standard of care and including multidimensional training. Further studies are required to assess its efficacy.
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Publication date: Available online 12 October 2019Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Arnaud Chaumeron, Jeremie Castanie, Louis Philippe Fortier, Patrick Basset, Sophie Bastide, Sandrine Alonso, Jean-Yves Lefrant, Philippe CuvillonABSTRACTBackground: Rapid sequence induction (RSI) is recommended in patients at risk of aspiration, but induced hemodynamic adverse events, including tachycardia. In elderly patients, this trial aimed to assess the impact of the addition of remifentanil during RSI on the occurrence of: tachycardia (primary outcome), hypertension (due to intubation) nor hypotension (rem...
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
ConclusionsThis case series demonstrates that the use of a high frequency jet ventilator for cardiac MRI was feasible, safe, providing good quality cardiac imaging and avoiding anesthesia personnel to be inside the hazardous environment of MRI room. Future studies are needed to confirm its safety and efficiency in pediatric patients.ResumoJustificativa e objetivosA ressonância magnética (RM) cardíaca é uma técnica utilizada na avaliação de crianças com cardiopatias congênitas. A anestesia geral garante imobilidade, especialmente em pacientes não cooperador...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
Publication date: Available online 12 October 2019Source: Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)Author(s): Q. Xu, M. Lv, Y. Xia, Y. Zhao, W. Zhang, Y. ChenAbstractA 42-year-old woman presented with a ten-day history of dysphagia, slight chest pain and occasional vomiting. With the performance of thoracic and abdominal enhanced computed tomography (CT) and upper gastrointestinal contrast, once esophageal cancer was suspected. Significant activity mass in esophagus and mediastinal lymph nodes could be found on the imaging of 18F-FDG PET/CT, which also supported malignancy. However, T...
Source: Revista Espanola de Medicina Nuclear e Imagen Molecular - Category: Nuclear Medicine Source Type: research
Publication date: 1 January 2020Source: NeuroImage, Volume 204Author(s): Rebecca S. Dewey, Susan T. Francis, Hannah Guest, Garreth Prendergast, Rebecca E. Millman, Christopher J. Plack, Deborah A. HallAbstractIn animal models, exposure to high noise levels can cause permanent damage to hair-cell synapses (cochlear synaptopathy) for high-threshold auditory nerve fibers without affecting sensitivity to quiet sounds. This has been confirmed in several mammalian species, but the hypothesis that lifetime noise exposure affects auditory function in humans with normal audiometric thresholds remains unconfirmed and current evidenc...
Source: NeuroImage - Category: Neuroscience Source Type: research
We report significant links between the rate of neuroplastic change of cortical surface anatomy, and children's early mathematical skills. In particular, most of the behavioral variance (about 73%) of children's visuospatial abilities was explained by the change in cortical thickness in the right superior parietal cortex. Moreover, half of the behavioral variance (about 55%) of children's arithmetic abilities was explained by the change in cortical folding in the right intraparietal sulcus. Additional associations for arithmetic abilities were found for cortical thickness change of the right temporal lobe, and the left mid...
Source: NeuroImage - Category: Neuroscience Source Type: research
Publication date: 1 January 2020Source: NeuroImage, Volume 204Author(s): Jingjing Chang, Jianping Hu, Chiang-Shan R. Li, Rongjun YuAbstractLife stress has been shown to impact cognitive functions, including inhibitory control. However, the immediate effects of acute stress on inhibitory control and the underlying neural mechanisms remain unclear. In a behavioral pilot study (N = 30) and a within-subject functional magnetic resonance imaging study (N = 30), we examined how acute stress induced by Trier Social Stress Test influenced inhibitory control in a stop signal task. Behavioral results across two studies showe...
Source: NeuroImage - Category: Neuroscience Source Type: research
Publication date: Available online 12 October 2019Source: NeuroImageAuthor(s): Joanes Grandjean, Carola Canella, Cynthia Anckaerts, Gülebru Ayrancı, Salma Bougacha, Thomas Bienert, David Buehlmann, Ludovico Coletta, Daniel Gallino, Natalia Gass, Clément M. Garin, Nachiket Abhay Nadkarni, Neele Hübner, Meltem Karatas, Yuji Komaki, Silke Kreitz, Francesca Mandino, Anna E. Mechling, Chika Sato, Katja SauerAbstractPreclinical applications of resting-state functional magnetic resonance imaging (rsfMRI) offer the possibility to non-invasively probe whole-brain network dynamics and to investigate the determinant...
Source: NeuroImage - Category: Neuroscience Source Type: research
Publication date: Available online 9 October 2019Source: NeuroImageAuthor(s): Aline M. Thomas, Jiadi Xu, Peter A. Calabresi, Peter C.M. van Zijl, Jeff W.M. BulteAbstractMultiple sclerosis (MS) is an autoimmune disorder that targets myelin proteins and results in extensive damage in the central nervous system in the form of focal lesions as well as diffuse molecular changes. Lesions are currently detected using T1-weighted, T2-weighted, and gadolinium-enhanced magnetic resonance imaging (MRI); however, monitoring such lesions has been shown to be a poor predictor of disease progression. Chemical exchange saturation transfer...
Source: NeuroImage - Category: Neuroscience Source Type: research
This study examines the association between physical activity and screen time with white matter microstructure in the general pediatric population. In a sample of 2,532 children (10.12 ± 0.58 years; 50.04% boys) from the Generation R Study, a population-based cohort in Rotterdam, the Netherlands, we assessed physical activity and screen time using parent-reported questionnaires. Magnetic resonance imaging of white matter microstructure was conducted using diffusion tensor imaging. Total physical activity was positively associated with global fractional anisotropy (β = 0.057, 95% CI = 0.016, 0.098, p...
Source: NeuroImage - Category: Neuroscience Source Type: research
More News: Cancer & Oncology | Cellulitis | Diabetes | Diabetes Mellitus | Diabetes Type 2 | Emergency Medicine | Endocrinology | Gas Gangrene (Myonecrosis) | General Medicine | Hypertension | MRI Scan | Pain | Thrombosis | Vasculitis