• 제목/요약/키워드: Diabetic coma

검색결과 5건 처리시간 0.021초

Short-term Effect of Ambient Air Pollution on Emergency Department Visits for Diabetic Coma in Seoul, Korea

  • Kim, Hyunmee;Kim, Woojin;Choi, Jee Eun;Kim, Changsoo;Sohn, Jungwoo
    • Journal of Preventive Medicine and Public Health
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    • 제51권6호
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    • pp.265-274
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    • 2018
  • Objectives: A positive association between air pollution and both the incidence and prevalence of diabetes mellitus (DM) has been reported in some epidemiologic and animal studies, but little research has evaluated the relationship between air pollution and diabetic coma. Diabetic coma is an acute complication of DM caused by diabetic ketoacidosis or hyperosmolar hyperglycemic state, which is characterized by extreme hyperglycemia accompanied by coma. We conducted a time-series study with a generalized additive model using a distributed-lag non-linear model to assess the association between ambient air pollution (particulate matter less than $10{\mu}m$ in aerodynamic diameter, nitrogen dioxide [$NO_2$], sulfur dioxide, carbon monoxide, and ozone) and emergency department (ED) visits for DM with coma in Seoul, Korea from 2005 to 2009. Methods: The ED data and medical records from the 3 years previous to each diabetic coma event were obtained from the Health Insurance Review and Assessment Service to examine the relationship with air pollutants. Results: Overall, the adjusted relative risks (RRs) for an interquartile range (IQR) increment of $NO_2$ was statistically significant at lag 1 (RR, 1.125; 95% confidence interval [CI], 1.039 to 1.219) in a single-lag model and both lag 0-1 (RR, 1.120; 95% CI, 1.028 to 1.219) and lag 0-3 (RR, 1.092; 95% CI, 1.005 to 1.186) in a cumulative-lag model. In a subgroup analysis, significant positive RRs were found for females for per-IQR increments of $NO_2$ at cumulative lag 0-3 (RR, 1.149; 95% CI, 1.022 to 1.291). Conclusions: The results of our study suggest that ambient air pollution, specifically $NO_2$, is associated with ED visits for diabetic coma.

소아의 고삼투압성 비케톤성 혼수에서 발생한 횡문근 융해증에 의한 급성 신부전 1례 (A Case of Acute Renal Failure Caused by Rhabdomyolysis due to Hyperosmolar Nonketotic Coma in Children)

  • 곽정원;오재민;김수영
    • Clinical and Experimental Pediatrics
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    • 제48권5호
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    • pp.565-568
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    • 2005
  • 저자들은 14세 남아에서 당뇨병에 합병된 고삼투압성 비케톤성 혼수에서 발생한 횡문근 융해증에 의하여 초래된 급성신부전으로 내원하여 치료 후 회복된 증례를 경험하여 문헌 고찰과 함께 보고하는 바이다.

당뇨병환자의 자가조절 (Self -Control)의 지식 및 태도 조사연구 (A Study of the Knowledge and Attitude of Diabetics)

  • 김완순
    • 대한간호학회지
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    • 제7권2호
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    • pp.83-94
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    • 1977
  • Diabetes Mellitus is a worldwide disease affecting millions of persons and appears to be on the increase in Korea. At the present time it can not be cured but can be controlled. To achieve control the patient must know about the disease. Education of the patient is an essential part of the management of the diabetic and is the responsibility of the nurse. The educational program must be adapted according to patient's knowledge and attitude about their diseases. Therefore, the opportunity to assess the knowledge and attitude of diabetics must provided. The objectives of this study were : 1. To describe the general characteristics of the study population. 2. To find out the characteries of experience of treatment. 3. To exams the knowledge and attitude of diabetics about the self-control. 4. To learn the influencing factors affecting the knowledge and attitude of diabetics about self - control. The study population defined and selected was 65 diabetics registered at the Diabetic Clinic of 5. hospital who visited the Diabetic Clinic from April 16, 1976 to May 14, 1976. The direct interview method was used. Statistical analysis of the data was X²- test. The following results were obtained : A. General characteristics of the study population : The respondent's average age was 50. 8 years old, sex ratio(male to female) revealed as 1 : 1.1, economic background was upper middle class, the most respondents had better than- average education, 75.4 Percents of the respondents lived in Seoul, 47. 2 percents were unemployed, the average size of family was 5.3 and 47.7 percents of respondents had religions. B. The characteristics of clinical experience : The average duration was 7.0 years, 46.1 percents of respondents had experience of hospitalization, 56.9 percents was taking oral drugs, 67.7 percents examined urine- sugar at home, 60.0 Percents had treat compilations and 20.0 percents had experience of coma. C. There was significant difference in the relationship : Between complications and durations of diabetes, hospitalization and therapeutic methods.

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당뇨 환자에서 발생한 안면부 털곰팡이증에 대한 증례 (Fatal Facial Mucormycosis on a Diabetic Patient: A Case Report)

  • 최정훈;김영준;권지은;김훈;남상현;최영웅
    • Archives of Plastic Surgery
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    • 제38권1호
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    • pp.93-95
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    • 2011
  • Purpose: Mucormycosis generally occurs in patients with uncontrolled diabetes mellitus and immunocompromised conditions. It is rare, but once a patient is infected with it, it can occur as a rapidly extending, aggressive, and life-threatening rhinocerebral infection with a high mortality rate. Methods: A 70-year-old female patient had a 40 years of history of adult onset diabetes mellitus. She presented herself with severe right hemifacial pain, swelling, and weakness for 3 days and was admitted to ENT. On a facial computed tomography (CT) scan, it was found that her infection extended from her inferior temporal scalp to her submental area and involved her submandibular, masseter, prevertebral, parapharyngeal, retropharyngeal, and pharyngeal mucosal space and pansinusitis. Through endoscopic sinus surgery, mucormycosis was confirmed via histologic examination. Results: Despite empiric antibiotics and amphotericin B administration, the patient was in a septic condition and in a coma. The patient's family wanted to withdraw her life support, and the patient expired. Conclusion: Mucormycosis is very rare, but is one of the disastrous complications of uncontrolled diabetes mellitus. Suspicion of its occurrence, based on identified risk factors, and its rapid diagnosis can enhance the chance of its cure.

식도부식증의 임상적 고찰 (Clinical Study of Corrosive Injury of the Esophagus)

  • 박철원;송기준;이형석;안경성;김선곤
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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    • pp.5.3-6
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    • 1981
  • 각종 부식제에 의한 식도부식증은 근래에 들어서 그 발생빈도가 현저히 감소되었으나 아직도 자살수단으로 택하거나 오연으로 인하여 적지않은 환자가 발생하고 부식제의 종류도 다양하여졌음을 볼 수 있다. 또한 식도부식증은 그 경과에 있어서 필연적으로 발생하는 식도협착증의 방지가 치료의 촛점이라고 할 수 있다. 저자는 1972년 5월부터 1980년 12월까지 한양대학병원 이비인후과에 내원한 식도부식증 환자중 발병시부터 치유될때까지 전 과정의 임상관찰이 가능했던 환자 51명을 대상으로 연령 및 성별, 월별빈도, 음독등기, 약물 종류, 음독후 내원시간, 구강 및 인두 점막변화, 검사소견, 응급처치 및 입원후 치료, 치료성적, 합병증 등을 정리 하며 다음과 같은 결과를 얻었다. 1) 성별비는 1. 13:1로 여자가 약간 많았으며, 남자가 24례(47.1%), 여자가 27례(52.9%)이었다. 2) 연령분포는 21∼30세가 20례 (39.2%)로 가장 많았고, 11∼20세가 11례 (21.6%), 31∼40세가 7례 (13.7%), 50세 이상이 7레 (13.7%)의 순이었다. 3) 월별빈도는 3월이 8례 (15.7%)로 가장 많았고 다음이 4절과 7월이 각각 7례(13.7%), 9월 6례 (11.8%), 10월 5례 (9.8%)의 순이었다. 4) 음독동기는 자살목적이 40례 (78.4%)로 주종을 이루였고 사고에 의한 오연이 11례 (21.6%)이었다. 5) 약물종류로는 초산이 24례(47.0%)로 가장 많았고, 다음이 염산 11례 (21.5%), 가성소다8례 (15.7%),.옥도정기 2례 (3.9%)의 순이었다. 6) 음독후 내원시간은 12시간 이내에 내원한 경우가42례 (82.4%)이었고, 다음이 12∼24시간내 4례 (7.8%)이었다. 7) 구강 및 인두점막변화는 충혈 및 부종이 있는 중등도가 20례(39.2%)로 가장 많았고, 다음이 궤양이동반된 18례(35.3%), 충혈만 있는 10례(19.6%)의 순이었다. 8) 검사소견은 혈액검사소견상 40례(78.4%)에서 백혈구 증가를 보였으며, 31례(60.8%)에서 혈구용적비(Hct)증가를 보였다. 뇨검사상 14례(27.5%)에서 Specific gravity가 1.030이상 이었고, 25례(49.0%)에서 단백뇨를 보였으며, 5례(9.8%)에서 당뇨를 보였고, 6례(11.8%)에서 혈뇨를 보였다. 9) 응급처치로는 위세척을 시행한 예가 30례 (58.8%)이었고, 3례 (5.9%)에서는 기관절개술을 시행하였다. 10) 치료방법으로는 전체 51례중 50례 (98.0%)에서Levin tube을 삽입 하였고, 49례 (96.1%)에서는 항생제를 투여하였으며, 46례 (90.2%)에시 제산제 및 Steroid를 사용하였다. 11) 치료후 36례 (70.6%)에서는 별다른 합병증없이 유효한 치료결과를 보였고 2례(3,9%)는 입원당시 사망하였으며, 4례 (7.8%)에서 식도협착을 보였고, 1례(2.0%)에서는 위유문부협착을 보였다. 12) 합병증은 8례 (I5.7%)에서 볼 수 있었으며 그중 신부전증이 4례로 가장 많았고, 다음이 폐염, 상부 위·장관출혈 등이 었다.

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