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Adamíková, A., Hrdý, P., Peňásová, S., Abrahámková, J. Lactate acidosis – emergency in diabetology. Kazuistiky v diabetologii 5, 2: 4–6, 2007. |
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Lactate acidosis belongs to severe conditions in diabetology and can be even life threatening. Indisputable benefit of biguanide therapy in type 2 diabetic patients can be significantly changed if therapy contraindications are violated as well as if concurrent diseases are underestimated. Our case history presents the course of the illness in a 59 years old female patient with type 2 diabetes mellitus with a history of alcohol abuse who was taking a combination of sulphonylurea and biguanides even during an acute gastroenteritis. The condition resulted in a severe dehydration, an acute renal insufficiency, a lactate acidosis (lactate 17 mmol/l) and a respiratory failure requiring artificial ventilation. A coma of toxometabolic etiology continued despite of a correction of laboratory parameters following intensive treatment and was complicated by cerebral ischemia and bronchopneumonia.
Key words: diabetes mellitus, lactate acidosis, biguanides, contraindications
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Švestka, L., Kojecký, V.
Urinary tract infection as a cause of decompensation of diabetes mellitus. Kazuistiky v diabetologii 5, 2: 8–10, 2007. |
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We present a case of a female patient with type 2 diabetes mellitus treated by oral antidiabetics who was admitted to the Internal Clinic IPVZ of the Zlín Hospital with the symptoms of urinary tract infection and decompensation of diabetes mellitus. We would like to demonstrate that concurrent disease – urinary tract infection in this case – can lead to a decompensation of the primary disease requiring hospitalization.
Key words: concurrent diseases, urinary tract infection, decompensation of diabetes mellitus
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Szabó, M. A control of nocturnal hypoglycemia in insulin-dependent diabetic patient with long-term insulin analogue – detemir.
Kazuistiky v diabetologii 5, 2: 11–12, 2007. |
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Insulin-dependent diabetic patient treated by intensified regime of human insulin used to suffer from frequent nocturnal hypoglycemia including a coma. Following the change of depot insulin to long-term derivate-insulin detemir the events significantly reduced.
Key words: long-term insulin analogues, nocturnal hypoglycemia, fasting hypoglycemia
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Gulášová, I. Application of diabetic patient’s motivation in a nurse’s educational process. Kazuistiky v diabetologii 5, 2: 16-19, 2007. |
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The basic condition of a successful treatment of diabetes mellitus is an effective cooperation among patient and physicians, nurses and medical team. This is not possible without familiarizing a patient with his/her disease and its course, possible complications – what he/she can, cannot and must do/follow with a respect of his/her medical condition to maintain a quality of life at the highest possible level. The author analyses psychological approach to a patient during the education using the motivation as the basic psychological tool to meet the educational target. Additionally, she highlights the importance of both external and internal motivation in a process of life style change in a patient with diabetes mellitus.
Key words: therapeutic education, motivation, communication, psychological approach, team approach, quality of life
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Antošová, M., Jiskra, J., Kotrlíková, E., Doležalová, R., Křemen, J., Housová, J., Límanová, Z.
Unrecognized primary hyperparathyroidism as a cause of chronic pancreatitis. Kazuistiky v diabetologii 5, 2 – Endokrinologie: 24–26, 2007. |
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Presented case history describes a 50 years old man who was hospitalized at the
3rd Internal Clinic of General Faculty Hospital and 1st Medical Faculty of Charles´ University of Prague following complicated resection of pancreatic pseudocyst. Primary hyperparathyroidism due to parathyroid adenoma was diagnosed as a cause of chronic pancreatitis and hypercalcaemic syndrome that complicated the course of hospitalization.
Key words: pancreatitis, hypercalcaemic syndrome, primary hyperparathyroidism
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Vávrová, H. About my family... Continuation of the story „My daddy has got everything“.
Kazuistiky v diabetologii 5, 2 – Endokrinologie: 27–31, 2007. |
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In 2005 we presented a case of completely asymptomatic 6 years old boy who inherited the aggressive type of RET proto-oncogene (cys 634) mutation from his father (Vávrová 2005). We follow the story now by presenting the genetic examination of his family.
Key words: type 2 multiple endocrinologic neoplasia (MEN 2), MEN 2A, MEN 2B, familiar medullar thyroidal carcinoma, medullar thyroidal carcinoma, RET proto-oncogene, prophylactic thyroidectomy, calcitonine producing C cells, Hirschsprung´s disease
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