Management Of Chronic Complications Research Articles

Toxicités aiguës et chroniques associées à l’usage et au mésusage du protoxyde d’azote : mise au point

Nitrous oxide (N2O) is used since the eighteenth century as an anesthetic and analgesic but also for recreational use. If the labelled uses of N2O and their modalities are nowadays perfectly framed, the misuse of N2O takes very alarming proportions among teenagers and young adults. This misuse is the cause of acute (hypoxia, barotrauma, burns, neuropsychiatric disorders) and chronic complications if repeated (myeloneuropathy, anemia, thrombosis, inhalant use disorder). The main mechanism of the latter is mainly related to a functional deficit in vitamin B12 induced by N2O. The management of acute complications is symptomatic. The management of chronic complications is based on vitamin B12 supplementation. The best biomarker of chronic N2O exposure is the elevation of the plasmatic level of methylmalonic acid. In all cases of recreational misuses, addiction treatment is necessary to prevent complications or their worsening by providing information in order to stop consumption.

Expert Consensus for the Diagnosis and Treatment of Gitelman Syndrome in China (2021)

In recent years, research on the clinical phenotypes of Gitelman syndrome (GS), new classifications, modified functional tests, biomarkers and management experience for patients with GS has made a lot of progress in China. Based on evidence-based medicine, this consensus summarizes aspects related to GS, including clinical manifestations and classification, diagnosis, treatment strategies, and management of chronic complications and comorbidity. This consensus provides an important reference for the diagnosis and treatment of GS.

P-533 - The correlation between depression and diabetic nephropathy in type 2 diabetes mellitus

Background Depression is frequent in people with diabetes mellitus, particularly in those with microvascular complications, as diabetic nephropathy is. Objective To realise a two years prospective study in T2DM patients with diabetic nephropathy, in order to explore the impact of depression in them. Methods and materials A prospective, observational study was realised at a hospital and two diagnostic centers in Tirana. 110 patients (55 males and 55 females) with T2DM, aged ≥ 20 years were enrolled in 2008. Exclusion criteria were personal and familial history for mental illness. For each patient were prescribed: gender, age, duration of diabetes, oldness of diabetic nephropathy, blood glucose level, HbA1c level, UAE level, education and nature of work. The evaluation of depression was done according to Hamilton Depression Scale, by psychiatrists. Results 83% of the studied cases with diabetic nephropathy resulted with a level of depression. 39% of them result with mild depression, 31% with moderate depression, 21% with severe depression and 9% with very severe depression. Depression was strongly associated with age, male gender, HbA1c levels, UAE rate, duration of diabetic nephropathy, the presence of diabetic retinopathy and diabetic foot disease, education level and mental work. However, the likelihood of depression was not significant with duration of diabetes and insulin use. Conclusions This study showed high prevalence of depression in type 2 diabetic patients with diabetic nephropathy. So, the management of chronic complications of diabetes is important for the depression prevention in type 2 DM patients.

A primary care provider’s guide to preventive and acute care management of adults and children with sickle cell disease

To familiarize primary care providers (PCPs) with the pathophysiological processes, diagnostic evaluation, and medical management of sickle hemoglobinopathies and their complications. Current standards of care, clinical research advances, and new treatment options will also be addressed to assist PCPs in the management of sickle cell disease (SCD). A selective search and review of the current literature on SCD and the authors' experience. Management of individuals with SCD is very complex, requiring a multidisciplinary approach that includes the patient or parent, PCP, specialist, nurse, and social worker. More patients living with SCD are relying on PCPs in nonspecialty practices for comprehensive disease management. Newborn screening detects new cases of SCD annually. The median life expectancy has more than doubled for individuals with sickle cell anemia. Healthcare providers are now in an era of increased routine screening, assessment, and management of chronic complications from this illness not previously seen in the care of adults with SCD.

Urethral stricture: the management of chronic complications.

Urethral stricture: the management of chronic complications.