Hypoglycemia and microorganisms

[Guest guest]

These articles show the link between hypoglycemia and microorganisms.

This gives us a hint that doing SCD would be helpful for hypoglycemia

since SCD starves out the

pathogens.

Mimi

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=10505722 & query_hl=20 & itool=pubmed_DocSum

1: Dig Dis Sci. 1999 Sep;44(9):1837-42. Related Articles, Links

Click here to read

Helicobacter pylori-induced gastritis may contribute to occurrence

of postprandial symptomatic hypoglycemia.

Acbay O, Celik AF, Kadioglu P, Goksel S, Gundogdu S.

Department of Internal Medicine, Cerrahpasa Medical School

Hospital, University of Istanbul, Turkey.

In our clinical experience, postprandial symptomatic hypoglycemic

(PSH) patients with H. pylori gastritis showed a substantial

improvement in their hypoglycemic symptoms after the eradication of H.

pylori. Therefore, in this study we have investigated whether H.

pylori gastritis may contribute to the occurrence of PSH. For this

purpose, we have evaluated the following parameters in 12 PSH patients

with H. pylori gastritis before and one month after the eradication

therapy: (1) the number and severity of PSH attacks that occurred in a

one-month period using a 30-day diary, (2) the total symptom score

following a mixed meal using a visual analog scale questionnaire

(VASQ), and (3) the glucose and insulin responses to the mixed meal.

After the eradication of H. pylori, the serum insulin responses at 30

and 60 min decreased (P < 0.001 in both), whereas the plasma glucose

levels at 150, 180 and 210 min increased significantly (P < 0.001 for

180 min and P < 0.01 in others) following the mixed meal. The number

and severity score of PSH attacks that occurred in a one-month period

and the area under curve for symptom score in VASQ decreased

significantly (P < 0.001 in all). These results suggest that H. pylori

gastritis may contribute to the occurrence of PSH.

PMID: 10505722 [PubMed - indexed for MEDLINE]

1: Dig Dis Sci. 1999 Sep;44(9):1837-42. Related Articles, Links

Click here to read

Helicobacter pylori-induced gastritis may contribute to occurrence

of postprandial symptomatic hypoglycemia.

Acbay O, Celik AF, Kadioglu P, Goksel S, Gundogdu S.

Department of Internal Medicine, Cerrahpasa Medical School

Hospital, University of Istanbul, Turkey.

In our clinical experience, postprandial symptomatic hypoglycemic

(PSH) patients with H. pylori gastritis showed a substantial

improvement in their hypoglycemic symptoms after the eradication of H.

pylori. Therefore, in this study we have investigated whether H.

pylori gastritis may contribute to the occurrence of PSH. For this

purpose, we have evaluated the following parameters in 12 PSH patients

with H. pylori gastritis before and one month after the eradication

therapy: (1) the number and severity of PSH attacks that occurred in a

one-month period using a 30-day diary, (2) the total symptom score

following a mixed meal using a visual analog scale questionnaire

(VASQ), and (3) the glucose and insulin responses to the mixed meal.

After the eradication of H. pylori, the serum insulin responses at 30

and 60 min decreased (P < 0.001 in both), whereas the plasma glucose

levels at 150, 180 and 210 min increased significantly (P < 0.001 for

180 min and P < 0.01 in others) following the mixed meal. The number

and severity score of PSH attacks that occurred in a one-month period

and the area under curve for symptom score in VASQ decreased

significantly (P < 0.001 in all). These results suggest that H. pylori

gastritis may contribute to the occurrence of PSH.

PMID: 10505722 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=11419494 & query_hl=20 & itool=pubmed_DocSum

1: Pediatr Infect Dis J. 2001 Jun;20(6):557-60. Related Articles, Links

Click here to read

Late onset infection in very low birth weight infants in Malaysian

Level 3 neonatal nurseries. Malaysian Very Low Birth Weight Study

Group.

Ho JJ.

Perak Medical College, Greentown, Ipoh, Malaysia. jackie@...

BACKGROUND: The purpose of this study was to examine the rate and

mortality from late onset infection occurring in very low birth weight

infants admitted to Malaysian nurseries. METHODS: Data on all infants

1500 g or below admitted to the 20 participating Level 3 nurseries

were analyzed for late onset infection (clinical infection and

positive blood or cerebrospinal fluid culture occurring after 48 h of

life). RESULTS: The overall survival of the 962 study infants was 69%.

The rate of late onset infection was 19.3%. The mortality in those

with late onset infection was 30.8%. The most common infecting

organism was Klebsiella pneumoniae, accounting for 38.3% of infections

and 46.9% of deaths in infants with infection, followed by

coagulase-negative staphylocci, 17.6 and 12.2%, respectively. On

logistic regression analysis risk factors for late onset gram-negative

compared with gram-positive infection were endotracheal intubation at

birth and blood transfusion. Hypoglycemia was associated with

gram-positive infection. CONCLUSION: The late onset infection rate in

Malaysian very low birth weight infants does not differ from that

reported from developed countries, but the mortality is higher. This

could be because of an excess of gram-negative infections.

PMID: 11419494 [PubMed - indexed for MEDLINE]

1: J Health Popul Nutr. 2005 Sep;23(3):259-65. Related Articles, Links

Risk factors for mortality due to shigellosis: a case-control

study among severely-malnourished children in Bangladesh.

van den Broek JM, Roy SK, Khan WA, Ara G, Chakraborty B, Islam S, Banu B.

Academical Medical Centre, University of Amsterdam, The Netherlands.

To determine the risk factors for death of severely-malnourished

Bangladeshi children with shigellosis, a case-control study was

conducted at the Clinical Research and Service Centre of ICDDR,B:

Centre for Health and Population Research in Dhaka, Bangladesh. One

hundred severely-malnourished children (weight-for-age <60% of median

of the National Center for Health Statistics), with a positive stool

culture for Shigella dysenteriae type 1 or S. flexneri, who died

during hospitalization, were compared with another 100 similar

children (weight-for-age <60% and with S. dysenteriae type 1 or S.

flexneri-associated infection) discharged alive. Children aged less

than four years were admitted during December 1993-January 1999. The

median age of the cases who died or recovered was 9 months and 12

months respectively. Bronchopneumonia, abdominal distension, absent or

sluggish bowel sound, clinical anaemia, altered consciousness,

hypothermia, clinical sepsis, low or imperceptible pulse, dehydration,

hypoglycaemia, high creatinine, and hyperkalaemia were all

significantly more frequent in cases than in controls. In multivariate

regression analysis, altered consciousness (odds ratio [OR]=2.6, 95%

confidence interval [CI] 1.0-6.8), hypoglycaemia (blood glucose <3

mmol/L (OR=7.8, 95% CI 2.9-19.6), hypothermia (temperature <36 degrees

C) (OR=5.7, 95% CI 1.5-22.1), and bronchopneumonia (OR=2.5, 95% CI

1.1-5.5) were identified as significant risk factors for mortality.

Severely-malnourished children with shigellosis having hypoglycaemia,

hypothermia, altered consciousness and/or bronchopneumonia were at

high risk of death. Based on the findings, the study recommends that

early diagnosis of shigellosis in severely-malnourished children and

assertive therapy for proper management to prevent development of

hypothermia, hypoglycaemia, bronchopneumonia, or altered consciousness

and its immediate treatment are likely to reduce Shigella-related

mortality in severely-malnourished children.

PMID: 16262023 [PubMed - indexed for MEDLINE]

Display

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=15962230 & query_hl=20 & itool=pubmed_docsum

1: J Infect Dis. 2005 Jul 15;192(2):336-43. Epub 2005 Jun 3. Related

Articles, Links

Click here to read

Mice with disseminated candidiasis die of progressive sepsis.

Spellberg B, Ibrahim AS, JE Jr, Filler SG.

Los Angeles Biomedical Research Institute, Division of Infectious

Diseases at Harbor-University of California at Los Angeles Medical

Center, Torrance 90502, USA. bspellberg@...

BACKGROUND: Candida species are among the most common etiologies

of nosocomial bloodstream infections, causing a mortality of >40%. The

murine model of hematogenously disseminated candidiasis is the

standard for investigating both the activity of antifungal agents and

the pathogenesis of this disease. However, despite decades of use,

little is known about the physiological characteristics of the host in

this model, and the cause of death remains unclear. METHODS: Using

i-STAT technology, we measured blood chemistry and hemodynamic

parameters to define host physiological characteristics during murine

disseminated candidiasis. RESULTS: Mice with hematogenously

disseminated candidiasis died of progressive sepsis, as manifested by

worsening hypotension, tachycardia, and hypothermia. The mice

developed metabolic acidosis, as well as profound acidemia and

hypoglycemia. They also developed renal insufficiency, which became

severe only shortly before death. Kidney fungal burden was correlated

with severity of renal failure and systemic acidosis. The presence of

significant weight loss, hypotension, or hypothermia was predictive of

imminent death. CONCLUSIONS: These findings indicate that the murine

model of hematogenously disseminated candidiasis accurately

recapitulates the progressive sepsis seen during severe clinical

cases. The results underscore the validity of the model for study of

the pathophysiological aspects of this disease, as well as for the

evaluation of antifungal drug efficacy.

PMID: 15962230 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=15570563 & query_hl=20 & itool=pubmed_docsum

1: Vet Clin Pathol. 2004;33(4):244-8. Related Articles, Links

Artifactual hypoglycemia associated with hemotrophic mycoplasma

infection in a lamb.

Burkhard MJ, Garry F.

Department of Pathology, College of Veterinary Medicine and

Biomedical Sciences, Colorado State University, Fort , CO, USA.

burkhard.19@...

BACKGROUND: A 35-day-old male lamb with Mycoplasma ovis infection

(previously Eperythrozoon ovis) was evaluated because of severe

hypoglycemia (serum glucose 4 mg/dL, Hitachi 704 automated chemistry

analyzer) inconsistent with the animal's condition. Whole blood

glucose concentration measured with a glucometer was 74 mg/dL.

OBJECTIVE: The purpose of this study was to investigate this

discrepancy through in vitro evaluation of the patient's blood.

METHODS: Blood was incubated alone, with increasing concentrations of

plasma, or with equine serum of known glucose concentration for 0, 15,

30, and 60 minutes at room temperature; end-point glucose

concentrations were compared with blood from a control sheep handled

similarly. RESULTS: A rapid decline in glucose concentration was

observed in heparinized or EDTA anticoagulated whole blood from the

infected lamb incubated alone or with the equine serum. Glucose

concentrations in incubated samples from a control sheep remained

stable. Incubation of increasing concentrations of heparinized blood

with autologous plasma resulted in decreased glucose concentrations in

patient, but not control, blood. As parasitemia decreased after

treatment, serum glucose concentration increased, serum lactate

concentration decreased, and in vitro glucose concentration

stabilized. CONCLUSIONS: These findings are consistent with

parasite-associated in vitro glucose consumption. An increase in the

lamb's plasma glucose concentration associated with reduction of

parasite load suggested excess glucose consumption also may have

occurred in vivo.

Publication Types:

* Case Reports

PMID: 15570563 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=15188715 & query_hl=20 & itool=pubmed_docsum

1: Epidemiol Infect. 2004 Jun;132(3):455-65. Related Articles, Links

Comment in:

* Epidemiol Infect. 2005 Dec;133(6):1143-4; author reply 1144-6.

An epidemic of gastroenteritis and mild necrotizing enterocolitis

in two neonatal units of a University Hospital in Rome, Italy.

Faustini A, Forastiere F, Giorgi Rossi P, Perucci CA.

Department of Epidemiology Local Health Authority RME, Rome, Italy.

In the summer of 1999 a cluster of 18 cases of necrotizing

enterocolitis (NEC) occurred in a University Hospital in Rome, Italy.

The cases presented with mild clinical and radiological signs, and

none died. Seventy-two per cent had a birth weight of > 2500 g, 66.7%

had a gestational age of > 37 weeks, 30% presented with respiratory

diseases and/or hypoglycaemia. All cases occurred within 10 days of

birth and between 5 and 7 days after two clusters of diarrhoea (14

cases). The NEC outbreak had two phases; most cases in the first phase

occurred in the at-risk unit, whereas those in the second phase

occurred in the full-term unit. In the multivariate analysis, invasive

therapeutic procedures, pathological conditions and formula feeding

were associated with NEC. Although no predominant common bacteria were

isolated, we suggest an infective origin of this outbreak.

PMID: 15188715 [PubMed - indexed for MEDLINE]

Display Show

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=15296272 & query_hl=20 & itool=pubmed_docsum

1: Rev Prat. 2004 May 15;54(9):957-62. Related Articles, Links

[Meningococcal purpura fulminans in children]

[Article in French]

Leclerc F, Binoche A, Dubos F.

Reanimation pediatrique, hopital Jeanne de Flandre, CHU de Lille,

59037 Lille Cedex. fleclerc@...

In France, the incidence of meningococcal infections is increasing

and the most severe presentation, called purpura fulminans, has still

a death rate of 20-25%. Diagnosis of invasive meningococcal infection

must be evoked in any child presenting with febrile purpura

(vasculitic rash not disappearing with " tumbler test " ); a fulminating

form must be suspected in the presence of only one ecchymosis and

signs of infection, remembering that recognition of shock is difficult

in children. The Health Authority recommend to administer a third

generation cephalosporin promptly for any child with signs of

infection and an ecchymotic purpura (>3 mm of diameter), and then to

refer the patient to the hospital. Children with purpura fulminans

should be referred to a paediatric intensive care unit. Management

includes antibiotics, steroids, fluid resuscitation and catecholamines

(be aware of hypoglycaemia, particularly in infants, and

hypocalcaemia). Treatment of cutaneous necrosis and distal ischemia is

difficult and still controversial: antithrombin, protein C, tissue

plasminogen activator and vasodilator infusion have no proved

efficacy. Cases must be rapidly notified to the Public Health Service

who will institute chemoprophylaxis for close contacts. Given the

predominance of serogroup B in France, we hope that an efficient

vaccine will soon become available.

PMID: 15296272 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=12793713 & query_hl=20 & itool=pubmed_DocSum

1: Intern Med. 2003 May;42(5):421-3. Related Articles, Links

Click here to read

Streptococcal toxic shock syndrome presenting with spontaneous

hypoglycemia in a chronic hemodialysis patient: pathophysiological

mechanisms.

Igaki N, Matsuda T, Hirota Y, Kawaguchi T, Tamada F, Goto T.

Department of Internal Medicine, Takasago Municipal Hospital, Takasago.

Hypoglycemia is fatal if associated with sepsis in end-stage renal

disease (ESRD) patients. We report a hemodialysis patient of

streptococcal toxic shock syndrome presenting with hypoglycemia. She

was found to be severely hypoglycemic with a plasma glucose level of

16 mg/dl. Immunoreactive insulin levels were undetectable throughout

the clinical course. Several factors including reduced renal

gluconeogenesis, reduced hepatic glucose output and excessive

peripheral glucose utilization may account for the hypoglycemia in

this patient. In conclusion, we would like to draw attention to the

fact that septic ESRD patients without diabetes are prone to develop

profound hypoglycemia with serious consequences.

Publication Types:

* Case Reports

PMID: 12793713 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=12442027 & query_hl=20 & itool=pubmed_DocSum

Pediatr Infect Dis J. 2002 Nov;21(11):1042-8. Related Articles, Links

Click here to read

Acute bacterial meningitis in children admitted to a rural Kenyan

hospital: increasing antibiotic resistance and outcome.

Mwangi I, Berkley J, Lowe B, Peshu N, Marsh K, Newton CR.

Kenya Medical Research Institute, Center for Geographic Medicine

Research-Coast, Kilifi, Kenya.

BACKGROUND: Acute bacterial meningitis (ABM) is an important cause

of mortality in Africa, but most studies are based in urban referral

hospitals. Poor laboratory facilities make diagnosis difficult, and

treatment is limited to inexpensive antibiotics. METHODS: We

retrospectively reviewed data from children admitted with ABM to a

Kenyan district hospital from 1994 through 2000. We calculated the

minimum incidence in children admitted from a defined area. We also

examined the antibiotic susceptibility patterns. RESULTS: We

identified 390 cases (1.3% of all admissions) of whom 88% were <5

years old. The apparent minimum annual incidence in children younger

than 5 years of age increased from 120 to 202 per 100,000 between 1995

and 2000 (P < 0.001). Increasing the lumbar punctures performed by

including prostrated or convulsing children significantly increased

the number of cases detected (P < 0.005). The most common organisms in

infants <3 months were streptococci and Enterobacteriaceae.

Streptococcus pneumoniae (43.1%) and Haemophilus influenzae (41.9%)

were predominant in the postneonatal period. The overall mortality was

30.1%, and 23.5% of survivors developed neurologic sequelae.

Chloramphenicol resistance of H. influenzae rose from 8% in 1994 to

80% in 2000 (P < 0.0001) accompanied by an apparent increase in

mortality. A short history, impaired consciousness and hypoglycemia

were associated with death. Prolonged coma and low cerebrospinal fluid

glucose were associated with neurologic sequelae. CONCLUSION: ABM in

rural Kenya is a severe illness with substantial mortality and

morbidity. Prognosis could be improved by broadening the criteria for

lumbar puncture and use of appropriate antibiotics.

PMID: 12442027 [PubMed - indexed for MEDLINE]