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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Radiocontrast exposure has now become an important cause of iatrogenic acute kidney injury (AKI) in hospitalized patients due to an increase in the number of diagnostic and interventional procedures done. Gadolinium, a well-known paramagnetic contrast agent used primarily for magnetic resonance imaging (MRI), has attracted a lot of attention for its safety in patients at risk for AKI, namely those with chronic kidney disease (CKD) and diabetes. Since its widespread use, a few cases of gadolinium nephrotoxicity have been reported in the literature. However, this remains a largely unrecognized complication in the field of nephrology. Here we describe such a case of AKI due to gadolinium toxicity in a 65-year-old African-American man with a history of hypertension, diabetes and chronic kidney disease, who was admitted for a toe infection and consequently developed AKI from multiple imaging studies involving the use of gadolinium.
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PMID:Gadolinium nephrotoxicity: case report of a rare entity and review of the literature. 1904 10

This report describes the results of 17 metatarsal ray resections performed through a minimal incision in 13 consecutive patients. Each patient underwent minimum-incision metatarsal ray resection for either definitive treatment or as the index incision and drainage procedure followed by transmetatarsal amputation. There were 10 male and 3 female patients with a mean age of 68.8 +/- 8.5 years (range, 59-83 years). Twelve patients had diabetes mellitus and 7 had critical limb ischemia. There were 11 right feet and 6 left feet involved, and 3 second, 3 third, 3 fourth, and 8 fifth minimum-incision metatarsal ray resections performed. Direct primary-incision closure was performed 7 times (1 with adjacent percutaneous metatarsal osteotomy), delayed primary closure was performed 4 times (1 with external fixation), and conversion to a transmetatarsal amputation was performed 2 times. Fourteen of 17 minimum-incision metatarsal ray resections were deemed successful. Two failures occurred when skin necrosis developed from excessive tension along the incision line requiring conversion to a transmetatarsal amputation, and the other occurred in a patient with unreconstructed critical limb ischemia who underwent multiple repeated incision and drainage procedures and vascular bypass with ultimate healing via secondary intent. When properly performed in patients with adequate vascular inflow, minimum-incision metatarsal ray resection as the definitive procedure or in conjunction with an incision and drainage for unsalvageable toe infection or gangrene represents a safe, simple, useful technique.
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PMID:Minimum-incision metatarsal ray resection: an observational case series. 2012 88