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  1. Article ; Online: Postprandial hyperglycaemia following insulin suspensions by the artificial pancreas: Implications for bolus calculators.

    Major, Sandrine / El Fathi, Anas / Palisaitis, Emilie / Kearney, Robert / Von Oettingen, Julia E / Krishnamoorthy, Preetha / Legault, Laurent / Haidar, Ahmad

    Diabetes, obesity & metabolism

    2020  Volume 22, Issue 8, Page(s) 1474–1477

    Abstract: Conventional bolus calculators apply negative prandial corrections when premeal glucose levels are low. However, no study has evaluated the need for this negative correction with closed-loop systems. We analysed data retrospectively from a cohort study ... ...

    Abstract Conventional bolus calculators apply negative prandial corrections when premeal glucose levels are low. However, no study has evaluated the need for this negative correction with closed-loop systems. We analysed data retrospectively from a cohort study evaluating a closed-loop artificial pancreas system conducted in a diabetes camp over a period of 11 days. Meal boluses with negative correction (n = 98) of 47 participants aged 8 to 22 years were examined. If there was no insulin-on-board from previous boluses at mealtime, the postprandial hyperglycaemia rate increased with increased duration of insulin suspension (P = .03), with odds ratios being exaggerated by 17% per 10 minutes of suspension. However, if there was insulin-on-board from previous boluses, the hyperglycaemia rate did not change with increased duration of insulin suspension (P = .24). When there was no insulin-on-board, the rate of hyperglycaemia after meals preceded by no suspension was 21% (3/14), compared with 52% (12/23) and 64% (9/14) after meals preceded by suspensions of ≥50 and ≥70 minutes, respectively. Meal size did not influence these results. We conclude that, in the absence of insulin-on-board, negative prandial corrections may not be necessary following long insulin suspensions.
    MeSH term(s) Algorithms ; Blood Glucose ; Cohort Studies ; Diabetes Mellitus, Type 1/drug therapy ; Humans ; Hyperglycemia/drug therapy ; Hyperglycemia/prevention & control ; Hypoglycemic Agents/therapeutic use ; Insulin/therapeutic use ; Insulin Infusion Systems ; Pancreas, Artificial ; Postprandial Period ; Retrospective Studies ; Suspensions
    Chemical Substances Blood Glucose ; Hypoglycemic Agents ; Insulin ; Suspensions
    Language English
    Publishing date 2020-06-13
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1454944-x
    ISSN 1463-1326 ; 1462-8902
    ISSN (online) 1463-1326
    ISSN 1462-8902
    DOI 10.1111/dom.14044
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A pilot non-inferiority randomized controlled trial to assess automatic adjustments of insulin doses in adolescents with type 1 diabetes on multiple daily injections therapy.

    El Fathi, Anas / Palisaitis, Emilie / von Oettingen, Julia E / Krishnamoorthy, Preetha / Kearney, Robert E / Legault, Laurent / Haidar, Ahmad

    Pediatric diabetes

    2020  Volume 21, Issue 6, Page(s) 950–959

    Abstract: Background: Multiple daily injections (MDI) therapy for type 1 diabetes involves basal and bolus insulin doses. Non-optimal insulin doses contribute to the lack of satisfactory glycemic control. We aimed to evaluate the feasibility of an algorithm that ... ...

    Abstract Background: Multiple daily injections (MDI) therapy for type 1 diabetes involves basal and bolus insulin doses. Non-optimal insulin doses contribute to the lack of satisfactory glycemic control. We aimed to evaluate the feasibility of an algorithm that optimizes daily basal and bolus doses using glucose monitoring systems for MDI therapy users.
    Methods: We performed a pilot, non-inferiority, randomized, parallel study at a diabetes camp comparing basal-bolus insulin dose adjustments made by camp physicians (PA) and a learning algorithm (LA), in children and adolescents on MDI therapy. Participants wore a glucose sensor and underwent 11 days of daily dose adjustments in either arm. Algorithm adjustments were reviewed and approved by a physician. The last 7 days were examined for outcomes.
    Results: Twenty-one youths (age 13.3 [SD, 3.7] years; 13 females; HbA1c 8.6% [SD, 1.8]) were randomized to either group (LA [n = 10] or PA [n = 11]). The algorithm made 293 adjustments with a 92% acceptance rate from the camp physicians. In the last 7 days, the time in target glucose (3.9-10 mmol/L) in LA (39.5%, SD, 20.7) was similar to PA (38.4%, SD, 15.6) (P = .89). The number of hypoglycemic events per day in LA (0.3, IQR, [0.1-0.6]) was similar to PA (0.2, IQR, [0.0-0.4]) (P = .42). There was no incidence of severe hypoglycemia nor ketoacidosis.
    Conclusions: In this pilot study, glycemic outcomes in the LA group were similar to the PA group. This algorithm has the potential to facilitate MDI therapy, and longer and larger studies are warranted.
    MeSH term(s) Adolescent ; Algorithms ; Automation ; Blood Glucose/analysis ; Blood Glucose/metabolism ; Blood Glucose Self-Monitoring/instrumentation ; Child ; Diabetes Mellitus, Type 1/blood ; Diabetes Mellitus, Type 1/drug therapy ; Drug Administration Schedule ; Drug Dosage Calculations ; Equivalence Trials as Topic ; Feasibility Studies ; Female ; Humans ; Injections, Subcutaneous ; Insulin/administration & dosage ; Insulin Infusion Systems ; Male ; Pilot Projects ; Quebec ; Treatment Outcome
    Chemical Substances Blood Glucose ; Insulin
    Language English
    Publishing date 2020-06-11
    Publishing country Denmark
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 1502504-4
    ISSN 1399-5448 ; 1745-1426 ; 1399-543X
    ISSN (online) 1399-5448
    ISSN 1745-1426 ; 1399-543X
    DOI 10.1111/pedi.13052
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Hypothalamic hamartoma associated with central precocious puberty and growth hormone deficiency.

    Rousseau-Nepton, Isabelle / Kaduri, Sagi / Garfield, Natasha / Krishnamoorthy, Preetha

    Journal of pediatric endocrinology & metabolism : JPEM

    2014  Volume 27, Issue 1-2, Page(s) 117–121

    Abstract: Hypothalamic hamartomas (HHs) are tumors generally associated with isolated central precocious puberty (CPP). To our knowledge, we report a unique case of a girl with HH associated with CPP and growth hormone deficiency. This case highlights the complex ... ...

    Abstract Hypothalamic hamartomas (HHs) are tumors generally associated with isolated central precocious puberty (CPP). To our knowledge, we report a unique case of a girl with HH associated with CPP and growth hormone deficiency. This case highlights the complex interaction between HHs and the hypothalamic-pituitary-gonadal axis. It also emphasizes the value of close follow-up of growth velocity in these patients even after treatment of the CPP.
    MeSH term(s) Adolescent ; Female ; Growth Hormone/deficiency ; Hamartoma/complications ; Humans ; Hypothalamic Diseases/complications ; Puberty, Precocious/etiology
    Chemical Substances Growth Hormone (9002-72-6)
    Language English
    Publishing date 2014-01
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 1231070-0
    ISSN 2191-0251 ; 0334-018X
    ISSN (online) 2191-0251
    ISSN 0334-018X
    DOI 10.1515/jpem-2013-0108
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Adrenal suppression from glucocorticoids: preventing an iatrogenic cause of morbidity and mortality in children.

    Ahmet, Alexandra / Mokashi, Arati / Goldbloom, Ellen B / Huot, Celine / Jurencak, Roman / Krishnamoorthy, Preetha / Rowan-Legg, Anne / Kim, Harold / Pancer, Larry / Kovesi, Tom

    BMJ paediatrics open

    2019  Volume 3, Issue 1, Page(s) e000569

    Abstract: Adrenal suppression (AS) is an important side effect of glucocorticoids (GCs) including inhaled corticosteroids (ICS). AS can often be asymptomatic or associated with non-specific symptoms until a physiological stress such as an illness precipitates an ... ...

    Abstract Adrenal suppression (AS) is an important side effect of glucocorticoids (GCs) including inhaled corticosteroids (ICS). AS can often be asymptomatic or associated with non-specific symptoms until a physiological stress such as an illness precipitates an adrenal crisis. Morbidity and death associated with adrenal crisis is preventable but continues to be reported in children. There is a lack of consensus about the management of children at risk of AS. However, healthcare professionals need to develop an awareness and approach to keep these children safe. In this article, current knowledge of the risk factors, diagnosis and management of AS are reviewed while drawing attention to knowledge gaps and areas of controversy. Possible strategies to reduce the morbidity associated with this iatrogenic condition are provided for healthcare professionals.
    Language English
    Publishing date 2019-10-23
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2399-9772
    ISSN (online) 2399-9772
    DOI 10.1136/bmjpo-2019-000569
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The Efficacy of Basal Rate and Carbohydrate Ratio Learning Algorithm for Closed-Loop Insulin Delivery (Artificial Pancreas) in Youth with Type 1 Diabetes in a Diabetes Camp.

    Palisaitis, Emilie / El Fathi, Anas / Von Oettingen, Julia E / Krishnamoorthy, Preetha / Kearney, Robert / Jacobs, Peter / Rutkowski, Joanna / Legault, Laurent / Haidar, Ahmad

    Diabetes technology & therapeutics

    2019  Volume 22, Issue 3, Page(s) 185–194

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Adolescent ; Algorithms ; Basal Metabolism ; Blood Glucose/analysis ; Blood Glucose Self-Monitoring/instrumentation ; Child ; Cross-Over Studies ; Diabetes Mellitus, Type 1/blood ; Diabetes Mellitus, Type 1/drug therapy ; Dietary Carbohydrates/analysis ; Female ; Glycated Hemoglobin A/analysis ; Humans ; Hyperglycemia/chemically induced ; Hypoglycemia/chemically induced ; Hypoglycemic Agents/administration & dosage ; Insulin/administration & dosage ; Insulin Infusion Systems ; Male ; Meals ; Pancreas, Artificial ; Treatment Outcome ; Young Adult
    Chemical Substances Blood Glucose ; Dietary Carbohydrates ; Glycated Hemoglobin A ; Hypoglycemic Agents ; Insulin
    Language English
    Publishing date 2019-10-25
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 1452816-2
    ISSN 1557-8593 ; 1520-9156
    ISSN (online) 1557-8593
    ISSN 1520-9156
    DOI 10.1089/dia.2019.0270
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Adrenal suppression with cushingoid features from inhaled corticosteroid therapy in an adult asthmatic patient.

    Tsoukas, Michael A / Krishnamoorthy, Preetha / Richards, Brent J / Pepe, Carmela / Christopoulos, Stavroula

    The American journal of medicine

    2014  Volume 127, Issue 5, Page(s) e1–2

    MeSH term(s) Administration, Inhalation ; Adrenal Cortex Hormones/administration & dosage ; Adrenal Cortex Hormones/adverse effects ; Adrenal Glands/drug effects ; Adrenal Glands/metabolism ; Adrenocorticotropic Hormone/blood ; Androstadienes/administration & dosage ; Androstadienes/adverse effects ; Anti-Asthmatic Agents/administration & dosage ; Anti-Asthmatic Agents/adverse effects ; Asthma/drug therapy ; Biomarkers/blood ; Bronchodilator Agents/administration & dosage ; Bronchodilator Agents/adverse effects ; Cushing Syndrome/blood ; Cushing Syndrome/chemically induced ; Drug Administration Schedule ; Female ; Fluticasone ; Humans ; Hydrocortisone/blood ; Middle Aged
    Chemical Substances Adrenal Cortex Hormones ; Androstadienes ; Anti-Asthmatic Agents ; Biomarkers ; Bronchodilator Agents ; Adrenocorticotropic Hormone (9002-60-2) ; Fluticasone (CUT2W21N7U) ; Hydrocortisone (WI4X0X7BPJ)
    Language English
    Publishing date 2014-05
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2013.11.024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy.

    Liu, Dora / Ahmet, Alexandra / Ward, Leanne / Krishnamoorthy, Preetha / Mandelcorn, Efrem D / Leigh, Richard / Brown, Jacques P / Cohen, Albert / Kim, Harold

    Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

    2013  Volume 9, Issue 1, Page(s) 30

    Abstract: Systemic corticosteroids play an integral role in the management of many inflammatory and immunologic conditions, but these agents are also associated with serious risks. Osteoporosis, adrenal suppression, hyperglycemia, dyslipidemia, cardiovascular ... ...

    Abstract Systemic corticosteroids play an integral role in the management of many inflammatory and immunologic conditions, but these agents are also associated with serious risks. Osteoporosis, adrenal suppression, hyperglycemia, dyslipidemia, cardiovascular disease, Cushing's syndrome, psychiatric disturbances and immunosuppression are among the more serious side effects noted with systemic corticosteroid therapy, particularly when used at high doses for prolonged periods. This comprehensive article reviews these adverse events and provides practical recommendations for their prevention and management based on both current literature and the clinical experience of the authors.
    Language English
    Publishing date 2013-08-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2434973-2
    ISSN 1710-1492 ; 1710-1484
    ISSN (online) 1710-1492
    ISSN 1710-1484
    DOI 10.1186/1710-1492-9-30
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Rituximab treatment of collapsing C1q glomerulopathy: clinical and histopathological evolution.

    Bitzan, Martin / Ouahed, Jodie D / Krishnamoorthy, Preetha / Bernard, Chantal

    Pediatric nephrology (Berlin, Germany)

    2008  Volume 23, Issue 8, Page(s) 1355–1361

    Abstract: A 13-year-old girl with obesity and hyperinsulinism developed steroid-resistant nephrotic syndrome due to collapsing glomerulopathy with dominant C1q-containing mesangial immune deposits (CG/C1qN). She became overtly diabetic while receiving alternate- ... ...

    Abstract A 13-year-old girl with obesity and hyperinsulinism developed steroid-resistant nephrotic syndrome due to collapsing glomerulopathy with dominant C1q-containing mesangial immune deposits (CG/C1qN). She became overtly diabetic while receiving alternate-day prednisone and tacrolimus, requiring insulin injections. Despite the addition of mycophenolate mofetil to the treatment regimen, renal function subsequently declined. Rituximab (four weekly doses of 375 mg/m2) was tried 6 months after initial presentation and 3 months after weaning all glucocorticoids. Glomerular filtration rate (GFR) and proteinuria improved. Unexpectedly, blood sugar control normalized 6 weeks after antibody infusion. Rituximab was readministered 20 months after the first course because of deteriorating renal function, but the effect on GFR and proteinuria was modest. A retrospective analysis revealed that tubulointerstitial infiltrates present in the biopsies prior to treatment with rituximab contained numerous CD20+ and CD3+ (CD4 > CD8) lymphocyte aggregates. Rebiopsy 10 weeks after repeat rituximab therapy demonstrated the elimination of B-cell infiltrates and the apparent decrease of interstitial T-cell infiltrates, yet persistent, advanced global glomerulosclerosis, interstitial fibrosis and tubular atrophy. In conclusion, CG/C1qN was associated with B- and T-cell-rich tubulointerstitial infiltrates. B-cell-directed therapy delayed clinical progression during early disease but failed to prevent or ameliorate chronic changes, despite effective tissue B-cell clearance. The incidental resolution of diabetes was noted after rituximab treatment.
    MeSH term(s) Adolescent ; Antibodies, Monoclonal/administration & dosage ; Antibodies, Monoclonal, Murine-Derived ; Biopsy ; CD4-CD8 Ratio ; Complement C1q/immunology ; Complement C1q/metabolism ; Drug Therapy, Combination ; Female ; Glomerulonephritis/drug therapy ; Glomerulonephritis/immunology ; Glomerulonephritis/pathology ; Glucocorticoids/administration & dosage ; Humans ; Immunologic Factors/administration & dosage ; Immunosuppressive Agents/administration & dosage ; Kidney Glomerulus/immunology ; Kidney Glomerulus/metabolism ; Kidney Glomerulus/pathology ; Nephrotic Syndrome/drug therapy ; Nephrotic Syndrome/immunology ; Nephrotic Syndrome/pathology ; Prednisone/administration & dosage ; Rituximab ; Tacrolimus/administration & dosage
    Chemical Substances Antibodies, Monoclonal ; Antibodies, Monoclonal, Murine-Derived ; Glucocorticoids ; Immunologic Factors ; Immunosuppressive Agents ; Rituximab (4F4X42SYQ6) ; Complement C1q (80295-33-6) ; Prednisone (VB0R961HZT) ; Tacrolimus (WM0HAQ4WNM)
    Language English
    Publishing date 2008-03-20
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-008-0781-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Pediatric hypothyroidism presenting with a polymyositis-like syndrome and increased creatinine: report of three cases.

    Sbrocchi, Anne Marie / Chédeville, Gaëlle / Scuccimarri, Rosie / Duffy, Ciarán M / Krishnamoorthy, Preetha

    Journal of pediatric endocrinology & metabolism : JPEM

    2008  Volume 21, Issue 1, Page(s) 89–92

    Abstract: We report three pediatric cases of primary hypothyroidism presenting with musculoskeletal complaints, elevated muscle enzymes and increased creatinine. Thyroid hormone replacement led to improvement in both the clinical features and laboratory ... ...

    Abstract We report three pediatric cases of primary hypothyroidism presenting with musculoskeletal complaints, elevated muscle enzymes and increased creatinine. Thyroid hormone replacement led to improvement in both the clinical features and laboratory abnormalities.
    MeSH term(s) Child ; Creatinine/metabolism ; Diagnosis, Differential ; Female ; Humans ; Hypothyroidism/complications ; Hypothyroidism/diagnosis ; Hypothyroidism/metabolism ; Male ; Polymyositis/complications ; Polymyositis/diagnosis ; Polymyositis/metabolism ; Syndrome ; Thyroid Function Tests
    Chemical Substances Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2008-04-02
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 1231070-0
    ISSN 2191-0251 ; 0334-018X
    ISSN (online) 2191-0251
    ISSN 0334-018X
    DOI 10.1515/jpem.2008.21.1.89
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Effect of Light-Emitting Diode Phototherapy on Serum Calcium Levels in Neonates With Jaundice.

    Panneerselvam, Karthikeyan / Mani, Sathyamoorthy / Vasudevan, Nandini / S, Preethi / Krishnamoorthy, Nedunchelian / Rk, Pratibha / Sundar, Subash

    Cureus

    2022  Volume 14, Issue 4, Page(s) e23938

    Abstract: Background: To assess the change in serum total calcium levels during light-emitting diode phototherapy treatment for jaundice in term neonates.: Methods: A prospective observational study was done on 104 term neonates with hyperbilirubinemia in a ... ...

    Abstract Background: To assess the change in serum total calcium levels during light-emitting diode phototherapy treatment for jaundice in term neonates.
    Methods: A prospective observational study was done on 104 term neonates with hyperbilirubinemia in a tertiary care center to investigate the effects of phototherapy using a light-emitting diode device. The total serum bilirubin along with total calcium levels was measured at the start and at the end of phototherapy. Additionally, all the newborns enrolled in the study were evaluated for hypocalcaemia-related symptoms such as jitteriness, irritability/excitability, lethargy, and convulsions.
    Results: A significant lowering of posttreatment total calcium level compared to that of pretreatment level (p<0.001) was found in our study. Hypocalcemia (serum calcium <8 mg/dL in term neonates) was found in 12.5% of the study subjects.
    Conclusions: In the treatment of neonatal jaundice, similar to conventional blue and white light phototherapy, light-emitting diode phototherapy also has hypocalcemia as an adverse effect. We recommend monitoring these babies for hypocalcemia during light-emitting diode phototherapy.
    Language English
    Publishing date 2022-04-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.23938
    Database MEDical Literature Analysis and Retrieval System OnLINE

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