Diabetes insipidus during pregnancy is an uncommon medical problem, and its cause is not entirely clear. We present a woman with twin pregnancy associated with HELLP syndrome, who developed diabetes insipidus during postpartum period. A hypertonic saline infusion study with measurement of plasma arginine vasopressin concentrations confirmed the diagnosis. She had mild response to 1-desamino-8-d-arginine-vasopressin (dDAVP) during the immediate postpartum period. On the 3rd postpartum day two doses of 100 microliters of dDAVP were administered, and her urinary volume gradually decreased. We could stop dDAVP on the 30th postpartum day. This exacerbation may result from increased vasopressinase activity caused by the excessive production in the placenta due to twin pregnancy, together with the insufficient degradation in the liver due to HELLP syndrome.
Amyloidosis of the uterine cervix is rare. A 35-year-old pregnant woman underwent a cervical biopsy and was found to have amyloid deposits. The results of liquid chromatography-tandem mass spectrometry revealed that these deposits mainly consisted of immunoglobulin light chain (kappa chain). After undergoing several examinations, the patient was diagnosed with localized amyloidosis, without systemic or secondary amyloidosis. She underwent a normal delivery without disease exacerbation. The possible presence of systemic and secondary amyloidosis must be evaluated carefully during the diagnosis of localized cervical amyloidosis.
Objectives: For the medical care of older adults diagnosed with type 2 diabetes later in life, it is necessary to provide medical staff support considering their life stage and to ensure that they live a stable life without fatigue. However, there is no measure for evaluating whether older diabetic patients have a stable life at the time of diagnosis. This study aimed to develop a scale to evaluate self-care stability for diabetic patients and to verify its reliability and validity. Methods: A cross-sectional study was conducted at four hospitals in Japan. A draft scale comprising 39 items was developed to identify patients' stability of diabetes self-care in life. A total of 69 patients diagnosed with diabetes for the first time at age 60 or older responded effectively to questionnaires. Results: As a result of item analysis and factor analysis, seven factors comprising 20 items were extracted. The cumulative contribution ratio before rotation was 70.577%. Cronbach's α was 0.700 overall. The total score on this scale and the sum of the revised Philadelphia Geriatric Center Morale Scale scores were significantly positively correlated (r = 0.379). On comparing the total scale score based on glycated hemoglobin level, the scale score of the stable group was found to be higher. Therefore, this scale was found to be reliable and valid. Conclusions: This scale may have utility in the measurement of self-care stability in patients diagnosed with type 2 diabetes later in life.
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