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I Can Not Wear My Sunglasses: An Unusual Sarcoidosis Presentation
José Pablo Miramontes González,Virginia Velasco Tirado,Pablo González García,Marta Sánchez García,Ángeles Fidalgo Fernández 대한가정의학회 2017 Korean Journal of Family Medicine Vol.38 No.4
A 39-year-old Caucasian man was referred to University Hospital Salamanca from a primary care unit due to the presence of an erythematous violaceous nodule at the superior portion of his nose. Physical examination indicated that the firm, fixed erythematous violaceous nodule measured approximately 2 cm in diameter and was located in-ferior to a scar on the nasal bridge. Cutaneous involvement in sarcoidosis occurs in 25% of cases. A wide range of clinical presentations of cutaneous sarcoidosis is recognized. Skin lesions are classified as either non-specific, of which erythema nodosum is the most representative and specific, or as granulomatous, which includes maculo-papular nodules, plaques, infiltrated scars, lupus pernio, ulcerations, warty lesions and erythroderma. Scar sarcoid-osis is a type of cutaneous sarcoidosis.
( Pedro Reales Figueroa ),( Yasser Hessein Abdou ),( Maria Martin Toledano Lucas ),( Ibrahim Hamad ),( Adrian Ruiz Fernandez ),( Juan Velasco Franco ),( Marta Salas Cabanas ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Aims: Current guidelines recommend the use of a basal-bolus insulin regimen in hospitalized patients with hyperglycemia or type 2 DM. In addition a simple strategy facilitating the reconciliation of medication on discharge can improve glycemic control post-discharge. With our study we want to test whether this better glycemic control is maintained over time. Methods: Our study is a prospective and observational study during routine clinical practice. It has been held in an Department of Internal Medicine during hospitalization, with follow-up visit at 3 months after discharge and followed up for 3 years. Study patients (30) were treated with a regimen of basal-bolus insulin during hospitalization and an adjustment of their antidiabetic treatment at discharge. As a control group we included patients(30) hospitalized with similar characteristics, treated with other regimen of insulin or oral antidiabetic agents and to which either no treatment adjustment is recommended at discharge. A follow-up to all patients at 3 months after discharge and again after 3 years I realize. Results: Comparing the study group with the control group we found no differences in baseline HbA1c (8,52%±0,81 vs 8,61%±0.72; p:0,652), age (67,7±3,76 vs 67,8±3,71; p:0,86), sex (16 male vs 17 mal) and BMI (30,33±1,62 Kg/m2 vs 30,41±1,63 Kg/m2). Compared with baseline, the HbA1c at 3 months after discharge is lowe r(7,51%±0.81 vs 8,52%±0,81;p:0,001) and 3 years after discharge also remains lower(7,81%±0,81vs8,52%±0,81; p:0,013). Compared with control subjects, patients included in study have lower HbA1c at 3 months after discharge (7,51%±0,81 vs 8,71% ± 0,81:p:0,004) and lower HbA1c at 3 years after discharge (7,81%±0,81 vs 8,91%±0,81; p:0,002). Conclusion: This study confi rm that protocols to manage hyperglycemia with basal-bolus insulin regimens are also feasible and effective in routine clinical practice, and demonstrate that a simple strategy facilitating the reconciliation of medication on discharge can improve glycemic control post-discharge, that remains after 3 years or follow.