Kandaswamy Jayaraj

Triangle endocrinology

A 70-year-old patient with refractory multiple myeloma, renal failure, and colon cancer was admitted with severe hyperglycemia (612 mg/dl). During the previous 3 weeks he had developed polyuria, polydipsia, fatigue, and a 2-kg weight loss. He had no personal or family history of diabetes. He had developed stress-related hyperglycemia during hospita...

Five to ten percent of patients with diabetes mellitus in the United States suffer from type 1 diabetes: approximately 1.5 million people. Type 1 diabetes occurs when there is no insulin production from the beta cells of the pancreas and has often been associated with younger patients and thin body habitus. Type 2 diabetes, often linked with obesit...

Our aging population is growing. As a result, dementia is becoming an ever more prevalent problem--with devastating consequences to the affected persons and their families. In the evaluation of the demented patient, it is crucial to look for and exclude conditions such as depression and other reversible causes of cognitive impairment before brandin...

Fluid balance is vital for cell survival. Thirst, osmoregulation, baroregulation and renal reabsorbtion control conservation and continued replacement of the lost water. The entire process is mediated by complex neurohumoral responses mediated through vasopressin, angiotensin, atrial natriuretic peptide (ANP) and the central endogenous opioid pathw...

Tumoral calcinosis is a condition characterized by ectopic periarticular calcifications without the involvement of visceral organs. Five salient features of tumoral calcinosis are: 1. elevated serum phosphorus concentration; 2. elevated serum 1,25 dihydroxy vitamin D (calcitriol) concentration; 3. elevated renal tubular phosphate reabsorbtion; 4. e...

Spontaneous bacterial peritonitis is a frequent and often serious complication of long-standing ascites in the presence of advanced liver disease. Coliform bacteria account for the infection in most cases and are thought to be related to translocation of bacteria from the bowel into the peritoneal cavity. The empiric use of cefotaxime is well estab...

The etiology of malnutrition-related diabetes mellitus (MRDM)--protein-deficient pancreatic diabetes (PDPD) and fibro-calculous pancreatic diabetes (FCPD)-is unclear. We studied the role of autoimmunity against pancreatic islet cells in the etiology of these two subtypes of MRDM by measuring islet-cell antibodies (ICA) in 23 patients with PDPD, 25...