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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Because of alarming delays in the diagnosis and treatment of vertebral osteomyelitis we have reviewed our experience over the past 15 years. Of the 36 cases, 25 were pyogenic and 11 tuberculous. Because of late referral there was a delay from onset of symptoms to diagnosis of at least three months in 13 patients. The reason for this was the failure of the initial physician to consider osteomyelitis in the differential diagnosis of a febrile illness associated with back pain. The majority of our patients from the onset did not have intense localized pain, tenderness and a high fever which is the classical clinical picture in this condition. Seven patients with a long history required surgical exploration and debridement of the lesion in order to eradicate the infection. The remainder did well on 6 to 12 weeks of antibiotic therapy. None required spinal fusion. Ten of 11 patients with spinal tuberculosis had curettage of the lesion and spinal fusion. Patients with diabetes, malignancy, alcoholism, corticosteroid therapy and recent lower urinary tract surgery were found to be at particular risk of developing spinal osteomyelitis. Very often it was difficult to identify differences in the presentation of pyogenic and tuberculous infections.
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PMID:Atypical manifestations of spinal infections. 40 8

Lipogranulomas from severe fatty livers due to alcoholism, diabetes or overweight were examined in the electron microscope. When a fat droplet protrudes through the cell membranes of a liver cell histiocytes and lymphyocytes settle around it, and a lipogranuloma is formed. Remnants of the liver cell may be seen between the fat droplet and the histiocytes. It is confirmed that the fat droplets are situated extracellularly in the fully developed lipogranulomas.
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PMID:Ultrastructure of lipogranulomas in human fatty liver. 42 5

To understand hydrazone formation in hydralazine metabolism, the reaction of hydralazine with various biogenic aldehydes and ketones (acetone, pyruvic acid, acetoacetic acid, formaldehyde, and acetaldehyde) in pH 7.4 buffer was studied for potential alterations in hydralazine pharmacokinetics secondary to alcoholism and diabetes. The corresponding hydrazones were isolated, and their structures were characterized. High-performance liquid chromatography was used to monitor the reactions. An aqueous solvent reversed-phase liquid chromatographic system was used to separate hydralazine and its derivatives. Reaction of hydralazine with formaldehyde or acetaldehyde produced the corresponding hydrazones. Formation of an s-triazolo ring system yielded the known s-triazolo[3,4-alpha]phthalazine and 3-methyl-s-triazolo[3,4-alpha]phthalazine metabolites, which also were isolated and characterized and suggested nonenzymatic metabolism.
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PMID:High-performance liquid chromatographic studies of reaction of hydralazine with biogenic aldehydes and ketones. 52 44

The phenomenon called paradoxical undressing has been described from 33 cases of hypothermia collected from Swedish police reports. The cases were almost evenly distributed with regard to sex, age, and geographical distribution. The cases occurred more frequently in open land although cases from town areas were also found. Most incidents were recorded from November to February at low ambient temperatures, although cases were also reported at temperatures above 0 degree C. Arteriosclerosis and chronic alcoholism were important concomitant illnesses, the latter being frequent in middle-aged men. Epilepsy, diabetes, and pregnancy were present in single cases. Ethanol and other drugs were present in 67% of the males and in 78% of the females, ethanol predominating in men and various psychotropic agents in women. The mean blood ethanol concentration in males was 0.16% and in females, 0.18%. Most frequent findings at necropsy were purple spots or discoloration on the extremities, pulmonary edema, and gastric hemorrhages. It is concluded that paradoxical undressing might be explained by changes in peripheral vasoconstriction in the deeply hypothermic person. It represents the last effort of the victim and is followed almost immediately by unconsciousness and death.
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PMID:"Paradoxical undressing" in fatal hypothermia. 54 27

The pathological aspects and clinical importance of secondary forms of hyperlipoproteinemia in old age are discussed by the author in his present review article. Consideration is first given to the relations between hyperlipoproteinemia and diabetes mellitus. Further, the author deals with secondary hyperlipoproteinemia consequent upon renal diseases, pancreatitis, alcoholism, endocrinal diseases, liver diseases, and use of certain drugs. Finally, therapeutic problems of secondary hyperlipoproteinemia, which hold in old age just as in any other, are also treated briefly.
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PMID:[On the clinical importance of secondary hyperlipoproteinemia in old age (author's transl)]. 55 95

The concept of risk in the field of avitaminoses is very important and useful for the practitioner, who should consider two aspects: a) risk factors, which could be individual (physiological, pathological and psychological) and extra-individual (alimentary, environmental, etc.); b) subjects with an elevated risk of avitaminosis (childhood, old age, pregnancy, etc.). In these subjects the risk can be a generical one, when there is an elevated requirement for all vitamins (nursing women, sportmen, etc.) or a specific one, when there is a high requirement only for a single vitamin (osteomalacia, some professional diseases, use of oral contraceptives) or a vew of them (alcoholism, diabetes, etc.). On the basis of this kind of knowledge it is easy for the practitioner to estimate which vitamins are necessary for each subject or for a group of subjects in physiological or in pathological conditions. For example, there is an elevated risk of apyridoxinosis in old age (acalciferolosis in aged women), of athiaminosis and apyridoxinosis in diabetes, of apyridoxinosis in oral contraceptives users, of axeroftolosis in hyperthyroidism, of athiaminosis, apyridoxinosis, aniacinosis and anascorbosis in alcoholics. In the second chapter the concept of the latency period in avitaminosis is illustrated. This period corresponds to the interval between the moment when deficiency stimulus starts operating and the moment when its effect, that is the picture of avitaminosis, appears. The latency time is not measurable, on account of the difficulties in establishing the onset of the deficiency stimulus; generally it is very long and is followed by the period of biochemical symptomatology and subsequently by the one of clinical symptomatology. Each of these three phases can be further divided in several steps, which have summarized in a Table. The last chapter is dedicated to the classification of avitaminoses. From the etiopathogenetic point of view avitaminoses can be due to: a) deficiency of introduction (alimentary level)); b) deficiency of absorption (enteric level); c) deficiency of utilization (tissue level). From the clinical point of view avitaminoses can be distinguished in deficiency with: a) a complete clinical symptomatology (scurvy, beriberi, pellagra, rickets, osteomalacia, xerophthalmia, hemeralopia); b) an incomplete clinical symptomatology (mono- or oligo-symptomatic or partial clinical picture); c) a biochemical symptomatology only (subclinic or clinically asymptomatic picture).
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PMID:[Vitaminology for practitioners. II. Avitaminoses, risk, latency period, classification]. 58 76

Intravenous glucose tolerance tests were carried out in 61 chronic alcoholic patients, divided into two groups, and in a third group consisting of healthy, nonalcoholic volunteers. Members of one experimental group were drinking alcohol throughout the study. The patients of the other experimental group received no alcohol and were in withdrawal from alcohol. The glucose tolerance tests were carried out on each patient on admission to the hospital and 1 wk later. During the test, blood was drawn at 10 min intervals for glucose, immunoreactive insulin, and glucagon determinations. The results indicated that there was transient carbohydrate intolerance in the great majority of both patient groups, and it became evident that the carbohydrate intolerance was the result of continuous alcohol consumption and was not part of the withdrawal syndrome. Significant decrease in insulin secretion was found in the early part of the glucose tolerance tests in the majority of the patients in both alcohol and withdrawal groups. Based on results of this study and evidence from the literature, it is suggested that chronic alcoholism is dabetogenic in susceptible individuals and that the transient carbohydrate intolerance found in our study represents and early step in the development of adult-onset diabetes eventually developing in a significant number of chronic alcoholics.
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PMID:Mechanism and significance of carbohydrate intolerance in chronic alcoholism. 68 69

477 cases of femoral head arthroplasty for fresh femoral neck fractures were reviewed to study the various factors modifying life prognosis during the first six months (age, associated disorders, type of prothesis, postoperative complications). Certain of these factors were found to affect prognosis unfavorably: bad general health, alcoholism, psychiatric or neoplasic disease, diabetes, and also, to a less degree, senility, neurologic and sensorial disturbances, cardiac deficiency. A rate table makes it possible to make a prognosis on the basis of these different factors.
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PMID:[Femoral neck fracture treated by head arthroplasty: factors of life prognosis. 477 cases (author's transl)]. 74 May 20

The karyomgrams of normal human livers (50 biopsides from patients of varied age) and of fatty livers (350 biopsies from patients with diabetes, alcoholism, and fatty cirrhosis) were investigated. The nuclear diameters were measured with an analyzer of particle size--the "TGZ-3 Zeiss"--, the cut surface of the nuclei was determined and the nuclei categorized accordingly. 1. The normal liver in each age group is characterized by a well-defined nuclear pattern that is specific for this organ. In the 3rd decade nuclei of the main class predominate. In later decades 2 classes of large nuclei gradually appear and reach their mximum after the 50th year. In the 7th decade a reduction of the cut nuclear surface takes place in all the categoreis, presumably determined by a reduction of function. 2. The increase in the number of large nuclei is explained by abortive karyokineses which in the course of the normal turnover of cells ("Zellmauserung"), increasingly replace normal mitoses. This is This is attributed to disturbances of the achromatic apparatus that occur with increasing age. 3. Alcoholic, and even more so diabetic, fatty change leads to the formation of particularly large nuclei. This appears to depend on the volume of the individual fat droplet within the individual cell rather than on the degree of fatty change of the whole liver. 4...
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PMID:[The karyogram of normal and of fatty livers in man (author's transl)]. 80 91

Analysis of twenty five personal observations of septic osteoarthritis compared with information from the literature led the authors to the following conclusions: 1) Diagnosis of septic osteo-arthritis must be considered when confronted with a picture of acute or subacute arthritis generally inflamed with variable fever, raised sedimentation rates and frequently polymorph neutrophilia, above all especially if there are particular antecedents (local trauma or intra-articular injection, conditions which favor infections: diabetes, alcoholism, impaired immunity, corticosteroid therapy or various therapeutic immuno-suppresives). 2) It may be established on absolute criteria (isolation of the organism at the site of the lesions) or, in the absence of direct bacteriological evidence, by a body of evidence amongst which 4 arguments are of particular value: identification of a pathogenic organism in one or more blood cultures and/or at the site of a closed infection, postive serology and particularly elevation of the antistaphylolysine titres, rapid-onset radiological changes of destruction and/or reconstruction. plus hypercellularity of the fluid greater than 100,000 cells/mm3. 3) Medical treatment sometimes includes local treatment (joint aspiration, local injection of antibiotics) and in all cases immobilisation during the acute phase and systemic antibiotics. The latter will vary according to the organism responsible and its sensitivity. It seems useful to continue this for twelve weeks at the minimum in the normal form, initially making use of the combination of 2 antibiotics and preferably using continuous perfusion and/or intramuscular routes during the first half of treatment. 4) The consistently good results of such medical treatment seem to limit considerably the place of surgery for which the indications have become rare during the acute phase and even more so at later stages.
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PMID:[Nontuberculous infectious osteoarthritis in adults (excluding spondylodiscitis) in rheumatology]. 85 89


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