Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A survey on the burden and quality of care and the parental and primary care physicians' views on management of eight chronic illnesses and disabilities was conducted from 1990 to 1993. Data were collected on 993 children and adolescents from family interviews and physicians' postal questionnaires. Approximately 70% of patients used two or more services for care management and 149 children were treated outside their region. Only 36% of the physicians were case managers and half of these agreed that better communication with other care providers could facilitate their role. A wide difference in parental satisfaction was found between medical and disabling conditions. Approximately 90% of the parents expressed satisfaction with care for children with coeliac disease (112/120), asthma (80/89) and diabetes (98/111), whereas approximately one-third of parents of children with cerebral palsy and Down's syndrome were dissatisfied (88/242 and 72/189, respectively). Primary care physicians expressed similar satisfaction with case management. Distance from hospital, the need for more information on disease management and financial aid were the sources of greatest dissatisfaction. Children with disabling diseases had more problems integrating at school than children with other chronic disorders. Closer interaction between health services, providers and families is necessary to manage the needs of disabled (Italian) children better.
 ...
PMID:Parental and primary care physicians' views on the management of chronic diseases: a study in Italy. The Italian Collaborative Group on Paediatric Chronic Diseases. 856 30

The prevention of fetal asphyxia or hypoxia starts with prepregnancy counseling and continues with careful antenatal care and intrapartum fetal surveillance. Further progress in eliminating antepartum and intrapartum deaths will only be made when it is accepted that, even with intense investigation by detailed autopsy, the cause of many deaths remains unknown. Many of these deaths may be ascribed to hypoxia. In the future, with more detailed non-invasive probing with CAT scanning and magnetic resonance imaging, other causes may be determined. The mother at risk of hypoxia requires specialized attention. Such mothers will include those with severe cardiac, pulmonary or circulatory problems. Others will be those with endocrine problems, such as diabetes or thyroid dysfunction. At present, failure of fetal growth is generally ascribed to hypoxia, but undoubtedly, in solution to such problems of possible hypoxia is elective delivery at the appropriate time. What Hensleig said in 1986 (Hensleig et al, 1986) is equally true today: 'Preventative programmes will remain unsuccessful until the causation of cerebral palsy is more understood. What we are presently lacking is an understanding of the underlying conditions responsible for brain injury when asphyxia occurs despite our best efforts. While we have learned much about the causation and prevention of perinatal mortality very little has been established about the causation and prevention of cerebral palsy'. Finally, Hall (1989), in a review of birth asphyxia and cerebral palsy, concludes the following five points. 1. The incidence of cerebral palsy is not falling despite improved obstetrics. 2. The cause of more than 90% of cases of cerebral palsy remains unknown. 3. Asphyxia is hard to define and measure and is rarely the cause of cerebral palsy. 4. Hypoxic ischaemic encephalopathy is the most reliable indicator of asphyxia. 5. Neither traditional clinical signs nor electronic monitoring allow reliable recognition of asphyxia.
 ...
PMID:Asphyxia. 884 58

Latent coeliac disease (L.C.D.) is an extremely rare condition to describe. In this study we analyzed three cases of patients affected by L.C.D.: two of them suffered from insulin-dependent diabetes mellitus (IDDM) and the other one from infantile cerebral palsy and eosinophilic gastroenteritis. We confirm the existence of this form of coeliac disease (C.D.), by means of duodenal biopsy, and stress the importance of an early diagnosis in order to prevent the serious consequences caused by untreated C.D.
 ...
PMID:Latent coeliac disease. Personal experience. 1002 94

Shoulder dystocia is an unpredictable obstetric complication with the incidence of 0.15% to 2%. An increase in the incidence of shoulder dystocia has been recorded over the last 20 years, probably just because it has now been regularly registered at maternity wards as an obstetric complication. The risk factors for shoulder dystocia include fetal macrosomia, fetal malformations and tumors, maternal adiposity, excessive weight gain during pregnancy, diabetes mellitus, pathologic pelvis, multiparity, short maternal stature, advanced maternal age, postterm pregnancy, so-called midforceps delivery or vacuum extraction, prolonged delivery stage II, oxytocin labor induction, premature fetal expression according to Kristeller, and previous shoulder dystocia in macrosomatic children. The sequels of shoulder dystocia and obstetric maneuvers for incarcerated shoulder release include clavicular fracture, brachial plexus lesions, sternocleidomastoid muscle distension with or without hematoma, diaphragmatic paralysis, Horner's syndrome, peripartal asphyxia and consequential cerebral lesions (cerebral palsy), and peripartal death. Maternal complications due to shoulder dystocia are postpartal hemorrhage, cervical and vaginal lacerations, frequent infections during the puerperium, symphysiolysis and rupture of the uterus, and secondary cesarean section with related complications due to unsuccessful obstetric procedures or as continuation of Zavanelli's maneuver. McRoberts' maneuver (or Gaskin maneuver) is recommended as the initial procedure for shoulder release in case of shoulder dystocia. If it fails, other obstetric procedures such as Resnik's suprapubic pressure and Woods' grip with posteriorly placed arm release should be used, always with gross lateral episiotomy. The performance of all these obstetric procedures requires skilfull and highly experienced obstetrician and obstetric team as a whole.
 ...
PMID:Fetal shoulder dystocia. 1259 26

Prenatal risk factors causing cerebral palsy (CP), here defined as a non-progressive motor abnormality of tone or posture, are much more numerous than once believed, when a great deal of brain injury was attributed to factors surrounding delivery. Scientific advances in genetics and biochemistry, as well as clinical technical advances in, for example, amniotic fluid examination or fetal neuroimaging, has permitted us to find a multiplicity of new etiologies causing neonatal encephalopathy, most of which were formerly attributed to perinatal hypoxia-ischemia. This article reviews an expanded list of etiologies, including asphyxia, which has been found to cause only 6-10% of CP in full term infants, and periventricular leukomalacia, which is associated with 30-50% of CP in premature births. We also review a few of the genetic causes of CP, which lead to metabolic encephalopathies in come cases, to congenital anomalies in others, and sometimes to both. We discuss maternal gestational or intrapartum infections which may affect the fetus by direct in utero contagion or by other less direct means. Inborn metabolic errors affecting the fetus, such as diabetes, are touched on, as are the effects of maternal medications or recreational drugs on the fetus. Finally, we briefly cite the curious phenomenon occurring in multiple births, namely the potential of CP in the surviving infant or infants were the others have died in utero.
 ...
PMID:[Cerebral palsy: prenatal risk factors]. 1293 60

Schizophrenia is a psychiatric disease affecting around 1% of the population, the negative signs of which are correlated with inactivity of the prefrontal dorsolateral cortex, while an increased, more deeply localized, activity in the mesolimbic pathway may explain the positive signs. Several events occurring during pregnancy are likely to be involved in its genesis: hormonal supplementation by diethylstilbestrol, severe maternal denutrition, exposure to influenza virus, repeated psychological stress. From multicentric studies and meta-analyses in the psychiatric literature, the risk of schizophrenia appears to be multiplied by two if pregnancy is complicated, mainly by diabetes, Rhesus incompatibility, bleeding, preeclampsia, premature rupture of membranes and preterm birth. When delivery is linked to an abnormal presentation or happens via a caesarean birth for acute foetal distress, the time when the first signs of psychosis appear seems to be earlier in adolescence or in early adulthood. Cerebral imaging of schizophrenic patients shows ventriculomegaly and gray matter reduction, mainly in hippocampal volumes and in the dorsolateral prefrontal cortex. Similar alterations in the neuronal pathways have been experimentally reproduced in rats after repeated prenatal stress and perinatal hypoxia. A region on the distal portion of chromosome 1 has shown evidence for linkage to schizophrenia. Therefore, a two factor model seems to be able to explain the onset of schizophrenia in which obstetrical complications may interact with a genetic liability and in which the consequences of hypoxic events may lie on a continuum ranging from cerebral palsy in some children to subtle cognitive and behavioural disturbances in others.
 ...
PMID:Obstetrical complications and subsequent schizophrenia in adolescent and young adult offsprings: is there a relationship? 1514 May 4

Nesidioblastosis is a rare disorder in pediatric surgery. It is caused by hypertrophy and hyperplasia of the islands of Langerhans, and can lead to persistent hyperinsulinemic hypoglycemia. If appropriate treatment is delayed there is a high risk of the development of cerebral palsy, impaired mental development, epilepsy or other forms of irreversible brain damage, so early detection and early treatment to stabilize serum glucose levels is essential. Initial treatment consists of nutritional management with administration of an adequate amount of calories along with drug therapy using diazoxide. In cases that are resistant to drug therapy a subtotal pancreatectomy is performed. Conventional recommended practice has been to perform a 95% pancreatectomy, however this can lead to the onset of diabetes due to abnormal pancreatic endocrine function. We report here a case of nesidioblastosis in which we performed an 85% pancreatectomy. Postoperative clinical course has been excellent, with no recurrence or impaired glucose tolerance during the four years since the operation.
 ...
PMID:Nesidioblastosis treated successfully by 85% pancreatectomy. 1515 Sep 6

In the field of paediatric health care, measures based on consequences of health conditions have been recently developed to screen for children with special health care needs. These tools have been primarily used in survey research. The aim of this cross-sectional clinical study is to test the performance of a screener for identifying children with special health care needs (CSHCN) in a population of children with chronic conditions diagnosed and treated in different European paediatric hospitals. In the current study, the screener was employed in a sample of children with different chronic conditions (asthma, arthritis, dermatitis, epilepsy, cystic fibrosis, diabetes and cerebral palsy) across seven European countries; 456 parents of children, aged 4-7, 8-12, and 13-16 years, responded to the screener items. The study included a range of clinical measures to assess the severity of the conditions as well measures on functional health status. The prevalence of children identified positively with the CSHCN screener was 80%, which was higher than in survey estimates in the United States. Considerable variation in the screener classification was found between chronic conditions with cystic fibrosis and epilepsy showing higher rates, and skin conditions lower rates. There was no significant relationship between the screener classification and functional limitation. Findings of this study support in general the validity of the children with special health care needs screener, which shows, however, a differential validity across specific conditions. Several clinical and theoretical explanations for the lack of identifying some children with chronic conditions and the considerable variation between the conditions are discussed.
 ...
PMID:The performance of the screener to identify children with special health care needs in a European sample of children with chronic conditions. 1532 69

Health-related quality of life (HRQOL) assessment in children and adolescents with chronic health conditions is increasingly considered as a relevant topic. The aim of the EU-funded DISABKIDS project is to develop, test, and implement European instruments for the assessment of HRQOL of children and adolescents with disabilities and their families. The current paper describes the development and pilot testing of a chronic generic HRQOL measure. Using literature searches, expert consulting and focus groups with children/adolescents and their families, items of the instruments were developed and translated into the respective languages. A pilot test with 360 children and adolescents was conducted. Children and adolescents (8-12, 13-16 years) with different chronic health conditions (asthma, epilepsy, diabetes, arthritis, atopic dermatitis, cerebral palsy, and cystic fibrosis) as well as their families were included. Data were analysed according to predefined psychometric and content criteria. Psychometric analyses resulted in a 56-item chronic generic HRQOL questionnaire with six domains ('Medication', 'Physical', 'Emotion', 'Independence', 'Social Inclusion', 'Social Exclusion') with acceptable internal consistency.
 ...
PMID:Development and pilot-testing of a health-related quality of life chronic generic module for children and adolescents with chronic health conditions: a European perspective. 1604 2

The Illustrations of Moxibustion, a remained book in Dunhuang Caves, is now available the earliest monograph of moxibustion methods since having writing in our country. In this paper, the points selected and therapeutic methods in The Illustrations of Moxibustion are used for treatment of typical cases of cerebral palsy, rheumatoid arthritis, diarrhea due to gastroenteritis, impotence, premature, diabetes, asthma and so on to explore characteristics of using points, find out the law, test and verify the actual effect and find guiding values for modern clinic, indicating that The Illustrations of Moxibustion can be applied for treatment and rehabilitation of many kinds of refractory diseases with unique therapeutic effects and practical significance.
 ...
PMID:[Experience on clinical application of acupoints in the remained book of the Illustrations of Moxibustion in Dunhuang Caves]. 1632 Jul 54


<< Previous 1 2 3 4 5 6 Next >>