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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several studies have demonstrated the efficacy of cyclosporin A in modifying the initial course of Type 1 (insulin-dependent) diabetes mellitus in older children and adults but none have reported the effects in very young children. We treated 14 newly-diagnosed Type 1 diabetic patients aged 22 months to 95 months with cyclosporin A. Mean insulin dose at entry was 0.7 +/- 0.07 IU.kg-1.day-1. Initial cyclosporin A dose was 10 mg.kg-1.day-1. Insulin dose reached a nadir of 0.13 IU.kg-1.day-1 by 180 days. Mean glucagon-stimulated connecting peptide levels were maximal at 6 months (0.75 nmol/l) and were maintained while on cyclosporin A. Insulin was discontinued in four patients for 4, 12, 15 and 30 months respectively. In five other patients the insulin dose was less than 0.15 IU.kg-1.day-1 for at least 3 months. Glycated haemoglobin levels for all patients were within the normal range. Side effects included anorexia, stomach pains, poor weight gain, hypertrichosis, gum hyperplasia, mild anaemia and elevated creatinine. All patients have now discontinued cyclosporin A and all but one have been followed for 5 years after discontinuation. Reasons for discontinuing cyclosporin A included exposure to chicken pox (varicella), non-resolving otitis media, incomplete or no response and relapse. All side effects have resolved since the treatment was discontinued. Following discontinuation of cyclosporin A insulin requirements and glycated hemoglobin levels increased while glucagon-stimulated connecting peptide levels declined dramatically.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cyclosporin A treatment of young children with newly-diagnosed type 1 (insulin-dependent) diabetes mellitus. London Diabetes Study Group. 139 85

The role of socioeconomic and anthropometric indicators, tobacco, alcohol consumption, dietary habits, and medical history in the etiology of soft-tissue sarcoma (STS) was examined in a hospital-based case-control study, conducted in the Friuli-Venezia Giulia region of northeast Italy, between 1985 and 1990. A total of 88 STS cases (53 males and 35 females; median age: 52 years) and of 610 controls (306 males and 304 females; median age: 54 years) were interviewed. There were significant excess risks associated with a history of herpes zoster infection (odds ratio [OR] = 2.4, 95 percent confidence interval [CI] = 1.1-5.3), chicken pox (OR = 2.2, CI = 1.2-4.3) and mumps in childhood (OR = 2.0, CI = 1.1-3.9). History of diabetes was also linked to a nonsignificant increase in STS risk (OR = 1.8, CI = 0.6-5.4), whereas exposure to radiation for diagnostic or therapeutic purposes was not related to the probability of developing STS. None of the investigated socioeconomic and anthropometric indicators seemed to affect STS risk; neither did tobacco smoking, nor consumption of alcohol, coffee, and tea beverages. Conversely, among the dietary habits investigated, a significant positive association emerged with an increasing frequency of consumption of dairy products (chi 2 for trend = 6.8, P less than 0.01) and oil (chi 2 for trend = 4.3, P less than 0.05), while a negative association was seen for intake of whole grain bread and pasta (OR for highest cf lowest tertile = 0.4, CI = 0.2-0.9).
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PMID:Non-occupational risk factors for adult soft-tissue sarcoma in northern Italy. 187 45

The paper describes two individuals presenting with acute insulin dependent diabetes mellitus for a brief and transient period. Both had had chicken pox infection in the immediate past. After establishing good diabetic control, insulin was withdrawn over a few weeks. Follow-up for the next two years did not reveal recurrence of diabetes. A causal relation between varicella zoster virus and the onset of diabetes is suggested.
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PMID:Transient diabetes following chicken pox. 226 90

Four hundred ten adolescents, ages 14-16 years, completed a questionnaire concerned with their understanding of the social and emotional consequences of AIDS and 5 other illnesses (lung cancer, German measles, chicken pox, asthma, and diabetes). Pupils distinguished between the diseases on all measured items, but younger pupils were more likely to believe that individuals were personally responsible for the onset of AIDS, lung cancer, and diabetes. The data are discussed in terms of the implications for health education campaigns.
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PMID:How adolescents compare AIDS with other diseases: implications for prevention. 232 12

A major part of the T lymphocyte response to mumps and Coxsackie B4 virus appears to be restricted by HLA-DR associated restriction elements. This was further corroborated in inhibition experiments using monoclonal antibodies reactive with different HLA class II molecules. Only antibodies reactive with DR molecules significantly inhibited the response. The frequencies of DR restricted antigen-reactive T lymphocytes (ARTL) to mumps and Coxsackie B4 virus were then investigated, using a limiting dilution assay. A decreased frequency of DR3 restricted ARTL to mumps and Coxsackie B4 was found compared to ARTL restricted by other DR associated elements. In contrast, an increased frequency of DR4 restricted ARTL to mumps and Coxsackie B4 was found. The results were similar for healthy individuals and Type 1 diabetic patients. No correlation was found between DR restriction elements and the frequencies of ARTL to varicella-zoster or PPD. The studies indicate that HLA-DR3 and DR4, which are associated with Type 1 diabetes, have a different regulatory function on the proliferative T lymphocyte response to mumps and Coxsackie B4.
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PMID:T lymphocyte responses to Coxsackie B4 and mumps virus. II. Immunoregulation by HLA-DR3 and -DR4 associated restriction elements. 241 85

The proliferative T lymphocyte responses to Coxsackie B4-, mumps- and varicella-zoster viral antigens were characterized. No significant difference in responsiveness was found between healthy individuals and patients with Type 1 (insulin-dependent) diabetes mellitus. Theophyllamine and verapamil decreased antigen-stimulated proliferation, whereas indomethacin in physiologic concentrations (1 microgram/ml) slightly increased proliferation. A major part of the response seemed to be restricted by HLA-DR molecules. Furthermore, for the mumps antigen the DR3- and DR4-determinants which are associated with Type 1 diabetes, seemed to have a different regulatory function on the T lymphocyte response in that an increased frequency of low responders was found among DR3 positive individuals and an increased frequency of high responders among DR4 positives.
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PMID:T lymphocyte responses to Coxsackie B4 and mumps virus. I. Influence of HLA-DR restriction elements. 299 51

To study the relationships between the responses to viral antigens and the HLA-DR3 and -DR4 associations in Type 1 (insulin-dependent) diabetes mellitus, the frequency of T-lymphocyte proliferating in response to mumps, Coxsackie B4 and varicella-zoster antigens was determined. A decreased frequency was found in T lymphocytes able to respond to mumps or Coxsackie B4 when presented together with DR3, as compared with the frequency of T lymphocytes able to respond to these viruses together with other DR determinants. This was not found for varicella-zoster or purified protein derivative of tuberculin. In contrast, an increased frequency was found in T lymphocytes responding to mumps or Coxsackie B4 together with DR4, compared with other DR determinants. The results were similar in Type 1 diabetic and healthy individuals. The results suggest that elements on the DR3 and DR4 molecules may control T-lymphocyte responses to mumps and Coxsackie B4 viruses.
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PMID:HLA-DR3 and -DR4 control T-lymphocyte responses to mumps and Coxsackie B4 virus: studies on patients with type 1 (insulin-dependent) diabetes and healthy subjects. 299 83

We conducted a randomized, double-blind comparison of prednisone and placebo (group I) v prednisone and azathioprine (1.5 mg/kg/day) (group II) as early treatment of extensive chronic graft-v-host disease (GVHD). Patients with platelet counts less than 100,000/microL were placed into therapy with prednisone alone (group III). All three groups received identical doses of prednisone (1 mg/kg every other day) and one double-strength trimethoprim-sulfamethoxazole (TMP-SMX) tablet twice daily. Between January 1980 and December 1983, 179 previously untreated patients were enrolled and 164 were evaluable. Patients randomized to group I (n = 63) and group II (n = 63) were well matched for prognostic factors; those placed into group III (n = 38) had more frequent acute GVHD and progressive onset of chronic GVHD. Median duration of therapy was 2 years. Complications included diabetes (5%), aseptic necrosis (5%) and infection. For groups I, II, and III, the respective incidence of infection was disseminated varicella, 11%, 24%, 34%; bacteremia, 6%, 11%, 34%; and interstitial pneumonia, 5%, 14%, 18%. Recurrent malignancy was the most frequent cause of death and did not differ significantly across the groups. Nonrelapse mortality, however, did differ: 21% in group I, 40% in group II, and 58% in group III (I v II, P = .003; I v III, P = .001). Forty patients in group I, 30 in group II, and 10 in group III survive with a minimum follow-up of 3.8 years. Karnofsky performance scores for 68 survivors are 90% to 100%, scores for seven survivors are 70% to 89% and scores for five survivors are less than 70%. Actuarial survival at 5 years after transplant is 61% in group I, 47% in group II, and 26% in group III (I v II, P = .03; I v III, P = .0001). Treatment with prednisone alone results in fewer infections and better survival than prednisone and azathioprine in standard-risk chronic GVHD. Treatment with prednisone alone is less effective in high-risk patients with thrombocytopenia, and other strategies are required.
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PMID:Prednisone and azathioprine compared with prednisone and placebo for treatment of chronic graft-v-host disease: prognostic influence of prolonged thrombocytopenia after allogeneic marrow transplantation. 304 41

The prevalence and incidence of diabetes mellitus in the age group zero to 14 years in Western Australia were determined from a survey by means of Schools Health Services. Additional information from the State's computer-linked hospital records system, the State's only children's hospital, diabetic clinics and physicians enabled virtually complete ascertainment of cases of childhood diabetes. Only 60% of school-age diabetic children were known to school nurses before the survey, but the nurses were able to identify two-thirds of the remainder during the survey. Among non-Aboriginal children, the prevalence of diabetes in the age group zero to 14 years was 0.59 per 1000 children and the incidence was 12.3 per 100,000 children per year. These rates are somewhat lower than those that have been reported from the United Kingdom and North America, and substantially lower than the rates that were reported from Scandinavia. All but one of the diabetic children who were identified required insulin and were assumed to be insulin-dependent. An excess of boys was found. None of 8715 Aboriginal or part-Aboriginal children had insulin-dependent diabetes mellitus, which indicates that this racial group has a low prevalence of this condition. In case--control studies, which used questionnaires for parents, no significant trends were found in relation to the history of immunizations or of specific viral illnesses except for a past history of varicella which was less frequent in diabetic children. A past history of established breast-feeding (of more than one week) was less frequent in diabetic children, as was the ingestion of vitamin C supplements before the onset of diabetes. Some evidence for a seasonality of onset was obtained. The diabetic children were absent from school for more days and had more admissions to hospital than did non-diabetic children. The majority of diabetic children were prescribed insulin twice a day or more often (84%); performed home blood-glucose monitoring (74%); and attended hospital diabetic clinics (91%).
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PMID:Diabetes in Western Australian children: descriptive epidemiology. 334 23

An analysis was conducted of the major findings of a long term follow up study of 3076 subjects who were exposed to viral infections in utero and who at the time of analysis were up to 40 years of age. Mortality and morbidity were compared with those in a control population matched for sex and date and area of birth. An excess of cancers (16 cases against seven) appeared to be clustered among those exposed to herpes viruses (varicella or cytomegalovirus). There was evidence of an increased risk of diabetes among those exposed to mumps during the first trimester (four cases among 128 subjects against none in 148 controls). The most surprising finding was a decrease of diseases of the skin and subcutaneous tissue and of the nervous system among subjects exposed to antenatal varicella zoster infection. The mechanism for the association may include production of fetal anti-idiotype antibodies in response to transplacentally acquired maternal autoantibodies.
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PMID:Long term effects of exposure to viral infections in utero. 391 51


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