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

In review, one is compelled to the notion that a variety of the aforementioned thoughts become pre-eminent in assuring quality. The selection of the tests available for home testing is crucial. They should be divided into categories of single encounter tests and multiple use tests. The single encounter implies a test that has an extremely high degree of reliability and is likely to achieve an answer to the question asked. This should relate to a disease or process for which potential favorable treatment can be achieved or which may have a major favorable impact on public health. In this category one thinks in terms of the worldwide prevalence of hepatitis B and other infectious diseases that are particularly common in third world countries. Yet, these are not "markets" likely to be able to afford this testing. Similarly, these societies are not currently sophisticated in terms of application of preventive measures. On the other hand, major benefits could be projected from the other category of testing, namely, therapeutic monitoring in the hands of individuals who will repetitively test for the same substance in the same manner. This includes not only diabetes but other conditions that are monitored for drug therapy, including seizure disorders and bronchospasm. Inherent in this aspect is the requirement for meaningful and ongoing instruction in proper testing methodology and recording of results. The incorporation of some type of memory device to enforce this aspect of testing appears extremely desirable, if not mandatory. Finally, we must consider the potential for misuse of the single test type of device. One suspects that it would be highly desirable that any test made available for self-testing should also be mandated as accessible through certified laboratories at the request of an individual, which would at least provide reliable performance of the test with a quality result. The development of the concept of quality assurance in home testing is in its infancy and will require continuing evolution.
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PMID:Quality assurance in home laboratory testing. 379 13

233 patients with erysipelas, admitted to the Department of Infectious Diseases, Danderyd Hospital, during a 2-year period were analysed for epidemiological, bacteriological and complicating features. Erysipelas was defined clinically as a febrile skin infection with a sudden onset of a red indurated expanding plaque with a distinct border. Common predisposing factors were alcohol abuse, diabetes mellitus and venous insufficiency, and complications were more common among such patients. No seasonal variation was found. 5% of patients with blood culture had streptococcemia (7/149). Erysipelas emerging from an infected ulcer was seen in 52% (122/233) and in 46% of these streptococci were isolated (57/122), 67% of which were of type A (38/57). Staphylococcus aureus was isolated from 59% of ulcerative cases (72/122) and in 3 of them staphylococci were found in the blood.
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PMID:Epidemiological, bacteriological and complicating features of erysipelas. 381 46

To identify the determinants of morbidity and mortality after hepatic lobectomy, we studied 17 potential risk factors in 58 consecutive patients who had right hepatic lobectomy (39 patients), left hepatic lobectomy (10 patients), extended right hepatic lobectomy (6 patients), and left lateral segmentectomy (3 patients). The lesions were benign neoplasm (11 patients), primary malignancy (12 patients), metastatic neoplasm (28 patients), and inflammatory conditions, namely, stones, ductal strictures, and abscess (7 patients). Two patients died (3.8 percent), one from operative hemorrhage and the other from sepsis. Major complications occurred in 29 patients (50 percent). The presence of diabetes or pulmonary disease correlated with the development of complications. Infection occurred in four of five patients with diabetes. The incision was extended into the thorax in nine patients, all of whom had complications. The mean weight of the resected specimen did not differ between patients who underwent thoracotomy and those who did not, but the two largest specimens (over 2 kg) were removed without thoracotomy. Minor complications developed in two patients with benign tumors. Biliary fistulas developed in three of seven patients with inflammatory conditions. Infectious complications were decreased in the presence of adequate perioperative antibiotics and closed drainage of the subphrenic space. These data show that in fit patients, elective liver resection can be performed with a low morbidity and mortality; diabetes, pulmonary disease, and inflammatory lesions increase the risk of hepatic resections; adequate antibiotics and closed drainage decrease the risk of infection; and thoracotomy markedly increases the chance of complications. Finally, since elective resection can nearly always be performed without thoracotomy, it should be avoided in most patients.
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PMID:Factors affecting the morbidity of elective liver resection. 381 94

Achromobacter xylosoxidans is an uncommon nosocomial pathogen known to cause many serious infections. A 69-year-old woman with diabetes mellitus and chronic renal failure was admitted with pulmonary edema. The patient developed fever and pulmonary infiltrate with bilateral pleural effusions while she was on a respirator in the intensive care unit. Culture of sputum, pleural fluid and blood grew A. xylosoxidans. Bilateral chest tubes were inserted and the patient was treated for one month with piperacillin and trimethoprim-sulfamethoxazole. Gradual response, both clinically and radiologically, was noted after prolonged therapy. A review of the literature on infections due to A. xylosoxidans, the unique susceptibility pattern of the organism to various antibiotics and the use of combination therapy in Achromobacter infections are discussed.
Infection
PMID:Infections due to Achromobacter xylosoxidans. Case report and review of the literature. 381 5

This is a report on 42 plantar abscesses in 40 patients with diabetes mellitus. Data concerning the mode of origin, the microorganisms involved, the antibiotics used, the end results or treatment, and the length of stay are given. Several typical cases are presented. Below-knee amputation can usually be avoided in diabetic patients with plantar abscess. The extremity can often be saved by a team consisting of specialists in infectious diseases, vascular surgery, and orthopaedic surgery.
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PMID:Plantar abscess in the diabetic patient. 383 Aug 49

Insulin sensitivity has been studied in ten young patients (22 years old means) and in eleven elderly patients (72 years old means). They were free of family diabetes history, glucose intolerance, hypertriglyceridemia, hepatic or renal failure or factor of insulin resistance such as infectious diseases. A two hours hyperinsulinic euglycemic clamp was done with an artificial pancreas (Biostator GCIIS Miles). The ten young patients and the eleven old patients had a stable hyperinsulinic level (93.3 +/- 5 uu/ml and 90 +/- 8 uu/ml) they respectively required 8.08 +/- 0.73 and 5.5 +/- 2.5 mg/kg/min of glucose. Metabolic clearance of insulin does not seem altered with aging. For a same hyperinsulinic level the glucose requirement is less in old patients. So there is an apparent insulin resistance in aging.
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PMID:[Peripheral sensitivity to insulin in aged subjects]. 390 77

The perianal mycotic flora was studied in proctological patients with and without pruritus ani, as well as in control subjects. Four groups of patients underwent perianal mycoculture. In Group 1, 53 patients with anal pruritus were treated for benign anorectal disease. In Group 2, 24 patients with no underlying disease presented with anal pruritus. Both of these groups underwent concomitant chemical and parasitical examination of the faeces and an oral glucose tolerance test. In Group 3, 50 patients without pruritus ani at present or in the past were treated for benign anorectal diseases. In Group 4, 47 surgical patients without pruritus ani were treated for benign (9) and malignant (38) non-proctological diseases. In Group 1 the mycoculture was positive in 24/53 patients (Candida albicans 14, dermatophytes 10). In Group 2 fungal infections were seen in 16/24 patients (C. albicans 7, dermatophytes 9). No parasites or diabetes were found in either group. In Group 3 C. albicans was isolated in 14/50 patients. In Group 4 C. albicans was found in 11/47 cases (2 in benign, 9 in malignant diseases). Infection by C. albicans was observed in all groups studied, independent of the presence of disease or anal pruritus. The presence of dermatophytes was always associated with pruritus ani.
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PMID:The mycotic flora in proctological patients with and without pruritus ani. 391 Jan 58

Due to new methods, including genic recombination, four anti-influenza vaccines are now available: whole inactivated virus vaccine; surface antigen (sub-unit); disrupted virus (split virus); live attenuated virus (used only in the USSR). The safest vaccine at the present time is the split vaccine, as it has been used on large populations (including children) for many years in Japan. Moreover, this is the only vaccine used in the USA on children (over three years of age). Systemic side effects of the split vaccine are exceptional (1 case in 5 million of subjects vaccinated) while local redness or fever are relatively more frequent. The following considerations make vaccination advisable in paediatrics: the increase in number of inpatients with respiratory and other diseases (e.g. febrile convulsions) during influenza epidemics; influenza is a diffuse and highly contagious disease which spreads in the population from children to adults. The split vaccine is not available in Italy, therefore vaccination in our country is limited to children at high risk for influenza related complications. As well as subjects aged over 65, the following children especially need to be vaccinated: patients with chronic disorders of cardiovascular and pulmonary systems (chronic asthma, cystic fibrosis, pulmonary disease due to inhalation) and some metabolic diseases such as diabetes mellitus or Addison's disease.
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PMID:[Anti-influenza vaccination in children]. 391 45

A 51-year-old male patient with diabetes mellitus complicated by ketoacidotic imbalance developed a rhinocerebral mucor mycosis that advanced despite early amphotericin B therapy and extensive surgical intervention. The MIC of amphotericin B for the isolated mucor species was 64 mg/l, meaning that in vitro resistance also existed. Only long-term treatment with ketoconazole (600 mg/day, perorally) was successful in curing the disease.
Infection
PMID:An amphotericin B-resistant case of rhinocerebral mucor mycosis. 392 96

Health economics research has shown pharmaceutical therapy to be a highly cost-effective modality of care in a variety of disease states. Specific examples include vaccines and products aimed at the treatment of infectious disease, mental illness, gastrointestinal disorders, diabetes, and cancer. A review of the characteristics of mitomycin (Mutamycin) for injection therapy and of patients with superficial bladder cancer facilitates examining mitomycin from the standpoint of cost effectiveness. Third-party payment programs, including Medicare and Medicaid, often provide coverage for intravesical chemotherapy for superficial bladder cancer. Methods for obtaining reimbursement for therapy associated with the management and treatment of superficial bladder cancer are suggested. Finally, the total cost of intravesical therapy is examined. Issues such as the cost of surgery and chemotherapy are discussed, as well as the importance of weighing intangible factors, such as lost work time, productivity, and social costs, into the sum of total cost of care.
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PMID:Economic aspects of treatment of superficial bladder cancer. 393 29


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