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

Scleredema diabeticorum is characterized by a dramatic increase in the thickness of the skin of the posterior neck and upper back. Of the 17 scleredema patients diagnosed by us in the last 15 yr, 16 have had type II diabetes mellitus. In a prospective study of 484 diabetic outpatients we found the prevalence of scleredema to be 2.5%. Angina pectoris was the only complication that occurred significantly more frequently in scleredematous diabetic patients than in a control group of diabetic patients without scleredema. Scleredema diabeticorum is a distinct cutaneous condition peculiar to diabetic individuals and ought not to be confused with scleredema of Buschke or scleroderma.
Diabetes Care
PMID:Scleredema diabeticorum: a common and distinct cutaneous manifestation of diabetes mellitus. 685 9

Autonomic dysfunction leads to a variety of clinical disorders involving all parts of the gut. These neural disorders are distinct from the four other recognised categories of disorders involving myogenic function, myoelectric activity, hormonal regulation and abnormal humoral factors. Criteria for establishing that a disorder has a neurogenic aetiology vary in different diseases. Absence of a neural mediated response with intact muscle function has been the major criterion used in most studies. Neural mediated responses of peristalsis, sphincteric relaxation and intestinal contraction following distension or feeding are the major parameters of assessment. Abnormalities in neural function have been demonstrated in achalasia, symptomatic diffuse oesophageal spasm, diabetes mellitus, amyloidosis, scleroderma and chronic idiopathic intestinal pseudoobstruction. The anatomical site and type of gut neurological disorder varies in each condition. Morphological studies have been helpful in demonstrating specific intranuclear inclusion bodies in some pseudoobstruction patients, and vagal and ganglionic lesions in achalasia. Intact muscle ad myoelectric function as well as normal responsiveness to drugs acting directly upon muscle may be established by morphological study. Advancement in basic technology should provide a rewarding area for future study of the pathogenesis and treatment of the gut neurological disorders.
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PMID:Clinical aspects of autonomic nerve dysfunction of the gut. 695 Dec 65

Two cases of Addison's disease, two cases of scleroderma, three cases of primary hypothyroidism possibly due to Hashimoto's thyroiditis, three cases of diabetes mellitus, and two cases of ovarian failure and secondary amenorrhoea were diagnosed in a single family. In 44 members of four generations of the family including all the diseased, we have performed HLA typing and measurement of circulating autoantibodies. All diseased patients were older than 12 years, all possessed HLA B8 antigen, and all but two showed specific autoantibodies in their serum. In contrast, none of the family members without HLA B8 developed any of the autoimmune diseases in spite of the fact that in 13 of them some circulating autoantibodies were demonstrable in the serum. It is concluded that genetic factors play an essential role in the development of autoimmunity in the studied family. The individuals acquire circulating autoantibodies as they develop the disease. Environmental factors play a secondary role as evident from the age dependence. HLA typing can become an important diagnostic tool in identifying the individuals at a risk of autoimmune disease. Detection of circulating serum autoantibodies alone correlated poorly with the autoimmune disease.
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PMID:Correlation of the HLA-A1,B8 haplotypes with circulating autoantibodies in a family with increased incidence of autoimmune disease. 698 Dec 77

A patient with progressive systemic sclerosis (scleroderma) and anti-insulin receptor autoantibody-induced diabetes mellitus was found to have pancreatic islet beta (B) cell hyperplasia by computerized morphometry and immunohistochemistry. Unlike most previously reported cases of islet cell hyperplasia, where the islet cell hyperactivity produced disturbed glucose metabolism (hypoglycemia, this case illustrates compensatory islet cell hyperplasia in response to a perturbation in glucose metabolism by insulin-receptor blockade with resultant hyperglycemia.
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PMID:Insulin receptor autoantibody-induced pancreatic islet beta (B) cell hyperplasia. 704 48

Aspects of cytotoxicity followed by cytolysis have been described by many authors in neoplasias. Using scanning electron microscopy, the authors have investigated the cellular population from 179 patients with various chronic internal diseases such as: chronic hepatitis, diabetes mellitus, systemic lupus erythematosus, scleroderma, chronic lymphocytic leukemia. In some of the forms of disease with severe clinical and biological phenomena, they have detected the presence of "killer" type phenomena, having as target cells either the monocytomacrophage or the T or B lymphocytes. Iconographic aspects are demonstrating the presence of this phenomenon, observed particularly in the peripheral blood. Detection of such phenomena is assumed to provide information on prognosis of the chronic disease investigated and on the effects of therapy at cellular level.
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PMID:"Killer"-type phenomena in the immune pathology of some chronic internal diseases. (Scanning electron microscopy studies). 715 19

Microvascular involvement in scleroderma is well recognized. Macrovascular disease is not. OBJECTIVE. To test the hypothesis that the prevalence of macrovascular disease is increased in patients with limited scleroderma (systemic sclerosis, lSSc). METHODS. A retrospective cohort study design was employed in which the prevalence of macrovascular disease in all female patients from specified hospitals (1974-90) with lSSc of at least 5 years' duration was compared and contrasted with that in a comparable group of controls. Each control was matched to one lSSc case by sex; age (+/- 5 yrs); number of inpatient admissions (+/- 2); year of last hospital admission (+/- 2 yrs), history of hypertension, cigarette smoking and diabetes mellitus, and medical record number most closely approximating the case. The distribution of vascular disease was assessed in the peripheral, coronary, and cerebral arterial territories. RESULTS. Peripheral macrovascular disease (PVD) occurred in 18 (58%) of the lSSC patients and only 3 (9.6%) of the controls (RR = 6.0; 95% CI 2.0-18). Of the 18 lSSc cases, 8 had PVD documented angiographically, 4 by arterial Doppler ultrasound, and 6 had absent peripheral pulses. Five of these required subsequent partial limb amputation. Two of the 3 controls with PVD had absent peripheral pulses, and 1 had an angiographically documented abdominal aortic aneurysm. No control required limb amputation. There was no significant difference in the prevalence of coronary artery or cerebrovascular disease between the groups. CONCLUSION. The prevalence of peripheral large vessel occlusive disease is increased in lSSC and associated with severe morbidity.
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PMID:Limited scleroderma is associated with increased prevalence of macrovascular disease. 778 63

Pain, swelling, or impaired function of the hand or wrist may be the result of one of several chronic or acute conditions, including tendinitis, arthritis, infection, or trauma. The first step in diagnosing a hand or wrist disorder is a detailed history. Include a review of the medical history, as many systemic disorders (eg, psoriasis, diabetes mellitus, rheumatoid arthritis, and scleroderma) may affect the hand and wrist. In the physical exam, assess motions of the cervical spine and those of all joints in the symptomatic extremity. A simple neurologic evaluation is required to assess function of the major nerves in the upper extremity. X-rays are indicated in any patient with hand or wrist pain.
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PMID:Hand and wrist disorders: how to manage pain and improve function. 788 98

A 21-year-old housewife with maturity onset type diabetes of young people developed scleredema diabeticorum, scleroderma-like skin thickness on forearms and dorsum of hands, digital sclerosis and cheiroarthropathy. She had diabetes mellitus since the age of 11 years. Her grandfather on the mother's side, her mother and 3 of 5 her mother's brothers and sisters have diabetes mellitus. Blood glucose was 295 mg/dl. Urinary glucose was 5.3 g/day. Nail fold capillary microscopy revealed a progressive systemic sclerosis pattern. Histologically, hematoxylin and eosin sections from back and forearm skin demonstrated broad collagen bundles separated by widened clear spaces throughout the thickened dermis.
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PMID:Diabetic scleredema and scleroderma-like changes in a patient with maturity onset type diabetes of young people. 818 15

Disturbances of small bowel motor function are increasingly recognized in clinical practice, either in the setting of an underlying disease that may affect the neuro-hormonal control of gut motility, such as diabetes or scleroderma, or as part of unexplained intestinal dysfunctions such as the irritable bowel syndrome or chronic idiopathic intestinal pseudo-obstruction. In the absence of endoscopic or radiological mucosal disease, it is often clinically helpful to define the motor function of the small bowel to understand the origin of the patient's symptoms. The hydrogen breath test after a lactulose oral load is currently used to measure mouth to caecum transit time. However, the reproducibility of this test is poor, and the range of normal values is wide. Scintigraphic determination of small intestinal transit time overcomes some of the limitations of the hydrogen breath test. This is however a time consuming procedure--up to 10 hrs when the time for acquisition, processing and analysis is included--and the costs prohibit widespread application of the technique. It is further restricted by the exposure to ionising radiation, particularly if repeated evaluations are necessary, for example in drugs trials. Manometry records mechanical activity of the bowel and detects quantitative and qualitative changes of small intestinal motility. As with scintigraphy, high costs and radiation exposure limit its usefulness. The major clinical application of the technique is in the diagnosis of chronic intestinal pseudo-obstruction.
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PMID:[Evaluation of small intestinal motility]. 821 Oct 47

A retrospective analysis of 30 angiograms in 29 patients performed at Doctor's Hospital since June of 1989 was carried out. Of these, 15 patients with 16 involved extremities presented with no antecedent trauma and significant symptoms of arterial insufficiency with impending digital necrosis. Eleven were female and four were male. Underlying medical problems included renal failure in four, diabetes in two, scleroderma in two and vasculitis in one. A unique group of six patients had no prior underlying medical problems. All six patients were female and all were smokers. A surprisingly high incidence of major arterial occlusion was noted. The radiographic features appeared distinct from the common causes of vascular insufficiency in the hand, that is, Raynaud's, thromboangiitis obliterans (Buerger's disease), and ulnar artery thrombosis from repetitive microtrauma (hypothenar hammer syndrome). This review is intended to discuss the evaluation and management of this group of patients.
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PMID:Diagnosis and treatment of atraumatic vascular insufficiency of the upper extremity: female smoker's syndrome. 850 76


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