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

A series of 30 patients who underwent transmetatarsal amputation over a 5-year period was analysed. The indications for amputation were gangrene, rest pain and ulceration. The mean age was 75 years and the male to female ratio was 3:2. A higher level of amputation was required in 50% of patients. Of a series of factors analysed for their influence upon outcome (age, diabetes, peripheral pulse status, pre-existing infection, smoking habits, previous digital amputation, prior sympathectomy and/or vascular reconstruction), none had any predictive value in terms of wound healing.
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PMID:Place of transmetatarsal amputations: a 5-year experience and review of the literature. 235 77

We have used polytetrafluoroethylene preferentially for bypasses to the above-knee popliteal artery since 1979. Since this approach has recently been challenged, we reviewed our experience with 138 grafts in 128 patients. The majority (74%) of patients were male with a mean age of 63.2 years. Risk factors included: smoking (85%), hypertension (55%), diabetes mellitus (45%), and coronary artery disease (41%). The indications for operation were disabling claudication (18%), rest pain (42%), gangrene/tissue loss (33%), and miscellaneous (7%). Perioperative (30 day) mortality was 3% and morbidity (excluding amputation or graft failure) was 5%. Patients were followed for up to eight years with a mean follow-up of 22.1 months. Grafts which remained patent, but did not prevent major amputation, were classified as "failed". Primary patency was 75% at one year and 54% at five years. Limb salvage was 88% at one year and 70% at five years. Risk factors, indication for operation and arteriographic runoff had no statistically significant impact on short- or long-term patency. However, bypass grafts to isolated popliteal segments had a significantly (p = 0.025) increased perioperative failure rate compared to all other grafts. Our data support the continued use of polytetrafluoroethylene for above-knee femoropopliteal bypass except perhaps in patients who require grafting to an isolated popliteal segment where higher early failure rates were seen.
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PMID:Preferential use of EPTFE for above-knee femoropopliteal bypass grafts. 189 36

This is a report on 153 patients (from 22 to 86 years of age) with acute ischemic gangrene of the lower limbs and severe concomitant diseases (ischemic heart disease, arterial hypertension, diabetes mellitus, etc.). Freezing of the necrotic limb with application of a tourniquet and general medical treatment were performed previous to amputation. Freezing was accomplished by dry ice and common ice in 16 patients and by a special refrigerator in 137 patients. 17 patients in a very grave condition died during refrigeration. Amputation of the lower limb was performed in 136 patients, 110 of them tolerated the operation favourably. Complications of wound-healing were observed in 23.1%.
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PMID:[Freezing of the extremity with acute ischemic gangrene before amputation]. 237 88

Doppler sonographic examination of 51 diabetic subjects showed that the macrovascular hyperemic response of the pedal blood flow was negatively correlated to the duration of the disease (p less than 0.01). In comparison with non-diabetic controls (n = 20), the response was increased by more than 210% in newly detected diabetics, but decreased by more than 20% in long-term diabetics. Vascular response was correlated also not only to the duration of the diabetes, but to peripheral neuropathy (p less than 0.001). The hyperemic response was reduced in patients with reduced nerve conduction time, or somatic neuropathy (142 + 152%, p less than 0.005), and in patients with reduced arterial pulsation, or autonomic neuropathy (152 + 88, p less than 0.005), both in comparison with non-diabetic controls (293 +/- 108%). The frequency of decreased macrovascular hyperemic response was in agreement with somatic neuropathy in 69.7% and with autonomic neuropathy in 75.8% of all patients. The results demonstrate that the macrovascular hyperemic response of blood flow in diabetic feet is already reduced at an early stage of peripheral neuropathy without peripheral vascular occlusive disease. The functional reduction of pedal blood flow may be important for the development of diabetic foot gangrene.
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PMID:Decrease of macrovascular hyperemic response of blood flow in diabetics with arterial neuropathy. 237 54

Femoropopliteal and crural bypass operations are performed frequently, but the results of operations for intermittent claudication and severe ischaemia are often reported jointly. However, the importance of the latter category for the quality of life is of a different order, so that its results should be studied separately. In a period of over eight years 199 bypass operation were performed. The cumulative proportion of preserved legs after three years was 82% for femoropopliteal and 68% for femorocrural transplantations. Factors such as presence of gangrene, diabetes mellitus and a systolic ankle blood pressure below 40 mm Hg were associated with a significantly smaller proportion of saved legs. The five-year survival rate for the group of patients as a whole was 42%, far lower than the 79% that applies to a comparable group of healthy persons. Cardiopathy was the main cause of death. Even if the number of remaining years of life is less, saving the leg by a bypass operation performed in time should be considered of major importance.
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PMID:[Results of bypass surgery for imperiled leg]. 238 97

Some indices of humoral and cellular immunity were studied in 98 patients with diabetes mellitus (DM), complicated with pyoseptic infection (phlegmon, abscess, gangrene of different sites, hematogenic osteomyelitis, furunculosis, sepsis). A course of hyperbaric oxygenation (HBO) was conducted. Multimodality antidiabetic therapy in combination with HBO resulted in the improved general status of almost all DM patients, stimulation of reparative processes and wound defect closure were faster; DM compensation was achieved and ketoacidosis stopped. Normalization of laboratory and clinical indices was accompanied by immunological tests. The use of HBO in multimodality therapy of patients with DM complicated with pyoseptic infection brings about a good therapeutic effect.
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PMID:[Hyperbaric oxygenation in the combined treatment of patients with diabetes mellitus complicated by a suppurative-septic infection]. 239 27

A 40-year-old male was admitted complaining of high grade fever, pain, redness and swelling of the right scrotum, right perineum and right flank region. He had no apparent history of previous infection or diabetes mellitus. At the time of admission, the scrotum was partly necrotic with repulsive feculent pus discharge and there was crepitus on palpation of involved areas. Culture of purulent discharge yielded the growth of anaerobic organisms. Surgical drainage was performed immediately and debridement of necrotic tissue in the involved areas was often repeated. At the same time, the patient received antibiotic therapy that included agents effective against anaerobic bacteria. However, the scrotal skin developed gangrene and the right testis hung suspended with cord exposed. This testis was intact. The scrotal skin defect was cured using a skin graft, after the infection had been brought under control.
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PMID:[Fournier's gangrene: a case report]. 239 63

Percutaneous atherectomy was performed using the Simpson Atherocath on 131 patients (87 male, 66%) with a mean age of 65 years. Clinical characteristics included evidence of significant coronary disease in 50%, hypertension in 46%, diabetes in 41%, and prior neurologic deficit in 32% of patients. The indication for atherectomy was claudication in 114 (87%) and rest pain, gangrene, or ulcer in 17 patients (13%). Atherectomy was successfully performed in 136/139 stenoses (98%) and in 56/56 occluded vessels with or without prior balloon angioplasty. No serious complications resulting in limb loss or emergency vascular surgery were encountered. Histopathology of retrieved specimens showed that 66% had atheromatous plaque, 45% had tunica media, and 30% had a form of thrombus. Material obtained from an occluded vessel was more likely to have thrombus and tunica media present than that from a stenosis (P less than 0.02 and P less than 0.05, respectively). Early angiographic follow-up (mean time, 17 weeks) showed a relatively low (17%) lesion recurrence rate. Percutaneous atherectomy can be successfully utilized in stenotic and occluded peripheral arteries with good success and no serious complications; stenoses appear to have a low recurrence rate.
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PMID:Percutaneous atherectomy of occlusive peripheral vascular disease: stenoses and/or occlusions. 252 70

Complications in 8793 hospitalised cases of diabetes in 14 years were present in 81.8 percent. It was equal in both sexes. They did not depend upon religious dietary habits or on economic condition/status of the patient. Hypertension was present in 42.2%. Ischaemic heart diseases in 27.2%. C.V.A. in 9.2% and gangrene and peripheral vascular diseases in 4.2%. Acute & chronic U.T.I. was in 31.4% and uraemia in 4.5% and K.W. Syndrome in 2.5%. In Infection Tuberculosis was in 5.9% and pyogenic skin infection in 4.1%. Vascular and renal complications increased with the duration of diabetes and with age in type II diabetes.
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PMID:Complications in 8793 cases of diabetes mellitus 14 years study in Bombay Hospital, Bombay, India. 259 29

Fibrocalculous pancreatic diabetes (FCPD) is a form of diabetes secondary to chronic, non-alcoholic pancreatitis in tropical countries. Being a secondary form of diabetes, vascular complications are believed to be rare. In this paper we present two case reports of macrovascular complications (myocardial infarction and gangrene). This shows that large vessel disease does occur in FCPD.
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PMID:Two case reports of macrovascular complications in fibrocalculous pancreatic diabetes. 262 52


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