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

A clinical, histopathologic, laboratory and therapeutic study in 44 subjects with "superficial vasculitis", consecutively observed during the last two years, has been carried out. The findings showed that 1. the anamnesis was sometimes not relevant; 2. the clinical pictures were not in a regular manner correlated with histologic reports (a polymorphonuclear infiltrate with leukocytoclasis or a lymphomononuclear + one); and 3. a non-correlation between clinical, histologic and etiologic data. Infectious agents were responsible, mostly pyogenic bacteria, Mycobacterium tuberculosis, and hepatitis B virus; Chlamydiae were rarely responsible, whereas the etiologic role of Toxoplasma was uncertain. In this respect, drugs were not relevant. All these agents seem to act on the immunological response of the patient with previous microvascular changes (diabetes, chronic venous insufficiency). The latter condition seems to play a predominant role: the recovery of the lesions and/or their relapse shows the same behaviour both in case of etiological and symptomatic therapy.
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PMID:[Clinico-pathogenetic observations on the subject of "superficial vasculitis"]. 236 4

The occurrence of hepatocellular carcinoma in a 22-year-old man with thalassemia major is reported. As a result of transfusional hemochromatosis, this patient had already developed diabetes, hypogonadism, heart failure, and the sicca syndrome; he was serum and tissue HBsAg negative. Liver iron concentration measured postmortem was found to be 50 times normal. Multiply transfused patients are at risk of developing hepatocellular carcinoma. Serial measurements of serum alpha-fetoprotein should permit early detection of the tumor and reduce mortality. Preventive measures include early immunisation against hepatitis B virus and prevention of iron accumulation by intensive use of desferrioxamine. Treatment of hemochromatosis-associated hypogonadism with androgens should be considered with caution.
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PMID:Hepatocellular carcinoma in thalassemia major. 243 Dec 57

Eighty-two consecutive Caucasian adults (52 males, 30 females, aged 17-86 years) with membranous glomerulonephritis were prospectively evaluated for possible aetiological factors 1-4 weeks after renal biopsy. Presumed causes were identified in 17 patients (21%) as follows: drugs in five (D-penicillamine 3, captopril 1, fenoprofen 1); malignancy in four; chronic thyroiditis in three; systemic lupus erythematosus (SLE) in two; secondary syphilis in one; hepatitis B virus (HBV) infection in one and non-insulin-dependent diabetes mellitus in one patient. Except for age (patients with secondary membranous glomerulonephritis were older), clinical presentation and histological stage distribution did not differ between the secondary and the primary groups. Ten out of the 17 patients with secondary membranous glomerulonephritis (59%) achieved complete clinical remission within 12 months. The incidence of associated conditions in adults with membranous glomerulonephritis in this study corresponds with that reported in the few previous series. Although membranous glomerulonephritis is deemed to be idiopathic in most cases, it seems warranted to search for medication, malignancy, SLE, HBV infection, syphilis and thyroiditis as possible aetiological factors. Further evaluation should be orientated by the clinical context. An improved outcome of membranous glomerulonephritis may be expected insofar as the underlying condition is controlled.
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PMID:Aetiology of membranous glomerulonephritis: a prospective study of 82 adult patients. 251 87

The quality of prenatal care offered in health centers (HC) and in the hospital (H) have been compared. Two samples were evaluated. One consisted of 476 pregnant women seen in HC and another of 213 who were seen in H. Five out of the 22 selected markers did not show differences in both levels (date of delivery; weight gain in g/week; measurement of uterine weight and height; and hypertension detection). Ten markers were better fulfilled in H than in HC (obstetrical formula; gynecological examination, fetal heart beats and edema examination; detection of diabetes, urinary tract infection and anemia). By contrast, there were seven markers that were better fulfilled in HC (serological tests for syphilis and hepatitis B; treatment of urinary tract infection and anemia; and compliance with follow up). The better fulfillment of the markers in H might be due to the recent inclusion of prenatal care programs in HC. The fact that in the first level of care the controls are earlier and more frequent shows that this level facilitates the access of pregnant women to services and their follow up.
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PMID:[Comparative study of the quality of prenatal care at health centers and hospitals]. 251 96

Radioimmunoassay and enzyme-immunoassay were used to study the detection rates of HBsAg and anti-Delta in blood donors and subjects at high risk of infection with hepatitis B (HB) in the Byelorussian SSR. The republic was found to belong to the region with a moderate prevalence of HB and low prevalence of delta-virus infection. The detection rate of anti-delta antibodies in individual population groups depends on the level of HBsAg carrier state and is closely associated with prolonged treatment in medical institutions. Patients with tuberculosis, rheumatoid arthritis, diabetes mellitus, and cirrhosis of the liver are important reservoirs of HB and delta-virus infection for a region with moderate prevalence of HB virus and low prevalence of delta-virus. Infection with delta-virus is very important in unfavourable outcomes of acute and chronic viral hepatitides in the region.
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PMID:[Detection rate of antibodies against delta virus among HBsAg carriers in a region with moderate prevalence of hepatitis B]. 253 51

The ethical distribution of health care is a central issue now that AIDS has started to be a drain on health care resources. If the worst predictions are true, the next half century will be capitalized by a great stress of the health care delivery system in the Pacific. The critical challenges that face the current leadership are: sustaining commitment to all levels of administration to reduce social and health inequities; making sound decisions on policies, priorities and goals that are based on valid information; strengthen health infrastructure, based on the principle of primary health care, including appropriate distribution of staffing, skills, technology and resources. The goals of the Pacific Health Promotion and Development center must not focus exclusively on AIDs. Hepatitis B control measures, hypertension and diabetes, primary care in remote areas, and rehabilitation initiatives must be kept in place. Humanitarian interests for AIDs patients must be balanced with the pragmatic reality of saving children's hearing, or extending useful lives. The attributes of respect, accountability, leadership, judgement, fairness, integrity and honesty controlled by principles of social justice must be part of the administrative decision making process. The 2 major issues facing public health professional are: (1) the financial considerations involved with increasingly expensive technology, services and research, contrasted against the need to prioritize their use and development; (2) pragmatic and ideological needs must be balanced to maximize preventative and curative services and make them available to those who can benefit from them.
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PMID:The ethics of health service delivery: a challenge to public health leadership. 262 19

A case-control study was carried out to explore possible risk factors of primary hepatocellular carcinoma (PHC) in Taiwan. One hundred thirty-one PHC patients and 207 hospital control patients were interviewed and blood samples were collected for blood type and hepatitis B virus (HBV) infection marker tests. Eighty-three percent of the PHC patients were found to be hepatitis B surface antigen (HBsAg) positive as compared with 21.0% of the control patients with an odds ratio (OR) of 21.5. Hepatitis B e antigen (HBeAg) positive status increased the risk of PHC. No significant association was observed between erythrocyte genetic markers and PHC, except c of the Rh system, which was significantly lower in the PHC cases. As compared with the control patients, the PHC patients had a higher proportion with a history of liver diseases and more siblings affected with liver diseases. However, the variables such as cigarette smoking, alcohol drinking, peanut consumption, frequent intake of raw fish, heart diseases, peptic ulcer, malaria, hypertension, diabetes, color blindness, G-6-PD deficiency, surgical operation, blood transfusion, and liver diseases of parents and children were not found to be associated with PHC.
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PMID:A case-control study of primary hepatocellular carcinoma in Taiwan. 284 88

Several investigators have reported high levels of gamma-glutamyl-transpeptidase (GGT) in the diabetic population. Therefore, we undertook a study to see the prevalence of 'isolated' high GGT in a large population of diabetics without chronic liver disease (CLD), as compared to an age- and sex-matched control group of non-diabetic subjects without CLD, and the role of extrahepatic factors in 'isolated' high GGT, as possible etiopathogenetic causes. We selected 351 diabetics with normal hepatologic screening, without echographic abnormalities of the hepatic parenchyma or the biliary tract. Age, duration and therapy of diabetes, body mass index (BMI), alcohol consumption, glycosylated hemoglobin (HbA1), and the presence of hepatitis B virus (HBV) were studied to see if they are related to high GGT. The control group included 260 age- and sex-matched non-diabetic subjects. We did not find any significant difference between diabetics and the control group in the prevalence of high GGT (mean: 17.5% vs. 23%; women: 16% vs. 14.5%). Multiple regression analysis showed that alcohol consumption plays the major role in the high GGT of both men and women.
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PMID:gamma-Glutamyl-transpeptidase in diabetics: a case control study. 290 Jul 6

Twenty patients with well controlled Type 1 (insulin-dependent) diabetes of at least 10 years duration and 47 control subjects were vaccinated against the hepatitis B virus using the Hevac B vaccine. The vaccine was administered into the deltoid region on three occasions at intervals of 1 month. Thereafter a fourth dose was given to subjects still negative for antibody to hepatitis B surface antigen (HbsAb). The median rise of HbsAb titres was 230 mIU/ml in normal subjects and 50 mIU/ml in diabetic patients (p less than 0.001). Eight patients (40%) failed to reach HbsAb titres above 30 mIU/ml, the level considered to give optimal protection against the infection, whereas only one normal control subject failed to reach this level. Five patients (25%) showed no response despite a fourth dose of the vaccine. There was an increased frequency of HLA-DR7 in low responders and a decreased (less than 1.5) helper/suppressor lymphocyte ratio. Diabetic patients are thus less likely to mount a protective antibody response following vaccination against hepatitis. Since hepatitis B surface antigen is reported to be considerably more common in diabetic patients than control subjects, infection with hepatitis B virus may have a greater risk of chronicity in diabetes.
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PMID:Reduced protection against hepatitis B virus following vaccination in patients with type 1 (insulin-dependent) diabetes. 296 92

Routine obstetric screening for all patients should include a Pap smear, urinalysis and urine culture, complete blood count, blood type, Rh factor and direct Coombs' test. Patients should also be screened for syphilis, rubella, gonorrhea and diabetes. For patients at high risk for certain conditions, additional studies of value include obstetric ultrasound, amniocentesis, serum alpha-fetoprotein level and screening for sickle cell anemia, herpes, hepatitis B, Chlamydia and human immunodeficiency virus.
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PMID:Prenatal screening. 328 2


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