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

Phase contrast microscopy has been used for examination of urinary sediments from 19 patients with hydronephrosis. Casts were seldom seen. A raised number of erythrocytes was seen only in association with catheter, calculi or diabetes. A raised number of leukocytes was seen in patients with bacteriuria. A striking observation was the finding of a great proportion (64%) of histiocyte-like cells in six out of 12 cases in whom a differential count was performed. The proportion of histiocyte-like cells was small (14%) in cases with bacteriuria or history of urinary tract infection.
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PMID:The urinary sediment in hydronephrosis. 7 Sep 64

A few rare syndromes have been delineated in which diabetes mellitus is inherited in association with other conditions. This paper describes five patients, including four siblings in one family, who have diabetes insipidus, diabetes mellitus, optic atrophy and deafness (the DIDMOAD syndrome). The parents of both families are normal but are first cousins. All the patients have insulin-dependent diabetes mellitus with a typical juvenile-onset. The onset of diabetes insipidus was insidious and the symptoms could easily have been ascribed to poor control of diabetes mellitus. The importance of diagnosing diabetes insipidus is that all these patients had dilatation of the urinary tract varying from mild hydroureter to severe hydronephrosis and this improved with treatment of the diabetes insipidus. It is suggested that patients with diabetes mellitus and optic atrophy should have regular screening tests for diabetes insipidus since it is likely that they represent cases of the full syndrome with incomplete clinical expression. The occurrence of this rare syndrome in four siblings of unaffected parents indicates that the syndrome is due to a recessive gene, but the pathogenesis is unknown.
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PMID:Recessive inheritance of diabetes: the syndrome of diabetes insipidus, diabetes mellitus, optic atrophy and deafness. 94 48

Four Sudanese children with DIDMOAD syndrome (diabetes insipidus, diabetes mellitus, optic atrophy and deafness) are reported. They were two boys (aged 15 and 16 years) in one family and a boy and a girl (aged 16 and 6 years, respectively) in another family. Diabetes mellitus was first to appear (at 3-8 years) followed by deafness and visual failure; and the disease ended fatally in one patient (aged 20 years). In the other three, diabetes insipidus was confirmed using water deprivation test for 8 hours. The maximum urine osmolality ranged between 131-523 mOsm/kg, whereas the corresponding plasma osmolality ranged between 315-332 mOsm/kg. Slight further improvement in urine concentration was observed in 2 of the patients following the use of desmopressin (DDAVP, 20 micrograms intranasally). Intravenous pyelography, voiding cystourethrography and ultrasound revealed severe bilateral hydronephrosis, dilated ureters and distended bladder without vesicoureteral reflux in the three patients. With the high rate of consanguinity prevalent in North Africa and the Middle East, we recommend examining children who present with diabetes mellitus in this region for features of DIDMOAD syndrome.
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PMID:Diabetes insipidus, diabetes mellitus, optic atrophy and deafness (DIDMOAD syndrome). A clinical study in two Sudanese families. 187 84

Differentiation of uncomplicated pyelonephritis versus complicated pyelonephritis has always been problematic. No clear physical signs or symptoms are diagnostic. To study differences between the two, we retrospectively reviewed charts of patients admitted to Charity Hospital, New Orleans, with febrile urinary tract infections. Criteria for inclusion were pyuria, positive urinary culture, and signs or symptoms of pyelonephritis. All patients underwent renal ultrasonography (US) before other diagnostic tests. US identified a potential emergency (hydronephrosis or abscess) in 11 of 98 patients (11.2%). The only significant contributing factor was the presence of diabetes mellitus, which was present in five of 11 emergent conditions and eight of 73 of the remainder (P = 0.003). US is inexpensive, easily obtainable in the emergency room, and sensitive enough to screen patients with pyelonephritis for complications. However, we believe it is mandatory in diabetics, because of the high incidence of abnormalities in this population.
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PMID:Ultrasonography in the differentiation of complicated and uncomplicated acute pyelonephritis. 223 41

We report a case of primary localized amyloidosis of the bladder which manifested post-renal failure. A 79-year-old woman with diabetes mellitus complained of anorexia and oliguria. Computed tomographic (CT) scan showed bilateral hydronephrosis. Cystoscopic examination revealed a broad-based nonpapillary tumor in the trigonum of the bladder and CT scan demonstrated thickening of the posterior wall of the bladder. Pathological examination of the transurethral biopsy specimen revealed amyloid deposits in the submucosa, but no malignant changes were found. Cytodiagnosis of washing fluid of the bladder revealed amyloid deposits around the exfoliative cells. Serum electrophoresis showed a normal pattern. Urinary Bence-Jones protein was not detected. Amyloid deposits were not found in rectal mucosa. Systemic or secondary amyloidosis was ruled out from these findings, and primary localized amyloidosis of the bladder was diagnosed. The mass of the bladder was transurethrally resected and pig-tail stents were indwelt. These procedures gave a satisfactory result.
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PMID:[A case of localized amyloidosis of the bladder manifesting post-renal failure]. 268 67

Clinical and pathological analysis of 66 cases of fibromatoses are presented. The age range in our series was 1 to 72 years. Superficial fibromatoses occurred predominantly in older patients with a peak incidence in the fifties while deep fibromatoses occurred predominantly in younger patients with a peak incidence in the twenties. Male to female ratio was 1.4 to 1. The abdominal fibromatosis occurred in female while our palmar fibromatosis occurred in male. There were 17 cases (26%) of multiple fibromatoses which occurred most frequently on both palms and had a tendency to symmetric distribution. The latent period between the two fibromatoses in a patient ranged from 1 year to 36 years. Clinical presentations included a palpable nodule or mass; flexure contracture of finger; penile hypertrophy, contracture, or discomfort on erection; and soreness, tenderness, or paresthesia over the tumor. Hydronephrosis may be complicated by intraabdominal fibromatosis. Size of the tumors ranged from 0.5 cm. To 30.0 cm. Three cases were associated with diabetes mellitus, 2 with alcoholics, 1 with liver cirrhosis, 2 with pulmonary tuberculosis, and 3 with hepatocellular carcinoma, cholangiocarcinoma, and mammary papillary carcinoma, respectively. Nine cases (14%) were associated with variable types of trauma, including being hurt by a stick, intramuscular injection in the gluteal region, tying penile shaft with a plastic band, breast massage and hot applying, and operation on abdomen. The superficial fibromatoses seldom recurred after excisional biopsy or fasciectomy while the deep fibromatoses often recurred. The recurrent rate of the deep fibromatoses was 21%. Malignant transformation or spontaneous regression was not found.
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PMID:[The fibromatoses. A clinicopathological study of 66 cases]. 281 66

The authors reviewed 102 cases of bilateral renal enlargement seen on excretory urography (excluding hydronephrosis and duplex kidneys) to determine the clinical significance of this finding. Associated abnormalities were found in 48 patients, including diabetes mellitus in 29; nondiabetic obesity, large body structures, or chronic steroid use in 16; acromegaly in 1; and unknown etiology in 37, 2 of whom were found to have diabetes five years later. Because of the striking preponderance of diabetes in this study, a fasting blood glucose analysis is recommended for patients with unexplained bilateral renal enlargement on excretory urography.
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PMID:Diabetes mellitus: the predominant cause of bilateral renal enlargement. 648 64

From March, 1976 to June, 1983, 22 patients (10 males, 12 females) treated by maintenance hemodialysis were autopsied in our department. Primary diseases of the autopsied cases were chronic glomerulonephritis (12 cases), diabetes mellitus (three cases), hydronephrosis (three cases), systematic lupus erythematosus (two cases), myeloma kidney (one case) and atherosclerosing nephropathy (one case). Direct causes of death in maintenance hemodialysis patients were bleeding (six cases), uremia (three cases), infection (three cases), carcinoma (four cases), heart failure (two cases), myocardial infarction (one case), brain ischemia (one case), cardiac tamponade (one case) and unknown (one case).
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PMID:Autopsy findings in maintenance hemodialysis patients. 653 69

Selective hypoaldosteronism is defined as diminished production of aldosterone, and sometimes also of 18-hydroxycorticosterone, with otherwise intact adrenal function. A decrease in the secretion of potassium and H+-ions and in the reabsorption of sodium in the distal nephron may result and lead to hyperkalemia, hyperchloremic acidosis, and impaired renal sodium conservation. The form of hypoaldosteronism which occurs in the adult is characterized by the following additional features: the aldosterone deficiency is due in the majority of cases to a decrease in enzymatically active plasma renin ("hyporeninemic hypoaldosteronism"), while various endogenous mechanisms as well as certain drugs (prostaglandin inhibitors, beta-blockers) may contribute. Other disturbances of the renin-angiotensin system (e.g. during treatment with converting-enzyme inhibitors) may rarely be responsible. Abnormalities in adrenal cortical synthesis may sometimes coexist, but proof that adrenal enzymatic defects play a primary pathogenic role in selective hyperaldosteronism in the adult is lacking. Such patients are frequently older (greater than 50 years), and often have diabetes mellitus and/or nephropathy (diabetic, interstitial, or hydronephrosis). Hyperkalemia and acidosis tend particularly to develop in association with mild to moderate impairment of renal function. The differential diagnosis should include other causes of impaired renal potassium secretion (Addison's disease, renal resistance to mineralocorticoids, potassium-sparing diuretics). Moreover, possible extrarenal factors contributing to hyperkalemia (oral potassium intake and redistribution of intracellular/extracellular space, particularly with associated insulin deficiency) should also be considered. For treatment, dietary potassium restriction is recommended as a general step. Replacement with the mineralocorticoid fludrocortisone acetate usually reverses the hyperkalemia and acidosis, but may sometimes induce sodium retention and hypertension. Loop diuretics, potassium-exchanging preparations and/or bicarbonate may also be useful as alternatives or additives.
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PMID:[Hyporeninemic hypoaldosteronism and the differential diagnosis of hyperkalemia]. 675 13

Kock's augmented and valved rectum was created in 10 patients following total cystectomy. During an observation period of up to 46 months, 4 patients died (1 from a recurrence of cancer, 1 from multiple organ failure subsequent to diabetes mellitus, 1 from coronary insufficiency, and 1 from cerebral hemorrhage). Post-operative complications included valve failure in 1, hydronephrosis in 2, and mild nocturnal urinary incontinence in another. Hyperchloremic metabolic acidosis was particularly notable in the cases without an intussuceptive valve of the rectum. Their base excess ranged from -6.9 to -15.0 mM/l but the condition was satisfactorily controlled by oral administration of alkaline agents. Although the present method has a number of shortcomings, the absence of a stoma and elimination of the need for self-catheterization are outstanding benefits. For these reasons, we believe that it is an effective option for urinary diversion.
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PMID:The augmented rectal bladder for urinary diversion: experience with the original valved rectum and a valve-less modification. 762 39


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