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

Sacral agenesis is a rare congenital anomaly of the spine and is usually associated with urologic abnormalities. Twenty-two patients are reviewed. Twenty-one had other congenital and developmental abnormalities in addition to sacral agenesis. Physical examination showed flattening of the buttocks, loss of the gluteal cleft, widely spaced buttock dimples, and a palpable sacral defect. Lateral views of the spine are essential when anteroposterior views suggest an absence of sacral segments. Seven patients had a significant familial history of diabetes mellitus. All patients with involvement of more than one sacral segment had neurogenic bladder dysfunction with incontinence. The degree of neurologic deficit could not be predicted from the radiologic appearance of the sacrum.
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PMID:Sacral agenesis. Analysis of 22 cases. 99 46

The aim of this study was to evaluate the prevalence of asymptomatic bacteriuria and its prognostic factors in a geriatric population living in a nursing home. Seventy-eight patients (68 females, 10 males) with a mean age of 82 +/- 6 years (range: 60-94) were studied. Once symptomatic infection is ruled out and the risk factors had been analyzed, a urine culture was performed in all cases. We then identified two different population groups: asymptomatic bacteriuria without risk factors (group A), and asymptomatic bacteriuria with risk factors (group B). Overall prevalence of asymptomatic bacteriuria was 38.5% (Group A: 23%, group B: 63%; p < 0.001). Considering all patients with bacteriuria, 50% of cases (15 out of 30 patients) had urine incontinence, 40% suffer from severe limitation of movements and 70% had a past history of pregnancy. The same figures for the population with negative urine culture were 12.5%, 14.5%, and 46% respectively (p < 0.01). In group B, 79% of cases had more than one RF, including all patients with the association of urine incontinence, movement limitation and diabetes. In group A, 93% of asymptomatic bacteriuria were due to E. coli with low adhesin expression (27%) whereas in group B, E. coli was isolated in 44% asymptomatic bacteriuria cases, with high adhesin expression (71.5%), other enteric gram-negative bacilli (31%), non-fermentative gram-negative bacilli (19%) and gram-positive cocci (6%). Group A patients were treated with a single dose of ciprofloxacin (500 mg) with elimination of bacteria in urine in 91% of cases (at one week) and 73% of cases (at one month).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prevalence and treatment of bacteriuria in the geriatric population]. 801 3

Fifty five patients between 65 and 89 years old who had their urinary problems assessed by urodynamics study were reviewed. The most common urinary symptom among males was urge incontinence, while retention and urge incontinence occurred with equal frequency among females. The commonest cause of retention in males was bladder outlet obstruction, while atonic neurogenic bladder was the most common cause in females. Urge incontinence was strongly associated with an unstable bladder, small bladder volume and Parkinson's disease. Retention of urine, and an atonic neurogenic bladder strongly correlated with diabetes mellitus. Three patients (out of 31) with unstable bladders also had detrusor external sphincter dyssynergia. Of these, two had Parkinson's disease. Although three patients were thought to have stress incontinence after history and physical examination, only two had stress incontinence with detrusor instability on urodynamic studies. The last patient had atonic bladder with overflow.
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PMID:Urinary symptoms and urodynamic diagnosis of patients in one geriatric department. 129 23

Treatment of acute urinary incontinence should be directed toward the underlying cause, such as infection, medication side effect, atrophic vaginitis, anxiety, depression and restricted mobility. Pharmacologic treatment depends on identification of one of the four subtypes of chronic urinary incontinence: stress, urge, overflow or mixed. Stress incontinence responds to alpha-adrenergic agents, which increase sphincter tone. Urge incontinence is the most common type of incontinence in the elderly; it can be treated with anticholinergic agents, smooth muscle relaxants, estrogen replacement therapy in women and, possibly, calcium antagonists. Overflow incontinence is caused by neurologic deficits, such as diabetes, or outflow obstruction, such as from prostatic enlargement, urethral stricture and tumors. Anticholinergic agents and alpha-adrenergic agents should be considered only after existing outflow obstruction is surgically corrected or intermittent catheterization is unsuccessful.
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PMID:Urinary incontinence in the elderly: pharmacologic therapies. 821 3

Disorders of gastric emptying are observed in many clinical situations. Their symptoms are diverse and correlate poorly with the objective abnormalities of gastric emptying. The underlying mechanism consists of abnormalities of basal electrical rhythm, fundic compliance, post-prandial antral motricity and, above all, antro-pyloro-duodenal co-ordination, associated to varying degrees. Among possible causes 3 clinical situations predominate: diabetes mellitus, functional gastrointestinal disorders (idiopathic dyspepsia) and sequelae of gastric surgery where retention of solids and accelerated evacuation of liquids may coexist in the same patient. Treatment of gastric incontinence rests, almost exclusively, on dietary measures, but several drugs, such as metoclopramide, domperidone and cisapride, are available to treat gastric stasis. Other compounds, notably motilin agonists (erythromycin and its derivatives) are currently being evaluated and will reinforce this therapeutic armentarium in a not too distant future.
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PMID:[Disorders of gastric emptying]. 138 39

To determine the prevalence of urinary incontinence, a questionnaire was administered to 2,911 women by 60 general practitioners, in April and May 1989. The first 50 women seen by the physician in his practice were included in the study. 1,075 women out of 2,911 (37%) declared the presence of episodes of incontinence. Among these 1,075 women, 77% had genuine stress incontinence, 60% urge incontinence, 35% spontaneous leakage. One out of five had these three conditions together. 12% of women with incontinence were less than 31 years of age, 36% were between 31 and 51 years, 20% between 51 and 70 years, and 31% above 70 years. Incontinent women were more frequently post-menopausal; 83% had children (74% for those without incontinence), but the parity was comparable in the two groups. Perineal tears, use of forceps for delivery, high-birth-weight children (above 3,500 g) were more frequently found in incontinent women; but not episiotomy. Incontinent women had more urinary infections, were more often obese, were slightly older at their first childbirth. Post-partum incontinence was found more frequently in incontinent women. A positive association is found with the presence of diabetes, neurological diseases, and chronic bronchitis and cough. Incontinent women more frequently underwent a gynecological surgical procedure, particularly hysterectomies. Incontinence had been present for more than 5 years in 34% of cases, one year in 77% of cases. Only 47 women out of 2,911 (1.6%) consulted specifically for their incontinence.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The prevalence of female urinary incontinence in general practice]. 146 26

Life expectancy and physical fitness of patients with neurogenic bladder dysfunctions is highly dependent on the urine status of the patient, and on the integrity and function of the upper urinary tract. Residual urine and urine incontinence give rise to infections, a vicious circle which ends with uraemia. Following nerve disorders can be the cause of a bladder dysfunction with outflow obstruction thus bearing the risk of ascending urine infection: 1) complete or incomplete spinal cord lesion, 2) myelomeningocele, 3) diseases of the CNS, 4) peripheral neuropathy (diabetes, chronic alcoholism, infectious diseases), 5) effect or side-effect of medications. An infravesical obstruction can occur at the alpha-adrenergic receptor site, at the level of the bladder neck or at the level of the striated external sphincter. The latter condition was termed detrusor-sphincter-dyssynergia. Instrumental bladder emptying for prevention of UTI can be achieved by: 1) catheterisation, 2) intermittent self catheterisation, 3) indwelling catheter--should be avoided for long term drainage, 4) suprapubic bladder drainage (cystocath)--the best treatment option for emptying the bladder and to avoid infections.
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PMID:[Neurogenic bladder as a cause of urinary tract infection]. 181 97

A survey of persons aged 60 years and over in Mae Sot in Tak Province, Thailand was conducted in 1989 to determine the prevalence of socio-economic, functional and medical problems. A total of 567 elderly persons from 8 villages systematically selected from 54 villages outside the municipality were interviewed and examined. Ninety-eight percent of them lived with their children or relatives. There were few elderly persons reporting difficulty performing basic physical activities of daily living due to the very low proportion of older elderly in this area. 13.3% of men and 14.5% of women reported some degree of urinary incontinence; however, most of them complained of only slight incontinence at occasional intervals. 62.4% of the study elderly had a body mass index below 20. The mean body mass index for men (19.5) was slightly higher than that for women (18.7). One hundred and two out of the 567 elderly surveyed were found to have hypertension and 51% of these hypertensives were newly diagnosed during this study. There was no association between the prevalence rate of hypertension and any of the other studied variables, including age, sex, educational level and smoking habits. The overall prevalence rate of diabetes in these elderly people was 1.6%. The mean body mass index of the diabetic group (23.1) was significantly (p less than 0.05) greater than that of the non-diabetic group (19.1). Special homes for the aged may become necessary in the future as young people migrate away from rural areas where their aging parents live to urban areas.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Assessment of socio-economic, functional and medical problems among the elderly in one rural community of Thailand. 181 79

Incontinence with onset in old age is due mainly to neurological factors, and in men to the presence of prostatic hypertrophy. Quite often, it is a combination of several different diseases that leads to urinary incontinence. A simple examination schedule suffices for a diagnosis in 90% of all cases. The examination schedule is presented. In the case of a non-inhibited neurogenic bladder, continence training is the most important therapeutic measure. However, various criteria must be observed if continence training is to be successful. The second most frequent cause of incontinence in women is a noncontractile muscle acontractility in the presence of diabetes mellitus. Suprapubic urinary puncture has considerable advantages over transurethral urinary diversion.
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PMID:[Urinary incontinence in old age]. 192 68

We measured anorectal sensory and motor function in 11 patients with multiple sclerosis and fecal incontinence, 11 continent patients with multiple sclerosis, 10 diabetics with fecal incontinence, and 12 healthy control subjects. The threshold volume at which patients with multiple sclerosis and fecal incontinence experienced rectal sensation was higher than that in healthy controls (42.7 +/- 6.2 mL vs. 13.3 +/- 2.8 mL; P less than 0.01) and was similar to that in incontinent diabetics (36.5 +/- 5.7 mL). Patients with multiple sclerosis and incontinent diabetics also showed increased thresholds of phasic external sphincter contraction compared with controls (P less than 0.05). Diabetics with incontinence had reduced resting and maximal voluntary anal sphincter pressures compared with controls (P less than 0.05), whereas patients with multiple sclerosis and incontinence showed only decreased maximal voluntary anal sphincter pressures (P less than 0.01 vs. controls and diabetics). Incontinent patients with multiple sclerosis also required smaller volumes of rectal distention to inhibit internal sphincter tone compared with diabetics and controls (P less than 0.01). Decreased maximal voluntary squeeze pressures were less severe in continent patients with multiple sclerosis than in incontinent patients with multiple sclerosis. We conclude that impaired function of the external anal sphincter and decreased volumes of rectal distention to inhibit the internal anal sphincter or both may contribute to fecal incontinence in multiple sclerosis. In addition, increased thresholds of conscious rectal sensation in some incontinent patients with multiple sclerosis and diabetes mellitus may contribute to fecal incontinence by impairing the recognition of impending defecation.
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PMID:Anorectal sensory and motor function in neurogenic fecal incontinence. Comparison between multiple sclerosis and diabetes mellitus. 198 43


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