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

Infections of the lower extremities in patients with diabetes mellitus have been attributed to Staphylococcus aureus and other facultatively anaerobic bacteria. However, a review of 30 consecutive diabetics who required surgery for lower-extremity infections revealed that 17 had mixed infections due to both obligate and facultative anaerobes; only six had infections due to S. aureus. Mixed infections often had characteristics of anaerobic suppuration and responded poorly to therapy. Patients with mixed infections required more operations than did those with staphylococcal infections, and their surgical wounds healed more slowly. Seven patients had infections with mixed enteric bacteria (neither anaerobes nor S. aureus), and their response to therapy was intermediate between that of the patients with mixed anaerobic infections and those with staphylococcal infections. Nine additional patients with mixed anaerobic infections were treated with cefoxitin; three required amputations at a level above the ankle, but six patients improved and required only limited surgery that preserved foot function. Bacteroides fragilis was the anaerobe isolated most often. Cefoxitin (less than or equal to 20 micrograms/ml) inhibited all of the anaerobes isolated from the nine patients and 97% of an additional 135 consecutive clinical isolates of B. fragilis; 98% of 54 strains of Bacteroides oralis and all of 34 strains of Bacteroides melaninogenicus were also inhibited. These in vitro results and the results of our clinical study show that cefoxitin is a promising antibiotic for therapy of foot infections due to a mixed flora of anaerobes in diabetics.
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PMID:The fetid foot: lower-extremity infections in patients with diabetes mellitus. 31 25

Indications, selection of donor and recipient, medical and surgical management and complications, problems of organ procurement. Renal transplantation has become routine therapy. Organs are predominantly obtained from cadavers, transplantations from living donors are rarely indicated. Advances in preservation methods have improved organ quality and prolonged storage time. Selection of the most suitable recipient is based on histocompatibility matching. Blood transfusions before transplantation seem to improve the results. Recognition of a rejection crisis is primarily based on clinical symptoms. Persistent rejection calls for prompt explantation and the patient has to return to dialysis. Infections, serum-hepatitis and gastro-intestinal bleeding are the most common complications. Late complicatons are diabetes mellitus, cirrhosis of the liver, osteopathy, recurring glomerulonephritis, and, rarely, malignomas. Transplantation frequency in the Federal Republic of Germany could be increased by more awareness of physicians and a better knowledge of the general public about the need for cadaver donors.
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PMID:[Kidney transplantation from a nephrological-urological viewpoint--results and problems. 2. Diagnosis and therapy after transplantation, complications, long-term results]. 33 52

The mortality in listeric meningitis and septicaemia, the two main clinical manifestations of the infection, is generally considered to be high. However, co-existing disorders rather than the listeric infection itself seem to determine the outcome. In the present study of 72 listeric infections among non-pregnant adults, 28 patients without co-existing disease had a fatality rate of 10.7% as compared to 57.9% among 19 immunocompromised individuals. Finally, in a third group of listeric patients, including alcoholics and people with heart disease or diabetes mellitus, the fatality rate was 24.0%.
Infection 1979
PMID:Outcome of Listeria monocytogenes infection in compromised and non-compromised adults; a comparative study of seventy-two cases. 43 92

Impairment of cell-mediated immunity has been described in chemically-induced as well as mutation diabetes in the mouse. The present report examines the host-parasite relationship during the acute phase of schistosomiasis mansoni in the mutation diabetic mouse (db/db). Cercarial penetration and maturation and egg output by adult worms were similar in the db/db mice and their littermate controls (db/+). In contrast, the pathological consequences of schistosomiasis were much less in the db/db mice. The mean liver weight computed as a percentage of body weight in db/db mice was 4.6 +/- 0.2 and following 8 weeks of infection it was 5.7 +/- 0.3 (difference is not statistically significant), whereas in infected db/+ mice it was 7.2 +/- 0.5. Infection in db/+ mice increased their mean portal pressure by 124% in contrast to an increase of only 12% in db/db animals. The most striking difference was noted in the mean granuloma diameter in the liver: 402 +/- 35 micrometer in db/+ in comparison to 147 +/- 10 micrometer in db/db mice (P less than 0.001). This study demonstrates the crucial role of the host granulomatous response in the causation of disease due to Schistosoma mansoni. Furthermore, it underlines the decreased pathological consequences when the host granulomatous response is suppressed, which can be compared to the response of modulated animals with chronic schistosomiasis.
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PMID:Host-parasite relationship in schistosomiasis mansoni in the mutation diabetic mouse (db/db). 45 35

Diabetic myelopathy occurred in 41% of 75 consecutive, unselected diabetic patients in an autopsy study; clinical peripheral neuropathy occurred in 13%, and histologic radiculopathy in 21%. Infection represented 2.7% of the cord lesions. Posterior column demyelination, seen in 27%, apparently has the same metabolic-toxic origin as diabetic neuropathy and radiculopathy; it is an independent lesion, not a secondary manifestation of peripheral demyelination. It occurs slightly more frequently in those with juvenile-onset diabetes. Spinal cord infarcts, seen in 19%, are related to anteriolar sclerosis of the intrinsic vessels of the spinal cord. They have a higher incidence in diabetics than in a nondiabetic aging population, show a predilection for the white matter, and are usually small. The myelopathy is not related to patient age or duration of diabetes. It is often clinically occult.
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PMID:Diabetic myelopathy. 58 Nov 51

Patients with end-stage renal failure shouldn't be denied the only possibility of cure just because they're old or have other chronic diseases. In this study of 69 patients over age 50-the largest series reported from a single medical center-kidney transplants from related donors had the same high rate of success as in younger patients. Over 80 percent of the patients who received kidneys from their children or siblings are still alive, in contrast to 52 percent of those who had to settle for a cadaver kidney. Infection posed the most serious hazard after surgery. Late complications, particularly hypertension and diabetes, were easily controoled and by no means debilitating. Four of the survivors still need hemodialysis, but over two-thirds have recovered completely.
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PMID:Kidney transplants in patients over 50. 78 13

In search of urinary tract infections 3185 gynaecological patients and 1600 pregnant women were examined by means of TTC-Test. 12.8% of the gynaecological patients and 12% of the pregnant women showed bacteruria. A special disposition to urinary tract infection was found by patients suffering from descensus, fistula of urogenital system and by gravid women with toxaemea of pregnancy and diabetes mellitus. Infection through E. coli was found to be dominating and the germs showed a relatively high sensitivity against Chloramphenicol and Nifurantin now as before. Problems of diagnosis and therapy are discussed. The necessity of most effective screening methods, of early diagnosis and of interdisciplinary team-work is pointed out.
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PMID:[Significance of urinary tract infections in gynecologic diseases and in pregnancy]. 91 92

There is reported about a case of vulvitis, which was resistant to usual forms of therapy. Infections as such of Candida or of Trichomonas as well as diabetes could be excluded. But there could be proved an incidence of Ancylostoma duodenale, which is nowadays more often to be observed. Adequate therapy was successful.
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PMID:[Vulvitis due to ancylostoma duodenale (author's transl)]. 96 93

We reviewed the records of 17 cases of Fournier's gangrene that had been diagnosed and treated in the Urology Service of the Marques de Valdecilla Hospital from 1982-1991. The series comprised male patients aged 32 to 77. Eleven cases (64.7%) were due to a known cause, above all infection. Most of the patients had factors that predisposed to the development and progression of the disease, predominantly diabetes mellitus (5 cases, 29.4%). The clinical features frequently corresponded to those of acute infection, with high fever, chills, pain, nausea and vomiting that could progress to a septic state. The local symptoms and signs included pain, swelling, erythema and necrosis, depending on the compromised area. Infection was usually caused by Gram-negative bacteria, particularly E. coli, although Gram-positive bacteria and anaerobes have been observed. Mixed bacterial infections have also been observed. Treatment must be instituted early using a combination of broad spectrum antibiotics that cover both aerobes and anaerobes, and wide surgical debridement of the compromised area. In some cases hyperbaric oxygen therapy may be warranted. The disease continues to be severe. In the present series, the outcome was favorable in 12 cases (70.5%) and there were 5 deaths (29.4%).
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PMID:[Our caseload in Fournier's disease]. 129 42

A large end stage renal failure population treated by chronic ambulatory peritoneal dialysis (CAPD) was examined for rates of infection, CAPD modality failure and patient survival (N = 347). Nearly half were considered high risk for survival for reasons of age (39% older than 60 years), diabetes mellitus (33%), hemodialysis access failure (10%), poor cardiopulmonary reserve (16%) or technical challenges (30% had morbid obesity, history of abdominal aortic aneurysm repair or multiple abdominal surgeries). Hence, CAPD was often initiated by default rather than choice in the 347 patients studied (mean age: 51 +/- 17 years). Infections greatly outnumbered technical failures as grounds for cessation of CAPD. Over 5521 patient-months, 51% of patients developed infection with peritonitis predominating (80%) when compared to exit site infections (20%). The frequency of infections was 1.9 mean episodes per patient; however, 55% of these patients had only one episode of peritonitis. A rate of 0.75 infections per patient per year was seen with an average interval of 16 months between infections. Technique and patient survival rates at 4 years were 50% and 61% respectively. High risk status does not preclude successful CAPD and should not preclude its implementation.
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PMID:Single center success with a high risk peritoneal dialysis population. 136 61


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