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

The authors observed 53 cases of diabetic ketoacidosis treated with low doses of insulin. Mean age of the patients was 41 +/- 17 years, duration of diabetes mellitus 7.5 +/- 6.4 years. Ketoacidosis was due to: infections in 36%, other diseases in 7%, and cessation of insulin therapy in 25% of cases. Ketoacidosis was a first sign of diabetes mellitus in 19% of cases while causative factor was not detected in 13% of cases. At the admission to hospital mean blood pH was 7.02 +/- 0.15, mean bicarbonate concentration 6.17 +/- 3.45 mM/l, and glycaemia 40.6 +/- 16.8 mM/l. Therapy of ketoacidosis was complicated by hypopotassemia in 1 patient and transient hypoglycaemia in another patient. Five patients (9.6%) died. Infections, myocardial infarction, acute pancreatitis, pulmonary edema, and disseminated intravascular coagulation were the causes of deaths.
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PMID:[Analysis of the cause of death in diabetic ketoacidosis based on 5 years of personal observation]. 251 62

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

Insulin-dependent (type 1) diabetes mellitus (IDDM) is due to the selective autoimmune-mediated destruction of pancreatic beta cells possibly initiated by viruses. To elucidate the possible role of viruses and cytokines in the pathogenesis of IDDM, we have examined the effect of reovirus infection on beta cell major histocompatibility complex (MHC) expression and the effect of interferon-gamma (IFN-gamma) and tumour necrosis factor-alpha (TNF-alpha) on beta cell function in vitro. Infection of RIN-m5F (rat insulinoma) cells with reovirus-1 or reovirus-3 was associated with a tenfold increase in class 1 MHC protein and mRNA expression. Reovirus infection did not induced the expression of class 11 MHC by RIN-m5F cells. Exposure of reovirus to ultraviolet light almost completely abolished its ability to induce class 1 MHC protein expression on infected cells. Murine islets cultured for 3 days with IFN-gamma and/or TNF-alpha had a significantly reduced insulin response to glucose, which was more marked with a combination of the cytokines. During 6 days of culture in IFN-gamma plus TNF-alpha islets underwent noticeable degeneration associated with an 80% reduction in insulin content. These findings together with previous data suggest viruses and cytokines may have multiple roles in beta cell destruction, indirectly through enhanced MHC protein expression and directly through functional impairment and loss of viability.
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PMID:Viruses and cytokines: evidence for multiple roles in pancreatic beta cell destruction in type 1 insulin-dependent diabetes mellitus. 254 35

Coxsackie B viruses are known etiological agents of pancreatic diseases, including diabetes. The pathogenesis of these infections is influenced by both host and viral factors. In this report, we examined whether the outcome of Coxsackie B4 virus infection is dependent on the genes within the major histocompatibility complex (MHC). We generated a pancreatic variant, CB4-V and established an animal model system of pancreatitis with concurrent hypoglycemia in mice. Infection of various B10 H-2 congenic strains of mice revealed that the development of hypoglycemia with accompanying pancreatitis was independent of the MHC haplotype. However, the severity of the disease as monitored by the extent and duration of hypoglycemia and by mortality rate was found to be associated with the H-2 haplotype, specifically the H-2Kq locus. Pancreatic damage induced by CB4-V appeared to be both immune-mediated and viral-mediated. Histological examination of pancreatic tissue from infected B10 H-2 congenic mice revealed an association between acute destruction of the exocrine pancreas and lymphocytic infiltration. This infiltration may correlate with immune-mediated destruction of the infected pancreatic tissue. Since preferential replication of CB4-V was not observed in the most susceptible B10 mouse strain, direct viral destruction may not be the major mechanism of pancreatic injury.
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PMID:Severity of disease induced by a pancreatropic Coxsackie B4 virus correlates with the H-2Kq locus of the major histocompatibility complex. 256 Feb 95

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

This study reports the morbidity that resulted from bacterial infections in Melanesian patients with non-insulin-dependent diabetes who attended the Port Moresby General Hospital, Papua New Guinea, between January 1, 1982 and June 30, 1984. Fifty-three of 160 patients with diabetes experienced 66 episodes of infection, 48 of which required inpatient hospital treatment. The average length of stay in hospital was 37.6 days per episode of infection. Of 88 patients who were newly-diagnosed as diabetic during this period, 30 patients initially had presented with a bacterial infection. The lower limb was the site that was infected most frequently, and Staphylococcus aureus and Klebsiella pneumoniae were the usual causative organisms. Eleven patients had bacterial gangrene of the foot; two of these patients were less than 23 years of age, and five patients were not known to have had diabetes previously. Five patients were suffering from pulmonary tuberculosis; the annual incidence of tuberculosis in this study group (12.5 cases/1000 patients) was about 11-times higher than that which has been reported for the general population. Thirteen patients with diabetes died in hospital during the study period. Infection was the cause of death in nine patients and three of these patients were less than 25 years of age. The morbidity of infection can be controlled if diabetes is sought more frequently in patients with infections, and if glycaemia can be controlled. This will have to be achieved through existing primary health-care structures, as resources for diabetes-specific preventive programmes in developing countries will be limited.
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PMID:Bacterial infections among patients with diabetes in Papua New Guinea. 264 92

Between February 1963 and January 1988, 174 patients were treated for acute and 307 for chronic renal failure by dialysis in the St. Joseph Hospital Eindhoven, a general hospital. Sixty-two per cent of the patients treated for acute renal failure had tubular necrosis as a cause. In the patients treated for end-stage renal disease the median age of the dialysis population increased from 37 to 62 years. Vascular renal disease and diabetes mellitus were more frequent during the last ten years. Because of the inflow of older people, the outflow by death increased strongly, while the outflow by transplantation remained stable during the last 15 years. Due to an active transplantation policy together with haemodialysis at home and CAPD, 66% of the total now living patient population could be discharged from the dialysis department. Infection and cardiovascular accidents were the major causes of morbidity and mortality among the dialysis and transplant patients. Overall survival curves of all treated patients showed a 5-year survival of 60% and a 10-year survival of 42%.
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PMID:[25 years of kidney replacement treatment at a general hospital]. 267 33

Infections observed after gynecologic surgical procedures are polymicrobial and require parenteral broad-spectrum antimicrobial therapy until the patient has been afebrile 24 to 72 hours. Therapy should be tailored to the specific infection and patient response thereto. When the infections are complicated by abscess or infected hematoma, combination therapy appears to be effective in a shorter period of time, and surgical drainage is infrequently necessary other than drainage of those in the supravaginal, extraperitoneal space. Administration of antibiotics immediately before surgery to women at high risk for postoperative infection has essentially eliminated pelvic infections. These infections range from cuff cellulitis through pelvic abscess and include pelvic thrombophlebitis. Pelvic infections and those in an abdominal, perineal, or vaginal incision can occur during the immediate postoperative period or after discharge from the hospital. As many as 50 per cent of these infections may occur after the patient is discharged from the hospital. Without question, the most appropriate means of objectively identifying infection rates, appropriate and inappropriate use of antimicrobials, and trends in morbidity is with an infection control program, usually consisting of an epidemiologist or specially trained nurses. Their contribution to appropriate patient care is significant. Information uncovered may put some clinicians on the defensive. This need not happen if gynecologic surgeons participate in and define criteria to be used for various infection diagnoses and similar situations. These diagnoses must be based on physical examination evidence, not "presumptive evidence." Antimicrobial administration and selection has an emotional component; objective evaluation avoids this bias. Optimal and efficient patient care is the goal and these programs should be established with that as their only goal. Several synergistic polymicrobial infections involve skin, subcutaneous tissue, and perhaps fascia; these are infrequently observed but require prompt recognition and antimicrobial therapy as well as wide surgical excision to healthy tissue to effect a cure. Clinical presentation extends to both ends of the spectrum with respect to degree of illness. These infections also occur spontaneously in gynecologic sites, and do so only in patients at high risk, such as those with diabetes, delibitating disease, advanced age, or evidence of arteriosclerotic disease. Another infection that was diagnosed and managed only surgically (that is, septic pelvic thrombophlebitis) can now be accurately diagnosed without surgery and can be adequately treated medically.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Infections after gynecologic surgery. 267 5

Infections of the distal finger have a varied presentation, course, and treatment. As in other hand infections, initial treatment should always include elevation of the extremity and the avoidance of snug clothing or constricting jewelry. Immunosuppressive states and systemic diseases such as diabetes must be considered, for they will alter the action of the causative organisms as well as the intensity of treatment that a patient will require. Appropriate, specific antibiotic treatment can be part of the initial treatment of acute felons and paronychias, but it should never replace adequate incision and drainage. Finally, "minor" finger infections are only minor when diagnosed and treated properly. If mistreated, their consequences can have long-term implications for both the individual and for society. It is important to understand the natural history, bacteriology, and anatomy of the distal finger if we are to return patients to their jobs with expedience and minimal long-term sequelae.
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PMID:The treatment of felons and paronychias. 268 Dec 34

Infections in the diabetic host have been shown to persist longer than those in the nondiabetic host. To investigate whether intra-abscess milieu might be a contributing factor to this persistence, the in vivo intra-abscess pH was measured in induced soft-tissue abscesses in diabetic and nondiabetic mice. Two models (female genetically obese insulin-resistant and male streptozocin-induced diabetic mice) were used with appropriate controls. The bacteria injected to produce the soft-tissue abscesses were Bacteroides fragilis and Enterococcus (B + E), Staphylococcus epidermidis and Enterococcus (S + E), and S. aureus (SA). Intra-abscess pH measured on day 3 was consistently and significantly lower in all diabetic mice compared with their controls. In the diabetic mice, the pH of an abscess induced with B + E, S + E, and SA was 6.28 (n = 17), 6.79 (n = 10), and 6.52 (n = 10), respectively; the pH in the controls was 7.21 (n = 20), 7.30 (n = 10), and 7.17 (n = 10), respectively. Differences in all groups between diabetic and nondiabetic mice were significant. The blood glucose values of the diabetic mice averaged 722 mg/dl, and in the nondiabetic mice were 210 mg/dl. No animals were ketotic. There were no significant differences in total colony counts between any groups. In conclusion, there is a significantly lower pH in the abscess of the diabetic host compared with the nondiabetic host that is not related to the numbers or types of causative bacteria.
Diabetes 1989 May
PMID:In vivo pH of induced soft-tissue abscesses in diabetic and nondiabetic mice. 271 21


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