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

The present study investigates the clinical significance of several possible causative or conditioning factors which have been proposed to be involved in the pathogenesis of dilated cardiomyopathy (DCM). By reviewing the medical records of 68 patients with DCM, we found a definite, and suggestive family history in 16%, and 28%, respectively, and antecedent flu-like symptoms in 43%. A history of hypertension was observed in 35%, habitual alcoholism in 49% and diabetic pattern on glucose tolerance test in 37%. We then classified the study patients into three groups; familial, myocarditic and acquired groups. The familial group showed advanced myocardial damage with the poorest prognosis. Abnormal T-cell subsets in this group suggested that genetically determined abnormal immune response is involved in the development of DCM. In the myocarditic group, endomyocardial biopsy demonstrated mononuclear cell infiltration in 53% and the myocardial damage and prognosis were of intermediate severity. The acquired group showed significantly more frequent histories of hypertension, habitual alcoholism or diabetes than their age- and sex-matched controls, suggesting that they developed the disease in association with these factors. The severity of hemodynamic impairment and myocardial damage was the least extensive and prognosis was relatively favorable in this group. These different clinical features in the three groups may provide evidence that these factors actually contribute to the development of myocardial damage in DCM and that the condition is a clinical syndrome associated with heterogeneous etiologies or conditioning factors. Determination and management of these factors would be of practical value in treating patients with DCM that has no established therapy against underlying etiologies.
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PMID:Dilated cardiomyopathy: clinical significance of possible related factors. 349 25

The immune response of diabetic patients to influenza vaccination was examined in 31 patients, 10 with Type 1 (insulin-dependent) diabetes and 21 with Type 2 (non-insulin-dependent diabetes), and in 19 normal subjects. Each received a single intramuscular injection of the 3 virus strains (A/Chile,A/Philippines,B/USSR) anti-influenza vaccine recommended by WHO. The antibody titre and the cell-mediated immune response to the 3 virus strains, as evaluated by the generation of activated lymphocytes and enumeration of B lymphocytes, were studied before and 18 h, 72 h and 1, 2, 3 and 6 weeks after vaccination. Overall, the humoral and cell-mediated immune responses were normal in both groups of patients. However, patients with Type 1 diabetes showed a statistically significant increase (p less than 0.01) of antibody titre of the A/Chile and an increased percentage of B lymphocytes one week after vaccination compared to age-matched control subjects. Four out of 21 patients with Type 2 diabetes had no antibody response to all 3 virus strains. A significant reduction (p less than 0.01) of the percentage of activated cells possessing receptors for interleukin-2 was observed 72 h after vaccination in patients with Type 2 diabetes compared to age-matched control subjects. None of the patients who received the vaccine developed influenza in the course of the following year. These results suggest that valid protection against the influenza virus can be obtained in patients with Type 1 and Type 2 diabetes.
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PMID:The immune response to influenza vaccination in diabetic patients. 356 90

Susceptibility to infection is assumed to be increased in diabetic patients, although its mechanism is unknown. The purpose of this study was to determine whether glycosylation of circulating immunoglobulins is related to the decrease of antibody activity in diabetic patients. Thirty-five patients with type II (non-insulin-dependent) diabetes and 14 age-matched normal controls were examined. Nonenzymatic glycosylation of serum immunoglobulin G (IgG) in vivo was measured by two different techniques, colorimetry and affinity chromatography. The levels of glycosylated IgG were significantly higher in diabetic patients than in normal controls. To evaluate the antibody activity of glycosylated IgG, anti-streptolysin O (ASO) titers after in vitro glycosylation of IgG and antibody titers before and after in vivo immunization with influenza vaccine were determined. IgG specific for streptolysin O purified by affinity chromatography decreased ASO titers after in vitro glycosylation. In diabetic patients, serum titers of hemagglutinin-inhibiting antibody against influenza viruses 4 wk after initial immunization were significantly lower than those in normal controls. These results indicate that serum IgG in diabetic patients was nonenzymatically glycosylated, and this modification in vivo might be associated with its functional alteration.
Diabetes 1987 Jul
PMID:Nonenzymatic glycosylation of serum IgG and its effect on antibody activity in patients with diabetes mellitus. 358 83

The antibody response and delayed type hypersensitivity reaction to commercially available trivalent influenza vaccine in 159 patients with diabetes mellitus was compared with response and reaction in 28 healthy volunteers. A correction for prevaccination titres was made. No differences were found between diabetic patients and control subjects with respect to antibody response to the three vaccine strains as measured by the difference between geometric mean titres of post- and prevaccination sera. In Type 1 (insulin-dependent) diabetic patients the incidence of non-responders to two vaccine components was significantly increased (p less than 0.05). The delayed type hypersensitivity reaction to influenza antigen was significantly decreased in patients with high concentrations of glycosylated haemoglobin (p less than 0.01). These findings suggest a role for impaired immune response in the increased influenza morbidity and mortality in patients with diabetes mellitus. Implications for therapy and vaccination strategy are discussed.
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PMID:Humoral immune response and delayed type hypersensitivity to influenza vaccine in patients with diabetes mellitus. 367 60

This study was designed to be an initial investigation of implicit models of illness, that is, the dimensional structure that organizes an individual's common-sense illness schema. Nurses, college students, and diabetics rated the qualities of two different diseases, one that was personally salient (i.e., flu or diabetes) and one with which they were familiar but did not have direct experience (i.e., cancer), on a 38-item Implicit Models of Illness Questionnaire (IMIQ). An exploratory factor analysis revealed a four-dimensional structure of illnesses composed of Seriousness, Personal Responsibility, Controllability, and Changeability. The stability of this four-dimensional model was established using confirmatory factor analysis to test the fit of this structure to the IMIQ data of another sample of subjects drawn from the same populations. The structure of this implicit model proved stable for judgments of different diseases and across groups of subjects, even though they differed in their physical-health status and occupational roles. The dimensions identified in the present study were compared to those described in other papers. Our dimensions seemed to be both personally and psychologically meaningful. The implications of this preliminary "generic" implicit illness model for future work in the field of health cognition are discussed.
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PMID:Implicit models of illness. 379 64

Due to new methods, including genic recombination, four anti-influenza vaccines are now available: whole inactivated virus vaccine; surface antigen (sub-unit); disrupted virus (split virus); live attenuated virus (used only in the USSR). The safest vaccine at the present time is the split vaccine, as it has been used on large populations (including children) for many years in Japan. Moreover, this is the only vaccine used in the USA on children (over three years of age). Systemic side effects of the split vaccine are exceptional (1 case in 5 million of subjects vaccinated) while local redness or fever are relatively more frequent. The following considerations make vaccination advisable in paediatrics: the increase in number of inpatients with respiratory and other diseases (e.g. febrile convulsions) during influenza epidemics; influenza is a diffuse and highly contagious disease which spreads in the population from children to adults. The split vaccine is not available in Italy, therefore vaccination in our country is limited to children at high risk for influenza related complications. As well as subjects aged over 65, the following children especially need to be vaccinated: patients with chronic disorders of cardiovascular and pulmonary systems (chronic asthma, cystic fibrosis, pulmonary disease due to inhalation) and some metabolic diseases such as diabetes mellitus or Addison's disease.
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PMID:[Anti-influenza vaccination in children]. 391 45

Ceftizoxime (CZX), a parenteral cephalosporin derivative belonging to the so-called third generation cephalosporin is reported to have a broad antibacterial activity, particularly against Gram-negative aerobic bacilli and some anaerobes, such as Bacteroides fragilis and a good stability to beta-lactamases. Clinical study was performed on a total of 20 cases, 9 females (1 case had urinary tract infection 3 times) and 11 males, aged from 27 to 82 years. All patients had the underlying diseases. They were bronchial asthma in 3 cases, influenza in 1, chronic pulmonary emphysema in 1, pulmonary fibrosis in 1, chronic bronchitis with strongyloidiasis in 1, lung cancer in 3, esophagus cancer in 2, stomach cancer in 1, hepatoma with urolithiasis in 1, liver cirrhosis with diabetes mellitus in 1, alcoholism with strongyloidiasis in 1, cholelithiasis in 1 and congestive heart failure in 1, respectively. Clinical diagnoses for infections were 2-acute bronchitis, 2-exacerbation of chronic bronchitis, 2-broncho-pneumonia, 2-pneumonia including one suspected case, 1-obstructive pneumonia, 2-secondary pulmonary infection, 1-pulmonary infection, 3-urinary tract infection (UTI), 1-UTI with sepsis, 1-sepsis, 1-sepsis with purulent meningitis, 1-biliary tract infection and 1-infected bronchoesophageal fistula. CZX was given by intravenous drip infusion, at a dose of 1 to 2 g, twice daily for 3 to 15 days. Because of severity in infections and underlying diseases, some cases were treated either steroid, gamma-globulin preparations or other antibiotics in combination with CZX. Twelve out of 15 cases assessed clinically responded satisfactorily to the treatment and efficacy rate was 80.0%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effectiveness of ceftizoxime on various infections in patients with underlying diseases]. 609 Jul 23

Autoimmunity is frequently involved in the pathogenesis of insulin-dependent diabetes, and viral infections have been implicated in some cases. We have investigated the possibility that islet cells and viruses share antigenic determinants with the result that antiviral antibodies would cross-react with islet cells. Antibody titers to Coxsackie B2, B3, B4, and B5, Influenza A and B, and mumps viruses were compared with islet cell antibody (ICA) titers in newly diagnosed insulin-dependent diabetic patients and in some diabetic patients followed prospectively for 1 yr postdiagnosis. Nondiabetic patients, with culture-proven Coxsackie B4 infections and large rises in Coxsackie B4 antibody titers, were evaluated for islet cell antibodies. No relationship between ICA and viral antibody titers was found either in diabetic or nondiabetic patients. We conclude that it is unlikely that islet cells and the viruses tested share antigenic determinants and other mechanisms relating viral infection and autoimmunity in insulin-dependent diabetes must be sought.
Diabetes Care
PMID:Antibodies to viruses and to pancreatic islets in nondiabetic and insulin-dependent diabetic patients. 618 49

The potential role of antecedent viral infection in the pathogenesis of Type 1 (insulin-dependent) diabetes was investigated by measuring antibody titres to several viruses in serum obtained at the time of diagnosis of diabetes. An outbreak of Coxsackie B4 infection followed by a wave of Coxsackie B3 and B5 infections occurred in Seattle during the time viral serology was obtained in the diabetic patients. Antibody titres to Cocksackie B5 and Influenza A and B viruses were comparable in diabetics and matched control subjects, but antibody titres to Cocksackie B3 and B4 were lower in the diabetics and a low antibody titre to Coxsackie B3/B4 was associated with a significantly increased relative risk of diabetes.
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PMID:Reduced Coxsackie antibody titres in type 1 (insulin-dependent) diabetic patients presenting during an outbreak of Coxsackie B3 and B4 infection. 628 94

Genetic, immunological and viral factors have been implicated in pathogenesis of Type 1 diabetes mellitus. The development of Type 1 diabetes in two siblings of patients with Type 1 diabetes studied as part of a large epidemiological study, is described. One case, a 13-year-old male not sharing either HLA haplotype with his diabetic sister, had virtually normal glucose tolerance 80 days before symptomatic presentation. He showed serological evidence of infection by Coxsackie CB4 (at diagnosis) and influenza A virus (soon after diagnosis). The other case, a 15-year-old male, had impaired glucose tolerance for over 500 days (i.e., since the diagnosis of diabetes in his HLA-identical brother) before symptomatic presentation which was not associated with serological evidence of acute viral infection. The former case was negative for islet cell antibody (cytoplasmic) when first seen though positive at diagnosis, while the latter was positive throughout. These two cases suggest contrasting interactions of the main pathogenetic factors associated with Type 1 diabetes.
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PMID:The development of Type 1 (insulin-dependent) diabetes mellitus: two contrasting presentations. 631 59


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