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

Cystic fibrosis (CF) is the most common serious genetic condition in the White population groups. Thirty-three White patients (mean age 20 years, range 14-32 years) seen at an adult CF clinic at the Johannesburg Hospital between January 1980 and January 1983 are reviewed. All had elevated sweat chloride levels. There was a family history of CF in 45,5% of the cases. Most were of normal height but significantly underweight. Chronic obstructive pulmonary disease was present in 94% of the patients. Pulmonary infections played a major role in both symptomatic exacerbations and progressive lung disease. Most frequently, mucoid Pseudomonas aeruginosa and/or Staphylococcus aureus were cultured from the sputum. The management of infective exacerbations is discussed. Other respiratory complications included cor pulmonale, haemoptysis, recurrent pneumothorax and sinusitis. Chest radiographs and pulmonary function tests are also analysed. Gastro-intestinal complications included pancreatic exocrine insufficiency (94%), intestinal obstruction, cholelithiasis, and liver disease. Insulin-dependent diabetes occurred in 9%. Five pregnancies were recorded in 4 patients. By January 1983 there had been 7 deaths (mean age 19,4 years). Most of the patients are highly motivated, with few psychological problems, and appear to be well-functioning and integrated members of society.
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PMID:Experience at an adolescent and adult cystic fibrosis clinic. An analysis and overview. 671 Feb 79

A prospective study of 208 consecutive survivors of acute myocardial infarction was undertaken to determine the differences between Q- and non-Q-wave infarction, concerning data from the history, clinical course, and 6-month follow-up. There were 177 patients with Q-wave infarction and 31 patients with non-Q-wave infarction. There were no significant differences for the following variables: age, sex, diabetes mellitus, smoking, positive family history, hypertension, obesity, previous infarction, history of unstable angina, heart failure or chronic obstructive pulmonary disease (COPD), Killip class in the Coronary Care Unit (CCU), arrhythmias and conduction defects in the CCU as well as drugs used. Patients with non-Q wave infarction had a higher incidence of stable angina before the myocardial infarction and a lower value of creatine kinase (CK) and serum glutamic oxalacetic transferase (SGOT). During the 6-month follow-up, 9 cardiac deaths and 17 reinfarctions occurred, while 74 patients presented angina. There were no differences between the two groups concerning the incidence of cardiac death or angina, but patients with non-Q-wave infarction had a higher incidence of reinfarction at 6 months (p less than 0.001). We conclude that although patients with non-Q-wave myocardial infarction have a lesser degree of myocardial damage, they have a high incidence of early reinfarction which puts them in a high-risk group.
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PMID:Q- versus non-Q-wave myocardial infarction: clinical characteristics and 6-month prognosis. 671 48

Eighteen cases of adult listeriosis (nine with meningitis, one brain abscess and eight bacteraemia) were diagnosed in the Chaim Sheba Medical Center in the years 1964-1982. The infection seemed to be opportunistic in all. Eleven patients had malignant disease, two had cirrhosis of the liver, one had ulcerative colitis, one had bronchial asthma with chronic obstructive pulmonary disease, one had pemphigus, one had diabetes mellitus and one had a renal transplantation. Twelve patients (66%) received radiation therapy and/or cytotoxic and steroid medication. Diabetes mellitus as an additional underlying disease was strikingly frequent and was found in eight out of 18 patients (44%), in one as the only underlying disease. In the meningitis group cerebrospinal fluid (CSF) cultures were positive in five patients, and negative in four who had, however, positive blood cultures. The cells in the CSF were predominantly lymphocytes in five and polymorphs in four. It may be concluded that diabetes mellitus is an important underlying disease in listeriosis. The results also reinforce the fact that lymphocytosis in the CSF does not exclude bacterial meningitis.
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PMID:Adult listeriosis--a review of 18 cases. 672 49

We studied 20 men (ages 46 to 69, mean 45 years) with chronic obstructive pulmonary disease (FEV1 of 0.55 to 2.1 L), to determine the relative importance of pulmonary impairment vs other occult physical or psychologic factors in the genesis of sexual dysfunction. Seven subjects had ceased sexual activity concomitant with worsening of their pulmonary symptoms; six because of erectile impotence and one due to dyspnea. Frequency of intercourse for the remaining 13 was 16 percent of prelung disease levels, and libido was decreased to 25 percent of premorbid levels. Nocturnal penile tumescence monitoring disclosed that six subjects had organogenic erectile impotence (OEI). None of the subjects showed signs of peripheral vascular disease as assessed by Doppler examination of peripheral pulses (including penile). The mean bulbocavernosus reflex latency (BCRL) for the OEI group (N = 5) was 40.2 msec, while that for the group with full nocturnal erections (N = 10) was 34.5 msec (P less than 0.005). Four subjects had occult diabetes mellitus evident on oral glucose tolerance tests, and one had evidence of an androgen deficit. The correlation coefficient for rank by sexual dysfunction vs pulmonary impairment and age was 0.66 (P less than 0.005) and 0.24 P greater than 0.05), respectively. Subjects with OEI tended to have the worst pulmonary function test results and the highest T-scores on the hypochondriasis, depression, and hysteria scales of the Minnesota Multiphasic Personality Inventory. Data suggest that sexual dysfunction worsens as lung disease worsens and that chronic obstructive pulmonary disease may be associated with male impotence in the absence of other commonly known causes.
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PMID:Sexual dysfunction and erectile impotence in chronic obstructive pulmonary disease. 680 73

A follow up study has been performed in thirteen patients suffering from (amaurosis fugax) (A.F.). From the case material analysis and from the review of the current literature it has been possible to infer that the current pathogenetic hypotheses (cerebral and/or retinal microembolism) of the amaurosis fugax and of the transient ischemic cerebral attacks without ocular symptoms are similar, at least in the most of the cases. In all the cases of amaurosis fugax examined, the clinical symptomatology, the frequency of the episodes and the time required for its complete recovery have been described. Some (risk factors) of cerebrovascular disease, such as hypertension, diabetes mellitus and high plasma levels of cholesterol and triglycerides, have been statistically analyzed using Student's t test and chi-square. As regards other possible risk factors (ischemic heart disease, peripheral vascular diseases, chronic obstructive pulmonary disease) only a statistical frequency analysis has been performed. The results of the anti-platelet therapy in modifying the frequency of the A.F. episodes have been discussed. It has been lastly considered the results of the follow-up study in regard to the prognosis of the A.F.
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PMID:[Amaurosis fugax]. 702 16

We conclude that chronic necrotizing pulmonary aspergillosis is a clinical entity which has not usually been recognized as one of the forms of pulmonary disease due to Aspergillus species. Patients are middle-aged, and often have some evidence of impairment of host defenses such as diabetes mellitus, a connective tissue disorder, poor nutrition, chronic obstructive lung disease or low dose corticosteroid therapy. They are almost always symptomatic with fever and a productive cough, and their chest roentgenogram shows infiltrative and cavitary disease, typical of a chronic destructive lung process such as tuberculosis or anaerobic infection. Cavity formation is often accompanied by the development of a mycetoma. The disease is usually of 1 to 6 months duration but can be present for years prior to diagnosis. The diagnosis is suggested by the clinical course and the isolation of the fungus from pulmonary secretions; negative cultures for other pathogens and failure to respond to antibacterial or antimycobacterial therapy are characteristic. The diagnosis is confirmed by pathologic evidence of tissue invasion by the fungus or a response to specific antimycotic therapy. The symptomatic response to antifungal chemotherapy, at times combined with surgical drainage or resection, is favorable. However, roentgenographic resolution is not uniform, and many patients have residual cavitary disease. The long-term prognosis is uncertain.
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PMID:Chronic necrotizing pulmonary aspergillosis: a discrete clinical entity. 703 73

In a prospective study (from April, 1980 to April, 1981) of 110 patients with moderately severe to severe pneumonia 11 were found to have 12 manifestations of Legionnaires' disease. Diagnosis was proven by indirect immunofluorescence tests, either a quadruple titre rise to 1 : 128 or a single titre of at least 1 : 256. The clinical picture in all 11 patients was the typical one of severe pneumonia, usually involving the lower lobes, high fever between 39 and 40.4 degrees C, as well as WBC counts between 6.8 and 28.9 X 10(9)/l. In nine cases artificial ventilation was required, in four there was acute renal failure requiring dialysis, in four other definite renal insufficiency. All patients had underlying disease, in some severe, such as chronic obstructive lung disease, diabetes mellitus, heart failure, liver cirrhosis, renal transplantation or extensive operations. Eight patients died, four of them of Legionnaires; disease. The relatively high infection rate (10%) indicates that in patients with risk factors, as well as those with a pneumonia unresponsive to the standard treatment within five to seven days, Legionnaires' disease should be considered in the differential diagnosis.
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PMID:[Legionnaires' disease: prospective study of its incidence, clinical features and prognosis. (author's transl)]. 706 Apr 96

A retrospective analysis was made of the case records of 1568 surgical patients admitted in 1975 to a tertiary care hospital in the Province of Newfoundland, to determine and classify the incidence of concurrent systemic disease. Almost 60 percent of patients had symptoms or signs of concurrent disease, the numbers increasing progressively from below 30 per cent at 21-30 years, to 90 per cent at ages 71-80. The predominant abnormalities were cardiovascular (60 per cent), followed by respiratory and metabolic conditions (41 and 40 per cent respectively). Detailed findings are presented, including those relating to the incidence of ischaemic heart disease and hypertension, to the coexistence of several diseases, to smoking and chronic obstructive lung disease, to obesity, to diabetes, and to alcoholism. This review documents the high incidence of concurrent disease in surgical patients and has implications for the training of anaesthetists and the organization of their work.
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PMID:Incidence of concurrent systemic disease in the surgical population of a tertiary care hospital. 723 6

The use of expanded microporous polytetrafluoroethylene (PTFE) as a small arterial substitute has been increasing. In this study 22 patients, averaging 66 years of age, underwent femoral popliteal or femoral distal tibial bypass. Risk factors included 1) previous atherosclerotic heart disease in 52 per cent, 2) previous myocardial infarctions in 43 per cent, 3) hypertension in 33 per cent, 4) diabetes mellitus in 27 per cent, 5) chronic obstructive pulmonary disease in 14 per cent, and 6) previous cerebral vascular accident in 14 per cent. The initial 30-day patency rate was 81 per cent, with long-termpatency being 73 per cent. Average operative time was 2 3/4 hours, with 81 per cent of patients undergoing intraoperative arteriography. Follow-up ranges from three to 13 months. The average pre- and postoperative ankle pressures were 54 mmHg and 100 mmHg, respectively. Four patients with failed grafts required amputation. One patients with a patent graft required amputation for gangrene secondary to diabetes. Other complications included multiple toe amputations, two superficial wound infections, one perforated cecum, and one pulmonary embolus. The initial and long-term patency rates of 81 per cent and 73 per cent, respectively, compare favorably to previous studies using autogenous saphenous vein. This suggests that expanded PTFE may be the initial arterial prosthesis of choice in high-risk or elderly patients. Longer follow-up is needed to determine if it will be a satisfactory substitute for autogenous saphenous vein in routine elective bypass for lower extremity occlusive disease.
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PMID:Preliminary results with the use of expanded microporous polytetrafluoroethylene in vascular occlusive disease of the lower extremity. 737 60

The prevalence and immunoreactivity of interstitial amyloid deposits of the pituitary glands of 109 consecutive autopsies of individuals over 84 years of age were studied using Congo red staining and antibodies directed against the major amyloid fibril proteins and pituitary hormones. In addition, the amount of interstitial amyloid formation was evaluated quantitatively and compared with all autopsy-related and clinical diagnoses available. Eighty-seven (80%) of the 109 cases exhibited interstitial amyloid deposits in the anterior lobe. All reacted immunohistochemically with antiamyloid lambda light chain and antiamyloid P-component. Quantitative analysis in 62 cases revealed a mean volume percentage of interstitial amyloid in the anterior lobe of 0.56%. In statistical analysis, only two of the 25 diseases recorded were associated with interstitial amyloid: chronic obstructive pulmonary disease and non-insulin-dependent diabetes mellitus. The prevalence of chronic obstructive pulmonary disease correlated positively with the occurrence (chi 2; P < .02) as well as with the amount of amyloid (Wilcoxon; P < .04) in the pituitary. In addition, non-insulin-dependent diabetes mellitus was accompanied with higher amounts of interstitial amyloid than with all other disorders (Wilcoxon; P < .03). Until now, a correlation was proposed only between non-insulin-dependent diabetes mellitus and islet amyloidosis of the pancreas.
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PMID:Interstitial amyloid deposits in the pituitary gland. Morphometry, immunohistology, and correlation to diseases. 748 7


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