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

The diabetic status of the local Jhansi patients (120 cases) was established before and after antileprosy treatment. Control studies were performed in normal healthy subjects (50 persons) without family history of diabetes mellitus. Random normals showed an incidence of diabetes only 2%, while leprosy patients (94 males and 26 females) had incidence of diabetic status of 14.2%. The highest incidence (19.3%) of diabetes was in lepromatous leprosy and lowest incidence (6.4%) in tuberculoid leprosy patients. Repeated studies in leprosy after treatment showed not only clinical improvement for leprosy but also disappearance of the chemical and latent diabetes mellitus and lowering of blood sugar levels in manifest diabetes mellitus. Incidentally it was noted that 'diabetic status' was worse among males (82.3%) and with advancing age. Association and improvement of diabetic status with specific treatment would tentatively suggest that Mycobacterium leprae lesions are not confined to skin alone but somehow also related to carbohydrate metabolism. A careful management of the chemical and latent diabetes may help in clinical management of leprosy too.
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PMID:Diabetic status in leprosy. 26 75

The 1991 literature on septic arthritis included a concise review of adult septic arthritis, examples of pseudoseptic arthritis, and two interesting animal studies. One animal study examined the induction of acute synovitis by the intra-articular injection of bacterial endotoxin and the cytokines tumor necrosis factor-alpha, and interleukin-1 beta; and the other studied the effects of early and delayed synovectomy in the management of septic arthritis. The predispositions to septic arthritis can be divided into local joint abnormalities, systemic factors, or both. Examples of the local joint abnormalities include osteoarthritis of the hip and apatite-associated arthropathy. Septic arthritis in a patient with rheumatoid arthritis, in a patient with diabetes mellitus and hip arthropathy associated with hemochromatosis, or in a patient with acquired immunodeficiency syndrome and hemophilic arthropathy are examples of how systemic predisposition is coupled with local joint pathology to increase the vulnerability of the host to joint infection. Other examples of systemic disease that predispose to septic arthritis are systemic lupus erythematosus, hypogammaglobulinemia, and human immunodeficiency virus infection, as well as intravenous drug abuse. Unusual microorganisms causing septic arthritis in the adult include Achromobacter xylosoxidans, Moraxella catarrhalis, meningococci, and diphtheroids. Uncommon pathogenesis is represented by a case of intra-articular inoculation of Mycobacterium gastri into the small joint of the hand and a case of mixed bacterial infection of the hip resulting from an extension of a contiguous pelvic infection associated with trauma. Two cases of immune complex glomerulonephritis illustrate the extra-articular complications of septic arthritis: one due to group G streptococcus and the other due to pneumococcus. Finally, septic bursitis is reviewed from the community practice perspective.
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PMID:Bacterial arthritis. 150 74

We investigated the clinical feature of 22 diabetic patients diagnosed as having recurrent pulmonary tuberculosis. More than half of the patients relapsed within five years after discharge from the hospital. The mean serum albumin concentration of those patients who experienced relapses within three years was significantly lower than that of the patients who experienced relapses a period of time greater than three years. We recognized a significant negative correlation between the recurrent period and body mass index or fasting plasma glucose values. Among these patients, 50% of them ceased treatment for diabetes mellitus personally or had not been diagnosed as having diabetes mellitus before the relapse. All of the patients who ceased treatment for diabetes mellitus before readmission were able to obtain good plasma glucose control only through diet therapy during their first hospital admission for pulmonary tuberculosis. From this study, We concluded that strict plasma glucose control is important for the prevention of a relapse of the mycobacterial infection in patients with diabetes mellitus.
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PMID:[Clinical feature of the diabetic patients with recurrent pulmonary tuberculosis]. 160 24

Ninety-eight cases of empyema thoracis admitted to Juntendo University Hospital between 1979 and 1990 were reviewed. Males accounted for 78 cases and females 20 cases. Thirteen pediatric patients ranged in age from 17 days to 4 years, while the 85 adult cases ranged from 16 to 89 years (mean: 58.4 years). The mortality rate increased with age. Fifty-three cases of community-acquired empyema thoracis consisted of 24 with no underlying disease (including 13 pediatric cases), and 29 with diabetes mellitus, alcoholic liver damage or chronic obstructive bronchopulmonary disease. Forty-five nosocomial empyema cases occurred after chest operation or thoracocentesis, or due to a subdiaphragmatic pathogenic condition or congestive heart failure complicated with aspiration pneumonia. In this series, 63 patients (64.3%) had para- or post-pneumonic empyema. Compared with the community-acquired infection cases, the mortality rate of the nosocomial infection cases was very high. Seventy-eight cases were culture-positive, including 3 positive for Mycobacterium tuberculosis. The remaining 20 cases were culture-negative. In 75 cases of culture-positive pleural fluid, aerobic bacteria were isolated from 31 cases (mortality rate: 22.6%), anaerobes mixed with aerobes from 21 cases (mortality rate: 52.4%), and anaerobes only from 23 cases (mortality rate: 21.7%). Thus, the mortality rate of mixed infected cases was highest. Anaerobes were frequently isolated from the community-acquired empyema cases, and were often found in para- or postpneumonic lesions, including aspiration pneumonia. The most commonly encountered aerobe was Staphylococcus aureus. Among the anaerobes, Bacteroides spp., microaerophilic streptococcus, Peptostreptococcus and Fusobacterium spp. were most common. A single organism was isolated in pure culture from 39 cases. Single organisms isolated from fluids were more frequently aerobes (25) than anaerobes (14). The cases harboring Bacteroides spp. showed the worst outcome, with 11 deaths in 25 such cases.
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PMID:[Analysis of 98 cases of thoracic empyema]. 178 10

Three hundred and forty-four cases of active primary tuberculosis admitted to the National Sanatorium Seiransou Hospital from 1980 to 1987 were studied and compared with 101 cases admitted from 1966 to 1969. None had a previous history of tuberculosis, and all were diagnosed via positive smears for acid-fast bacilli and/or positive Mycobacterium tuberculosis cultures. The age distribution showed that in the recent cases, the highest incidence among the male patients was observed in the middle-age group (30-59 yr) and in the older age group (over 60 yr) among the female patients. In the earlier cases, the younger (under 29 yr) and middle-age groups showed a higher incidence than the older age group for both sexes. However, when the prevalence rate was calculated for recent and past cases using the total population of the districts where the patients lived, it was observed that tuberculosis was most prevalent among the older age group for both sexes. Seventy percent of these cases were admitted to the hospital due to self-conscious symptoms, and 20% were referred as a result of mass-screening chest X-ray examinations. The rest of cases were discovered by routine radiographs taken during admission for unrelated illnesses. Some of the middle- and older-aged patients had predisposing factors, such as diabetes mellitus, gastric ulcers and malignancy, in their past histories or as complicating diseases. Twenty percent of all cases had a family history of tuberculosis. In most cases, a second family member was admitted with tuberculosis within 10 years after the first family member's presentation; however, some cases developed after 30-40 years. This fact suggests a possible hereditary or genetic disposition rather than direct transmission of M. tuberculosis. Drug resistance was observed in 5-19% of the primary cases, highest in the younger age group, in whom tuberculous lesions revealed on chest X-rays were unilateral rather than bilateral as in the older patients. Radiograph findings were primarily infiltrative in the past, whereas cavitation was the prominent feature in recent cases. Tuberculin skin testing was 90% positive in all groups except the older-age males, whose positivity rate was 71%. In the past, 25% of the cases were treated with both surgery and chemotherapy, including SM, PAS and INH, whereas only 2.5% were operated in recent cases. There were 11 cases (3.2%) of extrapulmonary tuberculosis that included involvement of the urinary tract, larynx, ribs and cervical lymph nodes.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Clinical comparison of active primary tuberculosis in recent years and the past]. 178

A case of Mycobacterium fortuitum presenting as an asymptomatic enlarging pulmonary nodule is described. This case is unusual because the patient was female, did not have underlying pulmonary disease, was not immunocompromised, had no evidence of dissemination, and had no history of aspiration or diabetes mellitus. The patient underwent thoractomy for resection of the pulmonary nodule, which led to the diagnosis. She recovered fully and is doing well without chemotherapy.
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PMID:Mycobacterium fortuitum presenting as an asymptomatic enlarging pulmonary nodule. 189 52

Mycobacterial infections are rarely reported in Cystic Fibrosis patients although they quite often develop predisposing risk factors such as underweight, secondary diabetes mellitus and chronic inflammatory pulmonary disease. Furthermore glucocorticoid therapy is mandatory in some patients. CF heterozygotes are said to have a selective advantage due to an increased host resistance against Mycobacterium tuberculosis. In this survey 1926 CF patients were investigated for the incidence of tuberculin conversion and manifest infection with mycobacterium tuberculosis in the Federal Republic of Germany (FRG). The results do not support the hypothesis of increased host resistance nor do they show any evidence of a higher risk for tuberculosis in CF. Implications for prophylactic, diagnostic and therapeutic measures are discussed in accordance to the recent epidemiologic data of tuberculosis in the FRG.
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PMID:[Tuberculosis and cystic fibrosis]. 194 50

The primary beta-cell antigen of insulin-dependent diabetes is thought to be a protein with a molecular weight of approximately 64 kD. Hyperthermic incubation and cytokines such as interleukin 1 beta, gamma interferon, and tumour necrosis factor induce synthesis of 64 kD protein by insulinoma cells. By western blot techniques, cross-reactivity was found between this 64 kD protein and monoclonal antibodies directed against Mycobacterium tuberculosis heat-shock protein 65, but not with antibodies directed against a similar epitope of M leprae heat-shock protein 65. Binding of M tuberculosis heat-shock protein 65 antibodies to interleukin-1 beta-treated cells was inhibited by prior addition of serum from insulin-dependent diabetic patients which contained antibodies to 64 kD beta-cell antigen. It is suggested that heat-shock protein 65 may be the 64 kD beta-cell antigen and that autoreactivity to an epitope of heat-shock protein 65 may confer susceptibility to insulin-dependent diabetes mellitus.
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PMID:Heat-shock protein 65 as a beta cell antigen of insulin-dependent diabetes. 197 88

Recent studies in nonobese diabetic mice have implicated the autoimmune destruction of pancreatic islet cells with immunity to a beta cell protein cross-reactive to Mycobacterium tuberculosis heat shock protein 65 (hsp 65). Therefore, our studies examined serological immunity to islet cell hsp in humans with insulin-dependent diabetes (IDD). Heat shock of human islet cells in vitro markedly increased the synthesis of proteins of 72,000, 75,000, and 90,000 Mr. No autoantibodies reactive to these hsp, nor to the constituently expressed islet cell hsp 65 protein (identified as 60,000 Mr) were observed in IDD patients. The islet cell 64,000-Mr autoantigen and hsp 65 proteins were physiologically and immunocompetitively distinct. These experiments do not support the hypothesis that IDD in humans is associated with autoimmunity to islet cell heat shock proteins.
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PMID:No evidence for serological autoimmunity to islet cell heat shock proteins in insulin dependent diabetes. 199 54

A retrospective review of all patients with vertebral osteomyelitis admitted to all Saskatchewan referral hospitals from 1973 to 1986 was undertaken to determine the incidence and clinical characteristics of the disease. There were 73 patients, an incidence of 5.3 cases/million per year. Erroneous initial diagnoses were common (41%). There was a significantly increased risk in patients older than 60 years. Staphylococcus aureus was the most frequent organism. Mycobacterium tuberculosis was present in 29.5% and was more common in native Indian patients. Surgery was performed in 31% of all patients, and in 50% of those with tuberculous infections. The outcome was excellent in 92% of patients. Diabetes and transurethral resection of the prostate were risk factors for vertebral osteomyelitis.
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PMID:Causes and clinical management of vertebral osteomyelitis in Saskatchewan. 202 98


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