Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With the graying of America, more older persons will be driving. Physiological changes associated with normal aging and diseases that commonly affect the elderly may compromise their ability to drive safely. Although all states have regulations governing driving licensure, few offer specific guidelines regarding older persons. Accordingly, much of the responsibility for determining medical competence to drive and counseling patients in this regard is left to physicians. Normal physiologic changes may limit sensory information, particularly visual, available to the driver. In addition, chronic diseases in older persons including coronary artery disease, dementia and other neurologic disorders, diabetes mellitus, and drug use may increase the risk of crashes while driving. Once the question of competence to operate an automobile has been raised, ethical dilemmas must be addressed regarding the benefit of continued driving for the individual versus the risk to that person and society as a whole. In this article, we review the medical grounds for determining competence to drive, discuss ethical implications, and report current legal regulations for physicians and aging drivers. Future directions and possible areas for further research are outlined.
 ...
PMID:The aging driver. Medicine, policy, and ethics. 305 52

The results of investigations in 50 impotent patients with neurological disease are presented. Using intracorporeal papaverine, Doppler duplex scanning, cardiovascular reflex testing and skin thermal threshold monitoring, the vascular and neurological components were assessed in each of three clinical groups with probable or overt neuropathy. These comprised spinal injury, diabetes and pelvic trauma. Anatomical detail of the penis was well seen using these techniques. In 15 patients with spinal injuries, although the aetiology was predominantly neurological, six exhibited poor flow in the deep penile arteries following injection of papaverine. This was associated with poor erections in these patients, suggesting a vascular pathology. In 27 patients with diabetes the results showed a mixed pattern. Vascular disease was almost universal, combined with varying degrees of autonomic and peripheral neuropathy, and only three had full erections with papaverine. Those with pelvic trauma (8 patients) also had a mixed picture, although some had good erections following papaverine injection. Duplex Doppler scanning of the deep penile arteries correlated with the quality of papaverine-induced erection. Thermal testing was a highly sensitive indicator of small nerve fibre dysfunction, possibly at an earlier stage than standard autonomic testing. A vascular component to impotence was shown to be common in those with neurological impairment, and may alter management.
 ...
PMID:Results of investigation of impotence in patients with overt or probable neuropathy. 342 44

Currently, we can make the following generalizations about the major long-term complications of diabetes. First, they occur commonly after 10 to 15 years of diabetes. Second, the complications of renal and retinal disease, but not of atherogenic and neurological disease, appear to be related to the severity of hyperglycemia. Third, some complications do not seem to be readily reversible by decreasing blood glucose for one to three years. Fourth, whether retinal and renal disease can be prevented or reduced by an early intervention is not yet known but is under intensive study. Fifth, the risks of some forms of intensive therapy include hypoglycemia, ketoacidosis, skin infection, weight gain, and poor adherence to arduous regimens. Finally, an analysis of the relationship of benefits to risk in intensive therapy is not yet possible and must await further study. Meanwhile, the diabetes research community will need to evaluate whether alternative procedures, e.g., aldose reductase inhibitors or islet transplants, might not be more reasonable than currently available modes of intensive therapy for reducing the long-term complications of diabetes.
 ...
PMID:Overview of the complications of diabetes. 353 May 40

The maintenance of adequate upright BP requires both a baroreceptor-mediated feedback loop and an effective circulating blood volume. Although functional disruptions of these mechanisms are reversible and common, several permanent and often progressive neurologic disorders exist that interfere with necessary reflexes and orthostatic BP control. Multiple system atrophy affects diffuse neurologic systems; autonomic dysfunction causes a failure of peripheral vasoconstriction from defective sympathetic stimulation. Idiopathic orthostatic hypotension is a selective disorder of autonomic nerves; postganglionic neurons cannot release norepinephrine properly and are supersensitive to exogenous pressors. Conversely, excessive sympathetic discharge occurs in sympathicotonic orthostatic hypotension, the pathogenesis and incidence of which are unclear. Any peripheral neuropathy may interfere with sympathetic vasoconstrictor activity and is most commonly seen in diabetes mellitus.
 ...
PMID:Orthostatic hypotension. I. Functional and neurogenic causes. 637 Jan 61

Measurements of transcutaneous oxygen tension were made on the foot and arm in 16 Type 1 (insulin-dependent) diabetic patients with no evidence of vascular or neurological disease on simple clinical examination and in 30 non-diabetic subjects. The mean transcutaneous oxygen tension measured at 45 degrees C on the foot was significantly lower in the diabetic patients than in the non-diabetic subjects. The hyperaemia response in the arm after cuff occlusion (measured by transcutaneous oxygen tension at 37 degrees C) was also significantly lower in the diabetic patients. These results may reflect abnormal capillary blood flow in diabetic patients. As the methods are simple and non-invasive, they may prove useful in the early assessment and subsequent monitoring of peripheral vascular problems in diabetes.
 ...
PMID:Reduced transcutaneous oxygen tension and impaired vascular response in Type 1 (insulin-dependent) diabetes. 664 97

Nerve conduction velocities (NCV) of the median motor, median sensory, peroneal motor, and sural nerves were measured on 40 lead-exposed automobile production workers as part of a comprehensive health survey. Blood lead (Pb-B) and blood zinc protoporphyrin (ZPP) were measured. The control group (N = 31) consisted of workers without lead exposure. All subjects were screened for the following conditions: Limb, neck or back injury, diabetes, neurological disease, and alcohol consumption of more than 28 alcoholic beverages per week. Limb temperature was assessed at three sites for each NCV measurement. The lead-exposed workers had slower median sensory NCV (42.9 vs. 46.8 m/sec, p less than 0.006) and slower sural NCV (37.8 vs. 42.8 m/sec, p less than 0.0004). All NCV estimates were then statistically adjusted for age and temperature, and transformed to Z values for further analyses. The mean standardized NCVs were slower in the lead-exposed group for the median sensory (-1.03 vs. -0.04, p less than 0.0003) and the sural nerves (-2.52 vs. -0.52, p less than 0.001). The study group was divided into two groups, with less than ten years and more than ten years of lead exposure. The subsample exposed less than ten years showed slowing of the median sensory (-0.94 vs. -0.04, p less than 0.005) and the sural nerves (-2.42 vs. -0.52, p less than 0.0001). Pb-B and ZPP levels were correlated with sural velocity (r = -0.54, p less than 0.04, and 4 = -49, p less than 0.06, respectively. Mean Pb-B was 59.7 micrograms/dl and mean ZPP was 175.8 micrograms/dl).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Lead exposure and nerve conduction velocity: the differential time course of sensory and motor nerve effects. 668 60

Little information is available in Japan regarding the clinical and experimental bone infections induced by non-spore-forming anaerobic bacteria. 1) The detection of anaerobic bacteria using the pre-reduced anaerobically sterilized GAM medium was carried out on 15 patients admitted to the Department of Orthopedic Surgery, Gifu University Hospital due to bone infections in the past 2 years (1977-1978). Anaerobic bacteria were isolated and identified in 7 patients out of the 15 (46.7%). Complications of various kinds of neurological disease, such as caudal nerve injury, spinal cord tumor and other neuropathies, were also detected in these patients. In addition, the complication of diabetes mellitus was found in 2 patients. All patients had open wounds, decubitus on sacral region or intractable ulcer of foot infected with both anaerobes and aerobes. II) The attempt to make an experimental osteomyelitis was undertaken using non-spore-forming anaerobic bacteria B. fragilis. A) B. fragilis (10(5) CFU) adsorbed on a 10 mm No. 8 silk thread was inserted into the medullary cavity of the left tibia of Sprague Dawley rat through trocar equipped with a mandrine. Experimental osteomyelitis was shown to be quite similar to that of human by X-ray and pathohistological examinations. By using this procedure, it is possible not only to produce an osteomyelitis in 100 per cent, but also to observe it for 16 weeks without any loss of test rats. B) Injection of B. fragilis (10(6) CFU) with 5% sodium morrhuate into the medullary cavity of the rat tibia through a microsyringe did not induce osteomyelitis produced by S. aureus or P. aeruginosa. On the other hand, sodium morrhuate was observed to have an inhibitory effect on the growth of B. fragilis in vitro.
 ...
PMID:[Studies on bone infections induced by non-spore-forming anaerobic bacteria--clinical investigation and an experimental osteomyelitis (author's transl)]. 732 May 99

In order to assess the possible progression of neurological abnormalities over time and the value of visual evoked potential alterations in predicting stability and severity of diabetes-related optic pathway disease, a longitudinal study in non-insulin-dependent diabetic patients was performed. Neurological examination, visual evoked potentials with pattern reversal, motor and sensory nerve conduction velocities and metabolic control were studied in 18 non-insulin-dependent diabetic patients and in 35 normal control subjects at baseline and again after 4.6 +/- 0.8 years (range 4-6). At the first recording the peak P100 wave latencies were significantly delayed in the diabetic patients compared with the control subjects; signs of peripheral neuropathy were detected in five patients, clinical in three and in two there was only neurophysiological alteration without clinical signs. The second recording revealed no significant alterations of P100 latencies in patients compared with baseline, but the number with clinical signs and/or neurophysiological alterations with no clinical signs of peripheral neurological disease was increased to seven. In conclusion, we observed that visual evoked potential alterations were stable over time whereas peripheral neurological disease progressed and correlated positively with metabolic control.
 ...
PMID:Visual evoked potentials in NIDDM: a longitudinal study. 748 40

62 men with prostatic hypertrophy and bladder obstruction and 31 age matched women without lower urinary tract obstruction, underwent urodynamic testing which included uroflowmetry, gas cystometry, urethral pressure measurement: electromyography and pressure flow study was only performed to the patients with prostatic hypertrophy. No patient with neurological disease, diabetes mellitus, pelvic operation, neoplasm or stone of the bladder was admitted to the study. Involuntary detrusor contractions (unstable detrusor) were found in 74.2% of male patients and in 25.8% of female patients. In male patients aged over 72 the percentage was 81.8% while in the female patients of the same age was 60%. All the 62 male patients underwent prostatectomy. Two months after surgery, acystometry was done. Unstable detrusor was found in 63.1% of cases. Patients over 80 had a percentage of 100%. These data suggest obstructive prostatic hypertrophy as an important factor in development of involuntary bladder contractions, but the primary pathophysiological factor appears to be age of patients.
 ...
PMID:[Bladder instability in the elderly patient with obstructive prostatic hypertrophy: comparative urodynamic study using non-obstructed women of the same age]. 751 83

Several studies have shown a consistent maternal effect in the transmission of Type 2 diabetes (NIDDM). The mitochondrial encephalomyopathies are a group of diseases characterized by maternal inheritance and a variety of mitochondrial DNA defects. Diabetes is a feature of some of these disorders and therefore the hypothesis arose that mitochondrial DNA mutations might play a role in patients with diabetes but no other features of neurological disease. Recent studies have confirmed that a specific point mutation in the gene encoding the mitochondrial tRNA for leucine segregates with diabetes and nerve deafness in families from the UK, Holland, France and Japan. Mitochondrial gene deletions have also been reported. Affected subjects present with progressive insulin deficiency and may fall into the broad classifications of either Type 1 (IDDM) or Type 2 diabetes (NIDDM). Future studies are aimed at searching for other mitochondrial gene defects in diabetes and attempting to explain the mechanism of hyperglycaemia by the development of phenotypic expression systems. Although an exciting development in the genetics of diabetes, currently described mitochondrial mutations do not fully explain the maternal effect in the transmission of Type 2 diabetes.
 ...
PMID:Maternally inherited diabetes mellitus: the role of mitochondrial DNA defects. 774 54


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>