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

A retrospective analysis was undertaken of 365 consecutive patients, 75 women and 290 men with a mean age of 59.9 +/- 9.7 years, who had coronary artery bypass surgery during 1981. Complications classified as major were: mediastinal hemorrhage, pericardial tamponade, wound dehiscence, sternal osteomyelitis, myocardial infarction, bacterial endocarditis, dissecting aneurysm and diabetes insipidus. Complications classified as minor were: atrial fibrillation, postpericardiotomy syndrome, cellulitis, thrombophlebitis and phrenic nerve palsy. There were 48 patients (13%) with 52 major complications. Age more than 60 years, cardiopulmonary bypass time longer than 150 minutes, aortic cross-clamp time longer than 100 minutes, number of grafts greater than five and presence of diabetes mellitus were significantly associated with major complications. Complications tended to occur more frequently in women, obese patients and those with emergency operation or ejection fraction less than 30%, but the associations were not statistically significant. Physicians referring patients for coronary artery surgery should be cognizant of the incidence of morbidity along with the other risks and benefits when considering coronary artery bypass surgery.
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PMID:Coronary artery bypass surgery morbidity. 660 79

A middle-aged man with diabetes mellitus and cardiomyopathy developed both cryptococcal arthritis and cellulitis. Unusual aspects included the benign nature of the joint effusion and lack of contiguous osteomyelitis.
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PMID:Cryptococcal arthritis and cellulitis. 674 13

A retrospective review of the cases of sixty-one patients with vertebral osteomyelitis revealed that the associated diseases of diabetes mellitus and rheumatoid arthritis as well as increased age and a more cephalad level of infection predisposed to paralysis. For patients with paralysis and a long-term follow-up, the prognosis for isolated nerve-root deficits is good with or without surgery. For patients with spinal cord compression, the results generally are better with anterior decompression and stabilization than with laminectomy. Early treatment should be directed at prevention of intrinsic spinal-cord damage, which is irreversible.
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PMID:Pyogenic and fungal vertebral osteomyelitis with paralysis. 684 75

A patient with diabetes mellitus who sustained an iatrogenic perforation of the cervical esophagus subsequently had osteomyelitis of the cervical spine involving the bodies of C-6 and C-7. This occurred despite early and aggressive surgical treatment of the perforation. Roentgenograms of the cervical spine should be included in the follow-up of selected patients treated for perforation of the esophagus.
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PMID:Cervical osteomyelitis after esophageal perforation. 707 29

This is possibly the first documented case of Torulopsis glabrata osteomyelitis. Torulopis glabrata is a common fungus similar to Cryptococcus. It is though to largely represent a contaminant in routine cultures. The patient was a 58-year-old severely debilitated woman with diabetes. To establish a definitive diagnosis, careful culture and positive identification of the causative pathogen from the fresh bone biopsy were required. Treatment with amphotericin B was successful; however, optimally amphotericin B combined with local surgical excision would be the treatment of choice.
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PMID:Torulopsis glabrata osteomyelitis: report of a case. 719 43

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.
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PMID:[Studies on bone infections induced by non-spore-forming anaerobic bacteria--clinical investigation and an experimental osteomyelitis (author's transl)]. 732 May 99

During the last few years atypical forms of human salmonellosis were observed in 27 patients. Most frequent were acute gastroenteritis with bacteraemia or septicaemia, abscess formations in various organs and septic infections with gastroenteritis Salmonellae but no demonstrable gastroenteritis. In addition there were cases of osteomyelitis, peritonitis, one case of infected hip replacement, one of infected adrenal cortical tumour, and one of infected aortic aneurysm. In 24 of the 27 patients there was an underlying disease likely to have favoured the development of such infections. Diabetes mellitus, cholelithiasis and malignant tumours were the most frequent condition. Isolation of the positive organism was obtained from various materials (blood, abscess pus, gallbladder smear, operative specimen). Chemotherapy is definitely indicated in such Salmonella infections. Often additional surgical measures, e.g. to control spread of septic foci, were necessary. Prophylactic chemotherapy is recommended for patients with risk factors in order to prevent bacteraemic-metastatic events.
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PMID:[Atypical course of human salmonellosis (author's transl)]. 741 26

Group B streptococcal infection has recently been recognised as an important and apparently increasingly common cause of invasive disease in nonpregnant adults. The annual incidence of invasive disease has been estimated at 4.4 per 100,000 nonpregnant adults and is highest among adults over 60 years of age. The most common clinical diagnoses include skin and soft-tissue infections, bacteraemia with no identified source, osteomyelitis, urosepsis and pneumonia. Other important but less common infections include peritonitis, infectious arthritis, meningitis and endocarditis. The majority of adults with group B streptococcal infections have underlying diseases including diabetes mellitus, malignant neoplasms and liver disease. Nosocomial infection and polymicrobial bacteraemia occur in a significant proportion of patients with invasive group B streptococcal disease. Mortality from invasive disease is particularly high in the elderly. For treatment of serious group B streptococcal infections, high doses of benzylpenicillin (penicillin G) are recommended because of the somewhat higher minimal inhibitory concentrations. In addition to parenteral antibiotic therapy surgical management may be required for successful treatment, particularly in the case of soft-tissue or bone infection. Invasive group B streptococcal infection is a major problem in elderly adults and those with chronic diseases, and efforts should be made to identify and treat such infections early. Future approaches may include vaccine prevention of serious group B streptococcal infection in adults at highest risk.
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PMID:Group B streptococcal infection in older patients. Spectrum of disease and management strategies. 761 18

Recurrent rejection is an uncommon, severe complication after heart transplantation that is associated with a poor long-term prognosis. Photopheresis (ECP), a new form of extracorporeal photo-chemotherapy used for the treatment of cutaneous T cell lymphoma and several autoimmune diseases, has also been used for prevention and treatment of acute rejection in heart transplant recipients. It seems to induce specific suppression of both cellular and humoral rejection. In this study, we evaluated whether ECP added to standard therapies allowed better control of rejection and reduction of conventional immunosuppressive drugs in patients with repeated rejection episodes. Eight heart transplant recipients (6 men and 2 women, mean age 48 yr), with recurrent rejection were treated with ECP for 6 months. Endomyocardial biopsies (EMB) were performed monthly. As a result of treatment, 7 patients on ECP experienced a reduction of the number and severity of rejection episodes. The fraction of EMB negative for rejection increased from 13 to 41%, whereas the fraction of specimens with multifocal and/or diffuse moderate lymphocytes infiltration (grades 3A and 3B) decreased from 41 to 21%. ECP allowed reductions of daily immunosuppressive therapy: prednisone by 44% (16.9 vs. 9.4 mg), cyclosporine by 21% (366 vs. 291 mg), and azathioprine by 29% (137 vs. 97 mg). No major side effects were observed. We conclude that, although the number of patients is small, the use of ECP was safe and associated with improved control of recurrent rejection. This allowed tapering of immunosuppressive drugs, which was particularly useful in two patients with insulin-dependent diabetes and one with sternal wound osteomyelitis.
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PMID:Extracorporeal photochemotherapy as adjuvant treatment of heart transplant recipients with recurrent rejection. 762 41

The clinical presentation of psoas abscess is often non-specific and insidious that may mislead the diagnosis and treatment. The abscess often extends beyond the retroperitoneum and pelvis before its diagnosis, and leads to serious complications. Many diseases have the similar signs and symptoms and must be ruled out. Computed tomogram is the most useful and reliable diagnostic tool. Only a few cases of salmonella psoas abscess were reported in the literature, and were usually associated with spinal osteomyelitis or septic hip. We present a case of salmonella psoas abscess in a patient with diabetes mellitus. The patient had the history of cholecystitis with sepsis due to salmonella infection 4 years before and cholecystectomy had been done. No associated lesion was found to be associated with the abscess, and we believed the abscess being the result of recurrent bacteremic attack. High index of suspicion, early diagnosis, adequate drainage and effective antibiotic treatment are the key points in managing the disease.
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PMID:Salmonella psoas abscess--a case report. 764 Nov 11


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