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

The prevalence and incidence of bacteriuria in 304 girls and 337 boys with type I diabetes was studied by screening for bacteriuria at their regular outpatient controls. In 90 girls and 108 boys a urine specimen was sampled every third month during a year. The prevalence of bacteriuria was 3/304 in girls and 0/337 in boys. During the one year follow-up one of the 90 girls had pyelonephritis and two cystitis while none of the boys had bacteriuria. It is concluded that the rate of urinary tract infection in young diabetic persons does not differ from that present in healthy young people.
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PMID:Urinary tract infection in children with type I diabetes. 398 32

A case of emphysematous pyelonephritis is presented. A 54-year-old woman with diabetes mellitus was admitted because of bilateral ureteral stones. Five days after bilateral ureterolithotomy, she developed left flank pain, chills and fever. Plain x-rays of the abdomen (KUB) showed an enlarged left kidney with a giant gas shadow on the left renal area and no evidence of stone shadow. Drip infusion pyelogram revealed a decrease in the left renal function and the presence of the gas in the pyelocalyceal system. Contrast-enhanced computerized tomograms confirmed the presence of the gas in the parenchyma and pyelocalyceal system. The patient was treated conservatively with intensive antibiotic therapy, intravenous fluids and control of diabetes mellitus. After 3 weeks of therapy, the gas shadow disappeared, and a good recovery of renal architecture and function was achieved.
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PMID:[Emphysematous pyelonephritis: report of a case]. 401 46

Forty-five women with diabetes mellitus and urinary tract infections have been followed an average of 34 mo on treatment protocols based on localization of infection as determined by the presence or absence of antibody-coated bacteria (ACB). Treatment was usually, but not exclusively, trimethoprim-sulfamethoxazole. Two weeks of oral therapy was equally efficacious to 6 wk of treatment in asymptomatic women with antibody-coated bacteria (ACB)-positive infection in eradicating bacteriuria. Recurrences in all groups were predominantly reinfections with differing serotypes or species of microorganisms. The sustained remission rate (fractional extraction) after initial treatment was similar to other reported groups, but possibly less efficacious with recurrences. Suppressive therapy with trimethoprim-sulfamethoxazole for repeated recurrences effectively prevented infection but provided no posttreatment benefit. A high prevalence of underlying structural genitourinary tract abnormalities, usually detectable on pelvic examination, and which were not direct consequences of diabetes mellitus, were possible contributing factors to recurrent infection in this patient group. Progressive elevation in serum creatinine in seven patients with initial ACB-positive infections appeared to relate more closely to diabetic nephropathy rather than chronic pyelonephritis. ACB-positivity correlated well with elevated serum antibody titers and the presence of underlying anatomic abnormalities, but ACB categorization did not lead to improved therapeutic strategy or outcome and hence was of limited clinical usefulness.
Diabetes Care
PMID:The treatment of urinary tract infections in women with diabetes mellitus. 405 37

From 1976 to 1981, 28 episodes of group B streptococcus (GBS) septicemia were identified in our hospital (CHUV, University Hospital Lausanne), 18 in 17 adults and 10 in newborns. The latter had acute respiratory distress syndrome (8 cases) or meningitis (2 cases). In adults the skin was the main source of infection (6 diabetic foot, 4 acute cellulitis complicating chronic skin diseases, 2 infections secondary to diagnostic procedures (capillary and ascitic taps) and 1 meningitis secondary to neurosurgery). The other sources of infection were 1 pharyngitis, 1 pneumonia and 1 pyelonephritis. Eleven patients had an underlying disease (7 diabetes and 4 malignancies). Four patients developed septic osteoarticular metastases, one after a 3 weeks' course of antibiotic. In the latter case, as well as in the two adult patients who died, the strains of GBS were found to be tolerant to penicillin. Thus, GBS septicemia are not rare in adults and occur often in compromised hosts such as diabetics. The portal of entry is frequently the skin and the course may be severe with distant complications.
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PMID:[Streptococcus group B septicemia. Analysis of 18 cases in adults and 10 in newborn infants]. 633 80

In a survey the present possibilities are outlined to get knowledge about diseases of inner organs with the help of enzyme determinations in the urine. Here it is remarkable that changes of the enzyme excretion appear not only in renal disease with acute renal failure, pyelonephritis, glomerulonephritis, renal infarction and nephroptosis but are also to be observed in primarily extrarenal diseases such as diabetes mellitus, hyperthyroidism, thesaurismoses, myocardial infarction, hypertension, acute pancreatitis, epidemic hepatitis, liver cirrhosis, obstructive jaundice and rheumatoid arthritis. The causes of the changes of enzyme excretions are various. Since enzymes of different origin and localisation behave themselves variably, the simultaneous determination of a brush border marker (e.g. alanine aminopeptidase), a lysosomal enzyme (e.g. beta-glucuronidase or N-acetyl glucosaminidase) and a low molecular enzyme (e.g. lysozyme) is of use for the recognition of renal alterations. By the control of activities of urinary enzymes it is possible to get without risk informations about pathobiochemical processes in the kidney which are not to be gained by means of other methods.
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PMID:[Urinary enzyme excretion in diseases of the internal organs]. 636 87

Diabetic patients are said to be prone to infections. Several studies of different host defense mechanisms report defects in individual granulocyte functions and cell mediated immunity, especially in patients with poorly controlled diabetes. Diabetic females have an increased risk of developing urinary tract infections. This high susceptibility is probably due to local risk factors such as diabetic cystopathy and vaginitis, the latter being frequently associated with glucosuria. Urinary tract infections in diabetic individuals often have a complicated course which may be explained by the aforementioned compromised host defense mechanisms. Diabetics have an increased risk not only of lower, but also of upper urinary tract infections. Urinary tract infections such as emphysematous cystitis and pyelonephritis, as well as papillary necrosis as a complication of pyelonephritis, are not uncommon in diabetic patients. Rapid recognition and management of such complicated urinary tract infections is important.
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PMID:[Urinary tract infection in the diabetic patient]. 637 86

The one-year kidney transplant survival rates from parental donors into recipients with pyelonephritis (PN) was 79% as compared with the low rate of 62% for polycystic disease (PC) and diabetes mellitus (DM). Even more striking was the 42% one-year graft survival in systemic lupus erythematosus (SLE) patients receiving parental donor grafts. HLA-identical sibling donor transplants into patients with DM had a low survival rate of 75% as compared with 90% in PN patients. These results were analyzed for interactions of donor type and disease by comparing the relative survival rates among types of donors within each recipient disease. After taking into account higher overall risks attributable to medical complications inherent in the different disease categories, related donor grafts into patients with PC, SLE, and DM have lower graft survival rates than would be expected from differences in cadaver donor rates by disease. In practical terms, for related donor transplants into patients with SLE, DM, and PC, it may be necessary to consider the vulnerability of the donor organ as another factor.
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PMID:Increased vulnerability of the donor organ in related kidney transplants for certain diseases. 637 16

A case of emphysematous pyelonephritis in a women with diabetes mellitus who previously underwent total pelvic exenteration is presented. The emergency nature of this syndrome and its therapy are discussed.
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PMID:Emphysematous pyelonephritis in a patient with diabetes mellitus and total pelvic exenteration. 649 67

Out of 9015 necropsies of patients, over the age of 14, performed between January 1, 1967 and March 1, 1979 at a general hospital in Sofia, 729 of them (8,07%) proved to have diabetes as well. Renal complications were found in 315 of them (43,2%)--chronic pyelonephritis being most frequent (21,2% of all diabetics) followed by diabetic glomerulosclerosis (DG)--18,5 per cent of the diabetics and in 7,9 per cent--a combination of both complications. The authors studied only the patients with DG. They lived about 5,2 years, on the average, less than the other diabetics and 91,1 per cent of them had arterial hypertension versus 61,3 per cent among the rest of the diabetics. A total of 90 per cent of the hypertonics with DG had left ventricular hypertrophy--I--III stage. Atheromatosis of aorta and coronary arteries were found, in those deceased from hypertonic disease, to be more frequent and more severely manifested, than those decreased from chronic pyelonephritis with hypertension and than those deceased from chronic glomerulonephritis with hypertension in all age groups. Regardless of that, the morbidity rate among the deceased with DG from cardiac complications is a little less than that among the deceased from hypertonic disease and the causes for brain vascular complications among diabetics, in spite of the more frequent and more severe atherogenesis has been three times less rare than among the deceased from hypertonic disease. Very likely, the involvement of the kidneys contributes to those discrepancies.
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PMID:[Cardiovascular changes among deceased patients with diabetes mellitus and diabetic nephropathy among 9015 autopsied over the age of 14]. 667 84

Pyelonephritis was studied after an intravenous injection of Candida albicans, Staphylococcus aureus, or enterococcus in alloxan-diabetic rats and in water-diuresing or non-diuresing nondiabetic rats. The renal microbial populations of C. albicans or S. aureus were found to be greater than 10(5) colony-forming units per g for up to 42 days in diabetic rats, whereas the kidneys tended to become sterile in nondiabetic rats. No significant difference was found in the course of enterococcal pyelonephritis in diabetic versus control rats. The difference in the 50% infective dose for each microorganism between diabetic and control rats was less than or equal to log10. Neither duration of diabetes nor weight loss contributed to the greater and more sustained renal populations of C. albicans and S. aureus in diabetic rats. The inflammatory reaction in kidneys infected with S. aureus or C. albicans was greater in diabetic rats. Fungus balls associated with ureteral obstruction and gross multiple renal abscesses occurred in diabetic, but not in nondiabetic, rats infected with Candida. Growth of C. albicans and S. aureus in vitro in urine from diabetic rats was significantly greater than it was in urine from control rats. Addition of water or glucose to the urine of non-diuresing, nondiabetic rats significantly increased in vitro growth of S. aureus and C. albicans. These studies demonstrate greater severity of infection in the diabetic kidney due to S. aureus and C. albicans, which can be partially explained by decreased inhibitory activity of urine for these organisms in diabetic rats.
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PMID:Experimental Candida albicans, Staphylococcus aureus, and Streptococcus faecalis pyelonephritis in diabetic rats. 680 Sep 56


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