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

Thirty-four patients of diffuse idiopathic skeletal hyperostosis (DISH) were presented. Twenty-four of them were associated with myelopathy or radiculopathy, mainly due to spinal stenosis. Plain X-ray films showed there was spinal flowing or laminated ossification on the anterior or right lateral side, forming continuous bony bridge at least of four vertebral bodies. Ossification occurred both on the spinal and extra-spinal region. Operative findings of 11 cases revealed significant encroachment of the ossified mass on the dural sac, especially at the level of the apophyseal joint. OPLL was found in ten cases. DISH and OPLL may be different manifestations of same entity. In this series, there was not enough evidence of diabetes mellitus related to DISH, and no specific antigen in HLA typing.
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PMID:[Myelopathy and radiculopathy in diffuse idiopathic skeletal hyperostosis]. 251 51

The existence of myelopathy as a complication of diabetes is debatable and, in the few reported cases, spinal involvement has been diffuse. We describe 2 cases of focal myelopathy. Two insulin-dependent, middle-aged men with adult-onset diabetes presented with gradually ascending lower limb pain and numbness without sphincteric symptoms. Examination showed mixed upper and lower motor signs in the lower limbs, with a severe impairment of cutaneous sensation below a sharply demarcated band at the T9-10 level with relative preservation of posterior column function. Myelography was normal. CSF showed mild elevation of protein and in one case showed 23 x 10(6) white cells/L. Nerve conduction studies showed a co-existing, mild sensorimotor neuropathy. There was no evidence of truncal radiculopathy on paraspinal EMG. Extensive investigation for other causes of myelopathy was negative.
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PMID:Diabetic focal myelopathy. 326 39

Median nerve compression at the wrist (Carpal Tunnel Syndrome) is commonly associated with local trauma around the flexor retinaculum. Repeated manual activity also exacerbates the disease severity. We undertook a prospective study of the incidence of Carpal Tunnel Syndrome (CTS) in 47 paraplegic patients who have used their hands extensively for daily activity. Since surgical decompression generally provides excellent relief of symptoms, early detection of CTS will be particularly important in these patients. Of the 47 patients studied, 19 had clinical CTS (40%). A total of 91 hands (nerves) were tested with motor and sensory nerve conduction of the median and ulnar nerves. Electrophysiological evidence of CTS was noted in 57 hands (63%). The incidence of CTS appears to be related to the duration of Spinal Cord Injury. Concurrent ulnar neuropathy at the elbow was noted in 19 patients (40%). There was no predisposing factor such as diabetes mellitus in any of these patients, and the compressive neuropathy appears to be purely mechanical.
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PMID:Carpal tunnel syndrome in paraplegic patients. 401 Dec 94

Modern care of patients with spinal cord injury is leading to greater numbers of individuals surviving into old age and the emergence of a cohort that has sustained injury at an advanced age. The clinical characteristics of either group of patients has not been well characterized. Analyses from the Aging with a Long-Term Disability Research Program database, which is enriched by the presence of a high quality Spinal Cord Injury Service, revealed a population of 510 recently assessed individuals with a mean age of 50 years, ranging from 16 to 84 years. Twenty-three percent of the patients were at least 65 years of age. Spinal cord injuries were usually the result of automobile accidents in individuals injured younger than 50 years of age and falls in individuals injured when older than 50 years of age. Patients surviving late life injury are much more likely to have incomplete injuries predominantly affecting the cervical spine. A number of conditions were found to be more prevalent in older patients. These included carpal tunnel syndrome, chronic obstructive pulmonary disease, myocardial infarction, diabetes, kidney stones, pressure ulcers and hypertension. The development of diabetes, kidney stones and perhaps pressure ulcers was directly related to aging with SCI, but not just to aging alone. The better functional outcomes in late life spinal cord injury may be secondary to selective survival. The excess morbidity associated with late life spinal cord injury has significance for future planning of healthcare needs for the spinal cord injured patient.
J Spinal Cord Med 1995 Jul
PMID:Late-life spinal cord injury and aging with a long term injury: characteristics of two emerging populations. 859 Oct 73

A 64-year-old man who had suffered from diabetes mellitus and a recurrent intractable ulcer of the foot developed subacute transverse myelopathy with severe inflammatory reactions. Magnetic resonance imaging (MRI) revealed destructive lesions in both upper thoracic and lumbar spines. In plain X-ray film, although intervertebral spaces of the lumbar spines were apparently normal on the supine position, they became narrow spaces on the sitting position. The aspiration biopsy from the intervertebral spaces of the lumbar spines showed non-specific necrotic tissues. These findings suggested that the destruction of the intervertebral disks also occurred simultaneously. According to the clinical course and radiological studies, we diagnosed this patient as pyogenic osteomyelitis, and performed the antibiotics therapy. Although he showed no change in his signs and symptoms due to transverse myelopathy, radiological studies exhibited an improvement of both the lumbar and thoracic lesions. In addition, MRI studies in the lumbar lesions revealed low intensity signals on both T1 and T2 weighted images before the antibiotics therapy. It was suggested that lumbar lesions were older than the thoracic lesions. Serial studies including bone X-ray film and MRI were not only useful for the diagnosis of pyogenic osteomyelitis but also for an evaluation of the lesions.
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PMID:[A case of transverse myelopathy caused by pyogenic vertebral osteomyelitis having extended from a pedal ulcer]. 802 33

Dorsal column function and peripheral motor and sensory conduction velocities (MCV, SCV) were evaluated in experimental diabetic rats and compared with those in 2,5-hexanedione (2,5-HD) intoxicated rats. Hyperglycemia was induced by a single injection of streptozocin, and electrophysiological studies were performed 4 and 12 weeks after the injection. For 8 weeks 2,5-HD was administered daily by drinking water to make the 2,5-HD neuropathy rats. Age-matched rats were used as control. In diabetic rats, gracile surface potentials evoked by electrical stimulation of the lumbosacral trunk remained normal during the experimental period, whereas the N and P waves of the evoked potentials were suppressed and the duration of the N wave was prolonged in the 2,5-HD rats. In 4-week diabetic rats, the antidromic compound action potentials of the gracile tract recorded at the most proximal site of lumbosacral trunk were normal. In 12-week diabetic rats, the gracile tract conduction velocity (GTCV) was decreased, although the duration of these potentials was normal. By contrast, the GTCV was decreased and the duration was markedly prolonged in 2,5-HD rats. These findings might indicate that temporal dispersion of incoming volleys in the gracile tract is increased in 2,5-HD rats, but not in diabetic rats. These results suggest that diabetic myelopathy exists that but the magnitude and progression of this condition are quite different from those of 2,5-HD intoxication, typical dying-back-type neuropathy and that the dorsal column is less vulnerable than the peripheral nerve in diabetes mellitus.
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PMID:Electrophysiological study of dorsal column function in streptozocin-induced diabetic rats: comparison with 2,5-hexanedione intoxication. 846 93

Thermoregulation involves a long term adaptation system with hormonal processes and an immediate regulation system by extrapyramidal tracts, sympathetic part of autonomic nervous system and cortical integration of body temperature changes. Both system are under control of a hypothalamic center. Prolonged accidental exposure to intense cold and myxoedematous coma are the best known etiologies of hypothermia. However milder and often misdiagnosed hypothermia can occur at home in patients without endocrinologic disease. In these cases, hypothermia is due to dysfunction of immediate thermregulation under neuronal control, especially somatomotor and autonomic system. We report four cases of hypothermia of this kind. Two patients had an inhibition of peripherical mechanisms of protecting against cold (cutaneous vasoconstriction, shivering) and had dampened perception of cold: one was 73, had diabetes mellitus and took different drugs, the other one suffered from systemic lupus with myelopathy. The two other patients probably had a disorder of the thermoregulation hypothalamic center: one had Wernicke's encephalopathy and the other multiple sclerosis. From these cases and a review of the literature, we describe the different etiologies of hypothermia and their pathophysiology.
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PMID:[Hypothermia and the nervous system. Review of the literature apropos of 4 cases]. 876 Jun 89

Clinical data, MR-scans, time-dose fractionation schemes and neuropathologic findings of two cases of delayed radiation myelopathy (DRM), are presented. Both patients, a 72-year-old diabetic woman with cervical lymphnode metastasis from a squamous cell carcinoma and a 46-year-old woman with tonsillar carcinoma, developed paraparesis followed by quadriplegia, at 7 and at 10 months following radiation. The spinal cord received 46 and 49 Gy. (Fraction dose 2.25 Gy and 2.0 Gy, 4 times/week). Serial MR-scans showed spinal cord enlargement and focally increased signal intensity (T1-gd). The second patient survived and stabilized following therapy with coumarins. The first patient died 13 months after radiotherapy. At autopsy necrosis, local calcium deposits, lipid macrophages and swollen astrocytes were observed in the white matter. There was slight hyalinosis of the intramedullary vessel walls. We conclude that serial MRI may be helpful to distinguish DRM from other causes of spinal cord injury. DRM may occur at a total dose less than 50 Gy. Additional risk factors (diabetes, hypertension), and fraction doses above 2 Gy contribute to the development of DRM.
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PMID:Delayed radiation myelopathy: serial MR-imaging and pathology. 883 1

A 59-year-old man with a history of diabetes mellitus (NIDDM) presented with fever, back pain and weakness in the left lower limb. Three weeks later he suddenly developed flaccid paraklegia, a sensory deficit below the abdomen and sphincter dysfunction. MR images of the spinal cord showed an extensive anterior spinal epidural abscess extending from the seventh cervical to the twelfth thoracic spine and osteomyelitis in the lower thoracic spines. He died of pulmonary infection one year after the disease onset. Postmortem examination revealed a large empyema in the lung. On neuropathological examination, small multiple hemorrhagic or ischemic lesions were found in the basal ganglia and the pons. The spinal cord was markedly atrophic in the lumbar cord. However, there was neither compression deformity in the cord nor occlusion in the anterior spinal artery. Throughout the thoracic cord, rarefaction and focal cavity formation was selectively present in the gray matter, particularly the posterior horns. In the white matter, vacuolar changes were seen peripherally as well as Wallerian degeneration in the lateral and anterior corticospiral tracts and in the fascicles gracilis bilaterally. The mechanisms inducing the cord damage in cases of epidural spinal abscess have been speculated to be either direct compression by the abscess or the secondary circulatory disturbance in the cord due to compression. In our case, the cord showed necrotizing poliomyelopathy, which was similar to that of ischemic myelopathy found in the cases of cardiac arrest or dissecting aneurysm of the aorta. Autopsy study of spinal cord lesion associated with epidural abscess has been limited in number and our case should contribute to the understanding of the pathomechanism of such myelopathy.
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PMID:[An autopsy case of an extensive epidural spinal abscess demonstrating necrotizing poliomyelopathy]. 888 33

In previous articles on the Stockholm Spinal Cord Injury Study (SSCIS), we have reported the frequent occurrence of medical problems in a near-total regional SCI population comprising 353 subject. This present study further investigates health-related issues in this SCI population, by a level-of-living survey that has been used annually on 8000-14,000 Swedes since 1974. The health-focused version of this survey was used for data collection in those 326 subjects in the SSCIS who were residents of the Greater Stockholm area. Subjects of the SSCIS living on the island of Gotland were excluded because they represented a sociodemographically different (rural) population. The normative material consisted of 1978 interviews of residents of the Greater Stockholm area, provided by the Swedish Bureau of Statistics. Results show a higher utilisation of health care resources among SCI subjects, shown by higher rates of long-term sick leave and sick pension, and more treatment as inpatients, emergency room attendees, and outpatients. Pain, bladder problems, and psychological symptoms are more commonly reported by SCI subjects. Medications such as antibiotics, analgesics, sedatives, hypnotics and laxatives are used more frequently in the SCI group. In contrast, no statistically significant differences were found as regards reported prevalence of diseases other than SCI, including diabetes, hypertension and cardiac disease. The results thus verify the impression from our previous studies of a clearly increased morbidity among these SCI subjects. The increased morbidity seems to be accounted for by the SCI itself, or conditions directly caused by it.
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PMID:The Stockholm Spinal Cord Injury Study. 3. Health-related issues of the Swedish annual level-of-living survey in SCI subjects and controls. 892 13


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