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)

A 44-year-old woman with a 5-year history of poorly controlled Type 1 diabetes mellitus presented with a painful, firm and warm swelling in her right thigh. Pain was severe but the patient was not febrile, and had no history of trauma or abnormal exercise. Laboratory tests showed ketoacidosis, major inflammation (erythrocyte sedimentation rate (ESR) = 83 mm/h), normal white blood cell count and normal creatine kinase level. Plain radiographs were normal, and there were no signs of thrombophlebitis at Doppler ultrasound. Magnetic resonance imaging (MRI) showed diffuse enlargement and an oedematous pattern of the adductors, vastus medialis, vastus intermedius and sartorius of the right thigh. The patient's symptoms improved dramatically, making biopsy unnecessary, and a diagnosis of diabetic muscular infarction was reached. Idiopathic muscular infarction is a rare and specific complication of diabetes mellitus, typically presenting as a severely painful mass in a lower limb, with high ESR. The diabetes involved is generally poorly controlled longstanding Type 1 diabetes with established microangiopathy. Differential diagnoses include deep vein thrombosis, acute exertional compartment syndrome, muscle rupture, soft tissue abscess, haematoma, sarcoma, inflammatory or calcifying myositis and pyomyositis. In fact, physician awareness should allow early diagnosis on the basis of clinical presentation, routine laboratory tests and MRI, thereby avoiding biopsy and its potential complications as well as unnecessary investigations. Rest, symptomatic pain relief and adequate control of diabetes usually ensure progressive total recovery within a few weeks. Recurrences may occur in the same or contralateral limb.
Diabetes Metab 1999 Sep
PMID:Painful swelling of the thigh in a diabetic patient: diabetic muscle infarction. 1049 95

Thromboangiitis obliterans (TAO) has been reported to become less common in general population but more common in women, and in elderly patients. The authors looked at the clinical characteristics of TAO in Poland where there was no significant decrease of smoking and the extent of aging of the general population is less profound. They retrospectively reviewed the records of 377 patients with the diagnosis of TAO hospitalized in their institution from 1970 to 1995. If young smoking males demonstrated distal-extremity ischemia with no bruits audible over major arteries, upper limbs involvement, or superficial thrombophlebitis, the diagnosis of TAO was considered certain. When at least one of those criteria was missed, and in men older than 35 years, but in all females, typical arteriographic findings were required for the diagnosis of TAO. Connective-tissue disease, hyperlipidemia, diabetes, and hypercoagulable state were excluded. Three hundred forty-two men (91%), and 35 (9%) women had a mean age of 29.5 years at the onset of the disease (the oldest patient was 50 years old). The prevalence of TAO in southwest Poland is 8.1/100,000 and the incidence of the disease steadily declines; there was no increase of TAO in women. Three hundred thirty-seven (89%) experienced rest pain, 321 (85%) had ischemic necrosis, and 233 (62%) thrombophlebitis at some (continued on next page) time in the course of the disease. Raynaud's phenomenon occurred in only 39 patients (10%). Those patients who had quit smoking had a 50% decrease of the disease recurrences compared to their smoking period. Because the cause of declining incidence of TAO is obscure, the authors critically evaluated previously used explanations of this phenomenon. They did not confirm the observation of a change in the TAO clinical spectrum: occurrence in women did not increase, the aging of the TAO population was not observed. In Poland TAO is still a disease affecting the peripheral circulation of young smoking males with recurrent episodes of superficial thrombophlebitis and common involvement of the upper extremities; Raynaud's phenomenon is rather infrequent. Smoking cessation ameliorates the course of the disease but does not invariably stop further exacerbations.
 ...
PMID:Sustained classic clinical spectrum of thromboangiitis obliterans (Buerger's disease). 1070 22

Suppurative thrombophlebitis is a well recognised and potentially fatal complication of intravenous cannulation in burns patients. We report a case of an Afro-Caribbean patient with noninsulin-dependent diabetes who developed signs of systemic sepsis two weeks after a 14% total body surface area flame burn. Despite an initial paucity of clinical signs at the cannulation site, exploratory venotomy revealed frank suppuration within the long saphenous vein from the ankle to the groin. This was treated successfully by total excision of the vein and its tributaries and delayed wound closure. Following this, a retrospective analysis of the measured clinical parameters and blood tests revealed no obvious, missed pointers to the impending sepsis other than a dramatic increase in the overall daily insulin requirement. This had doubled over a 48-h period, preceding the clinical diagnosis by three days. The relevant literature and guidelines for management are reviewed.
 ...
PMID:Cannula related suppurative thrombophlebitis in the burned patient. 1071 66

Antibiotic prophylaxis was applied to patients with high risk of infection undergoing: myomectomy m. Martin, procedures on the uterine adnexa, total and/or subtotal hysterectomy and laparoscopy. The influence of this prophylaxis on the incidence of fever and wound infection was observed. For vaginal hysterectomy antibiotic prophylaxis was not applied. The risk factors included: the history of at least 1 laparotomy, suffer from chronic adnexitis in the past, past thrombophlebitis, diabetes and obesity. Statistically significant decrease of wound infections among patients underwent total and/or subtotal hysterectomy was noted, the highest incidence of fever occurred after myomectomy m. Martin, there was no wound infection following laparoscopy, the rate of infections after vaginal hysterectomy was much lower than after abdominal hysterectomy.
 ...
PMID:[The influence of antibiotic prophylaxis on the incidence of fever and wound infection after gynecological operations in patients with increased risk of infection]. 1188 7

The pill is discussed. Discovery of the pill was carried out by Dr. G. Pincus. He developed a substance called norethynodrel. Through Professor Marker's work progesterone was made available. Dr. Pincus and Dr. J. Rock started clinical trials with progesterone in Puerto Rico. The chief effect of progesterone in the 20 day pill is to prevent the release of the ripe egg. It also disrupts the normal sequence of hormones that make the lining of the womb receptive to a fertilized egg. Small amounts of a substance resembling estrogen are added to the progesterone to reduce the unpleasant side effects produced by progesterone. Oral contraceptives should not be used by women with thrombophlebitis, thromboembolic disorders, cerebral apoplexy or past history of these conditions, markedly impaired liver function, known and suspected carcinoma of the breast, uterus, and cervix, estrogen dependent neoplasms, jaundice, diabetes, congestive cardiac failure, epilepsy, or severe allergic conditions. It is also advised that oral contraceptives not be used by nursing mothers in the first 6 months and by those with vaginal bleeding. There are side effects to the contraceptives, and certain precautions should be taken before oral contraceptives are prescribed. Physical examinations should be carried out. The patient with history of psychic depression should be carefully observed on orals, and if severe depression occurs, use of the pills should be discontinued. British studies have shown higher mortality and hospitalization rates due to thromboembolic disease in oral contraceptive users than in nonusers.
 ...
PMID:The pill. 1225 8

In the Henry Ford Hospital during a 14-month period thromboembolic d isease occurred in 6 women who had been taking norethynodrel (Enovid). Thrombophlebitis was observed in 3 and pulmonary infarction in 2. An arterial occlusion in 1 patient resulted in the loss of a leg below the knee. Mild diabetes also existed in this patient. Another patient has worn a cast for fracture until 3 weeks prior to admission. Although no local signs of thrombophlebitis were elicited, x-ray of the chest showed a pleural effusion considered typical of pulmonary infarction. During a pregnancy 6 months previously 1 patient may have had a thrombophlebitis. In the other 3 cases no predisposing cause was detected. Although statistical and experimental evidence is lacking, cl inical experience suggests that a possible etologic relationship exists in susceptible individuals.
 ...
PMID:Thromboembolic disease associated with norethynodrel: report of six cases. 1225 92

The US Food and Drug Administration approved the contraceptive implant Norplant in December 1990. Many US physicians and nurse practitioners have received training in inserting the implant, but few health educators know enough about Norplant and potential users to provide adequate education and counseling. The 6-capsule system steadily releases 50-80 mg levonorgestrel into the bloodstream for five years for a contraceptive effectiveness rate greater than 99%. Levonorgestrel keeps the pituitary gland from releasing two hormones needed for ovulation, thickens the cervical mucus, and suppresses endometrial development. Irregular bleeding is the most common side effect. Contraindications for Norplant include liver tumors, active liver disease, breast cancer, active thrombophlebitis, unexplained uterine bleeding, pregnancy, blood clots in the eyes or lungs, diabetes, hypertension, and cigarette smoking. Advantages are its 5-year effectiveness period, that it is easy and convenient to use, does not require compliance, and is reversible. Disadvantages are that it offers no protection against sexually transmitted diseases, especially HIV/AIDS; it requires a surgical procedure; and its cost ($500-$750/patient). Few studies present a profile of US women using Norplant. Potential users are adolescents, vulnerable women, low income women with children, and women who do not want to become pregnant for a long time but do not consider the pill or sterilization viable options. Extensive research indicates that Norplant is safe in the short and intermediate term. More research is needed to identify the demographic profile of a typical user, why she chooses Norplant, how well she understands it, or whether she was well informed about it; to learn about satisfaction with Norplant; and to find out who discontinues Norplant before the end of 5 years. This information would help health educators in their counseling and education strategies.
 ...
PMID:Norplant: what health educators need to know. 1228 63

The author describes a range of contraceptive methods, and their side effects, which may be acceptable for new parents. The methods are the oral contraceptive pill, Norplant, Depo-Provera, and intrauterine devices (IUD). Natural methods and permanent contraception are options described in insets. The author notes that differences in the effectiveness rates among available types of oral contraceptive pills are small enough not to merit consideration when deciding which kind of pill may be appropriate. Combination birth control pills are taken daily at the same time for 21 out of 28 days. Combination pills are not recommended for women with a history of hypertension or other cardiovascular diseases, thrombophlebitis, migraine headaches, diabetes, active gallbladder disease, or mononucleosis. Any hormonal method may be particularly risky for smokers over age 35. The mini-pill, containing a smaller amount of progesterone and no estrogen, is taken every day and is also on a 28-day cycle. Containing no estrogen, the mini-pill is often recommended for women who are nursing, who are over age 35, or who suffer from hypertension or migraines. Both adverse and positive side effects may be experienced from use. Norplant is the brand name of a contraceptive system which releases progesterone from under the skin of a woman's upper arm over the course of a five-year period. The system has a theoretical effectiveness rate of more than 99%, although the duration of effectiveness may be less than five years in overweight women. The most common side effect is irregular bleeding, and removal is often a longer and more difficult procedure than insertion. The most commonly used injectable hormonal contraceptive is Depo-Provera, a progesterone solution which works for up to three months. The majority of users experience some side effects. Finally, IUDs are highly effective and need to be replaced only every 1-10 years depending upon how they are made. Women typically experience discomfort during IUD insertion, and they should not be used by women under age 20 years, who have never had children, or who have ever had a pelvic infection.
 ...
PMID:Birth control for new parents. 1229 Aug 91

Results of standard three-hour oral glucose tolerance tests (OGTT) and intravenous glucose tolerance tests (IVGTT), performed on the same subjects, were compared in an attempt to determine their value in the diagnosis of borderline diabetes. A total of 83 such tests were carried out on 81 subjects. Applying the U.S. Public Health Service point count method to the results of the OGTT test, there were 38 normals, 23 possible diabetics and 22 diabetics. A constant (K) was calculated from the glucose disappearance rate in the IVGTT curves.K disagreed with the OGTT classification to a significant extent, especially in the possible diabetic and non-diabetic groups. Also, the correlation coefficients between K and the OGTT values were not impressive. This does not mean that one test is superior to the other, only that the accuracy of either test in diagnosing early diabetes is doubtful.Technically, the IVGTT was more difficult and time-consuming, and six of the 81 subjects suffered from thrombophlebitis at the site of glucose injection.
 ...
PMID:A COMPARISON OF THE ORAL AND INTRAVENOUS GLUCOSE TOLERANCE TESTS IN NON-DIABETIC, POSSIBLE DIABETIC AND DIABETIC SUBJECTS. 1422 26

Vascular access (VA) is mainly a problem confronting patients undergoing hemodialysis (HD). In some cases, peripheral veins are damaged or thrombosed because of repeated vein punctures and subsequent thrombophlebitis or accompanying ailments like diabetes or other kinds of vasculitis, making the use of conventional VA methods unsuitable. In this study, we present our experience using a synthetic vascular graft as an arterio-arterial duct (AAD) in the upper arm of patients undergoing HD, in whom other procedures had failed. In this procedure, we used a synthetic vascular prosthesis of polytetrafluoroethylene(ePTFE) (Gore-Tex) or Vasculink as an AAD, subcutaneous in the media aspect of the upper arm. HD was performed for this duct. Twenty patients were selected in whom all other VA means had failed. Patient age ranged from 33-83 yrs. In two patients (12%), early graft thrombosis was the cause of failure. In the remaining 14 patients (87%), a suitable flow was established. In another two patients, after several dialysis sessions the duct stopped functioning. We believe the reason for this malfunction was too much pressure on the graft to control bleeding due to the inadequate training of the HD personnel. The remaining 12 patients (75%) used the duct for >6 months. With this method, because we used only the artery for placing the conduit, complications relating to the vein such as limb ischemia, edema and venous hypertension did not prevail. On the other hand, because the conduit is an accessory duct, should it have become thrombosed, arterial flow to the limb would be unhindered. Therefore, we believe when all other conventional VA methods have failed, AAD is a suitable technique.
 ...
PMID:Arterio-arterial prosthetic duct (AAD) as a vascular access in hemodialysis. 1659 51


<< Previous 1 2 3 4 5 6 7 Next >>