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

Our study was done to determine whether patients with schizophrenia and a coexisting physical disorder could adequately discuss the physical illness with a physician. We defined the minimal standard of adequate communication as the ability to acknowledge and name a physical problem during an index hospitalization. Of the 110 patients studied, 38 had a total of 54 medical illnesses (diabetes mellitus, hyponatremia, thyroid disorder, urinary tract infection, bladder dysfunction, hypertension, anemia, liver disorder, and seizure disorder). After two years of follow-up, 28 of these 38 patients agreed to participate in the second part of the study. Upon interview, 24 patients were unable to name at least one of their physical problems. This study reproduces the previous findings of psychiatric patients' difficulty in communicating about physical illness. It suggests that the communication difficulty is constant and not lessened in the nonacute situation.
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PMID:Communication difficulty of patients with schizophrenia and physical illness. 335 75

By a retrospective relative risk analysis for conditions associated with urinary tract infection over a four-year period in a defined teaching nursing home population (n = 97), we reached the following conclusions: (1) UTI was associated with cerebrovascular accident (relative risk 2.2, 95% confidence interval 1.4 to 3.2), decreased activities of daily living (relative risk 2.6 to 3.2, 95% confidence interval 1.4 to 4.7), decreased mental status (relative risk 2.2, 95% confidence interval 1.2 to 3.1), urinary catheterization (relative risk 2.5, 95% confidence interval 1.3 to 3.7), and antibiotic prophylaxis (relative risk 2.1, 95% confidence interval 1.2 to 3.0). (2) Risk of UTI from urinary catheterization and antibiotic prophylaxis was additive for these functionally impaired patients. (3) Renal insufficiency, diabetes, anemia, malnutrition, age, and incontinence (without catheterization) were not related to risk of UTI.
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PMID:Antecedent factors in urinary tract infections among nursing home patients. 337 79

Development of nosocomial and iatrogenic UTI was investigated over 3 months period of time. Included were 140 patients following 228 instrumentations or endoscopical or surgical interventions. Of these 84 were carried out under antimicrobial medication. 30 UTIs developed 1-8 days after the various procedures (= 13.2%): 10% after TUR-B, 14% after TUR-P and ureteral instrumentation, 16% following cystoscopy and catheterisation. No significant difference was observed between: Males and females, patients with or without antimicrobial medication, younger and older patients and after long or short procedures. Indwelling catheters remain sterile for 3 days. Though antimicrobial prophylaxis did not significantly influence the generally low rate of infection it appeared as a trend that the elderly patient who requires repeated interventions and who suffers from additional diseases as diabetes, consuming tumours and renal insufficiency may benefit from medication.
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PMID:Development of nosocomial and iatrogenic urinary tract infections (UTI) following urological interventions. A prospective clinical study. 348 69

As a result of decreases in maternal mortality and infectious diseases, women's life expectancy has increased rapidly in this century and is expected to reach 83 years by the year 2000. However, there are a large number of chronic conditions that negatively affect the quality of life of women today: urinary tract infection, menstrual cycle disorders, hypertension, diabetes, osteoporosis, arthritis, eating disorders, substance abuse, and mental depression. Although women's life expectancy is 7.5 years greater than that of men, the morbidity rates are significantly higher for women. As women continue to enter the labor force in large numbers, questions are being raised regarding the physical and psychological hazards of jobs traditionally considered to be women's work, the risks associated with jobs that are physically demanding or involve exposure to toxic substances, and the association between pregnancy outcome and employment. Further research is needed on the effects of multiple role stress on women's health. Another recent trend has been the feminization of poverty: 2/3 of all US adults classified as poor are women. The lack of financial resources has a detrimental effect on nutrition, access to health care, and other preventive behaviors. Yet another social change related to women's health is the increasing number of elderly in the population. Women comprise 72% of the elderly poor, and over 80% of all retiring female workers do not have pension benefits. Access to, availability of, and payment for health care are problems for elderly women. It is important that research address the physiologic, psychosocial, and economic factors that together affect women's health status.
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PMID:Changing factors and changing needs in women's health care. 351 29

During a period of 22 months one or more episodes of bacteraemia were detected in 168 patients in hospital. Of these, 29% also had diabetes compared with 10% of the total number of patients admitted to hospital during this time (P less than 0.001). The diabetics with bacteraemia were elderly and diabetes had usually been present for many years. Most of them were not receiving insulin at the time bacteraemia was diagnosed. Escherichia coli was the commonest pathogen (33%) in the diabetics, the main source of infection being the urinary tract. This finding may be due to diabetic autonomic neuropathy, which leads to a poorly emptying, chronically infected bladder. Urinary tract infections with bacteraemia in elderly diabetics are often accompanied by vague non-specific symptoms and poor diabetic control. Fever is infrequent. Prompt antibiotic therapy and insulin injections to control the diabetes usually cure these serious infections.
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PMID:Bacteraemia in diabetics. 352 48

Nosocomial urinary tract infections represent approximately 40 per cent of all nosocomial infections, thereby contributing considerably to secondary bacteremia and sepsis and possibly increased mortality. Urethral catheterization is the single most important predisposing factor in the development of urinary tract infection. Patients at increased risk of nosocomial infectious complications are the elderly, malnourished and debilitated, those with diabetes or prosthetic devices, and those on immunosuppressive therapy. About 75 per cent of nosocomial urinary tract infections are attributable to gram-negative bacteria, a disproportionate number of which when compared with community-acquired infections are caused by Proteus, Klebsiella, and Pseudomonas. There is enough evidence in the literature to support the use of prophylaxis in urologic surgery. Antimicrobial prophylaxis reduces the incidence of postoperative urinary tract infection. It does not seem to reduce the incidence of transient perioperative bacteremia but probably prevents the development of sepsis, thereby reducing the number of serious infective complications, the average hospital stay, and the associated total cost of treatment. To achieve adequate urine, blood, and tissue levels of the antimicrobial agent at the time of surgery, the drug should be given preoperatively. A short perioperative course represents sufficient prophylaxis. Regimens with combinations of beta-lactam and aminoglycoside antibiotics or single use of an extended spectrum beta-lactam antibiotic are acceptable for this purpose.
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PMID:Antimicrobial prophylaxis in urologic surgery. 353 3

There are fewer studies on bacteremia coming from the community hospital, where the practicing family physician is likely to see this problem, than from the university hospital. The hypothesis of this study was that patterns of bacteremia would be different between the two types of hospitals. Two hundred four patient episodes of culture-proven bacteremia from two analogous community hospitals were reviewed. Bacteremia was discovered in 2.6 of 1,000 patients, which is lower than reports from university hospitals. Of the 213 organisms isolated, slightly more were gram-negative than gram-positive, whereas many tertiary care centers report a preponderance of gram-negative organisms. About 20 percent of the episodes of bacteremia ended in death, a rate lower than in many tertiary care centers, and slightly more patients died of gram-negative than gram-positive bacteremia. The most common organisms in descending order were the streptococci and Escherichia coli followed by Staphylococcus aureus, Klebsiella pneumoniae, Proteus species, and Streptococcus pneumoniae. The most common sources of bacteremia were, in decreasing order, urinary tract, source unknown, heart valve, and lung. The most common underlying disorders were, in decreasing order, malignancy, diabetes mellitus, complicated urinary tract infection, valvular heart disease, and postoperative infection. Correctness of treatment of bacteremia appeared to increase survival.
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PMID:A two-center review of bacteremia in the community hospital. 354 87

The urinary tract is resistant to ascending infection due to Candida albicans. Host and microbial factors that may alter such resistance were evaluated in the rat after inoculating C. albicans into the urinary tract. Diuresis, diabetes, candidal germ-tube formation, and vaginal Candida colonization (alone or in concert) failed to promote ascending urinary tract infection with two vaginal isolates of C. albicans capable of producing renal infection by the hematogenous route. Both germinated and ungerminated Candida adhered poorly to bladder mucosa. Unlike prior urinary tract infection due to an enterococcus that failed to agglutinate Candida in vitro, prior urinary tract infection with a mannose-binding strain of Escherichia coli that agglutinated C. albicans in vitro enhanced adherence of C. albicans to bladder mucosa and increased susceptibility to ascending C. albicans urinary tract infection. Thus, resistance to Candida ascending urinary tract infection is likely to be due to poor adherence of C. albicans to normal bladder mucosa.
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PMID:Susceptibility to experimental Candida albicans urinary tract infection in the rat. 354 21

In an open, non-comparative study 40 patients with severe, often life-threatening infections, were treated with Timentin 5.2 g (5 g ticarcillin plus 200 mg potassium clavulanate) by iv infusion every 6 or 8 h. They were suffering from septicaemia (9), obstructed UTI (8), non-obstructed urinary tract infection (10), respiratory tract infection (6), infected burns (4) or malignant otitis externa (3). Many patients had important aggravating factors such as renal transplantation, peritoneal or haemodialysis, leukaemia, extensive burns, renal stones, tracheostomy and diabetes. Pathogens included Pseudomonas aeruginosa (21), Escherichia coli (7), and other Enterobacteriaceae (6). Twenty-four pathogens (13 P. aeruginosa) were ticarcillin-resistant. Thirty-six patients were clinically cured including all cases of malignant otitis externa, infected burns and non-obstructed urinary tract infection. Three patients improved and one patient with obstructed urinary tract infection failed. In 32 patients the pathogen was eradicated, in one patient it persisted and in seven it reappeared. In particular, 11 of 13 patients with infections due to ticarcillin-resistant P. aeruginosa were cured and two improved. There was, however, bacteriological relapse in five. There were no side-effects or evidence of toxicity in any of the patients. In an in-vitro study a synergistic effect between ticarcillin and clavulanate was noted against Enterobacteriaceae but only a slight synergistic effect against P. aeruginosa. Studies in patients with normal liver and kidney function showed pharmacokinetic compatibility of the two agents. Timentin can be recommended for the initial treatment of serious infections.
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PMID:Ticarcillin and clavulanic acid in serious infections. 363 32

Blood glucose and glucose tolerance tests demonstrated that many male MM mice are diabetic. Serial urine sampling showed that the diabetes occurred only in mature MM males and consisted of a single self-limiting episode. Histological examination of the pancreas, together with measurements of body weight, glycosylated haemoglobin and plasma insulin, revealed that the diabetes was of the maturity-onset insulin-resistant type. Bacteriological examination of the urine samples showed that urinary tract infection, a known feature of male MM mice, occurred in the diabetics but only after the onset of hyperglucosuria. It was concluded that the high urinary glucose levels of diabetic MM males are of prime importance in the aetiology of the renal infection which occurs rarely in non-diabetic MM males or in other strains in the colony. An infectious aetiology for the diabetes per se was excluded by the existence of diabetes in germfree MM males.
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PMID:The association between spontaneous pyelonephritis and maturity-onset diabetes mellitus in male MM mice. 369 89


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