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

The presence of residual urine was determined by postvoid bladder ultrasonography in 37 control subjects and 102 unselected insulin-dependent and non-insulin-dependent diabetic patients. Significant residual volume was detected in 19 diabetic subjects without explanation other than diabetic neurogenic bladder dysfunction in 15. The four others had prostatic hypertrophy. Excluding these four subjects, those with residual urine were slightly older than the others (P less than 0.05), but the known duration of diabetes was increased only for the insulin-dependent group (P less than 0.05). The presence of residual urine was strongly associated with peripheral neuropathy (P less than 0.001). In contrast, of all the manifestations of autonomic failure studied, only impotence (P less than 0.01) and decreased pupil motility (P less than 0.05) were associated with residual urine. The prevalence of urinary tract infection was higher in women than in men (P less than 0.02). This prevalence was increased in the presence of residual urine (P less than 0.02) but only for men (P less than 0.001).
Diabetes Care
PMID:Ultrasonographic determination of residual urine in diabetic subjects: relationship to neuropathy and urinary tract infection. 718 35

Of 1017 patients admitted to the Royal Perth Hospital Diabetic Survey 142 were found to have significant bacteriuria. In these bacteriuric patients serum pyridoxal concentrations were significantly reduced (P = less than 0.001) when compared with 142 diabetic patients matched for age (+/- 5 years) and sex but without infection of the urinary tract. Measurements were repeated up to 6 mth after antibacterial treatment and serum pyridoxal concentrations were still low. Pyridoxal has a role in immunological competence, and it is possible that the increased incidence of urinary tract infection in patients with diabetes reflects impaired immunological competence due to pyridoxal deficiency.
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PMID:The association of bacteriuria and reduced serum pyridoxal concentrations in patients with diabetes mellitus. 730 22

The incidence and clinical course of urinary tract infections in postmenopausal diabetic patients in comparison to non-diabetic women have been evaluated. All cases with former history of urinary instrumentation or underlying conditions favoring urinary infections were rejected. Urinary tract infection was present in 14.9 percent of postmenopausal diabetics versus 10.5 percent in the non-diabetics. The incidence of urinary tract infection in premenopausal women was 12.5 percent. Urinary pathogenes showed similar incidence rate in both groups: E. coli (41 versus 57 percent), P. mirabilis (20 versus 28 percent) and Klebsiella (11 versus 20 percent). Diabetic women showed a higher rate of sepsis and infection recurrence than non-diabetic (10.7 and 17.8 percent versus 2.6 and 2.6 percent, respectively). Severe impairment of renal function (plasma creatinine clearance > 2 mg/100 ml) was registered in 12.5 percent of postmenopausal patients with diabetes mellitus, but none of the non-diabetics suffered renal damage (p < 0.01).
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PMID:[Urinary tract infection in postmenopausal diabetic women. Clinical survey of hospital and nonhospital populations (author's transl)]. 742 60

This study sought to characterize patients with renal papillary necrosis seen at one tertiary referral center by reviewing medical records of patients with a confirmed diagnosis between January 1, 1976 and September 1, 1992. One hundred sixty-five cases were identified. The mean age at diagnosis was 57 yr (SD 15). The female-to-male ratio was 1.1:1.0. Ninety-two percent of patients were white. Seventy-seven percent of cases were unsuspected before diagnosis, and 16% were diagnosed at autopsy. The most common associated conditions were urinary tract infection, analgesic abuse, urinary tract obstruction, diabetes mellitus, and sickle cell disease. There was considerable overlap in the presence of these conditions, with two or more identified in 36% of patients. In addition, 11% of patients had none of these well-recognized risks. Other diagnoses in this group included lupus nephritis, Wegener's granulomatosis, and renal artery stenosis. A decline in case numbers of approximately 50% was demonstrated over the last 10 yr studied. This period was associated with a 57% reduction in the number of excretory urograms carried out, suggesting that changes in diagnostic imaging preference may have contributed. Vital status and renal outcome data after diagnosis were obtained in 93% of cases. Of those diagnosed while living, survival was lowest among diabetic patients. Ten-year survival for nondiabetics was not significantly different from the expected survival of an age- and sex-matched cohort. The overall risk for requiring renal replacement therapy after the diagnosis of renal papillary necrosis in surviving patients was low (7% of 136 patients at risk).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal papillary necrosis--a sixteen-year clinical experience. 757 92

A case-control study was conducted to investigate risk factors for eclampsia. A total of 66 cases of eclampsia were ascertained from deliveries between 1977 and 1992 at two hospitals in Houston, Texas, based on the criteria defined by the American College of Obstetrics and Gynecology. Cases were matched to nonpreeclamptic controls on a 4:1 ratio on the basis of hospital and month of delivery. The ratio of eclampsia cases to number of deliveries over the study period was 0.63 per 1,000. In a logistic regression model, risk factors for eclampsia included 1) two or fewer prenatal care visits (odds ratio (OR) = 6.10, 95% confidence interval (CI) 2.26-16.41), 2) urinary tract infection (OR = 4.23, 95% CI 1.27-14.06), 3) primigravidity (OR = 2.87, 95% CI 0.97-8.44), 4) obesity (OR = 2.49, 95% CI 0.78-7.96), 5) black ethnicity (OR = 2.25, 95% CI 0.88-5.78), 6) history of diabetes (OR = 2.07, 95% CI 0.45-9.62), and 7) age < or = 20 years (OR = 1.55, 95% CI 0.47-5.10). Nulliparity was not shown to be a risk factor for eclampsia when controlled for primigravidity, and neither were previous history of abortion or previous history of pregnancy-induced hypertension. Thus, prior pregnancy itself, independent of outcome and preeclamptic/eclamptic complications, appears to be the protective factor against eclampsia in a subsequent pregnancy.
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PMID:Case-control study of the risk factors for eclampsia. 762 9

We investigated skin diseases associated with mucocutaneous Candida infection by analyzing the clinical records of 44695 in-patients of the department of dermatology of Kiel. For more than eighty skin diseases the relative risk (RR) was calculated by age-and sex-adjusting methods. 1996 patients demonstrated a mucocutaneous candidosis, 14.8% of them being hospitalized because of extensive Candida infection. In patients with dermatomyositis, bullous pemphigus, tinea inguinalis, and condylomata acuminata a Candida infection was observed more than threefold than expected. Furthermore, patients with urticaria, folliculitis, and bullous pemphigoid demonstrated candidosis more than twice as often as control patients. In addition, patients with erysipelas, acne, psoriasis, and atopic dermatitis showed a candidosis significantly more often (RR between 1.3 and 1.6). Some internistic maladies were investigated, too. In patients presenting with diabetes mellitus, heart-insufficiency, hypertension, chronic tonsillitis, and urinary tract infection a mucocutaneous Candida infection was significantly increased.
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PMID:[Mucocutaneous candidiasis in patients with skin diseases]. 763 Mar 73

Pre-operative and operative complications in 2266 patients having undergone transurethral resection of prostate (TURP) for the past 20 years at Kitasato University Hospital were analyzed. They consisted of 2008 benign prostatic hyperplasia and 258 prostate cancer patients. Seven hundred and fifty four patients showed some of physical disorders prior to TUR:hypertension in 147 cases, diabetes mallitus in 87, ischemic heart disease in 46, chronic obstructive lung disease in 41 and others. Operative and postoperative complications of TURP were seen in 308 cases (13.6%). Perforation of the prostatic capsule was seen in 100 cases (4.4%) and bladder perforation into intraperitoneal cavity in 6 cases (0.3%). Transurethral fulgulation for postoperative hemorrhage was conducted on 79 cases (3.5%). Hyponatremia lower than 130 mEq/L was noted in 14 cases (0.6%). Severe urinary tract infection leading to bacteremia was observed in 9 cases (0.4%). Postoperative epididymitis was evident in 20 cases (0.8%). There was postoperative urinary incontinence in 19 cases, 3 of which was treated with Teflon-paste injection successfully. One patient had to undergo AMS-800 artificial sphincter implantation. The number of postoperative urethral stricture patients requiring urethral dilatation or internal urethrotomy was 12 (0.5%) and postoperative bladder neck contracture was seen in 20 cases (0.9%). One patient (0.04%) who developed DIC after profuse postoperative hemorrhage died on the 37th postoperative day. The efficiency of TURP depends not so much on the skill of cutting as on the speed and accuracy of orientation and haemostasis. The quick recognition of anatomical landmarks will assure effective and safe resection.
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PMID:[Pre-operative, operative and postoperative complications in 2266 cases of transurethral resection of the prostate]. 768 90

This study explored the prevalence of comorbid conditions in hospitalized patients with multiple sclerosis (MS) who were 65 years of age or older. Using 1989 data from the Quality of Care Medicare Provider Analysis and Review (MEDPAR) file, hospitalized MS patients were compared with respect to discharge diagnoses to an age- and sex-matched group of hospitalized patients without MS. As expected, the following discharge diagnoses were more common (P < 0.05) for MS patients: urinary tract infection, pneumonia, septicemia and cellulitus. In contrast, MS patients were less likely (P < 0.05) to have discharge diagnoses of acute myocardial infarction, heart failure, hypertension, angina pectoris, cerebrovascular disease, diabetes mellitus and chronic obstructive pulmonary disease. Possible explanations include under-reporting of certain comorbid conditions on discharge records of MS patients, a protective effect of MS or its treatment, reduced prevalence of risk factors, disproportionate mortality in younger MS patients with comorbidity and the benefits of medical surveillance.
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PMID:Patterns of comorbidity in elderly patients with multiple sclerosis. 772 46

Bacterial UTIs are a common problem in patients with diabetes mellitus. Bacteriuria is more common in diabetic women than in non-diabetics owing to a combination of host and local risk factors. Upper tract disease is also more common in this group. Diabetics are at higher risk for intrarenal abscess, with a spectrum of disease ranging from acute focal bacterial pyelonephritis to renal corticomedullary abscess to the renal carbuncle. A number of uncommon complicated UTIs, such as emphysematous pyelonephritis and emphysematous pyelitis, occur more frequently in diabetics. Because of the frequency and severity of UTI in diabetics, prompt diagnosis and early therapy is warranted.
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PMID:Bacterial urinary tract infections in diabetes. 776 19

Blood-group antigens found on uroepithelial cells and in the secretions may affect bacterial adherence and thereby the predisposition to urinary tract infection. We determined P1, Lewis-blood-group phenotype and secretor status in patients with diabetes mellitus: 12 with asymptomatic bacteriuria and 7 without its presence. There was no difference between the two groups in the distribution of the P1 phenotype. There was also no statistical difference in the distribution of the Lewis phenotype and secretor status, although there appeared to be general trend of higher number of Le (a+b-) phenotype and non-secretors present in the asymptomatic bacteriuria group. Further studies are necessary to determine the role of blood groups and secretor status in the pathogenesis and susceptibility to urinary tract infection.
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PMID:[P1 blood group, secretion status and susceptibility to asymptomatic bacteriuria in diabetes]. 780 31


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