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

The objective of the present study was to assess factors related to the presence of microalbuminuria in essential hypertension. Ninety-five patients with essential hypertension (58 males and 37 females, mean age 38.6 +/- 6.1 years) who had never been treated previously for hypertension were included in the study. Patients with nephropathy or diabetes mellitus, hyperglycemia > 120 mg/dL, glomerular filtration rate < 80 mL/min/1.73 m2, urinary tract infection, or positive dipstick for albumin or glucose were excluded. Blood pressure, echocardiographically determined left ventricular mass, serum biochemistry, and lipid profile were obtained. Twenty-four-hour urinary albumin excretion (UAE) was measured on two separate days using an immunonephelometric assay. Microalbuminuria (UAE 30 to 300 mg/24 h) occurred in 26% of patients and was associated with higher diastolic blood pressure (DBP), left ventricular mass index (LVMI), and a higher prevalence of hypertriglyceridemia and hyperapolipoproteinemia B (apo-B). Logistic regression analysis showed that the risk of microalbuminuria was independently related to diastolic blood pressure and hypertriglyceridemia when controlling for age, sex, body mass index, LVMI, and apo-B. Multiple regression analysis likewise confirmed that both DBP and LVMI were linearly related to UAE independent of age, sex, body mass index, total cholesterol, triglycerides, and apo-B. In conclusion, our study indicates that among hypertensive patients with elevated excretion rates of urinary albumin, even at the subclinical level, an increased cardiovascular risk exists compared to normoalbuminuric patients with a similar blood pressure. Assessment of the presence of microalbuminuria may be useful in the evaluation and management of hypertension.
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PMID:Factors related to the presence of microalbuminuria in essential hypertension. 781 38

A survey of traditional healers in Ibadan, Nigeria, demonstrated that fewer than 10% of them were involved in the treatment of patients with diabetes mellitus and the total number of such patients under their care was less than 100, compared to those receiving western-type of medical treatment (up to 1000 at the University College Hospital, Ibadan, alone). An interview of 20 native practitioners revealed that they had little understanding of the nature of diabetes mellitus. Their diagnosis of diabetes was based largely on intuition and the disease was often confused with other medical problems like urinary tract infection or venereal disease. In a parallel study, 10 diabetic patients being treated exclusively by traditional healers were followed up on an ambulatory basis for periods of up to 16 weeks and another group of 8 patients had a hospital-based trial of traditional anti-diabetic medicines for about 4 weeks. Most of the patients reported improvement in their symptoms with less polyuria and improved sense of well-being. However, no objective improvement in the blood glucose was demonstrated. For the hospitalized group, n = 8, pre and post-treatment blood glucose respectively were, mean (+ SD), 13.9 (3.5) mmols/l and 14.9 (4.3) mmols/l, P > 0.50. It is concluded that the effectiveness of traditional anti-diabetic drugs in lowering blood glucose still remains to be demonstrated. Any claims of "cure" of diabetes using native medicines can be firmly rejected. However, further studies into the potential usefulness of native herbs in the treatment of diabetes must be pursued.
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PMID:The efficacy of traditional medicine in the management of diabetes mellitus in southwestern Nigeria. 783 78

As part of a programme for improving hospital infection control in Mauritius a nationwide survey, including a prevalence study, was carried out in order to identify characteristics of the hospitals, the population, and the infections. Community-acquired infections were three times more prevalent than nosocomial infections: 15.0% and 4.9%, respectively. Surgical wound infection was by far the most common nosocomial infection, with a prevalence rate of 8.2 per 100 operations, followed by urinary tract infection with a low rate of 0.8 per 100 admissions. The survey showed that these hospitals in Mauritius housed mainly a young population (mean of 36.8 years for females and 39.4 years for males) with few risk factors for acquiring nosocomial infection. Although diabetes mellitus is prevalent in Mauritius the diagnosis of diabetes was not associated with nosocomial infection. The spectrum of operations offered was limited, and Caesarean section was the most prevalent operation. The amount and types of antibiotics used in hospitalized patients were recorded. More than one third of the patients received antibiotic treatment at the time of the survey, which is comparable to figures reported from large teaching hospitals in Western Europe. The information gathered from the survey, the interviews and the inspection were used to establish priorities for a collaborative programme for improved infection control. It included the draft of a set of custom-made guidelines, which were eventually studied by staff members from hospitals in Mauritius during a training period in Denmark. We believe that a prevalence survey is useful for initiating infection control programmes in hospitals in developing countries.
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PMID:Prevalence of infections and use of antibiotics among hospitalized patients in Mauritius. A nationwide survey for the planning of a national infection control programme. 790 23

Results of studies of the urinary tract of 43 pregnant women with insulin-dependent diabetes have been presented. No clinical symptoms of infection of this system were observed in particular trimesters of pregnancy. It was found that, despite the lack of symptoms of the urinary tract infection, the infection as such did occur-most frequently in the 2nd trimester. The most common bacteria in pregnant women with insulin-dependent diabetes (lasting over 10 years) were Staphylococcus epidermidis and Staphylococcus saprophiticus.
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PMID:[Asymptomatic bacteriuria in pregnant women with insulin-dependent diabetes]. 798 18

Fungal urinary tract infection has become a frequent clinical entity. Despite limited evaluation of its efficacy, bladder irrigation with amphotericin B has become the usual means of therapy for such infections. The outcome of treatment with amphotericin B bladder irrigation for an average of 5 days for 95 hospitalized patients with funguria (mean age, 75 years) during a 14-month period is presented. All patients who received treatment were identified from pharmacy records; those for whom urine culture results were obtained after treatment were studied. Fever and/or pyuria was identified in the majority of cases. Funguria was eradicated in 80% (confidence interval, 72%-88%). Concomitant diabetes mellitus or the previous use of indwelling bladder catheters did not alter response to treatment. The mortality rate following treatment of funguria was 39%, compared to 30.5% for a similar population during the same period. Amphotericin B bladder irrigation may not prove to be ideal therapy despite the fact that it initially eradicated funguria in the majority of subjects in this study.
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PMID:Bladder irrigation with amphotericin B for treatment of fungal urinary tract infections. 801 10

Due to inadequate cadaveric and living related organ supply, many end-stage renal disease patients go to third-world countries for living unrelated (paid) kidney transplantation. Thirty-four patients who have had transplantations in two centres in India before coming to our centre for post-transplant care and follow-up are reported in this study. In the post-transplant phase at our centre, the mean follow-up period of the patients was 209.7 +/- 137.3 (range 6-450) days. Fourteen of them, having an uneventful course, were followed on an outpatient clinic basis. The rest of the patients were hospitalized because of the following surgical and/or medical complications, during admission: urinary fistula in two patients; lymphocele in three patients; urinary tract obstruction in two patients; decubitus ulcer in one patient; severe wound infection in one patient; subacute myocardial infarction in one patient; acute irreversible vascular rejection in two patients; urinary tract infection in two patients; pneumonia in two patients; congestive heart failure and severe electrolyte disturbance in two patients; post-transplant diabetes mellitus and ketoacidosis in one patient; cyclosporin nephrotoxicity in two patients; cyclosporin nephro-, hepato-, and neurotoxicity in one patient. Plasmodium falciparum malaria in three patients, generalized mucormycosis infection in one patient, and genitourinary aspergillosis in one patient were seen during the first month. Hepatitis B virus infection followed by chronic active hepatitis was diagnosed in two patients, 2 and 4 months after the operation; and Kaposi's sarcoma was noted in another two patients, 1 and 5 months after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Living unrelated (paid) kidney transplantation in Third-World countries: high risk of complications besides the ethical problem. 808 44

An experimental ascending urinary tract infection was induced by transurethral instillation of Escherichia coli in streptozotocin (STZ)-induced diabetic mice, in which bactericidal capacity of the perineal exudating neutrophils had been damaged. The local immune response in uninfected diabetic mice and the response time fluctuation of local immune responses in diabetic mice following infection were compared with those in normal mice, and the nature of induced changes in the local immune response was determined. The diabetic model was prepared by a single administration of 280 mg/kg of STZ after it had been fasted for 15 hours. The mouse was then fasted an additional 2 hours to induce the diabetic state. Compared with the normal mice, the diabetic mice prepared using this method were found to have a significant suppression of the bactericidal capacity of the perineal exudating neutrophils, 3 weeks after induction of diabetes. The study of the cellular distribution in uninfected urinary tract tissue demonstrated a reduction in CD4-positive T cell distribution in bladder submucosa of diabetic mice at 3 weeks after induction of diabetes (diabetic group), compared with that in the normal mice (control group). In the diabetic group, probably in order to compensate for the reduction in CD4-positive T cell distribution in the bladder submucosa, the distribution of macrophages was increased in the bladder epithelium, compared with the control group. This finding suggested that diabetic mice are thought to have protective mechanisms against infection different from those of normal mice in the uninfected state. The study of the response time fluctuation of local immune response at the infected sites demonstrated infiltration of macrophages was the same grade as that of neutrophils in the control and the diabetic group. However, in the diabetic group, a marked infiltration of macrophages was recognized when compared with the control group in the early phase of infection. These findings suggested that macrophages aid in protection against infection when damage to the bactericidal capacity of neutrophils results in insufficient elimination of microorganisms. On the other hand, infiltration of T and B cells was weaker in the diabetic group, than in the control group.
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PMID:[Study on local immune response in diabetic mice, in which bactericidal capacity of the neutrophils had been damaged--Escherichia coli induced experimental urinary tract infection]. 808 53

This study estimated the risk of very-low-birthweight delivery among Black and White women with selected treatable antepartum medical conditions. A logistic regression model was applied to a retrospective, population-based data set identified by computerized, linked birth certificate and maternal hospital discharge records. For Black mothers, the adjusted odds ratio for very-low-birthweight delivery was statistically significant for essential hypertension and urinary tract infection. For White mothers, the adjusted odds ratio was statistically significant for essential hypertension, urinary tract infection, pregnancy-induced hypertension, and diabetes mellitus. Public policy designed to reduce the risk of very-low-birthweight delivery must include strategies for attenuating the impact of treatable antepartum medical conditions.
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PMID:Selected antepartum medical complications and very-low-birthweight infants among black and white women. 809 80

Renal parenchymal malacoplakia is uncommon, and coexistence of extensive invasion into the liver and duodenum is extremely rare. Typically, there is an associated long-term urinary tract infection. We report on a 53-year-old woman with a history of diabetes and recurring pyelonephritis, who presented with a renal tumor and upper gastrointestinal bleeding. Surgical intervention included radical nephrectomy, lymphadenectomy, segmental hepatectomy, cholecystostomy, duodenorrhaphy, jejunostomy and appendectomy. There was no surgical morbidity. A pathologist confirmed the diagnosis of malacoplakia. All of the diagnostic criteria, including hematoxylin and eosin stain, iron stain, calcium stain and electron microscopy of Michaelis-Gutmann bodies, were classic. The literature is reviewed.
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PMID:Renal malacoplakia with secondary hepato-duodenal involvement. 812 44

Nosocomial urinary tract infection (UTI) is an important cause of increased morbidity and mortality in hospitalised patients. The increasing use of broad spectrum antibiotics will result in changes in the microbiological and antibiotic sensitivity pattern of pathogens isolated from nosocomial UTI. We have endeavoured to study the bacteriological pattern of nosocomial UTI and the antibiotic sensitivity patterns of the pathogens concerned. Over a period of one year, a total of 541 patients with 656 episodes of nosocomial UTI were studied. A total of 748 organisms were isolated. The two main complicating factors in nosocomial UTI were urogenital instrumentation (70.4%) and diabetes mellitus (24.2%). Klebsiella species (spp) was the predominant organism isolated (25.0%) and was significantly associated with age and diabetes mellitus. Klebsiella spp in nosocomial UTI showed an overall increase in resistance to antibiotics and multiple antibiotic resistant strains were not uncommon. Escherichia coli was isolated in 17.7% of cases. Streptococcus faecalis was isolated in 10.6% of cases and was significantly associated with instrumentation. Pseudomonas spp was isolated in 8.6% of cases and was generally sensitive to ceftazidime and amikacin. It was associated with systemic malignancies and the use of immunosuppressants.
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PMID:Nosocomial urinary tract infection: a microbiological study. 812 47


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