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

Hydroxyethylrutosides is a standardised mixture of semisynthetic flavonoids, mainly mono-, di-, tri-, and tetrahydroxyethylrutosides, which acts primarily on the microvascular endothelium to reduce hyperpermeability and oedema. In patients with chronic venous insufficiency or diabetes, hydroxyethylrutosides improves microvascular perfusion and microcirculation, and reduces erythrocyte aggregation. The preparation also has a possible protective effect on the vascular endothelium. In short to medium term placebo-controlled studies (up to 6 months) hydroxyethylrutosides therapy improved signs and symptoms of chronic venous insufficiency, including venous insufficiency associated with pregnancy and lymphoedema, and was well tolerated. However, the long term effects of hydroxyethylrutosides administration have yet to be demonstrated. The preparation also alleviated symptoms in patients with severe haemorrhoids, although there were no corresponding objective improvements. Hydroxyethylrutosides administration has been associated with reductions in retinal vascular permeability in patients with diabetic retinopathy but has no apparent effect on signs of retinal haemorrhage, although a reduction in oedema and haemorrhage has been reported in other patients receiving oral hydroxyethylrutosides in the acute phase of central retinal vein occlusion. There are only limited effective pharmacological treatment options for patients with chronic venous insufficiency or lymphoedema, and hydroxyethylrutosides clearly improves signs and symptoms of these disorders. While its role in diabetic retinopathy and haemorrhoids requires some clarification, hydroxyethylrutosides therapy shows promise as a useful additional option for the management of oedema and other symptoms of chronic venous insufficiency.
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PMID:Hydroxyethylrutosides. A review of its pharmacology, and therapeutic efficacy in venous insufficiency and related disorders. 128 62

When adipose tissue enlarges in obesity, as the result of an imbalance between caloric intake and caloric expenditure, many changes occur in the cellular components of the adipose mass. A combination of increased cell size and number underlies the accretion of the adipose mass, however, only a reduction in cell size is possible with weight loss. Several metabolic abnormalities accompany obesity--most important--hyperinsulinemia, hyperlipidemia, insulin resistance, and carbohydrate intolerance. Clinical consequences of obesity include hypertension, venous insufficiency, gallbladder disease, osteoarthritis, pulmonary and cardiovascular insufficiency, diabetes, and atherosclerotic cardiovascular disease, and all are dependent on the severity and duration of the obesity. Once established, obesity is difficult to correct because of the development of many adaptive mechanisms by which obesity defends itself.
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PMID:Cellular, metabolic, and clinical consequences of adipose mass enlargement in obesity. 180 21

Six patients suffering from solitary cryofibrinogenaemia are described. In one patient idiopathic cryofibrinogenaemia was present, while the others showed secondary cryofibrinogenaemia associated with borrelia infection, chronic venous insufficiency with pulmonary embolism, primary biliary cirrhosis, diabetes mellitus or von-Willebrand syndrome. Subcutaneous injections of the thrombin-like snake poison batroxobin/ancrod were administered over a period of several weeks. Five patients experienced almost complete remission of their symptoms, especially of pain following cold exposure. In one patient partial relief was achieved. Overall we found a 75% reduction of symptoms. When blood fibrinogen levels are carefully monitored this therapy is an efficient and safe form of treatment for cryofibrinogenaemia.
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PMID:[Cryofibrinogenemia--successful therapy by decreasing fibrinogen]. 186 Jul 98

Three hundred eighty-two patients with active leg ulcers were clinically examined after random selection out of a population of 827 patients identified within a previous cross-sectional population survey. Bidirectional Doppler ultrasonography was used for objective assessment of arterial and venous circulation. The purpose was to register causative factors and the etiologic spectrum. Venous insufficiency was present in 332 (72%) of 463 legs with active ulceration; deep insufficiency occurred in 176 (38%), and purely superficial insufficiency was present in 156 (34%). Ankle/brachial index was 0.9 or less in 185 (40%) of ulcerated legs. Venous insufficiency was the dominating causative factor in 250 legs (54%), of which 60% was the result of deep venous insufficiency. Arterial insufficiency was judged to be the possible dominating factor in 12%, and 6% showed clearly ischemic ulcers. Mixed ulcers with combined arterial and venous insufficiency were found to be common as were patients with diabetes and arterial impairment. In 10% of the legs a multifactorial origin was present, and in 10% no venous or arterial impairment was detectable. Thus after classification of causes 40% of all ulcerated legs showed potentially surgically curable circulatory disturbances. It is necessary to objectively assess all patients with chronic leg ulcers to be able to detect patients with potentially surgically curable disease.
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PMID:Leg ulcer etiology--a cross sectional population study. 192 Jun 53

In vascular diseases, when the vasomotor reserve is exhausted, microcirculation is strongly dependent on blood fluidity. For patients with vascular disorders, it was therefore decided to evaluate red blood cells (RBC) aggregation and disaggregation (SEFAM erythro-aggregometer) which are important factors determining blood viscosity in low flow areas. Our results show that, in essential hypertension (EH), RBC aggregation is significantly increased (+15%), and disaggregation is decreased (-20%). The highest frequency of troubles was found in EH. This observation led to exclusion of EH subjects in all the other studied pathological groups. When EH is excluded from a group of 70 patients with cerebrovascular disorders (CVD), we did not observe significant changes in RBC aggregation. However, in essential and post-thrombotic venous insufficiency there remains a significant increase in RBC aggregation (+10%) and a decrease in disaggregation (-13%). In diabetes, disaggregation is more disabled than for controls (-16%). In all these pathologies presence of EH magnifies the abnormalities, or makes them appear like in CVD. This study underlines the critical importance of taking the influence of hypertension into consideration when evaluating RBC aggregation in vascular pathology. The increase in RBC aggregability and in the shear resistance of the aggregates, when present in vascular pathology, is likely to add a burden to the circulatory system already hindered by a deficient vasomotor regulation system.
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PMID:[Erythrocyte aggregation in vascular disease. Influence++ of hypertension]. 194 Jun 53

A nonoperative approach to venous stasis ulceration of the lower extremity, consisting of initial bedrest, ulcer cleansing, dressing changes, and ambulatory elastic compression stocking therapy, has been maintained for over 15 years. All patients had class III, severe chronic venous insufficiency. One hundred five of 113 patients (93%) experienced complete ulcer healing in a mean of 5.3 months. One hundred two patients were compliant with elastic compression stockings, and 11 patients were noncompliant. Complete ulcer healing occurred in 99 of 102 patients (97%) who were compliant versus six of 11 patients (55%) who were noncompliant (p less than 0.0001). The influence of noncompliance, previous venous ulceration, previous venous surgery, previous known deep venous thrombosis, peripheral arterial insufficiency (ankle brachial systolic blood pressure index less than or equal to 0.60), pretreatment ulcer duration, ulcer size, age, sex, diabetes, smoking, and photoplethysmography venous refill time on ulcer healing was determined by logistic regression analysis. Only noncompliance with elastic compression stockings (p less than 0.0001) and a pretreatment ulcer duration of more than 9 months (p = 0.02) significantly decreased initial ulcer healing. Posthealing follow-up was available in 73 patients for a mean of 30 months. Fifty-eight patients (79%) continued to be compliant with stockings; 15 patients were noncompliant. Total ulcer recurrence in patients who were compliant was 16%. Five-year lifetable recurrence was 29%. All patients who were noncompliant had recurrent ulceration by 36 months. Previous ulceration, previous venous surgery, and peripheral arterial insufficiency had no effect on ulcer recurrence (p greater than 0.05).
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PMID:Fifteen-year results of ambulatory compression therapy for chronic venous ulcers. 202 Sep 2

In this retrospective study, distal hyperirrigation syndrome was identified by "irrigraphy", a functional exploration method used to define an irrigation index at various levels of the lower limbs as determined by pulse wave amplitude, heart rare and segmental resistances. In 47 lower limbs studied, there were 26 unequivocal, 14 relative and 7 "masked" hyperirrigations. The main etiology was diabetes (24 limbs), but the syndrome was also noted in cases of peripheral neuropathy and chronic venous insufficiency. There was no basic difference between unequivocal and relative hyperirrigations. Some hyperirrigation states were not apparent in irrigraphy because of arterial lesions on upstream axes. The syndrome was also observed in approximately the same number of cases in insulin-dependent and noninsulin-dependent diabetes. The clinical disorders observed were especially peripheral trophic ones, notably perforating ulcers of the foot or various ulcers. Changes in the irrigraphic profile were followed regularly in 20 limbs. The rise in distal irrigation indices was due to a drop in peripheral resistances related to an abnormal opening up of arteriovenous anastomoses. A state of spontaneous sympathectomy was thus constituted, particularly in diabetic patients. The process was similar in syndromes of neurologic origin and in venous stasis. The mechanism was local, with venous hypertension causing the opening up of arteriovenous shunts. However, microangiopathic lesions must also be taken into account, since they can cause or favor arteriovenous shunting. The opening up of arteriovenous anastomoses is in effect the element common to all syndromes of distal hyperirrigation of various origins.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Distal hyperirrigation syndrome. Clinical and physiopathological aspects]. 228 13

A clinical, histopathologic, laboratory and therapeutic study in 44 subjects with "superficial vasculitis", consecutively observed during the last two years, has been carried out. The findings showed that 1. the anamnesis was sometimes not relevant; 2. the clinical pictures were not in a regular manner correlated with histologic reports (a polymorphonuclear infiltrate with leukocytoclasis or a lymphomononuclear + one); and 3. a non-correlation between clinical, histologic and etiologic data. Infectious agents were responsible, mostly pyogenic bacteria, Mycobacterium tuberculosis, and hepatitis B virus; Chlamydiae were rarely responsible, whereas the etiologic role of Toxoplasma was uncertain. In this respect, drugs were not relevant. All these agents seem to act on the immunological response of the patient with previous microvascular changes (diabetes, chronic venous insufficiency). The latter condition seems to play a predominant role: the recovery of the lesions and/or their relapse shows the same behaviour both in case of etiological and symptomatic therapy.
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PMID:[Clinico-pathogenetic observations on the subject of "superficial vasculitis"]. 236 4

233 patients with erysipelas, admitted to the Department of Infectious Diseases, Danderyd Hospital, during a 2-year period were analysed for epidemiological, bacteriological and complicating features. Erysipelas was defined clinically as a febrile skin infection with a sudden onset of a red indurated expanding plaque with a distinct border. Common predisposing factors were alcohol abuse, diabetes mellitus and venous insufficiency, and complications were more common among such patients. No seasonal variation was found. 5% of patients with blood culture had streptococcemia (7/149). Erysipelas emerging from an infected ulcer was seen in 52% (122/233) and in 46% of these streptococci were isolated (57/122), 67% of which were of type A (38/57). Staphylococcus aureus was isolated from 59% of ulcerative cases (72/122) and in 3 of them staphylococci were found in the blood.
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PMID:Epidemiological, bacteriological and complicating features of erysipelas. 381 46

Several studies have suggested the presence of hemorheological abnormalities in venous insufficiency. The present prospective study was carried out to determine whether the increase in hemorheological disturbances parallels the evolution of the disease. Patients were recruited among ambulant outpatients and classified in 3 evolution stages of venous insufficiency according to the clinical and functional examination. Once a certain number of patients were included, the following successive inclusions were made in order to match for age and sex, in the other stages of venous insufficiency, the previously included patients. Since blood rheology is frequently altered in hypertension, diabetes and several other vascular pathologies, patients with those pathologies were not included. Sixty nine patients with venous insufficiency and 23 healthy subjects were tested, making up twenty three matching sets. Red blood cell (RBC) aggregation and disaggregation were assessed with the SEFAM erythroaggregameter on blood samples adjusted to 40% hematocrit. Statistical analysis showed a significant difference for the aggregation index (p = 0.0001), disaggregation shear rate (p = 0.0001) and fibrinogen (p = 0.006) between the 4 groups. Aggregability parameters increased gradually with the evolution of the disease, while the fibrinogen rise was significant only when varicose veins were present (stages 2 and 3). This progressive rise in RBC aggregability with the aggravation of venous insufficiency, by superimposing to the haemodynamic deficit, is likely to induce the formation of RBC aggregates in vivo, to perpetuate venous stasis and to contribute to the development of severe skin damages.
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PMID:Red cell aggregability increases with the severity of venous insufficiency. 765 8


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