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

In this review of the surgical experience with pancreatitis, 55 patients had acute relapsing pancreatitis associated with gallstones and 47 had chronic pancreatitis of alcoholic, idiopathic, or familial causation. The severity of pancreatitis associated with gallstones could not be correlated with results of preoperative biochemical tests; only one-third of patients were found to have stones within the biliary ductal system; and postoperative mortality (5%) could not be correlated with the severity of pancreatic inflammation or the timing of surgical intervention. Postoperative observations have revealed that all but four of the patients have remained asymptomatic. With regard to the patients with alcoholic, idiopathic, or familial disease who had significant pancreatic ductal dilatation or obstruction, ductal drainage procedures with or without resection benefited 80%. In the absence of ductal dilatation or obstruction, major resective surgery benefited 50% of patients. Continuing alcohol abuse limited the effectiveness of any operative procedure, and diabetes occurred more often after major resective procedures.
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PMID:Surgical treatment of pancreatitis: review of a series. 44 16

From a group of 424 patients with histologically verified fatty liver 92 patients without diabetes mellitus and alcohol abuse were subjected to follow-up examination for 3 1/2 years. 56 patients underwent second liver biopsy at this time; 20 of these patients had shown marked fatty liver at the initial liver biopsy examination. These 20 patients with marked fatty liver and 25 further patients with moderarte fatty liver could be followed up 5 and 7 1/2 years later; the clinical examination, the various liver function tests, liver scan and blind liver biopsy did not show any evidence of progression of fatty liver towards chronic inflammatory liver disorders or precirrhotic states. This clinical study therefore suggests the harmlessness of non-alcoholic fatty liver.
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PMID:Follow-up study on patients with non-alcoholic and non-diabetic fatty liver. 49 27

Forty patients with a history of alcohol abuse were treated with a 2% solution of methacholine to determine the prevalence of iridic parasympathetic denervation. Three (8%) of the alcoholics showed iris constriction of 1.0 mm or more, compared with three (8%) control subjects. In contrast, damage to the iridic parasympathetic nerve supply occurs in approximately 80% of patients with diabetes mellitus as determined by the same pharmacological technique.
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PMID:Absence of parasympathetic denervation of the iris in alcoholics. 50 66

A total of 201 patients with chronic pancreatitis were treated surgically between 1964 and 1975. In 116 cases (57,7%) resection was done at operation: 44 partial and 18 total duodenopancreatectomies, 37 partial and 17 subtotal left pancreatic resections. The mortality rate of the operation was 12.9%. The late mortality was 9.4% based on an average observation period of 2 7/12 years. Three quarters of the patients became completely asymptomatic. Preoperative diabetes was observed in 21% rising to 38% postoperatively. Satisfactory long-term results were mainly seen after partial duodeno-pancreatectomy and subtotal left resection. However, continued alcohol abuse limits the success rate.
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PMID:[Results of resection treatment of chronic pancreatitis (author's transl)]. 83 84

Although L-carnitine is not considered as an essential nutrient, endogenous synthesis may fail to ensure adequate L-carnitine levels in neonates, especially those born prematurely. Free L-carnitine is found in many foods, mainly those from animal sources. Absorption of free L-carnitine is virtually complete. Lysine and methionine are necessary ingredients for the biosynthesis of L-carnitine. All tissues in the body can produce deoxy-carnitine but, in humans, the enzyme that enables hydroxylation of deoxy-carnitine to carnitine is found only in the liver, brain and kidneys. Complex exchanges of carnitine and its precursors occur between tissues. Muscles take up carnitine from the bloodstream and contain most of the body carnitine stores. L-carnitine and L-carnitine esters are eliminated mainly through the kidneys, which may play a central role in the homeostasis of this compound. Thyroid hormones adrenocorticotrophin (ACTH), and diet all influence urinary excretion of L-carnitine. Free L-carnitine can be assayed in plasma and urine and is occasionally measured in muscle biopsy specimens. Plasma L-carnitine levels may not accurately reflect L-carnitine body stores. L-carnitine ensures transfer of fatty acids to the mitochondria where they undergo oxidation. This process is associated with production of short-chain acylcarnitine which exit from the mitochondria or peroxisomes. L-carnitine ensures regeneration of coenzyme A and is thus involved in energy metabolism. L-carnitine also ensures elimination of xenobiotic substances. Carnitine deficiencies are common. Currently, these deficiencies are classified into two groups. In deficiencies with myopathy, only the muscles are deficient in L-carnitine, perhaps as a result of a primary anomaly of the L-carnitine transport system in muscles. In systemic deficiencies, L-carnitine levels are low in the plasma and in all body tissues. Systemic L-carnitine deficiencies are usually the result of a variety of disease states including deficient intake in premature infants or long-term parenteral nutrition; renal failure; organic acidemias; and Reye's syndrome. Modifications in L-carnitine metabolism have also been reported in patients with diabetes mellitus, malignancies, myocardial ischemia, and alcohol abuse. A large number of supplementation trials have been carried out.
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PMID:[L-carnitine: metabolism, functions and value in pathology]. 129 65

Serum immunoglobulin (Ig) levels were assayed in 672 patients admitted for acute myocardial infarction with onset within 24 hours of hospitalization. Supranormal Ig levels (A > or = 300, G > or = 1,200) or subnormal Ig levels (M < 40 mg/100 ml) were seen in patients with one or several risk factors (diabetes mellitus, alcohol abuse) or a history of previous myocardial infarction. Patients with one or more Ig anomalies were more likely to exhibit unfavorable outcomes, including early death, suggesting that increased viscosity due to aggregation of Ig molecules may occur.
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PMID:[Value of serum immunoglobulin assays in early myocardial infarction]. 140 82

In a case-control study of 92 Indian patients, 46 with active tuberculosis (cases) and 46 tuberculin reactors without the disease (control subjects), significantly more control subjects than patients had prior adequate isoniazid chemoprophylaxis. While the Indian Health Service recommends treating all tuberculin reactors with isoniazid prophylaxis, most (75%) of our tuberculosis (TB) cases could have been prevented if the guidelines of the American Thoracic Society had been followed. Diabetes, alcohol abuse, and chronic renal failure were risk factors for active TB. Despite marked reductions in TB morbidity and mortality rates among American Indians and Alaska Natives over the past 30 years, their TB rates are still two to three times higher than overall United States and white rates. Enhanced TB control programs with an emphasis on preventive therapy for patients at risk for developing active disease, especially those with diabetes and chronic renal failure, could decrease the incidence and eventually eliminate TB among American Indians and Alaska Natives.
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PMID:The benefits of isoniazid chemoprophylaxis and risk factors for tuberculosis among Oglala Sioux Indians. 154 17

Necrotizing fasciitis is a destructive soft tissue infection that rarely involves the eyelids. Three cases of necrotizing fasciitis of the eyelids are described. Necrotizing fasciitis was preceded by minor forehead soft tissue trauma in two cases and occurred spontaneously in one. In two patients necrotizing fasciitis was bilateral and involved both the upper and lower eyelids. Review of these cases, in addition to 18 cases previously reported in the English literature, reveals a predominance in females, preceding minor local soft tissue trauma, frequent bilateral involvement, and an association with alcohol abuse and diabetes. In all of the patients, group A beta-hemolytic streptococci were cultured from the wound. Early recognition of the disease process, prompt surgical debridement of the necrotic tissue, aggressive antimicrobial therapy, and delayed skin grafting combine to minimize morbidity.
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PMID:Necrotizing fasciitis of the eyelids. 156 82

From 1983 all incident cases of diabetes in the age group 15-34 years in Sweden have been recorded prospectively. The aim of the present study was to assess the mortality pattern of cases reported for 1983-87 and followed until the end of 1987. Eighteen deaths were identified by linkage to the national death register. When comparing the mortality in the cohort with Swedish males and females in general, an excess mortality was found in all the groups studied. It is, however, less pronounced if the analysis is restricted to those with Type 1 diabetes (standardized mortality ratio (SMR) and 95% confidence interval = 2.1; 0.8, 4.6), Type 2 diabetes (SMR = 4.8; 1.3, 12.3) or Type 1 + Type 2 (SMR = 2.7; 1.3, 5.0). Eight (44%) of the deaths were in patients with secondary diabetes, a diagnosis that applied to less than 3% of the cohort. Alcohol abuse was prevalent in six cases and suspected in another two. Hypoglycaemia was established as a cause of death in only one case but could not be excluded in a further six. Only one death was associated with ketoacidosis. No valid support for an increased risk of the 'dead in bed' syndrome was found. We suggest that diabetes was decisively important for the death in two cases and less important in 10. In the remaining six cases the existing documentation precludes a proper judgement.
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PMID:Mortality of all incident cases of diabetes mellitus in Sweden diagnosed 1983-1987 at age 15-34 years. Diabetes Incidence Study in Sweden (DISS) Group. 161 28

Changes in heart rate induced by inclining an orthostatic table to 30 degrees and 60 degrees and by standing was studied in 200/healthy volunteers of either sex. Study subjects were divided in eight ten-year age groups, from 16 to 97 years. The 56-65 year age group was the youngest group to develop systolic orthostatic hypotension. This response occurred in 4% of subjects aged 56-65 years and became increasingly prevalent from one age group to the next (25%, 36% and 44%). In some patient, the fall in systolic BP reached 70 mmHg. Systolic hypotension occurred in some patients at 30 degrees but in most cases developed only at 60 degrees. No significant difference was found between the falls in SBP seen at 60 degrees and during active standing (90 degrees), indicating that muscular activity does not play a major role in BP regulation. Diastolic hypotension was less common and was mainly seen in patients above 75 (20%) who also had systolic hypotension. Orthostatism was responsible for tachycardia but this response became increasingly less common beyond 55 years of age (60, 60, 52 and 36% in the four age groups above 55). This reflects increasing loss of sensitivity of the baroreflex with advancing age. These date are useful for comparing the age-specific effects of disease states (e.g. diabetes mellius, alcohol abuse) or treatments (psychoactive drugs, antihypertensive agents).
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PMID:[Cardiovascular responses to passive and active orthostatism in healthy subjects, in relation to age]. 175 18


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