Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Investigation of the effect of allo- and xenotransplantation of pancreatic tissue cultures on the hemodynamic indices of 85 patients with diabetes mellitus using ophthalmoscopy, biomicroophthalmoscopy, integral rheography, capillaroscopy and clinical biochemical tests at varying time (from 3 mos to 4 yrs.) showed a gradual improvement of the ophthalmological picture of the fundus of the eye in 58 patients (86%) during the first 9 mos with further stabilization of a process. Lower limb improvement was noted in 18% of the patients, stabilization of a process--in 74%. The improvement of the renal clinico-biochemical indices was noted in 47-67%. Contraindications for beta = culture transplantation were diabetic glomerulosclerosis with stage III chronic renal insufficiency and retinopathy of diabetorenal type.
 ...
PMID:[Effect of the transplantation of cultured pancreatic islet cell on the status of diabetic microangiopathy]. 250 Jun 56

In this prospective study we sought to establish the incidence and nature of lower limb ischemia in patients undergoing treatment with intraaortic balloon pump (IABP) counterpulsation and to determine risk factors for its development. The sample was composed of all 258 balloon catheter insertions or attempted insertions for IABP therapy in 249 patients during a 16-month period. Assessment of the lower limbs, hemodynamic status, and pertinent medications were recorded daily throughout the patient's hospitalization. Lower limb ischemia was present in 47%, with 14% having major ischemic complications. Multivariate logistic regression, which was based on variables found to be significant in univariate analysis, revealed that preexisting peripheral vascular disease, female sex, and diabetes mellitus were related to the development of the whole range of lower limb ischemic problems. Diabetes mellitus, cardiogenic shock, and a history of smoking were associated with major ischemia. Evaluation of risks and benefits before treatment with IABP counterpulsation and careful lower limb assessment before, during, and after counterpulsation may help reduce the complications associated with this lifesaving device.
 ...
PMID:Lower limb ischemia related to use of the intraaortic balloon pump. 258 43

Lower limb venous compliance and transcapillary escape rate of transferrin were measured in eight normotensive, insulin-dependent male diabetic patients and eight control subjects using a dual isotope technique. Technetium-99m labelled autologous erythrocytes were used to measure venous compliance and to correct for local changes in blood volume, whilst Indium-113m labelled transferrin was used to measure transcapillary escape of protein. The diabetic patients were found to have reduced venous compliance 1.5 (0.7 to 3.4) x 10(-2) mmHg-1 compared with controls 3.2 (2.4 to 4.1) x 10(-2) mmHg-1 (p less than 0.01). The diabetic patients were also found to have greater transcapillary escape of transferrin -2.7 (-1.5 to -5.3) x 10(-3), compared with control subjects -5.2 (-4.1 to -8.1) x 10(-3) (p less than 0.02) in response to increasing hydrostatic pressure. These results show reduced venous compliance in patients with a mean duration of diabetes of 15 years and with only at most, early complications of diabetes, and confirm previous observations showing increased transcapillary escape of protein.
 ...
PMID:Reduced venous compliance and increased transcapillary escape of protein in insulin-dependent diabetic patients. 297 Sep 19

Lower limb amputations were performed on over 105,000 individuals in United States short-stay hospitals between 1989 and 1992. Additional amputations were performed in VA, military, Indian Health, and charitable orthopaedic hospitals. Half of all lower extremity amputations occurred in individuals with diabetes. When the causal chain leading to diabetic amputations was examined in 80 consecutive patients at the VA Medical Center, Seattle, WA, 23 unique pathways were identified. Multiple pathway components were identified for 96% of patients, while in 4% a single ischemic pathway was sufficient in itself to require amputation. The majority of the scenarios leading to amputation began when patients with absent peripheral sensation sustained a pivotal event that initiated the causal chain to amputation. In nearly half the patients, this event was foot-wear-related. The pivotal event was followed by ulceration and faulty wound healing in 73% of patients. Each year thousands of individuals with diabetes undergo amputation in VA facilities, resulting in substantial cost to the Department of Veterans Affairs and to themselves. If the VA is to address the prevention or delay of limb loss, the causal pathway information indicates that attention to the footwear of diabetic patients is necessary.
 ...
PMID:Who is at risk of limb loss and what to do about it? 786 84

Lower limb amputation is performed predominantly to alleviate acute and chronic limb ischaemia caused by vascular disease, poorly controlled diabetes or, occasionally, infection. Atherosclerosis is the primary cause of chronic arterial ischaemia and the most common reason for amputation. The vascular nurse has an important role in reducing the need for amputation, by providing information on health promotion and illness prevention to patients with vascular insufficiency to halt progression to amputation. This is the first of four articles focusing on lower limb amputation. It examines the indications for lower limb amputation in detail, and briefly outlines other treatment options including revascularization techniques.
 ...
PMID:Lower limb amputation. 1: indications and treatment. 936 31

Lower limb amputation (LLA) is a devastating complication experienced by some veterans with diabetes. The Veterans Affairs (VA) Healthcare system has identified the prevention of LLA as a priority goal. This study was designed to describe the sources of outpatient care received by veterans with diabetes who have undergone LLA, to determine whether these persons would have been impacted by a VA amputation prevention program. This study was also designed to describe prior amputation history, footwear history, and the pivotal events that led to these amputations. We found that the vast majority of these subjects identified the VA as their primary source of care, and thus would have been available for enrollment in a prevention program. Since over one-half of them had had a prior amputation, diabetics with a prior amputation should be particularly targeted for foot care interventions. Lastly, prescription of protective footwear has the potential to reduce the incidence of shoe-related ulcers and amputations.
 ...
PMID:Diabetic amputations in the VA: are there opportunities for interventions? 1065 95

Lower limb ischaemia is one of the determinants in the development of diabetic foot ulcers and the most important factor preventing their healing. There are a number of misleading factors masking the presence of atherosclerotic disease and tissue damage; these are reduced inflammatory response to infection, autosympathectomy and mediasclerosis, which all diminish the clinical suspicion of ischaemia. Therefore, adequate assessment of the lower limb circulation should be routinely performed in complicated diabetic foot. This evaluation can often be made with simple methods. In addition to clinical examination ankle/brachial pressure index, systolic toe pressure, plethysmographic pulse volume recordings and simple hand-held Doppler auscultation are most often sufficient to make a decision as to whether angiography is needed or not. Duplex examination can give more profound information on the severity and extent of arterial occlusive disease, but the method is strongly user-dependent. Early vascular consultation is mandatory in diabetic foot work-up and should be undertaken within 2 weeks if a new skin lesion shows no tendency to heal. Long bypass grafting procedures and microvascular free flap techniques have been shown to achieve excellent results in relieving critical leg ischaemia, even in the presence of large foot lesions, and should be used to prevent major amputation. The timing of various procedures is a controversial issue. Feet with small ulcers or restricted dry gangrena can be revascularised first, with minor amputations and local surgery of the ulcer being done thereafter. In the septic neuroischaemic foot, major amputation may be unavailable but if the infection is not immediately life-threatening the infected part of the foot should be drained and debrided properly and left wide open, sometimes with a guillotine amputation in order not to risk the bypass graft, which can be done a couple of days later.
Diabetes Metab Res Rev
PMID:Never amputate without consultation of a vascular surgeon. 1105 84

In Africa, a rise in complications of diabetes mellitus has gone in hand with the growing disease prevalence, clearly demonstrating the importance of assessing complications. Diabetes mellitus constitutes a major financial burden in developing countries in Africa with relatively limited resources. Ketoacidosis is observed in 24% of juvenile diabetes and is the inaugural sign in 76% of all cases, progressing to coma in 34%. Even in type 2 diabetes, acidoketosis occurs in 34% of the cases. Infection is particularly frequent and is often fatal in tropical Africa because of the involvement of Staphyococcus and Gram-negative microorganisms. Hyperleukocytosis and anemia are correlated with ineffective antibiotic therapy. Pulmonary tuberculosis is the ninth most frequent complication of diabetes. Overall mortality is 14.9 per 1000 person-years of diabetes. Mean age at death is 51.6 years for women and 57.6 years for men after a mean 12.5 year disease duration. Thirty percent of all deaths result from acute metabolic complications, infections and stroke. More than half of the patients with insulin-dependent-diabetes have retinopathy. Differences observed in patients with different ethnic origins is linked basically to unfavorable social and economic conditions that worsen the risk of poor blood glucose control. Retinopathy accounts for 32% of all ocular complications, similar to other African data and more generally in ophthalmology centers. The rate of neuropathy is high, reaching 70% in patients with microangiopathy. Impotence concerns 48.7% of the diabetic population with a mean age of 41.4+/-15.5 years. Coronary artery disease had a recognized influence on hemoglobin diseases, particularly when the coronarography is normal. Lower limb arteriopathy is observed in 18% of the diabetic patients.
 ...
PMID:[Main complications of diabetes mellitus in Africa]. 1117 5

We conducted a retrospective study of 3 years duration beginning from the 1st January 1997 to the 31st December 1999 in order to identify the epidemiology of major limb amputations in Seremban Hospital. Two hundred and four patients were included in this study out of which 65.7% were male and 34.3% were female. The mean age of the amputees was 39.7 years old. Non traumatic amputations constitute 85.8% of the cases mainly due to diabetic ulcers or gangrene (91%) followed by peripheral vascular disease (7%) and malignancy (2%). Traumatic amputations represent 14.2% of the cases with road-traffic accident as the major cause (82.8%) followed by industrial accident (17.2%). Lower limb amputations were performed in 97.5% of the cases with below knee amputations as the commonest procedure (72%), followed by above knee amputations (27%) and Syme amputations (1%). Five patients had upper limb amputations done. Four of them were below elbow amputations while one had forequarter amputation done of the left shoulder. Of note, there were increasing number of amputations done over the last three years with alarming increasing trends of traumatic amputation. The three main risk factors for major limb amputations are diabetes mellitus, male gender and road traffic accident.
 ...
PMID:Major limb amputations in Seremban Hospital: a review of 204 cases from 1997-1999. 1181 45

Lower limb compartment syndrome is an unusual but severe complication of prolonged surgery more than four hours in lithotomy position. It is usually a consequence of hypoperfusion of the lower extremities and muscle necrosis may occur. Several risk factors are pointed out: trendelenburg, the hardness of operating table, hypothermia, control hypotension, occlusion of arterial blood flow of the lower extremity, arteritis (and smoking), diabetes, obesity, arterial hypertension, myopathy and an important muscle mass. The symptoms are postoperative pain with neurological signs. A rapid diagnosis and aggressive management (i.e. resuscitation and aponevrotomy) is recommended. Neurological sequelae are sometimes invalidating. Reporting a case of bilateral syndrome, we reviewed the literature and describe the present diagnosis and therapeutic management as well as prevention modalities of this iatrogenic complication.
 ...
PMID:[Bilateral compartment syndrome after colorectal surgery in the lithotomy position]. 1240 49


1 2 3 Next >>