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)

The purpose of this descriptive study is to develop a profile of patients with adhesive capsulitis and to describe the patients' perceived clinical progression. A total of 32 patients diagnosed with adhesive capsulitis and 31 control subject completed anonymous questionnaires designed to elicit demographic data as well as medical information. The adhesive capsulitis and control samples were selected from the same facilities in an effort to reduce bias. Data comparing the adhesive capsulitis group with the control group was analyzed using the Odds Ratio and Taylor Series Confidence Interval for Odds Ratio. Twenty-seven patients (84.4%) diagnosed with adhesive capsulitis fell within the age range of 40-59 years. Diabetes and heart disease appeared to be more prevalent in patients diagnosed with adhesive capsulitis as compared with the control group and general population. The majority of patients with adhesive capsulitis (90.6%) reported a perceived clinical progression that started with a pattern of pain followed by loss of motion. Age and concomitant medical conditions appeared to be most correlated with the occurrence of adhesive capsulitis. Possible reasons for the prevalence of diabetes and heart disease in adhesive capsulitis patients are discussed.
 ...
PMID:A profile of patients with adhesive capsulitis. 926 13

The SF-36 Health Survey is a patient self-administered general health status evaluation designed to measure the impact of disease on an individual's perception of his or her health. Five hundred forty-four patients with five common shoulder conditions (anterior glenohumeral instability (149 patients), complete reparable rotator cuff tear (111 patients), adhesive capsulitis (100 patients), glenohumeral osteoarthritis (67 patients), and impingement (117 patients)) completed the SF-36 Health Survey before undergoing treatment. When compared with U.S. general population norms, the patients with each of these shoulder conditions had statistically significant decreases in their health for Physical Functioning, Role-Physical, Bodily Pain, Social Functioning, Role-Emotional, and the Physical Component Summary as measured by the SF-36 Health Survey. Comparison with published data demonstrated that these shoulder conditions rank in severity (in terms of affecting a patient's perception of his or her general health) with five major medical conditions (hypertension, congestive heart failure, acute myocardial infarction, diabetes mellitus, and clinical depression). The data presented in this study should serve as a baseline to document the impact of shoulder musculoskeletal conditions and possibly to allow comparison among various methods of operative and nonoperative treatment.
 ...
PMID:Self-assessment of general health status in patients with five common shoulder conditions. 965 47

This study was done to examine the association between shoulder adhesive capsulitis and chronic diabetic complications and diseases closely related to diabetes in Akdeniz University Hospital. Shoulder adhesive capsulitis were evaluated in 297 consecutive type II diabetic patients attending an outpatient diabetic clinic. Shoulder adhesive capsulitis was detected in 86 patients (29%). There was a significant association between shoulder adhesive capsulitis and limited joint mobility (p = 0.006), shoulder adhesive capsulitis and Dupuytren's disease (p = 0.003). Odds ratios (OR) for carpal tunnel syndrome, limited joint mobility, and Dupuytren's disease with shoulder adhesive capsulitis were respectively 1.4, 2.1, and 2.4 [95% confidence interval (CI), respectively, 0.7-2.9, 1.2-3.69, and 1.3-4.4]. Also, shoulder adhesive capsulitis was associated with the age of patients (p = 0.000) and the duration of diabetes (p = 0.03). When other associations between shoulder adhesive capsulitis and diabetic complications were compared, it was associated with retinopathy [p = 0.014, OR = 2.2 (95% CI 1.1-4.2)], but there was no association with neuropathy or macroproteinuria. On the other hand, the degrees of passive abduction, internal rotation, external rotation motions of shoulder joints in the all patients were correlated with age of patients, duration of diabetes, neuropathy, and the other hands' problems (Dupuytren's disease, limited joint mobility) (p<0.05). The presence of shoulder adhesive capsulitis may indicate presence of organ involvement.
J Diabetes Complications
PMID:Shoulder adhesive capsulitis and shoulder range of motion in type II diabetes mellitus: association with diabetic complications. 1050 73

The aim of this study was to research the benefit of hydraulic arthrographic capsular distension (hydrodilatation) in the management of adhesive capsulitis of the shoulder. One hundred and nine shoulders with primary adhesive capsulitis were treated with hydrodilatation. Prior to the procedure, 93 shoulders were painful. Two months following the procedure, 31 continued to have some pain. In the 109 shoulders, the measured range of passive glenohumeral movement improved by approximately 30 degrees in all directions. The procedure was of similar benefit if carried out early or late in the disease process. The absolute improvement in movement range was similar in severe and mild cases. The severe cases in the long term, although improved, still had more restriction in movement and tended to have more pain than the other cases. There was considerable improvement in all the non-diabetic patients. The patients with diabetes responded less well in the long term to hydrodilatation and had an increased requirement for arthroscopic surgery. Effective treatment of adhesive capsulitis can be achieved in the majority of cases with an immediate hydrodilatation of the shoulder. Technically, it is important to achieve maximum distension, preferably with capsular rupture, and to utilize cortisone in the fluid injected.
 ...
PMID:Hydrodilatation in the management of shoulder capsulitis. 1289 Feb 43

A 41-year-old male with insulin-dependent diabetes mellitus was admitted for an elective arthroscopic release of adhesive capsulitis of his left shoulder. At the end of the surgical procedure, he appeared to regain consciousness but then became unresponsive at the time of tracheal extubation after a violent bout of coughing, developing bilateral up-going plantar responses, decorticate posturing and abnormal pupillary reflexes. He was transferred to the intensive care unit. The following day, the patient made a full neurological recovery. Contrast echocardiography, performed using agitated saline delivered through a femoral venous line, revealed a large patent foramen ovale with evidence of right to left shunting. In the absence of risk factors for air embolism, the clinical diagnosis was one of paradoxical embolism of venous thrombus resulting in brain stem ischaemia. The patient was commenced on life-long aspirin to minimise future embolic risk.
 ...
PMID:Paradoxical embolism through a patent foramen ovale: an unexpected complication of tracheal extubation. 1581 72

In this review, musculoskeletal manifestations in diabetic patients are presented. Late complications of diabetes mellitus (neuropathic arthropathy and diabetic muscle infarction), consequences of metabolic derangement inherent to diabetes (diffuse idiopathic skeletal hyperostosis, osteopenia, and osteoporosis), syndromes that may share etiologic mechanisms with changes of collagen and microvascular disease (limited joint mobility syndrome (cheiroarthropathy), palmar flexor tenosynovitis (trigger finger), Dupuytren's disease, adhesive capsulitis of the shoulder, and reflex sympathetic dystrophy) are described. Moreover, carpal tunnel syndrome, gout, osteoarthritis and their probable association with diabetes mellitus are discussed.
 ...
PMID:[The musculoskeletal system in diabetic patients]. 1599 89

The incidence of intrinsic disorders of the shoulder presenting in general practice has been estimated to be 14.7/1000 per year with adhesive capsulitis (also termed frozen shoulder, stiff painful shoulder or periarthritis) accounting for around 20% of cases (incidence 2.4/1000 per year), but occurring more frequently in the middle aged and those with diabetes. The aetiology of pathological findings of intra-articular inflammation and fibrosis is not known. Adhesive capsulitis is diagnosed clinically based on characteristic symptoms and signs: spontaneous onset of severe shoulder pain that interferes with activities of daily living and sleep, and progressive stiffness or restriction of both active and passive movements, especially elevation and external rotation.
 ...
PMID:Oral corticosteroids--their place in the management of adhesive capsulitis. 1804 80

Shoulder pain is defined as chronic when it has been present for longer than six months. Common conditions that can result in chronic shoulder pain include rotator cuff disorders, adhesive capsulitis, shoulder instability, and shoulder arthritis. Rotator cuff disorders include tendinopathy, partial tears, and complete tears. A clinical decision rule that is helpful in the diagnosis of rotator cuff tears includes pain with overhead activity, weakness on empty can and external rotation tests, and a positive impingement sign. Adhesive capsulitis can be associated with diabetes and thyroid disorders. Clinical presentation includes diffuse shoulder pain with restricted passive range of motion on examination. Acromioclavicular osteoarthritis presents with superior shoulder pain, acromioclavicular joint tenderness, and a painful cross-body adduction test. In patients who are older than 50 years, glenohumeral osteoarthritis usually presents as gradual pain and loss of motion. In patients younger than 40 years, glenohumeral instability generally presents with a history of dislocation or subluxation events. Positive apprehension and relocation are consistent with the diagnosis. Imaging studies, indicated when diagnosis remains unclear or management would be altered, include plain radiographs, magnetic resonance imaging, ultrasonography, and computed tomography scans. Plain radiographs may help diagnose massive rotator cuff tears, shoulder instability, and shoulder arthritis. Magnetic resonance imaging and ultrasonography are preferred for rotator cuff disorders. For shoulder instability, magnetic resonance imaging arthrogram is preferred over magnetic resonance imaging.
 ...
PMID:Chronic shoulder pain: part I. Evaluation and diagnosis. 1832 64

Treatment for idiopathic adhesive capsulitis or frozen shoulder of the shoulder is controversial. The hypothesis of the study is that intra-articular corticosteroid injection in the early stages of idiopathic adhesive capsulitis will lead to a rapid resolution of stiffness and symptoms. This is a retrospective cohort study of only patients with stage 1 or stage 2 adhesive capsulitis. The diagnosis was made by history and physical examination and only when other causes of pain and motion loss were eliminated. Stage 1 adhesive capsulitis was defined as significant improvement in pain and normalization of motion following intra-articular injection. Stage 2 included patients who had significant improvement in pain and partial improvement in motion following injection. Seven patients with stage 1 and 53 patients with stage 2 comprised the baseline cohort. The mean age was 52 years (range: 30 to 78); 46 patients were female and nine patients had diabetes mellitus. Patients completed a physical examination as well as a shoulder rating questionnaire for symptoms and disability. Criteria for resolution were defined as forward flexion and external rotation to within 15 degrees of the contralateral side and internal rotation to within three spinal levels of the contralateral side. Forty-four of the patients out of 60 met the criteria for recovery at a mean of 6.7 months. The mode and median time to recovery was 3 months. The mean score at final follow-up for 41 patients using the shoulder-rating questionnaire of L'Insalata was 90 (range 52-100). The mean time to recovery for the stage 1 patients was 6 weeks (range: 2 weeks to 3 months), and it was 7 months for stage 2 patients (range: 2 weeks to 2 years). Glenohumeral corticosteroid injection for early adhesive capsulitis may have allowed patients to recover motion at a median time of 3 months. In many cases, the patients had improvement prior to the 3-month mark; however, that was the routine time for follow-up. Patients with stage 1 disease tended to resolve more rapidly than stage 2 patients. Prompt recognition of stage 1 and stage 2 idiopathic adhesive capsulitis and early injection of corticosteroid with local anesthesia may be both diagnostic and therapeutic.
 ...
PMID:Intra-articular corticosteroid injection for the treatment of idiopathic adhesive capsulitis of the shoulder. 1875 95

The musculoskeletal system can be affected by diabetes in a number of ways. The shoulder is one of the frequently affected sites. One of the rheumatic conditions caused by diabetes is frozen shoulder (adhesive capsulitis), which is characterized by pain and severe limited active and passive range of motion of the glenohumeral joint, particularly external rotation. This disorder has a clinical diagnosis and the treatment is based on physiotherapy, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections and, in refractory cases, surgical resolution. As with adhesive capsulitis, calcific periarthritis of the shoulder causes pain and limited joint mobility, although usually it has a better prognosis than frozen shoulder. Reflex sympathetic dystrophy, also known as shoulder-hand syndrome, is a painful syndrome associated with vasomotor and sudomotor changes in the affected member. Diabetic amyotrophy usually affects the peripheral nerves of lower limbs. However, when symptoms involve the shoulder girdle, it must be considered in the differential diagnosis of shoulder painful conditions. Osteoarthritis is the most common rheumatic condition. There are many risk factors for shoulder osteoarthritis including age, genetics, sex, weight, joint infection, history of shoulder dislocation, and previous injury, in older age patients, diabetes is a risk factor for shoulder OA. Treatment options include acetaminophen, NSAIDs, short term opiate, glucosamine and chondroitin. Corticosteroid injections and/or injections of hyaluronans could also be considered. Patients with continued disabling pain that is not responsive to conservative measures may require surgical referral. The present review will focus on practice points of view about shoulder manifestations in patients with diabetes.
Curr Diabetes Rev 2010 Sep
PMID:Shoulder manifestations of diabetes mellitus. 2070 86


1 2 3 Next >>