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

Diabetes mellitus can lead to blindness through its effects on the retina and lens, yet diabetes is a systemic disease influencing the entire eye. The current interest in extended wear contact lenses emphasizes the need for the practitioners to have a thorough knowledge of the pathophysiology of the anterior eye and cornea of the diabetic. The current literature is reviewed, and its relevance to contact lens wear is discussed.
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PMID:A review of manifestations of diabetes mellitus in the anterior eye and cornea. 328 72

Medicare allowable charges were compared between 21 continuous ambulatory peritoneal dialysis (CAPD) and 25 center hemodialysis (CHD) patients for the 12-month period from Sept 1982 through Aug 1983 to determine if savings from CAPD therapy were offset by higher hospitalization charges. All adult patients on a single therapy for the 12-month period who were not dialyzed or hospitalized at other institutions were included. The CAPD and CHD patient groups did not differ significantly by age, sex, or incidence of systemic disease. However, the CHD group had significantly more black patients. The primary renal disease, the incidence of diabetes mellitus, and other systemic diseases did not differ between the groups. The number of hospital admissions was similar between the two groups. However, the CHD patients tended to have a higher number of hospital days than the CAPD group (17.5 v 12.4). Although the total hospital charges tended to be higher for CHD ($16,145) than CAPD patients ($9,872), this difference was not significant. Outpatient dialysis charges were significantly less expensive for CAPD ($16,470) than CHD ($28,233). Emergency department charges were also significantly less for the CAPD group. Charges for patients with and without systemic disease were analyzed separately. In both subgroups, all charges were less for CAPD therapy; however, this difference was significant only for outpatient dialysis charges. Total charges for the 12-month period were significantly less for the CAPD group ($26,453) than for CHD ($45,586). This demonstrates that hospitalization charges did not offset the savings of home dialysis in these patients.
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PMID:A comparison of inpatient and outpatient Medicare allowable charges for continuous ambulatory peritoneal and center hemodialysis patients: a single-center study. 353 72

Sixty-eight foreign-born Hispanic patients with angiography-proven retinal-vein occlusion (RVO) and 50 age-, sex-, and race-matched controls were evaluated for systemic disease. Thirty of the RVO patients had central retinal-vein occlusion, and 38 had branch retinal-vein occlusion. Hypertension, the most commonly associated factor, was present in 66.2% of the RVO patients in contrast to 18% of the controls (P less than .001). Other factors which were more common in the RVO population included open-angle glaucoma (19.1% vs 8%), diabetes mellitus (16.2% vs 12%), and atherosclerotic heart disease (14.7% vs 10%); these, however, were not statistically significant (P greater than .05). Hyperlipidemia was present in 12% of the controls and 10.3% of the RVO group (P greater than .50). This is in direct contrast to reports of nonHispanic populations where hyperlipidemia has been reported to be present in up to 60% of RVO patients.
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PMID:Factors associated with retinal-vein occlusion in Hispanics. 366 15

The ability to recognize diverse clinical forms of xanthomas, such as tuberous, planar, eruptive and tendinous, is important in the detection of underlying systemic disease. A variety of primary genetic disorders, as well as numerous secondary conditions such as diabetes, obstructive liver disease, thyroid disease, renal disease, and pancreatitis, can lead to hyperlipoproteinemia that results in the formation not only of xanthomas but also of life-threatening vascular atherosclerosis. An understanding of the pathogenesis of the underlying lipoprotein alterations provides a rational approach to therapy utilizing dietary manipulations and drugs. Such treatment is capable of correcting most disorders of lipid metabolism, and, if appropriate therapy is initiated at the first sign of xanthoma evolution, it may prevent progression of atherosclerosis, provide resolution of xanthomas, and in some instances prevent serious pancreatitis.
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PMID:Xanthomas and hyperlipidemias. 403 Nov 42

Among 82 members and four generations of a French-Canadian family, 14 cases of hereditary nephropathy (Alport's syndrome) were documented. Five additional members of the family had died, probably because of this same illness. Deafness occurred in five family members with nephropathy and in one without renal disease. Ten of 12 affected males died in uremia before they had reached the age of 40 years. One of seven affected females died following a pregnancy. In two surviving patients, special investigations failed to elicit intrinsic tubular defects such as amino-aciduria, renal tubular acidosis, hyperphosphaturia or renal glucosuria. Systemic illness such as abnormal aminoacids in serum, primary hyperoxaluria, diabetes mellitus and infections were also excluded. Immunological defects were not demonstrable and the staining of renal biopsy tissue with fluorescein-labelled anti-beta(1)c, anti-IgG and antifibrinogen was negative. Renal tissue material of early, advanced and terminal hereditary nephropathy showed both tubular and interstitial, vascular and glomerular lesions. Electronmicroscopy showed marked thickening of tubular and glomerular basement membranes, increase of mesangial tissue and fusion of foot processes but failed to demonstrate "immune deposits." It is postulated therefore that hereditary nephropathy results from an inborn error of metabolism where an as yet unidentified metabolite damages the renal tissue as well as the acoustic nerve, analogous perhaps to the action of certain drugs, e.g. nephro-ototoxic antibiotics.
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PMID:Hereditary nephropathy with hematuria (Alport's syndrome). 490 62

The fingernails of 512 consecutive hospital inpatients were examined and Terry's nails (by criteria modified slightly from those of Terry) were found in 25.2%. The nail abnormality was associated with the presence of cirrhosis, chronic congestive heart failure, and adult-onset diabetes mellitus, and was also associated with age. In younger patients the nail disorder was associated with an increased risk of systemic disease. Tissue biopsy showed that the nail abnormality was due to distal telangiectasias.
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PMID:Terry's nails: revised definition and new correlations. 614 96

During the first 10 years of the treatment program for end-stage renal disease at the Saint John (New Brunswick) Regional Hospital 164 adults were treated by hemodialysis (with or without renal transplantation, performed outside of the province) or peritoneal dialysis. The primary causes of renal disease were not significantly different in men and women except for glomerulonephritis, which was twice as common in men as in women. Life-table analysis showed that the younger transplant recipients had the highest survival rate, but that the prognosis was almost as good among the much older patients who received continuous ambulatory peritoneal dialysis. Probably because they tended to be younger and their renal disease was caused by less threatening conditions, men survived longer than women. The survival rates were significantly related to the primary cause of the renal disease; patients with diabetes or systemic disease had the worst prognosis. Overall, these results compare well with those obtained in major university centres.
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PMID:A large regional hospital's experience with treatment of end-stage renal disease. 634 64

Retinal hemorrhages can be associated with typical cystoid macular edema. We examined the fundus photographs and fluorescein angiograms of 313 eyes of 264 patients with documented cystoid macular edema to establish the incidence and characteristics of associated intraretinal hemorrhages. As we wanted to study only those hemorrhages unique to cystoid macular edema, we excluded 86 eyes because the patients had diseases known to be associated with retinal hemorrhages. These diseases included diabetes mellitus, branch retinal vein occlusion, hypertensive retinopathy, venous stasis retinopathy, and perifoveal telangiectasia. Of the remaining 227 eyes with cystoid macular edema, 56 (24.7%) were identified with retinal hemorrhages not associated with systemic disease. The hemorrhages were characteristically oval, round, or linear and frequently filled or partially filled the intraretinal cystoid space. In many patients, a blood-fluid level was observed.
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PMID:Intraretinal hemorrhages in cystoid macular edema. 646 76

Of 196 patients with anterior ischemic optic neuropathy, 169 had the nonarteritic form and 27 had the arteritic type. Visual acuities were 20/40 or better in 83 of 184 eyes with nonarteritic anterior ischemic optic neuropathy but only eight of 45 eyes with the arteritic type. We found systemic disease associations for hypertension and diabetes mellitus only for patients with nonarteritic anterior ischemic optic neuropathy who were between 45 and 64 years of age. After a mean follow-up period of five years, 92 nonarteritic patients showed no changes in the first affected eye; there was eventual involvement of the second eye in 20 patients.
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PMID:Clinical profile and long-term implications of anterior ischemic optic neuropathy. 662 29

A retrospective study of 44 cases of generalized pruritus (GP) was undertaken to determine the incidence of systemic disease in this population. This data was compared to that of a group of 44 age- and sex-matched psoriatic controls. We found 13 (30%) of the GP cases to have a systemic disease that in the literature is believed to be associated with GP, versus 10 (23%) in the psoriasis group. Excluding hypothyroidism and diabetes mellitus, two disorders with questionable relationship to GP, the number of pruritus patients with an associated systemic disease was reduced to 8 (18%) compared to only 1 (2%) psoriatic patient, a difference which is statistically significant (p less than 0.02). In 6 (14%) of the GP patients a temporal relationship of systemic disease and GP was suggested. Recommendations for outpatient workup of GP are given. Patient follow-up of 1 to 6 1/2 years revealed that 29 (66%) of the patients had persistent itching. The mean duration of itching to the time of the present follow-up was 57.7 months.
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PMID:Generalized pruritus and systemic disease. 663 May 98


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