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

Melioidosis is an infection of humans and animals caused by a gram-negative motile bacillus, Pseudomonas pseudomallei. Forty-nine patients with melioidosis complicating diabetes mellitus, collagen vascular disorders, leukemia/lymphoma, and other hematologic malignancies are described. Twenty-nine of these patients had disseminated/septicemic infection, two developed toxic shock syndrome, and one with AIDS experienced recrudescent melioidosis. Patients with disseminated melioidosis often have a variety of defects in cellular immunity both in vitro and in vivo. In humans with recrudescent melioidosis, cellular immunity can be transferred by a transfer factor and by levamisole, a cellular immunopotentiating agent. The results of the treatment of our patients with disseminated/septicemic melioidosis with antimicrobial agents in combination have been successful. In recent years, four cases of fungal arteritis due to Pythium species and one case of keratitis due to Pythium were seen. Almost all patients with fungal arteritis had thalassemia; all presented with pain in the lower extremities and gangrenous lesions of the toes. Pythium species, an aquatic Phycomycetes, was identified in these cases as a human pathogen on the basis of clinical features, pathologic findings, and--of greatest importance--the isolation of the etiologic fungi. These five cases with remarkably similar presentations exhibited certain similarities with and differences from cases of mucormycosis, entomophthoromycosis, and peniciliosis.
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PMID:Tropical disease in the immunocompromised host: melioidosis and pythiosis. 260 81

Staphylococcus aureus is a ubiquitous organism that is normally carried on the skin and body surfaces of man. The nares are sites frequently colonized, and patients and hospital personnel represent the major source of infection. The occurrence of staphylococcal infection depends on the availability of staphylococci and the host resistance to infection. Factors that influence the carrier rate of S. aureus include minimal colonizing dose, effects of antimicrobial therapy, disinfectants in the environment, coincidental respiratory infections, possible effect of immune factors, duration of hospital stay, and regular needle injections. Certain patients such as drug abusers, patients with diabetes, and patients with chronic renal failure are at high risk of S. aureus infections. although underlying immune deficiencies are present, increased carrier rate also might be related to regular needle use, as shown among allergy patients. The significance of carrier state has been defined in outbreaks in hospital nurseries, postoperative patients, and systemic infections such as endocarditis in the drug abuser, the toxic shock syndrome, and dermatologic infections.
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PMID:Skin and skin structure infections in the patient at risk: carrier state of Staphylococcus aureus. 637 66

Superantigens (SAgs) are viral or bacterial proteins that act as potent T-cell stimulants and have been implicated in a number of human diseases, including toxic shock syndrome, diabetes mellitus and multiple sclerosis. The interaction of SAgs with the T-cell receptor (TCR) and major histocompatibility complex (MHC) proteins results in the stimulation of a disproportionately large fraction of the T-cell population. We report here the crystal structures of the beta-chain of a TCR complexed with the Staphylococcus aureus enterotoxins C2 and C3 (SEC2, SEC3). These enterotoxins, which cause both toxic shock and food poisoning, bind in an identical way to the TCR beta-chain. The complementarity-determining region 2 (CDR2) of the beta-chain and, to lesser extents, CDR1 and hypervariable region 4 (HV4), bind in a cleft between the two domains of the SAgs. Thus, there is considerable overlap between the SAg-binding site and the peptide/MHC-binding sites of the TCR. A model of a TCR-SAg-MHC complex constructed from the crystal structures of (1) the beta-chain-SEC3 complex, (2) a complex between staphylococcal enterotoxin B (SEB) and an MHC molecule, and (3) a TCR V(alpha) domain, reveals that the SAg acts as a wedge between the TCR and MHC to displace the antigenic peptide away from the TCR combining site. In this way, the SAg is able to circumvent the normal mechanism for T-cell activation by specific peptide/MHC complexes.
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PMID:Crystal structure of a T-cell receptor beta-chain complexed with a superantigen. 890 79

Nonperipartum group B streptococcus infection usually occurs in elderly persons and in patients with underlying systemic diseases (e.g., diabetes, malignancy, or alcoholism). Group B streptococcal infections in adults are often life threatening, and have been associated with a toxic shock-like syndrome. We present a case of fulminant group B streptococcal cellulitis in a patient with sarcoidosis who was receiving corticosteroid therapy and who became hypotensive as her cellulitis rapidly progressed to involve her entire right thigh.
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PMID:Group B streptococcal toxic shock-like syndrome with fulminant cellulitis. 895 Jan 30

Superantigens have been implicated in the pathogenesis of type I diabetes and other immune-mediated diseases. We therefore tested the hypothesis of an abnormal reactivity of the immune system toward bacterial superantigens during the prediabetic phase. For this purpose, splenocytes from NOD (H-2g7) mice were exposed to two well-characterized superantigens: Staphylococcal aureus enterotoxin-B (SEB) and toxic shock syndrome toxin-1 (TSST-1). Cells from BALB/c (H-2d) and C57BL/6 (H-2b) mice as well as those from NON (H-2non) and NOR (H-2g7) mice were used as controls. After 72 h of co-culture with the superantigens or the mitogen concanavalin A (Con A), proliferative response and mitochondrial activity were determined. In the culture supernatants, the cytokines gamma-interferon (IFN-gamma) and interleukin 10 (IL-10) were measured. Striking similarities between NOD cells and major histocompatiblity complex (MHC)-identical NOR cells could be observed with regard to a low proliferative and mitochondrial response to SEB, accompanied by a normal response to TSST-1 and Con A, respectively. In addition, only NOD and NOR spleen cells were low producers of the T-helper 1 (Th1) cytokine IFN-gamma in response to SEB. Conversely, abnormally high IFN-gamma levels were induced by TSST-1 in NOD and NOR spleen cells. The cytokine response to Con A was also biased toward IFN-gamma in both NOD and NOR. Since IFN-gamma and IL-10 are crucial disease-promoting or -protecting mediators in prediabetic NOD mice, superantigens may affect pathogenesis by acting on the Th1/Th2 cytokine balance. The low responder status toward SEB in NOD spleen cells may be of pathogenetic relevance in view of recent findings that the insulin B-chain also interacts with the SEB binding site on MHC class II molecules. In conclusion, we show here that immune cells from mice with a diabetes-associated MHC type respond differently to common environmental superantigens than do immune cells from control strains.
Diabetes 1997 Mar
PMID:MHC class II-dependent abnormal reactivity toward bacterial superantigens in immune cells of NOD mice. 903 92

Studies of two post-mortem pancreata of children at the onset of type I diabetes have suggested activation and expansion of islet infiltrating T cells by a superantigen. We present the first reported case of a superantigen mediated disease, toxic shock syndrome (TSS), occurring at the diagnosis of type I diabetes. A 12-year-old girl presented with TSS and newly diagnosed diabetes with ketoacidosis. At presentation she was unconscious, febrile and hypotensive, with a desquamating erythematous rash and Kussmaul breathing. During resuscitation, her renal impairment, diarrhoea, thrombocytopaenia and ketoacidosis resolved. Vaginal discharge and blood cultures grew Staphylococcus aureus. T cell studies at 2 weeks after diagnosis detected a high level of spontaneous and islet antigen-specific proliferation with associated interleukin-10 production compared to human leucocyte antigen DR matched controls.
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PMID:Toxic shock syndrome associated with newly diagnosed type I diabetes. 1084 34

A recent increase in reports of necrotizing fasciitis resulting from group B streptococcus has alerted physicians to a possible concomitant increase of toxic shock-like syndrome. We report the second case of group B streptococcus causing necrotizing fasciitis and toxic shock-like syndrome. A black woman, aged 52 years, with newly diagnosed diabetes mellitus had necrotizing fasciitis type II of the left groin. Hypotension, elevated bilirubin and liver enzymes, and adult respiratory distress syndrome rapidly developed. Because group B streptococcus was isolated from a normally sterile site, the patient's condition met the criteria for toxic shock-like syndrome. Extensive surgical debridement, hyperbaric oxygen therapy, and intravenous antibiotic therapy (including clindamycin) were required for complete recovery. The antitoxin effects of hyperbaric oxygen therapy and clindamycin should be further investigated for the treatment of such patients.
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PMID:Necrotizing fasciitis and toxic shock-like syndrome caused by group B streptococcus. 1109 61

This retrospective study aimed to compare the characteristics of group A streptococcal bacteremia in children and adults. A total of 76 (12 children and 64 adults) patients with group A streptococcal bacteremia treated from October 1995 through September 2000 at the Linko Chang Gung Memorial Hospital were included. The mean age was 47.6 years (range, 12 days-90 years). Forty-four (57.9%) patients had predisposing medical conditions. Malignant cancer (23.7%) and diabetes (22.4%) were the 2 most common conditions, which occurred only in adults. Two (16.7%) children had chickenpox associated with secondary group A streptococcal bacteremia. Skin and soft tissue infection (60.5%) was the most common clinical manifestation. The mortality rate related to group A streptococcal bacteremia was 25%. Twelve patients met the criteria of streptococcal toxic shock syndrome and 6 (50%) were children (p<0.05). Despite immediate and aggressive treatment, mortality due to streptococcal toxic shock syndrome was 66.7%. The incidence of streptococcal toxic shock syndrome was much higher in children (50%) than in adults (9.4%). Early diagnosis of invasive group A streptococcal infections and streptococcal toxic shock syndrome requires awareness of the presentations and a high level of suspicion. For fulminant group A streptococcal infection, a combination of a beta-lactam antibiotic plus clindamycin and/or adjuvant therapy with intravenous immunoglobulin is recommended.
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PMID:Characteristics of group A streptococcal bacteremia with comparison between children and adults. 1160 11

To determine whether the incidence and pattern of group A Streptococcal (GAS) infections in Thailand have paralleled those in the United States and Europe, we conducted a retrospective study of invasive GAS infections at Chulalongkorn University Hospital from 1995 to 1999. A total of 42 cases were identified. There were 18 males and 24 females (median age of 59 and 46 years, respectively). Most patients were in two age groups: 20-39 (33%) and 60-79 (38%). Underlying conditions were present in 34 patients (81%), including mostly chronic system diseases (50%), alcohol abuse (19%), diabetes mellitus (14%), connective tissue diseases (12%), immunosuppressive illnesses (12%), and human immunodeficiency virus infection (10%). The most common clinical presentations were skin and soft-tissue infections (31%), primary bacteremia (29%), and arthritis (14%). Of these, 24 (57%) presented with toxic shock syndrome (TSS). Overall mortality rate was 33 per cent. All GAS but one isolate were susceptible to penicillin.
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PMID:Invasive group A Streptococcal infections at Chulalongkorn University Hospital. 1185 3

One hundred and twenty-one patients with diabetic polyneuropathy (DP) underwent a clinical and electroneuromyographic investigation before and after treatment with impulse complex modulated electromagnetic fields (ICM EMF) of varying frequency (100 and 10 Hz). Based on TSS and NIS LL scale tests, a correlation between the progression and occurrence of the basic subjective and objective signs of the disease and a DP stage was revealed. The alterations of segmental and peripheral neuromotor system manifesting in reduction of muscular bioelectrical activity, impulse conduction velocities in efferent fibers of peripheral nerves and maximal M-response amplitude were found to be related to DP stage and diabetes mellitus duration. A decrease of H-reflex amplitude and Hmax/Mmax ratio measured in crural muscles proved to be the earliest and most significant electroneuromyographic DP trait. ICM EMF application promotes a regression of DP basic clinical symptoms, an improvement of conduction function of peripheral nerves and 1a afferents state as well as a reflex excitability of functionally different spinal motoneurons. Therapeutic efficacy of a 10 Hz ICM EMF, particularly for DP primary stages and diabetes mellitus up to 10-year duration, was proved.
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PMID:[Application of impulse complex modulated electromagnetic fields in management of patients with diabetic polyneuropathy]. 1252 Jul 73


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