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

A programme is described in which indigenous personnel are trained to provide culturally appropriate rehabilitation services for islanders of the Pacific Basin. The disabling conditions most commonly dealt with are associated with stroke, diabetes, arthritis, trauma, and back and neck pain. The programme could be adapted to meet needs in other remote rural communities lacking suitably trained carers.
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PMID:Rehabilitation technicians for remote rural communities. 146 25

In 59 young stroke patients without predisposing conditions (thromboembolic mechanisms, diabetes, cardiac disease, coagulation disturbances), the angiographic findings and the clinical observations in combination make arterial dissection the most probable diagnosis in 45 patients. In an additional 7, this diagnosis remains as a possible diagnosis. It is suggest that in patients under 40 years of age with no predisposing disease and with sudden onset of neurologic deficits, preceded or accompanied by headache and/or neck pain and often associated with physical strain, arterial dissection should be regarded as the most likely diagnosis.
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PMID:Young stroke patients. An angiographic study. 298 Apr 92

A 75-yr-old diabetic woman presented with right ear tenderness and neck pain. Pseudomonas aeruginosa was cultured during surgery from an inflammatory area in the region of the cervical vertebrae. A diagnosis of malignant external otitis was made and parenteral antibiotics were given, which produced a cure. This disease has a high mortality rate, which accounts for the use of the word malignant. Our patient also manifested the jugular foramen syndrome involving multiple cranial nerves. If there is cranial nerve involvement, which is seen in at least one-half of cases, the mortality ranges as high as 80%. We describe here the first case with invasion of the cervical vertebrae.
Diabetes Care
PMID:Malignant external otitis: now a medical problem. 677 32

We report a case of cervical spine epidural abscess in a 50-year-old man with a 4-day history of neck pain but no neurologic deficits or fever. The patient had no predisposing risk factors such as recent spinal surgery, trauma, instrumentation, distal site of infection, immunosuppression, diabetes, or i.v. drug abuse. A review of the literature follows.
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PMID:Cervical spine epidural abscess in a patient with no predisposing risk factors. 895 74

Gout, like diabetes mellitus, is a common metabolic disorder. Typically affecting the distal joint of the appendicular skeleton, its occurrence in the spine is rare. We report the case of a 68-year-old male with a long history of diabetes mellitus and hyperuricemic gout. Neck pain developed over two weeks with subsequent quadriparesis, with concomitant subcutaneous deposition of gouty tophi in the right elbow. Magnetic resonance image of the cervical spine revealed multiple segmental narrowing of the thecal sac at the C3-6 levels due to hypertrophic spurs and bulging discs. Anterior discectomies of C3-4 and C4-5 were performed, with a chalky-white, granular material noted in the C4-5 disc space. Histological examination of the surgical specimen revealed deposits of needle-like crystals surrounded by histiocytes and multinucleated giant cells, with the appearance compatible with gout. The patient was ambulatory with the assistance of a walking frame six months after the operation. We emphasize that gouty tophi can be deposited in the spine over a relatively short time, subsequently precipitating a variety of symptoms, from pain to cord compression. The regular administration of antihyperuricemia drug treatment for hyperuricemic gout is necessary to prevent this deposition. If neurological defects are found, surgical decompression can provide satisfactory results.
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PMID:Cervical myelopathy due to gouty tophi in the intervertebral disc space. 1186 23

A 63-year-old man had a history of diabetes mellitus for more than 10 years and took oral hypoglycemic agents regularly. He visited Taipei Veterans General Hospital with the complaint of progressive weakness in all 4 limbs and neck pain for 6 months. Computed tomography of the cervical spine revealed increased soft tissue density in the epidural space from C2 to C5 with cord compression. Surgical decompression was done and Aspergillus flavus was isolated from the inflammatory tissue. He was initially treated with oral itraconazole 200 mg 3 times per day for 4 days and then twice daily. Later, the treatment regimen was shifted to intravenous amphotericin B 25 mg/d. He died of intraventricular hemorrhage and complicated fungal meningoencephalitis 2 weeks postlaminectomy. This case reminds us that a prolonged history of back pain accompanied with peripheral neuropathy in diabetic patients should raise the suspicion of Aspergillus epidural abscess. Prompt aggressive diagnostic testing and management is needed to improve the likelihood of a good outcome of these patients.
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PMID:Aspergillus flavus epidural abscess and osteomyelitis in a diabetic patient. 1288 68

A seventy-one-year-old woman was hospitalized with a suspicion of deep neck infection and poor general health. She had been receiving treatment for hepatitis, diabetes mellitus, and cardiac failure and had a history of tooth ache and severe neck pain lasting for the past 10 days. She had been admitted to another center where she had received antibiotic treatment for five days for widespread swelling in the neck and lower extremities, fatigue, and difficulty in breathing and swallowing. Upon admission, computed tomography showed gas formation in the neck and facial regions. Prompt abscess drainage was performed and intense treatment with antibiotics was continued. Despite all efforts, the patient died on the second day of hospitalization from cardiopulmonary arrest. This case emphasizes how urgent drainage is when gas formation is detected in deep neck infections, with inevitable poor prognosis with antibiotic treatment alone.
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PMID:[The adverse effect of gas formation on prognosis in a patient with deep neck infection]. 1469 56

This paper investigates comorbidity between chronic back and neck pain and other physical and mental disorders in the US population, and assesses the contributions of chronic spinal pain and comorbid conditions to role disability. A probability sample of US adults (n=5692) was interviewed. Chronic spinal pain, other chronic pain conditions and selected chronic physical conditions were ascertained by self-report. Mood, anxiety and substance use disorders were ascertained with the Composite International Diagnostic Interview (CIDI). Role disability was assessed with questions about days out of role and with impaired role functioning. The 1 year prevalence of chronic spinal pain was 19.0%. The vast majority (87.1%) of people with chronic spinal pain reported at least one other comorbid condition, including other chronic pain conditions (68.6%), chronic physical conditions (55.3%), and mental disorders (35.0%). Anxiety disorders showed as strong an association with chronic spinal pain as did mood disorders. Common conditions not significantly comorbid with chronic spinal pain were diabetes, heart disease, cancer, and drug abuse. Chronic spinal pain was significantly associated with role disability after controlling for demographic variables and for comorbidities. However, comorbid conditions explained about one-third of the gross association of chronic spinal pain with role disability. We conclude that chronic spinal pain is highly comorbid with other pain conditions, chronic diseases, and mental disorders, and that comorbidity plays a significant role in role disability associated with chronic spinal pain. The societal burdens of chronic spinal pain need to be understood and managed within the context of comorbid conditions.
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PMID:Chronic spinal pain and physical-mental comorbidity in the United States: results from the national comorbidity survey replication. 1566 41

We report a case of a 65 year old Malay lady with long-standing diabetes mellitus, who presented to our institution with a one month history of worsening neck pain and progressive upper and lower limb weakness. She was stable despite severe hyponatraemia which was initially treated as syndrome of inappropriate anti-diuretic hormone (SIADH). This was consistent with her underlying illness which was concluded as cervical tuberculosis (TB) with spinal cord compression. She underwent decompression and bone grafting. Despite continuous treatment her serum sodium levels remained low. There were no other problems with her adrenals or thyroid. A water loading and hypertonic saline perfusion test was performed and supported the diagnosis of reset osmostat. Her serum sodium remained below the normal range and she was discharged well.
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PMID:A case of persistent hyponatraemia due to reset osmostat. 1762 70

Diabetic muscle infarction, also known as diabetic myonecrosis, is an uncommon neuromuscular complication of longstanding diabetes. It usually involves the thigh or calf muscles. Patients typically present with severe pain in the affected area. This complication is more often seen in middle-aged diabetic patients with poorly controlled glycemia. We describe a 38-year-old female Type 1 diabetic patient who developed acute neck pain 3 weeks following islet transplantation.
J Diabetes Complications
PMID:Case report: diabetic myonecrosis of the neck complicated by infection in an islet transplanted patient. 1835 51


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