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

After Whipple operations, follow-up examinations were conducted under hospital conditions in order to investigate the function of the remainder of the pancreas and the extent to which general health was adversely affected. General parameters such as vocational rehabilitation, history of pain, and weight were analyzed, as well as chemistry related to the severity of pancreatic malassimilation, e.g., stool weight, stool fat contents, fat utilization, chymotrypsin in stool, and PABA test. An exocrine pancreatic insufficiency was found in 80% of patients, but this was easily manageable using medications, sometimes in combination with a MCT fat diet. Subclinical diabetes mellitus was shown in 80% of patients using glucose tolerance tests. However, clinical manifestations of diabetes did not occur.
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PMID:[Function of the residual pancreas following partial duodeno-pancreatectomy]. 45 44

A five year retrospective review of anorectal abscesses included 181 admissions in which all but five were explained by the anal glandular hypothesis of causation. Delays in treatment occurred because of misdiagnosis, attempts at nonoperative management and inhospital procrastination. These abscesses are notorious for the recurrence rate after treatment. One-third of the patients in our series had a history of previous abscess and a postoperative recurrence rate of at least 6 per cent. Associated medical problems, such as diabetes mellitus, inflammatory intestinal disease or carcinoma, should be suspected in these patients. The fact that the majority of the patients in our series were afebrile and had minimal leukocytosis is a possible indication that our index of suspicion should be high in any patient with anorectal pain and that we must rely primarily on local findings. Treatment should be prompt incision and drainage under spinal or general anesthesia. Wide unroofing procedures and overzealous attempts at primary fistulotomy are discouraged as is the use of local anesthesia. Associated procedures, such as hemorrhoidectomy, can be safely performed and may prevent certain postoperative complications.
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PMID:Anorectal abscess. 50 65

In the reported case unilateral external ophthalmoplegia developed in a young woman, with concomitant pain and anaesthesia in the area innervated by the 1st branch of the trigeminal nerve. After ruling out an expanding lesion of the central nervous system, aneurysm, diabetes, myasthenia, multiple sclerosis and other diseases dexamethasone was administered in a total dose of 30 mg. Complete clinical remission was achieved. In the light of observations and a survey of the peritinent literature it has been accumed that the disease was caused by a non-specific process in the small vessels in the vicinity of the cavernous sinus.
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PMID:[Tolosa-Hunt syndrome (ophthalmoplegia dolorosa)]. 52 41

789 patients with diabetes mellitus were studied by clinical and electroneurographical examination. Motor conduction velocity of the median and the tibial nerve and sensory conduction of the median nerve were determined. 81.1% of the patients we suffering from diabetes which began in childhood or adolescence, 13.9% were suffering from maturity onset diabetes. Average duration of the disease was 9.5 years, average age was 26.7 years. Clinical signs of polyneuropathy were found in 19.1%. Typical findings were pain and paraesthesia, lack or abolition of triceps surae reflexes, impaired pallaesthesia on lower extremities. 48.3% of 151 patients with clinical signs of polyneuropathy were suffering from combined angiopathy, 32.5% from microangiopathy, 7.9% from macroangiopathy. Severity of complicating retinopathy and macroangio,athy were found to be correlated with polyneuropathy. 58.2% of 323 diabetics with at least one delayed nerve conduction velocity exhibited signs of angiopathy. In nearly 30% of children and adolescents after comparatively short duration of the disease at least one conduction velocity was delayed. In diabetic children and adolescents metabolic disturbances are assumed to cause peripheral nerve dysfunction.
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PMID:[The diabetic polyneuropathy. II. Polyneuropathy, angiopathy and nerve conduction velocity]. 53 79

Martha, an elderly patient, presented a real challenge to our nursing staff. As a new diabetic, she needed a great deal of education in addition to extensive nursing care for her multiple bleeding leg ulcers, dehydration and malnutrition due to uncontrolled diabetes, and reactive depression. Despite these problems, in approximately one month's time Martha was able to return to her home in control of her diabetes and her emotions and ambulating without pain. Her successful return to normal life was enhanced by holistic nursing management. The nursing staff found that the use of a problem list and a diabetes educational plan assisted them in individualizing their patient care.
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PMID:A new diabetic with complications: primary nursing care. 58 27

Myocardial infarction is considered the prime cause of death among adult diabetic patients. In a great number of cases, during myocardial infarction the patients don't feel pain or it is atypical. Diagnosis can be neglected, and mortality increases. In search of an explanation for the absence of pain in these patients, the authors studied the autonomic nerve fibers of the heart muscle with argentic and combined techniques, looking for lesions in the sympathetic or parasympathetic nerve fibers that conduct pain. In the five cases of painless myocardial infarction studied, the nerve fibers showed typical lesions of diabetic neuropathy: beaded thickenings, spindle-shaped thickenings, fragmentation of fibers, and diminution of the number of fibers in the nerves. The patients in the control group (five diabetics with painful infarction, five diabetics with infarction, five nondiabetics with painful infarction, and five nondiabetics without infarction) had no lesions. These facts led us to assume that the absence of pain in diabetics with myocardial infarction could be due to a lesion of the afferent nerves that conduct pain.
Diabetes 1977 Dec
PMID:Autonomic neuropathy and painless myocardial infarction in diabetic patients. Histologic evidence of their relationship. 59 Jun 38

A study was undertaken to determine the effect of the development or disease on patients' smoking habits. Interviews with 841 subjects (591 smokers) were conducted following a standard protocol. Of the 841 subjects, 96 (61 smokers) had hydroceles or hernias and were considered a control group; the remainder had neoplastic diseases, respiratory disorders, diabetes, cardiovascular diseases, psychiatric illnesses, peripheral vascular diseases, and gastrointestinal and liver disorders. Patients with cardiovascular, pulmonary, and neoplastic diseases, diabetes, gastrointestinal diseases, and cirrhosis of the liver significantly reduced or stopped smoking because of medical advice (19%), socioeconomic factors (8%), or aggravation of disease (24%). The advent of disease was associated with an increase in smoking in several patients (including 2 with bronchial asthma and 12 with peripheral vascular disease) because of the apparent belief that smoking is beneficial in overcoming the disease or in controlling pain. Additional long-term studies are needed to explore the relationship between disease and smoking habits.
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PMID:Effects of the advent of disease on smoking habit. 60 78

Small-bowel ischaemia is the least familiar cardiovascular complication of the oral contraceptive but is 1 associated with a high mortality rate and much morbidity. Hoyle et al have recently reviewed 21 cases and found that 1/2 the patients had died and 1/2 had required 2 or more operations, resulting in the removal of much of the small bowel. Small-bowel ischaemia occurs in women taking the oral contraceptive as a result of either mesenteric artery or mesenteric vein thrombosis. The dominant presenting symptom in small-bowel ischaemia, found in all patients, is abdominal pain. Some patients had associated nausea and vomiting; others complained of diarrhea. On examination the patient has usually been found to be febrile with generalized abdominal tenderness. Bowel sounds are present unless infarction has occurred. In nearly all cases reported the diagnosis has been made only at laparotomy, when the bowel was usually infarcted. Since many of the patients had had pain for 2 or more weeks, the condition might be reversible if it could be detected earlier. A diagnosis of small-bowel ischaemia should be carefully considered in any woman taking an oral contraceptive who presents with vague abdominal pain and has an associated condition known to predispose to circulatory disorders: cigarette smoking, hyperlipidaemia, diabetes, hypertension, obesity, or blood group A. If it seems like small-bowel ischaemia is the likely diagnosis, the contraceptive pill should be stopped immediately and treatment started with heparin.
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PMID:Flap lacerations. 62 Jan 42

Although many patients with coronary artery disease (CAD) have a positive exercise test without pain, the frequency and significance of this "silent" ischemia is unclear. Therefore, we studied 122 consecutive clinically stable patients with angiographically defined CAD (greater than 75 per cent luminal stenosis) and a positive exercise test. Seventy-eight patients had pain or anginal equivalent during or after a positive exercise test; 44 did not, including 32 (26 per cent) with no symptoms at all. Patients were evaluated as to age, sex, prior myocardial infarction, congestive failure, hypertension, diabetes mellitus, and digoxin or propranolol therapy--in addition to anginal symptoms before, during, or after the exercise itself. Extent of CAD, presence of collaterals, and left ventricular ejection fraction were also determined. All exercise tests were evaluated for evidence of ST-T abnormalities or prior infarction on the control ECG as well as peak heart rate during exercise and post-exercise degree of ST segment depression. There were no significant differences between patients with and without exercise-induced pain in regard to any of the clinical and angiographic features noted above, demonstrating that "silent" myocardial ischemia during or after exercise testing is not uncommon and is not readily attributable to any obvious clinical or catheterization findings. Further studies are necessary to determine if patients with evidence of "silent" myocardial ischemia are especially prone to sudden death.
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PMID:"Silent" myocardial ischemia during and after exercise testing in patients with coronary artery disease. 63 80

Twenty-eight patients with total occlusion of the infrarenal aorta have been seen at the UCLA Hospitals in the past 11 years. Claudication was the presenting complaint in all but one patient, with one-third having ischemic rest pain. The average age of these patients was 54 years, and their histories revealed a surprising absence of myocardial infarction, stroke, or diabetes, although 40% had essential hypertension. Heavy tobacco use, however, was characteristic of the entire group. Arteriography proved valuable in identifying and characterizing the vascular abnormalities, but posed problems in technique and interpretation. Significant distal arterial disease was detected radiographically in only 21% of these patients. Operative correction of the aortic occlusion was performed on 26 patients, 18 by aortic bypass grafts and eight by aorto-iliac endarterectomy, with one early postoperative death. Although the thrombus extended to the renal artery origins in 77% of the cases, a well-designed technical approach did not require renal artery occlusion. Using serial creatinine determinations, one case of renal insufficiency was detected which was associated with prolonged postoperative hypotension. Although the extent of distal disease was more severe in those who underwent bypass, symptoms of claudication returned earlier and were more prominent in the endarterectomy group. This recurrence of systems was not favorably altered by sympathectomy performed concomitantly with the initial procedure. Even though this condition seems to pose difficult technical obstacles and has a poor prognosis, infrarenal aortic occlusion can be successfully treated by aortic bypass, with favorable long-term results, if particular attention is paid to elements of the preoperative evaluation and the intraoperative technical requirements peculiar to this relatively uncommon disease entity.
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PMID:Infrarenal aortic occlusion. 64 79


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