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

Chemical intolerance, or reported illness from odors of common environmental chemicals (e.g., car exhaust, pesticides), is emerging as an important environmental and public health-care issue. Epidemiologic methods provide relevant heuristic devices for studies of complex disorders, such as chemical intolerance. The authors examined personal and reported parental cardiopulmonary disease prevalence rates in a community sample of chemically intolerant and control individuals. A county government (Tucson, Arizona) employee and kin subset (N = 181; 113 households) completed standard health questionnaires. Investigators determined chemical intolerance (n = 41/181) from self-reports of individuals who felt "moderately" to "severely" ill from exposure to at least three of five chemicals (i.e., car exhaust, pesticides, paint, new carpet, and perfume) on a Chemical Odor Intolerance Index. The authors chose the control group (n = 57/181) on the basis of self-reports of "never" feeling ill on the Chemical Odor Intolerance Index. The chemically intolerant group, which primarily comprised women (78% versus 51% of controls, p < .05), was significantly more likely to report-and to have sought--medical attention for heart problems, bronchitis, asthma, and pneumonia. Reports of heart problems in the chemically intolerant index cases and the occurrence of heart disease in both of their parents were significant (Fisher's p < .05). The chemically intolerant individuals were also significantly more likely to report maternal histories of chest problems (e.g., inhalant allergens, tuberculosis) than controls. The findings of the study suggested that the chemically intolerant individuals (a preponderance of whom were women [sex-related risk]) were more likely to have (a) reported cardiopulmonary problems (i.e., greater health risk); (b) actively sought medical care for these problems (i.e., increased medical utilization); and (c) reported more parental illnesses-particularly heart disease, asthma, and diabetes (i.e., genetic risk). Additional community-based studies of chemical intolerance are needed.
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PMID:Increased cardiopulmonary disease risk in a community-based sample with chemical odor intolerance: implications for women's health and health-care utilization. 976 80

To compare the hypoglycaemic symptoms reported by children with Type 1 diabetes and signs observed by and symptoms reported to their parents, 101 pairs, consisting of a child with diabetes and one of their parents, were asked to report the frequency with which they experienced, or witnessed, each of 31 symptoms during hypoglycaemia. The hypoglycaemic symptoms reported by the children and the reported symptoms and signs observed by their parents were classified, using multivariate statistical analyses, and compared. Close agreement was observed between the children and their respective parents' scores for frequencies of most symptoms/signs, as demonstrated by Spearman's rank correlations (median tau s = 0.25, p < 0.02). Principal Components Analysis of the symptoms/signs observed by the parents showed three factors: autonomic, neuroglycopenic, and behavioural disturbance. Analysis of the symptoms experienced by the children also identified three factors: behavioural disturbance, malaise and a third factor consisting of a combination of autonomic and neuroglycopenic symptoms. The parents could differentiate three separate groups of reported hypoglycaemic symptoms and signs (autonomic, neuroglycopenic, and behavioural disturbance) in their children. The children reported a similar group of behavioural symptoms but did not discriminate between autonomic and neuroglycopenic symptoms. These findings have important implications for the education of parents and children with Type 1 diabetes regarding the symptoms and signs of hypoglycaemia.
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PMID:Hypoglycaemic symptoms reported by children with type 1 diabetes mellitus and by their parents. 979 84

In a woman aged 80 years arriving in the Emergency Room with progressive malaise, anorexia and somnolence, a large resistance was found in the lower abdomen, which proved to be due to cystitis emphysematosa. The patient was known to suffer from non-insulin dependent diabetes mellitus. Imaging revealed a large accumulation of gas in the urinary bladder, which was treated successfully with catheterization and antibiotics. Cystitis emphysematosa is a rare condition, characterized by collection of gas in the bladder and bladder wall and brought about by gas-forming micro-organisms that decompose glucose. In patients with diabetes mellitus optimal regulation of the blood glucose levels, with a view to preventing glycosuria, is a condition of speedy recovery. Although cases with a fatal outcome have been reported, the prognosis in general is favourable.
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PMID:[A diabetic patient with cystitis emphysematosa]. 986 38

Biases can distort, limit or inhibit the value of mortality data as an epidemiological re source. From 9500 deaths occurring in Naples (Italy during 1994, a random sample of 372 death certificates reporting ill-defined causes and multiple causes of death was extracted. The code for the underlying cause on the death certificate (assigned code) was compared with the cause reattributed with the aid of interview of the certifying physician or clinical records (modified code). The aim was to investigate the extent of misclassification of 'underlying cause' in deaths attributed to ill-defined and/or multiple causes and the shortcomings in the ICD-IX. Ill-defined underlying causes of death (7.0% of death certificates) were cardiovascular diseases, tumours with no specified site or nature, symptoms, signs, ill-defined conditions and senility. There was disagreement between the initially assigned code and the modified code in 53.8% of ill-defined underlying causes; discordance was high for the certificates filled in by the family physician. Multiple causes of death were observed in 23.6% of certificates; of these 59.2% concerned subjects aged 75 years and over at death. Diabetes was always listed in association with other pathologies but neoplasms and traumas were generally listed alone. Disagreement between codes occurred in 48 (54.5%) certificates indicating multiple causes. In 10 of them, death was established as due to a concurrence of causes. As regards ill-defined causes of death, the authors concluded that specific training on certifying procedures would be insufficient on their own; the physician should be made aware that certification is a fundamental requirement for building up epidemiological data. Evidence-based educational interventions are needed. As regards multiple causes of death, multicausal analysis may be indicated for deaths due to a concurrence of causes.
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PMID:Ill-defined and multiple causes on death certificates--a study of misclassification in mortality statistics. 1020 43

The history of antiarrhythmic therapy reveals these agents to be associated with a high incidence of toxicity. Although several agents have ocular effects, amiodarone is the most widely recognized for producing adverse effects in the eyes. Corneal microdeposits are almost ubiquitous in patients being treated with amiodarone. However, they are, for the most part, benign and produce no changes in visual acuity. Lack of microdeposits should prompt the physician to investigate whether there is a problem with drug absorption or adherence to therapy. Other effects on the eye have been reported including optic neuropathy, but no causal link has been proved with amiodarone. The population of patients treated with amiodarone often have ischemic disease and/or diabetes, which affect retinal and optic nerve health. Many antiarrhythmic agents also affect lung function. The frequent association of procainamide with a lupus-like syndrome, where half the cases develop pleural-pericardial involvement, may require discontinuation of that drug. Although beta blockers and to a lesser degree, calcium antagonists, may cause bronchospasm in some patients, this is not usually a major clinical problem. Again, it is amiodarone that has the most widespread reputation for causing pulmonary toxicity. Although infrequent (< 1% incidence), it generates the most fear as it is sometimes fatal. Because of the lack of a diagnostic "gold standard," it is often overdiagnosed, placing patients at risk from overlooked congestive heart failure and infections and from recurrent arrhythmias after drug withdrawal. Patients with pre-existing pulmonary disease appear to be more at risk. Common features include indolent onset of cough, malaise and fever associated with patchy peripheral infiltrates, and severely decreased diffusion capacity. Several cases of pulmonary toxicity have had inordinately high serum desethylamiodarone to amiodarone ratios. Most cases recover with cessation of amiodarone therapy. Steroids are commonly used, but are of unproved efficacy. In terms of its toxicity, amiodarone remains the most feared of the antiarrhythmic agents. In the future, a better understanding of its pharmacokinetics, mechanisms of toxicity, and optimal dosing regimens should provide a possibility of better strategies for avoidance, early diagnosis, and more directed therapy of toxicities associated with amiodarone.
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PMID:Clinical organ toxicity of antiarrhythmic compounds: ocular and pulmonary manifestations. 1056 58

The principle of a Third Way is to balance the autonomous needs of the individual with the need for community. Elevating Arts into a pivotal role across the spectrum of healthcare may provide a third way. Ill health is not isolated from society. A holistic approach sees health as successful adaptation to environment; Unemployment, social exclusion and bereavement become as much health concerns as diabetes. The health perspective should widen from the narrow scientific to a broader humanistic approach: changing professional medical education; introducing arts in healthcare settings and understanding the community impact of participation in the arts. Harnessing disparate perspectives present a challenge. Professional medical education should change to bridge the gap between science and society. Evidence suggests that the healthcare settings that support and reflect the perspectives offered by Dance, Music, Literature, Museums and Galleries lead to health gain and are in the long term cost-effective. Over the last decade a number of studies and grassroots projects have demonstrated the therapeutic value of arts in treating and preventing illness, yet there is a need to fully exploit this potential; health planners should provide leadership and support. The potential for arts to inform and facilitate individual expression is enourmous and should be further explored. A third way for health requires fundamental reassessment: what is health? What is a health centre: Arts should provide a third way to a dynamic engagement between the NHS and its constituents.
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PMID:Arts, health and wellbeing: a third way for health? 1062 13

We report a case of giant psoas abscess with aggressive extension outside the muscles of the iliopsoas component. A 57-year-old man was admitted to our hospital, presenting with right flank pain and severe general malaise. He had been diabetic, but no treatment had been performed for diabetes. Leukocytosis, positive CRP and hyperglycemia were noted, but he was nearly afebrile on admission. Computerized tomography revealed a large multilocular mass in the right retroperitoneal space involving the ipsilateral psoas muscle. The diagnosis was not apparent until the 12th hospital day, when moderate grade fever was noted and brownish purulent fluid was obtained by percutaneous puncture of the mass. Staphylococcus aureus was isolated on culture. Antibiotic chemotherapy was started, and ultrasound-guided percutaneous drainage was then performed under the diagnosis of psoas abscess. At that time, the abscess was aggressively extending from the iliopsoas component into the pelvic floor, involving the rectus muscle, the gluteal muscles and formation of subucutaneous lesions. At 46 days after drainage, surgical resection of the abscess with removal of the adjucent tissue was performed because of persistent discharge of pus and multiple residual lesions. The postoperative course was uneventful, and there has been no recurrence. Many cases of psoas abscess have been reported in the Japanese literature. Prompt drainage, either percutaneously or surgically are required. Surgical resection of the abscess, with not only opening the cavity but also removal of the adjacent tissue, may be recommended in some cases, especially those diffuse or multilocular lesions.
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PMID:[Giant psoas abscess with aggressive extension: report of a case]. 1065 17

Brucellosis is an infection due to Brucella species and is characterized by acute febrile illness, chilly sensations, sweats, weakness, generalized malaise, body aches and headache. The involvement of the nervous system is rare. A few cases have been reported with symptoms and sign of optic neuritis, meningoencephalitis, meningomyelitis and cranial nerve palsy. We report a case with culture proven neurobrucellosis who presented with diabetes insipidus along with systemic signs. Neuroimaging revealed multiple lesions in brain parenchyma, including the suprasellar region. Both diabetes and suprasellar lesions improved markedly with specific antibiotic therapy.
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PMID:Diabetes insipidus in neurobrucellosis. 1099 15

A 62-year-old man who had a 14-year history of diabetes complained of low-grade fever, general malaise, pain of bilateral femurs and hip girdle, and was adniitted to our hospital. The diagnosis of polymyalgia rheumatica (PMR) was made from the clinical symptoms, elevated C-reactive protein and erythrocyte sedimentation rate. Electromyography revealed abnormalities that suggested diabetic peripheral neuropathy. However, the abnormalities were improved after starting treatment with corticosteroids (PSL). After stopping PSL, electric nerve conduction disturbance developed; therefore, it was suggested that peripheral nerve involvement due to PMR was improved by administration of PSL regardless of the existence of diabetic peripheral neuropathy.
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PMID:Polymyalgia rheumatica and type 2 diabetes mellitus complicated with electromyographic abnormalities that responded well to corticosteroid therapy. 1119 6

A 32-year-old student reported fatigue and malaise since two months in the absence of specific symptoms. Clinical examination and extensive laboratory testing revealed no abnormalities at his first presentation. Some weeks thereafter, on re-admission, hyperpigmentation suggestive of Addison's disease was observed and pathognomonic autoantibodies directed against the thyroid gland and the adrenal cortex were detected. Further evaluation led to the diagnosis autoimmune polyglandular deficiency syndrome, also named "Schmidt syndrome", comprising adrenocortical insufficiency (Addison's disease) and lymphocytic thyroiditis (Hashimoto thyroiditis). The diagnosis of polyglandular insufficiency is often delayed due to non-specific symptoms at early disease stages and progression may be rapid, culminating in Addisonian crisis under physical stress or infection, requiring immediate high-dose hormone replacement therapy. Hence, careful re-examination is mandatory to ensure adequate treatment before life-threatening complications occur. Nowadays this type of disease is classified as autoimmune polyglandular syndrome type II (APS type II) with an increased risk of developing insulin-dependent diabetes mellitus (IDDM), vitiligo, alopecia, pernicious anaemia, coeliac disease, myasthenia gravis and primary hypogonadism. The cause of the disease remains obscure but in addition to an autosomal dominant trait with variable penetrance some hints at viral infection triggering the disease process exist.
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PMID:32-year old patient presenting with autoimmune polyglandular syndrome. 1131 87


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