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

Acid-base status was studied in 30 diabetic mothers and their infants and in 30 healthy mothers and their babies after general or spinal anesthesia for cesarean section. A normal acid-base state was found for the diabetic subjects following general or spinal anesthesia. However, the infants of diabetic mothers given spinal anesthesia had an average pH of 7.20 and a base excess value of -5.67 mEq/l in umbilical-artery blood at delivery. These values were significantly lower than those observed in the infants of the other groups, where the average pH was between 7.28 and 7.30 and the base excess between -1.87 mEq/l and 1.00 mEq/l. These findings were significantly related to maternal diabetes and maternal hypotension.
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PMID:Acid-base status in diabetic mothers and their infants following general or spinal anesthesia for cesarean section. 1 53

Experimental diabetes in the rat was induced by alloxan (40 mg/kg body weight) and resulted in permanent hyperglycaemia (mean glycaemia: 403.0 mg/100 ml). The animals were left untreated for more than 16 months. The mesangial cell of the renal glomerulus was studied by serial biopsies performed each month under light anaesthesia in the diabetic animals and in normal controls of the same age. Large dense bodies appeared in the cytoplasm after 3 months in the diabetics and after 10 months in the controls. With time, a larger number of mesangial cells contained these dense bodies. At the end stage they seem to be mainly lipidic. When NO3Ag is given in the drinking water the dense bodies accumulate particles of silver, suggesting that they contain fragments of the basement membrane. While the acid phosphatase reaction was negative in biopsy specimens from diabetic animals, it remains possible that the large dense bodies belong to the lysosomial system. This point, as well as the pathologic significance of the dense bodies is currently investigated.
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PMID:Long-term alloxan diabetes in the rat. Study of mesangial cell morphology by serial biopsies. 19 6

Cyclic AMP, glucose and cortisol in plasma were measured in three groups of patients undergoing hysterectomy. The operations were performed under general anaesthesia, under general anaesthesia combined with epidural analgesia and under epidural analgesia alone. Surgery elicited a significant rise in plasma cyclic AMP, glucose and cortisol when performed under general anaesthesia alone. Epidural analgesia extending from T4-6 to S5 combined with general anaesthesia abolished the rise in cyclic AMP and reduced the increase in glucose and cortisol and epidural analgesia alone extending from T4 to S5 blocked the rise in glucose and cortisol as well as that in cyclic AMP. The results support the theory that afferent nerve impulses from the area of trauma are of major importance for the catabolic state induced by surgical procedures and indicate that anaesthetic management which includes blockade of afferent nerve impulses which includes blockade of afferent nerve impulses from the area of trauma can be reduce the catabolic response to surgery. These observations could be of value in the operative management of patients with diabetes mellitus and possibly in other groups by patients with a high surgical morbidity.
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PMID:Inhibition of plasma cyclic AMP, glucose and cortisol response to surgery by epidural analgesia. 20 31

Patients, particularly older ones, with internal medical diseases, may be hazards for the dental treatment. Therefore, anamnestic data seem to be most important in order to uncover the hazard patient (diabetes, survived heart attacks, anticoagulation, rheumatic heart affections, hypertonics, allergies). Local anesthesia can be another problem, because it may lead to collapse (psychogenous or from anaphylactic shock). Focal infection, although in general overrated in its importance for the general organism, may pose some problems before heart surgery and antibiotic therapy previously may seem necessary. Finally, therapeutic consequences from emergencies in the dental office are reviewed.
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PMID:[General medical concepts for the dental treatment of aging patients]. 26 8

This report presents an unusual case of visual impairment following cardiac arrest during general anesthesia. The presumptive etiology was macular capillary insufficiency secondary to vascular stagnation which occurred during cardiac standstill. Ophthalmic examination confirmed areas of macular edema corresponding to localized perifoveal regional infarcts. Isolated macular infarction is not a unique condition and has been reported in hemoglobulinopathies, diabetes, and other systemic diseases.
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PMID:Transient visual impairment following cardiac arrest. 30 10

Six normal weight subjects without any heredity of diabetes (group 1), 3 obese subjects with normal (group 2) and 9 with pathological carbohydrate tolerance (group 3) were characterized by a 2-h glucose infusion test. Adipose tissue fragments were obtained from the abdominal wall by surgical biopsy under intracutaneous anesthesia. Adipocytes were isolated by collagenase digestion and incubated in buffer containing [1-14C] glucose and different concentrations of insulin. The metabolic effect of insulin was expressed as percent increase above control 14CO2 production. Maximal CO2 raised to 207 +/- 25% and 154 +/- 9% in groups 1 and 2, respectively. These values were significantly higher than in obese subjects displaying a pathological carbohydrate tolerance (group 3; 119 +/- 6%). A negative correlation was found between blood glucose levels and biological activity of insulin on adipocytes. The results suggest that insulin sensitivity of target tissue seems to play an important role in development of carbohydrate intolerance.
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PMID:Relationship between carbohydrate tolerance, insulin secretion, and insulin sensitivity of isolated fat cells from obese protodiabetics. 36 Jul 50

Injection of streptozotocin in newborn rats induced a severe diabetic syndrome on day 4 after birth, with acute hyperglycaemia and glycosuria. Over the next 3 weeks spontaneous recovery occurred as attested by normal basal blood glucose and plasma insulin levels. Recovery was, however, incomplete in the adult since a definite impairment in insulin release and glucose disposal was observed. This state was characterized by the following features: 1) a 72% decrease in pancreatic insulin stores without change in pancreatic glucagon stores; 2) a slight but consistent elevation of blood glucose in the fasted and fed basal states and especially of blood glucose 90 min after an IV glucose load (2 g/kg) performed under pentobarbitone anaesthesia; 3) a considerable decline in the glucose-induced insulin release with a decrease in the maximal response. Both early and late phases of insulin release were impaired, as indicated by in vivo glucose infusion experiments. Basal plasma glucagon levels were normal. Over a period of 12 months with a normal laboratory diet no aggravation of the chemical diabetic state was observed. This new experimental syndrome is a potentially interesting model for the study of the influence of environmental factors on the development of overt diabetes.
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PMID:Chemical diabetes in the adult rat as the spontaneous evolution of neonatal diabetes. 39 4

Sacral agenesis is an uncommon condition associated with familial diabetes mellitus and complicated pregnancy. The condition is characterized by gluteal skin dimpling, loss of gluteal fold, myelomeningocele, sacral lipoma, as well as numerous orthopedic, anorectal and other widespread anomalies. The motor nerve deficit, for example poor anal sphincter tone, is more pronounced than the sensory nerve deficit, for example perianal anesthesia. Diagnosis is made by anteroposterior and lateral spinal x-rays. All of our patients had bladder or external sphincter dysfunction, while 91 per cent had vesicoureteral reflux. Early diagnosis and conservative management with intermittent catheterization and uropharmacological agents are now advocated.
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PMID:Sacral agenesis: an analysis of 11 cases and review of the literature. 50 26

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

Orthostatic hypotension due to autonomic failure may occur secondary to systemic disease states (notably diabetes) or as a disease entity in its own right with a variable degree of neurological involvement that has resulted in a confused classification. The diagnosis, classification and treatment of these latter forms of orthostatic hypotension is reviewed. The pathology is in the central and efferent autonomic pathway, resulting in a disordered baro-receptor reflex, postural hypotension, abnormal responses to tilting and the Valsalva manoeuvre, an inappropriately fixed heart rate and other autonomic features. Anaesthesia may be associated with profound hypotension and some of the signs of anaesthesia may be absent. The response to cardiac depressant drugs and reduction of circulating blood volume may be exaggerated due to absence of compensatory mechanisms. The response to vasoactive agents is unpredictable. The importance of preoperative evaluation, monitoring during operation and the careful selection of anaesthetic agents and techniques is discussed.
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PMID:Anaesthetic considerations in idiopathic orthostatic hypotension and the Shy-Drager syndrome. 50 50


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