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

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

A technique is described for glucose infusions and for frequent sampling of small quantities of blood in unrestrained and unanesthetized small laboratory animals. Under pentobarbital anesthesia, polyethylene catheters were implanted into the jugular vein and the aorta, and distal ends were exteriorized on the back of the neck of 250-gm. rats. Five to seven days following surgery the rats regained weight and were in a normal anabolic state, despite indwelling catheters. On the day of the intravenous glucose tolerance test (ivGTT), the exterior ends of the indwelling jugular and aortic catheters were connected to specially prepared extension catheters, through which a glucose pulse was given and frequent blood samples in small quantities were collected, respectively. During the entire procedure, the animals were resting quietly, unrestrained and unanesthetized. In another group of similar rats with indwelling catheters, ivGTT was performed after they were restrained in plastic restrainers. During the ivGTT, serum glucose levels were significantly higher in the restrained rats than those observed in the control rats. The mean glucose disposal rate (K) of 2.2 +/- 0.2 was significantly slower in restrained rats than the K of 3.0 +/- 0.3 in unrestrained rats. Following the glucose pulse, insulin secretion was significantly lower in restrained rats than that observed in the unrestrained rats. These observations emphasize the importance of controlling the modifying effects of mild stress on glucose tolerance and insulin secretion.
Diabetes 1977 Jan
PMID:A method for studying acute insulin secretion and glucose tolerance in unanesthetized and unrestrained rats. The effect of mild stress on carbohydrate metabolism. 55 8

A newly developed artificial pancreatic beta cell is described and its use in five children with diabetes mellitus is evaluated. This device can be programmed to bring the blood glucose concentration rapidly to a preselected level and normalize glucose tolerance in juvenile diabetic patients with markedly different insulin requirements. It is portable, can be operated by one person, and has been used to regulate the blood glucose concentration before, during, and after surgery requiring general anesthesia. The potential value of the device as an investigational tool is shown by demonstrating that regulation of the blood glucose concentration with insulin for seven to 24 hours does not alter circulating glucagon concentrations in the juvenile diabetic patients studied.
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PMID:Clinical evaluation and preliminary studies on the use of an artificial pancreatic beta cell in juvenile diabetes mellitus. 56 36

During the years 1974 and 1975 at our institution, 587 patients who had suffered previous myocardial infarctions underwent anesthesia and surgery. Thirty-six (6.1%) had a reinfarction and 25 (69%) died. Patients operated on within three months of the previous infarction had a 27% reinfarction rate. This decreased to 11% if the infarct had occurred three to six months previously and stabilized at 4% to 5% if the interval was more than six months. Risk factors associated with significantly increased reinfarction rates included preoperative hypertension, intraoperative hypotensive episodes, and noncardiac thoracic or upper abdominal operations of more than three hours' duration. Time under anesthesia was strikingly correlated with reinfarction rates in the entire group. Postoperative intensive care unit admission did not significantly affect the reinfarction rate, nor did diabetes, angina, patient age or sex, or site of the previous myocardial infarction.
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PMID:Myocardial reinfarction after anesthesia and surgery. 66 Jul 89

The origin, background, and mechanism of operation of the Maternal Mortality Study Committee in Wisconsin is outlined. Its value as a teaching vehicle is emphasized. Trends in maternal mortality in Wisconsin and the continued decline are presented, with 45 per 100,000 live births in 1953 to 9.2 per 100,000 live births in 1975. An appeal for standardization of terms and definitions and a continuation of these studies in each state is made. Study committees in many states are inactive. It is suggested that chairmen of maternal mortality committees in many states are inactive. It is suggested that chairmen of maternal mortality committees and representatives meet in geographic areas comparable to Districts of The American College of Obstetricians and Gynecologists to compare trends and statistics. Hemorrhage, once considered the important cause, has decreased from 56.4% of maternal loss to a low of 12.1% in 1975. Presently, a category listed as "other causes"--that is, other than hemorrhage, sepsis, and toxemia--account for approximately 60% of deaths. This group includes anesthesia, emboli and coincidental disease involving kidneys, heart, malignancy, and diabetes. An appeal is made to continue these studies.
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PMID:Mothers are still mortal. 70 97

A postal inquiry into the current use of subarachnoid spinal analgesia obtained replies from approximately 70% of consultants in both Scotland and Sweden. Although medico-legal anxiety was still an important feature of Scottish practice, the publication of large series with a low incidence of complications had also exerted some influence, and 40% of consultants employed the technique. In contrast, 70% of Swedish replies indicated current use of spinal analgesia and the individual frequency of administration was considerably higher. The present popularity of epidural analgesia has contributed to some decline in the use of subarachnoid spinal analgesia in Sweden, particularly in the case of longer surgical procedures. Anaesthetists in both countries expressed dissatisfaction with the limited choice of available spinal agents and considered their duration of action to be inadequate. In Scotland, conditional indications, such as diabetes mellitus and respiratory disease, were of major importance, whereas Swedish users more often specified surgical procedures for which subarachnoid spinal analgesia was considered to be the anaesthetic of choice. Few anaesthetists had experience of complications and no major neurological sequelae were reported. More than 80% of replies indicated that subarachnoid spinal anaesthesia had a useful place in anaesthetic practice.
Anaesthesia
PMID:Subarachnoid spinal analgesia. A comparative survey of current practice in Scotland and Sweden. 72 13

Some of the acute metabolic derangements of unstable diabetes have been discussed. The management of patients undergoing surgical operations has also been considered. No problems are usually encountered in diabetic patients treated with diet alone or with oral hypoglycaemic compounds, although chlorpropamide may need to be stopped sometime before operation. Patients receiving insulin therapy should be stabilised pre-operatively on a regimen which will allow more flexible management during operation and in the postoperative period; this can be readily performed by placing the patient on soluble insulin and giving spaced dosages. Other routines may be used for minor procedures. Adequate supplies of carbohydrate should be given in the form of intravenous dextrose and under no circumstances should oral glucose be given in the 6 hours before operation.
Anaesthesia 1975 Jul
PMID:The emergency management of diabetes mellitus. 80 20

Thirteen bovine heterografts were placed in nine patients: three for renal dialysis, four for treatment of diabetes mellitus, and six for cancer chemotherapy. One graft became occluded on the night of operation. One graft caused dilation of distal veins sufficient for dialysis and was never used; this graft was occluded by a blow ten months later. Two grafts were thrombosed by poor puncture technic, one after three months' use and one after seven months' use. One graft became infected, then thrombosed, and was never used. The remaining eight have served as intravenous conduits for 6 to 19 months. Despite the problems we have encountered with these grafts, we believe that their use is the procedure of choice in cancer patients with limited life spans, even when such patients have available and satisfactory saphenous veins. The establishment of a bovine heterograft requires less time than establishment of a saphenous vein graft and requires only regional or local anesthesia--both advantages in seriously ill patients.
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PMID:Use of bovine heterografts in intravenous therapy. 94 29

In vivo studies were undertaken in rats to provide evidence of the neural nature, tentative localization and mode of excitation of the insulin-sensitive central nervous system (CSN) glucoregulator center. In rats under light barbiturate anesthesia minute amounts of insulin injected into the carotid artery resulted in an immediate decrease of the systemic blood sugar. This hypoglycemic action of regional insulinzation of the CSN was lost when the animals were subjected to prolonged, deep barbiturate narcosis. Competitive inhibition of glucose utilization in the CSN region by intracarotid administration of 2-deoxy-D-glucose did not block the systemic hypoglycemic effect of subsequent intracarotid insulin injection. Chronic endogenous hyperinsulinemia produced by daily growth hormone treatment resulted in an insensitivity of the CNS glucoregulator center to exogenous insulin. The ratio of the quantity of the injected insulin and the pre-existent plasma insulin concentration showed direct correlation with the systemic hypoglycemic response that followed intracarotid injection. Present data support the hypothesis that the insulin-sensitive glucoregulator center located in the area supplied by the carotid artery is neural in nature, because of its inhibition by barbiturate anesthesia. The data are compatable with the working hypothesis that the center is located in the hypothalamus, since light cortical barbiturate anesthesia did not, but deep anesthesia did have an inhibitory effect on it. Marked interference by chronic hyperinsulinemia suggests that the receptor center estimates the metabolic status of the animal through means related to physicochemical binding of insulin to specific receptors. However, since our attempt to inhibit glucose utilization in the CNS was without effect on the activity of the center, it appears that the singal for the glucoregulatory impulse is not insulin facilitation of glucose utilization in the receptor area, but another parameter of insulin action.
Diabetes 1975 Apr
PMID:Studies on the nature and mode of action of the insulin-sensitive glucoregulator receptor in the central nervous system. 113

In German speaking countries peridural anesthesia in obstetrics has been introduced 25 years ago by Anselmino. Because of the increase of operative delivery and the--however rare--serious complications in the mother the technique has been employed less and less. Now, with the introduction of the catheter technique, which renders lower doses of the anesthetic effective and with improved treatment of complications due to it, the technique has become safer for the mother. Anomalies of the position of the fetal head are not more common than in deliveries without peridural anesthesia. But the more frequent need for low forceps delivery remains, since the strain-reflex is abolished, although motorfunction of lower limbs and abdomen are intact. The safe use of peridural anesthesia requires a considerably increased personnel, since the doctor conducting the delivery is only rarely sufficiently qualified in anesthetics and even then should not have to take the responsibility for both delivery and anesthesia. Since we can consider the technique safe for the mother, its effect on the child is predominant interest. Examination of the acid-base metabolism in the fetal blood from the scalp and umbilical cord post-partum has shown favorable results. The effect of complete painlessness on respiration and blood-gases of the mother is of interest (Strasser, Huch, Huch). Further investigations of the effects on fetal heart frequency and its assessment in supine or constant lateral positioning and of the maternal circulation with modern cardiologic techniques have not yet been concluded. On their results will depend, at least in part, the indication for peridural anesthesia in pregnancies and deliveries at risk. Clinical observations and comparison with deliveries under general anesthesia indicate that catheter peridural anesthesia may be advantageous for the child with diabetes, EPH gestosis and prematurity.
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PMID:[Peridural anesthesia in obstetrics (author's transl)]. 124 49


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