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

The diagnosis of lactate acidosis is complicated by the fact that lactate determination is not a routine method in clinical chemistry. In fact, lactate analysis is performed only in special laboratories. Even in greater clinics this method is not routinely performed in differential diagnosis of acidotic states. Various diseases are accompanied by a lactate emia or even by lactate acidosis. Anaerobic synthesis of lactate is an emergency reaction to supply minimum energy to tissues with insufficient oxygen supply. The main diseases complicated by increased blood lactate concentrations are shock, circulatory collapse, cardiac failure and peripheral circularoty disturbance. Additionally diabetes mellitus, septical infections, and-the most prominent situation-biguanide intoxications are complicated by an increase in blood lactate concentration.
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PMID:[Clinical picture of lactate acidosis. 4: Clinical significance of lactate acidosis]. 2 Mar 98

Out of 1,251 patients above 65 years of age staying at the Charles Foix Hospital (prolonged hospitalization) and the St. Joseph Hospital (acute cases), 168 had one or more positive blood cultures. Urinary tract infection is a major source of septicemia due to gram negative bacilli. It is important to stress cases of septicemia due to pneumococcal pneumoniae, eschars, and other skin lesions. Mortality varies between 33 and 36%, depending upon the hospital. Collapse, although infrequent, still portends a grave prognosis (61% of cases of collapse led to death at Charles Foix Hospital). The combination of more than two risk factors considerably worsens the prognosis. Hypoproteinemia and dementia are every bit as grave as diabetes and cancer. A better isolation of the microorganisms involved in cases of septicemia in the elderly will lead to a more judicious choice of antibiotics. The administration of chemotherapy immediately after the samples were obtained remains the main guarantee of successful therapy.
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PMID:[Septicemia in the elderly (author's transl)]. 2 83

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

The present report describes a patient with insulin-dependent diabetes who developed simultaneously lactic acidosis and ketoacidosis following insulin deprivation. Administration of insulin at low doses rapidly corrected both ketosis and lactic acidosis. There had been neither circulatory collapse, nor phenformin intake, and hepatic function was normal. The development of lactic acidosis in this case was possibly precipitated by hyperthyroidism. A review of the literature indicates that lactic acidosis is a very rare complication of diabetic ketosis per se.
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PMID:Lactic acidosis complicating diabetic ketosis in a patient with hyperthyroidism. 40 2

The histopathology of a case of profound hearing loss which seemed to be induced by noise exposure (explosions and drillings in a gold mine) is reported. The patient's only residual hearing was 250 Hz at 90 dB SPL in the right ear. The major histopathological findings were as follows: Bilateral absence or collapse of Corti's organ was observed in the middle and basal turns of the cochlea; however, in the remaining area (approximately 6.0 mm in range in the apical portion of the cochlea) Corti's organ was well-preserved with a moderate loss in number or atrophy of the hair cells. Bilateral marked decrease of the cochlear nerve was noted in the middle and basal turns; however, the nerve was well-preserved in the remaining apical portion (approximately 6.0 mm in range) of the cochlea. These pathological findings were somewhat less severe in the right cochlea than in the left. In general, there was good correlation between the profound hearing loss and the extensive pathological findings in Corti's organ. The residual hearing in the right ear would seem to be explained by the less severe pathological changes found in the apical portion of the right cochlea than in the left cochlea. In addition to noise exposure, other possible etiological factors contributing to this hearing loss are discussed. These include diabetes mellitus and presbycusis.
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PMID:Noise-induced hearing loss. A human temporal bone case report. 73 22

Four cases of intravascular coagulation associated with a state of acidosis in diabetics were observed in 57 patients with diabetic acidosis and 19 with lactic acidosis, in a series of 112 cases of consumption coagulopathy admitted to a department of medical resuscitation. In three cases the coagulopathy was found only on investigation; in one there were clinical and anatomic signs. The coagulopathy may be found either during the phase of recovery from ketoacidosis, or during the course of severe lactic acidosis, particularly during a recurrence of this form of acidosis. In spite of the unfavorable outcome in 3 of the 4 cases, the abnormal findings of coagulopathy reverted toward normal along with successful metabolic corrections. The factors responsible for consumption coagulopathy are acidosis, collapse, generalised systemic reactions and alterations of platelet function, of coagulation, of the balance between fibrin deposition and lysis and of lipid levels, all characteristic of diabetes. The clinical effects of this coagulopathy seldom become apparent but provide a possible explanation of some of the complications of diabetic ketoacidosis, particularly certain hemorrhagic or thrombotic events, as well as certain visceral complications, especially those affecting renal, pulmonary and cerebral areas.
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PMID:[Consumption coagulopathy and acidosis in the diabetic patient (author's transl)]. 82 99

In a prospective study, 100 patients undergoing open heart surgery were randomly allocated to receive ice/slush topical hypothermia for myocardial protection (Group I, n = 56) or not (Group II, n = 44). Chest radiographs, diaphragm screening, lung function and phrenic nerve conduction time were assessed pre-operatively and at 1 week and 1 month post-operatively in all patients and subsequently at 3 months, 6 months, 1 year and 2 years in all patients with radiological evidence of diaphragm paralysis. The two groups were similar in terms of age, sex, diabetes and smoking habits. Cardiopulmonary bypass and aortic cross-clamp times were similar in the two groups. Radiological evidence of partial left lower lobe collapse was more frequent in Group I (79 per cent vs. 36 per cent, p < 0.01). Twenty (36 per cent) Group I patients developed unilateral diaphragm paralysis (19 left-sided) compared with none in Group II. Diaphragm paralysis was still present in 19 patients (34 per cent) at 1 month, in five patients (9 per cent) at 1 year and in one patient (2 per cent) at 2 years post-operatively. Phrenic nerve conduction time was recorded in 98 per cent of patients pre-operatively, but was unrecordable on the appropriate side in all 20 patients with diaphragm paralysis 1 week post-operatively. Prolonged phrenic nerve conduction time on the left side was found in a further seven Group I patients 1 week post-operatively. There were no significant differences between the two groups in terms of post-operative arrhythmias, myocardial infarction or mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Phrenic nerve and diaphragm function following open heart surgery: a prospective study with and without topical hypothermia. 148 46

Intra-uterine fetal death along with discontinuation of fetal circulation is followed by intraplacental processes which result in the following pathologico-anatomic pattern: Fetal vessels in terminal villi are doomed to collapse, with the major arteries being occluded due to proliferation. This is followed by substantial proliferation of connective tissue in peripheral villi, and by total disappearance of capillaries in terminal villi. Possible remnants of cytotrophoblast are lost from trophoblast epithelium, with the syncytiotrophoblast undergoing proliferation. Multiple syncytial proliferations were recorded from cases in which some time had passed from the event of intra-uterine fetal death. Stromal fibrosis is introduced by transient activation of mesenchyma of the terminal villi. Complete regression with totally fibrosed (collagenized) villi, vascular occlusion of stem villi, numerous spots of syncytial proliferation, and increased deposition of intervillous fibrin ist the morphological equivalent of missed abortion. Stromal fibrosis of terminal villi is a consequence of regression after intra-uterine fetal death or may possibly result from impairment of placental circulation of different causative background. Certain forms of fibrosis may possibly develop via stromatic edema (e.g. diabetes mellitus, blood group incompatibility, immunological disorders) together with edema-activated mesenchymal proliferation. Edema of villous stroma may be of diffuse or focal manifestation in the terminal villi and in advanced cases may affect all parts of the placenta. It is usually linked to diseases in which the entire fetoplacental unit is prone to edematization (maternal diabetes mellitus). Severe stromatic edema leads to formation of so-called stromatic ducts in which edema liquid is accumulated but is incapable of flowing out for absence of lymphatic drainage of the placenta.
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PMID:[Pathology of the placenta. IX. Intrauterine fetal death. Regression. Edema and fibrosis of the villous stroma]. 159 79

The examination of early perinatal mortality (between 28 weeks gestation and 1 week after birth) was conducted in the Machakos District Hospital in Kenya over a 4-month period. The hospital provides full gynecological and obstetric services and family planning. Out of 2171 deliveries recorded that early perinatal mortality rate (EPMR) was 53/1000 (114 losses). The maternal mortality rate was 2.7/1000 due to 3 ruptured uteri, 1 postpartum hemorrhage, 1 case of cerebral malaria, and 1 care of anesthetic complications. In the analysis of factors associated with EPMR, the findings showed that there was a statistically significant difference between married and single/separated status with regard to EPMR. Although not statistically significant, EPMR was lowest at a parity of 2. Maternal educational level and socioeconomic status had a statistically significant impact on EPMR. 70% of the mothers were in the low socioeconomic group, which had the highest rates of mortality. 5% of the birthing mothers did not receive prenatal care and contributed 22% of the perinatal mortality. There was also an unexpected number of perinatal deaths for mothers who had received prenatal car at a sub-district hospital. There was a very low EPMR (34/1000) for mothers without any complications, which constituted 81.4% of pregnancies. The highest EPMR of 315/1000 was found among those mothers with "threatened abortion." Malpresentation accounted for an EPMR of 242/1000, and prepartum hemorrhage, for an EPMR of 210/1000. 1.1% of mothers had a urinary tract infection, .1% had cardiac disease, and .1% had diabetes, but these complications were not associated with EPMR. 17% were premature births; 10% were births after 42 weeks. Mortality was highest among babies of less tan 28 weeks gestation. Among the 82% with the uncomplicated labor the EPMR was 10/1000. The 6% with prolonged labor had an EPMR of 177/1000. The highest EPMR was found among women with a ruptured uterus an cord collapse. The birth weight groups of 3000 to 3494 had the lowest EPMR. The recommendations pertained to improvements in the health care system.
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PMID:Factors influencing early perinatal mortality in a rural district hospital. 164 26

The analysed clinico-biological manifestations, evolutive course and treatment of 30 patients with GCA are presented. The most frequent symptoms were fever and headache. 33% of patients had FOD criteria. 26% had various visual alterations. All patients were initially treated with steroids. Of the 26 patients followed up, 21 (81.7%) experienced some sort of complication: Cushing iatrogenic, osteoporosis, vertebrae collapse, aseptic necrosis of the femur head, arterial hypertension, diabetes mellitus, hyperlipidemia, steroid myopathy. 6 patients were treated with cyclophosphamide, following severe complications secondary to steroid therapy, and all of them had a good clinical evolution.
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PMID:[Giant-cell arteritis: the clinico-biological manifestations and the complications secondary to steroid treatment]. 191 67


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