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

A 3-year-old boy with diabetes mellitus contracted meningitis caused by Pseudomonas aeruginosa. The disease lasted for several months in spite of antibiotic treatment. Diabetes mellitus was poorly controlled and hypoglycemia often occured. Immunoglobulin levels were normal. Investigations of leukocyte functions showed (no bactericidal activity), decreased phagocytic activity and very low NBT dye reduction by neutrophils during phagocytosis. Under the administration of polymixin, leukocyte transfusions and stabilization of glycemia the pathological clinical and laboratory findings disappeared within three weeks. Serial investigations of leukocyte function showed a gradual recovery of normal activity.
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PMID:[Reversible bactericidal defect of leukocytes. Pseudomonas meningitis in a child with diabetes mellitus (author's transl)]. 17 80

Sixty patients with bone and joint infections secondary to gram negative infection were evaluated in relation to treatment with amikacin. Forty-seven of these patients had osteomyelitis, and 13 had joint infections, including 3 prosthetic replacements. The patients' average was 35 years and there was no predilection for any particular skeletal location. Only 6 patients had no associated predisposing medical problems. Of these problems fracture, diabetes and narcotic abuse were most common. Thirty patients had Psuedomonas infection, and 15 others had multiple pathogens including Pseudomonas. Aminoglycoside antibiotics had been previously used in 25. Amikacin was given for an average of 22 days with a mean dose of 13.4 mg/kg. Bone and synovial fluid levels of amikacin were in therapeutic range. At least 48 patients had concurrent local wound treatment in addition to parenteral administration of amikacin. In 47 patients enough information was available to determine the efficacy of treatment. Twenty-seven (57%) of these patients were considered cured, both clinically and for bacteriologic response; and additional 9 (19%) were considered partially cured. Amikacin is effective against susceptible pathogens in bone and joint infections and is a reasonable choice when aminoglycoside antibiotic is indicated.
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PMID:Gram negative bone and joint infection: sixty patients treated with amikacin. 36 14

On the basis of an own observation the rare clinical picture of an external otitis with pareses of the brain nerves is casuistically described. Up to now it was observed only in elder persons with diabetes mellitus. The pathogenic agent is always Pseudomonas aeruginosa. The inflammatory process, issuing from the external auditory passage and under circumvention of the tympanum, spreads to the skull base and according to the localisation causes adequate pareses of the brain nerves. Early operation and aimed antibiotic therapy is the therapy of choice.
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PMID:[Progressive necrotizing otitis externa in an elderly diabetic with cranial nerve paralysis]. 52 41

Bactericidal activities of peripheral white blood cells obtained from patients and from healthy persons were examined in vitro. The results obtained are summarized as follows. 1. Peripheral white blood cells from patients receiving corticosteroid and radiation therapy showed decreased levels of intracellular bactericidal activities against Staphylococcus aureus. The leukocytes from almost all patients examined displayed intense activities of intracellular bacterial killing against Streptococcus pyogenes. 2. Only polymorphonuclear leukocytes (PMNs) and macrophages obtained from patients in severe stages of diabetes mellitus exhibited decreased levels of intracellular bactericidal activities against S. aureus. 3. The leukocytes from all patients examined exhibited the same levels of intracellular bactericidal effects against S. pyogenes as leukocytes from healthy persons. 4. Pseudomonas aeruginosa, which was phagocytized by PMNs obtained from healthy persons, demonstrated a remarkable degree of resistance to any intracellular bactericidal effect.
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PMID:Intraleukocytic bactericidal activity in patients receiving corticosteroid and radiation therapy, and in patients with diabetes mellitus. 80 64

The incidence of postoperative endophthalmitis in a series of 4,498 consecutive cataract operations, performed in a period of 10 years, was examined and found to equal 0.533%. Paracentesis of the anterior chamber was done in two cases and revealed Staphylococcus albus to be the causative organism in both instances. Conjunctival cultures were recovered in a further 17 cases, and showed S. albus in pure culture in eight cases and in combination with Pseudomonas aeruginosa and Proteous morgani in two cases. Streptococcus haemolyticus was isolated in pure culture in one case, while the cultures from six other patients were negative. The role of such factors as age, diabetes mellitus, chronic bronchitis, "weak ocular tissue", and persurgical complications which predisposed to postoperative infections was examined and found to have no significance on the occurrence of endophthalmitis in the present study. The visual end results were assessed and showed a better prognosis than generally expected. Of 24 cases, five achieved good visual acuity (6/6-6/12), 13 had a useful vision (6/18-6/60), while five remained actually blind (less than 6/60). In only one case was the eye enucleated. Methods of treatment and prophylaxis are described and discussed. A total suppression or elimination of all regional bacteria at the time of surgery seems to be the logical goal.
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PMID:Endophthalmitis following cataract extraction. A study of 24 cases in 4,498 operations. 80 83

Forty-five patients (25 male and 20 female) over 12 years of age with cystic fibrosis have been studied clinically, radiologically and physiologically. Their mean age at the first visit was 17 years; they were followed for a mean period of 4 years and attended at least every six months. The first symptom which developed before the age of five in 42 of the 45 patients was respiratory. Thirty-two of the 45 patients had severe lung disease (Group III) at the start of the study of the seven patients died during the study. Cough and sputum were almost universal, 23 had haemoptyses and eight pneumothoraces. Staphylococcus pyogenes, Haemophilus influenzae and Pseudomonas aeruginosa were the common pathogens isolated from sputum and the increasing prevalence of the latter was again confirmed. Acquisition of the mucoid strain of pseudomonas signified poor prognosis. Established infection was never eradicated. Forty-three patients had evidence of pancreatic insufficiency; in all but one patient the symptoms were mild and five patients abandoned dietary restriction and pancreatin without ill effect. Seven patients had symptoms of partial bowel obstruction (meconium ileus equivalent) but only one required surgical relief. The liver was enlarged in seven patients and the spleen was felt in three. Three patients had diabetes mellitus. The influence of cystic fibrosis on growth and development is reported--the growth spurt is late in the majority but growth failure is not confined to those with severe lung infection or malabsorption and in these circumstances remains unexplained. Mean weight was low in relation to height and puberty was delayed in both sexes.
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PMID:Cystic fibrosis in adolescents and adults. 82 Oct 91

Between September, 1984, and March, 1991, 79 patients underwent heart-lung transplantation for end-stage cystic fibrosis at the Harefield Hospital. Short-term outcome has already been reported, and we now present intermediate-term results. The overall actuarial patient survival was 69% at 1 year, 52% at 2 years, and 49% at 3 years. 17 patients had diabetes mellitus with a survival of 62% to 1 year and 51% to 2 years. 23 patients had one or more other possible high-risk factors, and survival of these patients was 64% at 1 year and 57% at 2 years, compared with 71% and 49%, respectively, in the low-risk group (n = 56). Pseudomonas aeruginosa infection was the most common respiratory infection encountered postoperatively. 92% of patients had at least one episode of acute rejection during the first 3 postoperative months. Lung function was greatly improved after transplantation, the mean forced expiratory volume in 1 s and forced vital capacity increasing from 22% and 35% predicted, respectively, preoperatively to 68% and 70% predicted, respectively, by the sixth postoperative month. This improvement was maintained at 1, 2, and 3 years after transplantation. Lymphoproliferative disorders (4 patients) were successfully treated. Obliterative bronchiolitis developed in 17 patients and the cumulative probability of getting this complication at 1, 2, and 3 years postoperatively was 17%, 23%, and 48%, respectively. Overall, 7 patients were retransplanted. There was no coronary artery disease in the 37 patients who underwent coronary angiography at 1 year, 14 at 2 years, and 9 at 3 years after surgery. 58 patients donated their hearts for subsequent "domino" heart transplantation. Our 5 1/2-year experience with heart-lung transplantation is encouraging but the shortage of donor organs and the complication of obliterative bronchiolitis are the two main obstacles to be overcome.
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PMID:Intermediate-term results of heart-lung transplantation for cystic fibrosis. 135 59

The impact of peritonitis on CAPD results was evaluated in 1990 pts (mean age +/- SD:58.4 +/- 14.8 yrs, 55.9% males), treated in 30 centres participating in Italian PD Study Group, during 1980-89, with an overall observation period of 3953 years (mean +/- SD 24.1 +/- 22.3 months). The incidence of peritonitis decreases from 1.21 (1980-84) to 0.48 (1985-89) ep/year (overall:0.68) with a significant (P < 0.001) reduction of the probability of developing the first peritonitis episode (FPE) through the same periods. The probability of developing FPE and the relative risk of peritonitis were significantly lower (P < 0.001) in pts for whom CAPD has been the first treatment (80.1%); on the contrary these parameters did not gain significant difference according to sex, age 65 years, diabetes or cardiovascular disease. As far as the organisms responsible for peritonitis are concerned a significant reduction of S. epid. and an increase of S. aureus, other Gram pos. and Pseudomonas was observed in the second 5-yr periods. Peritonitis episodes caused catheter removal in 8.2% of cases and were associated with catheter infection in 10.8% of cases. Peritonitis accounted for 24.2% of hospitalization causes and for 6.7% and 30.0% of death and of drop-out respectively. The probability of death and drop-out was significantly high (p < 0.001) in pts with a peritonitis incidence > 1 ep/year than in those with < 0.5 ep/year. The probability of drop-out due to peritonitis was not higher in diabetic or older patients.
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PMID:The impact of peritonitis on CAPD results. 136 4

The impact of pre-diabetes on clinical status was retrospectively studied in 38 cystic fibrosis (CF) patients with diabetes mellitus (DM) and 38 non-diabetic CF patients (control patients), matched in pairs for age, sex, and chronic Pseudomonas aeruginosa lung infection. Quarterly parameters of CF clinical status were collected for 6 years prior to the diagnosis of DM in the index case. Compared to the control patients, decreases in body weight, body mass index (BMI), forced expiratory volume in 1s (FEV1), and forced vital capacity (FVC) and an increase in the daily intake of pancreatic enzyme capsules were found in the pre-diabetic patients. Statistically significant differences in body weight, BMI, FEV1, FVC, and intake of pancreatic enzyme capsules between pre-diabetic and control patients emerged 4, 4, 1.25, 3 and 4.5 years prior to the diagnosis of DM, respectively. The number of lung infections did not differ between the two groups of patients. Thus, when DM develops in CF patients, an insidious decline in overall clinical status is observed for years prior to its diagnosis. Whether clinical deterioration in CF leads to DM, or pre-diabetes results in declining CF clinical status is presently unknown. Accumulating evidence suggests that the latter may be the case since insulin therapy seems to improve lung function in CF.
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PMID:Influence of the development of diabetes mellitus on clinical status in patients with cystic fibrosis. 139 31

Two recent cases of cervical necrotizing soft-tissue infection are herein presented. Case 1. A 52-year-old man with uncontrolled diabetes was hospitalized because of an erythematous swelling of the left side of his neck and high grade fever. Fetid yellowish pus exuded from the left parotid area. The swelling extended from the left temporal area to the left supraclavicular fossa, with necrosis of the parotid gland, sternocleidomastoid, masseter and a portion of the strap muscles. Wound cultures revealed Staphylococcus aureus and alpha-hemolytic streptococcus. No anaerobic bacteria were detected. Treatment consisted of intravenous administration of antibiotics, control of diabetes with insulin, and debridement of the necrotic tissue, which left an epidermal defect in the initially swollen area. Transfer of a forearm free flap was done after the growth of healthy granulation tissue over the affected area. Case 2. A 55-year-old woman with rheumatoid arthritis was transferred to our hospital after tracheotomy performed in another hospital because of dyspnea due to severe crepitant swelling of her cheeks and submandibular areas bilaterally, and her left temporal area. A copious amount of fetid pus exuded from the incisions made in the left temporal area, left cheek, and right submandibular area. There were bilateral diffuse rales. Culturing the pus revealed alpha-hemolytic streptococci, while MRSA and Pseudomonas aeruginosa were detected from cultures of sputum. No anaerobic bacteria were found. After intravenous administration of antibiotics, infected wounds and pneumonia were ameliorated, and necrotic subcutaneous tissue and fascia were debrided. The patient was discharged with a residual depression in her left cheek and a scar on her left temporal area.
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PMID:[A report of two cases of cervical necrotizing soft-tissue infection]. 140 20


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