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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The primary care physician should educate all diabetics regarding the roles of diet, exercise, and insulin therapy in controlling the course of their disease, as well as the potential complications, including retinopathy. In type I diabetes, blood glucose levels should be controlled as rigidly as possible with multiple insulin injections and self-monitoring of glucose level. Hypertension should be aggressively treated in all diabetics. Yearly eye examination in patients with type I diabetes is important, and ophthalmologic referral should be considered after the disease has been present for five to ten years, with the first evidence of retinopathy, at puberty, during pregnancy, or if ocular symptoms occur. In patients with type II diabetes an ophthalmologist should make an evaluation as soon as the blood glucose level is controlled. Through use of these steps, the risk of blindness in diabetics will be minimized.
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PMID:Diabetic retinopathy. The primary care physician's role in evaluation and management. 633 91

The appearance of proteinuria in an insulin-dependent diabetic patient is an ominous sign. Proteinuria heralds the presence of diabetic nephropathy and early death, or chronic renal failure requiring dialysis or transplantation, in 50% of patients. The pathogenesis of diabetic nephropathy is unknown. Adequate insulin administration is the most important preventive measure. Hypertension, if present, should be aggressively treated to delay progression of renal disease. Good nutrition, prompt treatment of urinary tract infections, and caution in the use of radiocontrast agents are other important preventive measures. Hemodialysis, peritoneal dialysis, and transplantation are options for patients with end-stage renal disease. No matter which is selected, the patient may still have multiple amputations, blindness, congestive heart failure, infections, and uncontrolled glycemia. Advancements are being made, however, that promise a better future for insulin-dependent diabetics.
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PMID:Diabetic nephropathy. Is end-stage renal disease inevitable? 635 91

Blindness is a rare complication of acute glomerulonephritis. During three years (1980-82) 32 cases of acute glomerulonephritis are admitted in a Pediatric Department. Five children had neurologic complications among whom three developed complete, bilateral and transient blindness. In all cases blindness is associated with hypertension and intracranial pressure. The mechanism suggested in this kind of amaurosis is cerebral oedema, and the adequate treatment of this oedema permit a complete recovery of the vision.
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PMID:[Glomerulonephritis and blindness. Apropos of 3 cases]. 653 74

Two brothers, aged 20 and 12, with the 11 beta-hydroxylase deficient form of congenital adrenal hyperplasia, are presented. They had refused treatment for the previous four years until the younger was admitted with malignant hypertension, partial blindness and evidence of myocardial damage. The elder was therefore admitted for assessment and found to have less severe hypertension. Gas liquid chromatographic analysis of the steroids in urine from each revealed a possible difference in the enzyme defect between the two brothers--the younger having a complete, while the elder had only a partial block. Family studies have confirmed no association with the HLA locus.
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PMID:Malignant hypertension in congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency. 660 91

To clarify the epidemiological and clinical features of blindness due to diabetic retinopathy, 21 patients were studied. Blind diabetics seen at our clinic numbered 2, 3, 4 and 12 in 1965-1969, 1970-1974, 1975-1979 and 1980-1981 respectively. The ratio of males to females was about 4:3. Patients whose onset was in the 10-19, 20-29, 30-39, 40-49 and 50-59 year age group numbered 4, 5, 6, 3 and 3 respectively. No difference was seen in the duration of the disease between patients whose onset was below and patients whose onset was above 40 years of age. Most of the blind diabetics (81.8%) were treated with insulin and hypoglycemic symptoms had occurred on several occasions in 14 cases. Hypertension was a complication in 10 (45%) and orthostatic hypotension in 7 cases (31.8%). Patellar tendon reflex disappeared in 15 cases (68.2%). Proteinuria was strongly positive in 11 cases (52.4%). It was therefore concluded that the number of blind diabetics has been increasing in our clinic since 1975. Insulin therapy and the association of hypoglycemia were thought to be important precipitating factors of blindness in diabetics. The levels of plasma fibrinogen and soluble fibrin monomer complexes in blind diabetics were higher than those in diabetics without retinopathy.
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PMID:Epidemiological and clinical studies on blindness due to diabetic retinopathy. 668 May 12

The authors retrospectively investigated 62 diabetics who had received dialytic therapy at our department and our associated hospital over the past 10 years. We studied the complications and causes of death among the 62 subjects. Of the 62 patients (male 42, female 20), 27 (male 21, female 6), had died. The causes of death in the 27 cases included 7 from general weakness, 4 from gastrointestinal bleeding, 4 from cerebrovascular hemorrhage or thrombosis, 3 suicide, 3 congestive heart failure, 2 myocardial infarction, 2 hyperkalemia, 1 infection and 1 from hepatoma. With regard to diabetic retinopathy, 19 of the 62 patients suffered from bilateral blindness and 12 from unilateral blindness. In 8 patients, visual complications developed after hemodialysis, but 16 patients were already blind at the introduction of hemodialysis. There was no evidence that retinopathy was accelerated by dialysis and the authors suggest that the treatment of retinopathy is very important at the nondialyzed stage. With regard to other complications in dialyzed diabetics, unstable hypertension, diabetic gastroenteropathy, peripheral neuropathy, ischemic heart disease and gangrene were discovered in our population. Some rehabilitation was possible in all but 3 of the subjects (1 peripheral neuropathy, 2 leg amputation).
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PMID:Clinical study of complications in dialyzed diabetics. 668 May 16

Cortical blindness without retinal changes is a rare complication in preeclampsia. We report two patients, both of whom developed cortical blindness one and two days post partum. In one of these patients, the blindness occurred following eclamptic seizure. In both patients the total blindness recovered fully after two and three days respectively following treatment for hypertension and cerebral edema. Spasm of small vessels in the occipital cortex is assumed to be the cause of this complication.
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PMID:[Postpartum amaurosis in patients with pre-eclampsia]. 668 42

The water and sodium content of the saphenous vein was measured in 26 dogs with one-kidney, one wrapped hypertension. For comparison, the same measurements were performed on the contralateral saphenous vein which was removed prior to the induction of hypertension. Malignant hypertension characterized by blindness and a rise in plasma renin activity, developed in 10 dogs. The course of hypertension in the remaining 16 dogs was benign. In benign hypertension, the water and sodium content of the saphenous vein was increased. In contrast, the water content of the saphenous vein was unchanged and its sodium content fell in dogs with malignant hypertension. The dogs with malignant hypertension had a greater sodium content of the saphenous vein prior to the induction of hypertension than the dogs with benign hypertension. The findings indicate that the loss of body water and sodium that has been described in malignant hypertension also affects the composition of blood vessels. The sodium content of blood vessels may be a predictor of the dog's response to a hypertension-producing stimulus.
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PMID:Abnormalities of vascular wall sodium content in dogs with benign and malignant renal hypertension. 672 84

The prognosis for vision in most patients with pseudotumor cerebri is excellent; however, visual loss, which is the only serious complication, may occur either early or late in the course of the disease. A group of 57 patients was followed up five to 41 years with visual fields, visual acuity, and fundus photographs. Blinding visual loss or severe visual impairment in one or both eyes occurred in 14 patients, and in seven patients, this occurred months to years after the initial symptoms. Systemic hypertension was a significant risk factor for visual loss in patients with pseudotumor cerebri, and blindness occurred in eight of 13 patients who were hypertensive. Despite suggestions that blind spot measurement is useful for following up patients with this condition, we believe that sequential quantitative perimetry gives more complete information and is essential to rational decision making in the treatment of pseudotumor cerebri.
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PMID:Visual loss in pseudotumor cerebri. Follow-up of 57 patients from five to 41 years and a profile of 14 patients with permanent severe visual loss. 710 94

The authors describe 5 male patients aged 38 to 69 years with cardiac diseases, arterial hypertension and atherosclerosis in whom cortical blindness developed suddenly associated with other symptoms such as asynergia (4 cases), delirium (3 cases) and pyramidal syndrome (in 2 cases). In 3 cases the outcome was lethal due to brainstem damage. In all cases lesions of both occipital lobes were demonstrated by means of computerized tomography (4 cases) or autopsy (3 cases). In 3 cases the vertebral artery was occluded and in 1 case it was stenosed. Presence of additional symptoms makes possible intravital diagnosis of vertebrobasilar insufficiency and arteriography is not indicated in such cases. The treatment is conservative.
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PMID:[Cortical blindness after vertebral artery occlusion]. 715 83


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