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

Patients with amaurosis fugax (transient monocular blindness) have been studied including an ophthalmodynamometry. In most of the cases there were general circulatory disturbances with marked orthostatic decrease of the ophthalmic pressure, and comparatively seldom carotid stenosis and hypertension.
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PMID:[Temporary blindness as a symptoms of circulatory disorder]. 730 Jul 86

Multiple Sclerosis (MS) cases found at autopsy in patients who had died from other diseases and in whom no sign or symptom could be related to MS are called "asymptomatic". Three cases are reported. The first patient was a 62 year old man who presented with a slowly progressive disturbance of gait, incontinence and deterioration of intellectual function. A falx meningioma was surgically removed. The patient died 3 years later with an acute respiratory illness. Examination of the brain disclosed evidence of the operation and numerous old plaques disseminated through the cerebral hemispheres (centrum semi-ovale, periventricular regions, internal thalamus and junction between cortex and white matter) and in the brain stem. The second case, a 77 year old woman with diabetes mellitus and hypertension, presented with cortical blindness and disturbances of memory of acute onset. She died one year later. Examination of the brain showed multiple infarcts involving the territories of both posterior cerebral arteries and the left middle cerebral artery. Numerous old plaques were seen in the periventricular regions, in the corpus callosum and in the left middle cerebellar peduncle. The third case, a 60 year old woman with mitral and aortic stenosis, presented with cortical deafness and transient right hemiparesis. She died 5 years later. Brain examination showed infarcts involving both middle cerebral artery territories. There was also many old plaques in the periventricular areas, thalamus, internal capsule, centrum semi-ovale, brain stem and right nucleus dentatus. In the 3 cases, the optic tracts were normal. The spinal cord, examined only in the first case, was also normal. The asymptomatic character of these MS cases can be explained first by the location of the plaques and the lack of spinal cord and optic tract involvement. It could also be due to the small size of the plaques and to axonal preservation. Such features are rare since our 3 observations have been selected from a pathological collection of 125 MS cases and 9,300 general neuropathological records. Six other cases have been previously reported by other authors.
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PMID:[Asymptomatic multiple sclerosis - 3 cases (author's transl)]. 733 73

Fundus lesions are said not to be found in direct relationship to rheumatoid arthritis. A vasculitis or retinopathy if present is said to be secondary to concomitant hypertension or due to some connective tissue disease other than rheumatoid arthritis. The case is presented of a 64-year-old female with sero-positive rheumatoid arthritis. During a period of exacerbation of her arthritis she developed anterior ischaemic optic neuropathy (A.I.O.N.) resulting in blindness of one eye, followed two weeks later by a temporary occlusive episode in a cilioretinal arteriole in the other eye. The patient was normotensive and had neither clinical nor immunological evidence of other connective tissue disease. The patient died two months later from cardiac arrhythmia. The autopsy findings confirming posterior ciliary arteritis as the cause of the A.I.O.N. are presented. The subject of rheumatoid vasculitis in relation to the eye is reviewed and immunological mechanisms and investigations discussed.
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PMID:Vasculitis and ischaemic optic neuropathy associated with rheumatoid arthritis. 742 72

The purpose of this retrospective study was to determine the risk factors for the morbidity of the mothers and their fetus in patients with diabetic retinopathy and/or nephropathy with an open family planning. We compared the course of pregnancies, complications as well as the maternal and neonatal morbidity in 76 patients with diabetic retinopathy or nephropathy (White R F) with 85 patients without severe microangiopathy (White C D). We found a correlation between retinopathy progression and hyperglycaemia during the first trimester (p < 0.05). There was an increase in the deterioration of visual acuity up to blindness due to the progression of this microangiopathy in cases of proliferative retinopathy. There was a significant increase of the mean diastolic blood pressure (mdp) and preeclamptic symptoms occurred in 71% of the cases with severe microangiopathy (p < 0.05). Deterioration of the diabetic nephropathy with excessive proteinuria (> 10 g/d) and unmanageable hypertension or a progression of the retinopathy led to an earlier delivery in 80% of the patients (p < 0.05). A high rate of preterm deliveries (39%) and a frequent occurrence of intrauterine growth retardation's (9%) characterised the fetal outcome. The following examinations for a patient with an open family planning, if diabetes is diagnosed during childhood or the course of the disease is between 10 and 15 years, should be done: Ophthalmological evaluation, control of the renal function, contraceptive advice and an improvement of the metabolic situation. In case of a diabetic nephropathy in combination with hypertonus the patients shoud be warned against pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diabetic retinopathy and nephropathy--complications in pregnancy and labor]. 760 85

Age related cataract is the most common cause of blindness in the world. Most of these patients are elderly and are likely to have various associated systemic diseases. Higher mortality has been reported in patients undergoing cataract surgery. In order to determine the prevalence of associated systemic disease, we carried out a large eye camp based study in 6103 age related cataract patients. Seventeen percent of our patients had systemic problems. Pulmonary disease was seen in 4.3%, cardiovascular disease and hypertension in 4.1%, diabetes mellitus in 3.8%, skin disorder in 1.4%, orodental disease requiring tooth extraction in 3%, and other diseases were seen in 0.4% of the cases. Seventy eight patients (1.27%) had significant systemic complications post-operatively, 46% of whom required hospitalization in a tertiary care center. Thus, all patients undergoing cataract surgery should be evaluated for associated systemic diseases to prevent morbidity and mortality in the preoperative, operative and postoperative period.
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PMID:Systemic diseases in age related cataract patients. 785 16

In November 1990, we carried out a survey of chronic complications of diabetes in more than 2000 diabetic patients who were seen on one day in 35 medical institutions including university hospitals, other hospitals and small clinics. More than 60% were aged 55-74 years. About 7% of patients had IDDM. Hypertension was present in 38.5%. Proteinuria was positive in 20% and 1% of patients were on dialysis therapy. 28% had visual disturbance and 2.9% had blindness in one or both eyes. Retinopathy was observed in 38% and proliferative retinopathy in 10%. The prevalences of myocardial infarction, angina pectoris, cerebral infarction and foot ulcer and gangrene were 2.1%, 4.7%, 5.7% and 2%, respectively, including the histories of these complications. Amputation of lower extremities was seen in only 0.6%. Microangiopathies were generally more frequent and more severe in IDDM than NIDDM. The prevalence of microangiopathy was as common as, but macroangiopathy seems less frequent than, the figures given in 'Diabetes in America'.
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PMID:Prevalence of chronic complications in Japanese diabetic patients. 785

All persons with diabetes are at risk of retinal complications, although persons with type I (insulin-dependent) diabetes face a greater danger of severe vision loss than persons with type II (noninsulin-dependent) diabetes. Retinopathy has two stages: the nonproliferative stage, which includes intraretinal microaneurysms, hemorrhages, and soft and hard exudates, typically occurs well before the more serious proliferative stage, which is characterized by neovascularization and fibrovascular growth from the retina or optic nerve. Macular edema, a serious development, can occur in either stage. Untreated neovascularization and macular edema are the two major retinal complications that lead to blindness. Good glycemic control has been shown to reduce the development of retinopathy by 76 percent in diabetic patients and to slow progression by 54 percent in those with early retinopathy. Effective hypertension control and diabetic therapy, regular ophthalmologic examinations and properly timed focal laser treatments for macular edema and proliferative retinopathy can markedly reduce the risk of vision loss.
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PMID:Management of diabetic retinopathy. 788 46

Of 147 diabetic patients with end-stage renal disease who were treated in our CAPD program between 1978 and 1991, 6 men and 1 woman (5 had type II and 2 type I diabetes) with a mean age of 54 (range 21-70) years have been on CAPD for more than five years (mean: 76 mos, range: 65-109 mos) and on peritoneal dialysis (IPD+CAPD) for an average of 85 (range: 67-118) mos. They had a variety of comorbid conditions at the start of CAPD: Retinopathy (5/7), blindness (3/7), hypertension (5/7), peripheral neuropathy (7/7), peripheral vascular disease (3/7), congestive heart failure (3/7), myocardial infarction (1/7), ischemic heart disease (2/7). Two were smokers and five over the age of 65. Peritonitis rate was 1 episode/11.4 pt mos, exit-site infection 1/76.4 pt mos and average hospitalization rate 32.8 days/patient/year. Hypertension was well-controlled with discontinuation of all medications; after initiation of CAPD two of them remained without medications throughout the study but in the rest, medications had to be restarted. As assessed by HbA1c, blood glucose control improved with IP administration of insulin. Residual renal function progressively decreased. None of them developed severe hyperparathyroidism. Peripheral neuropathy remained stable in four and deteriorated in two. Total protein, albumin, cholesterol and triglycerides decreased during the last two years indicating a degree of malnutrition. Our experience with these seven patients suggests that diabetic patients, even the aged and those with many comorbid conditions and complications, can survive for long periods on CAPD.
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PMID:Long-term continuous ambulatory peritoneal dialysis in diabetics. 792 68

A 40-year-old man developed cortical blindness during cyclosporin treatment shortly after an allogeneic bone marrow transplantation for chronic myeloid leukaemia. At that time the patient had a therapeutic cyclosporin blood level (226 ng/ml), but a low serum magnesium level and a marginally decreased serum cholesterol level. In addition the patient had hypertension, headache and paraesthesia in the oral, palmar and plantar areas. Vision was fully recovered after discontinuation of the cyclosporin treatment and correction of the hypomagnesaemia. Eighteen cases of cortical blindness during cyclosporin treatment are now known in the literature. Hypomagnesaemia appears to be implicated in the pathogenesis.
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PMID:[Cortical blindness during treatment with cyclosporin]. 793 70

The purpose of this monograph is to describe the sociodemographic and health characteristics of individuals who identified themselves as diabetics (through self-notification) in a national health survey that was conducted in Mexico in 1988 and in which information about more than 200,000 persons was collected by interviewing an adult member of each household. Of the population surveyed, 1.2% stated being diabetic, and it was noted that the frequency of the disease increased with age and socioeconomic status and that it was 30% higher in women than in men. Diabetics had higher notification rates for hypertension, heart disease, and blindness than the rest of the population. Twenty percent of diabetic patients and 12% of nondiabetic individuals smoked. People with diabetes consulted physicians twice as often as nondiabetics and their chances of being hospitalized were four times higher. At the end we discuss the limitations and possible biases of self-notification as a method for detecting diabetics. Finally we conclude that diabetes is an important health problem in Mexico and that it warrants more attention from epidemiologists and other public health specialists.
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PMID:[Diabetes in Mexico: what does the National Health Survey tell us?]. 799 92


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