Cases reported "Chronic Disease"

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1/132. Latent coeliac disease. Personal experience.

    Latent coeliac disease (L.C.D.) is an extremely rare condition to describe. In this study we analyzed three cases of patients affected by L.C.D.: two of them suffered from insulin-dependent diabetes mellitus (IDDM) and the other one from infantile cerebral palsy and eosinophilic gastroenteritis. We confirm the existence of this form of coeliac disease (C.D.), by means of duodenal biopsy, and stress the importance of an early diagnosis in order to prevent the serious consequences caused by untreated C.D.
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ranking = 1
keywords = diabetes mellitus, diabetes, mellitus, insulin-dependent
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2/132. Hereditary pancreatitis and mutation of the trypsinogen gene.

    Hereditary pancreatitis is a rare form of chronic recurrent pancreatitis. A family, in which 11 members had chronic pancreatitis, five had diabetes, and two had pancreatic cancer, was studied, and hereditary pancreatitis was diagnosed in all patients by demonstrating the mutation in exon 3 of the cationic trypsinogen gene (R117H). The clinical implications of genotypic analysis in hereditary pancreatitis are discussed.
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ranking = 0.23302672887789
keywords = diabetes
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3/132. Use of topical recombinant human platelet-derived growth factor-BB (becaplermin) in healing of chronic mixed arteriovenous lower extremity diabetic ulcers.

    lower extremity ulcers cause significant morbidity and mortality in patients with diabetes. The primary factors that contribute to the development of this type of ulcer are peripheral neuropathy and peripheral vascular disease, which are often accompanied by infection. lower extremity diabetic ulcers are chronic and difficult to treat, in part due to underlying pathologic conditions in individuals with diabetes that can contribute to impaired wound healing. This article reports the author's experience with treatment of chronic lower extremity ulcers of mixed etiologies with recombinant human platelet-derived growth factor--BB [rhPDGF-BB, REGRANEX (becaplermin) Gel 0.01%] in a patient with multiple risk factors including long-standing insulin-dependent type 2 diabetes.
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ranking = 0.73967710758457
keywords = diabetes, insulin-dependent
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4/132. Healing of chronic leg ulcers in diabetic necrobiosis lipoidica with local granulocyte-macrophage colony stimulating factor treatment.

    Two young insulin-dependent diabetic patients suffering from chronic nonhealing leg ulcers of necrobiosis lipoidica diabeticorum were treated by applying topically recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) on the ulcer repetitively during 10 weeks. Evaluation of ulcer size was assessed with clinical examinations at 1-week or 2-week intervals. Topical GM-CSF healed the ulcers of both patients in 10 weeks. Decrease in the size of the ulcers was already evident after the first topical applications. During follow-up, the ulcers have remained healed for more than 3 years. This excellent treatment result suggests that topically applied GM-CSF may be a valuable drug for chronic, nonhealing ulcers in patients with diabetes.
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ranking = 0.27362364982879
keywords = diabetes, insulin-dependent
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5/132. Reactive eccrine syringofibroadenoma: an association with chronic foot ulcer in a patient with diabetes mellitus.

    Eccrine syringofibroadenoma is a rare skin tumor with a variety of reported clinical manifestations. We report a case of reactive eccrine syringofibroadenoma associated with a chronic skin ulcer of the foot in a patient with diabetes mellitus.
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ranking = 4.7970153952455
keywords = diabetes mellitus, diabetes, mellitus
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6/132. Following the clues to neuropathic pain. Distribution and other leads reveal the cause and the treatment approach.

    Neuropathic pain can seem enigmatic at first because it can last indefinitely and often a cause is not evident. However, heightened awareness of typical characteristics, such as the following, makes identification fairly easy: The presence of certain accompanying conditions (e.g., diabetes, hiv or herpes zoster infection, multiple sclerosis) pain described as shooting, stabbing, lancinating, burning, or searing pain worse at night pain following anatomic nerve distribution pain in a numb or insensate site The presence of allodynia Neuropathic pain responds poorly to standard pain therapies and usually requires specialized medications (e.g., anticonvulsants, tricyclic antidepressants, opioid analgesics) for optimal control. Successful pain control is enhanced with use of a systematic approach consisting of disease modification, local or regional measures, and systemic therapy.
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ranking = 0.23302672887789
keywords = diabetes
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7/132. Reversal of hypoglycemia unawareness in a long-term type 1 diabetic patient by improvement of beta-adrenergic sensitivity after prevention of hypoglycemia.

    The purpose of this study was to assess the effect of strict avoidance of hypoglycemia on beta-adrenergic sensitivity in a type 1 diabetic patient with hypoglycemia unawareness and a diabetes duration of 55 yr. beta-Adrenergic sensitivity was determined by an isoproterenol test and was expressed as the lowest dose of isoproterenol that increases the heart rate by 25 beats/min (IC25). plasma epinephrine and symptom responses to hypoglycemia were determined during a 3-h hypoglycemic (3 mmol/L) clamp. Initially, the patient had a near-normal counterregulatory plasma epinephrine response to hypoglycemia but reduced beta-adrenergic sensitivity (IC25, 2 microg) compared to 10 hypoglycemia aware, type 1 diabetic patients (0.65 /- 0.14 microg) and 10 normal control subjects (1.13 /- 0.21 microg). After 1 yr of strict avoidance of blood glucose levels below 4 mmol/L, the IC25 decreased to 0.25 microg, reflecting improved beta-adrenergic sensitivity. In conclusion, the reduced beta-adrenergic sensitivity in this patient was probably the reason for hypoglycemia unawareness and was reversed by strict avoidance of hypoglycemia.
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ranking = 0.23302672887789
keywords = diabetes
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8/132. Fibrocalculous pancreatic diabetes in a child: case report.

    A case of fibrocalculous pancreatic diabetes in a 12-year old boy is described. A medline literature search back to 1966 revealed that no cases had been reported from East africa. We reviewed the literature and suggest that the condition is probably under-reported.
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ranking = 1.1651336443894
keywords = diabetes
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9/132. Subcutaneous nodules attributed to nocardiosis in a renal transplant recipient on tacrolimus therapy.

    We report a renal transplant patient who suffered from disseminated nocardiosis after empirical tacrolimus rescue therapy for chronic allograft rejection. The nocardiosis presented initially as only mildly tender subcutaneous calf nodules without any other signs of inflammation nor constitutional upset, which later spread to the lung and brain causing bronchopneumonia and brain abscesses. The risk factors for nocardial infection in our patient include the use of potent immunosuppressive agents such as tacrolimus, poorly controlled diabetes mellitus and kidney dysfunction. She responded well to combination antibiotic therapy comprising parenteral meropenem, cefotaxime and oral minocycline. We conclude that in transplant recipients, especially those receiving newer and more potent immunosuppressive agents like tacrolimus, nocardial infection can present as apparently 'cold' subcutaneous nodules without any systemic upset. An associated brain lesion should be excluded even in patients without neurological symptoms.
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ranking = 0.9594030790491
keywords = diabetes mellitus, diabetes, mellitus
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10/132. Filleted toe flap for chronic forefoot ulcer reconstruction.

    Chronic plantar and dorsal forefoot ulcer may result from injury, structural deformity, and abnormal sensation or circulation. It is not uncommon that the distal portion of the affected toes is deficient functionally in these patients. A filleted toe flap from the expendable functionless toe can provide a durable, stable, and sensate skin flap of 4 to 5.5 cm for coverage of the forefoot defect. In this report, five cases of dorsal forefoot defects and four cases of plantar forefoot defects due to ischemia (N = 3), trophic change (N = 2), and diabetes (N = 4) were treated with filleted toe flaps. One flap failed due to postoperative deep infection. The other eight filleted toe flaps survived but 2 patients underwent secondary amputations 7 months and 2 two years later because of secondary diabetic foot infections.
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ranking = 0.23302672887789
keywords = diabetes
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