1/79. osteomyelitis associated with peripheral vascular disease secondary to diabetes mellitus.diabetes mellitus and arteriosclerotic vascular disease have been found to be the predisposing factors of osteomyelitis associated with peripheral vascular disease (10). A diabetic person is more susceptible to osteomyelitis because of the microangiopathy, peripheral neuropathy and decreased resistance to infection. In diabetes mellitus there can be microangiopathy which results from the proliferation of the endothelium of the intima and thickening of the basement membrane. This further contributes to a sluggish blood flow. In the patient with arteriosclerotic vascular disease, the lumens of the arterioles and arterioles are compromised by the atheromatous plaques. The anatomic structure of the blood supply to bone along with the pathologic membrane thickening, allows for slowing of blood. This slowing of blood flow causes micro-thrombi and enhances bacterial growth. In diabetes mellitus it has been shown that there is a decreased immunologic response which, along with the above, contributes to the sheltering and proliferation of bacteria in the small bones of the foot.- - - - - - - - - - ranking = 1keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
2/79. The management of hypertension in a diabetic pregnancy.pregnancy in a woman with Type 1 diabetes poses several clinical challenges. In addition to meticulous glycaemic control, careful attention must be paid to the management of developing and pre-existing diabetic complications which may progress in severity during pregnancy. pregnancy-induced hypertension is more common in women with diabetes and especially in those with diabetes of long duration. Diabetic renal disease is associated with hypertension which often deteriorates during pregnancy. The management of hypertension is difficult because of limited therapeutic options and the need to consider the implications for the developing fetus as well as the mother. This case report details the clinical management of a young woman with Type 1 diabetes whose pregnancy was complicated by the development of hypertension.- - - - - - - - - - ranking = 0.19075259839144keywords = diabetes (Clic here for more details about this article) |
3/79. Diabetic microangiopathy in the small bowel.AIMS: Microangiopathic changes in the gastrointestinal tract of patients with diabetes mellitus are frequently mentioned in the clinical literature. To our knowledge, pathological studies documenting these changes in bowel biopsies have not been previously reported. In this report, we describe striking duodenal biopsy findings of diabetic microangiopathy in a patient with long-standing insulin-dependent diabetes mellitus and chronic diarrhoea. methods AND RESULTS: The diagnosis was based on the histopathological and immunohistochemical findings in the appropriate clinical setting. blood vessels within the duodenum displayed prominent mural thickening and luminal narrowing secondary to accumulation of hyaline material, which was periodic acid-Schiff positive and intensely stained with monoclonal antibodies against type IV collagen. CONCLUSIONS: This is the first report of diabetic microangiopathy in a bowel biopsy. The pathogenesis, specificity and significance of these angiopathic changes, controversies about diabetic microangiopathy in the gastrointestinal tract, and the association with hypertension are discussed.- - - - - - - - - - ranking = 0.32916360311066keywords = diabetes mellitus, diabetes, mellitus, insulin-dependent (Clic here for more details about this article) |
4/79. Enhanced platelet aggregation, high homocysteine level, and microvascular disease in diabetic muscle infarctions: implications for therapy.Muscle infarction is a rare complication in patients with diabetes mellitus, probably because of the rich vascular supply of this tissue. We describe a patient with type 1 diabetes who had infarction of the muscles in her right thigh. We report, for the first time, that the patient, in addition to an advanced microvascular disease in the muscle, had increased plasma total homocysteine levels and increased platelet aggregation. These pathologies might have a synergistic effect on the development of this rare complication and should be treated aggressively to prevent further episodes.- - - - - - - - - - ranking = 0.21084611608334keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
5/79. Spontaneous splenic infarction secondary to diabetes-induced microvascular disease.splenic infarction is a clinical entity seldom encountered. The most frequent causes of splenic infarction include thromboembolic phenomena, hematologic malignant neoplasms, and vasculitides. We describe a patient who sustained splenic infarction secondary to diabetes-induced, small-vessel atherosclerotic disease.- - - - - - - - - - ranking = 0.2384407479893keywords = diabetes (Clic here for more details about this article) |
6/79. A diabetic patient with a black penile tip.This is a report of a patient with diabetes mellitus type II who presented with the rare complication of penile gangrene. The gangrene was unilateral and was associated with ipsilateral partial stenosis of the common iliac artery. An angioplasty followed by insertion of a stent, rehydration, and improved diabetic control did not improve the penile lesion, and penile amputation was carried out. In the postoperative period, the patient developed a bilateral basal pneumonia with a significant growth of saprophyte mycobacterium gordonae from the bronchial aspirate. This is the first reported case of unilateral penile gangrene and also that of mycobacterium gordonae infection in a patient with diabetes mellitus.- - - - - - - - - - ranking = 0.32631593297096keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
7/79. insulinoma occurring in association with fatty replacement of unknown etiology in the pancreas: report of a case.A 66-year-old woman with a 10-year-history of diabetes mellitus was admitted to our hospital for investigation of several recent attacks of hypoglycemia. Her fasting blood glucose level was very low, at 30-40 mg/dl, and abdominal ultrasonography and computed tomography revealed a tumor in the pancreatic tail with fatty changes. Endoscopic retrograde cholangiopancreatography revealed absence of the main pancreatic duct from the body to tail of the pancreas. Abdominal angiography showed a hypervascular tumor stain in the pancreas, and percutaneous transhepatic portal vein sampling demonstrated a step-up of immunoreactive insulin levels in the splenic vein. Based on these clinical findings, we made a preoperative diagnosis of an insulinoma accompanied by fatty changes in the pancreatic body and tail. During laparotomy for the insulinoma, fat tissue was identified in the anatomic location of the pancreatic body and tail, and resected. Pathological examination of the resected specimen revealed a number of Langerhans islets in the adipose tissue, and an islet cell tumor with fatty replacement of the pancreatic tissue around the tumor. The insulinoma was found not to have caused obstruction of the main pancreatic duct. We present herein a rare case of an insulinoma that developed in the pancreas, and was associated with fatty replacement of unknown etiology.- - - - - - - - - - ranking = 0.16315796648548keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
8/79. Dilated cardiomyopathy as the first early complication in a 14 year-old girl with diabetes mellitus type 1.Diabetic cardiomyopathy (DC) has been reported in type 2 diabetics with short duration of clinically overt diabetes. Impaired left ventricular function has been reported in young patients with diabetes mellitus type 1 (IDDM), but severe cardiomyopathy as the first early major complication of IDDM is very rare. We report a 14 year-old girl with a 5-year history of IDDM and very poor compliance with treatment and follow-up. She was referred to our clinic upon the development of congestive heart failure and dilated cardiomyopathy was diagnosed based on clinical findings, electrocardiogram, chest X-ray and echocardiography. She had no evidence of other major complications of IDDM such as retinopathy, nephropathy or neuropathy.- - - - - - - - - - ranking = 0.86347798202527keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
9/79. diabetes mellitus with left transverse sinus thrombosis and right transverse sinus aplasia.A 67-year-old woman with diabetes mellitus was hospitalized due to a throbbing headache. She appeared neurologically normal, except for meningeal irritation. The cerebrospinal fluid pressure was high. There was increased fluid protein without an increased cell count. brain CT scan showed no abnormality, however, brain magnetic resonance angiography (MRA) showed complete right transverse sinus stasis and partial left transverse sinus stasis, indicating bilateral transverse sinus thrombosis. At this time thrombin anti-thrombin III complex (TAT) and prothrombin fragment F1 2 (PTF1 2) indicating hypercoagulation had increased. Urokinase, followed by aspirin and ticlopidine hydrochloride were administered. After diet therapy and transient insulin administration, her blood glucose levels improved. By the 22nd day, the headache had disappeared. Subsequently, brain MRA showed left transverse sinus blood flow recovery and complete right transverse sinus stasis, while carotid angiography showed recovered left transverse sinus but right transverse sinus defect. TAT and PTF1 2 levels improved concomitantly with better blood glucose control. We diagnosed this case as left transverse sinus thrombosis because of the hypercoagulable state resulting from diabetes mellitus accompanied by right transverse sinus aplasia.- - - - - - - - - - ranking = 0.41052473731941keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
10/79. review and case report of idiopathic lower extremity compartment syndrome and its treatment in diabetic patients.Diabetic muscle infarction is a rare complication of diabetes mellitus. However, idiopathic compartment syndrome in the diabetic patient is even a rarer disease, which has been reported only in three cases up to date. The disease seems to occur in patients affected by type 1 diabetes mellitus with a history of poorly controlled glucose levels. MRI aids in the diagnosis by delineating the edema of the muscle. However, definitive diagnosis is made using the Stryker needle unit. Treatment is accomplished by immediate two-incision fasciotomy. We present a case where a 34 yr-old female with a long standing history of poorly controlled Type 1 diabetes mellitus presented with a painful right lower extremity and was diagnosed with compartment syndrome. In our patient, a single incision fasciotomy to release the pressure was sufficient and might be considered as an alternative and less morbid procedure in the diabetic patient with already poorly healing tissues. We conclude that the muscle infarction in these patients is from diffuse microangiopathic disease leading to muscular infarction and fluid accumulation in the cells causing a decrease in the space in the compartment in question causing compartment syndrome.- - - - - - - - - - ranking = 0.48947389945644keywords = diabetes mellitus, diabetes, mellitus (Clic here for more details about this article) |
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