Cases reported "Diabetes Complications"

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1/461. Vertebral osteomyelitis in insulin-dependent diabetics.

    Vertebral osteomyelitis continues to be a diagnostically and therapeutically challenging disease with a relatively high incidence in diabetics. The clinical features, investigations and treatment of 7 insulin-dependent diabetics with vertebral osteomyelitis are presented and possible aetiological factors in this group are discussed.
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2/461. A simplified method of total contact casting for diabetic foot ulcers.

    A simplified method of total contact casting for diabetic plantar ulcerations is described in which a standard, well-molded short-leg walking cast is applied. Weekly cast changes are performed initially, followed by longer cast change intervals. Either fiberglass or plaster casting tape appears equally efficacious. Healing of all ulcers was demonstrated in 12 patients treated with this technique.
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3/461. blood brain barrier destruction in hyperglycemic chorea in a patient with poorly controlled diabetes.

    A case of hemichorea in a patient with poorly controlled diabetes is reported. T1-weighted magnetic resonance imaging (MRI) showed an unusual homogeneous high-intensity area in the corpus striatum. Of interest in the case was the fact that the globus pallidus, which was enhanced with gadolinium at the onset of hemichorea, showed homogeneous high-intensity on a subsequent T1-weighted image. This indicated that blood brain barrier destruction preceded the signal intensity change in the basal ganglia. As far as the authors could determine, this is the first reported case showing such enhancement during the course of diabetic hemichorea.
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keywords = diabetic
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4/461. Thermal biofeedback for claudication in diabetes: a literature review and case study.

    temperature biofeedback (TBFB) is designed to alter cutaneous temperature in treated extremities by providing information corresponding to minor temperature fluctuations in the context of therapeutic structure and reinforcement. Toe TBFB may improve vascular flow and walking tolerance in patients with peripheral vascular disease. This case study documents improved walking in a diabetes patient with lower extremity complications, and suggests TBFB might increase lower extremity temperature and blood flow volume pulse in uncomplicated diabetes. ankle-brachial index (ABI) and walking function were assessed in a 60-year-old woman with type 2 diabetes and intermittent claudication, before and after five sessions of TBFB applied to the ventral surface of the great toe. Toe temperature increased during feedback phases but not during baseline phases. Improvements were seen in ankle-brachial index, walking distance, walking speed, and stair climbing. This case indicates the need for extended and controlled study of TBFB for improved vascular and ambulatory function in diabetic claudication.
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ranking = 0.16706415802044
keywords = diabetic, vascular disease
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5/461. Alternating Bell's palsy associated with diabetes mellitus. A report of four cases.

    Four diabetic patients are presented with alternating facial palsy. The term alternating is meant to imply facial nerve paralysis, the onset of which occurs at different points in time on both sides of the face. Clinical findings are presented and a short review of the literature is summarized. The authors conclude that alternating facial palsy is often associated with diabetes mellitus. Alternating facial palsy is an infrequent finding. This is in marked contrast to the unilateral form. Approximately every 13 minutes someone in the united states incurs idiopathic facial paralysis or Bell's palsy (20 persons per 100,000 per year). It is apparent that the majority of unilateral facial palsies fall into the idiopathic category. The alternating form of facial paralysis, however, appears to be an unusual finding in a symptom complex of several diseases which will be discussed. It is the diagnostic significance of this alternating facial paralysis and its occasional association with diabetes mellitus that prompts this report.
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keywords = diabetic
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6/461. Neurological deficit following spinal anaesthesia: MRI and CT evidence of spinal cord gas embolism.

    A 62-year-old diabetic woman developed permanent neurological deficits in the legs following spinal anaesthesia. MRI showed oedema in the spinal cord and a small intramedullary focus of signal void at the T10 level, with negative density at CT. Intramedullary gas bubbles have not been reported previously among the possible neurological complications of spinal anaesthesia; a combined ischaemic/embolic mechanism is hypothesised.
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keywords = diabetic
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7/461. mucormycosis of the central airways: CT findings in three patients.

    Computed tomographic (CT) findings are described in three diabetic patients with central airways mucormycosis. The CT findings of the tracheobronchial mucormycosis include enhancing areas of mural thickening (n = 3), luminal narrowing (n = 3), intramural air (n = 3), low-attenuation nonenhancing bronchial wall thickening (n = 2), and bronchonodal fistula formation (n = 1). These CT features in a diabetic patient should raise a high index of suspicion for tracheobronchial mucormycosis, particularly when typical radiographic features of pulmonary tuberculosis are absent.
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keywords = diabetic
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8/461. Concha bullosa pyocele--undiagnosed for 3 years.

    We report a rare case of post-traumatic concha bullosa pyocele in a diabetic teenager that has gone undiagnosed for 3 years. The clinical findings, radiological features and management are discussed. The literature is reviewed.
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keywords = diabetic
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9/461. Patient case studies.

    Three contrasting cases of obese patients with type 2 diabetes mellitus are presented, which illustrate the management difficulties faced by clinicians. The first raises the issue of when to commence an oral hypoglycaemic agent in a newly diagnosed but asymptomatic obese patient; the second case addresses the problem of when to commence insulin in the face of continuing weight gain and poor glycaemic control; the final case is an example of the vicious metabolic spiral which so many patients enter, with increasing body weight, poor diabetic control and associated co-morbidities. The discussion that follows each case presentation recognises the considerable cardiovascular risk faced by such patients and provides guidance about possible management pathways including adjunctive anti-obesity pharmacotherapy.
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keywords = diabetic
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10/461. Renal complications in patients with diabetes mellitus associated with an A to G mutation of mitochondrial dna at the 3243 position of leucine tRNA.

    The substitution of guanine for adenine at position 3243 of the leucine tRNA gene of mitochondrial dna was originally described in association with MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes). diabetes mellitus associated with the mutation (mitochondrial diabetes) is a different phenotype from MELAS. We identified 11 patients with the mutation among 385 Japanese diabetic patients: two had MELAS and nine had mitochondrial diabetes. We present data on a male patient with mitochondrial diabetes who developed the nephrotic syndrome at the age of 23. light microscopy revealed mesangial expansion, PAS-positive deposits and segmental sclerosis in the glomeruli. Scattered mesangial electron-dense deposits and thickening of the basement membrane were found on electron microscopy, suggesting that diabetic glomerulosclerosis accompanied by focal glomerulosclerosis (FGS). Mitochondrial diabetes may pre-dispose patients to renal complications, including forms of glomerulonephritis, such as FGS.
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keywords = diabetic
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