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At least 955 records · Page 53Linked to original sources
PubMed2000

Experimental intoxication by the mushroom Ramaria flavo-brunnescens in sheep.

Ramaria flavo-brunnescens collected in autumn from 1990 to 1994 was orally administered to 11 sheep. These animals were dosed with 100-430 g/kg bw administered over 3-13 d. Six sheep showed clinical signs and 4 of them died. The mininum toxic dose was of 150 g/kg bw. Clinical signs were anorexia, hyperthermia, dyspnea, polyuria, ataxy, muscle tremors and seizures. The eyes had hyperemia of the sclera and, in some cases, hemorrhages of the anterior chamber or corneal opacity. Sheep dosed with higher doses had ulcerations of the tongue and necrotic lesions in the hooves. The main histologic lesions of the feet and tongue were miopachynsis and endotelial degeneration followed by degeneration, necrosis and ulceration of the epithelium. Hemorrhages of the anterior chamber, and severe congestion and hemorrhages of the iris, ciliary body and process were observed in the eyes. Congestion and perivascular hemorrhages occurred in the central nervous system. The similarity of clinical signs and pathologic lesions induced by R flavo-brunnescens and those caused by ergotism in cattle and sheep suggests the presence ofa vasoactive constrictive substance in the mushroom. Fresh R flavo-brunnescens dosed in autumn 1993 was not toxic at doses of 200-400 g/kg demonstrating variations in the toxicity of the mushroom from year to year.

Animals↗
PubMed2000

Accidental ingestion of acyclovir in dogs: 105 reports.

Acyclovir is an antiviral agent that causes termination of viral DNA synthesis by inhibiting viral reverse transcriptase. Acyclovir is used therapeutically to treat herpes simplex, cytomegalovirus, Epstein-Barr, and varicella-Zoster. Although acyclovir is thought to be low in toxicity, it has caused an obstructive nephropathy from accumulation of crystals in renal tissue. A retrospective review (January 1995 through March 2000) was conducted of acyclovir toxicoses in dogs reported to the ASPCA National Animal Poison Control Center. Of 105 ingestions, 10 were considered cases of acyclovir toxicosis. The most common signs seen were vomiting, diarrhea, anorexia, and lethargy. Ingested dosages ranged from 40 to 2195 mg/kg bw. Polyuria and polydipsia were reported in I dog. In 6/10 cases, signs developed within 3 h of ingestion. Treatment included standard decontamination procedures, (ie induction of emesis, administration of activated charcoal), diuresis, and supportive care.

Acyclovir↗
PubMedDate not supplied

[25 years old woman with nocturia].

A 25 years old lady presented to our outpatient clinic complaining nicturia, polyuria and polydipsia. On the basis of clinical assessment and the results of a simple test, a diagnosis of Nephrogenic Diabetes Insipidus (NDI) was made. The diagnosis of NDI is often missed, and appropriate treatment therefore delayed, with severe consequences especially in elderly and bed restricted people.

Adult↗
PubMed2002

[Infundibulitis, an unusual case of central diabetes insipidus].

We report the case of a 53 year old patient who was admitted with polyuria, polydipsia associated with fatigue, depression and sexual dysfunction. Central diabetes insipidus with hypogonadotrophic hypogonadism was diagnosed by a water restriction test and different static and dynamic hormonal dosages. Nodular thickening of the pituitary stalk was noted on the MRI and the biopsy permitted a histological diagnosis of infundibulitis.

Biopsy↗
PubMedDate not supplied

[Mature onset diabetes of the young (MODY)].

Maturity-onset diabetes of the young (MODY) is a rare form of juvenile diabetes mellitus, defined by early onset, absence of ketosis, non-insulin-dependent diabetes and autosomal dominant inheritance. Advances in molecular genetic analysis have identified mutations accounting for different MODY subtypes, all of them associated with defects of insulin secretion. We present a case of a nine year-old boy, admitted to our outpatient clinic because of mild and intermittent osmotic symptoms (polyuria, polyphagia and polydipsia) and persistently high values of fasting blood glucose in the last year. He had a family history of diabetes in three consecutive generations compatible with autossomal dominant inheritance. His height was 138.5 cm (90th centile) and his weight was 33.5 Kg (90th centile). General examination was unremarkable, in a prepubertal boy. A standard oral glucose tolerance test was performed. The fasting blood glucose was 118 mg/dl with a two hour value of 160 mg/dl. ICA, IAA and GAD autoantibodies were undetectable. He started on diet therapy, keeping his fasting blood glucose measurements on the upper limits of normal and HbA1c in the normal range. He was diagnosed as having MODY 2 on a clinical basis, as it is not possible to perform molecular analysis of this pathology in Portugal. As MODY is recently thought to account for 2-5% of all cases of type 2 Diabetes Mellitus it is important to consider it as a possible diagnosis in children who present with incidental hyperglycaemia. Molecular genetic testing is very important as it enables us to make a firm diagnosis of MODY, to define a follow up plan and to reassure patients families, once the prognosis is significantly different among the different sub-types of MODY. We emphathize the need of creating national and international reference centres where such testing can be done.

Blood Glucose↗
PubMed2003

[Clinical manifestations of urinary disorders and their treatment in ageing men].

PROBLEMS OF THE PROSTATE: Benign hypertrophy of the prostate (BHP), when it occurs, is manifested by an obstruction or irritation related to overactivity of the bladder. The obstructive syndrome is defined by urodynamic tests. Urge incontinence and study of the pressure-flow ratio are the tests of choice. The functional handicap and impact on quality of life are assessed using the International Prostatism Symptoms Score (I-PSS). Efficient and fairly well tolerated medical treatment has reduced the indications for surgery. It relies on alpha-blockers, 5a-reductase inhibitors and phytotherapy. When indicated, the surgical treatment of choice is endoscopic resection of the prostate. Among the non-prostatic micturition disorders, urge micturition with, in extreme cases, incontinence are due to detrusor instability. This is of multifactor origin; enhanced by the local irritation or environmental factors, it usually occurs within a context of acute or chronic pathologies. Treatment is recommended with anticholinergic agents. New molecules have recently been launched, better tolerated than oxybutinine. Electrostimulation can be a good alternative in mentally normal patients. Micturition due to excess urine may be due to overactivity of the bladder, the major risk of which is acute urine retention. It can also be observed during neurological affections such as Parkinson's disease or during administration of certain drugs. Nocturnal polyuria is a frequent problem. However, simple hygiene and dietary measures and the control of certain concomitant diseases can usually relieve the symptoms. Medical treatment relies on desmopressine.

Adult↗
PubMedDate not supplied

Use of T1-weighted MR imaging to differentiate between primary polydipsia and central diabetes insipidus.

PURPOSE: To investigate the value of MR in differentiating patients with primary polydipsia, who have an intact neurohypophyseal system, from those with central diabetes insipidus, who have impaired synthesis and/or release of vasopressin. METHODS: Eighteen patients with clinically significant hypotonic polyuria were diagnosed endocrinologically as having primary polydipsia or diabetes insipidus (central or nephrogenic). These patients, and 92 patients without sellar disease, were then imaged with 1.5-T, T1-weighted, thin sagittal sections without gadolinium contrast. RESULTS: Normal hyperintense signal of the neurohypophysis was present in 90 of 92 patients without sellar disease. The signal was also present in all six patients with primary polydipsia. In contrast, the hyperintense signal was absent in all eight patients with central diabetes insipidus. Three of the four patients with nephrogenic diabetes insipidus also had an absent hyperintense signal. CONCLUSION: T1-weighted MR may prove important in differentiating patients with central diabetes insipidus from those with primary polydipsia.

Adult↗
PubMed2003

[Analysis of type 1 diabetes mellitus symptoms at admission to hospital].

AIM: The aim of study was analysis of type 1 diabetes mellitus symptoms at admission to hospital. MATERIAL AND METHODS: Thirty-seven patients (21 boys and 16 girls) aged from 1.87 to 19.75 years with admitting diagnosis of diabetes mellitus in the year 2000 (the greatest count of patients) were analyzed. In statistical analysis the t-Student test was used. RESULTS: The most frequent symptoms was dry sensation in mouth 95% of patients, polydypsia 84%, polyuria 65%, lose on weight 49%, nocturia - 27% children. Nine children were admitted to hospital in serious ketoacidosis. Twenty-eight children were admitted to hospital in good condition. There were not essential abnormalities in the blood. Observation period in poor general condition group was shortest for children living in the country - on the average 9 days versus patient from cities - 18 days. There was not difference in good general condition group. HbA1c, pH, HCO3 values were statistically significant. In 3 cases diagnosis of diabetes mellitus was preceded by an eliminating others diseases. In 2 children hyperglycemia was established by chance. CONCLUSION: 1) Ketoacidosis symptoms and serious state was observed in 1/4 patient admitted to hospital. 2) It is necessary to take diabetes mellitus into consideration more often in differentiation in pediatric practice. 3) Short observation period of severe ketoacidosis symptoms in-patient from country origin and dismiss preliminary diagnosis may indicate insufficient healthy education - especially in the field of diabetes mellitus. 4) Less than half of patients report to family doctors.

Adolescent↗
PubMed2003

Identifying and treating reversible causes of urinary incontinence.

Urinary incontinence can be a symptom of a variety of reversible conditions. Common and reversible causes of urinary incontinence include polyuria, exposure to irritants (including concentrated urine), infection, urinary retention, use of pharmaceuticals, stool impaction or constipation, atrophic urethritis or vaginitis, restricted mobility or dexterity, psychological conditions, and delirium or acute confused state. Healthcare professionals can use existing assessment strategies, tools, and parameters to guide decisions and treatment options to manage these conditions. First-line assessment tools are reviewed, including the use of a voiding and bowel diary, simple dipstick urinalysis, catheterization for post-void residual, the Folstein Mini Mental Status evaluation, and the Geriatric Depression Scale. Guidelines for estimating normal ranges of urine output, the influence of irritants, the risk of incontinence caused by stool impaction, and urinary retention are discussed. Primary care providers are well positioned to rule out or treat many of the reversible causes of urinary incontinence using simple assessment tools and pragmatic guidelines.

Causality↗
PubMed2003

[Pierre J. Desault and the birth of nephrology 1785-1795].

Desault's genius and methods opened up a new field, the pathology of those medical conditions which afflict the urinary apparatus. Though he was a surgeon and therefore an anatomically based clinician, his most important discoveries were in pathological physiology, the polyuria of atrophic kidneys, the fatal dehydratation which follows the various forms of polyuric diabetes, and the oligo-anurias which follow excess water loss from the gut, the lungs ... etc. In the last two conditions the kidneys might look normal and therefore might be presumed normal. If Desault's work had survived this physiological eruption into renal disorders would have been the first decisive step of modern nephrology. His message, though excellent, was delivered too soon and on barren soil, to poorly educated physicians who paid little attention. But then, one has to remember that Desault was just a surgeon!

Diabetes Insipidus↗
PubMed2004

[How to explore... insipidus polyuropolydipsia syndrome].

The finding of a polyuropolydispsic syndrome should prompt a complete biological investigation of its etiology. If polyuria can be a minor sign as in psychiatric disorder, it can also be the first manifestation of diabetes mellitus but also central diabetes insipidus, the latter linked to cerebral tumors, metastases in the hypothalamus, granulomatous disease, but also nephrogenic diabetes insipidus such as chronic renal disease or autoimmune disease. Intracellular dehydration is the major risk in case of a polyuropolydipsic syndrome. Prognosis depends on the capacity to maintain water balance through an intact thirst mechanism. After a brief review of the majority of causes of diabetes insipidus, we propose a diagnosis algorithm to easily make the diagnosis.

Diabetes Insipidus↗
PubMed1992

Urine cortisol:creatinine ratio as a screening test for hyperadrenocorticism in dogs.

A urine cortisol:creatinine (c:c) ratio, determined from a free-catch morning sample, was evaluated in each of 83 dogs as a screening test for hyper-adrenocorticism. The dogs evaluated were allotted to 3 groups, including 20 healthy dogs, 40 dogs with confirmed hyperadrenocorticism (HAC), and 23 dogs with polyuria and polydipsia not attributable to HAC (polyuria/polydipsia group; PU/PD). Overlap in the urine c:c ratios (mean +/- SEM), comparing results from the healthy dogs (5.7 x 10(-6) +/- 0.9) with those from the HAC dogs (337.7 x 10(-6) +/- 72.0) was not found. However, 11 (64%) of the 18 values from the PU/PD dogs (42.6 x 10(-6) +/- 9.4) were above the lowest ratio in the HAC group and 50% of the HAC group had a urine c:c ratio below the highest value in the PU/PD group. When the mean urine c:c ratio (+/- 2 SD) for the group of healthy dogs was used as a reference range, 100% of the HAC dogs and 18 (77%) of 23 dogs in the PU/PD group had abnormal urine c:c ratios. The sensitivity of the urine c:c ratio to discriminate dogs with HAC was 100%. The specificity of the urine c:c ratio was 22% and its diagnostic accuracy was 76%. On the basis of our findings, a urine c:c ratio within the reference range provides strong evidence to rule out HAC. However, abnormal urine c:c ratios are obtained from dogs with clinical diseases other than HAC. Therefore, measurement of a urine c:c ratio should not be used as the sole screening test to confirm a diagnosis of HAC.

Adrenocortical Hyperfunction↗
PubMed2006

[Skin manifestation of mixed hyperlipidaemia in the course of decompensated diabetes].

The 55-year-old patient was admitted to the hospital ward in a bad condition, with some symptoms of dehydration, polydipsia, polyuria, hyperglycaemia and slight metabolic acidosis and with numerous xanthomas on the trunk, forearms, thighs and buttocks. Moreover he was confirmed to have teeth caries. During the treatment the infusion liquids, insulin, metronidasol, amoxiclav, simvastatin were administered. The caries teeth extraction was performed. Metabolic compensation and disappearance of skin changes was obtained.

Anti-Infective Agents↗
PubMed1991

[An analytic study of cases of childhood diabetes in a pediatric department in Tunis].

Insulin-dependent diabetes mellitus is common in Tunisia. Eighty-six pediatric cases managed at the diabetes clinic of a department of pediatrics in Tunis from 1979 through 1989 were studied. Relevant clinical and biological findings were abstracted from case-records. Admissions of patients with diabetes mellitus accounted for approximately 0.44% of admissions to the pediatric ward during the study period. Mean age of patients was 7 years. Sex ratio was 0.89. Polyuria with polydipsia and ketoacidosis were the two most common presenting manifestations. Mean blood glucose level at diagnosis was 22.44 mmol/l. Rate of consanguinity was 48%. HLA typing studies demonstrated a high prevalence of DR3 and DR4 alleles and especially of simultaneous expression of both these alleles. Several factors are incriminated in the development of childhood insulin-dependent diabetes mellitus.

Adolescent↗
PubMed1991

Interpretation of the urine osmolality: the role of ethanol and the rate of excretion of osmoles.

One purpose of this report is to illustrate that calculating the rate of excretion of osmoles in the urine can be of value in the differential diagnosis of hypernatremia and polyuria. A second purpose is to illustrate a clinical example where the osmolality of the urine did not reflect the lack of action of ADH. A patient with ethanol intoxication seemed to have central diabetes insipidus on clinical grounds. However, the osmolality of the urine was 287 mosm/kg H2O, a value which made this diagnosis unlikely. Since the concentration of ethanol in plasma was 119 mmol/L, we suspected that the urine contained an appreciable quantity of alcohol; this might obscure the lack of action of ADH. A study was performed to document the quantitative relationship between the concentrations of ethanol in plasma and urine. The concentration of ethanol in the urine was approximately 1.4-fold greater than in plasma. Using this correction factor, the osmolality of the urine adjusted for ethanol in the patient was only 120 mosm/kg H2O, a value more consistent with the diagnosis of central diabetes insipidus.

Adult↗
PubMed1991

[Hyperuricacidemic nephrogenic diabetes insipidus].

Five weeks following the removal of the urate calculus the 58-year-old patient suffered from anadipsia and drank 6-8 litre of water daily. Uric acid level was high in the serum and the carbamide-N and creatinine showed also increased values. Upon the administration of adiuretin the polyuria and polydipsia ceased, yet the specific weight of the urine stayed under 1010.

Diabetes Insipidus↗
PubMed1991

[Saliva as a risk factor for caries in diabetic patients].

Saliva is an important factor upon which general health of the oral cavity is dependent and which influences the occurrence of caries. In diabetic patients, xerostomia may occur due to pronounced polyuria in non-regulated and inadequately regulated cases. The aim of this study was to determine the amount of stimulated saliva and salivary pH in diabetic patients and in normal subjects, and to study the possible difference in the occurrence of caries. Results pointed to a significant decrease in the amount of stimulated saliva in insulin dependent diabetics (1.22 ml/min vs. 1.43 ml/min in normal subjects; p less than 0.01). The lowest amount of stimulated saliva was found in non-regulated diabetics (1.00 ml/min). In all diabetic patients, a significantly lower salivary pH was recorded as compared to normal subjects (p less than 0.01). The DMFS index was significantly higher in both insulin dependent and non-insulin dependent diabetics as compared to normal subjects (p less than 0.01). Concerning the state of diabetes control, significant differences at the level of p less than 0.01 in the DMFS index were observed among all groups of subjects (normal subjects, and regulated, inadequately regulated and non-regulated diabetics). A decreased salivary flow and pH may represent one from a series of caries risk factors in diabetics, especially in inadequately regulated and non-regulated cases of the disease.

Adult↗