Sarcoidosis with ocular and hypothalamic-pituitary manifestations.
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Infrared data determined for known polymorphic forms and some new derivatives of acetohexamide and related compounds support the view that acetohexamide polymorphs exhibit keto-enol tautomerism. They indicate that type A polymorphs exist in the enol form, probably stabilized by intramolecular bonding between an O-H and S = O group to form a six-membered ring. Type B polymorphs exist in the keto form with the urea carbonyl group intermolecularly bonded to a sulphonamide N-H. The new evidence disputes previous interpretations of the data.
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Type 1 pili-adhesive fibers expressed in most members of the Enterobacteriaceae family-mediate binding to mannose receptors on host cells through the FimH adhesin. Pilus biogenesis proceeds by way of the chaperone/usher pathway. The x-ray structure of the FimC-FimH chaperone-adhesin complex from uropathogenic Escherichia coli at 2.5 angstrom resolution reveals the basis for carbohydrate recognition and for pilus assembly. The carboxyl-terminal pilin domain of FimH has an immunoglobulin-like fold, except that the seventh strand is missing, leaving part of the hydrophobic core exposed. A donor strand complementation mechanism in which the chaperone donates a strand to complete the pilin domain explains the basis for both chaperone function and pilus biogenesis.
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AIMS: To conduct a systematic review of drug induced adverse ocular effects in diabetes to determine if this approach identified any previously unrecognised adverse drug effects; to make a preliminary assessment of the feasibility of this approach in identifying adverse drug reactions; and to assess the current accessibility of this information to prescribing physicians. METHODS: Literature search of online biomedical databases. The search strategy linked eye disorders with adverse drug reactions and diabetes. Source journals were classified as medical, pharmaceutical, diabetes related, or ophthalmological. It was determined whether the reactions identified were recorded in drug datasheets and the British National Formulary. RESULTS: 63 references fulfilled the selection criteria, of which 45 were considered to be relevant to the study. The majority of these were case reports but cross sectional surveys, case-control and cohort studies, and review articles were also identified. 61% of the reactions were not recorded in the British National Formulary and 41% were not recorded in the datasheets. 55% appeared in specialist ophthalmology journals. CONCLUSIONS: This is a feasible approach to the identification of adverse drug reactions. Adverse reactions not listed in the most commonly used reference sources were found. The majority were published in specialist ophthalmology journals which might not be seen by prescribing physicians.
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Hypoglycaemic agents were replaced by placebos in diabetic patients attending a hospital clinic. Of 62 patients observed, 43 (69%) relapsed within six months but blood sugar control remained unchanged in 19 (31%) during the period of observation.
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Two cases are reported in which a remission of diabetes was sustained throughout pregnancy. This seemed to be due in part to improved beta-cell function consequent on restoration of normoglycaemia before pregnancy, and in part to an increase in insulin sensitivity during pregnancy, which in the first case disappeared very rapidly after delivery.
This report concerns nine cases of diabetes mellitus associated with infectious hepatitis, an epidemic of which swept through eastern Nigeria between 1970 and 1972. All the patients showed the classical symptoms and signs of diabetes. They quickly responded to treatment, and after a few months the diabetes completely disappeared. Corticosteroid-glucose tolerance tests in four patients 12 to 30 months after the remission of their diabetes were normal. Contact with the remaining five patients had been lost a few months after clinical remission of their diabetes. The infectious hepatitis virus may have damaged pancreatic islet cells to cause an acute remittant form of diabetes mellitus.
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