Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

alpha 2-macroglobulin-trypsin complexlike substance (MTLS) was determined in plasma of pancreatic and nonpancreatic diseases using a two-step enzyme immunoassay to study the diagnostic and pathophysiological significance of MTLS. Plasma levels of MTLS in acute pancreatitis (mean +/- SD = 265.6 +/- 346.2 ng/ ml, n = 9), calcified chronic pancreatitis (128.6 +/- 257.4, n = 13), and noncalcified chronic pancreatitis (13.5 +/- 12.5, n = 10) were significantly higher than that in controls (3.6 +/- 1.8, n = 81). In other diseases such as gastric cancer, hepatoma, diabetes mellitus, and gallstones, MTLS values were not different from those of control. Plasma MTLS values showed low correlation with serum trypsin, elastase 1, pancreatic amylase, lipase, and pancreatic secretory trypsin inhibitor (PSTI). The elevation of plasma MTLS values in acute pancreatitis suggests that plasma MTLS levels reflect that protease is inappropriately activated in pancreatic acinar cell and released into the circulation and that the determination of MTLS can be useful for diagnosis and pathophysiology of acute pancreatitis and chronic pancreatitis.
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PMID:Plasma alpha 2-macroglobulin-trypsin complexlike substance (MTLS) in pancreatic disease. 895 9

Age has been considered as a risk factor for the development of complications in acute pancreatitis. To confirm the above a retrospective study was designed including 526 cases of acute pancreatitis which were classified, according to age, into two groups: group I: > 65 years, and group II: < or = 65 years. The evolution of pancreatitis was classified as mild or severe according to the criteria of the Atlanta Meeting. Furthermore, other variables which may influence in the development of complications, such as the etiology or the presence of other associated diseases at the time of the appearance of pancreatitis were taken into account. On comparison of the severity of pancreatitis in both groups significant differences were only found in the appearance of acute renal failure. A relationship was, however, observed between the existence of certain diseases (arterial hypertension, diabetes mellitus and chronic renal failure) present at the time of the appearance of acute pancreatitis and the development of complications of the latter. In addition, on comparing the epidemiologic and etiologic data of the two groups, it was found that acute pancreatitis in the elderly is more often of biliary etiology, is more frequent in females and is usually accompanied by other diseases at the time of appearance. Age in itself is not a risk factor for the development of complications in acute pancreatitis. The association of diseases at the time of the initiation of pancreatitis implies a worse prognosis.
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PMID:[The value of age as a prognostic factor in the severity of acute pancreatitis]. 907 3

Cholelithiasis is a disease of high prevalence in the adult population. Prevalence increases with age; the incidence of complications, such as choledocholithiasis, acute pancreatitis, and cancer of gallbladder, also increase with age. Cholecystectomy has been considered as the gold standard in the treatment of symptomatic or complicated cholelithiasis. Laparoscopic cholecystectomy has become the new gold standard. Our Department of Surgery has adopted a policy of advising laparoscopic cholecystectomy in all patients with symptomatic cholelithiasis, but also subpopulation of high risk asymptomatic patients. This subgroup is made up by patients with long life expectancy, radioopaque stones, small calculus with patent cystic duct, nonfunctioning or calcified gall bladder, and patients with concomitant diabetes, cirrhosis, chronic hemolytic anemia, those that are candidates for kidney or heart transplantation, and those with underling degenerative diseases that are more likely to develop severe complication of cholelithiasis. Csendes of Chile has reported very high incidence of gallbladder cancer in Chile and Bolivia. He considers that cholecystectomy is indicated in asymptomatic patients as a "prophylactic" measure. Our group agrees that this is a valid indication in areas or populations groups where gallbladder cancer is of high prevalence.
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PMID:[Suitability of laparoscopic cholecystectomy in the asymptomatic cholelithiasis patient]. 918 Sep 56

One way to prevent the occurrence of insulin-dependent diabetes after major pancreatic resection is to perform islet of Langerhans autotransplantation. Thus far, we have performed nine autotransplantations. The last three autotransplantations were performed in patients with benign tumoral pathology (one corporeal mucinous cyst, one isthmic insulinoma and one corporeal cystadenoma). In these three cases, we performed a distal 40%, 75% and 80% pancreatectomy respectively, since enucleation was not indicated or not feasible. After resection and removal of the tumoral lesion, pancreatic segments were injected intraductally with collagenase and digested according to a modified semi-automated Ricordi's technique. We obtained 105,000, 415,000 and 144,300 non-purified islets which were then embolized into the liver by intraportal injection during the same operative procedure. After surgery, all patients were insulin-independent. There was no morbidity or mortality. In a patient who presented acute pancreatitis of the residual pancreas five months after transplantation, insulin therapy was introduced. More than one year after the graft, the two other patients remain insulin-independent. In conclusion, we propose islet autotransplantation after pancreatic resection for benign focal pathology, to prevent or delay the occurrence of insulin-dependent diabetes.
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PMID:[Islands of Langerhans autotransplantation after pancreatic resection for benign pathology]. 928 39

The aim of this review is to describe recent developments in the field of pancreatic disorders in children. First, recent developments in the genetic research of hereditary pancreatitis are discussed. Subsequently, several issues of acute pancreatitis are presented. These include a description of the potential hazardous morbidity and mortality of this disorder in children. In addition, various novel etiologies that have been described lately in the medical literature are illustrated. Next, this paper discusses two examples of pancreatic disorders associated with systemic manifestations, i.e., ganglioneuromatosis and diabetes mellitus. Finally, a few rare genetic syndromes with pancreatic involvement are touched upon, an association that is not very well recognized. Cystic fibrosis is not covered.
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PMID:An update on diseases of the pancreas in children. 936 Aug 29

The aim of our study was to analyze the influence of alcohol consumption on the early clinical manifestations of alcoholic chronic pancreatitis of the 517 patients in whom chronic pancreatitis was initially suspected, 158 were diagnosed with this disease; of these, alcohol was considered the cause in 136 (86.1%). Alcohol was considered a major etiologic factor when mean consumption was > or = 60 grams per day for at least 4 years. Alcohol consumption, initial clinical manifestations and time of onset were considered up until the moment of diagnosis in all patients. The sex distribution was 133 men (97.8%) and 3 women (2.2%). The average age was 22 +/- 6.5 years at onset of alcoholism, 38 +/- 9.4 years at onset of clinical features, and 44 +/- 9.4 years at diagnosis. The interval between the onset of alcoholism and the initial clinical manifestations was 15.8 +/- 8.8 years, and the interval between the latter and diagnosis was 6.1 +/- 4.9 years. Average alcohol consumption was 162 +/- 8 grams/day and total consumption was 1312 +/- 1017 kg. A statistically significant relationship was found only for mean alcohol consumption and abdominal pain. We found a higher frequency of acute pancreatitis outbreaks, calcifications, steatorrhea and diabetes until the moment of diagnosis in the higher alcohol consumption groups, although the relationship was not statistically significant.
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PMID:Influence of alcohol consumption on the initial development of chronic pancreatitis. 942 5

In conclusion, our study showed that serum G.G.T rises in cholestasis, and the rise is significantly higher in extraphepatic cholestasis as compared to intrahepatic cholestasis. Serum G.G.T has not shown any superiority over alkaline phosphatase in the evaluation of cholestatic liver disease. However, two considerations must caution against the use of serum G.G.T. alone for evaluation of hepatobiliary disease. The first of these is the lack of specificity for hepatobiliary disease. Serum G.G.T. activity can be elevated in some non-hepatic disorders such as acute pancreatitis, congestive cardiac failure, myocardial infarction, diabetes mellitus and alcoholism. Determination of serum G.G.T. in these patients is of no value. Second, the possibility that changes in serum G.G.T. activity results from drug administration in man.
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PMID:"Significance of serum gamma glutamyl transpeptidase in cholestatic jaundice". 949 80

Elevated serum triglyceride levels may be related to the following clinical features: increased blood coagulation and viscosity, increased serum fibrinogen levels, decreased fibrinolysis, and for serum levels over 1000 mg/dl, a strong increase of acute pancreatitis rate. Pharmacological choice among the numerous drugs to treat hypertriglyceridemias is currently debated. Our study was aimed to assess the therapeutic efficacy of acarbose in the treatment of non-diabetic subjects, affected by familiar hypertriglyceridemia (FH). We studied 18 non-diabetic patients (10 males, 8 females; mean age 57.61+/-6.85 years) without family history of diabetes mellitus affected by familiar hypertriglyceridemia. The study protocol planned a treatment period of 20 weeks, divided into five 4-week courses and made up as follows: diet plus acarbose therapy (4 weeks); diet therapy alone (4 weeks) alternatively. In the second and fourth 4-week courses diet plus acarbose were administered, while diet therapy alone was administered in the first, third, and fifth 4-week courses. Acarbose doses consisted of 50 mg (1/2 pill) twice daily. Mean serum triglyceride levels, after first month of dietary treatment, underwent a significant reduction from 481.5 +/- 67.1 mg/dl to 389.5 +/- 62.7 mg/dl, even if they did not reach the optimal levels to keep on the dietary therapy alone. After the first month of treatment with acarbose associated to diet, we observed a further reduction of serum triglycerides levels (p = 0.02). When diet alone was administered, mean triglyceride serum levels underwent a significant enhancement (p = 0.003). Restarting for the second time the association treatment, we observed a noteworthy reduction of mean serum triglyceride levels (p = 0.0001). Acarbose acts on the pathogenesis of FH, lowering the production of endogenous triglycerides. Our data suggested that acarbose can be considered a valid therapeutic tool in the treatment of familiar hypertriglyceridemias, also in non-diabetic patients.
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PMID:Beneficial effects of acarbose on familiar hypertriglyceridemias. 972 98

Although postmenopausal estrogen replacement is recommended to prevent disease and prolong life, little data are available regarding hormone replacement therapy (HRT; estrogen or estrogen plus progestin) in various high-risk subpopulations of women. Our study examined lipid levels, with and without HRT, in a cross-section of 694 postmenopausal women with diabetes and 5321 postmenopausal women without diabetes. Among the diabetic women, 70 were currently using HRT, 482 had never used HRT, and 142 had used HRT at some point after menopause but were not taking hormones at the time of the study. Among the nondiabetic women, 1147 were currently using HRT, 3210 had never used HRT, and 964 had formerly used HRT. We found that diabetic women appear to respond somewhat differently than their nondiabetic counterparts to HRT. Estrogens were associated with proportionately lower increases in HDL as compared with the increases produced in nondiabetic women--diabetic women currently taking estrogen had 6&#37; higher HDL levels than diabetic women who never used estrogen, and nondiabetic women currently taking hormones had 17&#37; higher HDL levels than nondiabetic subjects who were never on HRT (P=0.02). Further, there were proportional differences in triglyceride levels--diabetic women currently on HRT had 25&#37; higher triglyceride levels than diabetic women who never used hormone therapy, and among nondiabetic women on HRT, there was a 14&#37; increase in triglycerides compared with their counterparts who were never on HRT (P=0.08). LDL cholesterol appeared to respond similarly to HRT in diabetic and nondiabetic women. Diabetic women appear to have a blunted response to the HDL-raising effect of HRT and an exaggerated hypertriglyceridemic response. This may alter the cardiovascular benefits from postmenopausal HRT and increase the risk of acute pancreatitis from hypertriglyceridemia. The decision to use HRT should be individualized, and diabetic women who receive HRT should have their triglycerides carefully monitored at 1 month and then at every 3 months after starting therapy.
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PMID:How HRT Alters the Lipid Profile in Women with Diabetes. 974 62

Duodenum-preserving pancreas resection for chronic pancreatitis results in a subtotal resection of the pancreatic head. Of 488 patients suffering from chronic pancreatitis with an inflammatory mass in the head, 48% had a common bile duct stenosis in the ERCP, 63% had a pancreatic main duct stenosis, 25% had a duodenum stenosis, and 17% showed vascular obstruction--mainly compression or occlusion of the portal vein. Hospital mortality after duodenum-preserving head resection was 0.9%. In the late follow-up, 88% of patients were free of pain and 60% were professionally rehabilitated. The incidence of diabetes mellitus in the late follow-up was 14%; however, 6% of the patients had a lasting improvement of endocrine function. Late mortality after a median follow-up of 6 years (1-22 years after surgical treatment) was 9%. Only 10% of the patients needed further hospitalization due to recurrent attacks of acute pancreatitis. Duodenum-preserving head resection should be the surgical procedure of choice in chronic pancreatitis with an inflammatory mass in the head of the pancreas and in cases with pancreas divisum after failure of medical and interventional treatment. Duodenum-preserving total pancreatectomy is a last-resort surgical treatment after failure of left resection for pain in chronic pancreatitis.
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PMID:The surgical management of chronic pancreatitis: duodenum-preserving pancreatectomy. 989 40


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