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

Medical barriers to family planning (FP) are identified as contraindications, eligibility, process hurdles, the provider of contraception, provider bias, and regulation. These obstacles to FP are considered practices which may have a medical rationale in some manner but are scientifically unjustified. The denial or interference in obtaining contraception is unacceptable. Examples are given of barriers, i.e., eligibility criteria such as lack of headaches or history of diabetes. Obstacles that deter oral contraception (OC) are a by-product of testing requirements, repeat visits, and long waits. OC provision does not require a physician's prescription; a trained technician can perform similar functions. When a provider such as community-based distributor is limited in provision of methods, women are not given the right to choose from a full menu. Medical barriers occur due to the ignorance about the safety of contraceptives, the benefits of FP, and the role of health professionals in service delivery. Clinics tend to be curative rather than preventive. In place of careful thinking, there are rules in a hierarchical medical system suitable for treatment of complicated life-threatening illness. Barriers are complicated, interrelated, and situational. The solutions suggested are 1) informing the health community and mobilizing medical leadership, 2) defining and treating the FP seeker as a client and not a medical patient, and 3) engaging in more epidemiological research to assess the risk/benefits of contraceptive use and operations research to evaluate ways to reduce medical restrictions. The position that obstacles are an example of quality of care does not support the Bruce-Jain FP quality of care framework. Health and FP services may be integrated but contraceptive usage should not be at the expense of health care. The obstacles are not just in developing countries where it would appear that access to FP far outweighs the risks of maternal mortality from pregnancy. Providers are not the target is creating a win-win-win situation for the client, the provider, and organized public health.
 ...
PMID:Medical barriers to access to family planning. 809 86

Associations between hypertension and cardiovascular complications of diabetes mellitus in Nigerians, were examined in a cross-sectional study. 20 hypertensive-diabetic patients, 16 hypertensive patients, 10 non-hypertensive diabetic patients and 10 age- and sex-matched healthy controls, underwent M-mode and cross-sectional echocardiography, and Bruce-protocol treadmill exercise performance. Left ventricular (LV) mass indices (+/- SD) were significantly higher in hypertensive patients (164 +/- 12gm-2), diabetic (158 +/- 17gm-2) and hypertensive diabetic patients (125 +/- 129gm-2) compared with normal controls (111 +/- 17gm-2) p < 0.01. However, the LV mass index in the hypertensive-diabetic patients was significantly less than in hypertensive (p < 0.05) or normotensive diabetic patients (p < 0.05). Systolic cardiac contractility measured as fractional fibre shortening, was preserved in the hypertensive patients (24 +/- 4%) compared with the healthy controls (23 +/- 4%), but was depressed in diabetic patients (19 +/- 3%) and to a greater extent in the hypertensive-diabetic patients (15 +/- 4% p < 0.01). Treadmill exercise tolerance time was reduced independently in hypertension (309 +/- 73 seconds) or diabetes (321 +/- 119 seconds), p < 0.05, but was further impaired in hypertensive-diabetic patients (289 +/- 110 seconds) p < 0.01 compared to the healthy controls (490 +/- 156 seconds). The patients with hypertension and diabetes had a greater degree of proteinuria (p < 0.001) and a higher frequency of retinopathy (p < 0.001), in comparison to those with hypertension or diabetes alone.
 ...
PMID:A cross-sectional study of echocardiographic indices, treadmill exercise capacity and microvascular complications in Nigerian patients with hypertension associated with diabetes mellitus. 147 33

The prognostic value of the exercise testing as well as coronary risk factors was assessed in 890 patients (pts) with a history of myocardial infarction (MI, n = 114) or chest pain (typical angina; TA, n = 134, others; OTH, n = 642) in relation to cardiac events (cardiac death, non-fatal MI). Clinical questionnaires and symptomatic-maximal graded treadmill exercise were performed in all pts. Follow-up was obtained prospectively by mail or telephone interview annually. Twenty eight pts were lost to follow-up. In the remaining 862 pts (96.9%), the mean follow-up duration was 3.1 +/- 1.4 (mean +/- SD) years. During follow-up period, 39 cardiac events (21 cardiac death, 18 non-fatal MI) (4.5%) occurred. Cardiac event rates in pts with MI, TA, and OTH were 16.2%, 9.8%, and 1.3%, respectively. Univariate analyses revealed that the event rate was influenced by age, sex (male), hypertension, diabetes mellitus, and HDL-cholesterol among coronary risk factors, and by anginal pain during exercise, ST depression, poor exercise tolerance, and abnormal blood pressure response among treadmill exercise findings. By Cox proportional hazard model analysis, the history of MI, age, TA, and ST depression (within 6 minutes of Bruce protocol) was significantly independent predictors for future cardiac events in all pts; and age, sex, and TA in pts without MI. In conclusion, the exercise testing combined with conventional coronary risk factor analysis was effective means in predicting future cardiac events.
 ...
PMID:[A prospective study of future cardiac events in subjects who underwent treadmill exercise testing]. 260 49

We tried to establish the incidence of silent myocardial ischemia (SMI) in the general population and also in patients with recognised ischemic heart disease. For this, purpose 2, 375 stress tests (ST) with Bruce protocol were reviewed, 364 were positive and those patients were divided in two groups: group I with SMI during the ST and group II with myocardial ischemia and angina during the ST. Coronary risk factors ergometric behaviour and angiographic factors were analysed. Group I had 263 patients with SMI (71%). Group II had 111 patients with ischemia and angina (29%) P less than 0.05; 90 patients had diabetes mellitus in group I and 19 in group II P less than 0.05. A previous myocardial infarction was registered in 157 patients from group I and 55 from group II P less than 0.05. The remaining coronary risks factors, ergometrics variables and significance and number of diseased coronary vessels were similar in both groups. We conclude that SMI is a frequent event in patients with ischemic heart disease. It represents probably the most frequent event in this disease. Previous myocardial infarction and diabetes mellitus may play an important role in the pathogenesis of SMI. The ST and Holter monitoring are dependable procedures for the identification of SMI and should be always performed specially in patients with high coronary risk factors. Once detecting SMI a therapeutic plan should be considered for medical, angioplastic or surgical procedures even in asymptomatic patients.
 ...
PMID:[Silent myocardial ischemia: a problem in diagnosis and treatment]. 262 2

We have compared left ventricular function in 40 insulin-dependent diabetic patients (30 male, 10 female) aged 16-30 years (mean 23 years) with duration of diabetes 3 months to 25 years (mean 10 years) with 19 healthy age and sex-matched controls using radionuclide ventriculography at rest, during cold-pressor stimulation, isometric exercise, and dynamic exercise. There were no differences in exercise or smoking habits in the two groups. All subjects had a normal resting electrocardiogram and a normal electrocardiographic response to dynamic exercise using the Bruce protocol on the Marquette Computer Assisted System of Exercise. Left ventricular ejection fraction was similar at rest and fell in diabetics and controls, respectively, by 2.3 +/- 1.0% and 3.0 +/- 0.08% (NS) and by 2.4 +/- 0.8% and 2.2 +/- 0.8% (NS) during isometric exercise, and cold pressor testing. During supine dynamic exercise on a bicycle ergometer ejection fraction rose in both groups by 13.9 +/- 1.7% and 13.7 +/- 1.6%, respectively (NS). No statistically significant differences were found in peak ventricular filling and emptying rates and abnormalities of regional wall motion did not develop. Two female patients with diabetes for more than 10 years had an abnormal response to dynamic exercise manifested by a fall in ejection fraction. In comparison to the higher frequency of abnormalities reported in diabetics using echocardiography and the measurement of systolic time intervals, abnormal left ventricular function assessed by radionuclide ventriculography is uncommon in young patients.
 ...
PMID:Cardiac function and insulin-dependent diabetes: radionuclide ventriculography in young diabetics. 295 Oct 77

We reviewed the records of 2,400 consecutive patients undergoing cardiac catheterization at USAF Medical Center Keesler between 1978 and 1984 and found 35 patients (1.5 percent of all cardiac catheterizations) aged 35 years or less (mean age, 32 years) who underwent cardiac catheterization after myocardial infarction. These 35 patients (group 1) were compared to a randomly selected group of 100 patients (group 2) aged 55 years or greater who underwent cardiac catheterization for evaluation of coronary artery disease during the same period. The two groups were compared in terms of angiographic features and risk factors for coronary artery disease. The patients in group 1 had a higher proportion of normal coronary arteries (14 percent [5 patients] vs 0; p less than 0.01) and single-vessel disease compared to group 2, while the incidence of three-vessel disease was much less (14 percent [5] vs 47 percent; p less than 0.001). Involvement of the left main coronary artery was uncommon in group 1 (3 percent [1] vs 15 percent in group 2; p less than 0.01). Risk factor analysis revealed smoking to be the most common risk factor in both groups (89 percent [31] in group 1 and 91 percent in group 2). Hypertension (28 percent [10] vs 48 percent; p less than 0.05) and diabetes (3 percent [1] vs 23 percent; p less than 0.01) were more common in group 2. Importantly, of 19 patients in group 1 who underwent cardiac catheterization for prognosis despite being asymptomatic and able to reach at least stage 4 on a Bruce protocol exercise test, none was found to have residual surgically correctable disease.
 ...
PMID:Myocardial infarction in the young. Angiographic features and risk factor analysis of patients with myocardial infarction at or before the age of 35 years. 318 Aug 96

Eight insulin-dependent adolescents (4 boys, 4 girls) participated in an 8-wk program of supervised exercise, and 8 matched controls were encouraged to exercise on their own without supervision. All 16 subjects were asked to follow a standard ADA diet plan, kept a self-reported log of caloric intake, and met with a dietitian weekly to review their diets. Exercise for the supervised subjects was scheduled between the routine afternoon snack and the evening meal, and subjects were asked not to consume additional food on exercise days. After the 8-wk program, glycemic control, as measured by glycosylated serum albumin and blood glucose values (but not by glycosylated hemoglobin), improved in the supervised-exercise group despite reduced daily insulin dosage. Cardiorespiratory fitness, as measured by voluntary maximum treadmill time (Bruce protocol) and submaximal exercise heart rates, also improved. No changes were observed in the unsupervised control group.
Diabetes Care
PMID:Improved glycemic control after supervised 8-wk exercise program in insulin-dependent diabetic adolescents. 331 15

A 26-year old white male with Prader-Willi syndrome (PWS) and non-insulin-dependent diabetes mellitus presented with asymptomatic bilateral lower limb swelling. An electrocardiogram was consistent with an inferior wall myocardial infarction of unknown age and a graded exercise test using the Bruce protocol was consistent with inferolateral ischemia. Subsequent cardiac catheterization showed severe, inoperable, three-vessel coronary artery disease. Atherosclerotic coronary artery disease in PWS has been documented only once in the literature, and then only postmortem. This case provides further (and for the first time, premortem) documentation that premature atherosclerotic coronary artery disease may play an important but presently unrecognized role in the morbidity and mortality in PWS.
 ...
PMID:Premature coronary artery atherosclerosis in a patient with Prader-Willi syndrome. 368 25

In the practice of diagnosing occupational deafness resulting from noise effects of factors determining workers' hearing, such as living conditions, working conditions, nutritional and other habits, diseases and their therapy, are often neglected. Discussed in the paper are the significance and ototoxic effects of such factors as: aminoglycoside antibiotics, diuretics, salicylic acid derivatives, fenacetin, quinine, fluorine compounds, cytotoxic drugs, chemical compounds other than drugs (carbon monoxide, carbon disulphide, lead, organic solvents), ethyl alcohol, diseases (abdominal typhus, bacillary dysentery, diphtheria, brucellosis, epidemic parotiditis, poliomyelitis, rubella, aural shingles, syphilis, diabetes mellitus, chronic renopathies, hypothyroidism, serologic conflict, pigmentary retinitis). Exposure to intense noise is more and more frequently juxtaposed with the impact of the mentioned factors. If industrial physicians get aware of this association the prevention of deafness and reliability of treatment may be largely promoted.
 ...
PMID:[Ototoxic factors requiring consideration in the diagnosis of occupational hearing loss]. 390 48

This study was conducted with asymptomatic middle-aged male subjects with diabetes mellitus to detect latent cardiac disease using noninvasive techniques. One group of 38 diabetic males (mean age 50.5 +/- 10.2 years) and a group of 15 normal males (mean age 46.9 +/- 10.0 years) participated in the initial trial; 13 diabetic patients and 7 control subjects were restudied 1-2 years later. Maximal treadmill exercise with a Bruce protocol and myocardial scintigraphy with thallium-201(201Tl) were used. Diabetic subjects on initial examination and retesting achieved a lower maximal heart rate and duration of exercise than control subjects. Abnormal electrocardiographic changes, thallium defects, or both were observed in 23/38 diabetic males (60.5%) on the first study and only one 65-year-old control subject had such findings. On retesting, the control subjects had no abnormalities while 76.9% of diabetic subjects had either 201Tl defects or ECG changes. We conclude that despite the fact that none of diabetic males had any clinical evidence or symptoms of heart disease, this high-risk group demonstrated abnormalities on exercise testing that merit careful subsequent evaluation and followup and could be an effective method of detecting early cardiac disease.
 ...
PMID:The significance of repeated exercise testing with thallium-201 scanning in asymptomatic diabetic males. 407 7


1 2 3 4 5 Next >>