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Query: UMLS:C0011849 (diabetes)
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142 patients with endometrial cancer, and an equal size control group, were compared in regard to age, obesity, diabetes, hypertension, vaginal cytology, and endometrial histology. In a 2nd study, 335 patients with endometrial cancer were treated with abdominal hysterectomy, bilateral salpingo-oophorectomy, and radiation applications. In an experimental study, the percent of conversion of androstenedione to estrone in subcutaneous adipose tissue in 20 patients was studied using an in vitro method. The 1st clinical study showed that the frequency of diabetes, hypertension, the estrogen effect in the vaginal smear, and proliferative changes in the endometrium were significantly higher than in the control group. Obesity was also more frequent. The 2nd clinical study showed a survival rate of more than 5 years in certain parameters. The experimental in vitro study showed a higher aromatization of androstenedione to estrone in cancer patients, indicating etiological correlations between endometrial cancer and extraglandular estrone production.
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PMID:Estrogens and endometrial cancer: aspects of etiology and survival rate. 102 Oct 8

To test a methodology that used role-playing responses by nurses to simulated patient disclosures, a three-part investigation was carried out at Vanderbilt University, Nashville, Tennessee. Four simulated patients-with diagnoses of diabetes mellitus, alcoholism with bleeding ulcer, ulcerative colitis, and cancer of the large intestine-tape recorded 20- to 30-second segments on 12 topics pertaining to their illness. Six topics dealt with the patients' physical problems; six with psychological aspects of the problems. In the tests for nurses' willingness both to listen and to pass along information to the next nurse, the 48 tape-recorded segments of patient information were played for 16 volunteer nurses in a laboratory set up for the purpose. Although the nurses had an option of listening or preparing a medication, they were expected to listen to at least 16 of the 48 segments. Following this, they were asked to tape record a report on the patient for the nurse who would follow them. The nurses, on average, listened to 29 of the 48 segments. The diabetic patient was listened to least; the cancer and the colitis patients each received a similar amounts of attention. The nurses gave substantial amounts of information as well as interpretive data about the patients so that the methodology seemed to prove that nurses could become sufficiently involved in a simulated patient setting.
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PMID:A role-playing simulation approach toward studying nurses' decisions to listen to patients. 103 15

A 64-year-old black man presented with the syndrome of acanthosis nigricans and insulin-resistant diabetes mellitus requiring up to 3000 units of insulin per day. The patient's plasma contained circulating antibodies to insulin receptors thought to be responsible for the insulin resistance. The marked insulin resistance, the manifestations of acanthosis nigricans, the evidence of immunologic dysfunction by the absence of expected circulating antibodies to insulin, and the demonstration of circulating antibodies to insulin receptors put this patient in Kahn's category B of insulin resistance and acanthosis nigricans. There was no evidence of malignancy, lipodystrophy, or endocrine abnormality. The occurrence of acanthosis nigricans with insulin resistance due to binding of cell membrane insulin receptors by antibodies has been reported exclusively in women. This case report is the first description of a male patient with the syndrome of insulin resistance and acanthosis nigricans and focuses attention on features that might mislead one to suspect other causes of insulin resistance.
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PMID:Insulin resistance and acanthosis nigricans. Report of a case with antibodies to insulin receptors. 108 35

TAKING INTO ACCOUNT AGE, SEX, GEOGRAPHICAL DISTRIBUTION, OBESITY, AND ASSOCIATED CAUSE OF DEATH, IT WAS CONCLUDED THAT: (1) the extent of aortic calcification was much lower in cerebral haemorrhage than in cerebral infarct. In deaths due to cerebral haemorrhage aortic calcification was at about the same level as in those due to cancer of the stomach, while in deaths due to cerebral infarct it was at the same level as in those due to coronary heart disease; (2) the prevalence of large myocardial scar was low in deaths due to cerebral haemorrhage (at about the same level as in those due to prostatic cancer), while in deaths due to cerebral infarct it was more frequent (at the same level as in deaths due to diabetes); (3) the extent of coronary calcification and prevalence of coronary stenosis and fresh myocardial infarction were low in the cerebral haemorrhage and cerebral infarct deaths, but a little lower in the former; and (4) the extent of raised lesions of the aorta and coronary arteries was similar in the cerebral haemorrhage and cerebral infarct deaths, the level of aortic lesions being high and overlapping in level with those in the coronary heart disease and hypertensive deaths, and the levels of coronary lesions being much lower and well below those in the coronary and diabetic hypertensive deaths.
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PMID:Atherosclerosis and myocardial lesions in subjects dying from fresh cerebrovascular disease. 108 1

The relative extent of raised and calcified coronary aortic lesions, prevalence of coronary stenosis and of fresh and old myocardial infarction, and mean heart weight were expressed on a continuous scale for 4 disease groups (coronary heart disease, cerebral infarction/haemorrhage, hypertension/diabetes, cancer). Within these groups the relative position for each of the lesions was calculated by subgroups of disease in order to show the elevating or depressing effect of hypertension, diabetes, obesity, and combinations of disease. The strength of association between 33 factors (town 5, disease 24, obesity, heart weight, age, and sex) and the lesions was calculated. An analysis of variance was carried out and the proportion of the variance of the different lesions accounted for by town, disease, etc., is shown. The extent of raised aortic lesions is strongly associated with age and hypertension. It is positively associated with coronary heart disease and inversely associated with cancer. Town factors have a small positive association which is larger than that due to obesity. 33 factors taken together account for 50% of the variance. Age alone accounts for 37% and sex for only 0.3%. The extent of calcified aortic lesion is strongly associated with age, town, hypertension, coronary heart disease and diabetes mellitus. It is inversely associated with cancer, more strongly in cancer of the bronchus and the liver than in other cancers. It is inversely associated with obesity. 33 factors together account for 30% of the variance and age alone accounts for about 13%. The extent of raised coronary lesions is strongly associated with age, coronary heart disease, sex, diabetes mellitus, hypertension and obesity. It is inversely associated with cancer, more strongly in cancer of the prostate and the liver than in other cancers. Town factors have a small association. 33 factors taken together account for about 43% of the variance. Age alone accounts for 25%. The extent of calcified coronary lesions is associated with coronary heart disease and age. There is a low association with hypertension and diabetes, an inverse association with cancer, and a low inverse association with obesity. 33 factors together account for 20% of the variance. Coronary heart disease alone accounts for 12% and age alone accounts for 8%. The prevalence of coronary stenosis is strongly associated with coronary heart disease, age, and sex. There is a small association with town factors, obesity, and hypertension, and an inverse association with cancer. All the factors together account for about 30% of the variance. Coronary heart disease alone accounts for 23% and age 10%.
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PMID:Aortic, coronary, and myocardial lesions in relation to various factors. 108 2

The ability of our implantable pump to provide continuous long-term drug infusion in abulatory animals has been demonstrated. Chronic heparinization has been achieved in the dog for 6 mos. Anticipated complications, hemorrhage and osteoporosis occurred, but not to a prohibitive degree. The successful performance of the pump in these animal studies has led us to plan a clinical trial using the pump for heparin anticoagulation in patients and to investigate employment of the pump in cancer chemotherapy, insulin for the treatment of diabetes, and other purposes.
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PMID:Chronic heparin anticoagulant in dogs by continuous infusion with a totally implantable pump. 114 26

Copper IUDs, oral contraceptives, "morning-after' pills and injectables are discussed in general in this review. Small IUDs are less effective, but better tolerated. An exception is the Dalkon shield, which is no longer manufactured because several women died from latent infections when they became pregnant. The Copper T IUD is tolerated much better than the Copper 7, and has only a 3% failure rate. Copper Ts must be replaced every 2 years, however, and are difficult to remove. A beneficial effect of IUDs is cure of uterine adhesions; a subjective side effect if discomfort reported by husbands. Strict contraindications or oral contraceptives are history of cholostatic jaundice of pregnancy, thromboembolism, essential hypertension, tension, diabetes, gynecologic cancer and pregnancy. Relative contraindications are hyperthyroidism, hyperlipidemia, and depression. Depressions occuring soon after starting pills may be due to unconscious rejection; those appearing later may be due to the progestagen itself. The subjective sequelae of pills are more likely in maternal women, women raised to feel guilty for using contraception, women susceptible to believing sensational media reports about pills, and women dominated by their husband's views. Pills are beneficial for essential dysmenorrhea, menstrual irregularity, premenstrual syndrome, depression, frigidity due to fear of pregnancy, uterine hypotrophy, ovarian cyst, certain ovarian dystrophies such as Stein Levinthan syndrome, menopausal symptoms, acne and hirsutism. The morning after pill, 5 mg ethinyl estradiol for 3 consecutive days, is indicated only in exceptional cases such as rape. Injectables are more suitable for those who desire long-term contraception and whose who want no more children. A lower cancer rate has been reported for users of depot progestagens than for women notu sing contraception.
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PMID:[Subjective and objective aspects of modern methods of contraception]. 114 75

The frequency with which diabetes mellitus was mentioned on the death certificates of 18,733 patients dying from bladder cancer has been compared with that of 19,709 patients dying from other cancers (excluding cancer of the lung and pancreas). The estimated relative risk of bladder cancer in diabetics was 0-98 with 95% confidence limits 0-70-1-38. There was no increase in risk of bladder cancer in patients with diabetes of long duration. Diabetics were shown by questionnaire to consume substantially more saccharin than non-diabetics, and the duration of regular saccharin use by diabetics was highly correlated with the duration of diabetes. There was therefore no evidence from this study that consumption of above average amounts of saccharin had led to bladder cancer in diabetics. The proporation of current smokers among diabetics was significantly less than among non-diabetics, and this may account for a low relative risk of lung cancer in the former (0-72).
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PMID:Bladder cancer mortality in diabetics in relation to saccharin consumption and smoking habits. 118 56

In 1972 and 1973 altogether 130 women were treated with hormones and cytostatic drugs for progressive, metastasizing breast carcinoma. 30 of them also had subclinical or manifest diabetes mellitus. Clinical analysis indicated that metastasizing cancer of the breast in women who also have diabetes took a protracted course. Survival timed from the moment of operations, as well as from the occurrence of the first metastases, were significantly longer in women with than without diabetes. Those with a familial predisposition towards cancer of the breast were, however, not within the tested groups. It is possible that women with cancer of the breast and diabetes are also a favourable group for trying hormone therapy: in 18 of 24, hormones induced remissions, but in only less than one third of all the other patients.
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PMID:[Metastasizing carcinoma of the breast and diabetes mellitus, a prognostically favourable combination (author's transl)]. 118 56

During the two and a half year period from January 1971 through Jyly 1973, 23 patients had cultures positive for candida from intra-abdominal isolates. Most of these patients had intestinal or biliary fistulas or abscesses and were seriously ill. Major contributing factors to the development of candidal infections included the extensive use of multiple antibiotics, multiple operations, advanced age, and debility. Thirty additional patients had cultures positive for candida from skin and subcutaneous isolates. Candida appeared to contribute to the poor healing of wounds in some of these patients, particularly those with peripheral vascular ischemic lesions and decubitus ulcers. Antibiotics and concurrent diseases, such as diabetes, cancer, renal failure, and cardiovascular disease, were common factors relating to the development and growth of candida in these patients. There is often considerable difficulty in determing whether or not candida is only a contaminant or is an infectious agent contributing to the illness of the patient. This must be determined in each individual instance. In spite of the fact that candida appeared to be a significant infectious agent in many of these patients, specific antifungal therapy was used sparsely. It is suggested that appropriate antifungal drugs be used in patients with significant disease and that there should be greater awareness of the factors leading to the development of these extremely serious candidal infections.
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PMID:The importance of candida as an infectious agent. 120 74


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