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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An increasing incidence of endometrial cancer caused by a higher life expectancy and a number of other facters (i.e. obesity, diabetes, hypertension, lower pregnancy rate) as well as the unfavorable location for early detection when compared with cervical cancer has initiated this review in order to single out women with increased risk. Clinical characteristics of patients with endometrial cancer represented by age, menstrual disorders, reduced fertility, obesity, diabetes, hypertension, hirsutism, hyperplasia of the ovarian stroma or hilus cells in connection with an increased oestrogen effect in the vaginal smear and proliferative changes of the endometrium can be explained by extraglandular respectively peripheral aromatization of androgens to oestrogens, particular by the conversion of androstenedione to oestrone. This is supported by an increased plasma oestrone/oestradiol-ratio and increased conversion rate with age and overweight. In vivo- and in vitro-investigations have demonstrated the participation of adipose tissue in peripheral oestrogene production. The compiled data point towards the importance of the extraglandular oestrone production for the etiology of endometrial cancer by effecting the endometrium over a long period of time. The counter action of the normally cyclic changes of oestradiol and progesterone is lacking. Therefore, a dysoestrogenic effect of oestrone upon the endometrium can be fully effective, depending on the hormone receptor content of the respective endometrium. Based upon these data including recent publications, pre- and postmenopausal oestrogen therapy has to be critically reevaluated.
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PMID:[Endometrial cancer and extraglandular oestrogen biosynthesis (author's transl)]. 32 98

To evaluate the efficacy of coronary bypass surgery in reduction of sudden death, the prognosis of 286 similar patients with multivessel coronary stenosis was studied prospectively and the results of medical therapy (Group I, 114 patients) were compared with those of surgical therapy (Group II, 172 patients) after cardiac catheterization and coronary arteriography. During 39 months' evaluation of both groups, mortality from congestive heart failure and noncardiac causes did not differ (Group I, 14 percent; Group II, 8 percent) (P greater than 0.05). Sudden was evaluated in the remaining 217 patients (Group I, 96; Group II, 121 patients) who were matched for age (Group I, 52 years; Group II, 51 years); duration of overt coronary disease (Group I, 3.8 years; Group II, 4.0 years); angina pectoris (Group I, 83 percent; Group II, 95 percent); prior myocardial infarction (Group I, 77 percent; Group II, 74 percent); and congestive heart failure (Group I, 30 percent; Group II, 23 percent) (all P greater than 0.05). In addition, the prevalence of coronary risk factors was the same (P greater than 0.05) in both groups (hypertension, cigarette smoking, diabetes mellitus, lipid abnormalities and family history of coronary disease). Importantly, arteriography and catheterization established a similar extent and location of major coronary arterial stenoses and of ventricular dysfunction; two vessel disease (Group I, 32 percent; Group II, 33 percent) and three vessel disease (Group I, 68 percent; Group II, 67 percent); left ventricular end-diastolic pressure (Group I, 13; Group II, 14 mm Hg);cardiac index (Group I, 2.85; Group II, 2.91 liters/min per m2); and coronary collateral vessels (Group I, 58 percent; Group II, 61 percent) (all P greater than 0.05). Fifty-six percent of patients in Group II had multiple bypass grafts and a late patency rate (average 21 months) of 87 percent of one or more grafts. During subsequent prospective evaluation of over 3 years, bypass surgery provided greater symptomatic benefit of improved functional capacity (Group I, 12 percent; Group II, 69 percent) (P less than 0.05) and complete anginal relief (Group I, 30 percent; Group II, 60 percent) (P less than 0.05). Moreover, bypass surgery was associated with marked reduction in sudden death (Group I, 24 percent; Group II, 6 percent) (P less than 0.05). Thus, in patients with multivessel coronary disease carefully matched for clinical factors, hemodynamics, atherogenic precursors and coronary pathoanatomy, effective aortocoronary bypass surgery appeared to prolong survival by decreasing the incidence of sudden death, possibly by a decrease of unexpected fatal arrhythmias.
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PMID:Improved longevity due to reduction of sudden death by aortocoronary bypass in coronary atherosclerosis. 32 59

Some hypothesized risk factors in chronic open-angle glaucoma were investigated in a sample of 87 patinets with glaucoma and 87 matched controls. A significant positive association was found with diabetes, a systolic blood pressure/intraocular pressure (BP/IOP) ratio less than 5.75, and the taking of medication for systemic hypertension. No significant association was found with a history of smoking or an elevated systemic blood pressure. Analysis indicates that the systolic BP/IOP index may be useful as a screening test for the detection of glaucoma in samples where the prevalence of glaucoma is high.
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PMID:Relative risk factors in chronic open-angle glaucoma: an epidemiological study. 32 56

For a population-based, case-control study of cancer of the endometrium in Greater Boston from 1965 through mid-1969, 440 cases were drawn from nearly all hospitals in the area; controls were drawn at random from the general population. The age-adjusted incidence rate was 18.1/100,000 woman-years, with a peak at ages 55-59 and a gradual decline thereafter. Information was provided from 212 cases and 1,198 controls by mall questionnaire. A trend of reduced risk of endometrial cancer with increased parity was noted, the relative incidence (RI) for multiparous women being 0.3 compared to a RI of unity for married nulliparous women. The association of risk with age at first birth was irregular. Early menarche (RI=1.6) and late menopause (RI=1.7) were associated with increased risk of disease. Endometrial cancer risk was also found to be directly related to socioeconomic status, relative weight, diabetes, hypertension, and arthritis. The findings supported the idea that hormone activity during, and perhaps after, reproductive life is an important cause of this disease.
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PMID:Epidemiology of endometrial cancer. 33 20

The therapy of gout is discussed taking into consideration the concomitant diseases occurring significantly frequently in patients with gout: Hypertension, uric acid-nephrolithiasis, hyperlipoproteinaemia, obesity, premature arteriosclerosis as well as diabetes mellitus. In contrast to other opinions the authors are of the opinion that the dietetic treatment is furthermore of essential importance. It is referred to the still allowed sufficiently great number in the supply of nourishment, in which cases, however, the limitations in the supply of calories, protein or purin bodies, respectively, lipid and carbohydrate do not remain unmentioned. The propositions for the medicamentous treatment essentially correspond to the central therapeutic recommendations. For the acute attack of gout, however, following to the international experiences, the colchicine therapy is more emphasized again. The medicamentous therapy of the asymptomatic hyperuricaemia is to be included into the considerations after full exhaustion of all dietetic and other possibilities in constant increase of the serum-uric acid-level more than 8 mg/dl.
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PMID:[Therapy of gout]. 33 84

The incidence of cardiovascular risk factors was studied in 83 renal transplant recipients: 84.3% showed at least one cardiovascular risk factor, hyperuricaemia was found in 42.2%, hypertension in 39.7%, hypercholesterolaemia in 31.3%, hypertriglyceridaemia in 27.7%, diabetes mellitus in 19.3%, obesity in 14% and nicotine abuse in 13.2% of the patients. Patients aged from 30 to 39 and 40 to 49 showed a mean incidence of 2.7 and 2.9, respectively out of the 7 investigated cardiovascular risk factors. The results demonstrate that renal transplant patients are a high-risk group for the development of degenerative cardiovascular diseases.
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PMID:[Frequency of cardiovascular risk factors in renal transplant patients (author's transl)]. 35 73

This paper reviews and discusses the evidence supporting the involvement of defective fibrinolysis in the pathogenesis of atherosclerosis, with emphasis on diabetes mellitus. According to the literature, defective fibrinolysis has been observed in association with virtually every major "risk factor" for coronary heart disease, including diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, hypertension, obesity, cigarette smoking and lack of physical exercise. The interrelationships between disturbances in carbohydrate and fat metabolism and fibrinolysis are considered. Attention is drawn to the need for increased clinical attention to the potential role of defective fibrinolysis in atherogenesis, and periodic assessments of the fibrinolytic status are suggested as a promising approach toward early recognition of atherosclerotic tendency and risk. The judicious use of physiologic, dietary and pharmacologic means to correct defective fibrinolysis prophylactically and for the treatment of some forms of atherosclerosis is advocated.
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PMID:Fibrinolysis and risk factors of atherosclerotic disease, with special emphasis on diabetes mellitus. 35 70

Progress in our understanding diabetic angiopathy has been slow, but we are now learning a number of lessons of interest to the cardiologist. Diabetic angiopathy is a collective term for conditions specific to the diabetic state and related to its duration more than to patient age. The angiopathy produces calcification of the media of larger arteries, but its major effects are in the microcirculation. Intense interest in one feature, skeletal muscle capillary basement membrane thickening, has dominated the last decade. Capillary basement membrane thickening, while characteristic of diabetes, is associated with little direct impairment of the microcirculatin. It appears to play no role in the pathogenesis of diabetes itself. The pathology of diabetic retinopathy and diabetic nephropathy suggests that arteriolar changes may be the major mediator of diabetic angiopathy. This concept is supported by the interactions between hypertension and diabetes in the eye and kidney. The course of diabetes of youthful onset differs from that of maturity onset. The relative frequency of diabetic angiopathy is higher, and of atherosclerotic complications is lower. This has made it difficult to demonstrate the potential value of preventive measures. Benefit to one type of problem may become hidden by worsening of the other. If the diabetic benefits from what is learned about how ischemic heart disease risk can be reduced, he will require even more effective management to prevent or control diabetic angiopathy.
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PMID:Diabetic angiopathy--its lessons in vascular physiology. 35 70

Extensive evaluation of a small series of potential renal donors has revealed an alarming rate of previously unsuspected disease precluding acceptability for renal donation. Of 19 patients considered for donation at the Medical University of South Carolina, 15 were unsuitable for medical reasons (diabetes mellitus, multiple sclerosis, sickle cell trait, hypertension, polycystic kidneys, duodenal ulcer, pulmonary disease), psychologic reasons, or changes on renal arteriography consistent with nephrosclerosis. The importance of a thorough donor evaluation including total patient awareness of the risks involved for both himself and the recipient and extensive psychologic testing is stressed. Even with strict criteria for renal donation, this high rejection rate is surprising.
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PMID:Frustrations in renal donation. 36 Apr 3

Twenty-one insulin-dependent diabetics with azotemic nephropathy were evaluated for renal transplantation by selective coronary angiography and cine left ventriculography. All had hypertension, retinopathy, neuropathy, and required salt restriction plus diuretics for volume overload. There was no clinical or electrocardiographic evidence of ischemic coronary artery disease in twenty. Ten patients (five males, five females, mean age 29.3 years; mean duration of diabetes 21.9 years; mean serum cholesterol 239 mg%) had significant coronary artery disease, seven demonstrating focal abnormalities in left ventricular wall motion. Two patients (one male, one female; mean age 36.5 years; mean duration of diabetes 28.5 years; mean serum cholesterol 250 mg%) had no significant coronary artery disease, but demonstrated diffusely abnormal left ventricular wall motion with diminished ejection fraction. Thirty-eight percent had significant coronary artery disease unpredictable by electrocardiographic or clinical data. The finding of no significant coronary artery disease in 52% of a group with severe renal-hypertensive complications of diabetes is surprising. Two patients may have a demonstrated cardiomyopathy.
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PMID:Asymptomatic coronary artery disease: angiographic assessment of diabetics evaluated for renal transplantation. 36 Dec 77


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