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)

Using data from death certificates, we compared underlying causes of death for two populations of Michigan decedents: (1) persons 40 years of age and older for whom Parkinson's disease (PD) was listed as a contributing cause of death and who died in the years 1970 through 1989, and (2) all persons in Michigan over 40 years of age who died in 1970, 1980, or 1990. PD decedents were approximately 1.5 times more likely to die from cerebrovascular disease and three to four times more likely to die from pneumonia/influenza, but they had just 29% of the expected number of deaths due to cancer. These associations were maintained irrespective of gender or race. PD decedents had diabetes mellitus and heart diseases as frequently as decedents in the general population, but liver diseases were less frequent among PD decedents. These trends held throughout the 21-year study period. When we stratified cancers by whether they are known to be (1) highly related, (2) moderately related, or (3) weakly related or unrelated to smoking, there were still 2.5 times fewer cancers unrelated or weakly related to smoking among PD decedents than among decedents in the general population. We believe that the greater frequency of cerebrovascular disease in PD decedents may be due to a detection bias, since PD patients are more likely to be seen by neurologists, who are more apt to diagnose and document diseases of the nervous system. Pneumonia/influenza is more common among PD patients because of their relative immobility near the end of life.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Parkinson's disease and its comorbid disorders: an analysis of Michigan mortality data, 1970 to 1990. 793 38

Inferences regarding causes of birth defects in humans are often based on results of case-control studies conducted after birth. To address bias in these studies caused by potential differential recall of past exposures between case and control mothers, many investigators have advocated the use of affected controls (babies with birth defects other than the one of interest). To evaluate whether the use of affected controls is warranted for a wide range of scenarios, we analyzed data from a population-based case-control study of birth defects in Atlanta, in which there were 4,918 babies with serious defects ascertained in the first year of life and 3,029 babies without defects. We compared the magnitude of the odds ratios for 10 specific defects--risk factor associations between normal and affected controls. These associations included demographic factors (e.g., advanced maternal age and Down syndrome), chronic maternal illnesses (e.g., diabetes and cardiac defects), chronic exposures (e.g., multivitamins and neural tube defects), and acute exposures (e.g., flu and neural tube defects). In all instances, the use of affected controls did not change etiologic inferences derived from using normal controls and there were only moderate changes in odds ratios. On the basis of theoretical considerations, we show that recall bias can lead to spurious inferences only under extreme conditions. We conclude that concerns about recall bias are overrated in birth defects studies and that the use of normal controls is acceptable unless evidence of substantial recall bias exists.
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PMID:On the use of affected controls to address recall bias in case-control studies of birth defects. 807 66

Analysis of annual and seasonal incidence of insulin-dependent diabetes mellitus in children living in 4 Russian cities in the 1980s has shown only four rises of annual morbidity in three cities, but only one of them recorded in 1983 in Moscow conformed to the criteria of an epidemic outbreak of the disease. The incidence of the disease predominated by 29% in autumn-winter, though there was no clear-cut correlation between diabetes incidence, on the one hand, and incidence of influenza and acute respiratory diseases, on the other.
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PMID:[Epidemic outbreaks of insulin-dependent diabetes mellitus]. 810 48

The study describes 156 consecutive cases of pneumococcal bacteraemia among patients admitted to Hvidovre Hospital during the five-year period 1986-1990. Pneumococcal bacteraemia was most common in the age groups 0-4 and 50-99 years. The most common focus of infection was the lungs (84%). 81% had preexisting diseases and the most common were: Immunosuppression due to drugs, alcoholism, cardiovascular disease, chronic obstructive lung disease, diabetes and myelomatosis. Patients over 65 years of age had a higher case fatality (35%) than younger (12%). The overall case fatality rate was 24%. Twenty-three percent of cases were hospital-acquired, and associated with a case fatality of 37%. Pneumococcal bacteraemia was most common during the winter season and unrelated to influenza. Eighty-four percent of the examined isolates represented capsular types included in the 23-valent pneumococcal vaccine. Three percent of the tested strains were relatively resistant to penicillin (MIC > 0.1 microgram/ml). Despite antibiotic treatment, the mortality from pneumococcal bacteraemia, particularly in elderly, remains high. With this in mind, one may consider offering pneumococcal vaccination to persons over 65 years of age with chronic predisposing diseases.
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PMID:[Pneumococcal bacteremia in Hvidovre Hospital 1986-1990]. 825 59

Pneumonia and influenza (P&I) are the sixth leading cause of death in the United States, and persons aged > or = 65 years and persons with chronic conditions (e.g., lung or heart disease, diabetes, or cancer) are at greatest risk for P&I. During major epidemics, hospitalization rates for persons at highest risk may increase twofold to fivefold. However, only 30% of persons aged > or = 65 years responding to CDC's National Health Interview Survey for 1989 reported having received the influenza vaccine during the previous year. In 1988, the Health Care Financing Administration (HCFA) and CDC began a congressionally mandated 4-year demonstration project to evaluate the cost-effectiveness to Medicare of providing influenza vaccine to Medicare beneficiaries. This report presents final results of the Medicare Influenza Vaccine Demonstration conducted during 1988-1992.
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PMID:Final results: Medicare influenza vaccine demonstration--selected states, 1988-1992. 833 91

Current levels of influenza vaccine uptake in patients considered to be at high risk have been determined by means of a questionnaire survey. During March-April 1992, information was sought from 624 patients in Leicestershire, UK with either chronic cardiovascular or respiratory disease, or diabetes; questions related to current health status and the request, offer and receipt of influenza vaccine in the current and three previous seasons. Ninety-eight percent of all offers of immunization were made in the primary care setting, and vaccine was well tolerated as judged by the fact that 86% of vaccinees between 1988/9-1990/1 returned for immunization in the following year. However in the 1991/2 season the overall level of vaccine uptake was only about 41% which is at variance with the stated policies and practices of general practitioners. Opportunities were missed, in both hospitals and general practices, to publicise and offer immunization to individuals with vaccine indications. Future attempts to improve vaccine uptake should focus on increasing the role of hospital staff in influenza prevention, in addition to promoting better vaccine delivery through primary care.
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PMID:Influenza immunization; vaccine offer, request and uptake in high-risk patients during the 1991/2 season. 840 61

A large body of clinical experience on the adverse consequences of cytokine administration has accumulated since the last decade. Side-effects reported after the therapeutic use of cytokines has provided evidence that activation of the immune response may sometimes have deleterious consequences. Several effects appeared as a direct consequence of the immune activation induced by cytokines, e.g. flu-like reactions, vascular leak syndrome. Cytokine-induced exacerbation of underlying diseases or immune dysregulation were other complications of growing concern. Interferon-alpha (IFN-alpha) treatment has now been clearly linked with the exacerbation or the occurrence of several types of autoantibodies or autoimmune diseases (thyroiditis, systemic lupus erythematosus, hematologic disorders, insulin-dependent diabetes mellitus) or diseases involving altered cell-mediated immune functions (inflammatory dermatologic diseases, nephritis, pneumonitis, colitis). By contrast immunological side-effects of IFN-beta and IFN-gamma have been seldom reported. However, the extent of clinical experience with both of these cytokines is still very limited. Interleukin-2 (IL-2) has also been implicated in various conditions that may involve immunopathological processes (thyroid disorders, rheumatoid arthritis, dermatological diseases, interstitial nephritis). Growth factors have been more specifically linked with the development or the exacerbation of dermatological inflammatory diseases through neutrophils, monocytes/macrophages or eosinophils activation (e.g. cutaneous vasculitis and generalized cutaneous eruption, Sweet's syndrome, bullous eruption, psoriasis). Exacerbation of autoimmune thyroiditis was described with granulocyte-macrophage colony-stimulating factor (GM-CSF) only. The immunogenicity of cytokines is also of great relevance and the occurrence of antibodies binding IFN-alpha and IFN-beta, IL2 and GM-CSF have been reported. While the clinical significance of non-neutralizing antibodies is not clearly established, an absence of response or reversal of clinical efficacy has been described in patients developing neutralizing antibodies. Finally, several isolated reports have recently suggested that IFN-alpha treatment may be associated with several immunosuppressive effects while IL-2 is clinically associated with an increased incidence of infectious complications.
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PMID:Immune-mediated side-effects of cytokines in humans. 863 83

Transgenic mice that express the influenza virus hemagglutinin (HA) on pancreatic islet beta cells (ins-HA) demonstrate tolerance of HA even after immunization with influenza virus. Surprisingly, when Ins-HA mice were mated with a transgenic mouse expressing a TCR specific for an epitope of HA that is restricted by MHC class I H-2Kd (Clone-4 TCR), the resulting double transgenic (Ins-HA x Clone-4 TCR)F1 neonates developed spontaneous autoimmune diabetes immediately after birth and died within 10 days. This represents a unique situation in which all safeguards within the immune system that normally maintain tolerance of self-antigens in the neonate are insufficient.
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PMID:CD8(+) T cell-mediated spontaneous diabetes in neonatal mice. 875

This study was designed to determine the effect of Type II diabetes mellitus in older adults on two measures of the cell-mediated immune response to influenza vaccination. Twenty-two elderly persons with diabetes mellitus were compared to 20 healthy seniors, all of whom were living independently in the community. Peripheral blood mononuclear cells (PBMC) were challenged in vitro with live influenza virus, pre-vaccination and 4 and 12 weeks post-vaccination. PBMC culture supernatants were assayed for IL-2 activity as a measure of the helper T-cell response to vaccination. The cytotoxic T-lymphocyte response was determined using an assay of granzyme B activity in PBMC lysates. Initial analysis of the data showed increased IL-2 production in post-vaccination PBMC cultures from the diabetic group compared to the healthy group. However, when vaccination histories were used in an analysis of variance, it was found that the difference between the two groups was related to vaccination history. Study subjects vaccinated one year prior to participation in this study compared to those who had not been previously vaccinated, demonstrated a significantly suppressed IL-2 response to vaccination. Type II diabetes mellitus had no effect on the IL-2 response to vaccination. The granzyme B response to vaccination was not significantly affected by previous vaccination and results were similar for the healthy and diabetic elderly groups.
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PMID:Helper and cytotoxic T lymphocyte responses to influenza vaccination in healthy compared to diabetic elderly. 878 53

Our understanding of carbohydrate-protein interactions has significantly advanced over the past two years. In particular, a healthy amount of literature has appeared on selectins and their relevant ligands. A significant number of carbohydrate-metabolizing enzyme crystal structures have been solved which provide useful starting points for computer-assisted drug design. Some of these proteins have been implicated either directly or indirectly in playing roles in human-disease states, for example, in inflammation, in diabetes and its complications, and in microorganism-induced diseases such as influenza and cholera.
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PMID:Design and synthesis of carbohydrate-based inhibitors of protein-carbohydrate interactions. 891 94


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