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

Clinical, angiological, and biochemical examinations were performed in 981 men and 30 women with organic afflictions of peripheral arteries, and in 411 men and 50 women without any signs of peripheral arterial lesions. Their family histories were thoroughly recorded with particular reference to the occurrence of myocardial infarction, cerebral accidents before and after the age of 60 years, and death of these causes; further, of hypertension, diabetes mellitus, obliterations and gangraenes, in each patient's siblings, parents, and all four grandparents. Furthermore, the significance of positive family history in combination with other risk factors was investigated. Family history can be considered positive with respect to obliterative atherosclerosis when in anyone of the patient's grandparents, parents, or siblings an obliteration of peripheral arteries is present or when anyone of them died of myocardial infarction or apoplexy, especially when aged under 60 years. Presence of several factors in the specified next of kin accelerates the obliterative process in the patient. A positive family history, however, plays no decisive role either alone or in combination with any other single risk factor, but only in combination with two or more other factors, one of which is always tobacco smoking; it is not significant in any combination with obesity.
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PMID:Positive family history as a risk factor of obliterative atherosclerosis. 72 85

Survival of 312 patients with acute myocardial infarction was studied from data collected during the first 48 h in the coronary care unit. Only patients with recent onset of symptoms (48 h), with a 48-h survival, and with evidence of myocardial infarction, were selected. Mortality rate at 1 mth was 15.3% and 24.6% at 6. The following factors were significant for poor survival: increasing age, female sex, diabetes, previous angina, low blood pressure on admission and at the 48th h low average value and the lowest observed value of blood pressure, clinical and radiological left ventricular failure, high level of LDH, increased urea and leukocytosis. Among ECG data, the presence of signs related to extent of infarction, anterior as compared to inferior location, antero-lateral as compared to anterior, QRS frontal axis deviation, absence of sinus rhythm, sinus tachycardia, tachyarrhythmias with wide QRS complex, right bundle branch block, 3rd-degree AV block with wide QRS complex, was associated with significantly worse survival than the absence of these signs. A multivariate analysis of the 42 most significant data, assuming linear regression, was used to establish a discriminant prognostic index. Using this index, survival was predicted correctly in 90.2% of patients at 1 mth and 85.7% at 6 mth. Thus prognosis can be established in nonclear-cut groups of patients with myocardial infarction (severe and benign forms being excluded by criteria) from simple clinical data.
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PMID:Quantitative assessment of myocardial infarction prognosis to 1 and 6 mth--from clinical data. 72

Four hundred sixty patients with ischemic heart disease (IHD) were examined: 226 of them--with myocardial infarction; 38--stenocardia, 196--myocardiosclerosis. With age advancing all forms of IHD increase. The incidence of the followed up risk factors progessively increases. Hypertension has the greatest share--56.30 per cent out of all the subjects examined. Second place as regards incidence is occupied by the emotional stress--46.52 per cent. Further they are as follows: heredity--38.91 per cent; tobacco smoking--34.57 per cent, sedentary life--32,83 per cent, obesity--31.52 per cent, overfeeding--30 per cent, hypercholesterinemia--30 per cent, diabetes--17.61 per cent. The significance of the indicated risk factors alarmingly grows, consideration given to their combined effect. An average of 3.18 risk factors fall on patient. In patients with myocardial infarction they are more frequent and appear at an earlier age. Such an accumulation of the noxae upon the contemporary man requires the complex effors of the whole society.
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PMID:[Risk factors in ischemic heart disease patients]. 73 28

An analysis of the incidence of thromboembolism and heart ruptures with reference to different causative factors was conducted on the basis of 585 patients dying of myocardial infarction during the recent 30 years (autopsy data) and 1417 patients with myocardial infarction (298 mortality cases among them) hospitalized during the recent 10 years. A reduction of the incidence of thromboembolism and an increase of the incidence of heart ruptures in the recent years were revealed. Thromboembolism and heart ruptures play an important role among the causes of mortality in myocardial infarction. The development of thromboembolism in myocardial infarction is favoured by the macro-focal nature of the heart lesion, repeated necroses of the myocardium, localization of infarction in the posterior and posteriolateral zones, old age of the patients (over 60), presence of diabetes mellitus and acute cardiac aneurysm. Thromboembolism occurs with the same incidence rate within the initial 7 days, and later during the acute phase. Thrombi are most often found in the cardiac cavities, pulmonary, renal and splenic vessels, in the cerebral, mesenteric and other vessels. Heart ruptures are favoured by the macro-focal nature of the cardiac lesion, localization of the infarction in the anterior and anteriolateral zones, old age (over 60), presence of acute cardiac aneurysm. Most frequently the ruptures are observed in primary myocardial infarction within the initial 5--7 days of the disease. The use of anticoagulants in myocardial infarction decreases the incidence of thromboembolic complications and heart ruptures.
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PMID:[Thormboembolisms and heart ruptures in myocardial infarct]. 75 50

Myocardial infarct extension after the acute event was defined as a second reise in the myocardial isoenzyme of serum creatine kinase (CK-B) after the initial return of CK-B to normal values. In 43 patients with acute myocardial infarcts, CK-B was measured by radioimmunoassay every 12 hours for 14 days. Nineteen patients had anterior transmural myocardial infarcts AMI, 14 had inferior transmural myocardial infarcts (IMI) and 10 had subendocardial myocardial infarcts (SEMI). Infarct extension as detectd by a second rise in serum CK-B occurred in six patients (32%) with AMI, two (14%) with IMI and two (20%) with SEMI; these differences are not statistically significant. Infarct extension for all patients combined was 23%. Four patients with AMI also had infarct extension as determined by recurrent chest pain. ECG alterations and other enzyme changes. In the other six, the infarct extension was undetected clinically. Four patients with AMI and infarct extension died within 3 weeks after hospitalization. We did not note any additional morbidity or mortality in patients with infarct extension who had IMI or SEMI. There was no significant difference in the frequency of previous myocardial infarction, history of hypertension, diabetes mellitus or smoking history in patients with and without infarct extension shown by serum CK-B isoenzyme elevations. The measurement of serum CK-B values with a quantitative and sensitive assay suggests that myocardial infarct extension occurs more commonly than clinically recognized, but the frequency of extension may be less than that reported in patients in whom precordial mapping and total serum CK values were measured to identify this phenomenon.
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PMID:Detection of myocardial infarct extension by CK-B radioimmunoassay. 75 95

Glucagon is secreted not only by A2-cells of the pancreatic islets but also by A cells in the gastric fundus and duodenum. Several reports have demonstrated that the glucagon plasma concentration is increased in genetic diabetes as well as in many conditions associated with a decreased glucose tolerance such as hepatic cirrhosis, myocardial infarction, infectious diseases, burns, taumatic shock, glucagonomas, acute pancreatitis, acromegaly, pheochromacytoma and Cushing's syndrome. Hyperglucagonemia is particularly important in diabetic ketoacidosis and in non-ketotic hyperosmolar coma. The mechanisms responsible for the diabetic's hyperglucagonemia remain controversial. According to several authors, the increased glucagon secretion is, for its main part, secondary to a prolonged defect in insulin secretion and thus relatively insensitive to an acute insulin administration. According to others, the A cell abnormality is of primary origin, independant from insulin deficiency and its effects are cumulative with those of the insulin lack. Several reports dealing with induced or spontaneous experimental diabetes are in favor of the first or the second hypothesis. It appears likely that glucagon plays a role in the metabolic derangments of diabetes. Indeed, hepatic glucose production is closely related to the ratio of molar concentrations of insulin and glucagon. Finally, in insulin-dependant diabetics, somatostatin infusion reduces plasma glucagon concentration and blood glucose and prevents the development of ketosis after withdrawal of insulin therapy. These results illustrate the contribution of glucagon in the pathogenesis of hyperglycemia and ketosis. Several arguments have been accumulated in favor of the following concept: diabetes hyperglycemia results both from glucose under-utilization secondary to insulin lack and from hepatic glucose over-production due to glucagon excess. Although controversial, the role of glucagon in ketogenesis appears likely.
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PMID:[The role of glucagon in hyperglycemia. A review (author's transl)]. 79 28

Eleven percent of 905 consecutive patients with acute myocardial infarction admitted to the coronary care unit at Duke University Medical Center experienced cardiac arrest. Subgroups of patients at high and low risk for cardiac arrest were identified. Cardiac arrest was experienced by 17 percent of patients with signs of heart failure on admission but by only 3 percent of patients without diabetes mellitus, prior myocardial infarction or heart failure by history or on admission. Only 59 percent of patients with cardiac arrest survived hospitalization compared with 88 percent of those without cardiac arrest. Long-term survival for the 765 hospital survivors was significantly greater in the group without than in the group with arrest at each yearly interval from 1 through 5 years; the 2 year survival rate was 50 and 77 percent, respectively, in these two groups. Many of the deaths among the hospital survivors occurred in patients with signs of heart failure during hospitalization. Among 668 hospital survivors who had mild or no heart failure during hospitalization, cardiac arrest continued to be a significant predictor of mortality. The mode of death among hospital survivors did not differ in the groups with and without cardiac arrest; for example, the incidence rate of sudden death in the two groups was 44 and 37 per cent, respectively. In light of recent reports suggesting that the prophylactic use of antiarrhythmic agents can virtually eliminate virtually fibrillation during the hospital phase of acute myocardial infarction, we contend that such use may substantially reduce both long-term and hospital mortality after acute myocardial infarction.
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PMID:Cardiac arrest complicating acute myocardial infarction: predictability and prognosis. 83 30

A statistical study was done on two groups of patients. The first group included 128 subjects of less than 65 years of age. The second group comprised 75 subjects aged 65 years or older. The purpose of the study was to identify the most relevant clinical aspects of myocardial infarction in older aged patients. The following variables were taken into consideration: sexual distribution, predisposing factors, causative factors, initial symptoms, site of infarction, physical and instrumental indications, cardiac and extracardiac complications, immobilization time, recovery time, residual aspects at patient discharge, mortality and tyme and type of death. The analysis was performed using both non parametric X2 test and correlating some variables with age independently of the subdivision of cases in groups, according to the method of multiple step-wise and simple regression. In the older age group the most significant statistical data was: the major incidence of infarcts was in women; the prevalence of predisposing factors such as hypertension and diabetes; the most frequent presentation of initial atypical symptoms; the most elevated incidence of hemodynamic complications and the highest mortality.
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PMID:[Clinical aspects of myocardial infarction in elderly people. Statistical study of 203 cases (author's transl)]. 85 56

The standard test for sensitivity of insulin was conducted in 20 patients with acute large-focal myocardial infarction, and in 9 of them it was repeated 3 weeks later. The study includes only those patients who had no diabetes mellitus symptoms prior to the admission to the clinic, and whose immediate relatives were free of this disease. The test was conducted in the morning on an empty stomach, insulin was administered intravenously by infusion of 5 U/l m2 of body surface. Blood sugar measurements were made in samples procured 10, 20, 30, 45, 60, 90 and 120 min. following insulin administration. The blood sugar level was determined by the orthotoluidine method. In patients with acute myocardial infarction less distinct and slower deceleration of the reduction of the blood sugar level was noted in response to the intravenous insulin injection than during the repeated examination on the 22nd-24th day of the disease, which indicates a decreased sensitivity of insulin during the acute period of myocardial infarction. Reduction of insulin sensitivity seems to be one of the causes of frequent carbohydrates metabolism disorders in patients with acute myocardial infarction.
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PMID:[Sensitivity to insulin in acute myocardial infarct]. 85 71

Lipid and carbohydrate metabolism abnormalities are reviewed with particular emphasis on the role of insulin and interrelationships between carbohydrate and lipid metabolism. The pathogenesis of atherosclerosis is discussed in terms of the association of abnormal circulating insulin levels. Some of the conditions associated with abnormal insulin levels and atherosclerosis are diabetes mellitis, hypertriglyceridemia, obesity, uremia, and oral contraceptive use. There is evidence that a proportion of subjects who have atherosclerosis or at risk have elevated circulating insulin levels. There is also increasing evidence that the arterial wall is an insulin-sensitive tissue. More women with myocardial infarction take oral contraceptives than controls do. Those who take the pill have 9 times the risk of others to develop cerebral ischemia or thrombosis. Many oral contraceptives cause abnormalities in glucose tolerance associated with elevated plasma insulin levels, and a degree of insulin resistance is induced. A number of the metabolic consequences of the pill may be caused by the elevated insulin levels.
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PMID:The relationship of abnormal circulating insulin levels to atherosclerosis. 85 12


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