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

Neuropeptides are ubiquitous in the sympathetic system and modulate transmission at the levels of the intermediolateral cell column, sympathetic ganglia, and neuroeffector junctions. Several neuropeptide-containing pathways from the hypothalamus and medulla modulate excitability of preganglionic neurons. Neuropeptides coexist with norepinephrine or acetylcholine in subpopulations of chemically coded, target-specific sympathetic ganglion neurons. Neuropeptide Y is colocalized in adrenergic vasoconstrictor neurons, whereas vasoactive intestinal polypeptide is colocalized in cholinergic sudomotor neurons. Neuropeptide expression is plastic; during development, neurons that switch from a noradrenergic to a cholinergic phenotype increase expression of vasoactive intestinal polypeptide, somatostatin, and substance P. Preganglionic inputs increase neuropeptide Y and inhibit substance P expression. Sympathetic denervation produces sprouting of sensory fibers containing substance P and calcitonin gene-related peptide in target tissues. Neuropeptides from preganglionic fibers (e.g., enkephalin) and primary afferents (e.g., substance P, vasoactive intestinal polypeptide) modulate transmission in sympathetic ganglia. Neuropeptide Y produces vasoconstriction, prejunctional inhibition of norepinephrine release, and postjunctional potentiation of norepinephrine effects. Plasma neuropeptide Y increases during intense sympathoexcitation, hypertension, and pheochromocytoma. Dystrophic neurites containing neuropeptide Y occur in human sympathetic ganglia during aging, diabetes, and dysautonomia. Sympathetic neuropeptides may thus have important clinical implications.
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PMID:Neuropeptides in the sympathetic system: presence, plasticity, modulation, and implications. 802 63

The content of basal immunoreactive atrial natriuretic hormone (ANH) in the venous blood plasma was studied in patients with various types of endocrine hypertension (Conn's syndrome, pheochromocytoma, neuroendocrine form of hypothalamic syndrome, diabetes mellitus) and diffuse toxic goiter. Increase of the ANH level was revealed in patients with primary aldosteronism, diabetes mellitus and hypertension, as well as with decompensated thyrotoxicosis and pronounced cardiac changes. In patients with neuroendocrine pattern of the hypothalamic syndrome the ANH level remained unchanged, in those with pheochromocytoma it decreased.
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PMID:[Atrial natriuretic factor in endocrine pathology]. 804 13

The aim of this review was to demonstrate that RM function is altered in various endocrinopathies and that RM weakness is a common finding. RM function has been well-studied in diseases such as thyroid dysfunction, and steroid induced RM myopathies. Less well documented reports on RM function were found in parathyroid dysfunctions, disorders of mineralocorticoids and pituitary disturbances. Controversial reports were found in diabetes mellitus. No report was found connecting RM function with androgens, pheochromocytoma or adrenaline deficiency in humans. These diseases could potentially cause RM impairment leading to severe respiratory failure (pump failure) putting life in great danger. Therefore, it is obvious that further studies are needed to investigate the performance of RMs in endocrinopathies. Such studies are extremely urgent in Cushing's and Addison's disease, acromegaly, disorders of the adrenal medulla, and in diabetes insipidus.
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PMID:Respiratory muscles in endocrinopathies. 820 54

To evaluate the pathogenesis of orthostatic hypotension, we studied the autonomic regulation system by measuring heart rate variability during 60 degrees passive head-up tilt using power spectral analysis in 21 patients with orthostatic hypotension (mean age 62 +/- 2 years, five with histories of cerebrovascular accidents, five with Parkinsonism, five with diabetes mellitus, three with pheochromocytoma, and three with unknown causes) and 15 normal healthy subjects as a control (mean age 63 +/- 2 years). We also assessed plasma epinephrine and norepinephrine response to tilt. During tilt, control subjects showed an increase in heart rate with no change in blood pressure. Spectral analysis of heart rate variability demonstrated increases in the low frequency band (LFB, mainly sympathetic) and low frequency band/high frequency band ratio (LFB/HFB, sympatho-vagal balance). All patients with orthostatic hypotension showed a significant reduction in blood pressure with an increase in heart rate. In patients with histories of cerebrovascular accidents and with Parkinsonism, LFB and the LFB/HFB ratio did not increase. However, in other patients with orthostatic hypotension, LFB and the LFB/HFB ratio increased during tilt. Norepinephrine increased in control subjects and in patients with diabetes mellitus, pheochromocytoma, and unknown causes. In contrast, patients with histories of cerebrovascular accidents and patients with Parkinsonism showed no increase in norepinephrine. Epinephrine responses paralleled those of norepinephrine, but the changes were not significant. Thus, neurological response to tilt is not uniform in patients with orthostatic hypotension. Patients with histories of cerebrovascular accidents and patients with Parkinsonism may have impaired function of central neural mechanisms controlling blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of orthostatic hypotension using power spectral analysis. 846 6

Endocrine crises can occur in diabetes mellitus, in pituitary failure when there is a lack of ACTH, TSH or ADH secretion, in severe hyper- or hypothyroidism (thyroid storm and myxedema coma), severe hyper- or hypoparathyroidism (parathyroid crisis and tetany), in adrenal failure and in patients with pheochromocytoma or carcinoid tumors. Cushing's syndrome can be associated with psychotic crises. This review describes the most important clinical features and the basic diagnostic and therapeutic aspects of the non diabetic endocrine crises.
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PMID:[Endocrine crises]. 848 76

Hyper- or hypofunctioning endocrine organs present a number of perianaesthetic challenges. This review covers some of the issues of perianaesthetic management of patients with primary or coexisting pathology of the following endocrine organs: The pancreas with diabetes mellitus as the most common endocrine cause of primary and secondary organ dysfunctions affecting anaesthetic care. Adrenal cortical pathology with excess or deficiency of adrenocortical hormones. Pheochromocytoma of the adrenal medulla with infrequent but challenging perianaesthetic problems. Thyroid gland diseases with hyper- or hypothyroidism. Parathyroid gland pathology with hypercalcaemia or hypocalcaemia. Disorders of the anterior and posterior pituitary gland. The carcinoid syndrome and more uncommon endocrinopathies such as adenomas from the gastroenteropancreatic endocrine tissues and the ovarian hyperstimulation syndrome are also reviewed briefly.
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PMID:Perianaesthetic management of patients with endocrine disease. 890 15

A number of endocrine disorders are associated with varying degrees of glucose intolerance. Sustained hypersecretion of hormones with actions antagonistic to insulin (e.g., GH, glucocorticoidos, catecholamines, glucagon) or which interfere with insulin secretion (e.g., catecholamines, hypokalemia) is often associated. And so, acromegaly, Cushing's syndrome, pheochromocytoma, primary aldosteronism, hyperthyroidism, glucagonoma and others are included in endocrine-associated diabetes. The glucose intolerance occurring secondary to endocrine disorders is usually moderate degree and overt diabetes with symptomatic hyperglycemia is an uncommon event, unless an underlying genetic diabetic diathesis also present in the same individual. The small subgroup of acromegalics(5-10%) with severe glucose intolerance requiring insulin therapy have low endogenous insulin levels and insulin responses that are markedly impaired. It has been suggested that these patients are really true diabetics. These are patients with NIDDM. Retinal, renal and neurological complications are uncommon in patients with endocrine-associated diabetes.
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PMID:[Diabetes secondary to endocrinolopathies]. 891 32

We report a case of diabetic ketoacidosis (DKA) associated with pheochromocytoma in a college student of 22 years of age who was admitted to hospital because of hyperglycemia and hypertension with palpitations and subsequently was found to have an adrenalin and noradrenalin secreting pheochromocytoma. A diagnosis was made and the patient's impaired glucose tolerance and hypertension improved by tumor excision. This is the first reported case of a noradrenalin-predominant pheochromocytoma with associated DKA. Although DKA has been thought not to occur with pheochromocytoma, the possible cause of DKA associated with pheochromocytoma is now described. It is important to point out, as a clinical manager, that severe hypertension is a very unusual concomitant of DKA in young people and is the main indication for further examination.
Diabetes Res Clin Pract 1996 Sep
PMID:Diabetic ketoacidosis associated with the pheochromocytoma of youth. 896 91

The case of a 45-year-old woman with pheochromocytoma, who presented with severe abdominal pain and headache, diabetes mellitus, lactic acidosis and pulmonary edema, is described and discussed. Spleen infarction, not so far described as an ischemic complication of pheochromocytoma, was seen in computer tomography. After medical pretreatment with labetalol, a pheochromocytoma (2 x 2 cm) of the left adrenal gland was removed. The postoperative course was uneventful.
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PMID:[Splenic infarct, lactate acidosis, and pulmonary edema as manifestations of a pheochromocytoma]. 915 31

Adrenomedullin (AM) is a novel vasorelaxing peptide which was originally isolated from the extracts of human pheochromocytoma. It is produced by a number of organs among which the adrenal gland exhibits by far the highest concentrations. The peptide circulates in blood and its plasma levels have been reported to be increased in several diseases such as renal failure and sepsis. In the present study plasma concentrations of AM were measured in various forms of severe illness and compared to clinical and biochemical parameters in order to gain an insight into the factors controlling the plasma levels of this peptide. The highest concentrations of AM were found in patients with sepsis (344.4 +/- 60.4 pg/ml, n = 16) who exhibited up to 12-fold higher levels than a group of healthy subjects (74.1 +/- 4.1 pg/ml, n = 20). Markedly elevated levels were also measured in hemorrhagic (250.1 +/- 37.9 pg/ml, n = 9) and cardiogenic (216.2 +/- 29.4 pg/ml, n = 7) shock as well as in patients with cancer of the gastrointestinal tract (155.6 +/- 32.5 pg/ml, n = 11) or the lungs (146.5 +/- 19.1 pg/ml, n = 22). Plasma AM levels were positively correlated with serum creatinine concentrations in shock (r = 0.06, p < 0.001) and with C-reactive protein levels in patients with cancer (r = 0.64, p < 0.001) or sepsis (r = 0.63, p < 0.01). In order to examine the potential role of the adrenal gland as a site of AM release, hypoglycemia was induced in a group of healthy volunteers by graded infusion of insulin. Despite a more than 20-fold increase in plasma adrenalin indicating maximal stimulation of the adrenal medulla, no significant alterations of the plasma AM levels were observed. The study demonstrates that not only sepsis but also various forms of cancer and shock are associated with high levels of circulating AM. The correlation with C-reactive protein levels suggests a role of cytokines in mediating the elevations in plasma AM observed in sepsis and cancer. Reduced clearance of the peptide by the kidneys may be one of the mechanisms involved in the accumulation of AM in shock. The adrenal gland appears not to be a major source for circulating AM.
Exp Clin Endocrinol Diabetes 1997
PMID:High levels of circulating adrenomedullin in severe illness: correlation with C-reactive protein and evidence against the adrenal medulla as site of origin. 922 12


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