Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serious non-fatal complications of cardiac surgery include deep sternal wound infection (DSWI) and haemorrhage. Understanding the factors associated with these complications (both pre-operatively and intra-operatively) may aid in the prevention and avoidance of such complications. The aim of the current report is to identify factors associated with DSWI and haemorrhage for all patients undergoing cardiac surgical procedures in Victorian public hospitals from July 2001 to June 2005. Multiple logistic regression analysis incorporating preoperative and intraoperative variables was used to identify risk factors for DSWI and haemorrhage. There were 153 cases of DSWI (1.3%) and 413 cases of haemorrhage (3.5%) in 11,848 patients. The risk factors differ between DSWI and haemorrhage, with pre-operative factors being more commonly associated with DSWI and intra-operative factors associated with haemorrhage. Strategies directed towards minimising modifiable pre-operative risk factors (diabetes, preoperative dialysis, respiratory disease, being overweight and angina CCS Class 3 or 4) may reduce the incidence of DSWI. Improvements in operative factors (perfusion time, ventricular assist device, intraaortic balloon pump and aortic dissection) and surgical technique, may impact on reducing the incidence of haemorrhage.
 ...
PMID:Factors associated with deep sternal wound infection and haemorrhage following cardiac surgery in Victoria. 1766 1

The objective of this study was to compare the immediate post-operative outcome of two myocardial protection strategies. Data of consecutive elective first time coronary artery bypass grafting (CABG) were analysed: Group A (n=671, antegrade-retrograde cold St Thomas blood cardioplegia) and Group B (n=783, intermittent cross-clamp fibrillation). Age, angina class, myocardial infarction (MI), pre-operative rhythm, respiratory disease, smoking, diabetes mellitus (DM), hypertension (HT), renal function, cerebrovascular disease, body mass index (BMI) and Parsonnet score were comparable. Significant differences existed in gender (P=0.02), peripheral vascular disease (PVD) (P=0.04), heart failure class (P=0.0001), left ventricular (LV) function (P=0.01), disease severity (P=0.02), left main stem (LMS) (P=0.02) and preinduction intra-aortic balloon pump(IABP) (P=0.08). Group A had more grafts (P=0.008), longer bypass (P=0.0001) and cross-clamp time (P=0.0001). Post-operative inotrope, MI, arrhythmias, neurological, renal complications, multi-organ failure, sternal re-wiring, ventilation, length of stay and mortality were comparable. There was higher IABP usage and longer intensive therapy unit (ITU) stay (P=0.01) in Group B. Chronic obstructive airway disease (COAD), renal dysfunction, cross-clamp time, bypass time, post-operative inotrope or IABP and re-exploration predicted longer ITU stay. Intermittent cross-clamp fibrillation is a versatile and cost-effective method of myocardial protection, with the immediate post-operative outcome comparable to antegrade-retrograde cold St Thomas blood cardioplegia in elective first-time CABG.
 ...
PMID:Comparison of the immediate post-operative outcome of two different myocardial protection strategies: antegrade-retrograde cold St Thomas blood cardioplegia versus intermittent cross-clamp fibrillation. 1767 Jan 29

The increase in adiposity associated with aging is a concern in older adults, especially as it relates to the risk for ventilatory complications. Therefore, the specific aim of this study was to determine the association of various measures of abdominal adiposity with lung function in a sample of older healthy black women. Participants (n=27) had no history of diabetes or respiratory disease. The mean age was 67 years. Lung function was measured by spirometry using percent of predicted values for forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). Body fat was measured using a three-dimensional photonic scanner and dual energy X-ray absorptiometry (DXA). Correlation analyses show that percent body fat in the trunk (%TF) is significantly associated with percent predicted FVC (r=-0.38; p<0.05). No association was observed between anthropometric indices of truncal adiposity and lung function. Results of this study show that truncal fat mass measured by DXA is more strongly associated with lung function than anthropometric indices of truncal adiposity in this sample of women.
 ...
PMID:Truncal adiposity and lung function in older black women. 1795 6

Variability in the health of human populations is greater in economically vulnerable areas. We tested whether this variability reflects and can be explained by: (1) underlying vulnerabilities and capacities of populations and/or (2) differences in the distribution of individual socioeconomic status between populations. Health outcomes were rates of mortality from 12 causes (cardiovascular disease, malignant neoplasms, accidents, chronic lower respiratory disease, cerebrovascular disease, pneumonia and influenza, diseases of the nervous system, suicide, chronic liver disease and cirrhosis, diabetes, homicide, HIV/AIDS) for 59 New York City neighborhoods in 2000. Negative binomial regression models were fit with a measure of socioeconomic vulnerability, median income, predicting each mortality rate. Overdispersion of each model was used to assess whether variability in mortality rates increased with increasing neighborhood socioeconomic vulnerability. To assess the two hypotheses, we examined changes in the variability of mortality rates (as indicated by changes in overdispersion of the models) for outcomes with significant non-constant variability after accounting for (1) vulnerabilities and capacities (social control, quality of local schools, unemployment, low education), and (2) the distribution of individual socioeconomic status (low income, poverty, socioeconomic distribution, high income). Some variability in all mortality rates was explained by accounting for a range of potential vulnerabilities and capacities, supporting the first explanation. However, variability in some causes of mortality was also explained in part by accounting for the distribution of individual resources, supporting the second explanation. The results are consistent with a theory of underlying socioeconomic vulnerabilities of human populations. In areas with lower levels of income, other characteristics of those neighborhoods exacerbate or temper the economic vulnerability, leading to more or less healthy conditions. Understanding the vulnerabilities and capacities that characterize populations may help us better understand the production of population health, and may inform efforts aimed at improving population health.
 ...
PMID:Population vulnerabilities and capacities related to health: a test of a model. 1802 2

Interventions to prevent morbidity and mortality from chronic diseases need to be cost effective and financially feasible in countries of low or middle income before recommendations for their scale-up can be made. We review the cost-effectiveness estimates on policy interventions (both population-based and personal) that are likely to lead to substantial reductions in chronic diseases--in particular, cardiovascular disease, diabetes, cancer, and chronic respiratory disease. We reviewed data from regions of low, middle, and high income, where available, as well as the evidence for making policy interventions where available effectiveness or cost-effectiveness data are lacking. The results confirm that the cost-effectiveness evidence for tobacco control measures, salt reduction, and the use of multidrug regimens for patients with high-risk cardiovascular disease strongly supports the feasibility of the scale-up of these interventions. Further assessment to determine the best national policies to achieve reductions in consumption of saturated and trans fat--chemically hydrogenated plant oils--could eventually lead to substantial reductions in cardiovascular disease. Finally, we review evidence for policy implementation in areas of strong causality or highly probable benefit--eg, changes in personal interventions for diabetes reduction, restructuring of health systems, and wider policy decisions.
 ...
PMID:Scaling up interventions for chronic disease prevention: the evidence. 1826 36

This research study examined the usefulness of the ICD-10-CM system in capturing public health diseases (reportable diseases or the nationally notifiable infectious diseases, leading causes of death, and morbidity/mortality related to terrorism), when compared to ICD-9-CM.1-3 It also examined agreement levels of coders when coding public health diseases in both ICD-10-CM and ICD-9-CM. Overall results demonstrate that ICD-10-CM is more specific and fully captures more of the public health diseases examined than ICD-9-CM. In the analysis of all the public health diseases, such as reportable diseases (p<0.001), top 10 causes of death (p<0.001), and those related to terrorism (p<0.001), it was found that the overall rankings for disease capture for ICD-10-CM were significantly higher than the rankings for ICD-9-CM. When examining whether diseases were captured more straightforwardly and clearly (regarding agreement levels) between coding systems, statistically significant differences were found for external causes of injury (p<0.001), diabetes (average rank only, p<0.05), lower respiratory disease (p<0.001), heart disease (p<0.001), and malignant neoplasms (p<0.05). Although this result may be due to the coder's higher level of experience with ICD-9-CM, it also points to the potential need for more specific coding education and practice with the ICD-10-CM system.
 ...
PMID:The effectiveness of ICD-10-CM in capturing public health diseases. 1806 56

During 2007, the human species became predominantly urban. Australia is highly urbanised, and health varies within Australian cities. Australian urban life is characterised by sedentariness, excess food intake, reliance on cars for transport, a high level of exposure to media and marketing messages, and a consumer culture. These characteristics are linked to obesity, diabetes, heart disease, some cancers, chronic respiratory disease, injury, depression and anxiety. The evolution of cities has been characterised as a four-stage process: poverty, industrial, consumption and eco-city. Each stage but the last has defining health disorders. Transition to healthy and sustainable cities requires infrastructure investment in new urban areas (including mass transit, education and health services), better conditions for walking and cycling, access to healthy food and encouragement of suburban economic development. There is a role for everyone in the transition to healthy and sustainable cities.
 ...
PMID:The way we live in our cities. 1807 10

The increased mortality associated with acromegaly was first demonstrated in early epidemiological studies. Since the seminal paper by Wright et al. in 1970, nearly 20 studies have analyzed mortality rates in over 5,000 patients with acromegaly. Overall standardized mortality rates are approximately two times higher than in the general population, relating to an average reduction in life expectancy of around 10 years. The excess deaths are due predominantly to cardiovascular, cerebrovascular and respiratory disease. Malignancy deaths have been high in some studies but not others; in the largest series looking at cancer mortality in acromegaly, overall cancer deaths were not increased, but colon cancer mortality was higher than expected. In 1993, Bates et al. first demonstrated that outcome was related to the latest measurable growth hormone (GH), and treatment to reduce GH levels led to improved outcomes. Other factors predicting poor outcome include the presence of hypertension and diabetes. On the basis of current evidence, a latest GH of less than 2-2.5 mug/L is a better predictor of good outcome than a normal insulin-like growth factor-1 (IGF-1), possibly due to discrepancy between GH and IGF-1 at low GH levels. There is some evidence to suggest a more stringent GH cut-off (less than 1 mug/L) may yield additional benefit but further studies are required to investigate any added risk of increased mortality from hypopituitarism. Radiotherapy has been linked specifically to cerebrovascular mortality and its use in patients with acromegaly must involve a careful risk-benefit analysis in each case.
 ...
PMID:Does acromegaly enhance mortality? 1807 87

The relationship between mental disorders and chronic physical conditions is well established, but the possibility of ethnic group differences in mental-physical associations has seldom been investigated. This study investigated ethnic differences in associations between four physical conditions (chronic pain, cardiovascular disease, diabetes, and respiratory disease) and 12-month mood and anxiety disorders. A nationally representative face-to-face household survey was carried out in New Zealand from 2003 to 2004 with 12,992 participants aged 16 and older, achieving a response rate of 73.3%. The current study is of the subsample of 7,435 participants who were assessed for chronic physical conditions (via a standard checklist), and compares Maori, Pacific and Other New Zealanders. DSM-IV mental disorders were measured with the Composite International Diagnostic Interview (CIDI 3.0). The ethnic groups differed significantly in prevalences of both physical and mental disorders, but almost no ethnic differences in mental-physical associations were found. Independent of ethnicity, associations were observed between chronic pain and mood and anxiety disorders, cardiovascular disease and anxiety disorders, respiratory disease and mood and anxiety disorders. Despite differences in mental and physical health status between ethnic groups in New Zealand, mental-physical disorder associations occur with considerable consistency across the groups. These results suggest that whatever factors are conducive to the development of a mental disorder from a physical disorder (or vice versa), they are either unaffected by the cultural differences manifest in these ethnic groups, or, any cultural factors operating serve to both increase and decrease comorbidity such that they cancel each other out.
 ...
PMID:Mental-physical comorbidity in an ethnically diverse population. 1815 19

Previous studies of leptin with cardiovascular disease (CVD) risk factors have been limited by clinical samples or lack of representation of the general population. This cross-sectional study, designed to examine whether leptin or insulin may mediate the endogenous relation of obesity with metabolic, inflammatory, and thrombogenic cardiovascular risk factors, included 522 men and 514 women aged >or=40 years who completed a physical examination during the third National Health and Nutrition Examination Survey. Participants were free of existing CVD, cancer (except non-melanoma skin cancer), diabetes, or respiratory disease. In multivariable analyses adjusted for race/ethnicity and lifestyle factors, waist circumference (WC) was positively associated with blood pressure, triglyceride, LDL cholesterol, total cholesterol:HDL ratio, apolipoprotein B, C-reactive protein (CRP), and fibrinogen concentrations, and negatively associated with HDL cholesterol and apolipoprotein A1 levels. The associations of WC with the metabolic CVD risk factors were largely attenuated after adjustment for insulin levels, while the associations of WC with the inflammatory and thrombogenic factors (CRP and fibrinogen, respectively) were largely explained by adjustment for leptin concentrations. However, leptin levels were not independently associated with CRP and fibrinogen in men and CRP in women when adjusted for WC. Positive associations of leptin and insulin with fibrinogen in women, independent of WC, were noted. These results suggest that insulin may be an important mediator of the association of obesity with metabolic but not inflammatory or thrombogenic CVD risk factors, while leptin does not appear to influence cardiovascular risk through a shared association with these risk factors. However, we cannot rule out the possibility that leptin and insulin influence cardiovascular risk in women through independent effects on fibrinogen concentrations.
 ...
PMID:The relation of leptin and insulin with obesity-related cardiovascular risk factors in US adults. 1816 70


<< Previous 1 2 3 4 5 6 7 8 9 10