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)

A longitudinal study of 64 patients with chronic pancreatitis is presented. The patients were followed up for a median period of 4 years. Pain was the dominant symptom in 43 of the patients, but only 5 patients had pancreatic resection because of pain. Alcoholism was the etiology in 45 patients. Complications were common: 34 patients developed steatorrhea and 29 diabetes. Two major groups of associated diseases contributed to a high morbidity in chronic pancreatitis: 24 patients presented with duodenal ulcer, and 8 developed malignant tumors. This number is significantly higher than expected in a matched population (P less than 0.01). Twenty-six of the patients died within the observation period from complications of chronic pancreatitis (38%), from malignant neoplasms (15%), or from other causes (46%). The calculated mortality rate after 7 years of observation was close to 50%. Most patients were recruited from the lower social classes, and most were unemployed. We conclude that chronic pancreatitis in Copenhagen is associated with a high morbidity, a high mortality, and a poor social prognosis.
 ...
PMID:Chronic pancreatitis in Copenhagen. A retrospective study of 64 consecutive patients. 715 87

Nineteen patients with chronic alcoholic pancreatitis have been followed up for 7 to 81 months (mean 45 months) since resection for the relief of pain. Five had distal pancreatectomy, three had a Whipple resection, seven had 75% pancreatectomy and four had total pancreatectomy. Pain was completely relieved in all patients after total pancreatectomy and in four patients after 75% pancreatectomy. Recurrent acute pancreatitis was frequent after distal pancreatectomy. Alcoholism recurred in six patients. Steatorrhea was noted grossly in 14 patients after operation. It was corrected by enzyme replacement. All patients had long-term weight gain, except one who had undergone a Whipple resection. Diabetes developed in one patient who underwent 75% pancreatectomy, in one after distal pancreatectomy and in all patients who underwent total pancreatectomy; management of the diabetes was complicated by heavy alcohol consumption in one patient who underwent total pancreatectomy.
 ...
PMID:Resection for chronic alcoholic pancreatitis. 722 66

The present study has been designed to work out the factors regulating the fasting serum levels of trypsin-like immunoreactivity in chronic pancreatitis. One hundred patients with chronic pancreatitis have been included and studied during a painless phase of the disease. No relationships have been observed between serum trypsin-like immunoreactivity and the presence of pancreatic calcifications. Serum immunoreactive trypsin levels showed a gradual decline parallel to the progressive impairment of bicarbonate and enzyme (trypsin and chymotrypsin) outputs in duodenal aspirates during pancreatic secretory studies. Therefore, serum trypsin-like immunoreactivity levels are thought to reflect the functional capacity of the exocrine pancreas. Reduced levels of trypsin-like immunoreactivity were detected in almost all patients with diabetes and steatorrhea. However, the finding of low levels also in a minority of chronic pancreatitis patients with normal endoscopic retrograde cholangiopancreatography or pancreatic secretory tests points to other factors which, in addition to the atrophy of the pancreatic parenchyma, may influence the circulating levels of trypsin-like immunoreactivity in chronic pancreatitis.
 ...
PMID:Circulating trypsin-like immunoreactivity in chronic pancreatitis. 723 74

Although the development of islet cell autotransplantation has focused attention on extended resections of the pancreas, drainage of a dilated pancreatic duct remains an effective means of relieving intractable pain of chronic pancreatitis. Between 1954 and 1980, 98 men and two women with chronic pancreatitis were treated for pain with ductal drainage. All patients had a history of chronic alcoholism. Pancreatic calculi were found in 68 patients. Operative procedures include: seven caudal pancreaticojejunostomies, 42 longitudinal pancreaticojejunostomies, and 54 side-to-side pancreaticojejunostomies. Two caudal pancreaticojejunostomies were converted to longitudinal pancreaticojejunostomies, and one longitudinal pancreaticojejunostomy required revision. The operative mortality rate was 4%. Follow-up studies, lasting up to 24 years, were conducted for all but seven patients. Eighty per cent of these patients have had substantial improvement or complete resolution of their pain. Diabetes, as evidence by an elevated fasting blood sugar level, was present prior to operation in 30% of the patients, and developed after operation in 14%. Only nine of 21 insulin-dependent diabetics in this series did not require insulin prior to pancreaticojejunostomy. Pancreatic enzyme replacement was needed for control of steatorrhea in 18 patients. Four patients with continued pain underwent total or near total pancreatectomies. Three of these patients died of uncontrolled diabetes. Only one patient with a drainage procedure alone has died of uncontrolled diabetes. In patients with dilated pancreatic ducts, pancreaticojejunostomy is a safe, reliable means of providing pain relief, with minimal loss of endocrine and exocrine function.
 ...
PMID:Pancreatic duct drainage in 100 patients with chronic pancreatitis. 727 48

Somatostatinoma is one of the rarest tumours of the endocrine pancreas. Cardinal manifestations of a somatostatinoma include gallstones, mild diabetes mellitus, steatorrhoea, diarrhoea and dyspepsia. Like any other pancreatic islet cell carcinoma, a somatostatinoma may also produce several different hormones such as adrenocorticotropic hormone, calcitonin, vasoactive intestinal polypeptide, pancreatic polypeptide, gastrin, insulin, and glucagon. In many cases, the clinical picture is dominated by the effect of these other hormones. We present a patient with somatostatinoma in which an immunocytochemical study of the specimens from pancreas and liver showed a weak positive reaction for gastrin besides a strong positive reaction for somatostatin. Interestingly, this patient also showed the signs of carcinoid syndrome which was successfully treated with octreotide.
 ...
PMID:Carcinoid syndrome due to a malignant somatostatinoma. 749 79

Due to the progressive clinical course and unchanged poor prognosis of pancreatic cancer supportive therapy has to focus on improvement of the quality of life. Pain control is best achieved with slow release opiates and by chemoablation of the coeliac plexus. Furthermore, management of anorexia with megestrol acetate and tumor-adapted enteral and parenteral nutritional therapy are discussed. The treatment of chemotherapy-induced side effects with haemopoetic growth factors and antiemetics is dealt with as well. Finally, the therapeutic principles of the management of post-pancreatectomy diabetes mellitus and postoperative steatorrhoea are pointed out.
 ...
PMID:[Supportive therapy of pancreatic carcinoma]. 752 56

We report the case of a white woman with insulin-dependent diabetes for 12 years who had rapid deterioration in renal function over a 7-month period. A renal biopsy showed widespread deposition of a polarizing crystalline material consistent with calcium oxalate. Fat malabsorption due to diabetic diarrhea was first documented 5 years earlier when renal function was normal. Chronic malabsorption can lead to chronic interstitial nephritis secondary to oxalate deposition, but rarely leads to acute deterioration in renal function. This entity should be considered in individuals with steatorrhea and no other cause for their renal failure.
 ...
PMID:Rapid renal deterioration secondary to oxalate in a patient with diabetic gastroenteropathy. 761 Dec 71

A total of (152) patients who consecutively underwent extended pancreaticoduodenectomy between 1983 and August 1992 had reconstruction of alimentary continuity, using two independent jejunal loops. One for the fashioning of a pancreatic and biliary anastomosis and the other for creating the gastric anastomosis. From the results of this study it has been shown that the present technique is contributing to low mortality, early morbidity and a satisfactory quality of post-operative life in long-term survivors. Four patients died during the first 30 days after surgery, and only 25% of those with confirmed pancreaticojejunal anastomotic leakages required early reoperation. Moreover, no patient developed marginal ulceration, or reflux gastritis, or dumping, while the incidence of steatorrhea and diabetes mellitus remained low. Additionally, the present technique makes locoregional radical surgery possible and we thus believe that it merits consideration with respect to the choice of method of reconstruction of alimentary continuity after extended pancreaticoduodenectomy. The present technique has been proved to be safe, simple and effective in fulfilling current demands on resectional pancreatic surgery, particularly in the case of pancreatic malignancies, and can therefore be recommended.
 ...
PMID:Technical considerations and results of a "new" method of reconstruction of alimentary continuity after duodenopancreatectomy. 790 60

Magnesium (Mg) deficiency is a common yet underdiagnosed problem in the ICU. Since only 1% of total body Mg is in the extracellular fluid, serum Mg concentrations may not adequately reflect Mg status. Utilizing techniques to measure intracellular Mg concentrations, Mg depletion has been shown to be present in about one half of all ICU patients. These patients have significantly higher morbidity and mortality rates than Mg-replete patients. Accurate identification of patients with Mg depletion requires a knowledge of the risk factors associated with Mg deficiency. These factors include poorly controlled diabetes mellitus, alcohol ingestion, severe diarrhea and steatorrhea, and the use of a number of pharmacologic agents that induce renal Mg wasting. Manifestations of Mg deficiency include hypokalemia, hypocalcemia, neuromuscular hyperexcitability, respiratory muscle weakness, and intractable arrhythmias. Mg deficiency may also play a role in the genesis of myocardial ischemia. In this article, we review the assessment, causes, and manifestations of Mg deficiency and suggest guidelines for adequate treatment.
 ...
PMID:Should we supplement magnesium in critically ill patients? 792 43

Inflammatory diseases of the pancreas are not uncommon in the elderly; although acute and chronic pancreatitis in this age group are essentially the same diseases as in younger patients, some features are unique to the old patient. Acute pancreatitis in the elderly is more commonly of gallstone etiology; it is also more likely to have an atypical clinical presentation, making recognition more difficult. In acute necrotizing pancreatitis, the elderly patient has an increased risk of complications including multisystem failure; for this reason, such patients should be more carefully monitored and aggressively treated. Chronic pancreatitis with initial onset older than 60 years is rare in the elderly, and generally without apparent cause; much more commonly, it is seen as the advanced stage of a disease started in youth. Diffuse glandular destruction and resulting severe insufficiency are usually present; thus, rather than pain, the most frequent clinical manifestations are steatorrhea and diabetes. These complications should be adequately treated to avoid malnutrition, which may seriously affect the well-being and quality of life in the elderly.
 ...
PMID:Pancreatitis in the elderly. 793 Apr 38


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