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)

One hundred nineteen patients admitted to the coronary care unit with pulmonary edema were retrospectively reviewed to identify the demographic characteristics and underlying cardiac disorders of this population. The patients with pulmonary edema were compared with 119 patients admitted to the coronary care unit with chest pain. Cardiac catheterization in 71 patients with pulmonary edema and 93 with chest pain showed left main and 3-vessel coronary artery diseases to be equally common in both groups, although anginal pain was infrequent in patients with pulmonary edema (n = 28, 24%). Left ventricular function was reduced in the patients with pulmonary edema compared with those with chest pain (mean ejection fraction 42 vs 59%; p less than 0.001). More patients with pulmonary edema were black, and had diabetes and preexisting hypertension than those with chest pain. The results of cardiac catheterization were the same for black and white patients with pulmonary edema. In conclusion, patients with pulmonary edema have a high incidence of cardiac disease, and pulmonary edema may be 1 manifestation of silent myocardial ischemia. Important demographic differences exist between patients admitted with pulmonary edema and those who present with chest pain.
 ...
PMID:Comparison of angiographic findings and demographic variables in patients with coronary artery disease presenting with acute pulmonary edema versus those presenting with chest pain. 174 62

Before 1981, the neurologic morbidity and mortality associated with carotid endarterectomy (CEA) in the Los Angeles County/USC Medical Center public teaching institution was 20 per cent, similar to results from other hospitals. In 1981, a standardized protocol was adopted in an attempt to improve surgical outcome following CEA. Between 1981 through 1990, 89 patients with a mean age of 60.9 years (range 38 to 80 yrs) had 100 consecutive CEAs. Atherosclerotic risk factors included hypertension in 57 patients (61.8%), tobacco use in 57 (64.0%), and diabetes mellitus in 28 (31.5%). Forty-nine patients had a history of ischemic heart disease. Indications for CEA were stroke in 40 cases, transient ischemic attack in 33 cases, and asymptomatic, high-grade stenosis of the internal carotid artery (greater than 85 per cent) in 19. Perioperative and surgical management are detailed in the authors' protocol. Intraluminal shunts were routinely used (99 cases) and 24 arteriotomies were patched. Completion arteriograms were performed in 99 cases, four of which were revised because of arteriographic abnormalities. Three patients sustained postoperative ipsilateral neurologic events. Ten patients had cranial nerve palsies, six of which were transient. Two patients had nonfatal postoperative myocardial infarctions. There were no deaths. The combined stroke and transient ischemic attack (TIA) mortality rate was 3 per cent. In conclusion, the audit and quality assurance process identified unacceptable results following CEA. A protocol was developed that addressed pre, intra, and postoperative details of patient selection, operative technique, and postoperative care. By adhering to the protocol, the major neurologic morbidity and mortality rate has been reduced to 3 per cent.
 ...
PMID:A review of carotid endarterectomy at a large teaching hospital. 174 89

Autonomic neuropathy is associated with an increased incidence of silent myocardial infarction and sudden death. The purpose of this study was to investigate the prevalence of silent myocardial ischaemia in diabetic patients with autonomic neuropathy and without. Five standard autonomic function tests were performed on 41 men with diabetes: postural change in blood pressure, postural change in heart rate, heart rate response to deep breathing, heart rate response to Valsalva's manoeuvre, and blood pressure response to sustained handgrip. There were 17 patients with autonomic neuropathy (group A) and 24 with normal autonomic function (group B). All patients underwent 24 hour ambulatory electrocardiographic monitoring to detect silent ischaemia. There was no significant difference in risk factors for coronary artery disease or history of angina pectoris between these groups. The prevalence of silent ischaemia was 64.7% in group A (95% confidence interval (95% CI) 38.33 to 85.79%) and 4.1% in group B (95% CI 0.11 to 21.12%). This represents a relative risk of 42.2 (95% CI 4.5 to 39.4, p less than 0.001). These results are consistent with the concept that autonomic neuropathy may prevent the development of anginal pain and thus obscure the presence of ischaemic heart disease. Twenty four hour ambulatory electrocardiographic monitoring may identify a subgroup of diabetic patients with autonomic neuropathy who have myocardial ischaemia and to whom treatment may be offered.
 ...
PMID:Silent ischaemia in diabetic men with autonomic neuropathy. 174 85

Cardiovascular disease, and in particular ischemic heart disease, is the principal cause of morbidity, functional disability, and mortality in patients with non-insulin-dependent (type II) diabetes. The main risk factors for the macrovascular complications of diabetes are dyslipidemia, hypertension, and cigarette smoking. Although degree of hyperglycemia is a risk factor for microvascular complications, it is not a prominent risk factor for macrovascular complications. Nevertheless, there are theoretical reasons for believing that glycemic control could lower cardiovascular risk. For example, glycemic control may both improve clearance and suppress hepatic overproduction of very-low-density lipoprotein. Moreover, there is direct empirical evidence that improved glycemic control can favorably alter lipid profiles in type II diabetic patients. Despite this, the only clinical trial that has assessed cardiovascular mortality as an end point in diabetic subjects (i.e., the University Group Diabetes Program) failed to demonstrate a benefit of glycemic control. In this study, the insulin-variable group, which achieved sustained glycemic control relative to the placebo group, had essentially the same cardiovascular mortality as the latter group. All of the conventional lipid-lowering agents have been shown to produce favorable changes in lipid profiles in diabetic subjects. However, the optimum regimen remains to be defined. Metabolic differences between diabetic and nondiabetic subjects mean that the optimum lipid-lowering regimens for the two categories of patients may differ. For example, nicotinic acid, which is a powerful lipid-altering drug, may worsen glucose intolerance. The characteristic lipid abnormalities in type II diabetic subjects are hypertriglyceridemia and low high-density lipoprotein cholesterol, not hypercholesterolemia. Although the role of hypertriglyceridemia as a cardiovascular risk factor in the general population has been questioned, there is evidence that this lipid abnormality may play a stronger role in diabetic subjects. For all of the above reasons, there is an urgent need for large-scale clinical trials assessing cardiovascular end points and testing various strategies of improving lipid profiles in diabetic subjects, particularly given the fact that all of the current generation of lipid-lowering trials have systematically excluded diabetic patients.
Diabetes Care 1991 Dec
PMID:Dyslipidemia in type II diabetes. Implications for therapeutic intervention. 177 1

907 consecutive patients, (456 Asian and 451 Caucasian) were assessed, employing a similar methodology to the multi-centre WHO study. The Asians were older at diagnosis (46.5 years compared with 40.6 years, P less than 0.01); they had a shorter duration of diabetes (6.3 years versus 11.4 years, P less than 0.1), a higher rate of diabetes in the first degree relatives (29.5% compared with 16%, P less than 0.1), less ketonuria at presentation (85.3% compared with 47.8%, P less than 0.1), and fewer were treated with insulin (31.4% compared with 68.7%). Comparing the prevalence of complications between Asians and Caucasians, the ischaemic heart disease rate was similar; peripheral vascular disease was less (3.7% Asian, 9.3% Caucasian, P less than 0.05); retinopathy was less (11.6% Asian, 32.3% Caucasian, P less than 0.01) but renal disease was more (22.3% Asian, 12.6% Caucasian, P less than 0.01). After adjusting for age, sex, duration of diabetes, age at diagnosis, hypertension, smoking and treatment with or without insulin, these differences remained significant. Multivariate logistic regression failed to reveal a significant contribution due to any of the above variables, or due to body mass index (BMI), haemoglobin A (HbA1), or physical activity in the prevalence of complications in Asians compared with Caucasians. Marked heterogeneity in the complications of diabetes in the two ethnic groups studied was found, but must be confirmed from population-based studies.
Diabetes Res Clin Pract 1991 Dec
PMID:A comparison of the clinical features and vascular complications of diabetes between migrant Asians and Caucasians in Leicester, U.K. 177 13

Mildronate of 3-(2,2,2-trimethylhydrozinium)propionate, a novel anti-ischemic drug, inhibits the biosynthesis of carnitine from Y-butyrobetaine. Continuous administration of mildronate (200, 400 mg/kg for 10 days orally) to rats exerted a marked antiketogenic action on the animals deprived of food for 48 hours. In the fed rats receiving sodium octanoate a course treatment with mildronate elevated to concentration of ketone bodies in blood serum. Selective regulation of carnitine-independent and carnitine-dependent metabolism appears justified for the treatment of such pathological states as ischemic heart disease, diabetes and obesity.
 ...
PMID:[The effect of mildronate on carnitine-dependent and carnitine-independent ketogenesis in rats]. 178 24

Evidence of old cerebral infarction of magnetic resonance imaging (MRI) is common in acute stroke patients without a prior history of stroke. This experience led us to investigate the incidence of silent cerebral infarction (SCI) in the patients with essential hypertension, as well-known major predisposing factor for stroke. The incidence, number, size and localization of SCI on MRI (MARK-J, 0.1 T) and the prevalence of risk factors for stroke were investigated both in 66 hypertensive patients (WHO stage I or II; 63 +/- 9 (mean +/- S.D.) years old) and in 42 age-matched normotensive patients (61 +/- 9 years old). Risk factors selected were as follows: diabetes mellitus, hypercholesterolemia, daily alcohol intake, cigarette smoking, obesity, cardiac disease (arrhythmia and ischemic heart disease), hyperuricemia and high hematocrit. In hypertensive patients, the relationships between the incidence of SCI and hypertensive damages in major organs were also investigated. SCI was found in 45 out of the 108 subjects studied and a total of 216 SCI lesions were detected. All of the SCI lesions were localized in the subcortical white matter or in the basal ganglia. All SCI lesions were smaller than 3 cm in diameter and 201 lesions (93%) were smaller than 1 cm. The incidence of SCI tended to be higher in hypertensive patients (47%) than that in normotensives (33%) and increased significantly with advancing age in hypertensives from 26.9% in the 50s to 86.7% in the 70s, while no significant increase was noted in normotensives.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Silent cerebral infarction in the patients with essential hypertension]. 179 35

In chronic insulin overdosage patients with insulin-dependent diabetes mellitus have marked shifts in the values of blood serum lipid spectrum, increased number of circulating immune complexes correlating with the increased amount of immunoreactive insulin, and considerable shifts of the functional and metabolic characteristics of blood monocytes. Chronic overdosage of insulin leads in these patients to stable shifts of biochemical and immunological values similar to those encountered in patients with ischemic heart disease but without diabetes. These shifts persist in stable normoglycemia and predispose to the development of atherosclerosis.
 ...
PMID:[The role of hyperinsulinemia in the immunopathogenesis of atherosclerosis in diabetics]. 179 52

Fifteen cases of chronic heart block were studied. Eight of them could be designated as idiopathic or primary heart block; the others were associated with hypertension, diabetes and ischaemic heart disease, either singly or in various combinations. In six cases, the whole heart was available for histopathological study of the conduction system. In the other 9 cases, only a portion of the heart muscle was available for examination. A V nodal fibrosis extending upto the proximal bundle of His was seen in all the six whole heart autopsy materials. Fibrosis of the adjacent myocardium was seen in five cases. In three cases, conducting system fibrosis was associated with atherosclerotic (1 case) or diabetic changes (3 cases) of the intramural vessels. In the 9 partial autopsy studies, myocardial fibrosis was seen in two cases, diabetic microangiopathy in one and atherosclerotic changes in two including an old thrombus in one. Thus, diabetic microangiopathy was seen in total four cases. These changes may be responsible for the cardiomegaly and cardiac failure associated with conduction defects observed in diabetes. In the idiopathic group also, heart block could be considered as a significant facet of a primary myocardial degenerative process.
 ...
PMID:Cardiac changes implicated in chronic heart block. 181 5

Atherosclerosis is a multi-factor disease representing a real plague for developed countries, and spreading at an increasing rate in third world nations. In industrialized countries, coronary pathology occupied the first place in terms of morbidity and cardiovascular mortality, affecting more and more frequently younger people, thus constituting a serious problem of public health. Therefore, it seems absolutely necessary to carry out systematic screening for atherosclerosis amongst all high cardiovascular risk families groups, from infancy onwards. Lacking knowledge about the exact cause of atheroma, we had to determine what are commonly called the factors of cardiovascular risk. Among these, some are transmissible. Transmission may be direct: genetic and hereditary factors (sex, race, antecedents, dyslipemia, high blood pressure, diabetes) but it may also concern the transmission of a way of life. To prevent ischaemic heart disease, it is necessary to bring out change in behaviour from infancy onwards to detect high risk subjects and to correct every factor of cardiovascular risk upon which an action is possible.
 ...
PMID:[Risk factors for transmissible cardiovascular diseases]. 181 18


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