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 large end stage renal failure population treated by chronic ambulatory peritoneal dialysis (CAPD) was examined for rates of infection, CAPD modality failure and patient survival (N = 347). Nearly half were considered high risk for survival for reasons of age (39% older than 60 years), diabetes mellitus (33%), hemodialysis access failure (10%), poor cardiopulmonary reserve (16%) or technical challenges (30% had morbid obesity, history of abdominal aortic aneurysm repair or multiple abdominal surgeries). Hence, CAPD was often initiated by default rather than choice in the 347 patients studied (mean age: 51 +/- 17 years). Infections greatly outnumbered technical failures as grounds for cessation of CAPD. Over 5521 patient-months, 51% of patients developed infection with peritonitis predominating (80%) when compared to exit site infections (20%). The frequency of infections was 1.9 mean episodes per patient; however, 55% of these patients had only one episode of peritonitis. A rate of 0.75 infections per patient per year was seen with an average interval of 16 months between infections. Technique and patient survival rates at 4 years were 50% and 61% respectively. High risk status does not preclude successful CAPD and should not preclude its implementation.
 ...
PMID:Single center success with a high risk peritoneal dialysis population. 136 61

Three families with abnormal insulinemia have been reported in Japan and sequencing analysis revealed that they had the same point mutation in one allele of the insulin genes causing [Leu A3]insulin. To estimate whether or not this same mutation came from a common ancestor we determined the sequence of the hypervariable region 5'-flanking the third [Leu A3]insulin allele (insulin Tochigi). This region is composed of 42 tandem repeating oligonucleotides, is 599 base pairs long and the sequence is 5' cdi jfa faa aba baa aaa fab aaa caa aac aca cba aaf ccb 3' (abbreviated as a = ACAGGGGTGTGGGG; b = ACAGGGGTCTGGGG; c = ACAGGGGTCCTGGGG; d = ACAGGGGTCCGGGG; f = ACAGGGGTCCCGGGG; i = ACAGGGTCCTGGGG; j = ACAGGGGTGTGAGG). The length of this region is different from those of the first and second [Leu A3]insulin alleles (insulin Wakayama I,II). This difference suggests either that insulin Tochigi and insulin Wakayama I,II are not of the same origin, or that three cases of [Leu A3]insulin in Japan have the same ancestor but recombination has occurred in this region at some point in the past.
Diabetes Res Clin Pract 1990 Mar
PMID:Hypervariable region 5'-flanking [Leu A3]insulin gene of insulin Tochigi is different from those of insulin Wakayama I,II. 218 61

Decisions to resect small aortic aneurysms or employ non-operative treatment for aorto-iliac occlusive disease must depend on current rather than historical surgical results. To assess current morbidity and mortality, we reviewed 200 consecutive aortic resections in two groups of patients treated from 1981 to 1989: those undergoing elective aortofemoral bypass for occlusive disease (AFB, no. 100) or resection of infrarenal abdominal aortic aneurysms (AAA, no. 100). Indications for AFB included claudication (54%), rest pain (32%), and gangrene (13%). AAA size ranged from 3 to 14 cm (mean 6.5 +/- 2.4 cm); 45% presented with abdominal or back pain. Patients undergoing AFB were younger (AFB 61.5 +/- 10 years vs AAA 68.7 +/- 8.9 years) with a higher incidence of some atherosclerotic risk factors, diabetes mellitus 30% vs 10%, tobacco use 77% vs 49%, hyperlipidemia 21% vs 7%; p less than 0.001). Coronary artery disease (CAD) was more prevalent in AAA patients (49% vs 34%; p less than 0.001). Postoperative mortality was not different in occlusive or aneurysmal disease (3% AFB vs 2% AAA), nor was the occurrence of serious complications such as myocardial infarction (2% vs 1%) or pulmonary embolism (2% vs 3%). Improvements in patient selection, perioperative care and surgical technique have lowered the mortality of elective aortic surgery. Given the current standard of care, an aggressive approach to AAA even in high risk patients is appropriate. The low morbidity of AFB for occlusive disease mandates a critical appraisal of less effective nonoperative therapies.
 ...
PMID:Current results of elective aortic reconstruction for aneurysmal and occlusive disease. 221 95

A 64-year-old man undergoing abdominal aortic aneurysm repair with no history of diabetes mellitus had an episode of marked hyperglycemia during surgery. The peak concentration of glucose in plasma was 43.2 mmol/L. This hyperglycemia responded immediately to administration of 30 units of regular insulin. Factors involved in the hyperglycemia included surgical stress, multiple medications, and the anesthetic used (isoflurane), but do not fully account for the magnitude of the increase in glucose. The data suggest that the patient may have had an underlying insulin deficiency, which was unmasked by the stress of surgery.
 ...
PMID:Transient hyperglycemia during abdominal aortic surgery. 233 99

Selective coronary angiography to determine the prevalence of coronary artery disease (CAD) has been performed in patients with abdominal aortic aneurysm (AAA). Thirty patients in this series consisted of 26 men and 4 women with an age range of 48-87 years (mean +/- SD: 67.5 +/- 8.2 years). As the atherosclerotic risk factors, cigarette smoking was present in 19 patients (63.3%), hypertension was in 18 (60%), hypercholesteremia was in 10 (33.3%), and diabetes mellitus was in 2 (6.7%). Cerebral vascular disease was present in 11 patients (36.7%). Regarding CAD, angina pectoris or old myocardial infarction was found in 9 patients (30%), and abnormal electrocardiography (ECG) was in 16 patients (53.3%). Coronary angiography prior to operation of AAA was performed to 22 patients (73.3%), and 15 patients (68.2%) among them had significant coronary artery stenosis, and 9 patients underwent myocardial revascularization (4 CABG, 5 PTCA). CAD was frequently complicated both in patients without symptoms or ECG abnormalities and in less than 65-year patients. In order to prevent fatal myocardial infarction, we recommend routine coronary angiography to patients with AAA. And if necessary, myocardial revascularization must be indicated prior to aneurysmectomy.
 ...
PMID:[Coronary artery disease in patients with abdominal aortic aneurysm]. 237 12

We performed a prospective study to determine the prevalence of cholelithiasis in patients with abdominal aortic aneurysm. Over an 18-month period, the gallbladder and the abdominal aorta were evaluated routinely in all consecutive patients referred to us for sonography of the abdomen and retroperitoneum. The patients were divided into two groups: those with an abdominal aortic aneurysm (aorta greater than 3 cm in transverse diameter) (n = 96) and those whose aorta measured less than 3 cm in transverse diameter (n = 538), who served as control subjects. Cholelithiasis was found in 50% of patients with and 26% of patients without aneurysm (p less than .0001). A stepwise logistic regression analysis found age alone to be predictive of cholelithiasis (p = .030). However, age was not predictive of cholelithiasis when included with abdominal aortic aneurysm in a multivariate model. Diabetes mellitus and gender were not predictive of cholelithiasis. We found cholelithiasis in approximately half of the patients who had abdominal aortic aneurysms. This is almost double the prevalence in the general elderly population. A pathophysiologic explanation for this observation remains to be found.
 ...
PMID:Increased prevalence of cholelithiasis in patients with abdominal aortic aneurysm: sonographic evaluation. 264 75

A 67-year-old woman with pneumonia and diabetes mellitus was admitted with the complaints of abdominal and back pain. Sputum culture was positive for Klebsiella pneumoniae. Computed tomographic scanning (CT) of the abdomen and spinal radiograph of the lumber column revealed a paraventebral space-occupying lesion, abdominal aortic aneurysm and destructive change of L3 and L4. Pseudoaneurysm of the abdominal aorta associated with infectious spondylitis with paravertebral abscess was suspected and confirmed by aortography. Klebsiella pneumoniae was cultured from the abscess. The patient's condition improved rapidly after drainage of the abscess and administration of LMOX and gentamicin. Infectious pseudoaneurysm of the abdominal aorta associated with infectious spondylitis has rarely been reported. These two in combination due to Klebsiella pneumoniae has not been reported to our knowledge. The pathologic changes were found easily by CT scan. When infectious aneurysm or infectious spondylitis is diagnosed alone, possible combination of these diseases should be kept in mind.
 ...
PMID:A case of infectious pseudoaneurysm of the abdominal aorta associated with infectious spondylitis due to Klebsiella pneumoniae. 266 92

The authors present their experience with abdominal aortic aneurysm during the last 12 years. From 1976 up to now they treated 70 patients with abdominal aortic aneurysms. Sixty-seven patients (96%) were male, while 3 (4%) female. Mean age was 65 years (S.D. +/- 7.97). 82% of the patients were heavy smokers. Sixty-five patients were treated by means of resection and vascular reconstruction. Their associated pathologies were: M.I. or severe heart ischemia 34 (52.3%), diabetes 13 (20%), hypertension 25 (38.4%), T.I.A. 6 (9.2%), renal insufficiency 13 (20%), and respiratory insufficiency 18 (27.6%). Results demonstrated a 12-year patency rate of 91.8%. Five high-risk patients were treated by means of "palliative" treatment. Associated pathologies and risk factors were: smoking 5 (100%), M.I. or severe heart ischemia 5 (100%), diabetes 2 (40%), hypertension 4 (80%), T.I.A. 2 (40%), renal insufficiency 2 (40%), respiratory insufficiency 3 (60%). Treatment consisted in the sac thrombosis by means of Gianturco-Wallace coils into the aneurysm (2 cases) and iliac artery ligation (3 cases). Both techniques allowed acute thrombosis of the aneurysm. Vascular supply to the lower limbs was performed by means of an axillo-bifemoral reconstruction in all cases. Long-term prognosis of these five patients was poor due to their general condition.
 ...
PMID:[Surgical treatment of aneurysms of the abdominal aorta. Consecutive experience for 12 years]. 281 49

Thirty five patients who underwent simultaneous aortic and renal artery reconstruction are reviewed, to determine the value of the combined approach. The risk factors determining operative morbidity and mortality are discussed, on the basis of a long term follow-up of more than sixteen years. All patients had a significant renal artery stenosis, in addition to either severe aorto-iliac occlusive disease or an abdominal aortic aneurysm. Twenty seven patients were hypertensive, and eight patients normotensive. Combined aorto-renal reconstruction was carried out prophylactically in eight instances. There were two operative deaths (5.7%). Factors found to be associated with an increased operative risk were advanced age (over 65 years), heart disease with ECG changes, severe hypertension and diabetes. Renal insufficiency with azothaemia and high levels of creatinine, represented a major risk factor. Post operatively, six individuals (24%) were classified as "cured" and thirteen (523) were "improved". Patients with bilateral renal artery stenosis, mild azothemia and moderately elevated creatinine, were found to improve significantly their renal function post operatively. No patient required hemodialysis. Simultaneous aorto-renal reconstruction may be performed with a low mortality and gratifying improvement in hypertensive patients, without evidence of adverse features.
 ...
PMID:Simultaneous aorto-renal reconstruction and consideration to the value of combined approach. A 2-16 years follow-up study, with review of the literature. 331 23

Life expectancy after aneurysm surgery was analyzed for male patients over the age of 60 years with known risk factors classified by the Goldman cardiac risk index, which has previously been utilized for prediction of immediate perioperative risks of surgery and anesthesia. The preoperative risk factors, Goldman cardiac risk index, and long-term survival rates were tabulated for each of 96 male patients over the age of 60 years who had elective repair of infrarenal abdominal aortic aneurysm. Follow-up data of up to 14 years (mean 4.2 years) was entered into a SurvPak-PC biostatistical software program for construction of Kaplan-Meier survival curves and actuarial life tables to measure differences in survival between groups and for performance of nonparametric analysis (by log rank test) of the influence of preoperative risk factors. The operative mortality rate was 3.1 percent and the 5 year survival rate for the whole group was 61 percent, with a median survival of 8.7 years. Five year survival rates for patients in three age groups (60 to 70 years, 71 to 80 years, and greater than 80 years), when compared with age-matched populations, were 67 percent versus 88 percent, 50 percent versus 73 percent, and 35 percent versus 39 percent, respectively. Patients in Goldman class 1, 2, and 3 or 4 had 5 year survival rates of 79 percent, 53 percent, and 41 percent, respectively. Factors that adversely affected long-term survival were Goldman classes 3 or 4 (median survival 2.1 +/- 0.4 years, p = 0.001), cerebrovascular disease (median survival 1.9 +/- 0.6 years, p = 0.004), history of cardiac disease (median survival 3.2 +/- 0.6 years, p = 0.012), and creatinine concentration greater than 3 mg/100 ml (median survival 3.1 +/- 1.6 years, p = 0.034), whereas Goldman class 2 or the presence of hypertension, pulmonary disease, diabetes mellitus, peripheral vascular disease, and size of the aneurysm, although associated with a shortened length of survival, as independent variables did not reach statistical significance. A combination of any three of these risk factors, however, shortened the survival time markedly (median 1.9 +/- 0.7 years, p = 0.003). We believe that the Goldman cardiac risk index classification correlates with long-term survival in patients undergoing elective aortic surgery.
 ...
PMID:Cardiac risk index as a predictor of long-term survival after repair of abdominal aortic aneurysm. 340 Aug 5


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