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)

Retrospective analysis has been performed on 108 consecutive patients operated for primary hyperparathyroidism (HPT) at 75 to 85 years of age (mean 79 years). The preoperative serum calcium value averaged 2.99 mM, and six patients had hypercalcemic crisis. Psychic disturbances were seen in 60 patients (56%), 40% of whom demonstrated dementia. Skeletal and muscular complaints were registered in 29% and 19%, respectively, and only 6% were overtly asymptomatic. Cardiovascular diseases were presented by 69% of the patients, 13% had diabetes mellitus, and 26% were institutionalized prior to surgery. Bilateral neck exploration disclosed a single adenoma in 69%, which was of the oxyphil cell type in 13%, and water-clear (n = 3) or chief cell hyperplasia in 27%. The total glandular weight averaged 1085 mg. Altogether 72 patients operated on after 1980 demonstrated a perioperative (30-day) mortality of 1.4%; the corresponding morbidity of 8.7% mainly included infections as well as a vocal cord paralysis in one patient and two incisional hematomas. Analysis for mean 3.1 years postoperatively displayed reversal of hypercalcemia in 95% of the patients; 2.8% of those operated after 1980 had persistent disease. Symptoms seemed to be alleviated in 62%, with a similar rate attained in patients with dementia. Altogether 60 patients died from mainly cardiovascular diseases mean 4.2 years after the operation. Those succumbing the first postoperative year (n = 21) showed overrepresentation of cardiac diseases and diabetes mellitus. The results demonstrate prevalent psychic disturbances, oxyphil adenomas, and multiglandular parathyroid disease in elderly patients with primary HPT and favor rather liberal application of parathyroid surgery among these individuals.
 ...
PMID:Surgery for sporadic primary hyperparathyroidism in the elderly. 772 53

Among surgical patients renal diseases association with diabetes mellitus was found in 117, with thyroid affection in 82 patients. Twenty-six patients were treated for primary hyperparathyroidism, 46 were operated on for adrenal tumors: pheochromocytoma (23 cases), Conn's syndrome (3 cases). Hyperglycemic coma in patients with acute purulent renal diseases was primarily due to overlooked diabetes mellitus. Thyrotoxic crises emerged after urgent ureterolithotomy in a female patient suffering from toxic goiter, hypothyroid coma occurred in a male subject with undetected hypothyroidism following pyelolithotomy. Clinical variability of the symptoms, no attempts oriented on their detection led to diagnosis of pheochromocytoma, Conn's syndrome, primary hyperparathyroidism in emergency situations or at autopsy. Timely diagnosis and pathogenetic therapy of endocrine crises produced favourable outcomes.
 ...
PMID:[Endocrine crises in patients with kidney diseases]. 794 Nov 21

Secondary osteoporosis may be associated with a number of endocrine dysfunctions and metabolic disorders. In this paper, osteoporosis in patients with Cushing's syndrome, hyperthyroidism, primary hyperparathyroidism, acromegaly, hypogonadism and some metabolic disorders such as diabetes mellitus, chronic renal failure and malabsorption syndrome are described. While the major manifestation of bone in these conditions is a reduction of bone mass and may be somewhat different from bone loss in primary osteoporosis histologically or radiologically, it is considered to be the same bone loss as primary osteoporosis in the present paper. In some conditions, for example, Cushing's syndrome, diabetes mellitus etc, factors responsible for bone loss are demonstrated.
 ...
PMID:[Osteoporosis associated with endocrine dysfunctions or metabolic disorders]. 796 90

Some epidemiological aspects of Paget's disease were examined using questionnaires completed by 864 patients with physician-diagnosed Paget's disease and 500 controls of similar ages. Specifically studied were issues of familial aggregation of the disorder, history of exposure to certain infectious diseases, other medical disorders, and calcium intake (as assessed by milk consumption) in childhood. A history of Paget's disease in a first-degree relative was noted in 12% of patients and 2% of controls. Among patients, those with a positive family history had an earlier mean age at diagnosis and a greater prevalence of bone deformity than patients with a negative family history. The risk of a first-degree relative of a pagetic patient developing Paget's disease was 7 times greater than the risk of an individual without such a relative, and the cumulative risk to age 90 for a first-degree relative of a patient was 9%, compared with a 2% risk in a person without affected relatives. The risk to the relative was greatest if the patient had an age at diagnosis of less than 55 years and had deforming bone disease. There was no difference between patients and controls for a variety of viral infections, including measles, and no difference in ownership of dogs and possible exposure to canine viruses. Diabetes was more common in controls than in patients, but arthritis, skeletal fractures, primary hyperparathyroidism, osteoporosis, and thyroid disease (in women) and renal stones (in men) were reported more commonly by patients. Milk consumption during childhood and adolescence was lower in patients than in controls.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Epidemiological aspects of Paget's disease: family history and relationship to other medical conditions. 800 30

The effect of endocrine disorders on bone mass is being increasingly studied. It is suggested that the preceding thyroid disorder, rather than thyroxine replacement itself, may reduce bone mass. Fracture rate does not appear to be increased in primary hyperparathyroidism once the condition is diagnosed. Although osteopenia is widely accepted to be associated with diabetes mellitus, two studies report increased bone mass in this condition. However, diabetes appears to adversely affect bone formation and urinary calcium excretion. Osteopenia is not a problem in acromegaly despite that patients are often hypogonadal. The possible associations of thyroid disease with connective tissue disorders are discussed, and the role of androgens in the pathogenesis of connective tissue disease is debated.
 ...
PMID:Endocrine disorders. 803 83

The frequency of acute or chronic pancreatitis in primary hyperparathyroidism has decreased from the former 5-10% to 1-2% thanks to earlier diagnosis and operative treatment. Chronic pancreatitis, which occurs only in prolonged primary hyperparathyroidism, should therefore virtually disappear. We investigated this topic in a prospective long term study of chronic pancreatitis (1963-1992). Over the last three decades 336 patients with chronic pancreatitis have been studied at regular intervals. 245 suffered from alcohol-induced (84% with calcifications) and 91 from non-alcohol-induced chronic pancreatitis (77% with calcifications). The average period of observation in the group with non-alcohol-induced chronic pancreatitis was 10.6 years. Primary hyperparathyroidism was found in 6 patients (4 male, 2 female), i.e. 6.6% of non-alcohol-induced chronic pancreatitis (100% with calcifications). They were evenly distributed over the 30 years' study period. 3 patients had acute attacks of pancreatitis prior to the diagnosis of chronic calcific pancreatitis (2 months, 3 + 8 years). In 3 patients with primary painless chronic calcific pancreatitis the condition was diagnosed twice incidentally and once because of diabetes mellitus. Chronic pancreatitis was diagnosed 3 times before primary hyperparathyroidism (8.3 +/- 2.1 years), once simultaneously and twice afterwards (2 + 14 years). In three patients chronic pancreatitis was initially misinterpreted as alcohol-induced. Severe exocrine pancreatic insufficiency was present in 4 of 5 patients (no data in one), and diabetes mellitus in 3 of 6 patients. At the time of diagnosis of primary hyperparathyroidism, mean serum calcium was 3.08 +/- 0.43 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Chronic pancreatitis and primary hyperparathyroidism]. 807 34

It is generally known that patients with primary hyperparathyroidism (pHPT) feature disturbances in carbohydrate metabolism and hypertension. The incidence and prevalence of frank diabetes mellitus is significantly increased in these patients. The etiology and pathogenesis of the vascular and metabolic aberrations in this condition are still unclear. Glucose intolerance in pHPT is characterized by severe insulin resistance associated with pancreatic beta cell hypersecretion of insulin. Hypercalcemia is thought to be mainly responsible for the impaired glucose metabolism. However, several studies demonstrated that hypophosphatemia can also induce insulin hypersecretion and impair peripheral glucose uptake. Hypertension in primary hyperparathyroidism is mainly attributed to hypercalcemia. However, high peripheral insulin levels are also proposed to contribute to the development of essential hypertension and hyperinsulinemia per se is regarded as an important independent cardiovascular risk factor. After parathyroidectomy and decrease of the calcium levels to within the normal range, the blood pressure levels of the patients with pHPT normalised very quickly, whereas normalization of the high peripheral insulin levels was only found in a subgroup of patients. Thus, hypercalcemia seems to be mainly responsible for hypertension in primary hyperparathyroidism. Another important, yet unresolved issue is the question as to whether or to which extent the disturbances in glucose homeostasis are reversible after surgical correction of pHPT. At an early stage of the disease, insulin resistance and insulin hypersecretion are fully reversible after parathyroidectomy, whereas in patients with long-standing primary hyperparathyroidism and severely impaired glucose tolerance the metabolic disturbances will only partially improve. These results argue for improved screening to identify asymptomatic patients with primary hyperparathyroidism and for early surgical intervention in this disease.
 ...
PMID:[Diabetes mellitus and carbohydrate metabolism in primary hyperparathyroidism]. 847 26

Amylin, also named islet amyloid polypeptide (IAPP), is a protein that is processed and released from pancreatic beta-cells in parallel with insulin. Islet amyloid polypeptide is currently studied with regard to a role for insulin resistance in non-insulin-dependent diabetes. To elucidate a possible function of IAPP for impaired glucose tolerance in primary hyperparathyroidism (pHPT), we studied plasma IAPP levels during an oral glucose tolerance test (OGTT) in seven pHPT patients before and 8 weeks after surgery and in six healthy subjects. The B-glucose level of the patient groups was 4.34 +/- 0.12 mmol/l before and 3.97 +/- 0.16 mmol/l after surgery (NS), while the serum level of insulin was significantly higher before (16.9 +/- 2.8 mlU/l) than after (8.9 +/- 1.9 mlU/l) the operation (p < 0.05), indicating a moderately increased insulin resistance in pHPT. The basal plasma levels of IAPP were significantly higher in pHPT patients before than 8 weeks after surgery (9.71 +/- 1.05 and 4.30 +/- 0.82 pmol/l, respectively: p < 0.01). When compared to the plasma IAPP level of the controls at 1.80 +/- 0.38 pmol/l, pHPT patients had higher IAPP values both before (p < 0.01) and at 8 weeks after (p < 0.05) operation. There was a significant correlation between the serum levels of insulin and plasma levels of IAPP in pHPT patients before (r = 0.87, p < 0.01) as well as 8 weeks after surgery (r = 0.69, p < 0.05). The area under the curve for IAPP during OGTT in pHPT patients was 1872.4 +/- 187.7 pmol.min/l, which is significantly higher than after surgery (1010.8 +/- 93.7 pmol.min/l) (p<0.05) and compared to the area for the controls at 840.3 +/- 49.9 pmol.min/l (p<0.01). In conclusion, pHPT is associated with an increased plasma level of IAPP, correlated to the serum insulin level, but persistently higher than in controls also 8 weeks after surgery. Possibly, increased IAPP levels can have a role for impaired glucose tolerance in pHPT. The hyperparathyroid state might have a specific role for the release of this peptide, otherwise closely connected to insulin secretion
 ...
PMID:Increased plasma levels of islet amyloid polypeptide in patients with primary hyperparathyroidism. 861 29

Impairments in cardiovascular, respiratory and kidney function are considered as risk factors for complications following surgery. As the indication for surgery in asymptomatic primary hyperparathyroidism (HPT) is controversial, 123 patients undergoing surgery for HPT and 104 control subjects scheduled for common surgical procedures were evaluated pre-operatively. Compared with the age- and sex-matched control group, serum calcium (P < 0.001), creatinine (P < 0.01) and glucose (P < 0.02) were all increased in the HPT group, while peak expiratory flow (PEF) was decreased (P < 0.04). Furthermore, the patients with HPT, compared with controls, were more often receiving antihypertensive medication (P < 0.005) and were more likely to have a history of congestive heart disease (P < 0.01), thromboembolic diseases (P = 0.05), stroke (P = 0.06) or diabetes mellitus (P < 0.02). Increased frequencies of ST-segment depression (P < 0.001) and T-wave abnormalities (P = 0.05) at electrocardiography together with an increased prevalence of heart enlargement visible at chest radiography (P < 0.01) were also seen in the HPT group when compared with the controls. All HPT patients and controls survived, but one HPT patient suffered a myocardial infarction in the post-operative period. In conclusion, the present study showed the pre-operative risk factor profile to be altered in HPT subjects with impairments in both cardiovascular and respiratory functions as well as in kidney function and glucose control. These findings should be kept in mind when the indications for surgery in asymptomatic patients with HPT are discussed.
 ...
PMID:Pre-operative evaluation of risk factors for complications in patients with primary hyperparathyroidism. 871 37

Somatostatin (SRIF) is effective in the nonoperative management of a variety endocrine tumors. A potential role of SRIF for treatment of patients with primary hyperparathyroidism (pHPT) has been suggested. In a controlled, prospective, triple-blinded, randomized clinical trial, the somatostatin analogue octreotide (SMS 201-995, Sandostatin) was evaluated in 40 patients with well documented pHPT. Amongst other biochemical parameters, serum calcium and-phosphate and levels of parathyroid hormone, calcitonin, and osteocalcin as well as octreotide were assessed before and for 4 hours after a single iv. application of 200 micrograms ocreotide or placebo. SRIF-receptor autoradiography was performed in parathyroid tissue samples. Baseline values revealed a constellation of biochemical parameters typically found in pHPT. Following 200 micrograms octreotide, no significant changes in any of the biochemical parameters investigated for were observed. Multivariate analysis was performed to identify patient subpopulations in which any given combination of laboratory parameters changed in response to either drug or placebo. However, no 'responders' to octreotide were identified. 45% of patients receiving octreotide, reported side effects. Parathyroid tissue samples were negative for SRIF-receptor expression. It is concluded that a single dose iv. application of octreotide does not result in appreciable changes of biochemical parameters relevant in pHPT and carries a high rate of side effects. Furthermore, absence of SRIF-receptors in parathyroid tissue from patients with pHPT, together with lack of octreotide effects, suggests that somatostatin-analogues may not be effective in the non-operative therapy of pHPT.
Exp Clin Endocrinol Diabetes 1995
PMID:Influence of somatostatin to biochemical parameters in patients with primary hyperparathyroidism. 878 13


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