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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cause-specific mortality was surveyed among 23,180 male (580,000 person-years) and 3,860 female (86,898 person-years) employees with 1 or more years of service from 1940 through 1989 at a large chemical plant. Vital status was ascertained for 99.1% of the males (n = 5,658 deaths) and 98.6% of the females (n = 355 deaths). Comparisons of observed mortality with expected levels based on any of three population comparisons (United States, Texas, or five local counties) showed lower mortality for all causes of death, diseases of the circulatory system, diabetes mellitus, and cirrhosis of the liver. There was an increased risk for lung cancer mortality among male operations employees when compared to the U.S. and Texas populations but not to the local five-county region. Additional evidence suggests this increase was primarily attributable to cigarette smoking. Male operations employees also had an elevated, although not statistically significant, risk for kidney cancer. Prior research had shown an association with work in the cell maintenance area of chlorine production. As a result of a high prevalence of deaths certified by justices of the peace, a mortality excess was observed of cancer of other and unspecified sites and symptoms, senility, and ill-defined conditions. Although specific chemical exposures were not studied, the generally favorable mortality experience suggests that major hazards are unlikely.
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PMID:Half-century of cause-specific mortality experience of chemical manufacturing employees. 797 96

The addition of 5 years of follow-up and over 411,000 person-years of observation to a cohort of 34,081 men and women employed in U.S. furniture and other related industries allowed the investigation of mortality patterns among women and minority races in addition to white men. A significant excess of pleural mesotheliomas occurred among white men (standardized mortality ratio [SMR] = 3.7, 95% confidence interval [CI] = 1.2-8.7) but could not be linked to a particular type of furniture manufacturing. SMRs for myeloid leukemia and chronic nephritis were elevated among white men employed in the wood furniture industry but were not statistically significant. Males in the black/other race categories in wood furniture plants showed nonsignificant mortality excesses for infectious diseases and cancers of the prostate and colon and rectum. Among white women employed in wood furniture plants, mortality was elevated for cancers of the pancreas and lung during the most recent follow-up period. In metal furniture plants, mortality was raised among men in both race groups for kidney cancer (black/other SMR = 8.0, 95% CI = 1.6-23.2; white SMR = 2.1, 95% CI = 0.4-6.2) and diabetes mellitus (black/other SMR = 2.2, 95% CI = 0.6-5.6; white SMR = 1.8, 95% CI = 0.7-3.9). Stomach cancer mortality was significantly elevated (SMR = 3.3, 95% CI = 1.3-6.8) among white men in metal furniture plants and was of the same magnitude over both the previous and the most recent follow-up periods. Among those working with textiles, SMRs were significantly elevated for leukemia (SMR = 6.1, 95% CI = 1.2-7.8) and cancers of the colon and rectum (SMR = 3.2, 95% CI = 1.3-4.5) for white women. Lung cancer mortality was increased for white men and women in textile operations, but SMRs were not statistically significant. SMRs for a number of other causes of death that were elevated at the end of the earlier follow-up period were not increased during the new follow-up period.
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PMID:Extended mortality follow-up among men and women in a U.S. furniture workers union. 801 Feb 96

Cancer mortality rates for Aberdeen Area Indians exceed U.S. rates with lung cancer being the leading cause of cancer death. The Sioux Cancer Study, an ancillary study of the Strong Heart Study, investigated cancer and cancer risk factors among tribal members aged 45-74 in three Sioux tribes in North and South Dakota. An Indian-specific health risk appraisal was used to collect data and provide specific recommendations to participants. The high rates of smoking (56% for men and 48% for women) explain the high lung cancer mortality rates. Intensive smoking cessation and prevention programs will likely have the greatest impact in reducing preventable cancer deaths. More accessible cervical and breast cancer screening provided by female health care providers is needed to reduce preventable cancer deaths among Sioux women. Pap smear screening is an especially high priority since cervical cancer mortality is 4.4 times higher than U.S. rates, all races. Programs targeted to reduce obesity and excessive alcohol use will also likely reduce preventable cancer deaths associated with high rates of obesity, diabetes and binge drinking. Community-based cancer prevention and control programs tailored to the cancer risk factor profile of the community are the best strategy to reduce preventable cancer deaths in Indian communities.
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PMID:Cancer risk factors in three Sioux tribes. Use of the Indian-specific health risk appraisal for data collection and analysis. 816 Sep 19

The cohort consisted of 11,178 Mead Corporation employees (9,358 males and 1,820 females) who had worked for at least one year between January 1, 1975 and December 31, 1992 at seven pulp and/or paper mills in the United States. The vital status of the cohort was determined through a variety of sources over an observation period of 17 years (1976-1992). Mortality data were analyzed in terms of cause-specific standardized mortality ratios (SMRs), with expected deaths based on U.S. national mortality rates. Job categories with similar exposures were created based on an historical exposure assessment. Mortality analyses were performed separately for total female and male employees. Among female employees, overall mortality was less than expected, and no significant cause-specific mortality excesses were observed. The small number of deaths among female employees did not permit further detailed analyses. Among male employees, statistically significant deficits from overall mortality (SMR = 69.0) and from all cancers (SMR = 71.3) were reported. In addition, low mortality risks for many specific causes were also observed, including many specific cancer sites, various types of cardiovascular diseases, and different forms of nonmalignant respiratory diseases. In particular, there was no mortality excess from lung cancer (SMR = 77.5), digestive cancer (SMR = 69.4), stomach cancer (SMR = 46.7), laryngeal cancer (no observed death), rectal cancer (SMR = 82.8). Hodgkin's lymphoma (no observed death), non-Hodgkin's lymphoma (SMR = 103.6), leukemia (SMR = 72.2), diabetes mellitus (SMR = 110.4), ischemic heart disease (SMR = 80.0), and nonmalignant respiratory diseases (SMR = 36.7). Furthermore, detailed analyses by length of employment, interval since hire (latency), and job category demonstrated no occupationally related mortality increases from any of the diseases examined. Specifically, based on internal comparisons, no upward trends in cause-specific mortality risk were observed by duration of employment. In conclusion, the results of this epidemiologic investigation demonstrated a favorable mortality experience for employees at the seven pulp and/or paper mills.
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PMID:An epidemiologic study of employees at seven pulp and paper mills. 889 92

It has been reported that the incidence of lung cancer is higher in patients with pulmonary tuberculosis (TB). However, there is little information on the survival and clinical characteristics of these patients. We retrospectively reviewed the medical records of patients with coexisting pulmonary TB and lung cancer covering a period from 1988 to 1994. There were 31 such patients among a total of 3928 lung cancers diagnosed. Lung cancer patients had an increased risk of active pulmonary TB in comparison with the general population in Taiwan. Diabetes mellitus (DM) was found in 37.5% of patients who were diagnosed as having active pulmonary TB within 2 years before, or concurrent with, the diagnosis of lung cancer. However, none of the patients who had developed lung cancer before TB had a history of DM. Epidermoid carcinoma accounted for 64.5% of these cases. The patients who had developed active pulmonary TB before, or concurrently with, the diagnosis of lung cancer survived shorter than those who did not have pulmonary TB at diagnosis of lung cancer (P=0.007). Survival from diagnosis of pulmonary TB was longer in patients who developed the disease earlier than lung cancer (P=0.046). Survival from the time of diagnosis of lung cancer was significantly longer in patients who developed cancer earlier than active pulmonary TB (P=0.0048), those without DM (P=0.0132), those with an early tumor stage (P=0.002), and those given specific cancer treatment (P=0.0001). It is concluded that survival is shorter in lung cancer patients who present initially with active TB than in those who do not have TB.
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PMID:Shortened survival of lung cancer patients initially presenting with pulmonary tuberculosis. 889 72

Mortality at two engine plants was analyzed using proportional mortality and logistic regression models of mortality odds ratios to expand previous observations of increased cancers of the stomach, pancreas, and bladder, and cirrhosis of the liver among workers exposed to machining fluids. Causes of death and work histories were available for 1,870 decendents. There was a significant excess of deaths coded as diabetes for white men in both plants (PMR = 25/16.7 = 1.5, 95% CI = 1.02, 2.20), and a deficit of respiratory diseases. Black men had fewer than expected diabetes deaths and more emphysema deaths. Elevated PMRs for cancers of the stomach, pancreas, prostate, bladder, and kidney were not statistically significant in plantwide populations. However, stomach cancer mortality increased with duration in camshaft and crankshaft production at Plant 1 (OR = 5.1, 95% CI = 1.6, 17; at mean duration of exposed cases), and among tool room workers (OR = 6.3, 95% CI = 1.3, 31), but these results were based on five cases. Nitrosamines were probably present in camshaft and crankshaft grinding at Plant 1. Pancreas cancer risk increased among workers at both plants ever employed in inspection (OR = 2.5, 16), in machining with straight oil (OR = 3.6, 95% CI = 1.04, 12), or in skilled trades (OR = 2.9, 95% CI = 1.1, 7.5). Lung cancer increased in cylinder head machining (OR = 3.9, 95% CI = 1.4, 11), millwright work (OR = 3.8, 95% CI = 1.6, 9.0), and in Plant 2 generally (OR = 1.45, 95% CI = 0.97, 2.2). Potential lung carcinogens included heat treatment emissions, chlorinated oils, and coal tar fumes (millwrights). Bladder cancer increased with duration among workers grinding in straight oil MF (OR = 3.0, 95% CI = 1.15, 7.8) and in machining/heat-treat operations (OR = 2.9, 95% CI = 1.14, 7.2).
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PMID:A survey of mortality at two automotive engine manufacturing plants. 891 13

The object was to model and project utilization of hospital in-patient days for selected diseases in The Netherlands. We used sex- and age-specific standardized monthly utilization of hospital in-patient days during 1980-90 for lung cancer, diabetes, coronary heart disease, stroke, and pneumonia. These data were supplied by the Health Care Information Centre (Stichting Informatiecentrum voor de Gezondheidszorg). We applied Box-Jenkins time-series analysis seasonal autoregressive integrated moving-average (SARIMA) models. Estimated models are tested by considering the Portmanteau test and the Akaike information criterion. SARIMA models give an adequate representation of hospital-in-patient-days utilization for the major sex and age classes of most selected diseases. Poor modelling results are obtained for diabetes in all sex and age groups and in elderly women with coronary heart disease or with stroke. Seasonality is an important factor in most of the models that we have estimated, particularly for utilization of pneumonia and stroke patients. The major trends in standardized in-patient days are downward, and projected 1995 levels of standardized utilization are below the 1990 levels for all the selected diseases. Population-based projections for 1995 are lower than the 1990 projections only for lung cancer and diabetes. The adequacy of the SARIMA models appears to be sensitive with respect to the parameter in the Portmanteau test. We discuss two possible explanatory developments for in-patient-days utilization: (i) developments in the provision of hospital care, and (ii) epidemiological developments. The selected diseases showed a decreasing mean duration of stay in 1980-90. Only for coronary heart disease did a rise in discharges in the same period outweigh this trend. We assessed contrasts between published epidemiological developments and the trends in in-patient-days utilization. Possible explanations concern shifts from in-patient to out-patient care and changes in treatment. Finally, complementary to our SARIMA models, the investigation of future in-patient days utilization by means of scenario analytic approaches remains important.
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PMID:Projecting utilization of hospital in-patient days in The Netherlands: a time-series analysis. 891 56

To assess the clinical value of determination of the interferon (IFN)-producing capacity of patients, IFN production induced by Sendai virus (HVJ) in vitro was measured in cell cultures of whole blood from patients with various diseases. IFN production in patients with lung cancer, myelodysplastic syndromes, noninsulin-dependent diabetes mellitus, pulmonary tuberculosis, and asymptomatic HIV-1 infection was lower than that in healthy persons. Furthermore, periodic measurements of IFN production revealed decreasing IFN producing capacities in patients with lung cancer with progression of the tumor stage. However, increased IFN-producing capacities were observed in patients with tuberculosis after standard therapy. Further experiments showed that the main type of IFN induced in whole blood cultures was IFN-alpha, and decreased IFN production in patients did not result from a decreased number of leukocytes but rather from an impairment of cellular IFN production. The evaluation of IFN production in whole blood cell cultures may be a feasible method of assessing the impaired immune status.
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PMID:Determination of interferon-alpha-producing capacity in whole blood cultures from patients with various diseases and from healthy persons. 893 66

A 68-year-old man who worked as an editor was admitted to Aichi Medical University Hospital due to dyspnea on exertion and emaciation. The patient had noticed rapid weight loss during diet therapy for diabetes mellitus that started in the beginning of July, 1993. Laboratory examinations revealed elevated levels of LDH and amylase in serum. Ultrasonography disclosed minimal ascites. Dyspnea on exertion developed in September, 1993. Chest roentgenography showed diffuse bilateral small nodular or reticular opacities. CT-guided percutaneous needle aspiration was done and cytologic examination of a specimen of lung tissue revealed papillary adenocarcinoma. The diagnosis was bronchiolo-alveolar carcinoma. Serum levels of amylase were elevated. The amylase isozyme pattern was of the salivary type. Serum levels of CA19-9 and CEA were also elevated. The patient died of respiratory failure on December 4, 1993. Postmortem examination revealed diffuse small nodules in both lungs. Examination of the nodules showed bronchiolo-alveolar cell carcinoma. The tumor cells stained positively for amylase (salivary type, not pancreatic type) CA19-9, and CEA by the avidin biotin complex method, but they were immunohistologically negative for AFP. We conclude that this lung cancer produced amylase, CA19-9, and CEA. We know of only a few reports of cases in which lung cancer produced both amylase and CA19-9.
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PMID:[Diffuse bronchiolo-alveolar cell carcinoma that produced both amylase and CA19-9]. 921 68

The Nurses' Health Study was initiated in 1976 to study the relation between oral contraceptives and breast cancer. Subsequent funding was available to follow the cohort to address relations between cigarette smoking, postmenopausal hormones, hair dyes, and a range of cancers including breast, endometrial, ovarian, and lung cancer. The 121,700 participating nurses are followed up every 2 years via mail questionnaire to update exposure information to identify incident cancers and other illnesses. Follow-up through 1994 has achieved 90% response from living cohort members. Over the course of the study, additional exposures have been added and refined, including weight at age 18, current weight, height, waist and hip measurements and history of major voluntary weight loss among others. Our focus has been on the health effects of weight gain during middle age. The results relating to diabetes, coronary heart disease, certain types of cancer and total mortality are reviewed. Our primary analytic tools have been multiple logistic regression and Cox proportional hazards models. These methods allow for flexibility in defining the exposures of interest as well as determining their relative importance while controlling for key risk factors. Our models show that even moderate weight gain after age 18 increases risk of each condition. The benefits of physical activity include reduced risk of disease. Issues in the measurement and validation of weight and activity highlight the complexities that are inherent in observational studies addressing the health consequences of lifestyles and anthropometric variables. Our experience of working with repeated measures of body weight and recreational activity are described. Recreational activity has been ascertained in various ways on several questionnaires and may be subject to misclassification. For both weight and activity it may be the pattern of these values that is of importance (e.g. "weight cycling") for some outcomes or conditions. Our research in this area is ongoing. These issues regarding longitudinal measurement will never be completely resolved because weight and activity are intrinsically complex concepts. For these and other such variables, the primary solution is to minimize the problems associated with longitudinal studies. This is best accomplished by developing and maintaining a very strong study design/protocol, including: careful consideration of the sample frame and sample size; maintenance of a high response rate; and continuous monitoring and improvement of the survey/interview instrument(s).
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PMID:Weight, weight gain, activity, and major illnesses: the Nurses' Health Study. 927 43


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