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

The prevalence and causes of anemia have been studied in 104 patients over 60 years of age admitted to a general medical ward in Jerusalem. In males and females, mean hemoglobin levels were about 1 g less than in the corresponding groups of healthy younger controls. A primary nutritional anemia could not be implicated in any of the 15 patients with hemoglobins below 11 g/dl. The most important causes of anemia were chronic renal failure, metastatic carcinoma, gastrointestinal bleeding, and infection. Conversely, in diseases with no adverse effect on erythropoiesis such as chronic ischemic heart disease, hypertension and diabetes, hemoglobin levels were equal to those of the younger controls. These findings indicate that although diminished serum iron and RBC folate levels may occasionally be found in elderly subjects, nutritional deficiency is seldom responsible for anemia in this age group in Israel- and anemia when present is often the manifestation of a chronic underlying disease.
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PMID:Prevalence and causes of anemia in elderly hospitalized patients. 31 45

In 152 patients with diabetes mellitus, chronic ischaemic heart diseases and hypertension the so-called ptf-product resulting from the height of the amplitude of P and its time of spreading) measured in the lead V1 (PV1-index), was determined and compared with the values of 93 persons with healthy heart. Patients of the groups of diseases mentioned showed significantly higher pathological values than persons with healthy heart (limiting value -0.02 mms). A comparison between patients with chromic ischaemic heart disease at the age of 36-55 years and a group of diabetics of the same age without the clinical signs of an ischaemic heart disease resulted in no statistically ascertained differences. But compared with a group of persons with healthy heart of the same age the groups clearly differed: 63.9% of pathological values in the total group of disease compared with 18.5% of pathological values in persons with healthy heart. In 137 patients with latent diabetes (protodiabetes) in 54.7% also pathological ptf-values were found. It is possible that the determination of the ptf-product is able to ascertain already early forms of a chronic ischaemic heart disease still before its clinical manifestation. The large number of pathological values in patients with protodiabetes could be a first reference to early beginning disturbances of the left-sided atrial activity in the sense of a microangiopathy.
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PMID:[Significance of the PV 1 index in the ECG of diabetes mellitus and in the early forms of chronic ischemic heart disease]. 119 71

Most published calculations of mortality risk, especially those for lung cancer associated with smoking, are based almost exclusively on the underlying cause as recorded on death certificates. Such risk calculations implicitly assume that the conditional probability of recording lung cancer as the underlying cause of death, given that it really is the underlying cause, is the same for all exposure groups. If these probabilities are not equal for all exposure groups, we call the resulting bias a cause of death attribution bias. We analyzed the 1986 National Mortality Followback Survey, a sample of 18,733 U.S. death certificates, and the 1954-1962 Dorn study, a follow-up study of approximately 250,000 holders of U.S. Veterans Life Insurance. Both data sets include information on the smoking habits of decedents and on the underlying and contributing causes of their deaths. We found that lung cancer as an underlying cause is recorded with a much smaller relative frequency if the decedent is known to be a never-smoker and with a much larger relative frequency when the decedent is known to be a smoker. On the other hand, lung cancer as a contributing cause is recorded with a much larger frequency if the decedent is known to be a never-smoker and with a much smaller frequency when the decedent is known to be a smoker. The reverse is true for cancers other than of the lung. There is no similar pattern related to smoking for other causes of death (specifically for myocardial infarction, other chronic ischemic heart disease, diabetes, or cerebrovascular disease).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bias in the attribution of lung cancer as cause of death and its possible consequences for calculating smoking-related risks. 826 93

Thirty seven patients aged 70 and over (mean = 74 years) with an intracranial meningioma who had craniotomy between the years 1978-88 were reviewed. There were 20 women and 17 men. Resection was total in 28 (76%) and subtotal in 9 (24%) cases and each tumour was histologically verified. The location of the tumours were: base of skull 11, convexity 10, parasagittal 9, falx 6, and tentorial 1. The most frequent associated diseases were: hypertension (35%), chronic ischaemic heart disease (22%) chronic obstructive pulmonary disease (19%), and diabetes (14%). The Karnofsky Scale (KS) score before surgery ranged from 30 to 90 (mean = 59). It was less than 40 in ten patients. The length of anaesthesia during the surgical procedure varied from 4 to 12 hours and was not related to the outcome. There were two perioperative deaths (mortality = 5.4%). There were major complications in 8 patients and minor complications in 7 patients. In a mean follow up period of 29 months (shortest 6 and longest 96 months) the results were: excellent (KS 90-100) 39%, good (KS 70-80) 49%, fair (KS 60) 6%, and poor (KS 40-50) 6%. The difference between the mean preoperative KS value (KS = 59) and the mean postoperative KS value (KS = 80) was statistically significant (P less than 0.001). The results support a more aggressive therapeutic approach to the elderly patient with an intracranial meningioma.
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PMID:Surgical outcome in an elderly population with intracranial meningioma. 161 16

The nutritional status of 93 noninstitutionalized elderly of the city of Perugia, mostly of them examined longitudinally, was assessed at the eleventh year follow-up. Diet is still rather rich and unbalanced. Alcohol intake in men is very high. Biological dietary errors have an impact on the nutritional status, particularly for folates, of the individual. But in this regard it is interesting to note that in some cases vitamin and mineral nutriture has improved at this follow-up. In addition the distribution of malnutrition is rather different from that of the previous follow-up. As on previous occasions, no correlation was observed between vitamin intake and corresponding nutritional status (with the exception of riboflavin). Obesity is rather common among women; men present a higher muscular area and hand muscular strength. The clinical evaluation of nutritional status evidences principally changes which are mostly ascribable to old age. Among the pathologies, chronic ischemic heart disease, hypertension, chronic respiratory diseases, osteoarthrosis and diabetes occur most frequently.
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PMID:Nutritional status of the elderly V). Dietary and biochemical data and anthropometry of noninstitutionalized elderly in Perugia at the eleventh year follow-up. 180 40

The paper deals with the rheological properties of the blood of 38 male patients affected by ischaemic heart diseases (age: 40-75 years) and 19 healthy test persons of comparable age. The following haemorheological properties were measured. 1. Relative plasma viscosity 2. Erythrocyte aggregation 3. Erythrocyte deformability 4. Thrombocyte aggregation and 5. Whole blood viscosity. For the purpose of representing and assessing the results of measurement obtained a division was made into different groups according to the appearances of ischaemic heart disease (chronic ischaemic heart disease, unstable angina pectoris, acute heart infarct) and risk factors (smoking, diabetes mellitus, blood high pressure and hyperlipidaemia). The methods 1-3 proved to be especially suitable for representing gradual differences in the examined rheological parameters. The results obtained are discussed and evaluated.
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PMID:[Hemorheologic findings in patients with ischemic heart disease]. 248 31

In a sample of 301 men, aged 54-62 years, who were employed in the telephone industry in New Jersey, and who were followed prospectively from 1963/1964 to 1984, 65 of 148 deaths were manifested by the abrupt occurrence of fatal ventricular arrhythmias. On multivariate analysis, the factors present at the initial examination that were significantly related to the subsequent occurrence of arrhythmic deaths were: abnormal patterns of QRS conduction; the level of blood pressure; the number of cigarettes currently being smoked; chronic myocardial ischemia; chronic airway disease; and failure to engage in any exercise or heavy physical activity. Among 28 other potential risk factors representing myocardial disorders, ventricular dysrhythmias, other disorders of cardiac rate, rhythm, conduction, and repolarization, and non-cardiac risk factors (including cholesterol level, serum uric acid level, diabetes mellitus, alcohol intake, general arteriosclerosis, other non-cardiac disease, and social, behavioral, and attitudinal variables), none significantly added to risk for arrhythmic death. The risk factors related to the subsequent occurrence of other deaths, manifested by the gradual development of circulatory failure, were significantly different from the risk factors related to arrhythmic deaths.
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PMID:The risk factors for arrhythmic death in a sample of men followed for 20 years. 334 56

An increase of blood and plasma viscosity, an increased aggregation of erythrocytes and a decreased deformability of erythrocytes are pathogenetically important for a disturbance of the microcirculation. In rigidity of the vascular wall due to vasosclerosis according to Hagen-Poiseuille's law the fluidity of blood essentially determines the size of blood circulation, and a reduced blood flow by an impairment to the nutritive capillary blood supply leads to hypoxic tissue damages. For a series of pictures of a disease, such as polycythaemias, anaemias, paraproteinoses, diabetes mellitus, Raynaud's syndrome, myocardial infarction, degenerative angiopathies, are changes of the blood rheology of clinical relevancy. Own examinations on patients with chronic ischaemic heart disease resulted in a positive correlation between hyperviscosity and hyperlipidaemia. A treatment of the disturbed blood fluidity is at present possible by means of haemodilution, reduction of fibrinogen, improvement of the deformability of erythrocytes as well as of necessary by plasmapheresis.
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PMID:[The importance of hemorheology in internal medicine]. 675 Sep 41

In a prospective longitudinal study over 21 months the performance of general practitioners and the disease status of their patients was measured during the formulation and implementation of guidelines on follow-up care. Data on 15 general practitioners and on 613 patients with hypertension, 95 with diabetes mellitus, 66 with chronic ischemic heart disease, 115 with chronic respiratory disease, and 17 with osteoarthritis were used for analysis. Performance measures were defined and for each disease a disease status indicator was used. The possibly modifying effect of compliance of the general practitioner, and of patient compliance with the guidelines was taken into account. The general practitioners formulated consensus guidelines on follow-up care and implemented these guidelines in their practices. The implementation was supported by peer review. The performance of general practitioners tended to conform more with the guidelines during the study period, especially with regards to actions that should be performed routinely. There were no major changes in the disease status indicators. Compliant hypertensive patients had a normotensive status more frequently than non-compliant patients. Diabetic patients were more likely to be normoglycaemic when they received care according to guidelines. None of the differences were statistically significant over time.
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PMID:Implementing guidelines in general practice. Evaluation of process and outcome of care in chronic diseases. 779 62

Certainty of a diagnosis is not only important for the patient but also for morbidity studies. In the absence of a gold standard, agreement with diagnostic criteria is often the best approach in measuring the certainty of a diagnosis. The agreement with diagnostic criteria has been studied for 5 chronic diseases (hypertension, chronic ischemic heart disease, diabetes mellitus, chronic nonspecific lung disease and osteoarthritis) in 7 general practices with a total practice population of 23,534 persons. Agreement with diagnostic criteria is operationalized into 3 categories. For each chronic disease a diagnostic quality measure per general practitioner is computed. Retrospective data have been collected in the practices on 2295 diseases in 1989 patients. Two-thirds of the diagnoses were made in general practice. The agreement with the diagnostic criteria for the cases diagnosed in general practice is high, ranging from 96% true positive cases in diabetes mellitus to 58% in chronic nonspecific lung disease. The highest rate of false positive cases is 4%. On the level of general practitioners diagnostic qualities vary from 62 to 96% true positive cases for the different diseases. The variation in diagnostic quality between general practitioners is substantial. The prevalence rates for the 5 chronic diseases are lower after adjustment by only including true positive cases. Diagnoses of the 5 chronic diseases recorded in general practice are generally valid with low numbers of false positive cases.
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PMID:Validity of diagnoses of chronic diseases in general practice. The application of diagnostic criteria. 850 72


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