Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The associations or linkages between the polymorphisms of the Gm and Km immunoglobulin allotypes and the susceptibility to autoimmune diseases, including diseases with immuno-pathological pathogenesis are reported in this review. These diseases include multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, insulin-dependent diabetes mellitus, Crohn's disease, coeliac disease, Graves' disease, atrophic thyroiditis, Hashimoto's thyroiditis, myasthenia gravis, chronic active hepatitis, alopecia areata, uveitis, vitiligo, Turner's syndrome, glomerular nephritis, Berger's disease and idiopathic dilated cardiomyopathy. Immunoglobulin allotypes are described as well as the statistical methods used to analyse the data.
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PMID:Gm and Km allotypes in autoimmune diseases. 162 73

It is claimed that long-term treatment with beta-blockers improves cardiac function and exercise capacity in patients with various forms of congestive heart failure. This was first reported by Waagstein and coworkers in patients with idiopathic dilated cardiomyopathy in 1975 and was later confirmed in 8 further studies in this type of patient. A total of 211 patients with idiopathic dilated cardiomyopathy were treated for 12-19 months. About two thirds of the patients have improved to some extent. Seven other studies reported favourable long-term effects of beta-blockers in 120 patients with other forms of dilated cardiomyopathy, e.g. caused by coronary artery disease, adriamycin, diabetes, or valvular heart disease. Pooled data from 10 studies on 153 patients with various forms of cardiomyopathy, showed that ejection fraction was improved by 40% from 27 to 38%. Only two studies were inconclusive, both with only one month's treatment. In all studies with favourable effects of long-term beta-blockade, treatment was given for more than 2 months and in most cases for about 6 months. A number of beta-blockers have been used in the studies, including acebutulol, alprenolol, bucindolol, labetalol, metoprolol, practolol and propranolol. In most cases, a rather low dose was given initially and there was a stepwise increase in the dosages. After 6-8 weeks most patients were given beta-blockers in daily doses comparable to those given in patients with angina pectoris and hypertension. There is at present no indication that one beta-blocker is superior to others. It therefore seems reasonable to believe that the effects are due to beta 1-blockade.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:New therapeutic strategies in chronic heart failure: challenge of long-term beta-blockade. 168 18

In January 1990, as partial fulfillment of a 5-year contract to train Soviet health professionals, a six-person team from the International Diabetes Center went to Moscow to present a program on diabetes education and management to 45 of the USSR's leading endocrinologists and 20 physicians from Moscow's Central Institute for Advanced Medical Studies. The IDC team found a nation faced with major problems and shortages but filled with physicians and patients eager to learn and ready to act. Diabetes education as practiced in the United States is unknown in the Soviet Union, but through training programs such as this, the Soviets are updating and expanding their knowledge of diabetes education and management.
Diabetes Educ
PMID:Spaseeba balshohyi--kharohshiyi! (Thank you very much--it was great!). 193 54

Certain clinical and cardiac necropsy findings are described in 152 patients aged 16 to 78 years (mean 45) with idiopathic dilated cardiomyopathy: 109 (72%) were men and 43 (28%) were women. Compared with the women, the men had a significantly (p less than 0.05) shorter mean duration of chronic congestive heart failure (CHF) (43 vs 69 months), a higher percentage of habitual alcoholism (40 vs 24%) and a higher mean heart weight (632 vs 551 g). The male to female ratio among the 58 known alcoholics was 7.3:1 and among the 70 known nonalcoholics, 1.5:1 (p less than 0.05). The mean duration of clinical evidence of CHF was similar among the known alcoholics and the known non-alcoholics (each 50 months). Of the 152 patients, 148 (97%) had clinical evidence of chronic CHF; in 114 patients it was the initial manifestation of idiopathic dilated cardiomyopathy, and in most it became intractable and caused death. The interval from onset of chronic CHF to death (known in 120 patients) ranged from 1 to 264 months (mean 54). Comparison of the 27 patients surviving greater than 72 months after onset of chronic CHF to the 64 patients surviving less than or equal to 36 months disclosed a significantly higher frequency in the longer survival group of older patients, of women, of habitual alcoholics, of patients with chest pain syndromes, diabetes mellitus, pulmonary emboli, of patients treated with warfarin and of patients with larger hearts at necropsy. Each of the 4 patients without chronic CHF died suddenly and sudden death was the initial manifestation of idiopathic dilated cardiomyopathy in them. An additional 33 patients also died suddenly, but each of them previously had had chronic CHF. Of the 79 patients (of the 131 for whom information was available) with either pulmonary or systemic emboli or both, 67 (85%) had either right- or left-sided thrombi or mural endocardial plaques or both, whereas of the 52 patients without emboli, 36 (69%) had intracardiac thrombi or plaques (p less than (0.05). Electrocardiograms in the last 6 months of life in 101 patients disclosed atrial fibrillation in 25; complete left (41 patients) or right (6 patients) bundle branch block or indeterminate intraventricular conduction delay (4 patients) in 51 patients; QRS voltage indicative of ventricular hypertrophy in 44 patients (left ventricular in 39 patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Idiopathic dilated cardiomyopathy: analysis of 152 necropsy patients. 368 84

As first reported by our group in 1975, severe heart failure due to idiopathic dilated cardiomyopathy could be improved in patients receiving beta-blocker therapy starting at a very low dose and followed by a stepwise increase. Since then, these results have been confirmed by our own group and by others, and similar results were also obtained in patients with other forms of cardiomyopathy, including ischaemic cardiomyopathy. In 13 separate studies involving a total of 651 patients with idiopathic dilated cardiomyopathy, beta-blockade for 2 to 19 months (in addition to conventional treatment of heart failure, including angiotensin converting enzyme inhibitor therapy), significantly improved cardiac function. These studies were performed using metoprolol, bucindolol, labetalol and practolol. Eight studies investigated the effects of long term beta-blocker treatment in patients with heart failure and cardiomyopathy due to coronary artery disease, valvular heart disease, diabetes and doxorubicin therapy. A total of 128 patients were treated with metoprolol, carvedilol or bucindolol for periods of 2 to 12 months. All studies reported a significant improvement in cardiac function. Three studies reported results on survival and the need for cardiac transplantation. The first study published by our group reported improved survival in patients with idiopathic dilated cardiomyopathy treated with metoprolol plus digitalis and diuretics compared with a matched control group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The role of beta-blockers in the treatment of cardiomyopathy and ischaemic heart failure. 752 60

Although a number of clinical and demographic factors have been associated with the performance of angiography in cardiac patients, clinical studies of idiopathic dilated cardiomyopathy (DCM) have often excluded patients who have not undergone coronary angiography to rule out coronary artery disease (CAD). To examine the impact of this diagnostic criterion on population-based studies of idiopathic DCM, we examined characteristics of probable cases of DCM who did or did not have a recorded history of angiography. The cases (n = 129) were ascertained from five medical centers in the Washington, DC metropolitan area over the period 1 July 1990 through 29 February 1992. All of these cases had evidence of ventricular dilation and hypokinesis, with a left ventricular ejection fraction of less than 40%. Cases with a history of known CAD, congenital heart disease, valvular heart disease, or secondary cardiomyopathy were excluded. Sixty-two (48%) of the cases had a recorded history of angiography. Age, educational level, diabetes, alcohol use, insurance status, and type of hospital were significantly associated with angiography in bivariate analysis (p < 0.05). Diabetes and hypertension were inversely associated with history of angiography among black cases, and positively associated with angiography among whites. In logistic regression analysis, age was the strongest independent predictor of angiography (p < 0.025). The associations with educational attainment and alcohol use were of borderline significance (p < 0.10). Thus, in epidemiologic studies of idiopathic DCM, particularly in biracial populations, the exclusion of cases who have not undergone angiography may bias risk estimates and result in the underestimation of incidence and prevalence.
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PMID:Predictors of coronary angiography in patients with idiopathic dilated cardiomyopathy: the Washington, DC Dilated Cardiomyopathy Study. 773 Aug 76

We examined possible risk factors for idiopathic dilated cardiomyopathy in women by comparing newly diagnosed cases (N = 61) ascertained from five Washington DC area hospitals with neighborhood controls (N = 122) identified using a random digit dialing technique. We matched the cases and controls on 5-year age intervals and telephone exchange and analyzed the data using conditional logistic regression methods. We found that idiopathic dilated cardiomyopathy was associated with history of asthma, diabetes mellitus, hypertension, and black race. The association with hypertension was particularly strong among women who were less than 50 years of age [crude relative odds (RO) = 21.0, 95% confidence interval (CI) = 4.6-96.9]. We found a strong inverse association with history of oral contraceptive use (crude RO = 0.3, 95% CI = 0.1-0.7; adjusted RO = 0.1, 95% CI = 0.1-0.5, controlling for other identified risk factors). Only 13.2% (7 of 53) of the cases had a reported history of contraceptive use, as compared with 35.5% (43 of 121) of the controls. The possible protective effect from oral contraceptive use was not explained by race, educational attainment, asthma, diabetes mellitus, or hypertension, and was more pronounced among women who were less than 50 years of age.
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PMID:The epidemiology of idiopathic dilated cardiomyopathy in women: the Washington DC Dilated Cardiomyopathy Study. 791 16

An epidemiologic study was carried out to examine the possible role of diabetes mellitus and other factors in the development of idiopathic dilated cardiomyopathy. Possible associations with diabetes and other factors were examined by comparing newly diagnosed case patients (n = 129) ascertained from five Washington, DC area hospitals with neighborhood control subjects (n = 258) identified using a random-digit dialing technique. The case patients and control subjects were matched by sex and 5-year age intervals and were compared in the analysis using conditional logistic regression methods. A statistically significant association was observed between idiopathic dilated cardiomyopathy and history of diabetes (relative odds = 2.2; 95% confidence interval: 1.5 to 3.3). The association with diabetes was not explained by race, income, cigarette usage, or hypertension. A total of 28.7% (37/129) of the case patients had a reported history of diabetes, as compared with 13.6% (35/258) of the control subjects (P < 0.05). A possible interactive effect was also observed between diabetes and history of hypertension (P > 0.05). These findings support the view that diabetics, particularly those with a history of hypertension, may be at increased risk of idiopathic dilated cardiomyopathy.
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PMID:Diabetes mellitus and risk of idiopathic dilated cardiomyopathy. The Washington, DC Dilated Cardiomyopathy Study. 820 73

Possible predictors of mortality from idiopathic dilated cardiomyopathy were studied in 356,222 men who were screened as part of the Multiple Risk Factor Intervention Trial. The vital status of each member of this cohort was ascertained through 1986. Death certificates were obtained from state health departments and coded by a trained nosologist. Individuals with a history of myocardial infarction were excluded. A total of 206 deaths due to idiopathic dilated cardiomyopathy occurred in the cohort of 356,222 men after an average of 12 years of follow-up. The age-specific rates of mortality from idiopathic dilated cardiomyopathy increased from 0.10 per 10,000 person-years among men aged 35-39 years to 1.16 per 10,000 person-years among men aged 55-57 years. The proportional hazards model was used to obtain adjusted estimates of relative risks. Statistically significant, independent associations were observed with cigarettes smoked per day (p < 0.001), diastolic blood pressure (p < 0.001), and diabetes mellitus (relative risk (RR) = 2.97, p < 0.001). Black race was also associated with an increased risk of death from idiopathic dilated cardiomyopathy (RR = 1.59 and p = 0.045 without adjustment for income; RR = 1.58 and p = 0.058 with adjustment for income). No association was found with serum cholesterol or income. The information about possible risk factors obtained in this study may contribute to future preventive programs for idiopathic dilated cardiomyopathy.
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PMID:Predictors of mortality from idiopathic dilated cardiomyopathy in 356,222 men screened for the Multiple Risk Factor Intervention Trial. 829 83

Although an etiologic link between viral myocarditis and idiopathic dilated cardiomyopathy has long been recognized, the actual extent of this relation has been uncertain. In this review, we examine recent developments in the molecular analysis of endomyocardial biopsy specimens, particularly techniques for gene amplification, which have unequivocally confirmed this relation and given us some insight into its significance. In addition, we show that viral myocarditis in a murine model is associated with spasm of the coronary microvasculature, leading to myocyte necrosis, fibrosis, calcification and cardiac dilation. These findings are similar to those seen in the hearts of genetically cardiomyopathic hamsters, rats and humans with hypertension and diabetes, rats after acute brain injury and models of Chagas' disease. Treatment of microvascular spasm with verapamil, captopril or alpha 1-adrenergic blocking agents appears to interrupt this pathway and has been shown to markedly impede the evolution of dilated cardiomyopathy in the genetic hamster model and a murine model of myocarditis. There is some suggestion that digitalis, though beneficial during cardiac decompensation, may actually be detrimental when administered during the early stages of myocardial disease. These experiments have led to a new paradigm for the pathogenesis of cardiomyopathy after viral myocarditis, as well as a general hypothesis for the pathogenesis of some types of dilated cardiomyopathy. They also suggest that the selection of therapeutic agents for some forms of dilated cardiomyopathy may differ significantly between the early and late stages of the disease.
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PMID:Viral myocarditis: a paradigm for understanding the pathogenesis and treatment of dilated cardiomyopathy. 837 2


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