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)

For women beyond the desire for childbearing, the contraceptive options are discussed as appropriate for the age and in light of risks and benefits. Reeducation and careful history taking are important. A pregnancy for a woman 40 years places a woman at greater risk for an elective abortion and greater risk of maternal mortality from abortion; low dose contraceptive use can have beneficial effects for menopausal women. Methods are grouped as contraceptive steroids (combination pills, progestin-only pills, oral preparations, implants, and injections), IUDs, barrier methods (diaphragms, cervical caps, vaginal sponges, spermicides, and contraceptive film), condoms, sterilization, and natural family planning. Empowering women means providing current scientific information and urging women to examine their lives, and to review how and why contraceptive choices were made, and the consequences of the choices. Sexually transmitted disease counseling is appropriate for women in new relationships. A positive attitude toward menopause needs to be conveyed. Combination pills at the lowest dose possible are recommended for women 35 years who are healthy, nonsmoking (or smoking 15 cigarettes/day), blood group O, and able to derive benefits from the pill. Benefits include a 30% reduction in uterine fibroids and protection against endometrial cancer, and decreased risk of ectopic pregnancy, pelvic inflammatory disease (PID), and iron deficiency anemia. Multivitamin use with the pill is recommended due to reduced liver stores of vitamin A. Women 40 years with a parent dying of cardiac disease 50 years or with a history of hypertension, diabetes, or hyperlipidemia are not suitable candidates. 35 mcg preparations are recommended for women 35-45 years, and 20 mcg for women over 45 years. Progestin-only pills are recommended for those with contraindication to estrogen, but have a higher pregnancy rate. IUD use among older women may be difficult due to cervical or pelvic surgery; there is a higher incidence of PID and ectopic pregnancy with IUD use. Barrier methods are more successful for older women due to the changing vaginal anatomy. Vasectomy is the safest sterilization procedure.
 ...
PMID:Contraception for midlife women. 159 31

Biomedical researchers have added cardiovascular disease (CVD) to the list of symptoms resulting from lowered estrogen levels and menopause. Thus health providers promote hormone replacement therapy (HRT) to prevent CVD. Yet most women tend to be healthy during the postmenopausal years which constitute at least 33% of their lives. The medical community has taken a natural event, menopause, and labeled it as a disease which causes other diseases. Science is basically patriarchal. Physicians use it to justify their privilege to define illness and treatment. They reduce organic processes into a narrow cause-effect relationship and ignore socioeconomic and political factors. An often ignored problem with the scientific community's view of CVD is that almost all cardiovascular intervention studies included only men as subjects except the prospective Framingham Study. Traditional risk factors of CVD in women are hypertension, cholesterol levels, cigarette smoking, diabetes, excess weight, oral contraceptives, and genetics. Various studies show a reduction in the age adjusted risk of CVD morbidity any mortality in women on estrogen replacement theory (ERT). Specifically, estrogen affects serum lipids in a positive direction. Yet the women in the studies are healthy, lean, and exercise regularly. Some studies reveal an increased risk of breast cancer and endometrial cancer in women on ERT. HRT consists of a combination of estrogen and progestin, but data do not confirm that it is as protective against CVD as ERT. HRT is postmenopausal women is an untested hormonal experiment. In 1986, the US National Institutes of Health wrote a policy to include women as subjects in research studies. It did not happen so in 1991 it established the Office of Women's Health Research. The US Congress has also taken up the issue. Nurse researchers should critique methods used by patriarchal science to study menopause. Nurses can inform postmenopausal women about their choices concerning HRt to prevent CVD.
 ...
PMID:Cardiovascular disease in women and noncontraceptive use of hormones: a feminist analysis. 160 87

In a prospective study comprising 447 women with endometrial carcinoma stages I-II, the prognostic significance of clinical and flow cytometric variables was evaluated in univariate and multivariate analyses. The parameters studied included age, uterine cavity depth, clinical stage, histopathologic grade, myometrial invasion, weight, body mass index (BMI), parity, diabetes, oestrogen treatment, DNA - content and S-phase fraction. Patient selection for surgery influenced prognosis with a better survival in operated patients. In the univariate analysis the following parameters correlated with survival: age, grade, myometrial invasion, DNA - content and S- phase fraction. In the multivariate analyses which included clinical variables only, age, grade and myometrial invasion remained significant, but when flow cytometric variables were added, only S-phase fraction and myometrial invasion contained prognostic information. S-phase fraction also generally correlated with time of recurrence.
 ...
PMID:Prognostic significance of flow cytometric and clinical variables in endometrial adenocarcinoma stages I and II. 162 30

We analyzed the complications in 310 patients with pathologically documented endometrial carcinoma who received adjuvant radiation therapy (RT) at Fox Chase Cancer Center between 1970 and 1986. Variables included timing of treatment, technique, total dose, age, diabetes, previous abdominal surgery, hypertension, prior bowel pathology, and lymphadenectomy. According to the FIGO (1985) system, 258 patients had Stage I disease, 48 had Stage II, and one had Stage III. One hundred seventy patients received preoperative (preop) RT, 138 received postoperative (postop) RT, and 2 received preop and postop RT. A 4-field technique was used for 212 of 235 patients receiving external-beam (EX) RT, and 75 patients were treated with intracavitary (IC) RT only. Median follow-up was 5.5 years. Actuarial survival of all 310 patients was 78% at 5 years. Thirty-two complications occurred, involving the rectum, small bowel, femur, or lower extremity. Complications were graded according to the ECOG scoring system as grade 2 (mild) and grades 3, 4, or 5 (serious). One of 75 patients treated with IC RT only experienced a grade-2 complication (proctitis). Of 71 patients receiving 4-field EX RT only, 25 preop (16%) and 14 postop (14%) patients had complications. Of 139 patients treated with both EX and IC RT, grade-2 complications were seen in 5% of 87 preop patients and 12% of 52 postop patients (p = 0.17), whereas serious complications were observed in 4% of each group. Univariate analysis of the variables of interest revealed that the incidence of complications was associated with a lymphadenectomy (p = .03), use of external RT (p less than .01), and decreasing age (p = .04). Multivariate analysis confirmed that use of external RT was the most significant predictor for complications. In conclusion, similar complication rates were found in patients treated with either preop or postop 4-field EX RT. While pelvic RT clearly decreases pelvic relapse in patient with endometrial carcinoma, the risk benefit ratio for treatment of these patients should be carefully considered when recommending adjuvant RT for pelvic control.
 ...
PMID:Analysis of complications in patients with endometrial carcinoma receiving adjuvant irradiation. 191 20

Vaginal hysterectomy was performed on 31 patients with stage I endometrial cancer because of medical problems which placed them at high risk for morbidity and mortality from abdominal surgery. These risk factors included morbid obesity (87%), hypertension (58%), diabetes mellitus (35%), and cardiovascular diseases (26%). The perioperative morbidity was minimal, with only four patients (13%) experiencing complications requiring extended hospital stays and no deaths. Adjuvant radiotherapy was administered in 35% of patients with either deep myometrial invasion or unfavorable histology. The 3- and 5-year disease-free survival rates were 100 and 93%, respectively. The only cancer-related death occurred 4.5 years following surgery. Although the authors are not advocating vaginal hysterectomy as standard treatment of endometrial cancer, this approach provides an acceptable alternative to abdominal surgery in the medically compromised patient.
 ...
PMID:Use of vaginal hysterectomy for the management of stage I endometrial cancer in the medically compromised patient. 198 19

From July 1985 to January 1989, 133 patients underwent endometrial sampling for evaluation of post menopausal bleeding (PMB). Of these patients, 114 (85.7 percent) showed benign histology with an average age of 58.6 years. Nineteen (14.3 percent) were malignant, all of which showed endometrial carcinoma. The average age was 65. In addition, 26.3 percent of patients with carcinoma had higher grade of tumor at hysterectomy when compared with the preoperative biopsy. The average volume of tissue removed at curettage was significantly greater in those with carcinoma. Hormonal therapy, duration of symptoms, hypertension, obesity or diabetes were not significant risk factors for carcinoma in our series. PMB remains a major symptom that may predict endometrial carcinoma and must be evaluated. In those patients with carcinoma, intraoperative evaluation of the uterus for tumor grade and depth of invasion is important in determining the extent of surgery.
 ...
PMID:Post menopausal bleeding as a risk factor for endometrial carcinoma. 199 92

A 1-page check-off form that can be used to evaluate a woman's risk factors for oral contraceptives, IUD or diaphragm and spermicide, and provide a permanent health record of the evaluation, has been revised to reflect lower-dose pills and new information. Each risk factor is assigned points in columns under each contraceptive method, so that a score of 10 suggests that a contraindication may exist against that method. Some of the changes for orals are lower scores for age 40, unless other risk factors co-exist, especially smoking. Liver disease, hepatitis and gall bladder disease were eliminated, but liver tumors, endometrial cancer and cholestatic jaundice of pregnancy were each given 10 points. Scores were altered slightly for chloasma, hemoglobinopathies, hypertension and diabetes. Scores for the diaphragm were lowered for pelvic relaxation risk but 5 points were introduced for history of urinary tract infection. For IUDs, multiple sexual partners and abnormal bleeding are added as risks.
 ...
PMID:Family-planning risk-scoring system: updated. 201 9

The descriptive and analytical epidemiology of endometrial cancer is reviewed. Over the last few decades, age-standardized incidence rates have been rising in several countries. The rise has been even greater in terms of absolute numbers of cases, and hence public health implications, due to the aging of the population. Although endometrial cancer rates were found to be higher in richer countries and urban populations, there is now evidence of some changes in the socioeconomic determinants of the disease in developed countries. In etiological terms, any factor that increases exposure to unopposed estrogens (such as menopausal replacement treatment, obesity, and irregular menstrual cycles) tends to increase the risk of the disease, while factors that decrease exposure to estrogens or increase progesterone levels (such as oral contraceptives or smoking) tend to be protective. Less well defined, or more difficult to explain in biological terms, is the role of other factors, such as births, miscarriages, or diabetes and hypertension, and only suggestive evidence is available on diet from analytical epidemiology. The data reviewed herein are discussed in terms of models of carcinogenesis, as well as attributable risks and public health implications.
 ...
PMID:The epidemiology of endometrial cancer. 202 52

The health risks of obesity increase with its severity and reach significance at a weight greater than 20% above optimal, by using life insurance tables, or at a body mass index greater than 27. Risks include hypertension, insulin resistance and diabetes mellitus, cardiovascular disease, hypertriglyceridemia, low high-density-lipoprotein cholesterol, and, in some studies, high total-and low-density-lipoprotein cholesterol. There is an increased mortality from endometrial cancer in women and from colorectal cancer in men. Chronic hypoxia and hypercapnia, sleep apnea, gout, and degenerative joint disease can occur with more severe obesity. The distribution of body fat is directly related to these health risks. Abdominal obesity is more dangerous than gluteal-femoral obesity because the amount of intraabdominal fat seems to determine much of the increased peril; therefore, risks of cardiovascular disease, stroke, hypertension, and diabetes increase with abdominal obesity, even independently of total fat mass.
 ...
PMID:Health implications of obesity. 203 92

Knowledge of cyclic changes, connected with hormonal action and precancerous states, is of substantial significance for early diagnosis and timely treatment of endometrial carcinoma. Eighty six women with endometrial carcinoma, established histologically, were studied prospectively. A parallel study of histological differentiation of the tumour and some clinical symptoms was made. Serum level of F2 were examined as well. It was found that they were more manifested in highly differentiated adenocarcinomas. Women with histories for dysfunctional uterine bleedings suffering from hypertonic disease diabetes, obesity and with increased levels of E2 were considered as a risk group for development of endometrial carcinoma.
 ...
PMID:[Endometrial cancer. A clinico-morphological study]. 210 Sep 50


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