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)

Reduced estrogen content has significantly decreased the risks of oral contraceptive (OC) use. However, the systemic effects of OCs, but it is unclear if this change is physiologically significant. Estrogen-mediated inhibition of cortisol levels may contribute to the impairment of glucose tolerance by OCs. Women at high risk for diabetes, older than 35, obese, with family history of diabetes, or who have had glucose intolerance during previous pregnancies should either not take OCs or take pregestin-only pills. OCs raise plasma triglyceride levels 30-50 mg per dl in users of all ages. High density lipoprotein (HDL) cholesterol is also affected, and cholesterol and triglyceride levelshould be measured before and during OC use. The risk of hepatic adenoma rises with duration of OC use; however, most adenomas diagnosed before hemorrhage have regressed with discontinuation of the contraceptive regimen. The most significant adverse effects of OC use involve the arterial and venous vascular systems. OCs appear to raise the blood pressure in nearly all women. Change in systolic pressure is consistently greater than in diastolic, suggestingthat the primary hypertensive effect of OCs is on blood volume and cardiac output. Accumulated data indicate that if OCs are not used by women older than 35 or by women who smoke or who are hypertensive, then risk of subarachnoid hemorrhage or other cerebrovascular complication is very small. The relative risk of myocardial infarction in OC users has been from 0-6 times greater than in nonusers; this may depend on other confounding risk factors. Reduction in estrogen content of OCs decreases risk accordingly. The preponderance of evidence indicates that prolonged use of OCs does not increase risk of breast disease or ovarian and endometrial cancer, and, in fact, may protect users from malignant lesions by suppressing gonadotropins and ovulation.
 ...
PMID:Systemic effects of oral contraceptives. 608 41

Epidemiological data on 1017 cases of primary cancer of endometrium in Israel diagnosed over a 7-year period are presented. Incidence of corpus cancer in Israel has not changed in the last decade; the mean incidence for the current study is 18.73/100,000 women above the age of 25. Eight percent of patients were above the age of 51, with a steep increase of incidence being found above the age of 35. Endometrial carcinoma was four to five times more prevalent in Jewish women of European-American origin than in those of Asian-African background. In 85% of the patients diagnosis was made while the disease was in Stage I. A strong correlation was found between endometrial cancer and infertility, but no correlation was found with diabetes and hypertension. The five-year survival rate in the present survey was 65.0%. Factors affecting prognosis and clinical stage of the disease at diagnosis, degree of myometrial invasion, tumor differentiation, age of the patient and type of treatment are discussed.
 ...
PMID:Endometrial cancer in Israel, 1969-1975. 613 Sep 92

Patients with endometrial carcinoma (N = 1113) were treated by conventional therapy, using surgery and radiotherapy, complemented by daily administration of 100 mg oral medroxyprogesterone acetate (MPA) for a 2-year period. Only 7.3% of the malignancies were at an advanced clinical stage (III or IV), whereas 75.9 and 16.8% of the carcinomas were detected at clinical stages I and II, respectively. The 5-year survival rate was 71.0% overall, and 77.8%, 61.0, 29.0, and 5.3 for clinical stages I, II, III, and IV, respectively. Patients with anaplastic carcinoma (grade 3) at all clinical stages had significantly lower survival rates than had patients with well-differentiated (grade 1) and moderately differentiated (grade 2) adenocarcinomas. Death of grade 1, grade 2 and grade 3 endometrial carcinoma during the first 2 years occurred in 4.7, 6.8, and 18.2% of cases, respectively, in stage II, indicating that adjuvant MPA cannot totally prevent the progression of endometrial malignancy. The incidence of anaplastic endometrial carcinoma increased with the spread of the disease. It often appeared in patients with low body weight or a second invasive malignancy, but seldom occurred in young patients or patients with diabetes, uterine myoma, or a history of previous estrogen use. The worsened prognosis associated with old age, low body weight, and presence of a second invasive malignancy thus seems at lest partly due to the increased incidence of anaplastic carcinoma, which, on the other hand, did not contribute to the decreased 5-year survival rate of patients with diabetes or severe hypertension.
 ...
PMID:Clinical outcome in endometrial cancer. 621 34

Menopausal disorders coincide with the onset of luteal insufficiency and the resulting relative hyperestrogenism. At this stage the risks to be assessed are mainly related to a worsening of the menstrual syndrome (heaviness of the legs, abdominal distention, water retention, mastodynia, depressive syndrome), cycle changes, or various genital types of hemorrhage requiring investigation for detection of a possible fibroma, hyperplasia, endometriosis, or genital cancer. Once the menopause is settled a reduction in estrogen levels comes with reactive increases in FSM and LM levels, and the principal risk is the development of a cancer. The role of endogenous (obesity, diabetes, Stein-Leventhal, adenomatous hyperplasia) or exogenous (prolonged estrogen therapy alone) estrogens has to be evaluated in endometrial cancer. Cancer of the vulva also appears to be more frequent in menopausal women (natural or artificial), as well as cervical cancer and cancer of the breast. There is an apparent increase in cardiovascular risks in untreated menopausal women, but this is still discussed, as to the benefits of estrogen therapy.
 ...
PMID:[Menopausal risk factors (author's transl)]. 625 25

Endometrial cancer is the cause of considerable morbidity among women, but the disease has been underrated and its management more casual than its virulence warrants. Endometrial carcinoma is the most frequently diagnosed invasive neoplasm of the female genital tract in the US, and is third in incidence after breast and colonic cancer. The white population of the US has the highest age standardized incidence of endometrial cancer in the world, India and Japan have the lowest, and the European countries occupy intermediate positions. Between 75% and 80% of women diagnosed with endometrial cancer are postmenopausal, and the mean age at diagnosis is about 60 years. In many cases endometrial hyperplasia is misdiagnosed as frank malignancy. The predisposing factors for endometrial cancer seem to be obesity, hypertension, diabetes mellitus or an abnormal glucose tolerance curve, and prolonged or unopposed estrogen stimulation. Raised estrogen levels may occur in the following situations: 1) women with functioning ovarian tumors that produce estrogen; 2) women with polycystic ovarian disease; 3) women with ovarian dysgensis (Turner's syndrome) managed with estrogen replacement therapy; 4) women taking high estrogen sequential oral contraceptives (OCs); and 5) women undergoing estrogen replacement therapy. There is an increased risk of endometrial carcinoma associated with nulliparity. Carcinoma of the endometrium occurs in a variety of subtypes, the most frequent being adenocarcinoma, followed by adenocanthoma, adenosquamous carcinoma, clear cell carcinoma, papillary adenocarcinoma, and secretory carcinoma. Overall 5-year survival rates are 72% for adenocarcinoma, 68% for adenocanthoma, and 26% for adenosquamous carcinoma. The true extent of endometrial cancer can be ascertained only after exploratory laparotomy and then various therapies may be used according to the stage of the disease.
 ...
PMID:Carcinoma of the endometrium. 637 16

In the years 1952 to 1980 724 women were treated at the 2nd Department of Gynecology and Obstetrics, University of Vienna, for carcinoma of the endometrium. The mean age of the 463 (64%) women operated on rose from 56 to 62 years within three decades; the mean age of the 254 (35%) patients who received primary radiation therapy rose from 68 to 72 years; 7 women (1%) were treated symptomatically only. Looking at constitutional factors an increase of the number of women with manifest diabetes from 4% to 22% was noticed above all. Body weight and mean blood pressure increased slightly although not significantly. Irregular bleeding was the most common symptom, occurring in 90% of all cases and did not show any change in frequency. During the first decade of the period under consideration 86% of the women underwent primary operation, but that percentage decreased to 51% after 1970. Equally distinct was the decrease of 34% to 4% of the vaginal in favor of the abdominal operation. The number of cases with carcinomas with deep myometrial invasion and low differentiation increased. The high significance of these parameters for prognosis is shown by survival curves. The 5-year survival rates of patients primarily operated were about 75%, that of women receiving primarily radiation therapy at about 54%. These results remained approximately the same within the observation period. The increase of complicating factors such as higher age and more frequent incidence of diabetes mellitus accounts apparently for the increase in the number of women receiving primary radiation therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Changes in the clinical picture, morphology and therapy of endometrial carcinoma over 3 decades]. 637 32

In a population-based study 923 asymptomatic women with diabetes aged 40 to 70 years were investigated by aspiration curettage. The samples were evaluated histologically. During the initial screening 4 histologically proved endometrial cancers were diagnosed. All cancer patients were additionally obese and had hypertension, with one exception they were also nulliparous. During the same period the expected number of cases for all investigated women was estimated to 0,74. The expected number of cases limited to those with diabetes, obesity and hypertension was 0,31; and limited to those with diabetes, obesity, hypertension and nulliparity was 0,1, respectively. Additionally 4 cases of adenomatous hyperplasia of the endometrium were identified. The long-term impact on morbidity and mortality of endometrial cancer within the investigated population at risk cannot be assessed as yet.
 ...
PMID:[Screening for endometrial carcinoma in a group at risk]. 649 87

A cohort of 23 233 women who had received estrogen prescriptions was recruited for a prospective study of estrogen therapy and the associated risk of endometrial cancer. For a detailed study, a comprehensive questionnaire was mailed to 735 randomly sampled cohort members, and 89 per cent of them responded. Estrogen exposure and its implications were described in a preceding paper (part I). The present paper reports the distribution in the cohort sample of personal features known to be risk factors for endometrial cancer. A comparison with results from various materials derived from population-based surveys and case-control studies implied that the cohort members might have a lower proportion of nulliparity (infertility) and a somewhat higher prevalence of hypertension. Differences in the distributions of age at menarche or menopause, weight, height and prevalence of diabetes were according to these comparisons slight and probably without clinical significance. It was concluded that the prevalence of risk factors for endometrial cancer other than estrogen exposure was not higher in the cohort than in the background population. Moreover, approximately one-fifth of the estrogen takers had been freed of their risk through hysterectomies.
 ...
PMID:Characteristics of estrogen-treated women. A descriptive epidemiological study of a Swedish population. Part II. 663 3

The incidence of endometrial cancer has been on the increase in Japan. To clarify the risk factors for endometrial cancer in Japanese women, we and our collaborators conducted a strictly controlled case study. A total of 19 Japanese medical centers participated in the study. Sexual abstinence, sterility, postmenopausal status and menstrual irregularity after the age of 30 years appear to be factors which significantly raise the relative risk for endometrial cancer. Conventionally, hypertension, diabetes, obesity and dietary habits have been emphasized as risk factors, however, these factors did not make a significant difference in our study. Accordingly, we suggest that examination for endometrial cancer should be performed on postmenopausal Japanese women and on women with menstrual irregularity who develop abnormal genital bleeding.
 ...
PMID:[Case controlled study of endometrial cancer--high risk factors in Japanese women]. 666 73

411 patients suffering from endometrial carcinoma were seen at the Roswell Park Memorial Institure in Buffalo, New York, between 1970 and 1978. These patients were matched and compared with 338 controls having no neoplastic disease or neoplasms other than of the female genital tract. There was a significantly higher incidence of diabetes, hypertension, and obesity in the uterine cancer patients than in the controls. On the other hand, nulliparity or family history of uterine or other cancer could not be correlated with endometrial cancer in these patients. The control and cancer groups did not differ markedly in the use of estrogens for menopausal or gynecologic reasons. Estrogen use in oral contraceptives (OCs) and for uncertain or unknown reasons was higher in the control than in the cancer group. The uterine cancer group was slightly older (median age 64.2) than the control group (median age 59.7), but this difference is small and believed unlikely to account for the results described.
 ...
PMID:Estrogens and endometrial cancer. 694 29


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