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 aim of this phase IV study was to assess the tolerability and efficacy of acipimox, a lipid-lowering drug, in 3009 type II diabetic out-patients with types II and IV hyperlipoproteinaemia. The study was carried out by 150 Italian diabetes centres. Acipimox was given at the dosage of one capsule (250 mg), two or three times daily for at least 2 months. Acipimox produced a mean fall of 43% in serum triglycerides and of 18% in total serum cholesterol levels compared with baseline. The lipid-lowering effect was present throughout treatment, but was most pronounced at the end of treatment. An increase in the serum concentration of high density lipoprotein cholesterol (15%) was also observed at the end of the trial. Fasting blood glucose and glycosylated haemoglobin levels showed a slight reduction during the study. Adverse events were reported in 263 (8.8%) cases and 165 (5.4%) patients discontinued the treatment. The female trial population showed a nearly two-fold greater incidence of adverse events than the males. In the majority of cases the adverse events experienced by patients were transient episodes of flushing and mild gastro-intestinal disturbances (e.g. gastric pain and pyrexia).
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PMID:Results of a phase IV study carried out with acipimox in type II diabetic patients with concomitant hyperlipoproteinaemia. 267 53

A case of acute intestinal vascular necrosis in a 19-year-old user of oral contraceptives (OCs) is described, and hypotheses explaining the digestive complications of synthetic estrogens are reviewed. The patient had originally presented with a violent gastric pain that subsequently spread to the entire abdomen. An abrupt worsening of her condition involved cardiovascular collapse associated with a peritoneal syndrome, vomiting and dehydration, and hyperleukocytosis. Emergency opening of the peritoneum was followed by evacuation of a large quantity of fetid gas and alimentary debris, and observation of a completely necrosed stomach. A careful lavage of the entire intestinal cavity led to temporary improvement, but it became clear during an attempt at gastrectomy that further treatment would be unavailing and the patient died shortly thereafter. Estrogens were believed to be responsible for the digestive necrosis because it occurred in a young woman who had used an estrogen-rich OC for 3 years and who smoked; a hapatic biopsy confirmed the diagnosis. No traces of other risk factors such as hypertension, hyperlipidemia, diabetes, neoplasia, or obesity were observed. Recent publications indicate that OCs are responsible for a certain number of digestive problems, which may include acceleration of intestinal transit, severe diarrhea, rectorrhagia, ischemic or ulcerative colitis, intestinal infarct which is usually localized, and hepatocellular problems ranging from moderate hepatic insufficiency to malignant tumor and Budd-Chiari syndrome. OCs do not modify hemodynamic regimes, but they may cause elevation of fibrinogen and thrombin, diminution of antithrombin III acitivty, increased platelet adhesivity, and decreased fibrinolysis leading to hypercoagulability. These modifications in hemostasis occur in all OC users and are not statistically correlated with occurence of thrombotic accidents. OCs are probably responsible for parietal vascular lesions; experimental injection of synthetic estrogens is associated with both arterial and venous lesions. The most characteristic anomaly is at the level of the intima, with proliferation of smooth muscle cells and increased conjunctive tissue fibers associated with proliferation of the media or the endothelium. The absence of lipid deposits, the simultaneous appearance of arterial and venous lesions, and other evidence argues against and atheromatous origin of parietal lesions. A significant correlation has been found between high levels of anti-synthetic ethinyl estradiol antibodies and the presence of vascular lesions. It is hypothesized that these circulating immune complexes penetrate the vascular walls of OC users and produce lesions, which may depend on factors such as smoking.
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PMID:[Digestive complications of oral contraceptives: a case of extensive digestive necrosis in a young woman]. 647 54

Reactions in leprosy causing nerve function impairment (NFI) are increasingly treated with standardized regimens of corticosteroids, often under field conditions. Safety concerns led to an assessment of adverse events of corticosteroids, based on data of three trials studying prevention of NFI (the TRIPOD study). A multicentre, randomized, double-blind placebo-controlled trial was conducted in leprosy control programmes in Nepal and Bangladesh. Treatment was with prednisolone according to fixed schedules for 16 weeks, starting in one trial with 20 mg/day (prophylactic regimen: total dosage 1.96 g) and in the other two trials with 40 mg/day (therapeutic regimen: total dosage 2.52 g). Minor adverse events were defined as moon face, fungal infections, acne, and gastric pain requiring antacid. Major adverse events were defined as psychosis, peptic ulcer, glaucoma, cataract, diabetes and hypertension. Also, the occurrence of infected plantar, palmar, and corneal ulceration was monitored, together with occurrence of TB. Considering all three trials together, minor adverse events were observed in 130/815 patients (16%). Of these, 51/414 (12%) were in the placebo group and 79/401 (20%) in the prednisolone group. The relative risk for minor adverse events in the prednisolone group was 1.6 (P = 0.004). Adverse events with a significantly increased risk were acne, fungal infections and gastric pain. Major adverse events were observed in 15/815 patients (2%); 7/414 (2%) in the placebo group and 8/401 (2%) in the prednisolone group. No major adverse events had a significantly increased risk in the prednisolone arm of the trials. No cases of TB were observed in 300 patients who could be followed-up for 24 months. Standardized regimens of corticosteroids for both prophylaxis and treatment of reactions and NFI in leprosy under field conditions in developing countries are safe when a standard pre-treatment examination is performed, treatment for minor conditions can be carried out by field staff, referral for specialized medical care is possible, and sufficient follow-up is done during and after treatment.
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PMID:Adverse events of standardized regimens of corticosteroids for prophylaxis and treatment of nerve function impairment in leprosy: results from the 'TRIPOD' trials. 1475 May 77

Vessel luminal narrowing after percutaneous coronary intervention (PCI) is characterised by platelet aggregation, release of growth factors, inflammatory cell infiltration, medial smooth muscle cell (SMC) proliferation, proteoglycan deposition and extracellular matrix remodelling. It is broadly accepted that the central mechanism at the basis of the whole pathophysiological process of restenosis is inflammation, triggered by vascular injury and activated through autocrine or paracrine mediators. Glucocorticosteroids exert beneficial effects on platelet function, on SMC proliferation and on collagen synthesis as well as inflammatory cell migration and activation, thus interfering with several steps of the cascade leading to neointima formation and subsequent late lumen loss. Initial experiences with systemic administration of glucocorticoids after PCI failed to confirm the expected benefits of this treatment, probably as a result of inadequate dosage and pharmacokinetic calculations. Recently a short-term, high-dose immunosuppressive treatment scheme with oral prednisone has demonstrated remarkable clinical and angiographic results when prednisone was given orally at a dose of 1 mg/kg for 10 days, 0.5 mg/kg for 20 days and 0.25 mg/kg for 15 days. This treatment has dramatically reduced the incidence of clinical vascular events at 1 year compared with controls (relative risk 0.34; 95% CI 0.12, 0.96; p = 0.006) and reduced the incidence of angiographic restenosis below 10% in different clinical and angiographic subsets. Secondary effects of a short course of glucocorticoids are generally minor, predictable and reversible: gastric pain, water and salt retention and worsened hypertension manifest in nearly 10% of patients. The addition of diuretics and acid suppressants before discharge, and the upgrading of antihypertensive medication thereafter, if needed, are useful preventive measures to control these temporary disorders. A routine blood cell count 4 weeks after PCI is advised in patients receiving thienopyridines (clopidogrel or ticlopidine) in addition to prednisone to rule out infrequent haematological dyscrasias. Emerging evidence supports this strategy as a convenient and well tolerated alternative to more expensive and complex revascularisation procedures such as drug eluting stent (DES) implantation or cardiac surgery, provided that the treatment is reserved for carefully selected candidates, i.e. after the exclusion of those with diabetes mellitus, a recent transmural myocardial infarction, or contraindications to the administration of a short-course of high-dose glucocorticosteroids. The recent concerns regarding the long-term safety of first-generation DES and the as yet undetermined duration of dual anti-platelet treatment, further supports the need for a simple pharmacological treatment that can be applied in a large percentage of patients currently treated with PCI. Multicentre randomised studies aimed at defining the efficacy and safety of oral prednisone treatment compared with metallic stents and DES are ongoing, and will become available in upcoming years.
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PMID:Glucocorticoids in the prevention of restenosis after coronary angioplasty: therapeutic potential. 1754 69

Type 1 diabetes is usually associated with other autoimmune diseases. Parietal cell antibodies (PCA) are found in 20% of type 1 diabetic patients which might be an early sign of autoimmune gastritis and pernicious anemia. PCA destroy the gastric H+/K+ ATP-ase. The chronic auto-destruction of the proton pump leads to hypo/achlorhydria and hypergastrinemia which leads to the hyper/dysplasia of enterochromaffin-like cells (ECL). ECL hyper/dysplasia is known to increase the likelihood of gastric carcinoid tumor development in affected patients. Gastric carcinoid tumors forming from the hyperplasia of ECL cells are found in 4-9% of patients having autoimmune gastritis or pernicious anemia. The 29-years-old type 1 diabetic patient, having primer hyperthyroidism was admitted to our clinic because of gastric pain. Results of endoscopy and biopsy showed multiple small polyps in the fundus with non-antral hypergastrinemic (type A) atrophic gastritis. The parietal cell antibody test was positive, the serum chromogranin A level was 289,7 ng/ml (normal value $ 98 ng/ml), TSH level was 9,93 mIU/L. The histological examination indicated carcinoid tumor. Sandostatin therapy was started then partial gastrectomy was done. After the operation the plasma chromogranin level normalized. Non-antral, multiple polyps could cover silent neuroendocrine tumors, which are slowly growing benign endocrine tumors, however, they also might be high malignity endocrine carcinomas. These tumors could be easily recognized in the clinical practice by measuring the serum or tissue chromogranin A level and other markers of tumor growth. Thus screening of gastric endocrine tumors in type 1 diabetic patients with co-morbid autoimmune diseases is recommended.
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PMID:[Development of silent gastric carcinoid in a type 1 diabetic patient with primer hypothyreosis]. 1772 Jun 74

Over the past decades, herbal medicine has become a thing of global significance with medicinal and economic implications. Wide spread use of herbs throughout the globe has raised serious concerns over its quality, safety, and efficacy. Thus, exact scientific assessment has become a precondition for acceptance of herbal health claims. Persea americana Mill. (avocado) is a tree, native to central America, cultivated in tropical and subtropical climates around the world, belonging to the family Lauraceae, is widely used in Ayurveda and evidence-based phototherapy. There are 3 principal races or groups of avocado: Mexican, Guatemalan, and West Indian named for the areas where they were originally cultivated. The plant is used in traditional medicine for the treatment of various ailments, such as monorrhagia, hypertension, stomach ache, bronchitis, diarrhea, and diabetes. Peptone, b-galactoside, glycosylated abscisic acid, alkaloids, cellulose, polygalacto urease, polyuronoids, cytochrome P-450, and volatile oils are reported to be present in this plant. Biotechnologic approaches show that modified MS medium supplemented with 1.0 mg benzyladenine/L, 0-1mg Indole Butyric Acid/L, 0.1 mg Gibberalic Acid 3/L was optimum for adventitious shoot development. In the present review, an effort has been made to study the different aspects of P. americana Mill.
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PMID:The phytochemical and pharmacological profile of Persea americana Mill. 2222 45

For centuries, mushrooms have been appreciated as sources of food nutrients and pharmacologically important compounds useful in medicine. Yet not all the medicinal properties of mushrooms have been exploited. The above statement is more pertinent to mushrooms that are indigenous to Nigeria. There are inadequate data on the identity and medicinal properties of these wild mushrooms. Information on the ethnomedicinal uses of some mushrooms such as Pleurotus tuber-regium used for headache, stomach pain fever, cold, constipation; Lentinus squarullosus for mumps, heart diseases; Termitomyces microcarpus for gonorrhea; Calvatia cyathiformis for leucorrhea, barreness; Ganoderma lucidum for treating arthritis, neoplasia; G. resinaceum used for hyperglycemia, liver diseases (hepatoprotector); G. applanatum used as antioxidant and for diabetes had been gathered through survey. The above information is mostly obtained from traditional herbalists who in most cases will not disclose their preparation compositions. A lot of these mushrooms are obtained only in the wild. Scientific documents of the identities and medicinal properties are still scanty. Preliminary studies on some species of Temitomyces, Lenzites and Lentinus species showed that they possess appreciable antimicrobial and antioxidant properties. Moreover, molecular characterization also reveals that they are not 100% homologous with existing sequences under the same name in GenBank. It is therefore pertinent that well structured studies on their ecology, identification and medicinal uses be carried out. This will make the full exploitation of the medicinal potentials of mushrooms indigenous to Nigeria realizable.
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PMID:Medicinal uses of mushrooms in Nigeria: towards full and sustainable exploitation. 2246 5

Tribal peoples are endowed with enriched traditional wisdom to use available nature resources around them. They are well versed in the usage of plant for treating various diseases. They have used powder or extract or paste form of the plant parts such as root, shoot, whole plant, fruits and leaves etc. The recipe known by the tribal people was passed on only to their family members and community through mouth to mouth practice. Hence, the knowledge is confined to particular people alone. It is always expedient to store information in the database, so that it will be accessible by everyone from everywhere. To achieve this, MEDDB has been developed, which stores the details of 110 plant species that are commonly used by tribes for fever, asthma, cold, cough, diabetes, diarrhea, dysentery, eye infections, stomach ache, wounds and snake bite. The details of each plant were collected from the literature and through web search to give comprehensive and exhaustive information. Each plant entry is compiled under the subheadings viz., common name, classification, physical characteristics, medicinal uses, active constituents, and references.
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PMID:MEDDB: a medicinal plant database developed with the information gathered from tribal people in and around Madurai, Tamil Nadu. 2257 May 21

Medicinal plants are widely being used by the traditional medical practitioners for curing various diseases in their day-to-day practice. Biophytum sensitivum DC (Oxalidaceae) is used as a traditional folk medicine in ailments such as inflammation, arthritis, wounds, tumors and burns, gonorrhea, stomach ache, asthma, cough, degenerative joint disease, urinary calculi, diabetes, snake bite, amenorrhea and dysmenorrhea. It is a small, flowering, annual herb with sensitive leaves. It grows throughout tropical Africa and Asia, especially in Philippines and the hotter parts of India and Nepal. Phytochemical studies have shown that the major pharmacologically active constituents are amentoflavone and a polysaccharide fraction, BP100 III. Recent pharmacological study shows that it has antioxidant, immunomodulatory, anticancer, anti-inflammatory, chemoprotective, antidiabetic and wound healing potential. This review attempts to describe the ethnobotany, pharmacognosy, traditional uses, chemical constituents, and various pharmacologic activities and other aspects of B. sensitivum.
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PMID:Ethnobotany, phytochemistry and pharmacology of Biophytum sensitivum DC. 2265 7

Pancreatic exocrine insufficiency (PEI) is often observed in patients with pancreatic diseases, including chronic pancreatitis, cystic fibrosis, and tumors, or after surgical resection. PEI often results in malnutrition, weight loss and steatorrhea, which together increase the risk of morbidity and mortality. Therefore, nutritional interventions, such as low-fat diets and pancreatic enzyme replacement therapy (PERT), are needed to improve the clinical symptoms, and to address the pathophysiology of pancreatic exocrine insufficiency. PERT with delayed-release pancrelipase is now becoming a standard therapy for pancreatic exocrine insufficiency because it significantly improves the coefficients of fat and nitrogen absorption as well as clinical symptoms, without serious treatment-emergent adverse events. The major adverse events were tolerable gastrointestinal tract symptoms, such as stomach pain, nausea, and bloating. Fibrosing colonopathy, a serious complication, is associated with high doses of enzymes. Several pancrelipase products have been approved by the US Food and Drug Administration in recent years. Although many double-blind, placebo-controlled trials of pancrelipase products have been conducted in recent years, these studies have enrolled relatively few patients and have often been less than a few weeks in duration. Moreover, few studies have addressed the issue of pancreatic diabetes, a type of diabetes that is characterized by frequent hypoglycemia, which is difficult to manage. In addition, it is unclear whether PERT improves morbidity and mortality in such settings. Therefore, large, long-term prospective studies are needed to identify the optimal treatment for pancreatic exocrine insufficiency. The studies should also examine the extent to which PERT using pancrelipase improves mortality and morbidity. The etiology and severity of pancreatic exocrine insufficiency often differ among patients with gastrointestinal diseases or diabetes (type 1 and type 2), and among elderly subjects. Finally, although there is currently limited clinical evidence, numerous extrapancreatic diseases and conditions that are highly prevalent in the general population may also be considered potential targets for PERT and related treatments.
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PMID:Pancrelipase: an evidence-based review of its use for treating pancreatic exocrine insufficiency. 2293 95


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