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Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A mathematical model incorporating the processes of both cancer induction and subsequent tumor growth has been developed. The model was applied to incidence data of stomach classified into histologic subtypes: papillary adenocarcinoma (PAP), well and moderately differentiated tubular adenocarcinomas (WEL and MOD), poorly differentiated adenocarcinoma (POR), mucinous adenocarcinoma (MUC) and signet-ring cell carcinoma (SIG). The multistage theory was assumed for cancer induction as in the Armitage-Doll model. For the period of growth, exponential growth was assumed and clinical surfacing was formulated as a stochastic process related to tumor diameter. The number of stages in cancer induction and the tumor growth rate were simultaneously estimated for each histologic subtype using the maximum likelihood procedure. The present model showed better fits than the Armitage-Doll model in most histologic subtypes except WEL, PAP, WEL and MOD, which are characterized as differentiated subtypes with less mucous production, showed different features from POR, MUC and SIG: 1) the number of stages was estimated to be larger, 2) the differences in incidence rates between males and females were more marked, and 3) males tended to have larger growth rates in PAP and MOD, while in POR, MUC and SIG, females had larger values. The present study showed that an analysis by histologic subtypes is of importance in stomach cancer and that the period of tumor growth should not be ignored when formulating a model of the natural history of stomach cancer.
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PMID:Analysis of stomach cancer incidence by histologic subtypes based on a mathematical model of multistage cancer induction and exponential growth. 217 1

Seventeen postmenopausal women with pelvic abscesses were cared for at the Los Angeles County-University of Southern California Women's Hospital during the past eight years. Nine had experienced either postmenopausal bleeding or uterine instrumentation, or both, within the prior six months. Findings from physical examination and various laboratory and roentgenologic studies did not significantly help in improving the accuracy of preoperative diagnosis. In four, the abscess was associated with intra-abdominal pathologic conditions, and six had poorly controlled adult onset diabetes mellitus. Transfusion was required in eight patients. Two patients had a prolonged hospital stay because of pulmonary and septic complications. One patient had carcinoma of the ovary while another had carcinoma of the cervix uteri that was undiagnosed preoperatively. Our conclusion is that about one-half of postmenopausal patients with pelvic and tubo-ovarian abscesses have postmenopausal bleeding. The remainder may have associated intra-abdominal infective pathologic findings or a malignant condition of the genital tract. Expeditious surgical treatment should be undertaken.
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PMID:Pelvic abscesses in postmenopausal women. 277 95

In order to assess the prevalence and type of diabetes mellitus in patients with pancreatic carcinoma and if the risk factors for the cancer have a different distribution among diabetics and non-diabetics, we reviewed the charts of 127 histologically and/or cytologically proven pancreatic carcinomas consecutively diagnosed from 1977 to 1989 and referred to our Primary Care Hospital from the attending physician. 48 out of 127 (37.7%) subjects were found to be diabetic; 3 had long standing insulin dependent diabetes mellitus, 10 long standing non insulin dependent diabetes mellitus and 35 (73% of all diabetics) new onset diabetes mellitus. 5 out of 10 long standing non insulin dependent diabetics showed secondary failure to oral antidiabetic agents and weight loss in the last six months before the diagnosis of pancreatic carcinoma. When compared to non-diabetics, all diabetics were older (p = 0.05), drank less alcohol (p = 0.047) and had a higher rate of previous neoplasms (p = 0.005). New onset diabetics had a less advanced cancer than those of long standing (p = 0.009). Our study calls for a careful search for pancreatic carcinoma in new onset diabetes of elderly and in long standing, weight losing, non insulin dependent diabetics on secondary failure to oral antidiabetic agents and support the hypothesis that diabetes associated pancreatic carcinoma may bear an its own etiopathogenesis.
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PMID:Pancreatic carcinoma: differences between patients with or without diabetes mellitus. 761 56

A 71-yr-old man with a six-year history of Parkinson's disease (PD), Type II diabetes mellitus, myocardial infarction, and remote 20 pack-year smoking history, underwent an anterior resection of the rectum for carcinoma. Sixty hours later, the patient suffered a respiratory arrest; his antiparkinsonian medications had not been resumed. Preoperative flow-volume loops showed the characteristic saw-tooth pattern of PD indicating dysfunction of the striated muscle of the upper airway. Although postoperative respiratory distress was managed as lower airway obstruction, at the time of intubation there were no signs of lower airway pathology. Upper airway dysfunction and obstruction secondary to PD is thought to have been a contributing factor to the postoperative respiratory distress and failure. This case is presented to draw attention to the risk of upper airway dysfunction in Parkinson's Disease, especially with the withdrawal of antiparkinsonian medications.
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PMID:Upper airway involvement in Parkinson's disease resulting in postoperative respiratory failure. 778 33

A 40-year-old man with a 3-year history of uncontrolled NIDDM, 2-pack/month cigarette smoking habit and alcohol abuse, was admitted to our university hospital. He presented with severe back pain, persistent cough and fever. A left lung infiltrate was noted on chest X-ray film. Staphylococcus aureus was isolated from arterial blood. Thoracic bone destruction with pleural mass lesion confirmed by computed tomography (CT) and magnetic resonance image (MRI). These findings mislead our diagnosis to pyogenic osteomyelitis associated with NIDDM. An absence of marked clinical and roentgenological improvement after antibiotic therapy and strict glycemic control with insulin was noted. This suggested to us the need for needle biopsy of the osteolytic and mass lesions confirmed by imaging techniques. This resulted in making the diagnosis of metastasis of small cell carcinoma from the left lung. The correlation between NIDDM and pulmonary small cell carcinoma possibly induced by genetic abnormality remains to be resolved. By making the most of imaging techniques and needle biopsy, the possibility of pulmonary small cell carcinoma complicating NIDDM can be appropriately evaluated.
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PMID:Vertebral bone metastasis of small cell carcinoma of lung in a diabetic patient, initially diagnosed as pyogenic vertebral osteomyelitis. 807 45

A retrospective analysis of presenting clinical symptoms was performed in 584 patients who were operated on at a surgical university hospital during the last two decades because of carcinoma of the exocrine pancreas or the periampullary region. Patients with carcinoma of the pancreatic head primarily presented with jaundice, those with localisation of the tumour in the pancreatic body and tail with pain. In contrast to the common opinion ampullary carcinomas produced jaundice only in 70% of patients. In our series ampullary carcinomas did not present clinical symptoms at an earlier stage than pancreatic head tumours as it is commonly speculated. At the time of surgery carcinomas of the ampulla and the pancreatic head were found to be in equivalent stages. A NIDDM was significantly associated with carcinomas of the pancreatic body. Diabetes mellitus is more likely a result of carcinomatous destruction of the pancreas rather than a precancerosis. Almost all periampullary tumours could be resected while the resection rate was only 41% in case of exocrine pancreatic tumours. Pancreatic carcinomas which presented with upper abdominal pain, back pain, weight loss, inappentence, and diarrhoea were significantly more often irresectable. Jaundice, however, was more frequent in patients with resectable tumours. Back pain is probably caused by infiltration of the retroperitoneum and the aortic plexus and thus represents the clinical sign of an often occult retroperitoneal tumour spread. The precise knowledge of the presenting symptoms in cancer of the pancreas and ampulla is of primary importance because diagnostic procedures only commences after onset of symptoms and no possibilities of an effective screening can be envisaged.
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PMID:[Clinical symptoms in cancer of the exocrine pancreas in peri-ampullary region. Old and new knowledge from the analysis of a surgical patient sample]. 896 95

Many adolescents present with hirsutism and irregular menses. The challenge for the clinician is to distinguish physiologic anovulatory cycles from true menstrual disorders such as PCOS, and to differentiate PCOS from other causes of hyperandrogenism in hirsute adolescents. Common clinical features seen in adolescents with PCOS include hirsutism, acne, menstrual irregularity, and obesity. Biochemical abnormalities include hyperandrogenism, acyclic estrogen production, LH hypersecretion, decreased levels of SHBG, and hyperinsulinemia. Management strategies for a patient with PCOS include treatment of features which may cause distress to the adolescent, such as hirsutism, acne, and irregular menses, and prevention of long-term sequelae. Oral contraceptive pills, antiandrogens, and cosmetic treatments are used to treat hirsutism, acne, and menstrual irregularity. Oral contraceptive pills or medroxyprogesterone acetate are given to prevent endometrial hyperplasia and carcinoma. Counseling about weight loss and nutrition are essential, as weight loss may improve signs of hyperandrogenism and menstrual irregularity and may prevent NIDDM and cardiovascular disease. Insulin-sensitizing agents show promise in terms of decreasing hyperandrogenism, restoring ovulatory cycles, treating infertility, and preventing long-term sequelae. Finally, it is important to recognize that adolescents with PCOS may experience psychological distress because of the clinical manifestations of hyperandrogenism or when confronted with the information that they have a chronic illness. Psychological support should be available for these young women. Future research is likely to further elucidate the pathophysiology of PCOS, identify candidate genes, and clarify which adolescents are at risk for long-term sequelae. Prospective studies are needed to identify which therapies could potentially reduce the risk of infertility, diabetes, cardiovascular disease, and endometrial carcinoma in young women with PCOS.
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PMID:Polycystic ovary syndrome. 1037 Jul 13

In this review, tumor necrosis factor-alpha (TNF-alpha) is identified as the uniting principle linking the pathogenesis of insulin-dependent diabetes mellitus (IDDM), non-insulin dependent diabetes mellitus (NIDDM) and carcinoma. Elevated TNF-alpha initially increases, and then inhibits, the activity of a number of key enzymes involved in energy metabolism and major histocompatibility (MHC) class I molecule expression. These enzymes include: protein-tyrosine kinase (PTKase) and protein-tyrosine phosphatase (PTPase--enzymes involved in energy metabolism, cell proliferation and stimulation of the MHC class I molecule pathway. Of primary importance is the inhibiting effect of TNF-alpha on PTKase, since this induces insulin resistance in NIDDM and carcinoma, and PTPase, which inhibits MHC class I molecule expression. Studies have shown that IDDM is associated with an increase in PTPase activity which leads to overexpression of MHC class I molecules and a concomitant destruction of pancreatic beta cells. Conversely, carcinoma is associated with an inhibition of PTPase activity, which reduces the expression of MHC class I antigen expression on the cell surface thereby allowing malignant cells to escape immune surveillance. It will be argued that there is continuum of liability between these three conditions, initiated by the effect of TNF-alpha on these key enzymes.
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PMID:Tumor necrosis factor-alpha: a continuum of liability between insulin-dependent diabetes mellitus, non-insulin-dependent diabetes mellitus and carcinoma (review). 1046 70

In 1989, the main agent causing non A non B hepatitis was identified as a RNA virus of the flavivirus family, with several serotypes, and was denominated virus C. At the present moment, the knowledge about the infection features and diseases that it causes has expanded thanks to the availability of reliable laboratory techniques to detect the antibody and the virus. The prevalence of infection and the frequency of serotypes varies in different regions of the world. Chile is a country with a low prevalence. The detection of infected blood in blood banks has reduced the spreading of the disease. Other means of infection such as the use of intravenous drugs, hemodialysis and transplantation have acquired greater importance. Sexual, maternal and familial transmission is exceptional. Infected people develop an acute hepatitis, generally asymptomatic. Eighty percent remain with a chronic hepatic disease, that can be mild or progressive, evolving to cirrhosis or hepatic carcinoma. Chronic hepatitis, closely resembling an autoimmune disease, can be caused by the virus. Alcohol intake increases viral activity causing severe hepatic diseases, refractory to treatments. Several non hepatic diseases are associated to hepatitis C virus infection such as essential mixed cryoglobulinemia, mesangiocapillary glomerulonephritis, porphyria cutanea tarda, dysglobulinemias and probably type 2 diabetes mellitus. The only available treatment is interferon, that is successful in a minority of patients, frequently causing a transient improvement. The use of Ribaravine associated to interferon improve the effectiveness of therapy. Liver transplantation is the only therapy for severe hepatic disease. The use of new antiviral drugs should improve the prognosis of the disease.
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PMID:[Hepatitis C virus and resulting diseases]. 1083 42

We report on a 33-year-old patient from Sri Lanka who had been suffering from recurrent episodes of abdominal cramps since he was ten years old. He additionally suffered from postprandial flatulence and an increased frequency of bowel movements. By the age of 24, his condition had worsened with polyuria and polydipsia and he was diagnosed with type II diabetes mellitus. Recently, the patient's compliance deteriorated steadily and his diabetes mellitus was uncontrolled. His flatulence continued and he had six to seven bowel movements daily. He presented to us with renewed bouts of severe stomach cramps, similar to the painful episodes that the patient experienced in his youth. After exclusion of other etiologies and judging by the clinical picture, the patient's origin and the sonographically and radiologically verified pancreatic calcification, we rendered the diagnosis of a tropic calcifying pancreatitis with secondary diabetes mellitus. According to the literature, malignant neoplasia may develop on the basis of this disease. However, we were able to rule out a carcinoma as the cause of the current pain episodes in this patient based on clinical findings and course. We attributed the stomach cramps to compression of the common bile duct by the fibrotic head of pancreas. Pain and cholestasis regressed, thus obviating the need for surgical intervention (pancreaticojejunostomy). On therapy with enzyme substitution and insulin, the patient's exo- and endocrine pancreatic insufficiency was asymptomatic.
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PMID:[Chronic abdominal pain in a young diabetic patient]. 1111 10


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