Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A systematic 20-year follow-up study of 1,221 diabetic patients was carried out in Osaka, Japan. The mean annual mortality rates were 2.55% for men and 1.64% for women. The ratios of observed to expected numbers of deaths were 1.50 for men and 1.39 for women, indicating an excess mortality for diabetic patients of both sexes, and higher mortality in men than in women. Factors that predisposed diabetic patients to premature death were early age of onset, albuminuria, diabetic retinopathy and fasting glucose level greater than 11.1 mmol/l at the initial examination. Insulin dependence was also associated with poor prognosis. Cerebro-cardiovascular and renal diseases were the major causes of death in the diabetic patients; heart disease was the cause of death in 16.9%, cerebrovascular disease in 16.4% and renal disease in 11.9%. The relatively high incidence of renal disease as cause of death in diabetic patients was striking. Malignant neoplasms of liver and of pancreas and cirrhosis were also associated with increased ratio of observed to expected number of deaths in the patients.
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PMID:A long-term follow-up study of Japanese diabetic patients: mortality and causes of death. 664 95

Many patients with end-stage renal disease have now been maintained for 5 years or more with continuous ambulatory peritoneal dialysis (CAPD). Viewed initially as an experimental alternative to be used only when hemodialysis was not feasible, CAPD is now seen as the treatment of choice in an increasing number of situations. CAPD is suitable for self-care. The main concern in the early years--peritonitis--is now less frightening and less frequent (one episode occurring every 18 patient-months as compared with every 8 initially), and this has allowed chronic complications of CAPD, such as malnutrition and loss of the peritoneum's capacity for ultrafiltration, to come to light. As would be expected, among patients of advanced age and those who have heart disease or diabetes, survival rates tend to be lower than among other CAPD patients. However, hypertension seems to be more easily controlled, pre-existing anemia can be significantly ameliorated, and young children grow more normally than they do with hemodialysis. Diabetes-related changes in vision stabilize in most CAPD patients, and control of the blood glucose level is good; insulin is administered intraperitoneally. CAPD is thus showing itself to be a feasible form of long-term treatment for end-stage renal disease.
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PMID:Continuous ambulatory peritoneal dialysis: no longer experimental. 669 77

Left ventricular function at rest and during supine bicycle exercise was assessed by gated radionuclide angiography in 20 diabetic patients and 18 normal control subjects without clinical evidence of heart disease. The diabetic patients were aged 21 to 44 years and all except one used insulin. No subject developed chest pain or electrocardiographic changes during exercise. Both groups had a similar rest and exercise heart rate and blood pressure, and both achieved similar work loads. The control group had an ejection fraction at rest of 65.4 +/- 6.2% (mean +/- SD) and only 1 of 18 showed a decrease with exercise; peak exercise ejection fraction averaged 77.1 +/- 7.8%. The diabetic group had a mean ejection fraction at rest of 63.7 +/- 6.5%, similar to that of the control group, but 7 of 20 showed a decrease during exercise; the exercise ejection fraction averaged 67.7 +/- 9.7%, significantly lower than that of the control group (p less than 0.01). The diabetic patients varied widely in ejection fraction response to exercise, ranging from an increase of 25% to a decrease of 21%. This response did not correlate with age, sex, duration of diabetes, smoking, retinopathy, exercise heart rate, blood pressure or rate-pressure product, work load attained or ejection fraction at rest. These data suggest that approximately one-third of patients with diabetes have subclinical left ventricular dysfunction without correlation to risk factors for atherosclerosis or other diabetic complications. Whether this is due to unrecognized coronary artery disease or primary myocardial disease remains unknown.
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PMID:Clinically unrecognized ventricular dysfunction in young diabetic patients. 673 64

Serum immunoglobulin (G, A, M) levels were performed on 66 patients with non-insulin-dependent (type II) diabetes mellitus (NIDDM). When compared with 30 age-matched normal controls and 32 hospitalized controls there was no significant difference between the mean IgG and IgM levels. The IgA levels were significantly higher (P less than 0.005) in the diabetic group when compared with both control groups. This is true regardless of age, sex, duration of disease, and type of treatment (insulin/diet or oral hypoglycemic agents and/or diet). Thirty-six percent of the diabetic patients' IgA levels exceeded the mean +/- 2 SD of the normal control group. There were no significant differences in immunoglobulin levels between insulin-treated and non-insulin-treated diabetic groups. Since diabetic patients may have a number of secondary diseases, attempts were made to correlate the most common of these (acute and/or chronic bacterial infections, hypertension, arteriosclerotic heart disease, and diabetic neuropathy) with elevated IgA levels. Only IgA levels of diabetic patients with infections versus diabetic patients without infections were significantly different (P less than 0.05). However, IgA levels of uninfected diabetic patients remained significantly higher than those of normal controls (P less than 0.005), hospitalized controls (P less than 0.01), and hospitalized controls with bacterial infections (P less than 0.005). Possible reasons for the isolated elevations of IgA are discussed.
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PMID:Elevation of IgA levels in the non-insulin-dependent (type II) diabetic patient. 675 40

The control of blood glucose levels in diabetes involving devices are critically reviewed, and the role of blood-contacting biomaterial components analyzed. These include mechanical insulin-delivery systems of the closed-loop type that require an electronic glucose sensor and feedback, and open-loop systems that deliver insulin without a sensor and feedback. Whole pancreatic and islet transplantations, islet encapsulation, and the potential role of polymeric sustained drug delivery systems are discussed. The medical and social impacts of diabetes mellitus are of prime public health concern and of even greater magnitude than those of heart disease in the United States. While future advances in device design, miniaturization, and biomaterials technology will significantly add to the arsenal of therapeutic alternatives, devices capable of controlling blood glucose levels ought to be viewed as mere interim phases rather than as final goals of the problem.
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PMID:The role of biomaterials in insulin delivery systems. 678 Apr 71

Millions of Americans get virtually all their current events information from the national nightly television news programs. The purpose of this study was to learn what diabetes-related information had been broadcast over the last 11 years by the network news programs. Another objective was to learn how that coverage compared with that given other chronic diseases. The Vanderbilt Television News Archives (VTNA) has videotaped every ABC, NBC, and CBS nightly newscast since mid-1968. The contents of each telecast have been catalogued and indexed. Indexes were searched for every segment that had anything to do with diabetes from 1971 through 1981. In the last 11 years there have been 32 diabetes-related news segments. More than a third were about the controversial attempt to ban saccharin. Because each network may carry essentially the same story, the number of nonoverlapping reports was 20. The total time of the diabetes-related segments was 70 minutes. The topics covered by the news reports included oral agents (5 reports), artificial sweeteners (12), biosynthetic human insulin (BHI) (7), and an assortment of unique items. The 32 diabetes-related segments compare with 23 about arthritis, 215 about heart diseases, and 925 dealing with cancer. A compilation of the non-overlapping segments has been shown to health professionals, who felt the stories were generally accurate. Diabetes is not portrayed as a killer. Therefore, diabetes seems less serious, and therefore less newsworthy, than heart disease or cancer.
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PMID:Diabetes in the national TV news: 1971-1981. 683 27

Twelve carbohydrate-sensitive men selected due to their abnormally high insulin responses to a sucrose load and 12 men with normal insulin responses were fed diets containing 0, 7.5, and 15% fructose for 5 wk each in a cross-over design. The diets contained 43% total carbohydrate, 42% fat, and 15% protein. Initial fasting total cholesterol and low-density lipoprotein cholesterol were higher in the hyperinsulinemic men than in the controls. Diastolic blood pressure was not affected by diet, but systolic blood pressure was slightly higher after the men consumed the 0% fructose diet. Free fatty acids were not different. Total plasma cholesterol and low-density lipoprotein cholesterol were higher after the men consumed 7.5 and 15% fructose than when they consumed the 0% fructose diet. Plasma triglyceride increased significantly as fructose in the diets of the hyperinsulinemics increased, but was not affected in the controls. These changes in blood lipids are associated with heart disease.
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PMID:Blood lipid distribution of hyperinsulinemic men consuming three levels of fructose. 684 12

Long-term thiazide diuretic therapy for hypertension is associated with disturbances in carbohydrate, lipid, and potassium metabolism that theoretically may have serious adverse effects. It appears that diuretic-induced hypokalemia interferes with production of insulin, producing mild elevations of blood glucose in nondiabetic patients. The insulinopenia worsens glucose metabolism in prediabetic and type II diabetic patients. Increases in low-density lipoprotein cholesterol, triglycerides, and the low-density lipoprotein/high-density lipoprotein cholesterol ratio are frequently seen following thiazide treatment of hypertension. These changes are more pronounced in younger patients. Decrements of serum potassium of 0.6 mEq/L are commonly observed with diuretic therapy. Usually, patients remain asymptomatic and no potassium replacement is necessary. In patients with underlying heart disease, however, alterations in potassium metabolism may produce increased frequency and complexity of ventricular ectopic activity. All these metabolic disturbances appear to be, in part, dose related, and there is currently no evidence that they have clinical significance.
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PMID:Thiazide-induced disturbances in carbohydrate, lipid, and potassium metabolism. 686 6

Four dynamic tests of cardiac function were compared in a group of 13 long-standing insulin-dependent diabetics who had no clinical evidence of cardio-respiratory disease. One patient developed abnormal features during 24 hour ambulatory electrocardiograms while all 13 patients had normal exercise electrocardiograms. The change in left ventricular ejection fraction during dynamic supine exercise as measured by gated blood-pool scintigraphy was not significantly different from control subjects (p less than 0.1) while during cold stimulation testing the change in left ventricular ejection fraction in the diabetics was highly significantly different from the control subjects (p less than 0.01). Five of the patients had one or more abnormal tests of autonomic function. The cold stimulation test may be a sensitive index of cardiac dysfunction in diabetics but as the mechanism is unclear alternative explanations are possible. While the etiology of heart disease in such patients is uncertain it is likely to be multifactorial and this test may prove useful in investigating the natural history and pathogenesis of cardiac disease in diabetics.
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PMID:Cardiac function during stress testing in long-standing insulin-dependent diabetics. 688 May 65

The possible role of plasma insulin levels as a risk factor of coronary heart disease has been studied in a population of 7246 non diabetic, working men, aged 43-54 years, initially free from heart disease, and followed for 63 months on average. 128 new coronary heart disease events (non fatal myocardial infarction and coronary related deaths) were detected during this period. The annual risk is analysed by a multivariate model including age, serum cholesterol and triglycerides, blood pressure, smoking, obesity, plasma glucose and insulin fasting and 2 hours after a 75 g oral glucose load. It is shown that the fasting plasma insulin level and the fasting insulin-glucose ratio are positively associated with risk independent of the other factors. The same variables, 2 hours after the glucose load are also positively associated with risk but their contributions are not significant in the multivariate analysis. It is concluded that high insulin levels may constitute an independet risk factor for coronary heart disease complications in middle aged non diabetic men.
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PMID:Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population. 699 22


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