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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neutrophils have been implicated in the development of vascular disease, and increased plasma neutrophil elastase indicates increased neutrophil activation. The aim of this study was to determine whether neutrophil elastase levels, measured by radioimmunoassay, are altered in diabetes. One hundred Type 1 (insulin-dependent) diabetic patients and 35 comparably-aged control subjects were studied. There was no difference in the total white cell count, but the diabetic group had a higher neutrophil count (p less than 0.05). Plasma neutrophil elastase (p less than 0.001) and total neutrophil elastase (p less than 0.02) were increased in the diabetic group. The total neutrophil elastase levels reflected the neutrophil count, but plasma neutrophil elastase was independent of the number of neutrophils. The increased plasma neutrophil elastase level was not related to age, duration of diabetes, plasma glucose or HbA1. The results suggest an association between diabetes and neutrophil activation which may play a role in the development of vascular disease.
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PMID:Neutrophil activation detected by increased neutrophil elastase activity in type 1 (insulin-dependent) diabetes mellitus. 280 87

A study of hemostasis and lipid metabolism, a basal level of immunoreactive insulin, hemoglobin A1C was performed in 81 patients with non-insulin-dependent diabetes mellitus and associated angiopathy of the legs. Decompensated stage of the diabetes was characterized by hypercoagulation and hyperlipidemia. Treatment of diabetic angiopathy of the legs should be aimed both at compensation of diabetes and correction of abnormalities in hemostasis and lipid metabolism.
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PMID:[Hemostasis and lipid metabolism in patients with non-insulin- dependent diabetes mellitus and angiopathy of the lower extremities]. 281 Dec 44

This discussion reviews drugs that affect the eye, including antihyperglycemic agents; corticosteroids; antirheumatic drugs (quinolines, indomethacin, and allopurinol); psychiatric drugs (phenothiazine, thioridazine, and chlorpromazine); drugs used in cardiology (practolol, amiodarone, and digitalis gylcosides); drugs implicated in optic neuritis and atrophy, drugs with an anticholinergic action; oral contraceptives (OCs); and topical drugs and systemic effects. Refractive changes, either myopic or hypermetropic, can occur as a result of hyperglycemia, and variation in vision is sometimes a presenting symptom in diabetes mellitus. If it causes a change in the refraction, treatment of hyperglycemia almost always produces a temporary hypermetropia. A return to the original refractive state often takes weeks, sometimes months. There is some evidence that patients adequately treated with insulin improve more rapidly than those taking oral medication. Such patients always should be referred for opthalmological evaluation as other factors might be responsible, but it might not be possible to order the appropriate spectacle correction for some time. The most important ocular side effect of the systemic adiministration of corticosteroids is the formation of a posterior subcapsular cataract. Glaucoma also can result from corticosteroids, most often when they are applied topically. Corticosteroids have been implicated in the production of benign intracranial hypertension, which is paradoxical because they also are used in its treatment. The most important side effect of drugs such as chloroquine and hydroxychloroquine is an almost always irreversible maculopathy with resultant loss of central vision. Corneal and retinal changes similar to those caused by the quinolines have been reported with indomethacin, but there is some question about a cause and effect relationship. The National Registry of Drug Induced Ocular Side Effects in the US published 30 case histories of cataract suspected to be induced by allopurinol; numerous additional cases have been reported to the registry since. Phenothiazine, with an estimated 3% incidence of side effects, appears to be safer than other antipsychotic drugs, but the rate of ocular effects increases with the duration of therapy. Thioridazine and chlorpromazine are known to cause lens deposits and pigmentary retinopathy. There is a significantly high prevalence of thrombophlebitis and pseudotumor cerebri among women who use OCs and thrombotic retinal vascular disease, such as retinal vein occulsion, might be linked with them. It also is probable that, because of altered hydration of the cornea, there is a decreased tolerance to contact lenses.
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PMID:Drugs affecting the eye. 286 12

Patients with diabetes mellitus, especially the insulin-dependent variety, have increased circulating levels of growth hormone. On the basis of currently available information, the potential advantages of inhibition of growth hormone secretion as an adjunct in the treatment of diabetes mellitus include improved metabolic control (less hyperglycaemia, greater stability), resulting from diminution of the insulin-antagonistic actions of this hormone, and reduced micro- and possibly macro-angiopathy, resulting not only from improved metabolic control but also from decreased direct effects of growth hormone on blood vessels.
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PMID:Rationale for inhibition of growth hormone secretion in the management of the diabetic patient. 287

Abnormal albumin excretion in the range not previously detectable by routine clinical methods can now be readily quantified, and has been shown to predict the development of clinically significant nephropathy in insulin-dependent diabetes mellitus (IDDM) and to predict excess mortality in non-insulin-dependent diabetes mellitus (NIDDM). Albuminuria of this degree has been inappropriately called "microalbuminuria," a misleading term which should be abandoned. In IDDM, persistent minimal elevation of albumin excretion predicts the development of more severe proteinuria and clinical diabetic nephropathy, which frequently progresses to renal failure. In NIDDM, the predictive value for renal failure remains to be established, but excess mortality occurs in those with abnormal albumin excretion, suggesting that it is an indicator of generalized vascular disease. However, the normal range of albumin excretion in older subjects is not well established. The relationship of glomerular injury to mildly elevated albumin excretion is uncertain. Several means of reducing the excretion rate have been described, but whether these can halt or prevent progression of glomerular injury is unknown. Thus, at the present time detection of mildly elevated albumin excretion and intervention to reduce the incidence of diabetic nephropathy or other diabetes-related complications fail to meet generally accepted criteria for prescriptive screening. However, such measurements of albumin excretion provide an important tool for research into the natural history and pathogenesis of diabetic nephropathy.
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PMID:'Microalbuminuria' and diabetes: a critique--assessment of urinary albumin excretion and its role in screening for diabetic nephropathy. 291 62

PARD is a prospective study sponsored by the German research council with the aim to establish whether spontaneously enhanced platelet aggregation or changes of other hemostatic parameters are risk factors for new vascular occlusion in diabetic patients. Hemostatic parameters have been measured in diabetic patients at 3 month-intervals (363 patients aged 45-65 at recruitment). Of the 232 men, 53 were on diet, 104 on oral antidiabetic drugs and 75 on insulin. Of 131 women 16 were on diet, 46 on oral antidiabetic drugs and 69 on insulin. Baseline data and preliminary results obtained between May 1977 and December 31, 1983 are presented. 22 patients have died. 17 diet from cardiovascular disease, 3 from pancreatic cancer and 2 from other causes. 51 patients suffered a myocardial infarction, stroke or peripheral arterial occlusions. The mean levels of spontaneous aggregation (angle alpha-PAT III), F VIIIC, F VIII R:AG, fibrinogen, antithrombin III and plasminogen were higher in men who died or suffered cardiovascular occlusions than in those without these events. In women this difference is less pronounced or absent. In women the mean values of several hemostatic parameters at baseline were higher than in men and the incidence of cardiovascular occlusions was lower. The interim results lead to the hypothesis that spontaneous aggregation, high levels of F VIIIC, F VIII R:AG and to some extent also high levels of fibrinogen, antithrombin III and plasminogen may be indicators of progressive vascular disease and could be useful as predictors of vascular occlusions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:PARD: platelet aggregation as a risk factor in diabetics: results of a prospective study. 293 12

Beta-thromboglobulin (beta TG) is a platelet-specific protein and since its concentration in plasma rises when platelets are activated, it has been used as an indicator of platelet involvement in vascular disease. Since platelets might be involved in the pathogenesis of diabetic microvascular disease we measured urinary beta TG in 20 insulin-dependent diabetics with nephropathy and compared the results with those from 20 normal subjects. Measurement of beta TG in urine was undertaken to avoid errors induced by blood sampling and to gain information over a prolonged period using a single assay. Measurements were made of beta TG, beta 2-microglobulin and total protein in urine collected for 24 h and creatinine and beta 2 microglobulin in plasma. Survival of indium-111-labeled platelets was measured in nine patients. Urinary beta TG was significantly (p less than 0.02) increased in the 20 patients compared with 20 normal volunteers (median value 1.3 vs 0.8 microgram/24 h). There was a strong correlation between urinary beta TG excretion and plasma creatinine concentration (r = 0.8, p less than 0.0001) and plasma beta 2-microglobulin concentration (r = 0.9, p less than 0.0001). Urinary beta TG concentration did not correlate with platelet survival. The results indicate that although urinary beta TG is significantly increased in patients with diabetic nephropathy its concentration in urine correlates with indicators of glomerular filtration rather than with a test of platelet activation.
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PMID:Urinary beta-thromboglobulin correlates with impairment of renal function in patients with diabetic nephropathy. 294 92

Ninety-four patients with untreated diabetic maculopathy in at least one eye had their visual acuity and medical condition assessed and followed for 5 years. The mean patient age was 58 years (range 29 to 73 years) at the diagnosis of maculopathy, and they were predominantly non-insulin-dependent diabetics (NIDD). Thirty-two patients had maculopathy diagnosed at or within 2 years of the diagnosis of diabetes. Visual loss was severe, the mean final vision being 6/36 with 44 eyes blind. In addition to progression of the maculopathy, causes for loss of vision included complications of new vessels (vitreous haemorrhage and macular traction) often leading to complete blindness. Medical abnormalities were commoner than would be expected in a similarly aged normal population. Mean blood pressure was 163/90, 81 patients had degenerative vascular disease, 22 patients had nephropathy, and 35 had raised cholesterol levels. Twenty-six patients died during the study mainly from vascular disease and renal failure. No significant association was found between visual acuity loss and medical conditions, glucose control, type of therapy, age, diabetes duration, and mortality.
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PMID:Medical conditions in patients with diabetic maculopathy. 295 Oct 76

Platelet aggregation was measured in 15 patients having non-insulin-dependent diabetes mellitus (NIDDM) at the time of diagnosis and after three months of dietary treatment. Mean fasting plasma glucose fell from 13.0 to 8.8 mmol/l (p less than 0.0002), glycosylated haemoglobin fell from a mean of 11.3% to 9.0% (p less than 0.005) and insulin levels fell from a mean of 17.5 to 13.8 mU/l (p less than 0.005). Platelet aggregation showed a variable response and did not correlate with plasma glucose, glycosylated haemoglobin or plasma insulin. Multiple linear regression analysis was carried out on the aggregation values against the biochemical variables and platelet phospholipid fatty acid levels following logarithm transformation. Platelet linolenic acid and eicosapentaenoic acid levels were significantly inversely associated with aggregation but the difference between the relationship at diagnosis and after three months was not statistically significant. The association between platelet omega 3 fatty acids and platelet aggregation suggest that dietary change aimed at increasing the proportions of these fatty acids might favourably influence vascular disease in NIDDM via an effect on platelet function.
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PMID:Platelet aggregation in non-insulin-dependent diabetes is associated with platelet fatty acids. 295 Nov 37

Platelet function has been studied in diabetic subjects using a new electronic platelet aggregometer which enables platelet aggregation to be studied in whole blood. This may be a more physiological approach to the assessment of platelet behaviour as centrifugation is avoided and platelets are studied in the presence of other blood elements which may be important modulators of platelet function in vivo. Twenty insulin-dependent diabetic subjects were studied along with 20 age and sex-matched controls. Platelet aggregation to collagen (1 microgram/ml) and arachidonic acid (1 mM) was significantly increased in the diabetic group. In addition the sensitivity of diabetic platelets to the antiaggregatory effects of prostacyclin was significantly reduced. A significant inverse correlation was found between platelet sensitivity to prostacyclin and glycosylated haemoglobin concentration in the diabetic group. It is unlikely that the platelet abnormalities in this diabetic group are due to underlying vascular disease as none of the patients had evidence of diabetic complications. These findings may have important implications for the development of vascular disease in diabetics.
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PMID:Measurement of platelet aggregation in diabetics using the new electronic platelet aggregometer. 295 92


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