Gene/Protein Disease Symptom Drug Enzyme Compound
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 95,504 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of two studies about the course of pregnancy and delivery in adipose women in our hospital are combined and discussed. We found a higher rate of EPH-gestosis in overweight patients. The frequency of Cesarean section was increased. Belated uterine involution post partum is more frequent in adipose women, also the occurrence of urinary tract infections. There is a significant increase in perinatal mortality, mainly due to an increase in still-born. Pneumonia due to aspiration and birth traumata occur more frequently as well and endanger the children.
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PMID:[Obese patients in obstetrics]. 97 92

In Basle in 1972 a diabetes survey was performed in subjects with increased risk of diabetes mellitus (overweight, age above 50, relatives of diabetics). For screening, the blood sugar was determined one hour after ingestion of 50 g of glucose. 404 males and 768 females (known diabetics excluded) were examined. One third of males and one quarter of females had a blood sugar value above 150 mg%. Blood sugar values of more than 200 mg% were found in 9% of the male and 7% of the female participants. A positive correlation existed between age and blood sugar values in males and females. Body weight and blood sugar value correlated only in females. However, in male subjects with pronounced obesity (Broca index greater than 1.23) there was a significantly higher incidence of blood sugar screening value above 150 mg% than in the rest of the males. It would appear that even slight overweight enhances glucose intolerance in females, whereas in males only marked overweight favours the manifestation of glucose intolerance. The cost of the detection of a new case of diabetes mellitus (blood sugar greater than 200 mg%) amounted to Sfr. 70.-. The Basle diabetes survey provides a model for successful conduct of a preventive program through cooperation of private organizations such as the local Medical Association and the local Diabetes Association.
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PMID:[Procedures for the early recognition of diabetics in Basle 1972. Contributions to the early diagnosis of diabetes mellitus by means of blood sugar analysis with special reference to the practical procedures under Swiss conditions]. 125 14

3385 consecutive records of deliveries at the Ist Department of Obstetrics and Gynecology of the University Hospital, Vienna, were reviewed. Particular attention was paid to increased weight gain during pregnancy--defined as a total weight gain of more than 13,4 kg--and EPH-gestosis. Patients were put into one of two groups: (1) no increased weight gain during pregnancy, and (2) increased weight gain of over 13,4 kg. Each group was further divided into women with no or only slight symptoms of gestosis (gestosisindex 0 to 3) and gravidae with moderate or severe EPH-gestosis (gestosis index 4 or greater than 4). The four groups of gravidae were compared with regard to perinatal complications and fetal outcome. While the average weight gain for all gravidae was 13,2 kg, patients with EPH-gestosis did not gain significantly more than non-gestotic women. However, body-weight before pregnancy was positively correlated with the symptoms and the severity of EPH-gestosis. It was concluded, that weight gain per se has very little, if any influence on the appearance of toxemia. Patients, who are overweight at the onset of pregnancy must be considered at risk for the development of moderate or severe EPH-gestosis.
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PMID:[Influence of body weight and weight increase on the development and severity of an EPH gestosis (author's transl)]. 746 28

Overweight among black females is almost two times as frequent as among white females. Genetics, caloric intake, and physical activity have been identified as possible explanatory factors. This study assessed the differences in physical activity and body composition in 76 white and 66 black adult females. Black women had significantly higher (p = .0001) percent body fat (32.2 +/- 7.1) than white women (27.7 +/- 6.5) with a similar difference in weight (4.4 kg) approaching significance (p = .055). Physical activity was assessed using a structured 24-hour recall instrument. A purposive sampling design was implemented to control for age, education and occupation. A summary physical activity value unit for the 24-hour period revealed a significantly greater mean value for white females (41.93 +/- 4.7) than for black females (40.01 +/- 3.9) suggesting white females were more physically active (p = .02) although this was not a function of biracial differences in play/recreation and exercise/sport type of activities. Although both black and white females were found to be sedentary (MET value < or = 2) over 90 percent of the time, black women are significantly more sedentary (p = .03). Biracial differences in discretionary non-exercise oriented activities may contribute to different rates of overweight observed between black and white women.
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PMID:Biracial differences in physical activity and body composition among women. 852 Nov 47

Single nucleotide polymorphisms (SNPs) in the ADRB2, ADRB3, TNF, IL6, IGF1R, LIPC, LEPR, and GHRL genes were associated with the conversion from impaired glucose tolerance (IGT) to type 2 diabetes mellitus (T2D) in the Finnish Diabetes Prevention Study (DPS). In this study, we determined whether polymorphisms in these genes modified the effect of changes in physical activity (PA) on the risk of T2D in the DPS. Moreover, we assessed whether the polymorphisms modified the effect of changes in PA on changes in measures of body fat, serum lipids, and blood pressure during the first year of the follow-up of the DPS. Overweight subjects with IGT (n = 487) were followed for an average of 4.1 years, and PA was assessed annually with a questionnaire. The interactions of the polymorphisms with changes in total and moderate-to-vigorous PA on the conversion to T2D during the 4.1-year follow-up were assessed using Cox regression with adjustments for the other components of the intervention (dietary changes, weight reduction). Univariate analysis of variance was used to assess interactions on changes in continuous variables during the first year of the follow-up. No interaction between the polymorphisms and PA on the conversion to T2D was found. The Leu72Met (rs696217) polymorphism in GHRL modified the effect of moderate-to-vigorous PA on changes in weight and waist circumference, the -501A/C (rs26802) polymorphism in GHRL modified the effect of total and moderate-to-vigorous PA on change in high-density lipoprotein cholesterol, and the Lys109Arg (rs1137100) polymorphism in LEPR modified the effect of total PA on change in blood pressure. In conclusion, genetic variation may modify the magnitude of the beneficial effects of PA on characteristics of the metabolic syndrome in persons with IGT.
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PMID:Interaction of single nucleotide polymorphisms in ADRB2, ADRB3, TNF, IL6, IGF1R, LIPC, LEPR, and GHRL with physical activity on the risk of type 2 diabetes mellitus and changes in characteristics of the metabolic syndrome: The Finnish Diabetes Prevention Study. 1824 19

Habitual physical activity and chronic exercise may positively influence circulating cytokines in youth as in adults. The purpose of this study was to determine if adolescents reporting higher amounts of physical activity had a better cytokine profile independent of weight status. We compared the concentrations of cytokines in highly active (n = 60) and less active adolescents (n = 60) of different weight status [normal weight (BMI < 75th percentile), and overweight (BMI > 95th percentile)]. Vigorous physical activity (VPA) was obtained through a questionnaire and included activities with a MET level of > or =6. Adiponectin, resistin, TNF-alpha and IL-6 were measured in fasting plasma samples. Anovas indicated that girls with high VPA had higher adiponectin than girls with low VPA (P < 0.05), but similar resistin, TNF-alpha and IL-6 concentrations (P > 0.05). Boys with high VPA had only a trend to lower resistin than those with low VPA (P = 0.052). Differences between VPA groups were independent of weight status. In adolescents, higher amounts of accumulated habitual VPA may improve some cytokines, reducing the risk of inflammation associated with increased adiposity and insulin resistance. The effect of physical activity appears to be independent of weight status.
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PMID:Vigorous physical activity and cytokines in adolescents. 1841 17

We examined the relationship between body mass index (BMI) and measures of tenderness, quality of life, and physical functioning in female fibromyalgia (FMS) patients. A random sample of 100 female FMS patients from a database of 550 FMS individuals was interviewed and assessed according to a structured questionnaire that included FMS-related symptoms, measures of tenderness (point count and dolorimetry), quality of life (SF-36), physical functioning, and BMI. Weight was defined as normal, overweight, and obesity according to BMI. Twenty-seven percent of the FMS patients had normal BMI, 28% were overweight, and 45% were obese. BMI was negatively correlated with quality of life (r = -0.205, P = 0.044) and tenderness threshold (r = -0.238, P = 0.021) and positively correlated with physical dysfunctioning (r = 0.202, P = 0.047) and point count (r = 0.261, P = 0.011). Obese FMS patients display higher pain sensitivity and lower levels of quality of life. In designing studies that explore factors affecting tenderness, BMI should be included in addition to sex, age, etc.
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PMID:A cross-sectional study of the relationship between body mass index and clinical characteristics, tenderness measures, quality of life, and physical functioning in fibromyalgia patients. 1862 75

Factors influencing circulating estrogen levels, insulin-mediated pathways or energy balance through obesity-related mechanisms, such as physical activity, have been proposed as potential risk factors for endometrial cancer. We examined measures of physical activity in relation to endometrial cancer risk in the American Cancer Society Cancer Prevention Study II Nutrition Cohort, a prospective study of cancer incidence and mortality, using information obtained at baseline in 1992. From 1992 to 2003, 466 incident endometrial cancers were identified among 42,672 postmenopausal women with intact uteri who were cancer-free at enrollment. Cox proportional hazards modeling was used to compute hazard rate ratios (RR) while adjusting for potential confounders. To assess the role of body mass index (BMI) in this relationship, we computed multivariate RR with and without adjustment for BMI and stratifying by BMI. All measures of physical activity and the avoidance of sedentary behavior were associated with lower endometrial cancer risk. Baseline recreational physical activity was associated with 33% lower risk (RR = 0.67, 95% CI 0.44-1.03 for 31.5+ vs. <7 MET-hr/week, trend p = 0.007) in the multivariate model without BMI. However, the trend was attenuated after further adjustment for BMI (trend p = 0.18). BMI significantly modified the association between physical activity and endometrial cancer risk (heterogeneity of trends p = 0.01). The inverse relationship was seen only among overweight or obese women (trend p = 0.003) and not in normal weight women (trend p = 0.51). In summary, light and moderate physical activity including daily life activities were associated with lower endometrial cancer risk in our study, especially among women who are overweight or obese.
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PMID:The role of body weight in the relationship between physical activity and endometrial cancer: results from a large cohort of US women. 1865 69

Overweight and obesity is associated with an increased risk of postmenopausal breast cancer. However, less is known about the impact of anthropometric factors on tumor pathology and biology. A Swedish population-based prospective cohort study of 9,685 postmenopausal women not using hormonal replacement therapy (HRT) were followed for an average of 10.3 years during which 305 incident breast cancer cases were diagnosed. Invasive and sufficient tumor material was available in 248 cases. Pathological reevaluation of histological type and grade was conducted. Using a tissue microarray (TMA), the tumor expression of Ki67, HER2, ERalpha, ERbeta, PgR, cyclin D1 and p27 was evaluated. Six anthropometric factors: height, weight, body mass index (BMI), waist- and hip circumference and body fat percentage were categorized by quartiles of baseline anthropometric measurements, and relative risks were calculated using multivariate Cox regression models. Invasive breast cancer incidence was increased for women in the higher quartiles of all anthropometric measurements. Height was positively associated with Grade I and ERalpha-positive tumors. Women in the highest quartiles of weight, BMI, waist- and hip circumference and body fat percentage were all associated with tumors of ductal type, Grade II, low Ki67 index, HER2 negativity and low expression of the oncogene cyclin D1. Obesity was further associated with tumors expressing ERalpha and PgR but interestingly not ERbeta. This study confirmed previously described associations between overweight/obesity and increased risk of postmenopausal breast cancer. Furthermore, obesity was associated with tumors expressing several markers corresponding with low malignancy.
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PMID:Anthropometric factors in relation to different tumor biological subgroups of postmenopausal breast cancer. 1879 78

Physicians in Egypt and other Arab and developing countries still have to deal on a daily basis with large numbers of patients with advanced stages of breast cancer at presentation. Efforts at measuring the magnitude of the breast cancer issues, epidemiology, and awareness, are now moving further in the right direction. We are now starting to face the challenges of early detection of breast cancer as well as the implementation of proper modern management. Dorria S. Salem et al. publish in this issue of the Journal of Egyptian NCI an outline and initial results of a very ambitious Women Health Outreach Program (WHOP) designed to be completed in 5 phases 1. She and her co-authors state that those 5 phases include a prior training and demonstration phase that was completed in the Imaging Unit of Kasr El Aini Hospital in Cairo, as well as a one-year pilot phase completed between October 2007 and October 2008. Authors present us with results of screening of 20.098 women over the age of 45 years, between October 30, 2007 and February 9, 2009 in Cairo, Alexandria and Suez Governorates in Egypt. In addition to breast cancer, WHOP included screening for diabetes, hypertension and obesity. WHOP investigators are to be congratulated for this extraordinary ambitious project and all the efforts put into it. They were well prepared in regards to having a multi-disciplinary working team and they included in their project programs for training of clerks, data managers, radiographers, nurses, radiologists and other physicians who deal with diagnosis and management of breast cancer. They also included engineers and arranged for mobile units to reach women who could not otherwise reach them. WHOP investigators are to be commended also for performing a field plan demonstration project and testing it and for measuring citizens' response before finalizing their plans and starting the project1. They set a great example for other people working in the field. Breast cancer is the most common female malignancy in women in almost all Arab countries [2-5]. Randomized trials of mammographic screening of average-risk women above 50 years reduced breast cancer mortality by more than 36%. Analysis of the eight randomized trials, including the Canadian trials on women, ages 40-49 years old, showed a relative reduction of breast cancer deaths by 18% [6]. There is an obvious overlap as women with ages ranging from 40-49 years old reach the age of 50 and above, and enjoy the more clear benefits of mammographic screening beyond the age of 50 years. Many societies, including the American Cancer Society, recommend mammographic screening starting at age 40 years [7,8]. As it would be very difficult in this day and age to do more studies on breast cancer screening, and in view of the observations that almost 50% of cases are below the age of 50 years with a median age of 48-52 years at presentation, we recommend screening be done starting age 40, where resources are available and where setup for breast cancer care is appropriate [4,9]. Salem et al. report an initial very significant and alarming number of 10.215 women out of 20.098 women to be overweight and 2692 women to be obese [1]. Their observation that there is no significant correlation with breast cancer is only a one point in time observation and it cannot be used to confirm or refute any potential relationship between overweight, obesity and breast cancer. Future results, follow-up, and multivariate analysis will be awaited. Correlation of mammographic abnormalities with diabetes and hypertension in WHOP participants are very preliminary and will also need further multivariate analysis. WHOP investigators report that they invited women aged 45 years and up for screening. Eligibility criteria listed include only two points, women should have no personal history of breast cancer and no recent mammography [1], authors neither describe clinical history nor physical breast examination of selected and invited women. In future reports, authors will be asked about the assessement of those invited women, and what were the results and outcome if referred women were found to have abnormalities in their breasts. In another study from Cairo, Egypt, women were taught how to examine themselves, and authors reported that many were found to have clinical breast cancers for which they were effectively downstaged, and therefore treated for cancers that would have otherwise presented later as more advanced cases [10]. This issue brings me back to re-emphasize the importance of awareness, teaching women self-breast exam, and clinical breast examination once-a-year by a physician, particularly in countries with limited resources. Breast cancer awareness campaigns emphasize the benefits of early detection by promoting breaking of taboos, and teaching scientific facts that early breast cancer can be cured, and that cure can be achieved without the need of mastectomy. Advanced breast cancer is devastating to women and to their husbands and children, and therefore campaigns should be directed towards women as well as husbands who should be asked to encourage their wives to enroll in screening campaigns. Campaigns have begun to reduce the effects of taboos and people started to talk more freely about cancer, in fact, we and many centers in Arab countries have started to see more cases of early breast cancer and even a significant number of cases with microcalcifications [4]. Breast cancer screening in countries with limited resources have been recently reviewed [11,12]. As for the management of abnormal findings, Dorria S. Salem et al. [1] report performing FNAB as first line management in suspicious cases and reserving core biopsies for inconclusive cases. I fully agree with the authors' efforts to ensure accurate diagnosis and the importance of having an experienced cytopathologist. However, FNA is useful and recommended when there is a palpable tumor or a highly suspicious tumor with irregular borders and infiltrative characteristics on mammography and ultrasound. Core biopsy is indicated when FNA is inconclusive as the authors state, and also if mammography shows micro-calcifications where FNA cannot distinguish between in-situ and infiltrative carcinoma. A core biopsy is important for better assessment of pathology and determination of receptors (estrogen, progesterone, and HER2 receptors) especially in patients with large tumors who require preoperative (neoadjuvant) therapy, particularly when targeted anti-HER2 therapy is indicated [13]. In the present report, WHOP investigators [1] report that 31 patients, out of 86 true positive cancers, underwent modified radical mastectomy while 21 had breast-conserving surgery. Eleven patients required only excisional biopsy and had benign tumors, 25 had surgery at private institutions and no data is available on them. Further WHOP reports will be awaited to report to us on the stages and follow-up information on all patients. Availability of experienced surgeons and radiation oncology are also important issues when referring patients for partial or total mastectomy. After screening of over 20000 women, authors report that abnormal mammographies with BiRADS 4 and 5 were found in 433 cases (reported as 2.1%). Additional work-up with ultrasound and FNA/biopsy showed 2 false negatives, 110 false positives, and confirmed 86 true positive cases (0.4% of total 20.098 women screened). In the US, the likelihood of a woman being called back for additional testing after first round of screening is an average of 11% (range 3-57%) [14]. In women for whom a biopsy is then indicated, the likelihood of finding an invasive and/or insitu cancer is 25-47% [15]. This is what we call positive predictive value (PPV) and it varies with expertise and patients own risk factors for breast cancer. What is of concern in this present WHOP article, although not unexpected, is that more than half of the recalled women did not show up or no feedback is available on them. This should generate yet another important experience on how to deal with missing information and how to assure follow-up of patients in Egypt and other Arab countries, as well as in all limited resource countries. WHOP investigators will be asked to report in the future on screening intervals and data collection. Screening started at age 45 years, and data were analyzed by 10-year age groups starting age 50, which makes comparisons somehow difficult. In view of the high incidence of women with breast cancer with young age at presentation, it would be more helpful if WHOP investigators revise the starting age for screening mammography and make it 40 years and analyze data according to 10-year age groups starting age 40 years. On the other hand, it is important to note that increasing the time interval of periodic mammography diminished the mortality reduction by allowing undetected growth of interval cancers. Increasing the screening interval of women in their forties from annual to every 2 years or to every 3 years would diminish mortality reduction rates from 36% to 18% and to 4%, respectively [16]. Once a screening strategy is adopted, women aged 40 years and up should be screened at yearly intervals because data from Egypt and other Arab countries indicate that 50% of breast cancers are seen in women below age 50 years, and because young women have more aggressive tumors [17,18] and may be missed by two-year intervals. Finally, WHOP investigators, staff, and their sponsors are to be commended for this excellent, well planned and executed project that sets a great example for devotion for science and public health. In addition to regional and national cancer registries, they provide many new innovative approaches to characterize, diagnose and treat breast cancer in Egypt and other Arab countries. (ABSTRACT TRUNCATED)
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PMID:Responding to the challenges of breast cancer in egypt and other arab countries. 2057 88


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