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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Obesity increases the risk of metabolic complications such as diabetes, dyslipidemia, systemic hypertension and cardiovascular disease. These are mainly responsible for the increased mortality of obese people. Other metabolic consequences of obesity are: gallstones, steatosis of the liver and the polycystic ovary syndrome. Beside the body mass index the distribution of body fat is important. Centralized obesity, as measured by the waist-to-hip circumference ratio (WHR), is associated with increased mortality and morbidity. Insulin resistance and hyperinsulinaemia seem to play a central role in the pathogenesis of this association. Obesity has not only metabolic complications. There is a relationship between obesity and impaired respiratory function. Furthermore is obesity a risk factor for osteoarthrosis of the knee, the hip and even the hand and for pulmonary embolism and venous thrombosis. Obesity can also lead to psycho-social problems such as depression, social discrimination and isolation.
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PMID:[Consequences and complications of obesity]. 1102 85

The widely used distinction of Little and Rubin (1) about types of randomness for missing data presents difficulties in its application to dropouts in longitudinal repeated measurement studies. In its place, a new typology of randomness for dropouts is proposed that relies on using a survival model for the dropout process. In terms of a stochastic process, dropping out is a change of state. Then, the longitudinal measures and dropout processes can be modeled simultaneously, each conditional on the complete previous history of both repeated measures and states. In this context, Poisson regression is used to fit various proportional hazards models, some of which are new, to the dropout process using the longitudinal measurements responses as time-varying covariates. As examples of longitudinal measurement studies displaying nonrandom dropout processes, a dental study of testosterone production in rats and clinical trials for treatment of gallstones and of depression are analyzed.
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PMID:Dropouts in longitudinal studies: definitions and models. 1110 90

Trauma and surgical procedures can induce immune depression, related to the prevalent impairment of cell-mediated immunity, which may predispose to infections. The early recovery following laparoscopic cholecystectomy without infectious complications seems to be related to a lesser degree of surgical trauma and to only minimal impairment of immune functions. The present study was conducted in 20 patients with symptomatic gallstone disease, all undergoing laparoscopic cholecystectomy. Blood samples taken before operation and at 3 and 6 days postoperatively were tested for lymphocyte subsets (CD4+, CD8+, CD19+, CD57+), blood chemistry parameters (IgG, IgA, IgM, CH-50, C3, C4) and haemochrome. A group of 10 normal volunteers, matched for age and sex, were also examined twice at an interval of 48 h. Student's "t"-test was used for statistical comparisons. The findings showed only minimal changes in immune functions after operation (slight increase in CD57+ cells, and very slight decreases in IgM and C4 factor) and a slow reduction of serum haemoglobin levels as compared with preoperative values. All parameters returned to baseline levels within 6 days of the operation. This study demonstrates that laparoscopic cholecystectomy does not significantly affect immune functions, suggesting that immunity is preserved in the postoperative period.
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PMID:[Immunologic functions after laparoscopic cholecystectomy]. 1172 97

Progestins in oral contraceptives (OCs) produce potential complications, as well as noncontraceptive benefits, according to Robert A. Hatcher, MD, MPH, professor of gynecology and obstetrics, Emory University Medical School. Hatcher told CTU that lowering the progestin content in an OC may decrease complications, but could also decrease the benefits experienced by women. "The extent to which that will happen remains to be seen," he said. Hatcher cited the following potential complications of progestins in OC: hypertension; decreased levels of high density lipoproteins; acne; oily skin; headaches between pill cycles; dilated leg veins; pelvic congestion syndrome; thrombosis of superficial leg veins; gallstones; Monilia vaginitis; cholestatic jaundice; and depression, fatigue, and decreased libido. Progestins, according to Hatcher, also produce these noncontraceptive benefits: protection against PID; decreased dysmenorrhea; decreased menstrual blood loss, decreased iron deficiency anemia; protection against endometrial cancer; protection against fibrocystic breast disease, and fibroadenomas of the breast; decreased bleeding from fibroids; decreased growth of fibroids. When ovulation is suppressed, Hatcher emphasized, additional benefits that may occur include the following: decreased risk of functional ovarian cysts; elimination of mittleschmerz pain; decreased rick of ovarian cancer; protection against endometriosis.
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PMID:Potential risks, benefits of progestins in birth control pills outlined. 1231 83

The number of obese and overweight Oklahomans and Americans has grown both steadily and rapidly in the last few decades. Along with this increase in weight, doctors now see a higher proportion of chronic, degenerative diseases such as cardiovascular disease, diabetes, cancer, and osteoarthritis. Poor diet, sedentary lifestyle, and poor stress and time management contribute to weight problems and illness. Lifestyle changes have no side effects or risks, other than the perceived challenge of implementing and maintaining them. Healthier habits offer multiple organ system benefits including weight control, less anxiety and depression, improved energy, better sleep, and lower rates of gastrointestinal problems, such as reflux, gallstones, and fatty liver. By providing accurate and comprehensible information, doctors can motivate and support patients to better safeguard their health and manage their weight. This article will suggest specific phrases to use in the framework of motivational interviewing, as discussed in the first article, Part I, in this 3-part series.
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PMID:Putting prevention into practice: counseling patients to prevent and decrease obesity. 1602 2

In transsexual people, cross-sex hormone therapy is an important component of medical treatment. In male-to-female transsexuals, feminizing effects should be achieved before irreversible sex reassignment surgery (SRS) is considered. The most common treatment regimen in male-to-female transsexuals is a combination of ethinyl oestradiol and cyproterone acetate, with the exception of transdermal oestradiol-17beta in individuals over the age of 40. The mortality and morbidity rates with this treatment regimen have been reported in more than 800 patients. Typical side effects include venous thrombosis, elevated liver enzymes, symptomatic gallstones, hyperprolactinaemia and depression. Sixty male-to-female transsexuals were treated with monthly injections of gonadotropin-releasing hormone agonist (GnRHa) and oral oestradiol-17beta valerate for 2 years to achieve feminisation until SRS. There was a significant decline in gonadotropins, total testosterone and calculated free testosterone. In general, the treatment regimen was well accepted. An equal increase in breast size was achieved compared to common hormone therapy. Two side effects were documented. One, venous thrombosis, occurred in a patient with a homozygous MTHFR mutation. One patient was found to be suffering from symptomatic preexisting gallstones. No other complications were documented. Liver enzymes, lipids, and prolactin levels were unchanged. Significantly increased oestradiol and SHBG serum levels were detectable. In addition, an increase in bone mass density, in the femoral neck and lumbar spine, was recorded. We conclude that cross-sex hormone treatment of male-to-female transsexuals using GnRHa and oestradiol-17beta valerate is effective, and side effects and complication rates can be reduced using the treatment regimen presented here.
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PMID:Endocrine treatment of male-to-female transsexuals using gonadotropin-releasing hormone agonist. 1632 Jan 57

Cerebrotendinous xanthomatosis is a rare hereditary lipid storage disease characterised by deposits of cholestanol. In a female patient with bilateral swelling of the Achilles tendon who underwent biopsy, cerebrotendinous xanthomatosis was confirmed by combining disease patterns. She suffered from ataxia, depression, epilepsy, reduced intelligence, bilateral cataracts, gallstones, and atherosclerosis. Concentration of serum cholestanol was 10 times higher than normal. As causal therapy, ursodeoxycholic acid and statin drugs were prescribed to halt progression.
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PMID:[Cerebrotendinous xanthomatosis. Hereditary lipid storage disease leading to bilateral swelling of Achilles tendon]. 1848 1

A burgeoning pandemic of obesity is well characterized. 41% of U.S. adults are projected to be obese by 2015 and obesity, a potentially modifiable risk, is emerging as a leading predictor of lifetime health. The wide spectrum of morbidities related to excess body mass includes risks for diabetes, hypertension, coronary artery disease, dyslipidemia, malignancy, venous thrombosis, degenerative joint disease, pulmonary compromise, sleep apnea, cholelithiasis, depression and overall reduced quality of life. Beyond the myriad major and minor morbidities linked to obesity, increased all-cause mortality and cardiovascular mortality is recognized in the obese. Bariatric surgery literature suggests that, in the morbidly obese, increase in the lifespan is achievable with reversal of obesity, reinforcing the realization that sequelae therein are by no means inevitable. Aggressive efforts must be targeted towards population-based strategies to educate and sensitize all generations on contributors to and sequelae of excess body mass as obesity represents one of the few modifiable factors that impact on the quantity and quality of lifespan.
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PMID:Predictors of chronic disease at midlife and beyond--the health risks of obesity. 1979 85

Obesity increases overall morbidity mainly by the increased mass of fat tissues and by the hyperproduction of pro-inflammatory molecules by the abdominal tissue. Coronary artery disease, metabolic syndrome or diabetes mellitus are the main complications linked to the inflammatory low-grade syndrome whereas arthritis is linked to the adipocytes mass. Many other complications are associated with obesity: steato-hepatitis, glomerulo-sclerosis, digestive diseases such as gallstones, hypofertility, psychosocial dysfunction and depression and certain cancers. Obesity is also a risk factor for pregnancy and surgery. Most of these complications are reversible after a substantial weight loss.
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PMID:[Radical complications of obesity]. 2061 95

In previously untreated HIV-1 infection, one first-line therapeutic option is to combine efavirenz, a non-nucleoside reverse transcriptase inhibitor, with tenofovir and emtricitabine. Rilpivirine, another non-nucleoside reverse transcriptase inhibitor, has been approved in the European Union for the treatment of antiretroviral-naive patients with low viral load. Two double-blind "non-inferiority" trials compared rilpivirine- and efavirenz-based combination therapy in a total of 1368 previously untreated patients. Efficacy was similar with respect to the primary endpoint: 80% of patients had viral load below 50 copies/ml after 48 weeks of treatment. In these trials, combinations containing rilpivirine appeared less effective than those containing efavirenz in patients with high viral load (above 100 000 copies/ml). Overall, the risk of virological failure appeared to be higher with rilpivirine than with efavirenz (20.4% versus 18% after 196 weeks). In addition, the potential for cross-resistance to other non-nucleoside reverse transcriptase inhibitors in case of virological failure appeared to be higher with rilpivirine than with efavirenz. Compared with the known adverse effect profile of efavirenz, rilpivirine was associated with less rash (17% versus 31%) and dizziness (10% versus 29%). The incidence of depression appeared similar with the two drugs. In contrast, serum creatinine elevation was more frequent with rilpivirine (5% versus < 1%). Gallstones and adrenal insufficiency are also likely to be more frequent with rilpivirine. High doses of rilpivirine prolong the QTc interval. Rilpivirine carries a risk of pharmacokinetic interactions with many other drugs, including inducers and inhibitors of cytochrome P450 isoenzyme CYP3A4, drugs that increase gastric pH, and drugs transported by P-glycoprotein. Rilpivirine also carries a high risk of pharmacodynamic interactions, notably with drugs that prolong the QTc interval. In practice, as rilpivirine has no proven therapeutic advantages, when combination therapy containing a nonnucleotide reverse transcriptase inhibitor is chosen for previously untreated patients, it is better to continue to use efavirenz, a better-known drug that creates fewer problems in case of treatment failure.
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PMID:Rilpivirine. First-line treatment of HIV infection: efavirenz is better documented. 2321 Feb 55


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