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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The relationship of solvent exposure to self-reported neurologic and somatic symptoms as well as neuropsychological performance was examined in a sample of 567 female blue collar workers who were members of the International Brotherhood of Electrical Workers (IBEW). Structured interviews were conducted at IBEW offices. Five solvent exposure categories were derived--never exposed, exposed prior to but not during the past year, exposed during the past year but not currently, currently exposed less than 50% of the time, and currently exposed more than 50% of the time. No differences among the groups on neuropsychological performance were found. On the other hand, heightened exposure was significantly related to depression, severe headaches, light-headedness, room spinning, appetite difficulties, funny taste in mouth, weakness/fatigue, rashes, and abdominal pain after controlling for the effects of seven risk factors (age, smoking, moderate-heavy alcohol consumption, severe obesity, history of physician-diagnosed chronic illness, working in a clean room, and exposure to other chemicals). These findings are consistent with Scandinavian studies of solvent-exposed male workers and point to the need for careful prospective research.
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PMID:Health effects of long-term solvent exposure among women in blue-collar occupations. 234 72

The subclavian artery is the most important landmark of the supraclavicular brachial block. However, it is difficult to locate the artery by palpation in the patients with poor landmark. The present study was aimed to compare two localizing methods of the subclavian artery by a pulse oximeter or by palpation. One hundred patients were divided into three groups. Group A (Slim Group): 6 patients, Group B (Normal Weight Group): 75 and Group C (Obese Group): 19. All patients received both methods to locate the subclavian artery. The first method was by palpating the pulsation of the subclavian artery. The second was by observing the wave depression of the pulse oximeter while pressing supraclavicular area. It was found that the detection rate of the first method was 83.3% in Group A, 52.0% in Group B, 26.3% in Group C and 49.0% in overall patients. However, the detection rate of the second method was 100% in each group. It shows a significant difference between the two methods in Group B, Group C and all patients (P less than 0.001), but no difference in Group A (P = 0.68). There were 13 patients among the 100 patients undergoing surgery of the upper extremity. Seven of them whose pulsation was not clearly palpated but could be located exactly by pulse oximeter. Supraclavicular brachial block was still completed successfully in these 13 patients. No pneumothorax was found. Utilizing pulse oximeter in supraclavicular block provides a high detection rate of the pulsation of the subclavian artery and improves the reliability of the block, especially in the patients with poor landmark.
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PMID:The application of pulse oximeter for supraclavicular brachial block. 235 63

The effects of nutritional manipulation on immune function have been extensively studied in animals, but few studies have examined dietary restriction in humans. Obese patients enrolled in a protein-sparing, calorically restricted diet were monitored over a 3-month period with in vitro examination of mitogen- and antigen-induced lymphocyte blastogenesis. The sera from these patients were evaluated for effects on neutrophil chemotaxis, phagocytosis and microbial killing. Significant changes in body weight, triglycerides and glucose occurred during the diet, and most patients exhibited urinary ketosis. The diet was associated with increased blastogenesis in unstimulated cultures and in varicella and candida antigen-stimulated cultures, but blastogenesis was unchanged for phytohemagglutinin, concanavalin A, SK-SD and histoplasma. In assays of serum effects on neutrophil function, patients with urinary ketosis had depression of chemotaxis and microbial killing but not phagocytosis when compared to baseline or nonketotic patients. This study indicates that long-term caloric restriction is associated with significant effects on in vitro lymphocyte stimulation and with significant serum effects on normal neutrophil function.
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PMID:Effect of prolonged modified fasting in obese persons on in vitro markers of immunity: lymphocyte function and serum effects on normal neutrophils. 235 51

Sertaline [1S,4S-N-methyl-4-(3,4-dichlorophenyl)-1,2,3,4-tetrahydro-1- naphthalenamine] is a potent and selective inhibitor of neuronal serotonin uptake and is currently under development for the treatment of depression and of obesity. The drug is greater than 97% bound to plasma proteins, yet extensively distributes into tissues. The whole brain concentration of sertraline in the rat is more than 40-fold higher than that in plasma, and the volume of distribution is about 25 liters/kg in the rat and dog. Sertraline is extensively metabolized by the rat and dog prior to excretion. The metabolic clearance of sertraline is greater than 35 ml of blood/min/kg in each species, and first-pass metabolism occurs with oral administration. Initial metabolic steps include N-demethylation, N-hydroxylation, oxidative deamination, and glucuronidation of sertraline carbamic acid, which in solution is in equilibrium with sertraline and carbon dioxide. The N-desmethyl metabolite, which is 10-fold less potent as an inhibitor of serotonin uptake, is formed in both species. Plasma AUC for desmethyl-sertraline is 66 to 270% of that for sertraline, and is dependent on the species examined and route of drug administration. Sertraline and desmethyl-sertraline undergo oxidative deamination to the corresponding ketone, which is subsequently hydroxylated at the alpha-carbon, forming a diastereomeric metabolite pair. The glucuronides of sertraline carbamic acid, N-hydroxy sertraline, and the alpha-hydroxy ketone diastereomers comprise 45% and 82% of the total radiolabel excreted in urine and bile of bile duct-cannulated rats and dogs, respectively. Bile is the major route of elimination in both species.
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PMID:Metabolism and disposition of the 5-hydroxytryptamine uptake blocker sertraline in the rat and dog. 257 98

Application of Holter electrocardiography to an exercise test for heart function is useful in the group examination of school children. The circulatory responses to a step test among obese boys and girls and control were as follows: 1. Four cases of arrhythmia were detected, of whom 2 cases were discovered during exercise. ST-segment depression of 0.1 mV or more during and after exercise was recognized in 29 cases, 27 of the junctional- and 2 of the sagging slope, with a higher percentage in obese girls than in normal girls. 2. Serial ECG records during the procedure, performed for all children with the same single-step test, showed differences in the circulatory responses among the test groups. The load was estimated to be 76-86% of the maximal heart rate predicted by Cummings, with obese and girl groups being higher than other groups. The comparison revealed that the heart rate (HR) responses to exercise done by the boys increased faster than those by the girls at 1 minute after exercise. There were differences between obese and control and between boys and girls in HR at recovery, and also in HR before and 4 minutes after exercise between two sexes, which findings agree with other reports. 3. Concerning anthropometric factors, either the skinfold thickness or the obesity index was related to the HR at the peak of the exercise as well as immediately after it and to the half time. By contrast, the arm muscle diameter was found unrelated to the HR. Using this method, applied these combination of Holter ECG and step test to a group examination, we got ECG data for 254 subjects, 97.5% of which were suitable for analysis. We found this method to be effective for detecting ECG changes and for determining HR responses to exercise. This method is safe, simple, and inexpensive and is applicable to examination not only for school children but also for different population groups, for the estimation of circulatory responses.
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PMID:[Application of Holter electrocardiography to exercise testing for the group examination of school children: comparison between obese and normal children]. 264 92

The study of obesity from a variety of psychological perspectives has been exciting and inventive, although we still do not understand fully the role of psychological variables in the etiology of obesity. Many of the factors thought to be of etiologic significance--field dependence, lack of impulse control, inability to delay gratification, or a maladaptive eating style--have not been supported by experimental evidence. Other factors once thought to be of importance as causes of obesity, depression and dysphoria, for example, appear, instead, to be consequences of being obese and may serve to maintain and intensify weight-related problems. Dieting behavior in response to weight concerns appears, perversely, to be implicated in increasing overweight and adiposity. Finally, arousability in response to food cues in the environment may play a causal role in some obesities.
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PMID:Psychological features of obesity. 264 8

Excess body fat has been clearly associated with an increased risk of oligo-ovulation and endometrial/breast carcinoma. The connection has been assumed to lie within derangements of the metabolic/endocrine compartments, particularly of estrogens and androgens. To differentiate the effect of obesity from its related disease process, an attempt has been made to define the reproductive-endocrinologic alterations encountered in otherwise asymptomatic obese women. Androgen metabolism is accelerated in obesity. It is not clear whether the increased clearance precedes or follows the accelerated production of androgens. A servocontrol mechanism appears to be operative in these asymptomatic individuals, maintaining plasma steroid levels normal. The unbound fraction of T may be somewhat increased in overweight women with predominantly upper body fat deposition. The increased clearance of androgen may arise from an obesity-related depression in SHBG concentration (e.g., for T, E2, delta 5-diol, etc.). Adipose tissue, by virtue of the lipid solubility of most of these steroids, concentrates androgens, estrogens, and progesterone. This steroid sequestration not only contributes to the obesity-related increase in androgen clearance but also leads to an extremely enlarged total body steroid pool. Fat tissue sequestration also increases the concentration of androgens in the vicinity of adipose stromal cells, possibly encouraging their aromatization. Adipose tissue also has a moderate degree of 17-hydroxysteroid dehydrogenase activity, which appears to stimulate the conversion of A to T. Finally, alterations in peripheral and hepatic conjugation and an accelerated urinary excretion may contribute to the elevated clearance of androgens. The accelerated PR of androgens may simply result as compensation for the elevated MCR in obesity. Nonetheless, evidence of alteration(s) in adrenocortical steroidogenesis has been presented suggesting a selective obesity-related enhancement in adrenal androgen secretion. These remain to be confirmed. Nonetheless, adrenocortical abnormalities may arise secondary to the influence of other circulating and intra-adrenal factors, including insulin, prolactin, estrogens, and androgens. It is not known whether the accelerated androgen metabolism or the aberrant adrenal steroidogenesis improve with weight reduction. Excess body fat increases androgen aromatization which, together with an obesity-related decrease in SHBG, is associated with mildly elevated levels of E1 and free E2 in postmenopausal women. Although premenopausal obese individuals have the same tendency, the far greater ovarian estrogen secretion overshadows any differences. The bulk of aromatization activity in fat lies in the stromal comportment. The major substrate for peripheral estrogen production is A. Testosterone also contributes to the estrogen pool via its conversion to E2.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Reproductive endocrinologic alterations in female asymptomatic obesity. 268 Jun 25

This study examined psychological functioning and satisfaction with weight and figure in a total of 393 obese and nonobese adolescent girls from lower-middle to middle-class families. No significant differences were observed between the two groups on measures of trait anxiety or depression, and all subjects scored well within normal limits. Obese girls did, however, report significantly greater dissatisfaction with their weight and figure than did nonobese girls. Many nonobese girls also expressed dissatisfaction with their weight, supporting the view that women's dissatisfaction with weight is a 'normative discontent'. Nearly 70 percent of the total sample had attempted to lose weight in the past year. The results of this study indicate that obese girls in the general population are dissatisfied with their weight but are not significantly anxious or depressed, as had been suggested by studies of overweight adolescents in clinical settings.
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PMID:Dissatisfaction with weight and figure in obese girls: discontent but not depression. 270 97

We report 12 children with severe obesity in very early childhood who had no evidence of organic causes for their obesity and whose families evidenced psychosocial dysfunction comparable to that often seen in growth failure of psychosocial origin. Features seen include family disorganization, separation of mother and child, displacement of child care to others, maternal depression, denial of the growth abnormality, hostility towards health care providers, and inconsistent medical follow-up. In all cases, parental limit setting was impaired. We suggest that this condition should be called "severe obesity of psychosocial origin." Very severe obesity of early childhood may be conceptualized as the mirror image of growth failure. Like growth failure, it requires evaluation and management focused on psychosocial issues. Research is needed to clarify the prevalence, diagnostic features, and optimal treatment of obesity of psychosocial origin.
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PMID:Mirror image of environmental deprivation: severe childhood obesity of psychosocial origin. 274 83

The prevalence of diabetes is greatest among older persons, yet few studies have specifically addressed the impact of age on diabetic complications. The present study examines the prevalence of four diabetic complications: retinopathy, peripheral neuropathy, autonomic neuropathy, and hypertension, as well as depression, in older male patients with noninsulin-dependent diabetes. Participants ranged in age from 53 to 80 years. Multiple risk factors, including age, duration of illness, type of treatment, metabolic control, and obesity were evaluated as predictors of these complications using logistic regression. Results suggest a significant increase in the prevalence of retinopathy with aging, independent of the effects of metabolic control, duration of illness, and other risk variables. Age was also related to prevalence of peripheral neuropathy symptoms, hypertension, and impotence. Current metabolic control was significantly associated with retinopathy, peripheral neuropathy, and hypertension prevalence. Time since diagnosis was only independently related to impotence and hypertension. These findings suggest that the increase in many diabetic complications in older persons cannot be wholly accounted for by simple disease status variables, and may result from an interaction of diabetes variables and general age-related changes.
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PMID:Effects of age on complications in adult onset diabetes. 278 81


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