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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Physical conditioning induces many favourable changes in the body, including an increase of maximum oxygen transport, a decrease of body fat, a strengthening of muscles, tendons and bones, an improvement of blood lipid profile, and a better balance between oxygen demand and supply in the myocardium. The preventive value of such changes is often seen in measures of perceived health or their practical consequences. Industrial fitness programmes apparently reduce the use of medical services (physician visits and hospital days), with gains of productivity, a lessening of absenteeism, and a lower employee turnover. Techniques such as the Canadian Health Hazard Appraisal questionnaire suggest a general reduction in 'risk-taking' behaviour among exercise-class participants, with a substantial reduction in their 'appraised' age. There is little evidence that regular moderate exercise can alter the response to acute disease, but both theoretical considerations and epidemiological data suggest the value of physical activity in preventing manifestations of ischaemic heart disease, obesity and maturity onset diabetes, cholecystitis, hypertension, certain neuroses, and age-related pathologies. A fit individual is also at a lesser risk of industrial injury, and is capable of living independently for a longer fraction of his or her old age. It is concluded that physical activity is one of the more useful tactics of preventive medicine; the current challenge to both research workers and policy makers is to carry this message beyond the white-collar executive to such target groups as blue-collar workers, ethnic minorities, housewives, the elderly and the handicapped.
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PMID:The value of physical fitness in preventive medicine. 384 82

Natural BD is a nonpurulent acute/subacute encephalitis of horses and sheep with a propensity to involve the olfactory and limbic systems, and the brain stem. The inflammation is concentrated primarily in the gray matter, but subcortical white matter may also be affected. Experimental BD can be produced in a series of animals from birds to primates. The neuropathology after experimental infection is similar to that in natural disease but the inflammatory changes are more diffuse. In the rat and mouse, a persistent/tolerant infection can also be induced, in which inflammatory changes are conspicuously absent. In the course of persistent infection of the rat, an elective, focal degeneration ensues that involves the dentate gyrus, retina, and, less frequently, the magnocellular part of the hippocampus. The cytopathic destruction of the dentate gyrus is the likely anatomical substrate of learning deficiencies and behavioral changes, prominent features of chronic infection. Later in infection, more diffuse and random degeneration of neurons can be found. In all species infected, viral antigens are produced in excess and fill all neuronal processes. Beside neurons, glial cells are infected as well. The agent spreads in the nervous system axonally and transsynaptically (transneuronally). The type of neurotransmitter receptors in the synapse and their interaction with viral proteins may modulate the spread of infection (Gosztonyi et al. 1994). Virus particles have not been visualized in the brain in any phase of the disease. During persistent infection of the rat, production of viral proteins has a phasic character. Some rats survive acute infection and develop an obesity syndrome. The anatomical basis of this syndrome is not fully clarified; inflammatory destruction of the infundibular region, vacuolar degeneration of the paraventricular nucleus of the hypothalamus and severe, progressive involution of the hippocampal formation most probably play an important role in the production of this neuroendocrine syndrome. In the acute disease, inflammatory reaction can severely aggravate virus-induced cytopathology, but cannot be the sole cause of the neurological disease, since infection with high passage virus can lead to a similarly severe disease in the absence of inflammatory changes.
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PMID:Borna disease--neuropathology and pathogenesis. 778 50

Ninety-nine patients with acute pancreatitis in whom body mass index (BMI = weight (kg)/height2 (m2)) was measured were studied prospectively to determine the importance of obesity as a prognostic factor in this disease. Of 19 obese patients (BMI > or = 30 kg/m2), 12 developed severe pancreatitis; seven had abscesses, of whom five died, and two further patients died. In 80 non-obese patients, the incidence of severe pancreatitis (n = 5), abscess formation (n = 4) and death (n = 4) was significantly less (P = 0.0007). The mean(s.d.) BMI of 17 patients with severe acute pancreatitis was significantly higher than that in 82 patients with mild acute disease (31.2(5.6) versus 23.3(5.6) kg/m2, P < 0.001). As a single prognostic factor, obesity had a sensitivity of 63 per cent and a specificity of 95 per cent for predicting disease severity. When five obese women with gallstone pancreatitis were excluded, the sensitivity of obesity increased to 86 per cent. Severe pancreatitis occurred in all eight obese patients with disease of an alcoholic aetiology. These data suggest that increased fat deposits in the peripancreatic and retroperitoneal spaces in obese patients may increase the risk of peripancreatic fat necrosis, abscess and death. Consideration should be given to including obesity as a prognostic factor in acute pancreatitis.
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PMID:Obesity: an important prognostic factor in acute pancreatitis. 849 17

Prophylaxis of deep vein thrombosis with standard heparin and low molecular weight heparin has been studied in many clinical trials in surgical patients and in few and various medical conditions in hospitalized subjects. Clinical trials have been conducted in patients with recent myocardial infarction, heart failure, stroke, pulmonary sepsis, cancer, or any acute disease with a high risk factors for deep vein thrombosis (previous thromboembolism, thrombophilia, obesity, recent bedridden, dehydratation.). The combination of a high risk disease with a high risk factor related to the history of the patient might reasonably conduct to a prophylaxis with low molecular weight heparins. The duration of this treatment has to be short and limited to the period of the acute medical condition inducing a high risk for deep vein thrombosis. Prophylaxis has to be offered to patients with ischemic stroke, cardiac failure, recent myocardial infarction, active cancer or any other acute medical disease in patients with a previous thromboembolism or thrombophilia history. Bedridden status and age are not, by themselves, an indication for prophylaxis with heparins. A widespread diffusion of these recommendations is needed to reduce overprescriptions.
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PMID:[Prevention of deep venous thrombosis in medical patients]. 1089 73

Because of population aging in our geographical and social setting and progress in preventing premature death, there is an ever-increasing prevalence of chronic diseases, in this case diabetes. In our environment, the dietary changes and sedentariness that have led to the spectacular rise in obesity have increased the prevalence of diabetes. Our health system is reasonably well prepared to manage acute disease but neither health professionals nor referral circuits -nor probably patients- are prepared for the new scenario. Consequently, we should prepare ourselves for the management of chronic disease, encourage patient participation in decision-making and promote a new, less paternalistic, paradigm of the doctor-patient relationship. The experiences initiated by the University of Stanford, or in Spain by the National Patients' Forum, could serve as models. In the next few years, the figure of the expert patient will undoubtedly be highly useful. In general, physicians and patients place a great deal of faith in the contribution of new treatments and technologies to the relief or management of disease. To deny this in the XXI century would be ridiculous, but all the possibilities of these treatments and technologies only show positive results in suitably educated patients. This is a task that should never be forgotten.
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PMID:[Importance of patient involvement in disease self-management: the expert patient. Role of new technologies to support patient autonomy]. 2107 75

Identifying hyponutrition is essential at the hospital setting to avoid or minimize the impact on the patients' clinical course and its association with more severe complications, longer hospital staying, and increased mortality, and all of this is associated with increased costs for the institution and the society. The aims of this study were to disbelieve the epidemiology of hospital hyponutrition, the types of hyponutrition, the body response to fasting, the clinical course of the patient with hyponutrition and the consequences of hyponutrition in the different live stages and, thus, we carried out a review on hospital hyponutrition. We found that hyponutrition prevalence is high in the hospital setting, hyponutrition influences genetic, metabolic, and hormonal factors of the human being and leads to harmful effects from the intrauterine fetal development until the adulthood. There are also different types of hyponutrition, the differentiation being important to decide the best therapy. We also found that hyponutrition is related to inflammation. When inflammation is chronic and mild to moderate (such as in organ failure, pancreatic cancer, obesity, rheumatoid or sarcopenic arthritis), the term "hyponutrition-related chronic disease", and when inflammation is acute and severe (severe infection, burns, trauma or head trauma), the preferred term is "hyponutrition-related acute disease or hyponutrition-related lesions". Finally, the patient with hyponutrition has worse clinical course than the patient with an appropriate nutritional status.
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PMID:[Hospital hyponutrition]. 2166 60

This article looks at the existing evidence-base by which veterinary surgeons can make welfare-focused treatment choices. Narrative and structured reviews were conducted. Papers were categorised under headings based on (1) themes in the UK Animal Welfare Act (AWA 2006) - behaviour, environment, nutrition, company and health; (2) iatrogenic harm induced by treatment; (3) decision-making methods, and (4) the subjects' context (e.g. home versus laboratory). There is more information available about 'overt' problems (e.g. acute disease), than 'covert' issues (e.g. chronic pain, lack of company and obesity). Forty of 109 papers covered pain, suffering, injury and disease, compared to 69 across four other themes in the AWA. Twelve papers were identified as focusing on welfare assessment and clinical decision-making. Veterinary surgeons should consider each of the five welfare themes described in the AWA in both veterinary practice and in determining veterinary research priorities.
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PMID:Maximising canine welfare in veterinary practice and research: a review. 2244 66

The role of obesity in relation to various disease processes is being increasingly studied, with reports over the last several years increasingly mentioning its association with worse outcomes in acute disease. Obesity has also gained recognition as a risk factor for severe acute pancreatitis (SAP).The mortality in SAP may be as high as 30% and is usually attributable to multi system organ failure (MSOF) earlier in the disease, and complications of necrotizing pancreatitis later [9-11]. To date there is no specific treatment for acute pancreatitis (AP) and the management is largely expectant and supportive. Obesity in general has also been associated with poor outcomes in sepsis and other pathological states including trauma and burns. With the role of unsaturated fatty acids (UFA) as propagators in SAP having recently come to light and with the recognition of acute lipotoxicity, there is now an opportunity to explore different strategies to reduce the mortality and morbidity in SAP and potentially other disease states associated with such a pathophysiology. In this review we will discuss the role of fat and implications of the consequent acute lipotoxicity on the outcomes of acute pancreatitis in lean and obese states and during acute on chronic pancreatitis.
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PMID:Role of pancreatic fat in the outcomes of pancreatitis. 2527 11

The prevalence of overweight and obesity has reached epidemic proportions worldwide due to increasingly pervasive obesogenic lifestyle changes. Obesity poses unprecedented individual, social and multi-disciplinary medical challenges by increasing the risk for metabolic diseases, chronic organ failures and cancer, as well as complication rates in the presence of acute disease conditions. Whereas reducing excess adiposity remains the fundamental pathogenetic treatment for obese individuals, complex metabolic and lifestyle abnormalities as well as weight-reduction therapies per se may also compromise the ability to preserve muscle function and mass, especially when chronic disease co-exists with obesity. Emerging evidence indicates that low muscle mass and quality have a strong negative prognostic impact in obese individuals and may lead to frailty, disability and increased morbidity and mortality. Awareness of the importance of skeletal muscle maintenance in obesity is however low among clinicians and scientists. The term "sarcopenic obesity" has been proposed to identify obesity with low skeletal muscle function and mass, but its utilization is largely limited to the aging patient population, and consensus on its definition and diagnostic criteria remains insufficient. Knowledge on prevalence of sarcopenic obesity in various clinical conditions and patient subgroups, on its clinical impacts in patient risk stratification and on effective prevention and treatment strategies remain therefore dramatically inadequate. In particular, optimal dietary options and medical nutritional support strategies to preserve muscle mass in obese individuals remain largely undefined. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recognize and indicate obesity with altered body composition due to low skeletal muscle function and mass (sarcopenic obesity) as a scientific and clinical priority for researchers and clinicians. ESPEN and EASO therefore call for coordinated action aimed at reaching consensus on its definition, diagnostic criteria and optimal treatment with particular regard to nutritional therapy. We are convinced that achievement of these goals has strong potential to reduce the burden of morbidity and mortality in the rapidly increasing obese patient population.
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PMID:Sarcopenic obesity: Time to meet the challenge. 2985 21

The prevalence of overweight and obesity has reached epidemic proportions worldwide due to increasingly pervasive obesogenic lifestyle changes. Obesity poses unprecedented individual, social, and multidisciplinary medical challenges by increasing the risk for metabolic diseases, chronic organ failures, and cancer as well as complication rates in the presence of acute disease conditions. Whereas reducing excess adiposity remains the fundamental pathogenic treatment for obese individuals, complex metabolic and lifestyle abnormalities as well as weight reduction therapies per se may also compromise the ability to preserve muscle function and mass, especially when chronic disease co-exists with obesity. Emerging evidence indicates that low muscle mass and quality have a strong negative prognostic impact in obese individuals and may lead to frailty, disability, and increased morbidity and mortality. Awareness of the importance of skeletal muscle maintenance in obesity is however low among clinicians and scientists. The term 'sarcopenic obesity' has been proposed to identify obesity with low skeletal muscle function and mass, but its utilization is largely limited to the aging patient population, and consensus on its definition and diagnostic criteria remains insufficient. Knowledge on prevalence of sarcopenic obesity in various clinical conditions and patient subgroups, on its clinical impacts in patient risk stratification, and on effective prevention and treatment strategies remain therefore dramatically inadequate. In particular, optimal dietary options and medical nutritional support strategies to preserve muscle mass in obese individuals remain largely undefined. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recognize and indicate obesity with altered body composition due to low skeletal muscle function and mass (sarcopenic obesity) as a scientific and clinical priority for researchers and clinicians. ESPEN and EASO therefore call for coordinated action aimed at reaching consensus on its definition, diagnostic criteria, and optimal treatment with particular regard to nutritional therapy. We are convinced that achievement of these goals has a strong potential to reduce the burden of morbidity and mortality in the rapidly increasing obese patient population.
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PMID:Sarcopenic Obesity: Time to Meet the Challenge. 3001 92


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