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

Exophiala jeanselmei was isolated from three esophageal cultures over an 11-month period at Lutheran General Hospital. We believe this provides evidence for a new site of isolation, since previous reports of the organism's incidence were confined to skin and lung. Case 1 is an eight-year-old female with a three-year history of gagging and vomiting. Esophagoscopy revealed a mass biopsied as vegetable material. Case 2 is a 66-year-old retired male with a history of obesity, diabetes and spinal stenosis. Following back surgery, the patient developed odynophagia. Esophageal biopsies showed ulceration and bacterial colonies with no evidence of fungus. Case 3 is a 62-year-old male gardener who is also a nail biter. Esophagoscopy revealed a gastro-esophageal stricture with reflux and evidence of a hiatus hernia. Material biopsied was consistent with Barrett's esophagus and evidence of fungi was seen. The esophageal mass of case 1 and the esophageal brushings of case 2 and 3 grew E. jeanselmei. Aspiration, reflux, and mechanical disruption of the esophageal mucosa are possible predisposing factors in colonization of esophageal lesions by this ubiquitous, normally low virulence organism.
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PMID:Isolation of Exophiala jeanselmei associated with esophageal pathology--three cases, laboratory and clinical features. 649 12

Interpersonal dependency and locus of control orientation were studied in obese and nonobese samples. The Interpersonal Dependency Inventory (Hirschfeld, Klerman, Gough, Barrett, & Korchin, 1977) and the I-E Scale (Rotter, 1966) were administered to 106 obese adults in outpatient treatment for obesity. The I-E Scale was also administered to 97 nonobese control subjects. As predicted, the obese subjects were significantly more internally oriented than has been previously identified in obese populations. These findings challenge currently held assumptions about locus of control in obese groups. Although the obese and nonobese subjects maintained similar overall dependency scores, the obese subjects were more likely to show low levels of autonomy in comparison with the nonobese subjects. Interpersonal dependency and locus of control dimensions associated with obese conditions may serve as useful predictor variables influencing obesity treatment approaches and outcome.
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PMID:Interpersonal dependency correlates and locus of control orientation among obese adults in outpatient treatment for obesity. 781 80

The relation between obesity and new ABI is also unclear. The Framingham Study found that relative weight was not a risk factor for new ABI in older men but was a weak risk factor for new ABI in older women. Barrett-Connor and Khaw found no association between body mass index and new ABI in older men or women. The present study showed that obesity was not a risk factor for new ABI in older men. Obesity was a risk factor for new ABI in older women by univariate analysis but not by multivariate analysis. However, because obesity is associated with other risk factors for ABI and new coronary events, we would try to lower weight in obese older men and women.
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PMID:Risk factors for new atherothrombotic brain infarction in 664 older men and 1,488 older women. 867 88

The incidence of esophageal adenocarcinoma in the United States is rising at an epidemic rate. Although the cause for this rapid rise is unclear, it is well established that nearly all cases of esophageal adenocarcinoma arise from a premalignant lesion of the esophagus, known as Barrett's esophagus. Although Barrett's esophagus is recognized as a precursor lesion, the etiology, prevalence, and malignant risk of this lesion remain unclear. The relatively short, two-decade time frame for the rise in esophageal adenocarcinoma incidence and the increase across populations is a strong argument for environmental factors as etiological agents, perhaps interacting with genetically determined characteristics that define personal susceptibility. Because of the strong link between Barrett's esophagus and esophageal adenocarcinoma and the link between Barrett's esophagus and gastroesophageal reflux disease, risk factors for gastroesophageal reflux disease have been the prime suspects offered as possible explanations for the rise in esophageal adenocarcinoma. A plethora of hypotheses have been advanced, implicating tobacco and alcohol consumption, changes in obesity and diet, and the changing pattern in use of medications that affect the upper gastrointestinal tract. The following text will review what is currently known about the epidemiology of Barrett's metaplasia, its risk for malignant transformation, and the proposed theories of etiogenesis.
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PMID:Etiology of Barrett's metaplasia and esophageal adenocarcinoma. 952 45

Barrett's oesophagus is the eponym applied to the columnar epithelium-lined lower oesophagus which is acquired as a complication of chronic gastro-oesophageal reflux (GER). Various complications seen in the Barrett's oesophagus, such as peptic ulcer, stricture, adenocarcinoma are named as Barrett's ulcer, Barrett's stricture-and Barrett's carcinoma, respectively. It is now generally accepted that Barrett's oesophagus is an acquired condition resulting from chronic repetitive GER. The frequency of Barrett's oesophagus seems to be higher in Caucasian than in Oriental or Negro populations. There is a tendency towards increasing prevalence rates all over the world, including Taiwan, due to the Westernization of diet, rapid growth in the elderly population, obesity etc. Almost 6% of the patients who manifest heartburn in GI clinics in Taiwan now suffer from GER, which is almost similar to the 7% reported by Nabel, (USA) in 1976. During the last 30 years, the incidence of esophageal adenocarcinoma has increased rapidly. Patients with Barrett's oesophagus have an increased risk of developing oesophageal adenocarcinoma and should be kept under surveillance. Regular follow-up, at least twice a year or preferably, every 2-3 months, for those patients with SCE using endoscopic surveillance and biopsy for those with severe dysphasia (oesophageal columnar intraepithelial neoplasia) in the surrounding area to detect Barrett's oesophagus cancer, is very important.
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PMID:Review: Barrett's oesophagus in Taiwan. 919 7

The incidence of adenocarcinoma of the esophagus and esophagogastric junction (EGJ) has been increasing over the past 15 years in western countries. Surgical series and population-based studies show that, by 1994, adenocarcinomas of the esophagus accounted for half of all esophageal cancer among white men. The causes of this increase in incidence remain to be elucidated. Esophageal adenocarcinomas and a portion of EGJ adenocarcinomas arise from long and short segments of specialized intestinal metaplasia (Barrett's esophagus). The prevalence of long segments of Barrett's esophagus (> 3 cm) in patients having endoscopy for reflux symptoms is 3%, and 1% in those undergoing endoscopy for any clinical indication. However, a silent majority of patients with Barrett's esophagus remain unrecognized in the general population and may not be diagnosed unless adenocarcinoma develops. Recent studies document a rise in the diagnosis of specialized intestinal metaplasia of the cardia. Nearly all these patients have associated carditis, and Helicobacter pylori infection has been linked to this condition. The possible origin of EGJ adenocarcinomas in the sequence carditis--specialized intestinal metaplasia needs to be clarified. Smoking and obesity are additional risk factors for adenocarcinoma of the esophagus and EGJ. Current data does not confirm H. pylori as a risk factor for cancer of the EGJ.
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PMID:Epidemiology of esophageal cancer, especially adenocarcinoma of the esophagus and esophagogastric junction. 1069 34

Barrett's metaplasia develops in 6% to 14% of individuals with gastroesophageal reflux. Barrett's adenocarcinomas are increasing in epidemic proportions for, as yet unknown, reasons; approximately 0.5% to 1% of patients with Barrett's metaplasia develop adenocarcinoma. Heartburn duration and frequency (but not severity), male gender, and white race are major risk factors for developing cancer. Obesity and smoking are weak risk factors. Survival is determined by depth of tumor invasion (stage). Once invasion of the muscularis propria occurs, most patients have developed widespread metastasis, even when clinical staging studies are negative. No currently available therapy results in prolonged survival once metastases develop. Thus, the more widespread use of effective surveillance strategies is the only currently available means for reducing the morbidity and mortality associated with Barrett's adenocarcinoma.
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PMID:Barrett's esophagus. Reducing the risk of progression to adenocarcinoma. 1069 10

OBJECTIVE: The purpose of this study is to report and characterize six patients who have developed Barrett's esophagus after; a gastric restrictive procedure for massive obesity. METHOD: Retrospective analysis of patients operated with gastric banding (GB) and vertical banded gastroplasty (VBG) between 1981 and 1994. RESULTS: Four patients (4/92) initially operated with GB have developed Barrett's esophagus a mean of 9 years post-operatively. Two patients (2/198) operated with VBG developed Barrett's esophagus 18 and 47 months postoperatively. The histopathological type of Barrett's esophagus was cardia-like in three cases, gastric-like in two cases and intestinal-like columnar epithelium in one case. None of the biopsies showed signs of dysplasia. CONCLUSION: Gastric banding is again gaining popularity with the development of adjustable bands that can be placed laparoscopically. The development of Barrett's esophagus after GB and VBG, a premalignant lesion, is cause for some concern. Prospective long-term studies are needed to further address this complication.
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PMID:Six Cases of Barrett's Esophagus after Gastric Restrictive Surgery for Massive Obesity: An Extended Case Report. 1072 57

This is a review of some of the most important growing points in the specialties of gastroenterology and hepatology. It does not aim to be completely comprehensive but to pick out major areas of importance to examination candidates and doctors without special experience in the field. Topics covered include: upper gastrointestinal haemorrhage; Barrett's oesophagus; carcinoma of the oesophagus; achalasia; Helicobacter pylori; duodenal ulcer prevention; coeliac disease; dermatitis herpetiformis; Crohn's disease; small bowel overgrowth; ulcerative colitis; carcinoma of the large bowel; obesity; endoscope sterilisation; gall stones; liver transplantation; autoimmune liver disease; viral hepatitis; metabolic liver diseases; and pancreatic insufficiency.
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PMID:Advances in gastroenterology and hepatology. 1082 44

Over the last years the incidence of esophageal cancer in Germany has been rising. One of the reasons of this rise is the increase of adenocarcinoma (AC) of the esophagus, a nearly unknown diagnosis 30 years ago. The incidence of squamous cell carcinoma (SCC) is rising, too. The main risk factors for the development of SCC as well as for AC are heavy smoking and alcohol. Barrett's esophagus is predominantly developing in men after a longer lasting gastroesophageal reflux. In consequence, AC of the esophagus will be observed mostly in men. Patients with AC differ from patients with SCC by a smaller number of concomitant diseases, which are often caused by obesity of patients with AC. The preoperative risk factors of patients with SCC are caused by tobacco and alcohol. Only patients with early cancer (pT1) of the esophagus have a good prognosis with a 5-year survival rate of 83% for AC and 63% for SCC.
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PMID:[Carcinoma of the esophagus--actual epidemiology in Germany]. 1144 1


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