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

A case of advanced cervical carcinoma of the uterus with ectopic adrenocorticotrophic hormone (ACTH) syndrome is described. The patient was seen for general malaise 21 months after surgical treatment of the primary lesion whose histology was undifferentiated small cell carcinoma of the uterine cervix. She had extensive metastases in the liver and the abdominal wall. In addition to the typical clinical manifestations of Cushing's syndrome such as moon face, central obesity and acne vulgaris, hyperglycemia was so severe that she was in a hyperosmolar non-ketotic coma. Endocrinological examinations revealed elevated plasma ACTH and cortisol, and urinary excretion of 17-hydroxycorticosteroids and 17-ketosteroids, which were not suppressed by high-dose dexamethasone administration. Based on these clinical and laboratory findings, a diagnosis of ectopic ACTH syndrome was made. Among the results of other endocrinological examinations conducted to find the etiological cause of the hyperglycemic coma, which seemed to be unusual for ectopic ACTH syndrome, the plasma somatostatin level was abnormally high. Metastatic tumors in the liver obtained at the time of autopsy contained large amounts of both ACTH and somatostatin, and gel filtration studies revealed that the peptides produced by the tumor had the molecular sizes of the biologically active forms of the respective peptides. These observations suggest possible involvement of the somatostatin in deteriorating glucose intolerance to develop hyperglycemic hyperosmolar non-ketotic coma as a drastic disturbance of metabolism.
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PMID:A case of cervical carcinoma of the uterus presenting with hyperosmolar non-ketotic coma as a manifestation of ectopic adrenocorticotropic hormone syndrome. 164 12

A hospital-based case-control study was conducted over 4 years in Southern France to assess the pattern of established risk factors for breast cancer and to examine its variation according to age at diagnosis. Cases studied (450) were women admitted to the Montpellier Cancer Institute, with histologically confirmed primary breast carcinoma. Controls (576) were patients from a nearby hospital admitted in the early stages of a neurological or mild psychological diseases and from a clinic for general surgery. Any patient with malignant tumours, chronic and cardiovascular diseases were excluded. The total population globally showed the commonly reported pattern for these risk factors. When stratified by age, the reproductive factors occurring early in life (menarche, first full term pregnancy) were shown to be significant risk factors only in the youngest group of patients and do not seem to influence risk in older women, for whom risk factors are those occurring later in life (menopause, obesity). This suggests a complex involvement of the reproductive and sociodemographic features with the various stages of the 'natural history' of breast cancer.
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PMID:The pattern of risk factors for breast cancer in a southern France population. Interest for a stratified analysis by age at diagnosis. 193 17

252 evaluable patients were treated in the Centre Claudius Regaud from January 1974 to December 1983 for stage Ib, IIa or proximal IIb carcinoma of the uterine cervix. This retrospective analysis compares results obtained either by radio-surgical combination therapy (113 patients = RS group) or by exclusive irradiation (139 patients = RT group). The comparison of the two groups in terms of patient age, obesity, associated vascular pathology and previous abdomino-pelvic surgery favored the RS group significantly. The distribution according to clinical stage also significantly favored the RS group. The proportion of patients with stage IIb disease was 12% in the RS group as opposed to 25% for the RT group. Despite unfavorable patient and tumor characteristics, therapeutic results in the RT group were similar to those of the RS group. Pelvic recurrences developed in 18/110 (16%) and 18/139 (13%) of the patients in the RS and RT groups, respectively. Distant metastases occurred in 5/92 (5%) patients in the RS group and 13/121 (11%) patients in the RT group, but the difference was not significant (p less than 0.1). Five year corrected actuarial disease-free survival was 82% in both groups. There were no major early complications in the RT group while four were found in the RS group, of which three were fatal. 2% of patients had major late complications in the RS group versus 6% in the RT group and none were lethal. 25% of the RT group patients had a moderate or mild complication versus 10% in the RS group but 2/3 of these complications recovered without sequellae.
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PMID:Non-randomized comparative study of irradiation alone or in combination with surgery in stage Ib, IIa and "proximal" IIb carcinoma of the cervix. 195

From July 1985 to January 1989, 133 patients underwent endometrial sampling for evaluation of post menopausal bleeding (PMB). Of these patients, 114 (85.7 percent) showed benign histology with an average age of 58.6 years. Nineteen (14.3 percent) were malignant, all of which showed endometrial carcinoma. The average age was 65. In addition, 26.3 percent of patients with carcinoma had higher grade of tumor at hysterectomy when compared with the preoperative biopsy. The average volume of tissue removed at curettage was significantly greater in those with carcinoma. Hormonal therapy, duration of symptoms, hypertension, obesity or diabetes were not significant risk factors for carcinoma in our series. PMB remains a major symptom that may predict endometrial carcinoma and must be evaluated. In those patients with carcinoma, intraoperative evaluation of the uterus for tumor grade and depth of invasion is important in determining the extent of surgery.
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PMID:Post menopausal bleeding as a risk factor for endometrial carcinoma. 199 92

This report has the purpose to analyze the risk factors for Breast Cancer in the population of female Mexican workers and their relatives living in the same socio-cultural environment. These risk factors were: age, number of pregnancies, age while first pregnant, early menarca, late menopause, no lactance, use of contraceptive pills, hereditary, mammary pathology, obesity, diabetes mellitus. The questions were asked to women older than 30 years of age to which a breast biopsy had been practiced; in 123 patients the biopsy reported a breast carcinoma in 291 patients the hystological reports showed a benign pathology other than cancer. The statistics were comparative among both groups with a p less than 0.001 each factor was analyzed for chi square. The average was of 44 years of age to which a breast biopsy had been practiced; groups with breast cancer 80% were pregnant before the age of 26 one with two or more births. The risk factors as the obesity, no lactancy, anticonceptives widely discussed and contradictors in the literature; in this group of patient with breast cancer resulted with statistic significance. The results suggest a population with breast cancer with own characteristics.
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PMID:[Risk factors in breast cancer. Prospective analysis of 414 patients]. 206 3

Every day, American women are told that one in ten will develop breast cancer, and some groups perceive their risk to be so high as to justify immediate bilateral mastectomy. Many associations with breast cancer have been identified, including a history of benign breast diseases, in situ carcinoma, a family history of breast cancer, prolonged menstruation as a result of early menarche or delayed menopause, few or late pregnancies, excessive alcohol intake, obesity, and possibly the use of estrogens as oral contraceptives or postmenopausal replacement therapy. In spite of these associations, our understanding of either the cause(s) of breast cancer or the sequence of events leading to a diagnosis of breast cancer is still inadequate to make global public health recommendations regarding life style--or even to initiate well-designed studies. The epidemiologic evidence strongly suggests, however, that events relatively early in a woman's life are more important than later events, even though most of the risk of developing breast cancer will be expressed after the age of 75. Possibly one of the greatest contributions we can make to our patients' welfare is to share the knowledge that the risk of dying of breast cancer is considerably smaller than the risk of developing breast cancer; that the risk of early death from breast cancer rarely exceeds 10% in even the highest risk groups; and that the life styles most likely to reduce the risk of cardiovascular disease and other scourges of womankind are also those most likely to reduce the risk of developing breast cancer.
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PMID:What can a woman do about her risk of dying of breast cancer? 216 16

The connection of body fat distribution (BFD) and the risk of developing mammary, cervical, endometrial or ovarian carcinoma was ascertained for 163 patients with carcinoma (mean age 49.9 [19-78] years) and 489 controls of comparable age and body-mass index. BFD was expressed as the ratio of waist and hip circumference (T/H ratio of 0.822 vs 0.781 and 0.826 vs 0.789, respectively; P less than 0.01). In premenopausal women with mammary or cervical carcinoma and in all postmenopausal women BFD was similar to that in the control subjects. A common cause of android obesity and ovarian or endometrial carcinoma may be a reduction of sex-hormone-binding globulins with an elevated serum level of free androgens and oestrogens.
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PMID:[Obesity, body fat distribution and the incidence of breast, cervical, endometrial and ovarian carcinomas]. 225 79

Grade 2 or 3 injuries of the sigmoid colon were observed in 4 out of 42 patients with carcinoma of the uterine cervix who were treated by radiation therapy. The irradiation was planned as the combination of the external irradiation (whole pelvic 30 Gy and 20 Gy with central shielding by 25 fractions, 5 weeks) and the intracavitary irradiation (RALS, 19 Gy at point A by 3 fractions). To analyze the causes of the radiation sigmoiditis, we have investigated the following factors: age, dose at point A, dose at point C, grade of tandem dislocation, uterine angle, obesity score, evidence of previous surgery to the pelvic cavity and hypertension. The dose at point C and the grade of tandem dislocation were determined from the confirming X-Ps at RALS therapy and external irradiation. The superimposition of these films was performed with corrections for the angle between the projection direction of the X-Ps and the vertical magnification factor of the central shielding area. Point C was defined as a point 2 cm anterior to the intersection of the tandem axis and a curvilinear line 1 cm outside from the margin of central shield on the X-Ps. Grades of tandem disclocation were decided as the number of tandem tips which were outside of the central shielding area on X-Ps. As the results, the doses at point C showed very high statistical significance (p less than 0.001) with the evidence of radiation sigmoiditis. All the cases with radiation sigmoiditis were received over 1290cGy at point C. Age had also some significance (p less than 0.05) with radiation sigmoiditis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Injuries of the sigmoid colon following radiation therapy of carcinoma of the uterine cervix--a method of estimating the radiation dose to the sigmoid colon]. 234 97

The current trial was designed to assess whether the addition of prednisone or prednisone + tamoxifen would enhance the therapeutic effectiveness of 1 year of adjuvant CMF therapy. Premenopausal women with ipsilateral axillary node-positive breast carcinoma and known estrogen receptor (ER) status were randomized to receive 1 year of postoperative treatment with 12 28-day cycles of cyclophosphamide, methotrexate, 5-fluorouracil (CMF), CMF plus prednisone (CMFP), or CMFP plus tamoxifen (CMFPT). There were 553 analyzed cases with 188 receiving CMF, 183 CMFP, and 182 CMFPT. The overall time to relapse (TTR) and survival comparisons between the regimens are not statistically different at a median follow-up time of 7.7 years. The major subgroups currently with a suggestive TTR difference are greater than 3N+ (CMFPT greater than CMF, P = 0.07) and estrogen receptor-negative (ER-) greater than 3N+ (CMFPT greater than CMF, P = 0.03). Patients receiving CMFPT appeared to have a superior survival to CMF in the ER- greater than 3N+ cohort (P = 0.02). The following patient characteristics were associated with a significantly longer TTR: decreasing nodal involvement or tumor size, positive ER status, age greater than or equal to 40 years, and decreasing obesity. The favorable effects of decreasing nodal involvement, positive ER status, age 40 years or greater, and decreasing obesity carried over to survival. Development of amenorrhea was also significantly associated with improved survival (P = 0.001). Toxicity was increased by the addition of prednisone to CMF and by the addition of tamoxifen to CMFP. Overall relapse patterns were similar among the three regimens. The results of the current trial do not currently suggest an overall therapeutic benefit for adding prednisone or only 1 year of tamoxifen to CMF adjuvant treatment.
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PMID:Adjuvant chemohormonal therapy with cyclophosphamide, methotrexate, 5-fluorouracil, and prednisone (CMFP) or CMFP plus tamoxifen compared with CMF for premenopausal breast cancer patients. An Eastern Cooperative Oncology Group trial. 240 34

Obese mottled yellow Avy/a, lean pseudoagouti Avy/a and lean black a/a (YS X VY) F-1 hybrid female mice were fed diet containing 160 p.p.m. lindane (gamma-hexachlorocyclohexane) for 6, 12, 18 or 24 months. Clara cell hyperplasia was present in a majority of the mice after six months of lindane ingestion; however, more yellow mice (77%) than pseudoagouti (50%) or black (56%) mice had developed this lesion. Continued ingestion of lindane increased the incidence of Clara cell hyperplasia and resulted in similar prevalences in the three phenotypes. Lung tumors associated with lindane ingestion for 24 months were found only in yellow (19%) and pseudoagouti (14%) mice but not in the black mice. Prevalences of hepatocellular adenomas and carcinomas were very low (less than 10%) in untreated pseudoagouti and black mice. Lindane ingestion for 24 months resulted in an hepatocellular adenoma prevalence of 12% in pseudoagouti mice and 3% in black mice; comparable hepatocellular carcinoma prevalences were 5% and 1%. Among yellow mice fed lindane diet for 24 months, adenoma prevalence was 35% (9% among untreated controls) but carcinoma prevalence was only 17% (13% among controls). The tumorigenic responses evoked by lindane feeding in the lean pseudoagouti Avy/a mice but not in the black a/a mice indicate, for the first time, that the Avy gene itself, in the absence of obesity, sensitizes cells to transformation. The greater prevalence of hepatocellular adenomas in obese yellow Avy/a than in lean pseudoagouti Avy/a mice implicates obesity-associated factors in tumor promotion. Similarly, the increased prevalence of hepatocellular carcinomas in untreated obese yellow Avy/a mice, as compared to lean pseudoagouti mice, implicates obesity-associated factor as favoring histiotypic progression of liver tumors. Thus, the Avy gene not only sensitizes cells to respond to tumorigenic stimuli but also, by the induction of obesity, enhances promotion and progression of transformed cells.
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PMID:Tumorigenic responses to lindane in mice: potentiation by a dominant mutation. 244 99


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