Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The hypothesis that their psychological adjustment is related in part to resources present in their families was investigated in 153 children, age 4-16, who had one of five chronic physical disorders: juvenile diabetes, juvenile rheumatoid arthritis, chronic obesity, spina bifida, or cerebral palsy. Their mothers completed standardized psychometric instruments to measure specific dimensions of family psychological and utilitarian resources and of child adjustment. Variation in children's psychological adjustment was related both to their psychological and utilitarian family resources. Psychological family resources contributed uniquely to the prediction of adjustment beyond that provided by utilitarian family resources. These results are discussed as having implications for the identification of chronically ill and handicapped children at risk for adjustment difficulties.
 ...
PMID:Family resources as resistance factors for psychological maladjustment in chronically ill and handicapped children. 252 67

The relationship between social support and adjustment was investigated in children with a chronic physical illness or handicap. Mothers of 153 children with juvenile diabetes, juvenile rheumatoid arthritis, chronic obesity, spina bifida, or cerebral palsy reported on these children's family support, peer support, externalizing behavior problems, and internalizing behavior problems. Children reported as having high social support from both family and peers showed a significantly better adjustment than those with high social support from only one of these sources. Chronically ill or physically handicapped children without high support from both family and peers were reported to have significantly more behavior problems than children in general. Both family and peer support contributed negatively and independently to the variance in externalizing behavior problems, whereas only peer support did so for internalizing behavior problems. There were no interactions between type of support and either sex or age in predicting adjustment.
 ...
PMID:Social support and adjustment in chronically ill and handicapped children. 252 86

While deficient exercise performance of sick children results from hypoactivity and detraining, it can also be caused by specific pathophysiological factors. These can affect one or more components of physical fitness. A low maximal aerobic power will result from a low maximal stroke volume, as in aortic stenosis or cardiomyopathy; a low maximal heart rate, as in congenital complete heart block or intake of beta-blockers; a low O2 content of the arterial blood, as in anemia or advanced cystic fibrosis; and a high O2 content of mixed-venous blood, as in muscle atrophy or severe malnutrition. A high O2 cost of locomotion, as in advanced obesity or cerebral palsy, will cause the patient to exert at a high percentage of his maximal aerobic power and thus fatigue easily. A subnormal muscle strength, as in progressive muscular dystrophy or juvenile rheumatoid arthritis, is sometimes the primary factor that limits the walking ability or other daily functions. Recent data suggest that local muscle endurance, as assessed by the Wingate anaerobic test, is particularly deficient in some neuromuscular diseases. Examples are muscular dystrophies and spastic cerebral palsy. The ratio of peak anaerobic power to peak aerobic power seems lower in such patients than in able-bodied controls.
 ...
PMID:Pathophysiological factors which limit the exercise capacity of the sick child. 372 7

The authors report on a young girl with generalized developmental deficits originally thought to be caused by an unusual reaction to DPT vaccination. At the age of 4(1/2) years, chromosome analysis showed that the terminus of the short arm of chromosome 9 had extra material believed to originate from 7p terminus, thus she was considered to be trisomic for a segment of 7p and monosomic for a small portion of 9p [46,XX,der (9), t(7;9)(p15;p24)]. Ten years later, molecular cytogenetic testing using fluorescence in situ hybridization (FISH) confirmed that the extra chromosomal material represented partial trisomy 7p. The proposita had a high and large forehead, hypertelorism, and broad nasal bridge, findings seen in most individuals with trisomy 7p. Long-term follow-up showed the presence of hypothyroidism, obesity, and cerebral palsy. A review of all published cases of trisomy 7p with focus on associated complications suggests a well-defined pattern of abnormalities characterized by musculoskeletal, cardiovascular, neurological, genital, and ocular abnormalities in decreasing frequency. At least one-third of affected individuals died in infancy and close to half had severe mental retardation. FISH was essential in the confirmation of the cytogenetic abnormality and further delineation of the chromosomal disorder.
 ...
PMID:Trisomy 7p resulting from 7p15;9p24 translocation: report of a new case and review of associated medical complications. 1076 85

Clinical assessment of femoral anteversion (FA) in children with cerebral palsy (CP) is frequently determined by the trochanteric prominence angle test (TPAT). Limited three-dimensional volumetric imaging by axial tomography of the femur was performed before surgery for 35 hips in 20 children with CP. The TPAT was performed before the imaging study for 31 hips in 18 children. The TPAT angle was within 10 degrees of the FA as determined from the computed tomography scans (Murphy technique) for 17 femurs (55%). The most prominent portion of the greater trochanter was located anterior to the femoral neck axis (mean 27 degrees, range 0 degrees-52 degrees) on the three-dimensional images in 34 of 35 hips. A simulated TPAT, measured from the imaging studies, consistently underestimated the FA as determined by the Murphy technique (mean 10 degrees, range 0 degrees-18 degrees). Accurate clinical assessment of FA by the TPAT in children with CP presumes that the prominence of the greater trochanter lies perpendicular to the axis of the femoral neck. Three-dimensional imaging showed the prominence to be anterior, to a variable degree, to the femoral neck axis, which in addition to clinical factors such as obesity compromises the accuracy of this clinical maneuver.
 ...
PMID:Assessment of femoral anteversion in children with cerebral palsy: accuracy of the trochanteric prominence angle test. 1185 24

Our understanding of cerebral palsy (CP) in term infants is hindered by its low incidence and sporadic presentation. Many of these CP cases enter litigation, and a focused review of medicolegal consultations provides an opportunity to better understand the pathogenesis of these cases. In this study complete clinical and pathologic data from 158 cases of CP complicating singleton pregnancies after 36 weeks of gestation were prospectively collected over a 10-year period extending from 1998 to 2008. A hierarchical system was used to separate cases into the following 5 groups: (1) clinical/sentinel events (20%), (2) severe large fetoplacental vascular lesions (34%), (3) placental lesions indicative of chronic placental dysfunction (23%), and (4) placental lesions indicative of subacute/chronic adaptation to hypoxia (15%). The remaining 8% (group 5) of cases were idiopathic. Common to all subgroups was clinical and/or pathologic evidence of umbilical cord obstruction, which was observed in 63% of cases. The following clinical features significantly differed among subgroups. Group 1 had less maternal obesity and more cases involving multicystic encephalopathy. Group 2 had increased oligohydramnios, cerebral edema, nucleated red blood cell counts greater than 10 000/mm(3), hypoglycemia, pulmonary hypertension, and cardiac dysfunction. Group 3 had more preeclampsia and, together with group 2, more infants with a low ponderal index. Group 5 had a higher prevalence of positive family history of neurodevelopmental disorders. In conclusion, infant cases subject to litigation related to CP following term birth can be separated into distinct clinicopathologic subgroups with only a small number lacking either clinical/sentinel events or placental evidence of subacute or chronic in utero stress.
 ...
PMID:Cerebral palsy in term infants: a clinicopathologic analysis of 158 medicolegal case reviews. 1854 9

Childhood obesity is reaching epidemic proportions throughout the world; however, little is known on the nutritional status of children with disabilities. To address this issue, medical records of 748 children aged 18 years or younger receiving physical therapy during 2004-2005 at a privately sponsored free rehabilitation clinic in Punta Arenas, Patagonia, Chile were abstracted. Data included demographic, clinical, and anthropometric information recorded at the first visit. As a comparison, height and weight were also collected in 215 children attending local schools. Nutritional status was calculated as body mass index (above 6 years of age) or evaluated by growth curves (6 years of age or below) as undernourished, normal, overweight, obese, or morbidly obese. Logistic regression was used to determine risk factors for obesity in these children. Overall, a significant difference in nutritional status between disabled and non-disabled children was found (P<0.001). Children with disabilities had a higher prevalence of both below and above normal weight than non-disabled children. Risk factors for obesity included increasing age and living with a grandparent independent of other socioeconomic factors. Compared with normal children, risk of obesity was doubled for those with developmental delays [odds ratio (OR): 1.96; 95% confidence interval (CI): 1.16-3.34] and neurological disorders (OR: 2.58, 95% CI: 1.26-5.29), whereas individuals with cerebral palsy were less than half as likely to be obese than non-disabled children (OR: 0.46, 95% CI: 0.20-1.03). We conclude that overnutrition continues to be a problem for both disabled and non-disabled children in Patagonia. Programs to increase physical activity and improve nutrition are needed in this isolated part of the world.
 ...
PMID:Nutritional status and obesity in children and young adults with disabilities in Punta Arenas, Patagonia, Chile. 1900 79

Intrauterine or fetal growth restriction is best defined by using customised birth weight percentiles based upon the growth potential for an individual infant. Growth restriction in utero may be classified as asymmetric or symmetric depending upon the duration of the process. Asymmetric growth restriction is caused by placental insufficiency, maternal hypertensive conditions, long-standing maternal diabetes, smoking, living at altitude or multiple gestation. Symmetric growth restriction may be due to congenital infections, chromosomal or other abnormalities, fetal alcohol syndrome, low socioeconomic status or be constitutional. The underlying cause of growth restriction often predicts the potential adverse effects on the foetus and newborn and later effects in childhood and adulthood. With placental insufficiency, there may be chronic or acute on chronic fetal hypoxia with birth asphyxia and hypothermia, neonatal hypoglycaemia, polycythaemia and coagulopathy. Management is directed at prevention or early treatment of these conditions. In contrast, symmetrically growth-restricted infants should be examined carefully to look for congenital infections and malformations that may need specific interventions. Infants with constitutional short stature generally do not need any specific management. Feeding of growth-restricted infants is important to overcome deficiencies incurred in utero. Most infants show catch-up growth although about 10% do not. Those with excessive catch-up growth may be at greatest risk of developing insulin resistance in adulthood leading to diabetes, obesity and heart disease. The so-called fetal origins of disease may actually have a postnatal onset related more to excessive weight gain in infancy. There is still controversy over the indications for growth hormone treatment in growth-restricted infants who remain of short stature in early childhood. Intrauterine growth restriction is also associated with a five- to seven-fold increased risk of cerebral palsy probably due to chronic placental insufficiency.
 ...
PMID:Neonatal management and long-term sequelae. 1963 99

Sleeping disorders are frequently encountered in infants and adolescents. They often induce a distress in the family, an individual sadness possibly leaving at time to maltreatment. In the normal infant or the medically fragile infant due to prematurity or an acute episode, complaints from the patient or family sources force the medical team to find an explanation or a treatment, which are not always adequate. In other conditions such as asthma, obesity, anorexia nervosa, autism, cerebral palsy, hyperactivity, the sleeping disorders may be so unnoticed or remain insufficiently investigated. Globally, in this domain, the clinical description is often imprecise and sleep studies underused. A more accurate assessment should lead to a better educative approach and more appropriate therapy.
 ...
PMID:[Inertia or overtreatment in children. When sleeping time is disturbed in infants: how to improve the family's distress]. 2068 23

Deep brain stimulation (DBS) of the globus pallidus interna and subthalamic nucleus has restored some degree of motor control in many patients in advanced stages of Parkinson's disease. DBS has also been used to treat dystonia, essential tremor (progressive neurological condition causing trembling), chronic pain, obsessive-compulsive disorder, Tourette's syndrome, major depressive disorder, obesity, cerebral palsy, and the minimally conscious state. Although the underlying mechanisms of the technique are still not clear, DBS can modulate underactive or overactive neural circuits and restore disrupted communication between and among groups of neurons in interacting regions of the brain.This can control and relieve many symptoms associated with a range of neurological and psychiatric disorders. But the procedures of implanting and stimulating the electrodes are brain-invasive and entail significant risks. Some patients receiving DBS have experienced intracerebral hemorrhage, infection, cognitive disturbances such as impulsive behavior, and affective disturbances such as mania. It is not known whether continuous electrical stimulation of the brain would reshape synaptic connectivity and permanently alter neural circuits in ways that may not be salutary. The risk of these effects indicates that DBS should be used only when a patient's condition is refractory to all other interventions and when there is a high probability that the technique will benefit the patient and improve his or her quality of life. If a patient's quality of life is poor and all other treatment options have been exhausted, then the likelihood of benefit can justify physicians' exposing patients to some risk. The clinical and ethical significance of the risk in DBS underscores the obligation of physicians to obtain fully informed consent from patients undergoing the procedure.
 ...
PMID:Consent to deep brain stimulation for neurological and psychiatric disorders. 2086 16


1 2 3 4 Next >>