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)

Allograft coronary artery disease (CAD) is the major determinant of long-term survival following heart transplantation (HTx). In a group of 210 heart transplant recipients, we diagnosed CAD in 54 (27.1%) by coronary angiography, postmortem examination or examination of the transplanted heart at the time of retransplantation. Retrospective analysis of potential risk factors for the development of CAD was performed for both immunological (rejection pattern, immunosuppressive therapy, cytomegalovirus [CMV] infection), and nonimmunological (hyperlipidemia, smoking, hypertension, diabetes mellitus, obesity) risk factors. The total number of rejection episodes correlated significantly with the occurrence of CAD (P less than 0.05), showing that patients who experienced two or more rejection episodes had an incidence of CAD of 40%, as opposed to a 23% incidence in patients who experienced no rejection. A composite rejection score derived from multivariate regression analysis of the severity, frequency, and timing of acute cardiac rejection episodes was found to correlate with the development of CAD (P less than 0.05). Postoperative arterial hypertension also correlated significantly with the onset of CAD (P less than 0.01), with a 92.6% incidence of hypertension in the group with CAD versus 76.3% in the group without CAD. Smoking after transplantation correlated significantly with the occurrence of CAD (P less than 0.05). There was no significant correlation with other analyzed factors in this group of patients. In this review, the development of CAD after heart transplantation correlated with treated allograft rejection. Aggressive treatment of hypertension and cessation of smoking may contribute to alleviation of this serious complication.
 ...
PMID:Risk factors for development of accelerated coronary artery disease in cardiac transplant recipients. 236 Oct 19

Coexisted peripheral vascular disease (PVD: ankle/brachial pressure index A/PBI less than 0.75) or carotid artery disease (CTD: Brochenbrough's supraorbital Doppler flow analysis) were diagnosed by non-invasive testings, and correlated with clinical pictures and coronary backgrounds in 121 consecutive patients with confirmed coronary artery disease. PVD were found in 16.5%, CTD in 33.1% and both PVD and CTD in 9.9%. The mean age of PVD(+) patients was significantly higher than that of PVD(-) patients, furthermore CTD(+) patients displayed a significantly larger number of coronary risk factors than CTD(-) patients. Concerning the subjective symptoms, 20% of PVD(+) patients and 45% of CTD(+) patients were asymptomatic regarding PVD or CTD symptoms. However the degree of calcification of the aortic arch on the chest X-film (n = 104) significantly correlated with A/BPI. In patients with AMI, PVD patients showed significantly higher peak CK and CK-MB values than those in PVD(-) patients, which suggested large infarct size in coexistent PVD patients. With respect to the relationship between coronary risk factors, there was a statistically significant difference between PVD(+) patients and PVD(-) patients in terms of the obesity ratio in males as well as hypercholesterolemia ratio and obesity ratio in females. In CTD patients, significant differences between CTD(+) and CTD(-) patients were found with respect to the smoking ratio and obesity ratio in males as well as the smoking ratio in females. In whole study patients, A/BPI with lowered and A.I. (atherogenic index) increased significantly when patients possessed coronary risk factors equal or more than 4 items, which suggested the progression of PVD with increasing number of coronary risk factors.
 ...
PMID:[Clinical picture and background for progression of peripheral arteriosclerosis in Japanese patients with coronary artery disease]. 236 97

Patients with non-insulin-dependent diabetes are at greatly increased risk for coronary artery disease. Although exercise training has been shown to decrease risk factors, the presence of obesity, older age, and a sedentary lifestyle make a high-intensity exercise program an unrealistic choice of therapy. Therefore, we examined the effect of a low-to-moderate-intensity (mean 69 per cent of maximal heart rate) walking program on lipids, glucose, insulin, glycosylated hemoglobin and cardiovascular fitness. Nine women and seven men, mean age 56, were randomly assigned to a control or an exercise group which exercised three times per week for two months. Supervised exercise sessions consisted of 40-45 minutes of walking and/or slow jogging. Subjects continued on their usual diets. The trained group showed a significant improvement in VO2max from 1.65 to 1.95 L/min. Resting systolic blood pressure decreased from 141 to 130 mm Hg after training, and resting heart rate decreased from 88 to 81. Glycosylated hemoglobin decreased in the exercise group in seven or eight subjects and in only two of eight controls. Triglycerides decreased in the exercise group from 285 to 223 mg/dl. Body weight, total and HDL cholesterol, glucose, and insulin did not change in either group. These data indicate that a low-to-moderate level of aerobic training, independent of dietary changes, is an effective and feasible method of improving cardiovascular risk factors: physical fitness, systolic blood pressure, plasma triglycerides, and glycemic control in non-insulin-dependent diabetic subjects.
 ...
PMID:Coronary risk factors in type II diabetes: response to low-intensity aerobic exercise. 236 76

Although Hispanic Americans have shared in the nationwide reduction in coronary artery disease over the past 25 years, mortality data indicate that coronary artery disease remains the leading cause of death in this population. This article reviews the incidence of mortality due to myocardial ischemia and the prevalance of cardiovascular risk factors including cigarette smoking, hypertension, serum lipids, diabetes mellitus, and obesity in Hispanic Americans. Management strategies necessary to reduce cardiovascular risk factors in Hispanic Americans as well as sociocultural issues relevant to nursing research and practice are discussed.
 ...
PMID:Coronary artery disease in Hispanics. 237 63

The Preventive Health Examination (PHE) program was designed to screen for cancer of the lung, colon, skin, and prostate (or breast) and to detect the risk factors for coronary artery disease, i.e., arterial hypertension, hypercholesterolemia, cigarette smoking, and obesity. To investigate the cost-effectiveness of PHE performed by nurse practitioners, the first 176 subjects enrolled in the PHE program at a northeastern, suburban VA Medical Center were evaluated prospectively. The subjects were recruited through random mailing. The direct cost of PHEs was $80 per patient. PHEs were performed on 171 men and 5 women, mean age 57.2 years, divided into groups according to the date of evaluation. Nine percent of patients had findings highly suspicious of cancer (lung nodules in 7, skin lesions in 9). As a consequence, one patient underwent lobectomy for squamous carcinoma of the lung and another underwent prostatectomy for adenocarcinoma of the prostate. Fifty-five percent of patients had high cholesterol levels, 53% were obese, 30% were heavy cigarette smokers, and 19% were hypertensive. Nineteen percent of the patients had three or more coronary artery disease risk factors. We conclude that low cost PHEs performed by nurse practitioners have a high yield in detecting risk factors for coronary artery disease, and for detecting potentially treatable malignancies.
 ...
PMID:Screening for cancer and coronary risk factors through a nurse practitioner-staffed preventive health clinic. 251 28

The recent development of new drug therapies for headache disorders has allowed for the tailoring of treatment to specific patient needs. This paper reviews the pharmacologic management of patients with both headache and concomitant medical illness. The discussion specifically includes the treatment of hypertension, coronary artery disease, mitral valve prolapse, asthma, peptic ulcer disease, obesity, and chronic Epstein-Barr virus infection, occurring concomitantly in patients with headache. Medications that can exacerbate either the headache or concurrent medical condition are noted, and alternative therapies are advised.
 ...
PMID:Management of the headache patient with medical illness. 252 Mar 92

Observations are reported on 31 patients with coronary artery disease (CAD) from Nigeria (a region where CAD is rare). Hypertension either alone (12 cases), or associated with diabetes mellitus and obesity (4 cases), with diabetes mellitus and heavy cigarette smoking (1 case) was a frequent associated illness. Serum cholesterol measured in 15 cases was high in 13, but nine others without cholesterol assay were in the high socio-economic group, and serum cholesterol was likely to be relatively elevated in them also. Hyper-cholesterolaemia was the one factor that Nigerian patients with CAD had, but which is rare in the Nigerian general population. This observation appears to support the view that other major pre-disposing factors to CAD cause this disease usually when there is a back-ground of hyperlipidaemia.
 ...
PMID:A clinical profile of patients with coronary artery disease in Nigeria. 259 4

As is obvious from the previous discussions, obesity is associated with a wide variety of changes in endocrine parameters (Table 1). Some of these changes, such as the reduction in SHBG without change in serum free testosterone levels, reflect merely laboratory abnormalities that may influence interpretation of diagnostic tests but have no important physiologic relevance. Other abnormalities have major clinical impact, such as hyperestrogenemia-endometrial carcinoma and hyperlipidemia-coronary artery disease. In some cases, endocrine changes in obesity are beneficial--that is, hyperestrogenemia leading to lower incidence of osteoporosis. In other cases, such as the profound suppression of growth hormone output in obesity, the physiologic relevance is unknown. Several endocrine changes in obesity, such as the impaired response of many hormones (growth hormone, prolactin, vasopressin, corticotropin) to insulin-induced hypoglycemia and elevated endorphin levels, suggest hypothalamic dysfunction. Furthermore, the failure of all of these abnormalities to be normalized after weight reduction raises the possibility of an underlying disorder leading to both endocrine dysfunction and obesity, rather than the endocrine dysfunction being simply a consequence of the obesity. Successful elucidation of the pathogenesis of obesity, which might then lead to much needed specific treatment modalities, may be advanced if we can solve some of these puzzles.
 ...
PMID:Endocrine aspects of obesity. 264 1

Coronary artery disease has been demonstrated to conform to the principles of an epidemic disease. Therefore, the incidence of the occurrence of the disease is dependent in large part on "disturbances of human culture." These primarily include a cholesterol-rich diet, obesity, cigarette smoking, elevated blood pressure and sedentary life-style. It is gratifying that during the last quarter of a century, large segments of society in the United States have modified many of their adverse patterns of living. As a result, there has been a striking decline in both the incidence of the diagnosis of coronary artery disease and the frequency of premature death due to the disease process. Sudden cardiac death is frequently an unexpected first clinical manifestation of coronary artery disease and, despite heroic efforts, treatment of sudden death victims is frequently unsuccessful. Furthermore, progression of coronary artery disease, even in patients who present with angina pectoris or acute myocardial infarction, is unpredictable. Coronary arteriography, the "gold standard" used for evaluation, gives insight primarily into anatomy and ventricular function (under experimental conditions) existing at a given instant in time. Which lesions are serious and likely to progress are usually unknown, even to the most experienced angiographer. Therefore, surgical and catheter-directed therapeutic approaches are at best only "shotgun" or partial techniques. For these reasons, the principal and continuing therapeutic efforts to reduce the occurrence and control the ravages of coronary artery disease should be directed toward prevention. Such efforts should begin in early childhood and become a lifelong practice, one that all physicians, including the most procedure-dominated specialists, should personally adopt and teach.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Risk factors for cardiovascular disease and death: a clinical perspective. 266 27

Epidemiologic studies have established that elevated low-density lipoprotein (LDL) cholesterol values and decreased levels of high-density lipoprotein (HDL) cholesterol are risk factors for coronary artery disease (CAD). Results from clinical trials indicate that reduction in LDL cholesterol decreases the incidence of and reduces the risk of CAD. The National Cholesterol Education Program recently developed guidelines for the evaluation of plasma cholesterol in adults. Initial classification is categorized and based on the following values: less than 200 mg/dl is "desirable" blood cholesterol; from 200 through 239 mg/dl is classified as "moderate-high" blood cholesterol; and greater than or equal to 240 mg/dl is "high" blood cholesterol. Decision-making regarding therapeutic intervention is influenced by the presence of other lipoprotein risk factors, such as reduced HDL cholesterol and elevated lipoprotein (a), and nonlipid factors, including age, sex, hypertension, obesity, smoking, diabetes mellitus, and family or patient history of CAD. Persons with borderline-high blood cholesterol and established CAD or 2 other risk factors as well as those with high blood cholesterol should undergo lipoprotein analysis. LDL cholesterol is the primary lipoprotein to consider when determining treatment goals. Patients with LDL cholesterol levels greater than 160 mg/dl without CAD or 2 other risk factors and those patients with LDL cholesterol greater than 130 mg/dl with CAD or 2 other risk factors are initially managed with dietary therapy. The goal of treatment of hyperlipidemia is to reduce LDL cholesterol to less than 160 mg/dl or to less than 130 mg/dl in patients with established CAD or with 2 other risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Clinical significance of plasma lipid levels. 267 28


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>