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

A large response range can be observed in both behavioral and neuroendocrine responses to environmental challenges. This variation can arise from central mechanisms such as those involved in the shaping of general response tendencies (temperaments) or involves only one or the other output system (behavioral vs. endocrine response). The participation of genetic factors in this variability is demonstrated by family and twin studies in humans, the comparison of inbred strains and selection experiments in animals. Those inbred strains diverging for specific traits of stress reactivity are invaluable tools for the study of the molecular bases of this genetic variability. Until recently, it was only possible to study biological differences between contrasting strains, such as neurotransmitter pathways in the brain or hormone receptor properties, in order to suggest structural differences in candidate genes. The increase of the power of molecular biology tools allows the systematic screening of significant genes for the search of molecular variants. More recently, it was possible to search for genes without any preliminary functional hypothesis (mRNA differential expression, nucleic acid arrays, QTL search). The approach known as quantitative trait loci (QTL) analysis is based on the association between polymorphic anonymous markers and the phenotypical value of the trait under study in a segregating population (such as F2 or backcross). It allows the location of chromosomal regions involved in trait variability and ultimately the identification of the mutated gene(s). Therefore, in a first step, those studies skip the 'black box' of intermediate mechanisms, but the knowledge of the gene(s) responsible for trait variability will point out to the pathway responsible for the phenotypical differences. Since variations in stress-related responses may be related to numerous pathological conditions such as behavioral and mood disorders, drug abuse, cardiovascular diseases or obesity, and production traits in farm animals, these studies can be expected to bring significant knowledge for new therapeutic approaches in humans and improved efficiency of selection in farm animals.
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PMID:Molecular genetic approaches to investigate individual variations in behavioral and neuroendocrine stress responses. 1196 55

Necrotizing fasciitis is a rapidly progressive infection of the fascia and subcutaneous tissues accompanied by a high mortality rate approaching 80% to 100%. Factors that predispose patients to this life-threatening complication include obesity, malnutrition, malignancy, chronic alcoholism, drug abuse, peripheral vascular disease, diabetes mellitus, and immunosuppressive therapy. The pathomechanisms for the development of this rare disease still remain unclear. We report a case of necrotizing fasciitis with Clostridium perfringens after laparoscopic cholecystectomy. The patient left the hospital 5 months after admission. Early recognition based on clinical signs (pain, asymmetric abdominal thickening, crepitus) and computed tomography scanning (gas dissection along fascial planes), in conjunction with prompt, aggressive surgical therapy and debridement of all devitalized tissue, high-dose antibiotic therapy, and therapy at the intensive care unit, appears to afford patients the best chance of survival.
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PMID:Necrotizing fasciitis with Clostridium perfringens after laparoscopic cholecystectomy. 1197 28

Erectile dysfunction (ED) is defined as the inability to achieve and maintain a penile erection which is adequate for satisfactory sexual intercourse. It is a significant male health problem affecting approximately 150 million men worldwide. This value is expected to more than double by the year 2025. The incidence of ED increases sharply with age since it is a common cross-cultural denominator, affecting 19 to 64% of men aged 40 to 80 years, both in developing and industrialized countries. Epidemiological studies may underestimate the true dimensions of the problem because of the embarrassment or stigma that is associated with ED. Men with ED may experience diminished self-image and self-esteem, anxiety and fears of rejection, and even depression as psychogenic factors. Pathologic conditions which are commonly encountered in the ageing male (diabetes, hypertension, atherosclerosis, cardiovascular disease, etc) as well as chronic diseases (arthritis, renal and hepatic failure, pulmonary disease) represent a frequent cause of organic ED and are often treated with medications that can interfere with sexual function at central and/or peripheral level. In addition, incorrect lifestyle--i.e. obesity, cigarette smoking, alcohol or drug abuse--may all contribute to the onset of ED. Finally, trauma or surgery affecting either the nervous system or interfering with the blood supply to the penis are associated with increased incidence of ED.
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PMID:Pathology of erection. 1283 29

The upsurge of urbanization, often poorly planned and uncontrolled, has caused major impacts on human societies for at least two centuries. Urban environments and urbanized lifestyles have strong influences on health and well-being, including on infant and childhood populations in developed and underdeveloped countries, as well as among societies in developmental and environmental transition around the world. Urbanization will inevitably have significant impacts on the health of future generations. Notably, the health consequences of urbanized lifestyles are not confined to residents of cities and large towns but rather are becoming manifest in rapidly changing, previously traditional societies in rural and remote areas because globalization is altering infant feeding practices and the dietary habits and lifestyle patterns of their children. In underdeveloped countries, overcrowding and environmental pollution are huge problems that are exacerbated by undernutrition and infection, particularly respiratory and diarrheal diseases. In developed societies, other problems like injuries; poisonings; violence; drug abuse; exposure to chemical, biological, industrial, and atmospheric pollutants, including pesticides; sexually transmissible diseases; and 'lifestyle' diseases, including obesity and cardiovascular disease risk, are of great current and potential importance.
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PMID:Child health implications of worldwide urbanization. 1287 11

Surgery for morbid obesity should be considered in case of failure of conservative treatment (diet, physical activity, psychotherapy, supportive medications). It is strongly recommended also for patients with significant concomitant diseases (e.g. cardiovascular, pulmonary etc) difficult to manage with traditional therapy. Patients' selection for surgery seems to be essential issue. Typical indications for surgical procedure include: BMI > 40 or BMI > 35 in patients with at least two obesity-related diseases, ineffective conservative treatment. Main contraindications are GI tract diseases (esophagitis, peptic ulcer), severe cardiovascular insufficiency, alcohol or drug abuse and mental disorders. There are two types of operative procedures currently performed restrictive and malabsorptive. The first group consists of following operations: 1) Silicon Ring Vertical Gastroplasty (SRVG), 2) Vertical Banded Gastroplasty (VBG), 3) Adjustable Silicon Gastric Banding (ASGB), 4) Non-Adjustable Gastric Banding (NGB). The latter group comprises: 1) Roux-Y Gastric By-Pass (RYGB) and 2) Bilipancreatic diversion. The paper describes complications, advantages and disadvantages for both groups of bariatric procedures and points out factors that should be considered in patients' selection for various types of operation.
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PMID:[Indications and contraindications for surgical treatment of morbid obesity--the choice of operative method]. 1560 67

This report summarizes the background and specific objectives for a symposium on the neurobiology of nonhomeostatic eating and drug abuse that was held at the 2004 Annual Meeting of the Society for the Study of Ingestive Behavior (SSIB). The symposium was the first of a series funded by a conference grant from four institutes of the National Institutes of Health. The encompassing goal of the series is to analyze the roles for the biological mechanisms of ingestion in obesity, eating disorders and other theoretically related areas including addiction, depression and schizophrenia. The symptoms and treatments of these diverse pathologies routinely involve aberrations in the mechanisms regulating eating and body weight. The presentations and discussion from this symposium (1) identified changes in neurotransmitter dynamics and gene expression in brain "reward circuits" accompanying learning of behaviors to obtain palatable foods or drugs of abuse; (2) analyzed behavioral findings in animals and humans, and neuroimaging data in humans, supporting treatment with GABA(B) agonists to reduce craving for drugs of abuse and possibly for highly rewarding foods; and (3) used neuroimaging data in humans to establish novel serotonergic targets for normalizing reward processes and impulse control in anorexia nervosa and bulimia. Overall, the symposium clearly revealed our rapidly broadening understanding of the alterations in the brain at the molecular, cellular and systems levels that are associated with craving and nonhomeostatic consumption of food and drugs of abuse. This knowledge gained largely in animal models translates to novel and better strategies for treating human patients.
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PMID:NIH symposium series: ingestive mechanisms in obesity, substance abuse and mental disorders. 1612 61

Health care politics are changing. They increasingly focus not on avowedly public projects (such as building the health care infrastructure) but on regulating private behavior. Examples include tobacco, obesity, abortion, drug abuse, the right to die, and even a patient's relationship with his or her managed care organization. Regulating private behavior introduces a distinctive policy process; it alters the way we introduce (or frame) political issues and shifts many important decisions from the legislatures to the courts. In this article, we illustrate the politics of private regulation by following a dramatic case, obesity, through the political process. We describe how obesity evolved from a private matter to a political issue. We then assess how different political institutions have responded and conclude that courts will continue to take the leading role.
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PMID:Obesity, courts, and the new politics of public health. 1647 90

Our simple definition of ethics is good thought, speak and action. Epistemology means the hypothesis of facts about thought, speech and action. Medical practice is all means of medicine. Medicine classifies people into normal and abnormal. The abnormal are the sick. They loose some organs or those normal looking organs are dysfunctional. They are social problems, some can be treated, and some do not get the appropriate care. The problems of society of normal people are overeating and obesity, abortion, drug abuse, promiscuity, torture, terrorism, disobeying rules and order, corruption, brain-washing and unethical advertisements, etc. On the other hand, the social problems of the abnormal are down, deafness, blindness, dumb, hypertension, hypercholesterolemia, diabetes mellitus and cancer, etc. An example of the social-doctor problem is the mal distribution of doctors in rural areas. It was reported by the ministry of public health that the ratio of doctor to population to be 1:800 in Bangkok and 1:5, 700 in some rural areas in the north eastern part of Thailand. The doctors, themselves, are at a high grade of worker and intelligent quotient. They know all the problem and, at the same time, create problems, both, faster than the general population can do. It affects good and bad in the society. In the past, present and the foreseeable future the medical students get their studies in the western style. Their medical schools are situated in big cities. These schools are old and famous. They learn their medical procedure in a big hospital of more than 400 beds in the inpatient department wards. Their instructors and professors are highly qualified, are middle class people and well accepted in the society. Their families are lovely and warm. Their children study in the first class schools in town. The medical students feel very happy and appreciate seeing their professors in television routinely at prime time. In conclusion, their professors are an example of role model for them to follow. Everyone looks for security in her/his profession. Facts need no proof and reference. People with justice in mind should believe and understand the above mentioned. This leads to the problem of mal distribution of doctors in rural areas, why do doctors live in big cities or wish to be in the private sector? In fact, not many a number of doctors serve in the rural area. About 4-5 of them, their name will be announced yearly as the best rural doctor award. After the big ceremony, lasted not longer than a month, it is hard to remember their name. They are proud to be praised, it pushes them into stress intentionally with all the best of their intelligence and the total of their body strength to work harder in rural. Unfortunately their earning, the security of their profession, the increased chance of being sued, to get caught in the medical litigation, the expenses of their family social status and the study of their children cannot be compared to of those doctors in big city and/or in the private sector. Mal distribution of doctors in remote rural areas has been a persisting unresolved problem in many parts of the world, why not apply the principles of ethics and epistemology? They have been left, untouched forever.
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PMID:Ethics and the comprehensive application of epistemology in medical practice. 1651 4

Based on the results of the clinical follow-up study of 41 female patients, diagnostic criteria of bulimia nervosa that should be used in clinical studies are suggested as follows: (1) presence of anorexia nervosa or transitory amenorrhea in the premorbid period; (2) eating attacks with losing of the control over food consumption not less than twice a week during 3 months; (3) compensatory behavior in the form of spontaneous vomiting, abuse of purgative and diuretic medications etc; (4) fear of obesity; (5) cycloid affective changes with higher impulsivity, reduction of the control over primitive drives and/or expressed anxiety disorders; inclination to alcohol and drug abuse and nicotine dependence; (6) changes of the body mass index; (7) absence of amenorrhea. The disease dynamics is characterized by formation of the pathological cycle "diet--overeating--compensatory behavior" on the background of cyclothymic affective disorders. Two types of bulimia nervosa--with and without other drive disorders--have been singled out.
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PMID:[Clinical features and diagnostic criteria of bulimia nervosa]. 1684 79

Bupropion hydrochloride ((+/-)-2-tert-butylamino)-3'-chloropropiophenone x HCl) is a nonselective inhibitor of the dopamine transporter (DAT) and the norepinephrine transporter (NET) and is also an antagonist at neuronal nicotinic acetylcholine receptors (nAChRs). In animal models used commonly to screen for antidepressant activity, bupropion shows a positive response. Also using animal models, bupropion has been shown to attenuate nicotine-induced unconditioned behaviors, to share or enhance discriminative stimulus properties of nicotine and to have a complex effect on nicotine self-administration, i.e., low doses augmenting nicotine self-administration and high doses attenuating self-administration. Current studies show that bupropion facilitates the acquisition of nicotine conditioned place preference in rats, further suggesting that bupropion enhances the rewarding properties of nicotine. Bupropion has been shown to attenuate the expression of nicotine withdrawal symptoms in both animal models and human subjects. With respect to relapse, current studies show that bupropion attenuates nicotine-induced reinstatement in rats, but large individual differences are apparent. Clinically, bupropion is used as a treatment for two indications, as an antidepressant, the indication for which it was developed, and as a tobacco use cessation agent. In clinical trials, bupropion is being tested as a candidate treatment for psychostimulant drug abuse, attention-deficit hyperactivity disorder (ADHD) and obesity. Bupropion is available in three bioequivalent oral formulations, immediate release (IR), sustained release (SR), and extended release (XL). Extensive hepatic metabolism of bupropion produces three pharmacologically active metabolites, which may contribute to its clinical profile.
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PMID:Review of the pharmacology and clinical profile of bupropion, an antidepressant and tobacco use cessation agent. 1722 86


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