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

Between January 1, 1987-January 30, 1990, 374 laparoscopic sterilizations using silastic rings (Falope) were undertaken. Morbidity and major risk factors were analyzed. The most frequent surgical complications were: mesosalpinx rupture and fallopian tube rupture in 22 cases (5.8%); abdominal wall emphysema in 3 cases (0.8%); uterine perforation in 2 cases (0.5%); other pelvic structure lesions in 3 cases (0.8%). Morbidity risk factors were: previous abdominal surgery, obesity, salpingitis, use of a uterine mobilizer in a puerperal uterus, and the practice of tubal occlusion during the luteal hase of the cycle due to the possibility of a luteal phase pregnancy. Therefore, if a risk factor is present, it is advisable to use another contraceptive method. (author's modified)
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PMID:[Morbidity from bilateral tubal ligation, via laparoscopy]. 183 80

Evidence for a post-tubal sterilization syndrome was sought in a literature review of over 200 English-language articles. This syndrome has been described, variously, as encompassing symptoms such as abnormal bleeding and/or pain, changes in sexual behavior and emotional health, exacerbation of premenstrual symptoms, and menstrual symptoms necessitating hysterectomy or tubal reanastomosis. It has been postulated that the destruction of the fallopian tube and, in some cases, portions of the mesosalpinx, alters the blood supply to the ovary, with consequent impairment of follicular growth and corpus luteum function. Evaluation of the research literature is hindered by the failure to control for age, parity, obesity, previous contraceptive use, interval since sterilization, or type of sterilization. Despite the vast discrepancies in the research findings, it does appear that women 20-29 years of age with pre-existing histories of menstrual dysfunction are at increased risk of some post-tubal sterilization symptoms. After this age, however, there is no consistent evidence that tubal sterilization is associated with an increased risk of menstrual dysfunction, dysmenorrhea, or increased premenstrual distress.
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PMID:Is there any evidence for a post-tubal sterilization syndrome? 949 25

Hydrometrocolpos (HMC) and post-axial polydactyly (PAP) are common to both McKusick-Kaufman syndrome (MKS) and Bardet-Biedl syndrome (BBS). We review reported cases of MKS and BBS presenting with HMC and PAP early in life to determine if there are clinical features that allow discrimination between the two syndromes as the primary features of retinitis pigmentosa, obesity, learning disability in BBS are age-dependent. We did not find any phenotypic features that allowed reliable differentiation between the two syndromes in the neonatal period. However, uterine, ovarian, and fallopian tube anomalies are more common in BBS patients, and it may be that these clinical features prove to be useful discriminating features. We conclude that sporadic female infants with HMC and PAP cannot be diagnosed with MKS until at least age 5 years and that monitoring for the complications of BBS should be performed in these patients.
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PMID:Phenotypic overlap of McKusick-Kaufman syndrome with bardet-biedl syndrome: a literature review. 1110 25

Experience with 1000 minilaparotomy sterilizations performed over 6 years in a community hospital in Melrose, Massachusetts are reported. The method used was the Tural (tubouterine resection and ligation) technique. The Tural procedure was developed as a modification of previous surgical techniques. A loop of fallopian tube is grasped with a Babcock clamp and doubly tied with a double 0 chromic catgut. The tied loop is then excised and both free ends are doubly tied separately with double 0 surgilon suture. At the end of the procedure both severed ends of the tubes diverge from each other. In the 1000 case studies, 578 were primary interval sterilizations and 145 were sterilizations performed at the time of cesarean sections. The primary interval patients were done via a minilaparotomy Pfannenstiel incision, and the postpartum patients via a semicircular periumbilical incision. In 1980, the average postpartum hospital stay was 3.4 days. The average postpartum hospital stay with tubal sterilization added was 3.7 days. There was never a need to stop in midprocedure with minilaparotomy or extend the operation because of poor visibility. There was no unusual bleeding, cancelling of the procedure because of adhesions, adherent retroversion, or other pelvic disease. There were no pregnancies, no complications, and no hospital readmissions. Minilaparotomy for tubal sterilization emerged as a safe, economical alternative to conventional laparoscopy. It offers greater operative simplicity and avoids the rare major complications of visceral, vascular, and thermal injuries associated with laparoscopy. Because of disastrous consequences in a small but significant number of cases with laparoscopic electrocautery of the fallopian tubes, a method of nonelectric laparoscopic sterilization was sought by several investigators. A comparative study of female sterilization conducted by the International Research Program revealed the tubal ring was associated with a higher failure rate than electrocoagulation, the Racket clip, or modified Pomeroy technique. An unrecognized bowel injury is 1 of the most serious complications in laparoscopic sterilization. Uchida reported no failures and minimal complications in more than 20,000 minilaparotomies over a 28-year period. The argument that there is more postoperative pain with a minilaparotomy than a laparoscopic procedure was not found in this experience. Some of the positive aspects of minilaparotomy for sterilization are: no shoulder pain secondary to peritoneal insufflation; no contraindication for conditions such as obesity and previous surgery; and thermal injuries to bowel and pelvic organs are prevented.
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PMID:A report of 1000 cases of minilaparotomy sterilizations in a community hospital. 1226 15

Between January 1990 and June 1992 in France, obstetrician-gynecologists at Pr Magnin University Hospital in Poitiers inserted an IUD immediately after a legally induced abortion in 90 women aged 16-44. Five women were nulliparous. 16.7% had more than three children while 37.8% had had three pregnancies. 40% were living under unfavorable socioeconomic circumstances. 20 women were single, had no profession, and had children. 47.8% smoked at least 10 cigarettes a day, 10% of whom smoked 30-60 cigarettes a day. Tobacco contributed to hypertension in three cases, high cholesterol in one case, and obesity in two cases. 32.3% of the women had contraindications to combined oral contraceptives (OCs), especially hypertension and smoking. 21% were using OCs when they last conceived. 47.8% had had 2-3 pregnancies. 11% chose the IUD for personal convenience. Nine months to three years later, 89% of the women were still using the IUD. Complications or discomfort were reasons for removal among the remaining 11%. The complications included inflammation of the fallopian tube(s), IUD expulsion, retention of the trophoblast, and undiagnosed excessive bleeding. Other reasons were genital infection and desire for tubal ligation. 41% of the women did not return either after the IUD insertion. None of them had gynecological troubles, however. These findings show that postabortion IUD insertion is a practical and effective solution to recurrent abortion.
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PMID:[IUD (MLCu 375) insertion following induced abortion]. 1231 94

Invasive serous cancers are diagnosed in the ovary, fallopian tube and peritoneum. It is widely believed that these are variants of the same malignancy but little is known about fallopian tube and primary peritoneal cancers. A comparison of risk factors for these tumor types may shed light on common or distinct aetiological pathways involved in these types of cancer. We investigated risk factors for the three cancers using data from a large Australian population-based case-control study. We included women with incident invasive serous ovarian (n = 627), primary peritoneal (n = 129) and fallopian tube (n = 45) cancer and 1,508 control women. Participants completed a comprehensive reproductive and lifestyle questionnaire. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Hormonal contraceptive use was inversely related to risk of all three cancers. Parity and breast-feeding were also inversely related to risk of serous ovarian and fallopian tube cancer. In contrast, parous women had an increased risk of peritoneal cancer (OR = 1.8, 95%CI 0.8-3.9), and increasing parity did not lower risk. There was also no association between breast-feeding and peritoneal cancer. However, obesity was associated with a doubling of risk for peritoneal cancer alone (OR = 2.1, 95%CI = 1.3-3.4). The strikingly similar patterns of risk for serous ovarian and fallopian tube cancers and the somewhat different results for primary peritoneal cancer suggest that peritoneal cancers may develop along a different pathway. These results also call into question the role of the physical effects of ovulation in the development of serous ovarian cancer.
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PMID:Serous ovarian, fallopian tube and primary peritoneal cancers: a comparative epidemiological analysis. 1805 17

Different subtypes of ovarian cancer appear to have different causes; however, the association between body mass index (BMI) and the different subtypes is unclear. We examined the associations between body-mass index (BMI) and weight gain and risk of the different histological subtypes of epithelial ovarian cancer in a case-control study in Australia. Cases aged 18-79 with a new diagnosis of invasive epithelial ovarian cancer (n = 1,269) or borderline tumor (n = 311) were identified through a network of clinics and cancer registries throughout Australia. Controls (n = 1,509) were selected from the Electoral Roll. Height and weight (1 year previously, at age 20 and maximum weight) and other risk factor information were ascertained via a self-administered questionnaire. Obesity was positively associated with clear cell tumors (Odds Ratio 2.3; 95% confidence interval 1.2-4.2) but not invasive endometrioid or mucinous tumors. Although there was no association with invasive serous tumors overall (0.9; 0.7-1.2), we did see an increased risk of serous peritoneal tumors (2.9; 1.7-4.9), but not of serous tumors of the ovary and fallopian tube. Of the borderline subtypes, obesity was positively associated with serous (1.8; 1.1-2.8) but not mucinous tumors (1.1; 0.7-1.7). Overweight was not associated with any subtype overall. There was no association with BMI at age 20, or weight gain for any of the histological subtypes. These results add to the current evidence that obesity increases a woman's risk of developing distinct histological subtypes of ovarian cancer.
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PMID:Body size and risk of epithelial ovarian and related cancers: a population-based case-control study. 1844 87