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

Clinical therapy for hyperlipidemia and obesity mandates dietary changes. The rationale for modification of specific dietary components becomes more impressive with each decade, as research and epidemiologic studies continue. Treatment modalities should be based on lipid patterns and lipid aberrations. Intervention methods should become practical and behaviorally motivating for patients. The environment must be receptive, with sophisticated interaction between the physician and registered dietitian. Third party reimbursement trends should be considered, but should not deter nutrition care services essential for medical management of the individual with heart disease.
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PMID:Nutritional therapy for hyperlipidemia and obesity: office treatment integrating the roles of the physician and the registered dietitian. 307 26

To evaluate the effectiveness of contraceptive usage, a 2-year (1985-87) review of pregnant women registered in a large group medical practice west of London was carried out. Altogether, 518 pregnancies were reported during the study period, 187 (36%) of which were unplanned. Broken down by age category, the unplanned pregnancy rate was: 15-19 years, 7.5; 20-24 years, 6.5; 25-29 years, 5.4; 30-34 years, 3.5; and 35-44 years, 2.0. The methods of contraception used at the time of the unplanned pregnancies were: no contraception, 61 women; condom, 49 women; combined oral contraceptive, 27 women; progesterone-only oral contraceptive, 14 women; IUD, 12 women; cap, 12 women; rhythm, 6 women; and withdrawal, 6 women. Of the 49 couples who were relying on the condom for fertility control, 16 had not been using this method at the probable time of conception. In the 27 pregnancies due to failure of the combined pill, 16 indicated they had missed some pills and 3 had gastroenteritis at the probable time of conception; similarly, of the 14 pregnancies involving failure of the progesterone pill, 6 women had forgotten pills and 1 had gastroenteritis. The most commonly cited reasons for nonuse of contraception were fear of or actual side effects (obesity, cancer, heart disease). Unplanned pregnancies in women under 25 years of age tended to be the result of not using any form of contraception or of using combined oral contraceptives incorrectly; in women over this age, unplanned pregnancies were most often associated with condom use. These results suggest several steps: 1) physicians should discuss contraception with all teenagers thought to be sexually active; 2) more time should be spent exploring patients' fears of side effects; 3) patients should be counseled about procedures to follow if a pill is missed; and 4) use of both the condom and combined oral contraceptives should be encouraged in younger women.
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PMID:Lessons from an audit of unplanned pregnancies. 314 Sep 75

We investigated the prevalence of carotid atherosclerosis and its association with serum lipoprotein cholesterol fractions in 412 Eastern Finnish men ages 42, 48, 54, or 60 years who were examined between February and December 1987 in the Kuopio Ischaemic Heart Disease Risk Factor Study. Carotid atherosclerosis was assessed with high-resolution B-mode ultrasonography. Of the participants, 37% had thickening of the intimal or medial layer of the arterial wall, 10% had plaques, 2% had stenosis in the right or left common carotid artery or in the carotid bifurcation, and only 51% were free of any detectable carotid atherosclerosis. The prevalence of atherosclerosis was 14.1%, 32.0%, 67.7%, and 81.9% in the four age groups, respectively. The mean age-adjusted serum low density lipoprotein (LDL) cholesterol concentration was 3.67 mmol/l (142 mg/dl) in men free of carotid atherosclerosis and 4.02 mmol/l (155 mg/dl) in those with at least intimal thickening (p = 0.003 for difference). The mean age-adjusted serum cholesterol concentration in the high density lipoprotein (HDL) fraction was 1.34 mmol/l (52 mg/dl) in the atherosclerosis-free and 1.27 mmol/l (49 mg/dl) in the atherosclerotic men (p = 0.029 for difference). There was a similar difference in both the serum HDL2 and the HDL3 cholesterol levels. Serum LDL and HDL (inverse) cholesterol were significant determinants of severity of carotid atherosclerosis in a multivariate regression model adjusting for age, obesity, plasma fibrinogen, cigarette-years, and duration of hypertension. Our data reveal the high prevalence of atherosclerosis in middle-aged Eastern Finnish men and provide further evidence of the roles of LDL and HDL cholesterol in atherosclerosis.
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PMID:Prevalence of carotid atherosclerosis and serum cholesterol levels in eastern Finland. 319 22

One hundred three patients with ischemic heart disease (IHD) were compared with 29 patients with organic heart disease and normal coronary arteries (OHD) and with a control group of 101 patients free of heart disease and matched for age and sex. Twelve patients in the control group, 4 in the OHD group, and 34 patients in the IHD group were found to have hearing loss (HL) of different degrees, cause, and duration (P = 0.0003). Of the HL-IHD group, 19 of the 34 patients had no underlying etiologic factor compared with 4 of the 12 patients in the control group (P = 0.0005); age was not an important factor. Multiple logistic regression analysis suggests that the probability of a patient with HL of unknown etiology to have IHD is eight times greater than in individuals with normal hearing. In the HL groups (12 controls and 34 with IHD), there were no significant differences in sex, hypertension, obesity, or smoking, but there was a lower incidence of diabetes and a higher incidence of family history in the HL-IHD group than in the HL-control group. Two patients in the HL-IHD group had families with many members affected by both deafness and IHD, suggesting a heredofamilial disease. HL always preceded the clinical manifestation of IHD and appears to be an important "early marker" of a vascular or generalized arteriosclerotic process.
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PMID:Hearing loss and ischemic heart disease. 320 30

There are marked associations between social class and mortality from ischaemic heart disease (IHD). Using data from the Caerphilly and Speedwell Collaborative Heart Disease Studies the relationships between a number of known risk factors for IHD and social class are explored. The overall conclusions are that lipids and obesity are unlikely to play any part in explaining social differences in ischaemic heart disease. Blood pressure, particularly stystolic pressure, could be involved but the two data sets are inconsistent and associations are only shown in Speedwell. There are marked differences in the haemostatic related variables in the various social classes and the pattern of these is similar in Caerphilly and Speedwell. It is possible therefore that the class pattern of IHD is generated, in part at least, by differences in haemostatic mechanisms. These differences in haemostatic function are almost entirely due to the large social class differences in smoking habit. It is possible therefore that the class differences in IHD result from differences in smoking habit.
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PMID:Haemostatic and other risk factors for ischaemic heart disease and social class: evidence from the Caerphilly and Speedwell studies. 322 82

More and more people are turning to exercise as a means of achieving long-term health. The World Health Organization has endorsed this concept. The best available evidence suggests that an employee fitness programme will result in decreased health-care costs, decreased absenteeism and increased productivity for the employer. Regular physical activity is also associated with lower mortality rates. Appropriate physical activity may be a valuable tool in therapeutic regimens for the control and amelioration (rehabilitation) of cardiovascular disease, coronary artery disease, hypertension, congenital heart disease, peripheral vascular disease, obesity, chronic obstructive pulmonary disease, diabetes mellitus, musculoskeletal disorders, end-stage renal disease, stress, anxiety and depression, etc. Regular physical activity, independent of other factors, reduces the probability of coronary artery disease and early death. Patients with risk factors for coronary artery disease need more intensive preexercise evaluation than those not a risk, and those with known or suspected cardiovascular disease need the most intensive evaluation and follow-up. Participation in vigorous sports activities, such as jogging, swimming, tennis, etc., helps to protect against the development of hypertension, even when other predisposing factors are present. Several studies have been conducted on the use of exercise in the treatment of hypertension. Physical exercise also contributes to the control of body weight. Consideration of the metabolic abnormalities in patients with type II (adult onset) diabetes indicates that they would make excellent candidates for an exercise programme. Osteoporosis is an important health problem for the elderly. The best treatment available at present is prevention, and a high level of physical activity throughout life can result in a larger skeletal mass during old age.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The role of physical activity in the prevention and treatment of noncommunicable diseases. 323 11

In this paper I have defined obesity and indicated its prevalence, as well as its risks. Body fat and its relation to other body components can be quantitated in many ways. From a practical point of view, the use of body mass or Quetelet index, defined as the ratio of weight (kg) divided by the square of the height (m2) is the most useful. Overweight is defined as a BMI of 25 to 30 kg/m2 and obesity as a BMI above 30 kg/m2. The WHR can provide additional information about the risk of obesity. Using BMI, the prevalence of overweight in the English-speaking countries of Australia, Great Britain, and the United States is almost identical at 24% of women and 31 to 34% of men. In the obese category, there are more Americans (12%) than in the other two countries (6-8%). There is a U-shaped relationship between weight and risk of death. When body weight is increased 20% above average, the extra mortality rises to 20% for men and 10% for women. This extra mortality is associated with an increased death rate from heart disease, hypertension, diabetes mellitus, digestive diseases, and cancer. In addition to an increased risk of death, overweight individuals demand more from their heart, lungs, and musculoskeletal and digestive systems.
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PMID:Overweight is risking fate. Definition, classification, prevalence, and risks. 330 Apr 79

Snoring usually is trivial and unimportant, but it can turn into a social or medical problem. Obesity, hypertension and heart disease are more frequent among snorers than among nonsnorers, and especially snorers with hypersomnia during the day are at risk. Hypersomnia in association with snoring usually signifies obstructive sleep apnea. Increased resistance in the upper airways, together with negative inspiratory pharyngeal pressure and muscular hypotonia during deep non-REM and REM sleep, lead to collapse of the pharynx, hypoxia and hypercapnia. Only after arousal from sleep does muscle tone return, pharyngeal obstruction reopen and airflow resume. Since this process can occur 300 or 400 times a night, repetitive alveolar hypoventilation leads to pulmonary-arterial hypertension and cor pulmonale, and the repetitive sympathetic activations can cause systemic hypertension or serious cardiac arrhythmias. The countless arousals deprive the sufferer of deep non-REM and REM sleep and their consequence is sleep fragmentation. The symptoms are excessive daytime sleepiness, intellectual deterioration and personality and behavioral changes. Oronasomaxillofacial, endocrine and neuromuscular anomalies and diseases predispose to sleep apnea, and alcohol or CNS-depressant drugs can favour its occurrence. Diagnosis is made by nighttime oxymetry, and if this is abnormal, by polysomnography. After polysomnography it is possible to distinguish between obstructive and nonobstructive sleep apnea, and the decisions for an adequate treatment can be made.
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PMID:[Dangerous snoring. Sleep-apnea syndrome]. 331 92

Carpenter syndrome (ACPS type II) was first described by Carpenter in 1901. The syndrome consists of acrocephaly, soft tissue syndactyly, brachy- or agenesis mesophalangy of the hands and feet, preaxial polydactyly, congenital heart disease, mental retardation, hypogenitalism, obesity, and umbilical hernia. Here we review the literature on Carpenter syndrome and add 2 affected sibs with marked intrafamilial variability. This review showed that 2 reported variations of Carpenter syndrome, Goodman and Summitt syndromes, actually fall within the clinical spectrum of this disorder. This confirms earlier suggestions of Gorlin (personal communication 1982) and Hall et al [Am J Med Genet 5:423-434, 1980].
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PMID:Acrocephalopolysyndactyly type II--Carpenter syndrome: clinical spectrum and an attempt at unification with Goodman and Summit syndromes. 332 2

Large prospective studies and intervention trials have identified major risk factors for premature heart disease in men, while the Framingham Heart Disease Study has provided the leading evidence of predictors of cardiovascular disease in women. We evaluated the role of these risk factors in a 13-year follow-up study of 8935 premenopausal and 2716 postmenopausal women in the Walnut Creek Contraceptive Drug Study cohort in Northern California. Elevated cholesterol levels, high blood pressure, smoking, obesity, family history of heart disease, and diabetes were investigated for their contribution to premature death due to all causes and due to cardiovascular disease. In addition, risk factor profiles were developed separately for users and nonusers of Premarin (conjugated estrogen) in the postmenopausal cohort. The results show that the strongest predictors of cardiovascular mortality among premenopausal women were smoking, high blood pressure, and diabetes, with relative risks of 2.8, 10.5, and 11.6, respectively. A disparity between high cardiovascular risk factor prevalence and low rates of premature heart disease indicates that the high relative risks will not be accompanied by large attributable risks. Nevertheless, the study reconfirms the need for screening women for heart disease risk because life-style changes can improve cardiovascular risk factors and can potentially reduce the chance of premature death even further.
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PMID:Cardiovascular risk factors, premature heart disease, and all-cause mortality in a cohort of northern California women. 337 34


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