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

The study of fluid and electrolyte disturbances by isotope radiodilution method is carried out in 22 patients with chronic respiratory insufficiency and cardiac failure. The simultaneous measurements of hydro-ionic compartments have been carried out with tritiated water (HTO), labelled sodium (22Na), labelled potassium (42K) and labelled bromine (82Br). From these measurements, the various water spaces are calculated: total water (ET) and extracellular fluids (LEC), also exchangeable electrolytes: sodium (NaE), potassium (KE), chlorine (ClE) and derived values. Results are compared to corresponding values in controls with the same obesity index. Patients with respiratory insufficiency show a fluid and sodium rise, similar to that found in cardiac failure and denutrition. The (NaE + KE)/ET ratio is not significantly decreased and the natremia is only slightly lower. There is no real potassium depletion in most patients.
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PMID:[Isotopic study of fluid and electrolyte disturbances in decompensated chronic respiratory insufficiency (author's transl)]. 0 42

The weight of some organs [brain, heart, lungs, kidneys, liver] was ascertained in a group of 1,598 persons who died a violent death, and a comparison was made with values obtained in a group of persons who died of cardiac insufficiency. The figures found were correlated according to sex with age, obesity, lipomatosis, physical size, the presence and stage of atherosclerosis. --Within the violent death group, a correlation was also made between a subgroup with minimal or no presence of atherosclerosis and one with ascertained atherosclerosis. The average weight of the brain was found to be 1419.6 g in men, 1266 g in women; the heart--394.7 or 343 g; kidney--149.0 g or 124.1 g; lungs 1280.0 or 973.4 g; liver--1770.9 g or 1522.0 g.
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PMID:[Weight parameters of various internal organs]. 61 41

Recent epidemiologic studies have suggested that cardiac disease in common in diabetics and may often have a noncoronary basis. To examine the status of the left ventricle, 17 adult-onset diabetics of familial type without hypertension or obesity underwent hemodynamic study and were compared to 9 controls of similar age. Of the 17, 12 subjects had no significant occlusive lesions by coronary angiography. From this group eight without heart failure had a modest, but significant, elevation of left ventricular end-diastolic pressure. End-diastolic and stroke volumes were reduced, but ejection fraction and mean rate of fiber shortening were within normal limits. The left ventricular end-diastolic pressure/volume ratio was significantly higher than controls. Afterload increments effected a significant increase of filling pressure compared to normals without a stroke volume response, consistent with a preclinical cardiomyopathy. Four patients with prior heart failure had similar but more extensive abnormalities. None had local dyskinesia by angiography, and lactate production was not observed during pacing-induced tachycardia. Left ventricular biopsy in two patients without ventricular decompensation showed interstitial collagen deposition with relatively normal muscle cells. These findings suggest a myopathic process without ischemia. Postmortem studies were performed in 11 uncomplicated diabetics. Nine were without significant obstructive disease of the proximal coronary arteries, and the majority succumbed with cardiac failure. On left ventricular sections, none had evident luminal narrowing of the intramural vessels. All nine exhibited periodic acid-Schiff-positive material in the interstitium. Collagen accumulation was present in perivascular loci, between myofibers, or as replacement fibrosis. Multiple samples of left ventricle and septum revealed enhanced triglyceride and cholesterol concentrations, as compared to controls. Thus, a diffuse extravascular abnormality may be a basis for cardiomyopathic features in diabetes.
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PMID:Evidence for cardiomyopathy in familial diabetes mellitus. 89 79

Chronic diabetes mellitus can alter left ventricular function independent of vascular effects. On the basis of available morphologic data in human and canine diabetics, alterations of myocardial interstitium may be the basis for this preclinical abnormality. The abnormal function is independent of apparent duration and treatment by diet, insulin, or hypoglycemic agents. It occurs in both sexes and is independent of age. Whether the observed functional abnormality progresses to clinical heart failure may depend on intensification of the underlying pathophysiology of the myocardium or superimposition of complications such as hypertension, obesity, and obstructive disease of the coronary vessels.
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PMID:Diabetes mellitus and left ventricular function. 97 64

The Pickwickian Syndrome stimulated new pathophysiological concepts in regard to control of ventilation. With the advent of sleep laboratories, the peculiar sleep apnea occurring in some of these patients has been explained on the basis of intermittent upper airway obstruction. Two patients with different manifestations of the Pickwickian Syndrome are presented. The suggestion is made that these two subsyndromes should have unique designations. The Auchincloss Syndrome is manifested by right heart failure and respiratory acidosis in obese patients who are alert and have no major abnormality of breathing pattern. The fundamental cause of this abnormality is the increased work of breathing caused by the obesity. The cost of breathing is so high that the ventilatory regulation is compromised and respiratory acidosis results. The Gastaut Syndrome is characterized principally by hypersomnia and sleep apnea. The fundamental defect is upper airway obstruction during sleep, resulting in increased work of breathing, which together with the increased work caused by obesity leads to respiratory acidosis and right ventricular failure. Hypersomnia, rather than heart failure or respiratory acidosis, is the major manifestation of this syndrome, and is the result of sleep loss.
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PMID:Pickwickian syndrome, 20 years later. 117 87

In the course of a sterilization by tubal electrocoagulation, the patient suffered perforation of the abdominal aorta, causing a large hematoma and danger of bleeding to death. The aorta was repaired with a Teflon patch and the patient recovered, but the potentially fatal incident occasioned a review of the legal status of sterilization and of its complications. In the Dohrn case (1964), the Federal Court of Justice determined that voluntary sterilization is nonpunishable under German law. However, sterilization has increased less in Germany than, e.g., in England or Japan, and in 1969 the German Doctors' Conference declared sterilization permissible only for medical, genetic-eugenic, or pressing social reasons. As for complications, electrocoagulation of the tubes - involving anesthesia, inhibition of respiration by means of Trendelenburg's position, introduction of carbon dioxide into the abdomen, and manipulation of instruments through incisions - must be considered a complex procedure. Among 11,956 published cases described by 29 authors between 1969-1974, the complication rate was 1.71%; probably the actual rate is higher. 3 fatalities - from heart failure, peritonitis, and suffocation - were reported. In addition, there were 117 hemorrhages (.98% of the cases reported), 22 burns or mechanical injuries of the gastrointestinal tract (.19%), 26 perforations of the uterus (.22%), 44 infections (.37%), 25 skin burns (.21%), and 24 cases of skin or organ emphysema (.2%). Mechanical injuries carry the danger of perforation of organs over time, and the injuries reported included 13 perforations of colon, ileum, or stomach, requiring laparotomy and excision. Complications under electrocoagulation are reported to be less severe than in conventional operations; nevertheless, electrocoagulation should never be performed as an outpatient operation, and follow-up to check for delayed complications is advisable. Contraindications are poor general health, severely reduced respiration, and such conditions as anatomical anomalies, tumors, endometriosis, and obesity.
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PMID:[Aortic perforation following electrocoagulation of the tubes]. 126 30

The past decade has seen a shift in the strategy for hypertension treatment from stepped therapy--a highly structured monolithic series of steps--to recommendations for a more individualized selection of treatment. Severe hypertension is a clear indicator to bypass traditional steps. Demographic factors, such as age, gender, and race, are often cited, but have proved to be less helpful. Concomitant medical conditions and problems are very common and are more often the crucial determinants in the selection of antihypertensive therapy. Coronary artery disease, diabetes mellitus, heart failure, azotemia, asthma, and chronic obstructive pulmonary artery disease, anxiety, and depression are all common, and each has implications for the selection of antihypertensive therapy. Blood pressure reduction is a surrogate for reduction of cardiovascular risk, and therefore, consideration of concomitant medical problems has extended to left ventricular hypertrophy, obesity, mild hyperlipidemia, and insulin resistance, as additional risk factors in hypertension. Consideration of all these factors makes it possible to individualize antihypertensive therapy in most patients today.
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PMID:Treatment of hypertension: the place of angiotensin-converting enzyme inhibitors in the nineties. 128 28

Insulin resistance and hyperinsulinemia is now recognized in non-insulin-dependent diabetes, essential hypertension, obesity, atherosclerotic heart disease, dyslipidemia, heart failure, and in heavy smokers. Several mechanisms have been proposed to explain hyperinsulinemia, insulin resistance and its relationship to hypertension; reduced sodium excretion, activation of the sympathetic nervous system, increased activity of the sodium/hydrogen pump, and stimulation of cellular growth. Some of the nonpharmacological methods to control hyperinsulinemia are of benefit in the management of hypertension, most notably weight loss, exercise program, and reduced salt intake. High-fiber and reduced-protein diets also reduce hyperinsulinemia. Thiazide diuretics can result in insulin resistance, and insulin secretion may be inhibited, possibly associated with concomitant hypokalemia. beta-Blockers result in some reduction of glucose tolerance and mask some of the features of hypoglycemia. Angiotensin-converting enzyme (ACE) inhibitors and alpha-receptor blockers do not effect insulin resistance; probably the same is true for calcium antagonists. Although the effect on risk factors should not be discounted, it is the effect of treatment on hard end points, cerebrovascular accidents, myocardial infarction, or death that is most important. Evidence in hypertension is at present restricted to diuretics and beta-blocking drugs.
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PMID:Hypertension and insulin resistance. 128 47

We report on the prevalence of chronic heart failure (CHF) in a random sample of a population (aged 20-64 years) from the Veneto region in northern Italy. The relationship between CHF and hypertension and obesity was also investigated. These data were collected during an international research project coordinated by the World Health Organization. The overall prevalence of CHF was 2.0% both in the male and female population. The prevalence of CHF increased significantly with age and was positively correlated with body mass index in both sexes. Patients with borderline hypertension showed a 3.5-fold increased prevalence of CHF. The prevalence of CHF was 4.9-fold higher in hypertensive than in the normotensive subjects. Patients treated with hypotensive drugs had a significantly higher prevalence of CHF than untreated patients.
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PMID:[Heart failure in the population: prevalence data]. 129 74

Mounting data support a causal connection between high-normal fibrinogen levels and atherosclerotic cardiovascular disease. There is clearly a thrombogenic component to atherosclerosis and the onset of clinical manifestations. This offers the possibility to better identify high-risk candidates and also to protect them by reducing blood fibrinogen concentration or blocking its action. The relationship of antecedent fibrinogen to the subsequent development of cardiovascular disease is examined, based on 18 years of surveillance of a cohort of 1274 men and women aged 47 to 79 years who participated in the Framingham Study. The association with the development of peripheral arterial disease and cardiac failure is now examined in addition to previously studied relationships to coronary heart disease and stroke. In men and women, there is a significant age-adjusted relationship of fibrinogen level to coronary heart disease and to cardiovascular disease in general. In women, a significant relationship to cardiac failure and peripheral arterial disease, but not to stroke, was also found. These data on women are unique as they are not available elsewhere. Age-adjusted cardiovascular, all-cause, and coronary heart disease mortality were all related to fibrinogen in both sexes. In men, fibrinogen impact was the greatest for stroke and the least for peripheral arterial disease. For women, the impact on coronary heart disease was greatest. The absolute risk for an elevated fibrinogen level was greatest for coronary heart disease in both sexes. Average fibrinogen values are higher in women and in persons with other risk factors, including hypertension, cigarette smoking, diabetes, obesity, and elevated hematocrit. However, there is an independent contribution of fibrinogen to cardiovascular disease in general and coronary disease in particular, on adjustment for coexistent risk factors. Fibrinogen enhances the risk of cardiovascular disease in hypertensives, diabetics, and cigarette smokers. About half the cardiovascular risk of cigarette smoking appears due to the higher fibrinogen values. Now, five prospective studies document the excess incidence of cardiovascular events in persons with elevated fibrinogen levels within the "normal range." Each standard deviation increase in fibrinogen is associated with a 30% increment of coronary heart disease in men and a 40% increase in women. Fibrinogen should be added to the list of major cardiovascular risk factors. Trials of intervention to lower fibrinogen in high-risk coronary candidates are needed.
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PMID:Update on fibrinogen as a cardiovascular risk factor. 134 96


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