Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although prior studies have concluded that self-reported weight was accurate enough that it could readily be substituted for measured weight, the populations in these prior studies were either not well-defined or lacked generalizability. The present study was done in a well-defined group of 167 consecutive, male Veterans Administration (VA) patients. The relationship between actual weight (AW) and self-reported weight (RW) was found to be: AW = 0.96* RW + 16.3, and the standard error of estimate was 11.6 lbs, roughly twice as great as reported previously. The factors most closely associated with self-reporting error were obesity, race, and a history of congestive heart failure.
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PMID:Accuracy of self-reported weight in a non-normal population. 318 May 57

Hypertension is a major risk factor for cardiovascular morbidity and mortality. Antihypertensive therapy consistently reduces complications from stroke and congestive heart failure, whereas benefits from the treatment of ischemic heart disease events are variable. Several plausible explanations, including hemodynamic hypotheses, have been put forth to account for the failure of treatment to more favorably influence mortality from ischemic heart disease. The effect of hypertension on coronary heart disease is probably much more complex than a simple elevation of arterial pressure. Some of these complexities include the potential separate risks of high total peripheral resistance, high cardiac output, increased myocardial power that reflects pressure times flow, and several structural and functional vascular changes. These factors may act in concert to unfavorably alter the balance between myocardial oxygen supply and demand. Several of these factors will be highlighted in an attempt to offer alternative or adjunctive pathophysiologic examinations for the high-risk subgroups of obesity and the failure of antihypertensive therapy to normalize the rate of coronary heart disease events.
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PMID:The importance of hemodynamic considerations in essential hypertension. 329 3

Theophylline plasma levels and FEV1 were measured in patients affected by chronic obstructive pulmonary disease and a concomitant disease state (congestive heart failure, chronic cor pulmonale, obesity, peptic disease, hepatic cirrhosis, chronic renal failure) and treated with a sustained release theophylline preparation. Our results indicate that, only in patients affected by congestive heart failure and chronic cor pulmonale, is there a decreased plasma clearance of the drug. Low levels of plasma theophylline were measured in obese patients probably because they received an inadequate posology.
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PMID:Effect of various disease states on theophylline plasma levels and on pulmonary function in patients with chronic airway obstruction treated with a sustained release theophylline preparation. 330 82

Obesity and hypertension are two major risk factors for the cardiovascular system. Whereas arterial hypertension increases afterload to the left ventricle, obesity produces an increase in stroke volume and increases preload. As a result of this double burden, the heart adapts with eccentric left ventricular hypertrophy. Contractility becomes impaired early in the course of obesity hypertension, and ventricular ectopy is observed. As a consequence, the obese hypertensive patient is at a high risk for congestive heart failure and sudden death. Despite the synergistic effects of obesity and hypertension on the heart, patients appear to be relatively protected from nephrosclerosis and coronary artery disease. These epidemiologic observations are supported by the pathophysiologic changes that take place in obesity hypertension. At any given level of arterial pressure, cardiac output and renal blood flow are elevated in obese hypertensive patients, whereas systemic and renal vascular resistance are decreased when compared to lean hypertensive patients. Because total peripheral resistance is considered the hemodynamic hallmark of arterial hypertension, systemic vascular complications may be less pronounced in obesity hypertension. Weight loss decreases preload, afterload to the left ventricle, and the sympathetic drive to the heart. Protecting the heart from these hypertrophic stimuli should be a major goal of preventive cardiology.
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PMID:Obesity hypertension. 330 13

In relation to antiasthmatic treatment of hospitalized patients with theophyllines, results concerning: a) a retrospective analysis of plasma levels observed over a 18-month period; b) a pharmacokinetic study and consequent determination of an efficient individual posology are reported. On the 194 serum drug tests (each comprehensive of the trough and peak concentrations) evaluated, 58 (30%) entered the retrospective study, after screening by predetermined criteria. 96 out of 194 (49%) tests were eliminated because of inappropriate sample collection or irrational dosage regimen. The theophylline blood levels, distinguished by drug formulation and posology, were spread over very large ranges (coefficient of variation up to 88%, mean of 55%), so that many concentrations were subtherapeutic or potentially toxic. The kinetic study, undergone by 22 patients, was carried out by administering and intravenous test-dose of aminophylline, followed by collection of blood samples at determined times. Elimination half-life, clearance and volume of distribution were then calculated by means of the plasma theophylline concentrations and subsequently an individual optimized dosage regimen (so as to keep the blood drug levels within the 8-16 mg.l-1 range) was determined. The considerable variability of elimination rate observed among patients (extreme values of half-life and clearance differ 10-fold) mainly account for the unforeseeability of plasma levels obtainable with a given posology. Even if the factors affecting the elimination rate of theophylline (i.e. cigarette smoking, obesity, congestive heart failure, chronic obstructive pulmonary disease, pneumonia) are taken into account, the blood concentrations are frequently unforeseeable. Therefore, the monitoring of plasma levels is necessary for every patient treated with theophyllines and a pharmacokinetic study is desirable in some cases.
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PMID:[Importance of the laboratory in optimizing anti-asthma therapy with theophylline]. 332 89

Although the risk of developing congestive heart failure increases in parallel with the degree of obesity, load-dependent indexes of left ventricular function are found to be reduced in patients with morbid obesity only. We used the ratio of end-systolic wall stress to end-systolic volume index, which is load-independent, to assess myocardial contractility in 23 nonobese, 28 mildly obese and 26 moderately obese patients with mild to moderate essential hypertension. Although load-dependent indexes (i.e., ejection fraction, fractional fiber shortening and velocity of circumferential fiber shortening) were similar in the 3 groups, end-systolic wall stress to end-systolic volume index was lower in the moderately obese group (2.63 +/- 0.4, p less than 0.002) and even in the mildly obese group (2.88 +/- 0.8, p less than 0.05) than in the nonobese group (3.27 +/- 0.7). Further, there was a significant inverse relation between end-systolic wall stress to end-systolic volume index and body mass index (r = -0.34, p less than 0.005), diastolic diameter (r = -0.56, p less than 0.001) and left ventricular mass index (r = -0.55, p less than 0.001). Some obese patients have depressed myocardial contractility when compared with lean patients despite well-preserved pump function.
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PMID:Myocardial contractility and left ventricular function in obese patients with essential hypertension. 341 51

Diabetes mellitus has been associated with high mortality rates in patients with acute myocardial infarction (AMI). To better define prognosis in this population, the clinical course of 183 diabetics with AMI was studied. In-hospital mortality for all patients was 28% (52 of 183 patients). Mortality was significantly higher in patients with prior AMI than in patients without prior AMI (41 vs 18%, p less than 0.01) and was significantly higher in women than in men (37 vs 19%, p less than 0.01). The 2-fold increase in mortality among diabetic women was observed both in patients with and without prior AMI. The excess mortality among diabetic women was attributable to their increased risk for severe congestive heart failure (CHF) and cardiogenic shock. Death due to CHF occurred in 22% of all diabetic women with AMI compared with 6% of the diabetic men (p less than 0.01). Death resulting from complications other than CHF was similar for both sexes. There were no male-female differences in the history of prior AMI, systemic hypertension, obesity, nephropathy, frequency of Q-wave AMI, anterior AMI or peak creatine kinase levels to account for the high risk for CHF in diabetic women. It is therefore concluded that diabetic women with AMI are at increased risk for death due to CHF, and that this risk is not readily attributable to known conditions associated with CHF.
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PMID:Acute myocardial infarction in diabetes mellitus and significance of congestive heart failure as a prognostic factor. 342 Nov 62

To initiate drug therapy a preliminary dosage regimen is often calculated using literature values for pharmacokinetic parameters. However, in some cases literature data are not available or indicate large interindividual variations, or in certain cases an altered volume of distribution (such as in acute congestive heart failure, edema, obesity, etc.) and changes in renal and nonrenal elimination are expected. For such cases the repeated one-point method (ROPM) was suggested. The ROPM like the other methods for dosage regimens assumes equal maintenance doses at equal dosing intervals. Yet, in practice and in most hospitals, doses administered 3 or 4 times daily are often not administered at equal intervals. A modification of the ROPM is suggested for unequal dosing intervals. The following 4 situations are presented: different dose sizes to maintain Cssmin constant, different dose sizes to maintain Cssmax constant, equal dose sizes where the highest peak does not exceed a certain maximum concentration and equal dose sizes where the lowest trough does not fall below a certain minimum concentration.
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PMID:The repeated one-point method for predicting dose sizes with irregular dosing intervals. 373 83

The clinical features and course of 30 patients (26 men and 4 women) under 30 years of age (mean age 27.3 years) with an acute myocardial infarction (MI) are described. The most common risk factor among this group of patients was smoking in 20 patients (66%). The prevalence of the other risk factors was low: hyperlipidemia in four patients and family history of ischemic disease in another four patients, diabetes mellitus, hypertension, and obesity each in one patient. Seven patients (23%) had none of the conventional risk factors. Three patients were exerting themselves prior to the onset of their MI pain; all of them had normal coronaries. Five patients experienced chest pain prior to MI, among them only two experienced classical angina pectoris. Eighteen patients underwent uncomplicated MI. The complications in the other 12 during the acute MI were rhythm disturbances in eight and congestive heart failure in four. Cardiac catheterization was performed in 25 patients. The occurrence of zero, one, or multivessel disease was equal. The 30 patients were followed up from six months to 15 years (mean 7 years). In 18 patients circulating aggregated platelets were measured one year after the MI. Elevated values were found in all of them (mean +/- SD 34.9 +/- 9.1%). In 6 of the 18, all heavy smokers, extreme values were found in the range of 39-55%. Three out of the 30 patients died within five years after their first MI. The other 15 patients developed complications, most of them angina pectoris. Five patients were hospitalized for reinfarction. None of the 30 underwent aortocoronary bypass operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Myocardial infarction in young adults under 30 years: risk factors and clinical course. 381 21

This report summarizes the major design features, methods, and baseline characteristics of patients enrolled in a Veterans Administration Cooperative Study. In eleven V.A. centers, 231 male diabetic patients who had either a recent amputation for gangrene (N = 207) or active gangrene (N = 24) were randomly assigned to a group which received aspirin (325 mg t.i.d.) plus dipyridamole (75 mg t.i.d.) (N = 110) or two placeboes t.i.d. (N = 121). Major end point were vascular death and amputation of the opposite extremity for gangrene. Forty-one percent of the 563 patients screened were enrolled during a 39 month period. Enrollment errors were found in 8.7%. Historically, the two groups were well matched regarding the following variables: age, duration of diabetes, insulin therapy, previous oral agent therapy, hypertension, myocardial infarction, congestive heart failure, renal disease, sensory neuropathy, and smoking. The drug therapy group had an increased frequency of a history of cerebrovascular disease (19% vs 7%, p = 0.01). The groups were well matched regarding amputation site, obesity, extent of lower extremity vascular disease, retinopathy, and neuropathy upon examination. Their baseline fasting values of glucose, cholesterol, triglycerides, and creatinine were also comparable. We conclude that this study should provide definitive data on the efficacy of these antiplatelet agents in preventing further vascular disease in this patient group. It should also provide new prospective data on the natural history of vascular disease, and the association of vascular risk factors with subsequent vascular events in this patient population.
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PMID:V.A. Cooperative Study on antiplatelet agents in diabetic patients after amputation for gangrene: III. Definitions and review of design and baseline characteristics. 390 83


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