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

Breast-feeding contributes significantly toward the physical and psychological well-being of infants and health professionals should encourage mothers to breast-feed whenever possible. Nutritional advantages of breast milk include 1) a low sodium to potassium ratio; 2) an appropriate fat content; 3) optimal absorption rates for each compositional factor; and 4) high taurine levels which may promote nerve cell growth. Breast-fed infants are less likely to suffer from infant obesity than bottle fed infants. Most investigators agree that human milk affords the infant protection against infections; however, some diseases may be transmitted from the mother to the infant by breast feeding. Breast-feeding enhances the psychological well-being of both the mother and the child and strengthens the emotional bond between them. Breast feeding is contraindicated 1) for infants with phenylketonuria, rare amino acidurias, and galactosemia; 2) for infants whose mothers have diseases such as infectious tuberculosis and venereal disease; and 3) for infants whose mothers are taking medications which might be harmful to the infant. A history of breast cancer in the mother's family does not contraindicate breast-feeding. Hyperbilirubinemia in breast-fed infants can generally be prevented by the prompt initiation of breast-feeding following delivery and by providing the infant with frequent feedings throughout each 24 hour period. Infants with cleft palates can be breast-fed if they are fitted with a dental prosthesis. The threat of breast milk contamination by environmental pollutants is insignificant for most women in the U.S. Unless the mother has been exposed to an abnormally high level of chemical pollution, she need not worry about breast milk contamination.
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PMID:Breast-feeding and infant health. 52 12

Prophylactic antibiotics are given routinely to patients undergoing surgical treatment of the biliary tract to prevent postoperative infection if risk factors for postoperative sepsis are present. Cefmetazole (CM) is a new broad spectrum parenteral cephamycin antibiotic. This drug possesses a spectrum of activity against a wide range of gram-negative and gram-positive bacteria that is similar to cefoxitin (CX), an antibiotic widely used for prophylaxis with operations upon the abdomen. In this study, there was a random selection of two patients to receive CM to every one patient to receive CX. The dose of CM was 1 gram given intravenously every eight hours for three doses beginning 30 minutes before the operation; three doses of CX were given intravenously, 2 grams every six hours. Fifty-two evaluable patients comprised the CM group and 26, the CX group. The risk factors for postoperative infection were acute cholecystitis (CM, seven patients; CX, one patient), evidence from imaging procedure suggesting need for exploration of the common duct (CM, six; CX, one), hyperbilirubinemia (CM, eight; CX, four), hyperamylasemia (CM, 17; CX, seven); age of 60 years or more (CM, six; CX, one), obesity (CM, 36; CX, 14) and diabetes mellitus (CM, four; CX, five). Operative bactibilia and the organisms were comparable in both groups. Postoperative days of fever greater than or equal to 38 degrees C. (oral) (CM, 0.83 +/- 1.20; CX, 0.58 +/- 0.96) and hospitalization (CM, 6.59 +/- 2.20; CX, 5.04 +/- 1.26) were similar. Postoperative septic complications at the operative site occurred in two patients in the CM group (4 per cent) and in none of the patients in the CX group (p = 0.4; N.S., Fischer exact test). These two antibiotics had similar efficiency in preventing postoperative infections.
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PMID:Controlled comparison of cefmetazole with cefoxitin for prophylaxis in elective cholecystectomy. 240 23

The effect of long-term voluntary fasting on hematologic variables, biochemical profiles, and liver histologic findings was assessed in 15 obese cats (> 40% overweight). Clinical signs and laboratory results consistent with hepatic lipidosis were observed in 12 of 15 cats after 5 to 7 weeks of fasting, and were associated with 30 to 35% reduction of initial body weight. Histologic examination of successive liver biopsy specimens revealed that obesity was not associated with liver parenchymal lipid accumulation, but that fasting resulted in lipidosis in all 15 cats. The long-term fast was associated with an early (after 2 to 4 weeks of fasting) and significant (P < 0.05) reduction in serum urea, glucose, and albumin concentrations, and RBC mass. Fasting for 5 to 7 weeks was associated with a significant (P < 0.05) increase in hepatic-associated enzyme activities and in total and direct serum bilirubin concentrations. Significant (P < 0.05) changes in serum alkaline phosphatase developed as early as 3 weeks before the onset of hyperbilirubinemia. Except for development of hepatic lipidosis, cats appeared to tolerate the fast without other adverse effect. This study confirmed that long-term fasting may induce clinical hepatic lipidosis in obese cats. Fasting appears to induce a syndrome of hepatic lipidosis that is indistinguishable from feline idiopathic hepatic lipidosis and may be an appropriate model to study the pathophysiologic features and treatment of hepatic lipidosis.
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PMID:Experimental induction of hepatic lipidosis in cats. 780 98

In spite of the improvement on chemotherapy results in treating testicular cancer and the introduction of adjuvant chemotherapy to node negative (as well as node positive) breast cancer patients, there is still present a wide spectrum of early and late toxic manifestations. The combination of cisplatin, vinblastine and bleomycin given to testicular cancer might result in cariovascular, neurological, gastrointestinal and renal problems. Late effects of cyclophosphamide, methotrexate and 5-fluorouracil given to breast cancer patients might cause obesity, amenorrhea and infertility. We report a persistent asymptomatic indirect hyperbilirubinemia which was observed in two cancer patients (breast; testis) 3 and 14 months following the cessation of chemotherapy. Metastatic liver disease and involvement of other sites, as well as other causes of hyperbilirubinemia, were excluded. The exact cause of the indirect hyperbilirubinemia remained obscure.
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PMID:Chemotherapy-related persistent indirect hyperbilirubinemia. 788 4

The data on the value of pharmacokinetic parameters and pharmacologic properties of antibiotics for the development of optimal regimens of antibacterial therapy are presented. The impact of various symptoms and syndromes of purulent septic processes (uremia, anemia, obesity or hyperbilirubinemia) on antibiotic pharmacokinetics is discussed. Approaches to the improvement of schemes for antibiotic therapy of various pathological conditions are noted. Procedures (a microbiological one and those with the use of apparatus) for the determination of antibiotic concentrations in serum and tissues are described. Factors useful for the development of individual regimens of antibiotic therapy of various nosologic forms of infectious inflammatory diseases are indicated: some indices characterizing susceptibility of the pathogen to the drug used (minimum antibacterial, minimum inhibitory and bactericidal concentrations), difficulties with their interpretation (the phenomena of the pathogen persistence, microbial tolerance and Eagle's effect), environmental influences in the infection foci on the drug concentration.
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PMID:[Antibiotic pharmacokinetic indices and their significance in working out antibacterial therapy regimens and predicting their efficacy]. 808 89

The perinatal mortality rate of infants of diabetic mothers (IDMs) has declined dramatically from 250 per 1000 live births in the 1960s to a near-normal 20 per 1000 live births in the 1980s. Five to 8% of all IDMs suffer from major congenital malformations, and it is the latter that are responsible for 50% of these perinatal deaths. It has been shown that tight glycemic control prior to conception and during pregnancy can prevent an excess rate of congenital malformations, fetal macrosomia, birth trauma, and neonatal respiratory distress syndrome. We briefly review the short- and long-range complications that occur in offspring of diabetic mothers (ODMs) from gestation through young adulthood. Short-term neonatal complications, such as hypoglycemia, hypocalcemia, hypomagnesemia, hyperbilirubinemia, and polycythemia, are related mainly to fetal hyperinsulinemia, hypoxemia, and prematurity. They are readily controllable within the setup of modern neonatal intensive care units. Long-range complications include an increased rate of childhood and adolescent obesity, impaired glucose tolerance or diabetes mellitus, and subtle neuropsychological dysfunctions. These may be related to the severity of the maternal hyperglycemia during pregnancy, the consequent fetal hyperinsulinemia, and third trimester maternal lipid metabolism disturbances. Today we have at hand the knowledge and tools to properly treat both pregestational and gestational diabetes. Increased education of the general practitioner and the target population regarding early referral of pregestational diabetic mothers and the implementation of screening programs for gestational diabetes will further reduce diabetic pregnancy-related morbidity.
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PMID:Short- and long-range complications in offspring of diabetic mothers. 888 19

Recent reports using historical controls or registry cohorts suggest, respectively, either an increase in the mortality or a decrease in the incidence of hepatic veno-occlusive disease (VOD) with the administration of intravenous immunoglobulin (i.v.Ig) after bone marrow transplantation. These divergent results prompted us to conduct a retrospective analysis of two randomized clinical trials conducted at our center to determine the effect of i.v.Ig infusions on the development and severity of VOD. Patients were randomized to receive (n=318) or not to receive (n=315) i.v.Ig prophylaxis after human leukocyte antigen-identical sibling (n=414), mismatched or unrelated (n=178), or autologous or syngeneic (n=41) marrow transplantation. To determine the relationship of i.v.Ig to the development and severity of VOD, a single observer reviewed data displays created for each patient for grading VOD without knowledge of patient i.v.Ig use. In this analysis, VOD was defined as hyperbilirubinemia > or =2.0 mg/dL before day 20 and abrupt weight gain > or =2% before day 14 posttransplant in the absence of other causes of liver disease. Hepatic VOD developed in 235 (37%) of the 633 randomized patients. No evidence for VOD was found in 230 (36%) patients. The remaining 168 (27%) patients were classified as having liver disease of uncertain etiology. Hepatic VOD was judged to be severe in 63 (10%) and mild or moderate in 172 (27%) patients. The number of patients developing any VOD or severe VOD was similar between those randomized to i.v.Ig prophylaxis and untreated controls (115 vs. 120 and 32 vs. 31, respectively). Logistic regression models identified several covariates as significant (p < 0.01) factors associated with the development of severe VOD. Increased risk occurred with elevated pretransplant serum aspartate aminotransferase (odds ratio [OR] = 2.64) and earlier year of transplant (OR = 3.73); decreased risk occurred with autologous or twin donors (OR = 0.09) and acute myeloid leukemia (OR = 0.39). The development of any VOD was associated with an elevated pretransplant alkaline phosphatase (OR = 4.1), pretransplant use of vancomycin (OR = 1.6) or amphotericin (OR = 3.0), posttransplant use of cyclosporine (OR = 2.5), older patient age (OR = 1.03), and obesity (OR = 0.78). We concluded from the controlled trials of 633 patients that the administration of i.v.Ig did not influence the development or severity of VOD after bone marrow transplantation.
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PMID:Intravenous immunoglobulin and the risk of hepatic veno-occlusive disease after bone marrow transplantation. 970 88

A 66 year-old obese woman with arthrosis, self-medicated with oral nimesulide, 200 mg daily. After 6 weeks she developed nausea, jaundice and dark urine. Two weeks later she had recurrent hematemesis and was hospitalized. Besides obesity and anemia her physical examination was unremarkable. An upper GI endoscopy revealed 3 acute gastric ulcers and a 4th one in the pyloric channel. Abdominal ultrasonogram showed a slightly enlarged liver with diffuse reduction in ecogenicity; the gallbladder and biliary tract were normal. Blood tests demonstrated a conjugated hyperbilirubinemia (maximal total value: 18.4 mg/dl), ALAT 960 U/l, ASAT 850 U/l, GGT 420 U/l, alkaline phosphatases mildly elevated, pro-time 49% and albumin 2.7 mg/dl. Serum markers for hepatitis A, B and C viruses were negative. ANA, AMA, anti-SmA, were negative. Ceruloplasmin was normal. A liver biopsy showed bridging necrosis and other signs of acute toxic liver damage. Gastric ulcers healed after conventional treatment and hepatitis subsided after 2 months leaving no signs of chronic liver damage. The diagnosis of toxic hepatitis due to nimesulide was supported by the time-course of drug usage, sex, age, absence of other causes of liver disease, a compatible liver biopsy and the improvement after drug withdrawal. Peptic ulcers or toxic hepatitis have been previously described as independent adverse reactions in patients taking nimesulide or other NSAIDs but their simultaneous occurrence in a single patient is a unique event that deserves to be reported.
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PMID:[Bleeding gastric ulcers and acute hepatitis: 2 simultaneous adverse reactions due to nimesulide in a case]. 1122 44

Women with preexisting diabetes are at increased risk of adverse pregnancy outcomes and birth defects. Women with gestational diabetes are at increased risk for adverse outcomes, including neonatal hypoglycemia, hyperbilirubinemia, macrosomia, increased risk of obesity and diabetes in the offspring later in life, and increased risk for other maternal comorbidities. Studies have shown that tight glycemic control before and during pregnancy can decrease the risk for adverse outcomes, congenital malformations, and maternal complications resulting from maternal preexisting diabetes. It is important to identify women with gestational diabetes and provide interconception care to minimize the risk of a future pregnancy complicated by type 2 diabetes. To reduce the risk of adverse consequences for both the woman and her baby, it is important to effectively manage diabetes before, during, and after pregnancy. Several professional organizations have developed guidelines in an effort to establish some consistency in the diagnosis and treatment of diabetes and to decrease the risk of adverse outcomes. The objectives of this paper are to (1) compare the guidelines for women with preexisting (types 1 and 2) and gestational diabetes available to healthcare providers in the United States, highlighting the similarities and differences among them, and (2) discuss how differences among the guidelines might affect efforts to address the challenges of controlling and preventing diabetes and resulting complications during pregnancy.
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PMID:Comparison of guidelines available in the United States for diagnosis and management of diabetes before, during, and after pregnancy. 1767 49

News that a woman with diabetes is about to deliver brings up images of a macrosomic infant. This infant may experience birth injuries, asphyxia, respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia, polycvthemia/hyperviscosity syndrome, asymmetric sepral hypertrophy, and other congenital malformations. Uncontrolled diabetes has profound effects on embryogenesis, organogenesis, and fetal and neonatal growth, and evidence increasingly indicates that some of these effects are lifelong and may contribute to adult obesity. Preconception control of diabetes and monitoring throughout pregnancy are important in reducing the impact of diabetes on the fetus and newborn.
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PMID:Infants of diabetic mothers: the effects of hyperglycemia on the fetus and neonate. 1792 58


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