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Query: UMLS:C0028754 (obesity)
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Issuing from the present state of the influence of the basic nutritive substances (protein, fat, carbohydrates) and various nutritive factors discussed again and again (cholesterol, erucaic acid, sodium, calcium/magnesium quotient, pressor amines) on the development of the arteriosclerosis, the indididual factors of influence are critically evaluated. The investigations are getting under way, so that ascertained results are standing beside insufficiently claified or open problems, From the abundance of the observations conclusions are drawn which are of significance for practice. Unfavourable influences of nutrition on the factors of risk (hyperlipoproteinaemia, disturbance of the carbohydrate tolerance, hyperuricaemia, hyperalimentation) and on the manifest diseases (hypertension, diabetes mellitus, uric arthritis, obesity) of the metabolic syndrome which finally contribute to the development of arteriosclerosis are emphasized. In front of this background a clinically and ambulatorily tested basic metabolic diet is described. About 20% of the energy content (kcal or kJ) of this diet are protein, 35% fat and 45% are carbohydrates. The saturated fatty acids lie below 30%, the manifold saturated fatty acids, however, above 20% of the total fat proportion. The cholesterol content is below 400 mg, the purin-nitrogen below 200 mg, and the sodium content is about 2g per day. This diet can be produced for the treatment of persons with normal weight and overweight in different energetic degradations.
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PMID:[Nutrition and arteriosclerosis]. 70

For the past several decades, treatment of primary hypertension has relied chiefly upon the use of pharmacologic agents. Many hypertensive patients are obese. Evidence is accumulating that their hypertension may be reversed by aggressive and comprehensive regimens for weight reduction. Controlled studies are needed to determine whether there may be particular subtypes of obesity which respond more favorably to such management and to evaluate the long-term benefits of the dietary approach.
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PMID:The management of hypertension associated with obesity. 71 66

Risk factors were compared in 300 patients with brain stroke and 120 patients with neurosis or sciatic pains. It was found that arterial hypertension (p = 0.001) and diabetes (p = 0.01) were significantly more frequent in cases of brain stroke. Disturbances of lipid metabolism, tobacco smoking and obesity showed no significant difference. Extracerebral atherosclerosis (p = 0.001) increased the risk of stroke. Coronary arterial disease was most frequent (48.8%), myocardial infarction (8.3%) and calcifications in the aorta (32%) were second and third in frequency. Presence of at least two risk factors may be an indication to prophylactic treatment.
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PMID:[Risk factors in stroke]. 72 25

Exercise testing has a definite role in pediatrics today. Different methods are presented, and the value of maximal exercise with determination of oxygen uptake and blood lactate is stressed. In children with heart disease, exercise testing with precordial electrocardiogram can be of both diagnostic and prognostic value. The cardiovascular function at different intensities of exercise is evaluated, serious dysrhythmias may be revealed, hypertension judged and the effect of drug therapy can be checked by exercise testing. It is an important way in assessing the child's functional capacity after heart surgery in the decision whether she or he should take part in physical education and sports activities and in the choice of profession. It is also of great psychological value to the parents and the patient himself. In children with other chronic diseases, e.g., diabetes, obesity, asthma, neurocirculatory dysfunctions--physical training together with exercise testing is of importance for therapy and rehabilitation.
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PMID:Exercise testing in children. 72 65

We studied the prevalence and the risk factor among the patients of gout in Mexico. Research was conducted in the National Institute of Cardiology and in our private practice. Prevalence of hiperuricemia and gout in the Institute of Cardiology was of 1% (970 out of nearly 100,000 patients). We divided those cases of two subgroups: Reumatology patients (333) and Cardiovascular patients (529). In the first group primary gout was (96.3), and (50.32% in the second. Risk factor was quite different too: nephropathy 9.9%, lithiasis 9.3%, pyelonephritis 2.7%, cardioangiosclerosis 12.9%, aortosclerosis 6.6%, coronary insufficiency 6.3%, myocardial infarction 0.9%, arterial hypertension 24.6% obesity 56.1% and diabetes 9.9% in the Reumatology group; in the Cardiovascular one, nephropathy 14.3%, lithiasis 12.2%, pyelonephritis 7.1%, cardioangiosclerosis 62.7%, aortosclerosis 31.7%, coronary insufficiency 24.9%, myocardial infarction 29%, arterial hypertension 51%, obesity 54.8% and diabetes 20.4%. Among the private practice patients prevalence was of 10.1% (961). In an early age (39 years) in men and a later one for women (53 years). Other characteristics of epidemiology and risk factor are: primary gout 89%, atherosclerosis 5%, coronary disease 4.6%, lithiasis 4.7%, nephropathy 2%, pyelonephritis 1%, obesity 43%, and diabetes 4.6%. In an small group of patients of our private practice we made an exhaustive study of risk factor and the metabolic disorder of lipids. We found the following frequency: 9.3 of nephropathy, 31.2% of lithiasis, 18.7% of pyelonephritis, 68.9% of cardioangiosclerosis, 46.8% de coronary insufficiency, 9.3% of myocardial infarction, 68.7% of arterial hypertension, 68.7% of obesity and 18.7% of diabetes. In the lipid profile we found an increase in triglicerids and prebeta lipoprotein. We have amply discussed the relation between hiperuricemia and pathology considered as a risk factor from the genetic point of view as well as the metabolic and circumstancial aspect. From all that we concluded that risk is multifactorial.
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PMID:[Various epidemiological aspects of hyperuricemia and gout in Mexico: incidence and the cardiovascular risk factor]. 72 44

Clinical, angiological, and biochemical examinations were performed in 981 men and 30 women with organic afflictions of peripheral arteries, and in 411 men and 50 women without any signs of peripheral arterial lesions. Their family histories were thoroughly recorded with particular reference to the occurrence of myocardial infarction, cerebral accidents before and after the age of 60 years, and death of these causes; further, of hypertension, diabetes mellitus, obliterations and gangraenes, in each patient's siblings, parents, and all four grandparents. Furthermore, the significance of positive family history in combination with other risk factors was investigated. Family history can be considered positive with respect to obliterative atherosclerosis when in anyone of the patient's grandparents, parents, or siblings an obliteration of peripheral arteries is present or when anyone of them died of myocardial infarction or apoplexy, especially when aged under 60 years. Presence of several factors in the specified next of kin accelerates the obliterative process in the patient. A positive family history, however, plays no decisive role either alone or in combination with any other single risk factor, but only in combination with two or more other factors, one of which is always tobacco smoking; it is not significant in any combination with obesity.
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PMID:Positive family history as a risk factor of obliterative atherosclerosis. 72 85

Limited weight loss following jejunoileal bypass in 24 diabetic persons who were still distinctly overweight five to ten months after a mean weight decrease of 78 lbs. was accompanied by a return of normal fasting glucose and insulin levels, normal insulin responses, and a decrease in glucose intolerance. The glucose disappearance rate had improved in the majority of the subjects, but only three had attained values in the normal range. Concomitants of the undue hyperglycemia and/or obesity included labile and, rarely, sustained hypertension and/or cardiomegaly. The blood pressure returned to normal but heart size did not change. Electrocardiographic abnormalities noted in about one-half of the patients persisted after the operation. Triglyceride and cholesterol levels decreased. No patients had diabetic retinopathy visible on funduscopy. Proteinuria did not change in three patients. Neuropathy consisting of absent ankle reflexes and/or decreased vibration perception noted in one-half of the subjects persisted despite the improvement in carbohydrate metabolism.
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PMID:Remissions of diabetes mellitus after weight reduction by jejunoileal bypass. 72 40

Blood pressure was measured under standardized conditions in 151 first-grade schoolchildren. The values of this small sample were normally distributed and statistical analysis was therefore performed. The systolic blood pressure of boys and girls was 102.0 +/- 9 mm Hg and the diastolic blood pressure 69.5 +/- 7.3 mm Hg. Boys and girls were also analyzed separately. The data fit in very well those from the literature, and it is concluded that the values from the literature, especially those of the "Task force of blood pressure control", can be used with high probability for Berne and Switzerland as well. Additional findings: The skin thickness of all children and of girls correlates with blood pressure in the normal range. The family history with regard to risk factors is probably only of importance if precise questions are asked, since general inquiries about obesity, myocardial infarction, and hypertension did not yield useful results.
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PMID:[Blood pressure determination in children: normal values for a given age group]. 73 28

Four hundred sixty patients with ischemic heart disease (IHD) were examined: 226 of them--with myocardial infarction; 38--stenocardia, 196--myocardiosclerosis. With age advancing all forms of IHD increase. The incidence of the followed up risk factors progessively increases. Hypertension has the greatest share--56.30 per cent out of all the subjects examined. Second place as regards incidence is occupied by the emotional stress--46.52 per cent. Further they are as follows: heredity--38.91 per cent; tobacco smoking--34.57 per cent, sedentary life--32,83 per cent, obesity--31.52 per cent, overfeeding--30 per cent, hypercholesterinemia--30 per cent, diabetes--17.61 per cent. The significance of the indicated risk factors alarmingly grows, consideration given to their combined effect. An average of 3.18 risk factors fall on patient. In patients with myocardial infarction they are more frequent and appear at an earlier age. Such an accumulation of the noxae upon the contemporary man requires the complex effors of the whole society.
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PMID:[Risk factors in ischemic heart disease patients]. 73 28

Despite frequently good early successes the several therapeutic methods of obesity show in general unsatisfactory long-term results with large numbers of recidivations. Considering non-existing causal-therapeutic possibilities in the present paper in reported on a complex and differentiated therapeutic programme in 549 obese persons. After an initial subtotal fasting cure of ca. 100 kcal/a day with gradual increase of diet in more than half the obese persons an additional differentiated pharmacotherapy was performed. The indications resulted above all from the frequent syntropy with diabetes mellitus (28%), arterial hypertension (23%) and hyperlipidaemia (14%). In 122 test persons (adipose patients with hyperlipoproteinaemia and extremely obese patients without essential factors of risk, respectively) a treatment with 2 x 50 microgram tri-iodothyronine--partly in combination with diuretics--was performed in intermittent and gradually decreasing dosage. Apart from a vast normalisation of the lipid parameters a reduction of weight from 32.6 +/- 14.8 kg could be achieved after 31 +/- 14 months. Of 131 adipose hypertensive patients 74 received additionally diuretics on account of increased water retention with also good long-term results concerning the reduction of weight and normalisation of blood pressure. The biguanides were a therapeutic enrichment particularly in the treatment of adipose elderly diabetics with obligatory diet. Apart from an improvement of the carbohydrate tolerance regularly a more intensive reduction of weight was obtained.
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PMID:[Indications and results of an additional differentiated pharmacotherapy of obesity]. 73 44


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