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

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

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

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

Twenty-seven women referred to a sleep disorders clinic for symptoms of obstructive sleep apnea syndrome (OSAS) during one year were systematically analyzed after polygraphic monitoring of sleep and cephalometric x-ray examination. Our subjects, one-third of whom were premenopausal, comprised approximately 12 percent of the total OSAS population seen. Women with OSAS were compared with 110 OSAS men and with a group of 16 women without OSAS but referred to orthodontists for mild dental malocclusion. Women with OSAS were massively obese, much more so than their male counterparts. There was no significant difference between pre- and postmenopausal women, with the exception of the respiratory disturbance index (RDI), which was lower in the postmenopausal group despite similar morbid obesity (seemingly better tolerated by women with OSAS than by men with the same syndrome) and long mandibular plane-hyoid bone distance. The significantly higher RDI noted in premenopausal women, despite equally massive obesity and upper airway abnormalities, is thought to be related to hormonal status and better arousal response. Chronic obstructive lung disease (COLD) seen in a subgroup of women with OSAS did not differentiate this subgroup from the other OSAS patients when oxygen saturation during sleep, frequency of abnormal respiratory events and sleep variables were considered. Massive obesity is the dominant factor for the appearance of OSAS in women.
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PMID:Women and the obstructive sleep apnea syndrome. 333 38

Described is a 67-year-old man whose initial symptoms evoked an obesity-hypoventilation syndrome. Polysomnography showed hypopneas associated with O2 desaturation episodes, and no apnea; maximal changes were noted during REM sleep. A few months later, in spite of marked weight loss, acute alveolar hypoventilation occurred and necessitated mechanical ventilatory support. Tracheostomy was performed. The patient appeared to be dependent on nocturnal ventilatory assistance. Diaphragmatic paralysis was noted in addition to clinical and electrodiagnostic evidence of amyotrophic lateral sclerosis. While the patient was not ventilated, a nocturnal recording of SaO2 again revealed desaturation episodes partly corrected by O2 2 L/min administered through the tracheostomy tube. With volume-controlled ventilation, desaturations completely disappeared, although no oxygen enrichment of the air was provided. We speculate that sleep disorders with hypopneas and O2 desaturation episodes were the initial symptoms of amyotrophic lateral sclerosis. This leads us to suggest that nonspecific respiratory muscle fatigue frequently seen in COPD might be included in the hypothetic causes of nocturnal hypoxemia.
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PMID:Amyotrophic lateral sclerosis presenting with sleep hypopnea syndrome. 337 Nov 13

More than 30 million Americans are disabled. Wide experience has shown that these conditions do not prevent these individuals from becoming proficient in the knowledge and skills of CPR. Instructional materials and methods can be modified to help this special population learn CPR despite handicaps. The American Heart Association has supported these special efforts since 1978, but no comprehensive resource exists for CPR instructors interested in helping the "physically challenged" individual learn CPR. This article addresses general and specific suggestions for teaching selected handicapped populations. They are: hearing impaired, visually impaired, other physical impairment such as obesity, chronic obstructive pulmonary disease, arthritis, angina, and other medical conditions that may limit one's ability to learn the psychomotor skill of CPR.
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PMID:Teaching and credentialing the physically challenged: state of the art. A review of change in the clinical and scientific data since 1980. 353 65

Hypoxia is the major cause of pulmonary hypertension and right ventricular hypertrophy in chronic obstructive pulmonary disease, cystic fibrosis, kyphoscoliosis, chronic mountain sickness, and the obesity-hypoventilation and sleep apnea syndromes. Pulmonary hypertension develops in these patients because the long-standing vasoconstriction produced by hypoxia causes muscular hypertrophy of the pulmonary arteries and arterioles. These pathologic changes may regress if alveolar hypoxia is corrected and hypoxic pulmonary vasoconstriction is continuously inhibited. Intermittent inhibition of hypoxic pulmonary vasoconstriction does not reverse these pathologic changes. Since patient noncompliance with oxygen therapy makes it difficult to achieve continual relief of alveolar hypoxia, a drug that inhibits hypoxic vasoconstriction may be useful. Experimental findings indicate that hypoxic pulmonary vasoconstriction requires calcium influx and can be inhibited by certain slow-channel calcium blockers. Studies also demonstrate that slow-channel calcium antagonists can attenuate the pulmonary hypertension and right ventricular hypertrophy produced in rats by chronic hypoxia. Recently, two studies have shown that nifedipine inhibits hypoxic pulmonary vasoconstriction in patients with chronic obstructive pulmonary disease. If further studies demonstrate that these short-term effects are sustained, certain slow-channel calcium blockers may become a useful adjuvant to low-flow oxygen therapy in the treatment of hypoxic pulmonary hypertension.
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PMID:Calcium channel blockers in hypoxic pulmonary hypertension. 397 91

An analysis of the records of 2130 patients who consecutively underwent median sternotomy with or without cardiopulmonary bypass showed that sternal insufficiency necessitating refixation of the sternal plates developed in 12 patients (0.56%). This complication arose during the initial hospital stay in 11 patients, but in one patient the sternal instability appeared about a year after the operation. Re-exploration showed interruption of the stainless steel wires in six cases. In the other cases the wires had loosened, or knots had opened, or wires had cut through the sternal bone. All 12 patients had undergone open-heart surgery. The commonest risk factors for sternotomy dehiscence were excessive blood loss with heavy transfusion requirements, and postoperative wound infections. Other factors were respiratory complications and postoperative ventilatory support, low cardiac output syndrome, chronic obstructive pulmonary disease and obesity. Careful closure of the sternum, using figure-of-eight sutures if necessary, and avoidance of excessive application of bone wax are important for preventing this harmful complication.
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PMID:Postoperative median sternotomy dehiscence. 635 93

Forced vital capacity (VC) and forced expiratory volume at 0.75 s (FEV) were measured in 592 Cretan island men aged 25 to 74 in 1960, 1965, and 1970. Vital capacity and FEV were directly correlated with height, but percentage changes were unrelated to height. A prominent accelerating decrease with age was also observed, the longitudinal decrement becoming more marked with advancing age. Chronic obstructive lung disease at entry significantly accelerated the loss of lung capacity, more so for emphysema than for chronic bronchitis. Among heavier men, body weight gains intensified the age-dependent loss of vital capacity and FEV. Borderline statistically significant differences in FEV decreases (adjusted for age, height and entry FEV) were seen between cigarette smoking groups. Heavy smokers had more diagnoses of chronic bronchitis and emphysema. Modifiable factors in minimizing the decrease of lung capacity with age include obesity, obstructive lung disease, and smoking, the last through development of chronic obstructive lung disease.
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PMID:Longitudinal versus cross-sectional vital capacity changes and affecting factors. 661 Jun 99

500 adult Nigerian patients presenting for elective general surgery under anesthesia were studied with regard to age, sex, obesity, smoking and drinking habits and associated medical diseases. The results showed equal sex distribution with 60% of the patients in the 21-40 years age group. About 30% of the patients (predominantly females) were obese. Smoking and drinking habits were relatively low especially in the females. About 25% of the patients have associated medical disorders of which hypertension and anemia were the commonest. Chronic obstructive lung disease and atherosclerotic heart disease were relatively uncommon. Multiple drug therapy was not a problem in this series.
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PMID:A study of certain personal details of adult Nigerian patients presenting for elective general surgery under anesthesia. 667 91


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