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

The rate of radiation-induced side-effects is dependent from exogenous technical and endogenous factors. Widespread endogenous factors are arterial hypertension and other cardiovascular diseases. 130 breast cancer patients were retrospectively evaluated for side-effects to estimate the influence of arterial hypertension. All were treated with mastectomy and irradiation (telecobalt) and consecutively followed. 79 patients had normal blood pressure, 51 showed arterial hypertension. Hypertension proved to be the strongest endogenous factor for the development of side-effects. In contrast to the patients with normal blood pressure those with hypertension showed significant more arm lymphedema (p less than 0.005) and telangiectasia (p less than 0.0001). Other endogenous factors, like cardiovascular diseases or obesity, taken together led only to a higher rate of subcutaneous fibrosis (p less than 0.002). Patients with arterial hypertension should receive axillary radiation only for strict indications and perhaps with a reduced dosage.
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PMID:[Hypertension as risk factor for increased rate of side effects in the framework of breast carcinoma irradiation]. 162 Dec 13

To evaluate the relationship between maximum venous outflow (MVO) of the leg and development of deep vein thrombosis (DVT), venous occlusion plethysmography (VOP) using a Mercury strain gauge was carried out in 56 unilateral DVT patients. The data from these patients were compared with those obtained from several control groups. Then, the relationship between plethysmographic and 9 clinical variables was statistically analysed in the normal legs of these patients. The mean MVO of the normal legs of these patients was significantly higher than that of the affected legs, but it was significantly lower than those of normal controls and patients with mild congestive heart disease. However, it was similar to those in patients with lymphedema and obese men. A decrease in the MVO of the normal legs of these patients was noted in older females with femoral vein obstruction of the left leg, with a shorter number of days from the onset of symptoms or with higher values for the obesity index and calf circumference. Significant correlations between the MVO and the obesity index (r = -0.59), venous capacitance (VC, r = 0.49) and the number of days from the onset of symptoms (r = 0.40) were found in the normal right legs of these patients (n = 40). In the normal left legs (n = 16), on the other hand, significant correlations were found between the MVO and the VC (r = 0.65) and the MVO and age (r = -0.65).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Maximum venous outflow and development of deep vein thrombosis. 203 May 45

The use of a single axial slice through the mid calf in the differential diagnosis of a swollen leg is described. This is a very simple quick non-invasive investigation. Venous obstruction results in an increase in the cross sectional area of the muscle compartment. The subcutaneous fat layer is normally homogeneous; in obesity or lipoedema it is increased but remains homogeneous. In lymphoedema fluid collects in the interstitial spaces which become very prominent on CT images. In chronic lymphoedema a honeycomb pattern is seen as a result of increase in the interstitial tissue due to fibrosis. Popliteal cyst extensions result in fluid collections between muscle planes. Haematomas have higher attenuation, and are intramuscular. The findings in 64 patients and 10 controls are presented and the literature is reviewed.
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PMID:CT of swollen legs. 229 62

Fourteen individuals with the Turner syndrome (gonadal dysgenesis with X chromosome chromosome abnormalities) were evaluated for obesity using hydrostatic weighing and skinfold measurements. While skinfold estimates of body fat correlated well with clinical impression, hydrostatic weighing appeared to falsely overestimate percent body fat. We suggest that reduced skeletal mass and/or occult lymphedema in Turner syndrome may invalidate the formula used to calculate percent body fat derived from hydrostatic weights. In this population and possibly in other disorders where skeletal mass is reduced from the normal, the use of hydrostatic weighing may be inappropriate.
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PMID:Measurement of body fat in Turner syndrome. 372 7

Arm lymphedema (ALE) was evaluated in 74 patients treated conservatively for breast cancer. ALE was defined based upon measurements performed upon 35 volunteer subjects who did not have and were never treated for breast cancer. Multiple variable statistical analysis of 74 breast cancer patients revealed that age at diagnosis was the most important factor related to the subsequent development of ALE. ALE appeared in 7 of 28 patients (25%) 60 years of age or older but in only 3 of 46 (7%) younger patients (p less than 0.02). Axillary node dissection (AND) was the only other statistically significant factor. For the younger patients, obesity and post-operative wound complications appeared to be contributing factors. For the older patients, AND technique was the only significant factor. ALE developed in only 1 of 10 (10%) of the older patients who underwent AND without splitting the pectoralis minor muscle (PMM), but in 6 of 11 (55%) who underwent AND with PMM split (p less than 0.03). Splitting the PMM during AND did not yield more lymph nodes for pathological analysis nor did it yield a higher incidence of patients with nodal metastases. Neither the use of lymph node radiation therapy fields, radiation to the full axilla, nor systemic chemotherapy was associated with ALE. We conclude that older patients are at higher risk of ALE and that this complication can possibly be reduced by not splitting the PMM during axillary node dissection.
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PMID:Arm lymphedema in patients treated conservatively for breast cancer: relationship to patient age and axillary node dissection technique. 379 44

Massive scrotal edema is an unreported complication of abdominoplasty. This patient's postoperative decompensation of medial thigh and scrotal lymphatic return may well have been due to an occult lymphedema tarda or previously compromised lymphatics from the fibrosis of venous stasis disease and obesity.
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PMID:Massive scrotal edema as a complication of abdominoplasty. 403 83

An acute inflammatory exacerbation is the most frequent complication of lymphoedema. The provoking cause may be trauma. Favouring factors are obesity and heat. 1/3 of patients suffer from such acute inflammatory exacerbations. The onset is sudden, with fever, redness, pain and local heat. After repression of the acute, inflammatory episode, the oedema is often increased. Treatment involves antibiotics, corticosteroids, vaccinotherapy and bed rest. It is possible to prepare sequential treatment, drug prevention with general and dietary measures.
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PMID:[Clinical aspects of acute inflammatory exacerbations lymphoedema (author's transl)]. 746 43

Post-mastectomy lymphedema of the upper limb, that can be noticed by 10 to 20 percent of patients with breast cancer, is usually related to some risk factors: use of radiotherapy on the axilla, obesity, venous outflow obstruction, delayed wound healing or infection. The most important contributing factor to postsurgical edema is the development of lymphangitis in the upper limb. Although literature contains numerous accounts on the use of pharmacological agents for the treatment of postmastectomy lymphedema, the results are not satisfactory in term of clinical response and side effects. In the present study we investigate tolerability and feasibility of the use of suledexide in patients, submitted to mastectomy for breast cancer, with an initial lymphedema of the limb omolateral to surgery or other risk factors for the development of a clinical remarkable lymphedema. Our results show that sulodexide is a very satisfactory therapy in term of lack of side effects and good compliance.
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PMID:[Sulodexide in the prevention of post-mastectomy lymphedema]. 767 95

Morbid obesity is a chronic disease that manifests as a steady, slow, progressive increase in body weight. Because of both emotional and physical reasons, obese people resist pursuing healthcare and may be more difficult to care for. In taking a practical approach to skin and wound care, using an interdisciplinary team is valuable. Difficulty in assessment stems from problems such as equipment that is too small or as patient uncooperativeness. Skin/wound problems which are common, yet more difficult to manage for these patients, include pressure ulcers, tracheostomy care (potentially resulting from ventilatory insufficiency), candidiasis, tape-related skin tears, incontinence and lymphedema. In order to offer care and support to these patients and their families, clinicians must acknowledge and manage any personal prejudice they may have toward this patient population. A comprehensive patient-focused plan of care is the goal. With this article are included four annotated suggested readings introducing topics such as the failure of behavioral and dietary treatments for obesity, theoretical and practical aspects of obesity assessment, current views on obesity (such as a move back to pharmacotherapeutic treatment), and the psychological aspects of severe obesity.
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PMID:Morbid obesity: a chronic disease with an impact on wounds and related problems. 923 36

Elephantiasis nostras verrucosa is a rare, chronic, deforming disorder characterized by hyperkeratosis and papillomatosis of the epidermis with underlying woody fibrosis of the dermis and subcutaneous tissue. Chronic lymphedema, either congenital or secondary to infection, surgery, radiation, neoplastic obstruction, obesity, portal hypertension, or chronic congestive heart failure, plays a pivotal role in the pathogenesis. Without appropriate intervention, the slowly progressive cutaneous changes will culminate in massive and grotesque enlargement of the affected body region. In the following case report, the natural history and the management of elephantiasis nostras are discussed.
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PMID:Elephantiasis nostras verrucosa. 971 2


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