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

Exercise merits special consideration in caring for postmenopausal women, who face both the normal physical decline accompanying aging and climacteric changes resulting from diminished ovarian function. Regular physical exercise may decrease a woman's risk of developing several medical illnesses, including osteoporosis, cardiovascular disease, obesity, and depression. Moreover, regular exercise has been shown to have a beneficial effect on flexibility, coordination, mood, and alertness. Physicians bear a special responsibility in encouraging and motivating their older patients. At this juncture in their lives, many postmenopausal women seek guidance and assistance from their doctors.
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PMID:Exercise in the postmenopausal woman. 380 30

We performed iliac bone histomorphometry after in vivo double tetracycline labeling 3-14 years after intestinal bypass surgery for obesity in 21 patients, selected because of clinical suspicion of metabolic bone disease, and compared the results with those of 40 age-matched normal control subjects. Osteomalacia defined by rigorous kinetic criteria was found in six cases, histologic features of secondary hyperparathyroidism without significantly impaired mineralization in one case, and possible osteomalacia masked by impaired matrix synthesis in one case. In the patients with definite osteomalacia, nonfracture bone pain was more frequent, corrected plasma calcium lower, plasma alkaline phosphatase and magnesium higher, and secondary hyperparathyroidism more severe than in the other patients. In the patients without osteomalacia there was a 24.5% reduction in trabecular bone volume compared to the controls; in contrast to age-related bone loss and post-menopausal osteoporosis, this was due mainly to reduction in the thickness rather than the density of trabecular plates. About two-thirds of the reduction in trabecular thickness was due to reduction in interstitial bone thickness, representing the cumulative effect of increased depth of osteoclastic resorption cavities, probably due in part to secondary hyperparathyroidism. About one-third of the reduction in trabecular thickness was the result of reduced mean wall thickness, representing insufficient osteoblastic matrix synthesis, probably due in part to malabsorption of an unidentified nutrient necessary for normal bone health. Resorption indices were not increased at the time of the biopsy, but there were persistent defects in the recruitment and activity of osteoblasts. Clinically significant bone loss after intestinal shunt surgery, as in several other clinical situations, results from the combined effects of an unsustained increase in bone resorption and a sustained decrease in bone formation.
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PMID:Metabolic bone disease with and without osteomalacia after intestinal bypass surgery: a bone histomorphometric study. 384 Mar 79

We have evaluated radial bone mass and sex steroid concentrations in a group of postmenopausal white type 2 diabetics, that group at greatest risk of developing osteoporosis. The linear regression of midshaft bone mass on age for 79 patients showed a rate of loss about half the rate for normals. These data suggest that bone is lost at a slower rate by this group, and the difference cannot be explained by obesity or glucose control alone. A subset of 40 of these subjects was chosen for further study. As expected, these women had significantly higher bone mass than normals; in addition, they were significantly heavier (82.4 +/- 2.7 kg v 65.3 +/- 1.8 kg, P less than .001), and had higher body mass index (32.1 +/- 1.0 kg/m2 v 25.2 +/- 0.6 kg/m2, P less than .001), than controls. Serum estrone concentrations were higher (49.8 +/- 3.7 pg/mL v 28.5 +/- 1.8 pg/mL, P less than .001); serum androstenedione (0.28 +/- 0.03 ng/mL v 0.51 +/- 0.04 ng/mL, P less than .001), and serum testosterone (0.18 +/- 0.02 ng/mL v 0.26 +/- 0.02 ng/mL, P less than .02) concentrations were lower among diabetics than controls. Serum estradiol (15.1 +/- 1.7 pg/mL v 15.3 +/- 1.0 pg/mL, P greater than .5) was not significantly different. Multiple regression analysis indicates that the excess level of estrone concentration among diabetics increased with the degree of obesity. The explanation for the lower concentration of the other sex steroids among diabetics is not known.
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PMID:Bone mass and sex steroid concentrations in postmenopausal Caucasian diabetics. 399 76

Seventy-seven calcium balance and 47Ca turnover studies were performed in normal volunteers (n = 15) and in patients with osteoporosis (n = 12), primary hyperparathyroidism (n = 8), osteogenesis imperfecta (n = 5), medullary carcinoma of the thyroid (n = 4), thyrotoxicosis (n = 2) and intestinal bypass for obesity (n = 11). After intravenous injection of 20 microCi of 47Ca two retention curves of 47Ca were obtained: R1(t) directly measured on a whole-body counter and R2(t) calculated from the cumulated daily excretions of 47Ca in urine and faeces. The data were fitted to a modification of the continuously expanding exchangeable calcium pool model. Dermal calcium loss was estimated from the serum 47Ca specific radioactivity curve and the constantly increasing difference between the two retention curves. The median dermal calcium loss in 77 studies was 1.50 mmol 24 h-1 1.73 m-2 (range 0.13-4.60). The dermal calcium loss might be overestimated by redistribution of tracer or by eventual insufficient collection of urine and faeces. The possible influences of these errors have been evaluated. Patients with primary hyperparathyroidism had a greater (P less than 0.02) dermal calcium loss (2.64 mmol; range 0.80-4.50) than a control group (1.38 mmol; range 1.25-2.34).
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PMID:Calcium metabolism evaluated by 47Ca kinetics: estimation of dermal calcium loss. 641 10

We studied 41 patients who had gastric bypass for obesity from 1974-1979. The procedure was well received by patients and most achieved adequate weight loss, but most subjects consumed inadequate diets and many developed iron and/or vitamin B12 deficiencies. Ten were anemic and 13 had been treated previously for postbypass anemia. Severely vitamin B12-deficient subjects did not respond to 50 micrograms oral vitamin B12 tablets, but those with milder deficiencies usually did. Schilling tests were usually abnormal and corrected when intrinsic factor was given. Many subjects developed manifestations compatible with osteoporosis due to inadequate calcium intake and absorption, and some also developed abnormal laboratory tests suggesting coexisting osteomalacia. Hematopoietic complications of gastric bypass can usually be prevented and are relatively easy to treat, but musculoskeletal complications may be more difficult to prevent and treat.
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PMID:Late effects of gastric bypass for obesity. 650 7

Risk factors for vertebral fractures due to osteoporosis were evaluated in 105 consecutive male patients over a four-year period. An equal number of men with Paget's disease, matched by age, who concurrently attended the same subspecialty clinic served as control subjects. The relative risk for osteoporosis, estimated by the odds ratio, was increased among those who smoke cigarettes (relative risk = 2.3; p = 0.01), drank alcoholic beverages (relative risk = 2.4; p = 0.02), or had an associated medical disease known to affect calcium or bone metabolism (relative risk = 5.5; p less than 0.001). Obesity was protective (relative risk = 0.3; p less than 0.001). As assessed by a multiple logistic model, the risk associated with smoking and drinking increased with age. The effects of these four major risk factors were largely independent of one another and were cumulative. Thus, spinal osteoporosis in men is frequently associated with recognizable risk factors, some of which are potentially remediable.
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PMID:Risk factors for spinal osteoporosis in men. 665 May 52

We have carried out a prospective survey of 25 cases of male hypogonadism attending one hospital, and a retrospective study of 73 men attending other endocrine clinics in Manchester. In total, 47 had pituitary disorders, 15 isolated gonadotrophin deficiency (including 4 with Kallmann's syndrome), 10 testicular atrophy of unknown cause, 12 testicular damage, 10 with Klinefelter's syndrome, and 4 had miscellaneous disorders. Our survey emphasises the importance of adequate history and examination. Most patients presented with reduced libido, with marital problems in 62% of married men. Less common problems were facial flushing, osteoporosis and gross obesity. Several patients with pituitary disorders were asymptomatic, even in the presence of visual field defects. Klinefelter's syndrome, and testicular atrophy, may present with infertility or gynaecomastia rather than symptoms of androgen deficiency. On examination, the presence of gynaecomastia or obesity were of no help in differential diagnosis, whereas visual field defects clearly indicated a pituitary cause. Measurement of height/span was of little help. The precise diagnosis was usually established with basal plasma LH, FSH, testosterone and prolactin, with karyotype and pituitary radiology, and without more elaborate dynamic hormone tests. Testosterone esters given by intramuscular injection as "Sustanon 250" was the most commonly used replacement therapy. Improved libido usually resulted. Side-effect occurred in 10%, usually as muscle cramps, pain at the injection sites, acne, or excessive sex drive. One tragic case illustrates the potential dangers of androgen replacement therapy in an unrecognised psychopath, and where doubt exists a psychiatric opinion should be sought before starting therapy.
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PMID:Clinical aspects of androgen deficiency in men. 689 Jul 81

We are presenting a series of 23 patients with Cushing disease selected from a larger study in which the ectopic production of ACTH (paraneoplastic or tumoral), adrenal adenoma or carcinoma were discarded. Sixteen were female and seven male. Diagnosis was fundamentally realized by clinical manifestations derived from hypercortisolism (obesity, muscular atrophy, diabetes, osteoporosis or polyglubulia). The polytomography demonstrated a deformed sella in 19 patients. Endocrine exams showed an alteration in rhythm of Cortisol and elevated levels of urinary metabolites. Others exams, Liddle Test, Metopirona Test, or stimulation of exogenic ACTH did not always permit diagnosis of pituitary adenoma. Plasmatic dosage of ACTH is the best test although results did not always agree with clinical manifestations. In each case we performed clinical treatment in preparation for surgery and later selective removal of adenoma or total pituitary ablation by transphenoidal approach. Of 21 patients, we found an adenoma during surgery in 15; the other 6 on whom we performed a total hypophysectomy, the pathological study showed an adenoma in 5 and a hyperemic gland with thick capillaries in 1. Another type of treatment was used on 2 due to their age. Nine patients were given post-operative radiotherapy. We conclude that microsurgery by transphenoidal approach offers the best possibilities for patients with Cushing disease.
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PMID:[Surgical treatment in Cushing's disease (authors' translation)]. 731 90

The steadily increasing frequency of breast cancer, especially in elderly women, may be owing to the following three factors, among others: natural aging, the increased use of mammography leading to earlier diagnosis of in-situ carcinoma and occult carcinoma, and the indiscriminate use of hormone replacement therapy (HRT). That there is a correlation of estrogen with breast cancer cannot be refuted. Early menarche, late menopause, late first pregnancy, obesity and dietary factors are directly or indirectly connected with an increased likelihood of breast cancer. The recent flurry of interest in attempting to prevent osteoporosis-induced bony fractures and coronary artery disease among elderly women has not been fully tested as to its efficacy by a scientific, prospectively randomized clinical trial. Therefore, it seems timely to indicate clearly that the use of HRT should be made on an individual basis, with the tacit understanding and approval of the patients, some of whom are symptomatic but the majority of whom have no signs or symptoms of the diseases for which prevention is being advocated.
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PMID:Hormone replacement therapy: boon or bane? 755 58

Etiological factors in finger osteoarthritis are both local (single injury or repetitive joint use) and general. Epidemiological studies, twin studies, and studies of the ethnic influence have established that genetic factors play a role. The disease is more common in postmenopausal women, suggesting an influence of hormonal factors. Findings from studies of associations between finger osteoarthritis and osteoarthritis at other sites (spine, hips, knees), hyperostosis, and obesity, as well as the fact that the disease is less common in patients with osteoporosis and absent in hemiplegia, suggest that the concept of "osteoarthritic disease" is relevant.
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PMID:Etiologic factors in finger osteoarthritis. 758 77


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