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

The association between oral contraceptives (OCs) and infarction is still not very clear. Only an epidemiological approach and statistical studies of known cases could shed light on the problem. Other risks associatd with OCs include arterial hypertension, obesity, glycoregulation problems, and blood coagulation problems. The association between OCs and the risk of thromboembolism during pregnancy is also not proved. Even if the risk of myocardial infarction is 2.7 times higher for a woman on OCs it is still lower than the risk of cardiovascular diseases or the risk of phlebitis. The physician should be aware of all possibilities before prescribing any oral contraceptives.
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PMID:[Role of estro-progestational compounds in myocardial infarct]. 60 39

3 cases of retinal thrombosis in young patients on oral contraception (OC) are presented. Pathology disappeared completely as soon as the patients changed contraceptive method. Retinal thrombosis can be arterial or venous, but the incidence is not clear. The major complication with treatment with OC is cerebrovascular thrombosis, which also could be arterial or, more rarely, venous. The mechanisms causing such effects are not completely clear; it is known that OC increases hypercoagulability in 25-30% of women on OC, and that it diminishes the antithrombin 111 factor. Risk factors, such as familiar antecedents of thrombosis, phlebitis, obesity, arterial hypertension, smoking, age over 40, are all strong contraindications to OC. The authors also report on the abundant literature on this subject.
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PMID:[Neuro-ophthalmologic accidents caused by hormonal contraception]. 75 8

In a retrospective computerized study of 451 Austin Moore arthroplasties (211 for acute hip fractures and 240 for hip reconstruction), the operative and general complications were correlated with the historical, preoperative, operative, and early and late postoperative factors usually thought to influence the results. Wound complications were significantly associated with diabetes and fracture, obesity and fracture, and procedures lasting two hours or more. General complications showing significant associations were: death or pneumonia with fractures, phlebitis with obesity, and myocardial infarction with fracture. Factors not significantly associated with complications included age, previous hip surgery, time of day of the operation, surgical approach, wound irrigation, use of drains, postoperative anticoagulation, and reaming of the acetabulum.
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PMID:Complications of Austin Moore arthroplasty. Their incidence and relationship to potential predisposing factors. 107 27

The postphlebitic syndrome is a significant management problem that affects a large number of patients. Primary prophylaxis of deep-vein thrombophlebitis would reduce the risk of developing the postphlebitic syndrome and should be considered in high-risk patients. Patients who have had a phlebitis should be monitored with noninvasive tests of the deep venous circulation for the development of venous valve incompetence. Patients with venous hypertension should be placed in compression stockings to prevent the postphlebitic syndrome. In patients who progress to venous ulceration, several aggressive measures must be undertaken. Systemic treatment includes management of obesity, edema, immobility, poor nutrition, and comorbid illnesses. Some patients may require a short hospitalization of bed rest, lower limb elevation, and daily dressings and wound care. Outpatient therapy requires sustained compression of 35 to 40 mmHg at the ankle for many months to allow the ulcer to heal. The standard bandage material is Unna's boots, which is applied every one to two weeks by a trained nurse. Cadexomer iodide is an effective local treatment that helps debride the ulcer and accelerate healing. Finally, pentoxifylline therapy has also been shown to significantly improve the healing of venous ulcers.
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PMID:Contemporary treatment of venous lower limb ulcers. 147 73

This study was designed to identify those total arthroplasty patients at high risk for embolism even while on a proven warfarin prophylactic regimen and to identify the measure of anticoagulation that would be most efficacious in the prevention of pulmonary embolism (PE). A series of 2348 total arthroplasty patients had a preoperative perfusion scan and a postoperative ventilation/perfusion scan. All patients were placed on a low-dose warfarin protocol. Eighty-one patients were identified as having a PE by pulmonary arteriography (incidence of 3.4%). Of these, 89% were asymptomatic and no case was fatal. A control group of 159 patients without PE was used for comparison. Patients older than 65 years of age with a history of genitourinary infection were identified as being at higher risk of PE while on a proven warfarin prophylactic program. These patients may need additional prophylactic measures to reduce the risk of PE. In contrast, patients with a history of phlebitis, PE, obesity, or varicosities were not at excess risk for PE while on warfarin prophylaxis; therefore, no additional prophylactic measures are required. All prothrombin time profiles were within the prophylactic range. Therefore, the actual prothrombin time may not be the critical determinant of the level of anticoagulation or prophylaxis achieved.
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PMID:Pulmonary embolism in total hip and knee arthroplasty. Risk factors in patients on warfarin prophylaxis and analysis of the prothrombin time as an indicator of warfarin's prophylactic effect. 151 7

The records of 487 patients undergoing abdominoplasty combined with closed liposuction of flap and flanks were reviewed regarding complications, revisions, and certain risk factors related to flap necrosis. Six patients developed general nonfatal complications including 1 deep phlebitis and 1 pulmonary embolism. Thirty-nine local complications occurred including 24 cases of flap necrosis, 4 hematomas, 2 dehiscences, 1 abdominal perforation, 1 infection, and 5 cases of seroma. Wide undermining and the "opposite T" incision emerged as significant risk factors related to flap necrosis. Neither the suction procedure nor obesity nor age had significant influence on the slough incidence. Although the present study does not include controls, liposuction does not appear to represent any significant additional risk when performed in connection with abdominoplasty.
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PMID:Abdominoplasty combined with suction lipoplasty: a study of complications, revisions, and risk factors in 487 cases. 183 35

The anamnesis is believed to be poor in identifying patients with pulmonary embolism (PE), but the method of data collection may be critical for inference on this issue. We compared the prevalences of history findings recorded after a free verbal interview (VI) by the referring physicians with those recorded after completion of a standardized questionnaire (SQ) by the admitting physicians in a group of 177 consecutive patients referred to our Emergency Unit with the suspicion of PE (subsequently confirmed in 97). VI data were incomplete in 18 patients. In the remaining 159 patients, prevalences of symptoms and predisposing factors were higher after SQ than after VI. Accordingly, 8 items (obesity, prolonged immobilization, surgery, varicose leg veins, deep venous thrombosis, pleuritic chest pain, and sudden-onset dyspnea) were significantly more prevalent in patients with confirmed PE after SQ, compared to only 2 items (prolonged immobilization and pleuritic chest pain) after VI. When we tested for the agreement between the two methods of data collection, kappa values ranged from high values (for surgery and hemoptysis) to very low values (for prolonged immobilization and recurrent phlebitis). These results show that the use of an SQ could improve the accuracy of collecting clinical data in patients with suspected PE, as they are also consistent in separating patients with PE from those with unconfirmed suspicion of PE. Moreover, it allows the clinician to be alert towards findings which could be missed when not carefully searched for and which may be useful to raise or strengthen the suspicion of this disease.
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PMID:Improvement of screening for pulmonary embolism with a standardized questionnaire. 228 10

This multicenter, prospective, randomized trial of short-term antimicrobial prophylaxis in colorectal surgery was designed to compare the efficacy of a single dose of cefotetan vs. multiple doses of cefoxitin. Of the 403 evaluable patients, 206 received cefoxitin (1 gm intravenously at the beginning of surgery and after 3, 6, and 12 hours, group A) and 197 cefotetan (2 gm intravenously at the beginning of surgery, group B). The two groups of patients were similar in respect to age, sex, obesity, preoperative weight loss, diabetes, type of disease, type, and mean duration of surgery. The abdominal wound infection rate was 11.2 percent in group A and 9.1 percent in group B (difference not significant). The number of patients with infections at nonsurgical sites (respiratory and urinary tract, phlebitis, and septicemia) was significantly greater in group A than in group B (17 vs. 9.1 percent, P less than .05). The mean postoperative hospital stay was similar in both the cefoxitin and cefotetan groups (15.1 vs. 15.9 days). Both regimens were inadequate in preventing infections in the presence of severe contamination of the operative field.
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PMID:Single-dose cefotetan vs. multiple-dose cefoxitin--antimicrobial prophylaxis in colorectal surgery. Results of a prospective, multicenter, randomized study. 264 8

Obesity modifies the tissular anatomy and the mechanical characteristics of the limb. Because of this, there are difficulties in the interpretation of results produced by techniques designed to explore the venous functioning of the limbs. Our work has two main objectives. First of all a retrospective study shows that venous plethysmography is comparably sensitive in the obese patient with regard to the diagnosis of phlebitis (90% in the obese patient; 95% in the non-obese). As regards specific detail, however, it is not as good in the case of the obese patient (88.7% against 97.5%). Another, prospective, study on the normal, that is non-varicose, subject (obese and non-obese), enables us to analyse parameters modified by obesity, certain false positives in venous distensibility.
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PMID:[Difficulties of functional exploration of the veins in the obese. Problems that may be posed in its interpretation]. 322 95

Forty patients with forty-four unicompartmental McKeever metallic uncemented hemiarthroplasties were followed for five to thirteen years (average, eight years). Thirty-nine knees had a medial and five, a lateral arthroplasty. The age at surgery ranged from thirty-two to eight-two years (average, sixty-seven years). At the final follow-up, 70 per cent of the knees were rated as good or excellent. Seventy-nine per cent of the knees in patients who were less than sixty-five years old at the time of surgery were in these categories. Six knees (14 per cent) had required revision to either a unicompartmental or a bicompartmental total knee replacement. The average preoperative and postoperative knee flexion did not change, but knees with initially poor motion improved. The average preoperative flexion contracture of 10 degrees improved postoperatively to 5 degrees. Complications were rare and no cases of infection, peroneal palsy, or clinically detectable phlebitis occurred. Obesity did not seem to adversely affect the outcome. This study indicated that the McKeever unicompartmental metallic hemiarthroplasty can provide an attractive alternative in the treatment of unicompartmental degenerative arthritis when proximal tibial osteotomy is contraindicated or has failed or when the patient is too young, heavy, or active to consider total knee replacement.
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PMID:McKeever metallic hemiarthroplasty of the knee in unicompartmental degenerative arthritis. Long-term clinical follow-up and current indications. 396 10


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