Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Transvaginal ultrasonography has provided new anatomic and pathophysiologic information about the female pelvis. Because of probe proximity to the organ of interest and higher insonating frequency, resolution is dramatically improved. Problems previously encountered during transabdominal scanning, such as obesity, bowel gas, and a retroverted uterus, no longer preclude accurate diagnosis. Patient acceptance is nearly universal. Physiologic information concerning the endometrium and ovarian follicles has improved infertility diagnosis and treatment. Hormonal and vascular Doppler changes can be correlated with cyclic endometrial patterns and follicle size. Oocyte retrieval, management of pre-existing inflammatory disease, and treatment of complications of pregnancy are easier and safer with a transvaginal approach. Uterine malformations, leiomyomas, and cancers are more easily detected in premenopausal and postmenopausal women. The documentation of early intrauterine or ectopic pregnancy has decreased maternal morbidity and mortality. Tube-sparing procedures with preservation of reproductive potential are now more commonly employed due to earlier recognition of unruptured tubal pregnancy. Interventional TVS has led to improved recognition and treatment of pelvic cysts and abscesses and multiple pregnancy. Chorionic villous sampling can be performed more easily without the need for anesthesia, with adequate tissue obtained.
 ...
PMID:Transvaginal ultrasonography. 151 39

The overall risk of oral contraceptive (OC) use is minimal when women over 35 years of age, smokers, and those with multiple risk factors (thromboembolic disorders, cerebrovascular or coronary artery disease, liver tumors, breast cancer, estrogen-dependent neoplasms, undiagnosed abnormal genital bleeding, and congenital hyperlipidemia) are excluded. OC use increases the risk of hypertension by 1-5%, depending on age, parity, and duration of use, but even this small risk is decreased when multiphasic OCs are prescribed. Deep venous thrombosis in the leg is 4 times more prevalent in OC users than nonusers and the risk of superficial thrombosis is doubled. Again, fewer thromboembolic complications occur when the estrogen dosage is low. The risk of myocardial infarction is not believed to increase with OC use as long as other risk factors--smoking, obesity, hypertension, age over 35 years, hypercholesterolemia--are not present. Studies involving the original high-dose OCs revealed a 3-fold increase in the risk of thrombotic stroke and a 2-fold increase in the risk of hemorrhagic stroke, but low-dose OCs appear to have no effect on the potential for stroke. The impact of OC use on breast cancer cannot yet be determined given the very long latency period of this cancer. In terms of benign breast disease, OC users have been shown to be at substantially reduced risk of lesions, fibroadenomas, and fibrocystic changes. OCs also protect women from endometrial and ovarian cancer, although the pill seems to accelerate the progression of cervical dysplasia. Other beneficial effects of OC use include reductions in the incidence of pelvic inflammatory disease, endometriosis, ectopic pregnancy, and ovarian cysts.
 ...
PMID:Oral contraceptive pills. Part II: Potential complications and health benefits. 228 19

Surgical sterilization has changed dramatically over the past 20 years; the development of laparoscopy and minilaparotomy have made the procedure readily available even in developing countries. Improved sterilization procedures have resulted in lower costs for sterilization and lowered morbidity and mortality rates. Historically there has been concern that tubal sterilization by any method produces, in significant numbers of patients, the post-tubal ligation syndrome. More recent studies that have controlled for prior gynecologic problems and contraceptive usage have failed to show increased incidence of gynecologic sequelae in large numbers of women, but there are data to support the concept that in certain individuals, sterilization may result in disruption of ovarian blood or nerve supply, producing gynecologic sequelae. Data from the Collaborative Review of Sterilization (CREST) conducted by the Centers for Disease Control from 1978-81 are analyzed. Overall complication rates were 42.8% for abdominal hysterectomy and 24.5% for the vaginal procedure. Postoperative febrile morbidity was the most common complication but 0.8% of the abdominal hysterectomies and 1.6% of the vaginal hysterectomies required repeat exploratory operations. In another series of 5018 women 0.45% had bleeding complications during unipolar cautery, 0.29% required laparotomy. In a series of 846 silastic ring sterilizations, 3.1% had bleeding complications but only 2 of these required laparotomy and 1.6% had complications related to the ring technique. It was also shown by the CREST data that: 1) the use of an IUD 1 month prior to sterilization did not alter the risk of complications, 2) sterilization and removal of an IUD should not be performed at the same time, and 3) the risk of requiring laparotomy to complete the sterilization procedure is greater if the woman has a history of previous abdominal or pelvic surgery or obesity greater than 12% of ideal body weight. Pregnancy after sterilization is more common the 1st year after the procedure with the risk decreasing in subsequent years. 1st-year failures are about 0.18-0.37/100 women years and then fall off to 0.1--0.12/100 woman years in subsequent years. The ratio of ectopic pregnancy among these pregnancies is higher after laparoscopic cautery techniques. Band and clips may be slightly less effective than the use of electrocoagulation or the Pomeroy technique. Resection is associated with a slightly higer risk of mesosalpingeal bleeding.
 ...
PMID:Complications of female sterilization: immediate and delayed. 623 Feb 57

Eleven cases of an unusual endometrial glandular proliferation associated with early pregnancy are reported. All lesions were incidental discoveries in first-trimester gestational endometria (two elective abortions; five spontaneous abortions; three hydatidiform moles; one tubal ectopic pregnancy). Most patients (nine of 11; 82%) were older than 30 years of age; associated clinical features included oligoovulation (two), hypertension (one), and obesity (one). All lesions were small and localized, and displayed similar histological features of variable severity including glandular expansion with smooth external contours; epithelial stratification (4 to 15 layers); cribriforming (focal to extensive); mitotic activity; bland nuclear cytology; and prominent intraglandular calcifications (eight cases; 72%). Although the natural history of these distinctive pregnancy-associated endometrial lesions was unknown, nine lesions were initially classified as benign, and two were interpreted as atypical endometrial hyperplasia or focal adenocarcinoma. Follow-up for an average of 34 months (range, 18 to 56) in nine patients showed no residual endometrial lesion (seven endometrial curettages and two hysterectomies). Three patients followed by curettage have subsequently completed successful pregnancies. This unusual lesion may represent a localized, endometrial proliferation induced by pregnancy; although some endometrial lesions may display striking architectural complexity, follow-up to date suggests a benign behavior.
 ...
PMID:Localized endometrial proliferations associated with pregnancy: clinical and histopathologic features of 11 cases. 759 Jun 98

A set of new guidelines were formulated by an expert group meeting in Sweden organized by the pharmaceutical office during March 31-April 1, 1993. It contains various methods to avoid an undesired pregnancy and also advice about postcoital contraception. Among barrier methods, the condom is the only reversible method for men with a method failure of 2 and user failure of 10. It protects against gonorrhea, chlamydia, condyloma, herpes simplex, HIV, and hepatitis B. The diaphragm can be used with a spermicide and protects to a lesser degree against chlamydia, gonorrhea, and cervical cancer. The female condom is as effective as the condom. Among spermicides, nonoxynol-9 is not only effective against sperms but also against bacteria, viruses, and certain vaginal and cervical cells. The vaginal sponge is impregnated with nonoxynol-9 and is effective up to 24 hours. The copper IUD, with a method failure of less than 1, can cause profuse menstrual bleeding, dysmenorrhea, and endometritis-salpingitis. Hormonal methods include combination pills (2-phase and 3-phase pills) and gestagen methods (high dose with 150 mg of medroxyprogesterone acetate injection every 3 months and low-dose minipills with levonorgestrel, norethisterone, or lynestrol). Mechanisms of action concern combination pills, gestagen methods, minipills, Norplant, and Levonova. Drug cross reaction can reduce effectiveness. Side effects include bleeding and amenorrhea. Risk-benefit determination is based on health effects. Possible risks are associated with breast cancer, cervical cancer, blood pressure increase, venous thromboembolism, and heart infarction. Various phases of the reproductive age include young women, lactating women, and women in the later part of the reproductive age. Special groups include those who have experienced ectopic pregnancy, infections (candida, sexually transmitted diseases: chlamydia trachomatis, HIV infections), obesity, cardiovascular diseases, diabetes mellitus, tumors of the reproductive organs, liver diseases, migraine, epilepsy, surgery, and handicapped women. Postcoital contraception is used only in need, and methods for postcoital contraception include hormonal method and the copper IUD.
 ...
PMID:[Contraception. Recommendations from a group of experts]. 790 65

In an eight-year old Galloway cow, an ectopic pregnancy with mummification of the fetus which had been assumed because of history and clinical examination of the animal was diagnosed as a "tumor of the adipose tissue" (steatitis) following exploratory laparotomy. Possible problems of obesity in cows of extensively kept breeds are discussed.
 ...
PMID:[Simulation of an extrauterine pregnancy by a fatty tissue tumor in a Galloway cow]. 820 60

Included in this article is a table adapted from World Health Organization medical eligibility guidelines developed to assist practitioners in the prescription of low-dose oral contraceptives (OCs). These guidelines are part of a broader project aimed at improving access to all available methods of contraception without creating unacceptable risk. They were formulated in response to concerns that current practices are based on scientific studies of contraceptive products that are no longer in wide use, the bias of service providers, and a tendency to render relative contraindications absolute. If the presence of a condition creates no obstacle to method use, a Category I rating is assigned. If the benefits of a method generally outweigh the risks, the condition receives a Category 2 rating. Category 3 applies to conditions carrying risks that generally outweigh benefits, while Category 4 applies to conditions carrying unacceptable health risks. Health conditions categorized in association with low-dose OC use are post-abortion, diabetes, superficial venous thrombosis, known hyperlipidemias, headaches, vaginal bleeding patterns, unexplained vaginal bleeding, breast disease, pelvic inflammatory disease, sexually transmitted diseases, HIV/AIDS, viral hepatitis, uterine fibroids, past ectopic pregnancy, obesity, thyroid disorders, trophoblast disease, and sickle cell disease.
 ...
PMID:Increasing access to combination oral contraceptives. 1229 65

Pakistan and other countries with high population growth rates are in need of an acceptable procedure to prevent fertilization and lower birth rates and reduce maternal mortality. Vaginal tubectomy and nonsurgical tubectomy are discussed as forms of female sterilization which may be suitable to women and countries with limited finances. 15,000 cases of vaginal tubectomy have been performed in Pakistan during 1972-92 with a failure rate of 1/1000 and no ectopic pregnancies. Quinacrine nonsurgical procedures have been used on about 4000 case during 1990-93 with no serious complications or side effects; the failure rate is 4% and no ectopic pregnancies have resulted. Vaginal tubectomy is suitable for Pakistani patients who have fatty abdomens and are reluctant to have an abdominal operation. Women also find the absence of an abdominal scar desirable because of the fear of abdominal rupture. Laparoscopic tubectomy is compared to vaginal tubectomy. In laparoscopic sterilization ectopic pregnancy is high for patients who have coagulation and division. Laparoscopic tubectomy case also have more complications than vaginal tubectomy cases requiring laparotomy. Vaginal tubectomy procedures are simple and economical, require short hospitalizations, have short recovery periods, have minimal postoperative discomfort and lower minor morbidity and major complications, and can be combined with other vaginal procedures. Endoscopic procedures may require general anesthesia which carries its own risks, requires sophisticated equipment and operative skill, and is not suitable for obesity; endoscopes are expensive in cost and maintenance. Other types of interval sterilization are not as accepted by women. Culdoscopic tubal ligation and hysteroscopic tubal occlusion are feasible and acceptable alternatives to vaginal tubectomy. Many gynecologists acquired skills in one method, which is used continuously; this makes it difficult to compare methods. Both vaginal tubectomy and quinacrine introduction into the uterine cavity are described as medical procedures.
 ...
PMID:Non-endoscopic surgical contraception (vaginal tubectomy). 1234 33

There was evaluated the risk to health in females employed in shift work, including night shifts. According to the data of periodical medical examinations health indices of 403 females employed in shift work, including night shifts, were compared with indices of 205 females--workers of administrative units of the same enterprise. Overall relative risk (RR) for the health disorder associated with the night shift was 1.2 (95%; confidence interval (CI): 1.09-1.28). A statistically significant increase in risk was observed in relation to uterine fibroids (OR 1.3; 95% CI: 1.06-1.54), mastopathy (OR 1.4; 95% CI: 1.2-1.6), inorganic sleep disorders (OR 8.8; 95% CI 2.6-29.8). At the boundary of the statistical significance there was the increase in the risk for obesity (OR 1.2; 95% C: 0.97-1.39), hypertension (OR 1.2; 95% CI, 0.9-1.5) and endometriosis (OR 1.5; 95% CI: 0.98-2.16). There was revealed an adverse effect of night shifts on the gestation course: ectopic pregnancy in the experimental group occurred 6.6 times more frequently than in the control group (95% CI: 0.87-50.2), and spontaneous abortion--1.7 times (95% CI: 0.95-3.22). The performed study has once again confirmed the negative impact of smoking on women's reproductive health: smoking women in the experimental group compared with the control group smokers had 2.7 times increased risk of uterine fibroids (within 1.06-7.0), the risk in non-smokers was significantly lower--1.2 (0.98-1.4). The findings suggest about a wide range of health problems related to employment on shift work, including night shifts, which indicates to the need for adoption of regulatory and preventive measures aimed to this professional group.
 ...
PMID:[NIGHT SHIFT WORK AND HEALTH DISORDER RISK IN FEMALE WORKERS]. 2662 25

The present authors analyzed patients' backgrounds and pre-surgical findings to clarify the risk factors of rupture of fallopian tubal pregnancy. The surgical findings 113 cases were clearly diagnosed as fallopian tubal pregnancy with or without rupture. Twenty-six cases of fallopian tubal pregnancy were ruptured and 87 cases were not ruptured at the time of operation. The risk factors of fallopian tubal rupture were assessed by Chi-square for independence test and multiple regression analysis. Obesity (BMI over 26), prior birth history, social welfare entitlement, ultrasonography findings of fetal heart movement, and pre-surgical serum beta-hCG level more than 3,000 mIU/ml patient were significantly higher risk in fallopian tubal rupture. Fertility treatment patient were at significantly lower risk for fallopian tubal rupture. Higher beta-hCG levels, especially >3,000 mIU/ml is associated with increased risk of fallopian tubal rupture in ectopic pregnancy.
 ...
PMID:Rupture risk factors of fallopian tubal pregnancy. 2994 26


1 2 Next >>