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

From 1975 to 1989, 97 patients with ulcer diseases and concomitant obesity were operated on at the Tashkent branch of the All-Union Scientific Surgical Centre, Academy of Sciences of the USSR. The patients with a gastroduodenal ulcer, II and higher degree of morbid obesity accounted for 2.4% of the total number of patients operated on for ulcer disease. Gastric ulcer was diagnosed in 20 patients, a duodenal one--in 77. All the patients were operated on for disease complications. Of them, 36 underwent Billroth-II gastric resection, the remaining patients--Billroth-I gastric resection and truncal vagotomy with drainage operation. The best immediate result was noted after performance of truncal vagotomy with drainage operation. Use of gastric resection in a given category of patients is accompanied by the development of a large number of local and general complications.
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PMID:[Immediate result of surgical treatment of ulcer disease in morbidly obese patients]. 128 36

To determine its efficacy and safety in treating obesity, a silicone-rubber balloon was passed into the stomach of 10 nondieting, obese subjects. In a counterbalanced sequence, the balloon was inflated with 400 mL for 1 mo and deflated for 1 mo. Lower intakes of solid and liquid test meals (NS), significantly slower gastric emptying, and concomitant changes in glucose, insulin, glucagon, and cholecystokinin concentrations consistent with slower emptying resulted during balloon inflation. After balloon inflation, one small gastric ulcer developed, which subsequently healed. Significant weight loss occurred during the second and third week of the inflation period (F[1,9] = 5.0, p less than 0.05). However, the weight loss was small and the significant effect did not continue through the fourth week.
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PMID:Gastric balloon to treat obesity: a double-blind study in nondieting subjects. 218 57

A 54 year old man without pathologic past history but mild hypertension, obesity and gastric ulcer, presented with a syndrome of Wallenberg. He had complained for five days of progressive and diffuse headache. The neurological condition improved initially, but the patient died suddenly two weeks later. Pathological examination showed no significant alteration except for left ventricular enlargement and mild arteriosclerosis. There was a hemodissection (dissecting aneurysm) of the left vertebral artery next to the inferior oliva. It induced a lateral infarct and a limited dorsal infarct at the middle third level of medulla oblongata. Although the location of the arterial changes is usual, their nature is exceptional. The cause of the arterial hemodissection could not be ascertained: fibrous arterial dysplasia, atherosclerosis or congenital abnormalities of internal elastic layer may be discussed. But no definite conclusion can be reached.
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PMID:[Wallenberg's syndrome due to a dissecting aneurysm of the vertebral artery]. 713 26

A case of adrenocortical carcinoma, a 18-year-old female with Cushing's syndrome and later hypoglycemia, was reported. Cushing's syndrome was corroborated by clinical signs of moon face, obesity, hirsutism and amenorrhea as well as by elevated urinary steroid levels. A huge tumor in the right adrenal region weighing 171 g was removed and histologically diagnosed as adrenocortical carcinoma. Shortly after the surgery, urinary levels of steroid excretion became within normal ranges. However, hypoglycemia with elevated levels of urinary steroid appeared in 6 months postoperatively. She died of massive hemorrhage from gastric ulcer. Autopsy revealed a huge tumor in the right hypochondrial region pressing the liver and right kidney. Tumor cells of autopsy material showed much more anaplastic feature than those of surgical one. Several possible mechanisms for hypoglycemia were discussed.
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PMID:Hypoglycemia by adrenocortical carcinoma with Cushing's syndrome. 720 68

The incidence of postoperative wound infections is increased up to 35% after gastroduodenal surgery, when gastric motility and acidity are decreased, as in case of gastric ulcer or cancer, obstruction, bleeding, antacid therapy. The endogenous flora contaminating the operative-site consists of organisms of the oropharynx and the jejunum and includes anaerobes like bacteroides, aerobes like streptococci, staphylococci, E. coli. Antimicrobial prophylaxis is therefore indicated in these high risk patients. All groups of antibiotics have been used, however 1st and 2nd generation cephalosporins are the most effective. A single dose given intravenously just before anaesthesia is recommended, a second dose is advisable intraoperatively when surgery is prolonged or massive blood loss occurs. Antibiotic prophylaxis is also recommended in gastric bypass surgery for obesity, but remains controversial for percutaneous endoscopic gastrotomy.
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PMID:[Antibiotic prophylaxis in gastroduodenal surgery]. 777 99

Patients who undergo a gastric or duodenal operation present challenging problems to the physician. Currently, gastric or duodenal operations are performed to correct peptic ulcer disease and its complications, resect benign or malignant masses, and control obesity. Indications for surgery in patients with peptic ulcer disease include hemorrhage, perforation, obstruction, ulcer intractability, and the inability to exclude malignancy in a gastric ulcer. Neoplasms of the stomach and duodenum require resection, depending on their benign or malignant nature, their location, the extent of disease, and the underlying physiologic status of the patient. Most clinically significant gastroduodenal masses are malignant and require formal anatomic resection, usually with distal or total gastrectomy. Stapling procedures have been shown to be effective in reducing excess body weight with creation of a small gastric pouch to restrict the outlet and cause early satiety, decreased caloric intake, and weight loss. Reliable radiologic findings depend on a thorough understanding of the complex anatomic and physiologic alterations that occur after surgery and familiarity with appropriate techniques of examination. With this background, complications unique to the surgical procedure as well as general complications found in all postoperative patients with be detected quickly and accurately.
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PMID:Evaluation of the postoperative stomach and duodenum. 812 67

The intragastric balloon prosthesis (PBIG) is being used as a mechanical treatment for obesity; an evaluation of its physiopathological implications, efficiency, and complications is still incomplete. In order to investigate in our area the incidence of complications of this endoscopic treatment, we have used the Danish model "Danish Obesity Treatment" (DOT) (Ballobes) inflated with air, in a prospective study in which forty obese patients were treated during three months. We draw the attention upon a gastric ulcer, a spontaneous anal extrusion-migration, and a duodenal ulcer. We establish the safety of the method, the literature is reviewed, we discuss the cause and treatment of these lesions, and we conclude indicating the low morbidity and the absence of major complications such as oesophageal perforation or intestinal obstruction occurring with other prosthesis models.
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PMID:[Complications of the intragastric balloon prosthesis]. 830 55

A 78-year-old individual, who had a previous transthoracic Nissen fundoplication 20 years earlier, presented to our institution with hemoptysis. Initial workup included chest roentgenogram, upper gastrointestinal series, and upper endoscopy, all of which were nondiagnostic. A repeat upper endoscopy diagnosed a gastrobronchial fistula by revealing a large gastric ulcer that penetrated into the lung parenchyma. The patient underwent surgery for takedown of the fistula. One of the most common symptoms associated with gastrobronchial fistula is hemoptysis, although insidious cough, recurrent pneumonia, or gastrointestinal bleeding are also observed. The most useful diagnostic study is an upper gastrointestinal series, which must be read with a high index of suspicion. Gastrobronchial fistula is most commonly a long-term complication from hiatal hernia repair. The most frequently used procedure for repair of this disorder is the Nissen fundoplication. This can be done from either an abdominal or transthoracic approach. When the procedure is done such that the gastric wrap is left above the diaphragm, serious complications can occur. These include gastric ulceration, gastric herniation with gastric outlet obstruction, slippage or perforation of the wrap, and gastrobronchial fistula. Because of these serious complications, the Nissen fundoplication with the wrap left above the diaphragm should only be used in certain situations, such as obesity and shortened esophagus.
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PMID:Unusual presentation of hemoptysis in a 78-year-old with previous Nissen fundoplication. 984 51

The authors' aim in this study was to explore the prevalence, symptomatology, and risk factors for peptic ulcer in a general adult population. Between December 1998 and June 2001, the authors surveyed a random sample (n=3,000) of the adult population (n=21,610) in two communities in northern Sweden using a validated questionnaire, the Abdominal Symptom Questionnaire (response rate=74%). A subsample (n=1,001) of the responders was randomly invited to undergo esophagogastroduodenoscopy and symptom assessment (response rate=73%). The prevalence of peptic ulcer was 4.1% (20 gastric ulcers and 21 duodenal ulcers). Nausea and gastroesophageal reflux were significant predictors of peptic ulcer disease, but epigastric pain/discomfort was not. Six persons with gastric ulcer and two persons with duodenal ulcer were asymptomatic. Eight subjects with duodenal ulcer (38%) lacked evidence of current Helicobacter pylori infection. Five (25%) of the gastric ulcers and four (19%) of the duodenal ulcers were idiopathic (no use of aspirin or nonsteroidal antiinflammatory drugs, no H. pylori infection). Smoking, aspirin use, and obesity were risk factors for gastric ulcer; smoking, low-dose (<or=160 mg) aspirin use, and H. pylori infection were risk factors for duodenal ulcer. Peptic ulcer disease often coexists with atypical symptoms or no symptoms at all, and idiopathic duodenal ulcer may be more common than anticipated.
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PMID:Peptic ulcer disease in a general adult population: the Kalixanda study: a random population-based study. 1655 43

The literature data and our own studies show that in drivers of public transport vehicles, largely intensified work-related risk factors for arterial hypertension, ischemic heart disease, duodenal and gastric ulcer diseases and back pain syndrome are found. These involves occupational risk factors as well as classic ones, such as obesity, limited physical activity or tobacco smoking. Among occupational risk factors, stress induced by the responsibility for assuring public safety in heavy urban traffic, time pressure and contacts with passengers predominate. Other burdens observed in this occupational group include specific, partly forced, position of the body at work and the shift work system. Exposure to chemical agents present in exhaust gas may increase the incidence of cancer at some sites in this group of drivers. Multifaceted burdens occurring in this occupation may impair health, leading to temporary or permanent disability to work. Therefore, there is an urgent need to develop specific preventive programs addressed to this occupational group not only because of economic reasons, but mostly to increase public transport safety.
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PMID:[Selected work-related health problems in drivers of public transport vehicles]. 1678 Jan 75


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