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

Estrogenic compounds are the most important group of drugs that can induce hypertension. Studies have shown an incidence of significant hypertension amounting to less than 1% after 1 year of taking oral contraceptives and about 2% after 5 years. The ratio of the incidence of hypertension among ''takers'' to that of ''nontakers'' has been assessed at 1.8 by 1 study and 2.6 by another. Small but significant increments in systolic and diastolic pressures can be discerned during the first 2 years of treatment. Cessation of treatment has resulted in pressures returing to pretreatment levels within 3 months. In those previously normal the highest readings during oral contraceptive use were only 155/90 mm of Hg. Severe hypertension is more likely to occur in the predisposed, and malignant hypertension has been reported. Previous hypertension, toxemia of pregnancy, obesity, and nephropathy are predisposing conditions. Although progestagens, used alone, do not cause clinical hypertension the incidence of hypertension associated with an estrogen-progestogen combination was directly related to the dose of progestagen used. Weight gain is often observed in oral contraceptive users and is occasionally accompanied by edema and hypertension. There is a marked increase in the circulating level of renin substrate (angiotensinogen) which is caused by the estrogen component of the pill. The increase in renin substrate is associated with increase in plasma levels of renin activity, angiotensin 2, and aldosterone, together with a fall in plasma renin concentration. The suppression of plasma renin concentration can persist for weeks after stopping the pill. The factors responsible for hypertension are probably intrinsic and may be either neural, vascular, or renal. Patients taking oral contraceptives should have blood pressure checks at 6-month intervals, and more frequently in high risk cases. In the management of those with only mild blood pressure elevation, such patients should change to a preparation with the lowest available estrogen dosage, 30 mcg of ethinyl estradiol, or reserve the method for use during crucial periods of family planning. With moderate hypertension the oral contraceptive should be suspended for 3-6 months. If the blood pressure falls, oral contraceptives should not be resumed but another method recommended. Continuing hypertension requires further study and possibly elective sterilization. Severe hypertension requires withdrawal of the pill, urgent investigation, and treatment. Other drugs may cause hypertension. Management of these patients is outlined. Structural formulae of progesterone, norethisterone acetate, medroxyprogesterone acetate, and norgestrel are shown.
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PMID:Drug-induced hypertension: pathogenesis and management. 18 40

Gestational progress, delivery, postpartum period, fetal outcomes and hemodynamic status are described in 157 women with late toxemia of pregnancy and alimentary obesity. A high incidence of gestational complications and perinatal morbidity warrant a need for a special antepartum care of obese women.
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PMID:[Problem of late toxemia in obesity]. 208 90

This study involved 16 newborns of mothers with excessive body weight and 108 newborns with increased birth weight. Increased weights of the mothers and newborns as perinatal risk factors (RF) were compared with each other and further 31 RF in a total population of 1119 newborns. Maternal obesity correlated with increased birth weight. Further associations of perinatal RF included toxemia of pregnancy, cesarean delivery, contracted pelvis, and neonatal hypoglycemia.
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PMID:[Interrelations between obesity in pregnancy and fetal weight and their correlations with other perinatal risk factors]. 228 51

To examine the influence of obesity on obstetric performance, pregnancy outcome, and lactational performance, 163 mostly moderately obese gravidas were compared with age and parity-matched normal weight subjects. Significantly increased incidences of gestational hypertension, inadequate pregnancy weight gain, cesarean section, postpartum infections, and large-for-gestational age infants were observed in the study group. No significant increase in the incidence of diabetes, toxemia, breech presentation, postpartum hemorrhage, infant morbidity or lactational failure was noted in obese women. The mean birth weight of the infants of obese women was 163g greater than that of the control subjects; no difference was observed in infant length or gestational age. These results, while confirming that obesity is an important risk factor, suggest that methodological aspects of the previous studies may have contributed to magnify the severity of the problem.
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PMID:Complications and outcome of pregnancy in obese women. 252 Feb 81

The relationship between the body weight or weight gain during pregnancy and various obstetrical factors was investigated in 731 patients who delivered in San-ikukai Hospital for in the year 1986. The patients were classified into three groups according to their body weight in non-pregnant states: slender (n = 214), ordinary (n = 379) and obese (n = 138), according to the standard for "The decision diagram for the estimation of obesity and emaciation in Japanese" published in 1986 by the Ministry of Health and Welfare, Japan. Each of these groups was further divided into two groups according to the degree of weight gain during pregnancy (more or less than 15kg). Then, the duration of labor, the blood loss during delivery, the birth weight, the placental weight and the obstetrical abnormalities (prolonged labor, arrested labor, blood loss of more than 500 ml, fetal distress and toxemia of pregnancy) were investigated in these groups. The blood loss, the neonatal birth weight and the placental weight in the obese groups were much greater than those in the ordinary or the slender group (p less than 0.005). However, there was no significant difference in the duration of the labor among these groups. The incidence of obstetrical abnormalities in the obese group was significantly higher than in the ordinary or the slender group (chi 2 = 4.37, p less than 0.05, chi 2 = 5.27, p less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effects of obesity and weight gain during pregnancy on obstetrical factors]. 326 44

The amount of weight that women are advised to gain during pregnancy has changed significantly in the past few decades. In the past, recommendations were aimed at curtailing weight gain because of problems surrounding delivery (i.e., cephalopelvic disproportion or toxemia). More recently, concern for development of maternal obesity has been used to justify curtailed weight gain. Factors that should be considered for determining the appropriate gain for an individual woman are discussed.
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PMID:Weight gain in pregnancy. 364 94

Risk factors for first nonfatal myocardial infarction (MI) in women younger than age 50 years were evaluated in a case-control study of 255 women with MI and 802 controls. The relative risk of MI increased with the amount smoked. The estimated risk of MI for current smokers of 35 or more cigarettes per day was ten times that of women who never smoked; an estimated 65% of MIs were attributable to cigarette smoking. The relative risk of MI increased markedly with increasing levels of total plasma cholesterol and decreasing levels of high-density lipoproteins, and the effects of the two factors appeared to be independent. Other factors significantly associated with MI were hypertension, angina pectoris, diabetes mellitus, blood group A, and a history of MI or stroke before age 60 years in a mother or sibling. Factors not significantly associated with MI were obesity, history of preeclamptic toxemia, and type A personality. Women who were postmenopausal appeared to have a lower risk of MI than premenopausal women of similar ages. Of the identified risk factors, the most prominent was cigarette smoking, a habit that is amenable to change.
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PMID:Myocardial infarction in women under 50 years of age. 664 58

We describe the chronology of hepatic histopathologic alterations in 50 cases of fatal exertional heatstroke related to military training. Five patients who died in the field demonstrated the earliest alterations: fatty change (sometimes microvacuolar), amitotic hepatocellular regeneration, accumulation of hemosiderin, and congestion. In addition, the sinusoids contained polymorphonuclear leukocytes, immature erythroid and granulocytic cells, megakaryocytes, and lymphocytes. Fibrin was not evident. The other 45 patients, who survived up to 8 days following hospitalization, also demonstrated these findings. Microvacuolar fatty change was common in this group of patients, and degenerated hepatocytes resembled Councilman bodies. Coagulative degeneration and submassive necrosis were uncommon. Of those surviving over 12 h, more than half had bile stasis (sometimes ductal), frequently associated with acute cholangitis and ductular proliferation. Regeneration and pigmentary alterations have not been recognized as early hepatic findings in heatstroke, nor have intrasinusoidal bone marrow elements, ductal bile stasis, and acute cholangitis been described. Possible pathogenic factors, other than hyperthermia and sequellae of shock, include obesity, recent illnesses and immunizations, bacterial toxemia, hemolysis, and bone marrow injury.
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PMID:The liver in fatal exertional heatstroke. 667 6

Peripartum cardiomyopathy (PPCM) is a rare, idiopathic, life-threatening disease of late pregnancy and early puerperium, occurring in patients with previously healthy hearts. Risk factors include multiparity, age>30 years, African American race, multiple pregnancies, obesity, hypertension, and toxemia. Signs and symptoms of PPCM resemble systolic heart failure, and it is diagnosed by exclusion. An echocardiogram typically reveals an ejection fraction of <45% and/or fractional shortening of <30%, along with a left ventricular end-diastolic dimension>2.7 cm/m2 of body surface area. Early diagnosis and treatment are important for a successful outcome. Management is similar to other forms of systolic heart failure. Patients with PPCM are at high risk of thromboembolism, and therefore anticoagulation therapy should be considered. The prognosis is variable, ranging from complete recovery, to worsening heart failure requiring cardiac transplantation, or death. Future pregnancies are often discouraged because of the high mortality rate and risk of recurrence.
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PMID:Peripartum cardiomyopathy. 1846 6

Just when vitamin deficiencies were thought to be a "thing of the past" a new vitamin deficiency-that of vitamin D has developed over the past 20 years. Vitamin D works like a hormone being produced primarily in one organ (the kidney) before circulating through the bloodstream to multiple organs where it has multiple effects. The increased prevalence of vitamin D deficiency is due to changes in modern lifestyle-mainly lack of exposure to sunlight and the increased prevalence of obesity that, results in sequestration of this fat-soluble vitamin in adipose tissue. Distance from the Equator and increasing age and skin pigmentation are additional risk factors. In pregnancy vitamin D deficiency can result in low birth weight, pre-term labor, pre-term birth, infections, and pre-eclamptic toxemia. While vitamin D deficiency is classically associated with rickets and osteomalacia, its effects are much more protean.
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PMID:Protean manifestations of vitamin D deficiency, part 1: the epidemic of deficiency. 2160 11


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