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

To date, in publications on hamartomas, precocious puberty and laughing seizures have been discussed, but behavioural and cognitive abnormalities have been neglected. Therefore, we report a 14-year-old girl with a proven hamartoma, in which abnormalities of behaviour and cognition played an important role within the somatopsychic complex. In our patient, urinary incontinence during the seizures and psychiatric symptoms, such as eating disorder with obesity, school phobia, antisocial behaviour, withdrawal and cognitive problems (e.g. general slowness, deficiency of cognitive flexibility) came to the fore. The girl had not attended school regularly for almost 2 years, had stayed at home and was overtaxed psychosocially. The seizures and the urinary incontinence improved with drug treatment, but psychiatric difficulties increased and remained untreated until the girl came to a child psychiatric inpatient clinic where drug treatment and behavioural therapy were combined. During well-coordinated neurological and psychiatric treatment the laughing seizures (spontaneous, event-related, psychogenic) decreased and a considerable improvement in psychiatric and psychosocial problems was attained. Consequently, we recommend a close and timely integration of the psychiatric aspects in the treatment of children with hamartomas.
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PMID:Psychiatric disturbances in children with hamartomas: a neglected somatopsychic issue. A case report. 149 56

A new technique for transvaginal closure of the urethra and placement of a suprapubic catheter in 4 patients with total urinary incontinence gave excellent results with all patients remaining dry and accepting the suprapubic catheter. Suspension of the invaginated, closed urethra by sutures, passed through the bladder, is believed to reduce the risk of inadequate healing of the urethra. However, extreme obesity and extensive fibrosis of the periurethral tissue especially with adhesions to the pubic bone are contraindications to the transvaginal approach.
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PMID:Female urinary incontinence treated by transvaginal urethral closure and suprapubic catheter. 263 37

The authors report 1,000 cases (357 cesarean sections, 230 hysterectomies for benign lesions, 157 conservative utero-adnexal procedures, 128 tubal plasties, 58 prolapse or incontinence procedures, 70 cancers) ,of laparotomies performed according to the technique described by Mouchel in 1980, i.e. strictly supra-pubic and transverse, from skin to peritoneum, including section of the rectus abdominis. This incision enables to perform in ideal technical conditions, with a minimal complication rate (3 hematomas, 2 incisional hernias for 1,000), and satisfactory esthetic results, almost all of the gynecological and obstetrical surgical procedures (90% of two among the authors' practice). The only contra-indications are, except for cases of previous median laparotomy, ovarian tumors. Neither the high risk of infection, nor obesity, extended hysterectomy, nor fetal distress, represent contra-indications, which is a definite advantage over the Pfannenstiel incision. As compared with the median incision which at some time offered similar results, the esthetics and mainly the strength of the abdominal wall are markedly superior.
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PMID:[Low transverse laparotomy with rectus abdominus section in gynecology and obstetrics. Apropos of 1,000 cases]. 296 66

In a series of 368 incontinent women who presented to our urodynamic clinic for assessment, 232 (63%) were diagnosed as having genuine stress incontinence, and 136 (27%) as having detrusor instability. Obesity (greater than 20% more than average weight for height and age) was significantly more common in women with genuine stress incontinence and detrusor instability than in the normal population. In those with detrusor instability the body mass index was found to increase with age and parity. In women with genuine stress incontinence the body mass index increased with age and the number of previous incontinence operations; it was higher in nulliparous than in parous women. There was no significant difference between obese and nonobese women in any of the urodynamic variables measured in the two incontinence groups.
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PMID:Obesity and urinary incontinence in women. 334 13

Sixty-three of 303 patients complaining of urinary incontinence and referred to hospital for examination were not treated, but followed for a median period of 33 months. Eighteen did not wish for treatment. The remaining were followed either because they had few subjective symptoms or because of concomitant bronchitis, or obesity, or owing to the fact that urinary incontinence could not be demonstrated during the objective examination. The patients were followed in order to offer treatment should this become necessary and to register the spontaneous progress of the condition. Fifteen of the 18 patients not wanting treatment were seen at follow-up and none had changed their minds with regard to treatment. In the other group, only 8 of 35 patients complaining of urinary incontinence without concomitant disease wished to have treatment and required re-evaluation. Urinary incontinence had been verified primarily in four only. The finding underlines the importance of a careful history and emphasizes the fact that patients with slight symptoms and no objective findings of urinary incontinence rarely develop more severe symptoms.
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PMID:Follow-up of female patients complaining of urinary incontinence. 686 21

Possible aetiological factors for urinary incontinence were examined in a prevalence study among a random sample of 1000 women aged 18 and over. Infective factors were not markedly associated with incontinence but mechanical factors such as parity and obesity were. No association was found, however, between a history of perineal damage at childbirth and incontinence. Women with incontinence had on average a higher score for a 'neuroticism' trait elicited by questionnaire than women without the disorder.
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PMID:Factors associated with urinary incontinence in women. 706 57

The key to restoring urinary continence in the female is to raise the internal vesical neck of the bladder to a position behind the symphysis pubis. The operation which accomplishes this with the least morbidity, the most accuracy and the greatest permanency is endoscopic suspension; it is particularly applicable in patients with obesity, multiple operative failures, radiation incontinence, and severe pelvic fractures. Between December 1973 and May 1979, 203 patients underwent 211 operations with a minimum of six months of follow-up study at final review (November 1979). Twenty per cent of the patients were totally incontinent on referral, and 60 per cent lost urine with minimal activity; only 20 per cent of the patients had typical stress urinary incontinence, requiring coughing or sneezing to lose urine. Among the 203 patients, there were 188 previous operations for urinary incontinence, including 74 Marshall-Marchetti retropubic repairs. Forty-seven patients have been followed for over four years, and 156 patients have been followed for six months to four years. While 138 patients had a previous hysterectomy, 65 patients had not; the presence of the uterus did not affect the results. Urinary incontinence is not an indication for hysterectomy. Ninety-one per cent of the 203 patients were cured of their urinary incontinence by endoscopic suspension of the vesical neck. Technical advantages over the retropubic vesical neck suspensions include the use of monofilament heavy nylon (No. 2), a vaginally placed Dacron((R)) buttress to prevent tearing of the pubocervical fascia, less postoperative morbidity, minimal blood loss, functional measurements and anatomic visualization of a restored vesical neck during the operative procedure, easy access to a surgically difficult pelvis, and simultaneous repair of significant rectoceles or substantial cystoceles through the same operative field.
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PMID:Endoscopic suspension of the vesical neck for urinary incontinence in females. Report on 203 consecutive patients. 742 93

The aim was to study the possible role of obesity in adult female urinary incontinence (UI) etiology. A random population sample of 3114 women aged 30-59 were sent a postal questionnaire concerning urinary incontinence and, among other things, body weight and height. The overall response rate was 85%, and the present analysis comprises 2589 women who gave information about their body weight and height. The period prevalence of all, stress, urge, and mixed stress and urge urinary incontinence (UI) was 17%, 15%, 9% and 7%, respectively. The mean body mass index (BMI) was 22.7 kg/m2. Irrespective of other risk indicators, BMI was positively associated with UI prevalence (OR 1.07 per BMI unit, p < 0.0001). BMI interacted with childbirth in predicting stress UI prevalence, with cystitis in predicting urge UI, and with both in predicting mixed UI. Stress UI turned out to be the UI type most closely associated with BMI.
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PMID:[Overweight and urinary incontinence in women]. 748 64

The aim of the present investigation was to study the possible role of obesity in the etiology of adult female urinary incontinence (UI). A random population sample of 3,114 women aged 30-59 years were mailed a questionnaire concerning UI and, among other things, body weight and height. The overall rate of response was 85%, and the present analysis comprises 2,589 women who supplied information about their body weight and height. The period prevalence of all UI, stress UI, urge UI, and mixed stress and urge UI was 17%, 15%, 9%, and 7%, respectively. The mean body mass index (BMI) was 22.7 kg/m2. Irrespective of other risk indicators, BMI was positively associated with UI prevalence (OR, 1.07/BMI unit; P < 0.0001). BMI interacted with childbirth in predicting stress UI prevalence, with cystitis in predicting urge UI, and with both in predicting mixed UI. Stress UI proved to be the UI type most closely associated with BMI.
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PMID:Body mass index and adult female urinary incontinence. 788 69

Developments in understanding the pathophysiology of urinary incontinence caused by urethral sphincter mechanism incompetence (SMI) are reviewed. SMI is a multifactorial condition; affected bitches have shorter urethras, reduced urethral tone and more caudally positioned bladder necks than continent bitches. Other factors thought to be important in the aetiology of SMI include neutering, breed, body size, docking and obesity. Most of the recent developments in the understanding of SMI have resulted from radiographic and urodynamic investigations of normal and affected bitches. The urodynamic technique of urethral pressure profilometry is discussed and its contribution as an investigative tool reviewed.
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PMID:Developments in the understanding of the pathophysiology of urethral sphincter mechanism in competence in the bitch. 802 45


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