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)

Couples with fertility problems seeking treatment with assisted reproductive technologies (ART) such as in vitro fertilization should receive preconception counseling on all factors that are provided when counseling patients without fertility problems. Additional counseling should address success rates and possible risks from ART therapies. Success rates from ART are improving, with the highest live birth rates averaging about 40% per cycle among women less than 35 years old. A woman's age lowers the chance of achieving a live birth, as do smoking, obesity, and infertility diagnoses such as hydrosalpinx, uterine leiomyoma, or male factor infertility. Singletons conceived with ART may have lower birth weights. Animal studies suggest that genetic imprinting disorders may be induced by certain embryo culture conditions. The major risk from ovarian stimulation is multiple gestation. About one-third of live-birth deliveries from ART have more than one infant, and twins represent 85% of these multiple-birth children. There are more complications in multiple gestation pregnancies, infants are more likely to be born preterm and with other health problems, and families caring for multiples experience more stress. Transferring fewer embryos per cycle reduces the multiple birth rate from ART, but the patient may have to pay for additional cycles of ART because of a lower likelihood of pregnancy.
 ...
PMID:Preconception care and treatment with assisted reproductive technologies. 1680 86

The incidence of uterine fibroid tumors increases as women grow older, and they may occur in more than 30 percent of women 40 to 60 years of age. Risk factors include nulliparity, obesity, family history, black race, and hypertension. Many tumors are asymptomatic and may be diagnosed incidentally. Although a causal relationship has not been established, fibroid tumors are associated with menorrhagia, pelvic pain, pelvic or urinary obstructive symptoms, infertility, and pregnancy loss. Transvaginal ultrasonography, magnetic resonance imaging, sonohysterography, and hysteroscopy are available to evaluate the size and position of tumors. Ultrasonography should be used initially because it is the least invasive and most cost-effective investigation. Treatment options include hysterectomy, myomectomy, uterine artery embolization, myolysis, and medical therapy. Treatment must be individualized based on such considerations as the presence and severity of symptoms, the patient's desire for definitive treatment, the desire to preserve childbearing capacity, the importance of uterine preservation, infertility related to uterine cavity distortions, and previous pregnancy complications related to fibroid tumors.
 ...
PMID:Uterine fibroid tumors: diagnosis and treatment. 1755 38

Uterine fibroids are the most common benign tumour of the female genital tract. However, their true prevalence is probably under-estimated, as the incidence at histology is more than double the clinical incidence. Recent longitudinal studies have estimated that the lifetime risk of fibroids in a woman over the age of 45 years is more than 60%, with incidence higher in blacks than in whites. The cause of fibroids remains unclear and their biology poorly understood. No single candidate gene has been detected for commonly occurring uterine fibroids. However, the occurrence of rare uterine fibroid syndromes, such as multiple cutaneous and uterine leiomyomatosis, has been traced to the gene that codes for the mitochondrial enzyme, fumarate hydratase. Cytogenetic abnormalities, particularly deletions of chromosome 7, which are found in up to 50% of fibroid specimens, seem to be secondary rather than primary events, and investigations into the role of tumour suppressor genes have yielded conflicting results. The key regulators of fibroid growth are ovarian steroids, both oestrogen and progestogen, growth factors and angiogenesis, and the process of apoptosis. Black race, heredity, nulliparity, obesity, polycystic ovary syndrome, diabetes and hypertension are associated with increased risk of fibroids, and there is emerging evidence that familial predisposition to fibroids is associated with a distinct pattern of clinical and molecular features compared with fibroids in families without this prevalence.
 ...
PMID:Incidence, aetiology and epidemiology of uterine fibroids. 1853 13

New and more active concepts of steroid binding globulin action are emerging from recent research. As a result, examination of steroid levels in aging humans and the role of steroid binding globulins need to be re-visited. This review will discuss the possibility that sex hormone binding globulin (SHBG) plays an active role in the aging process. It will discuss the changes in blood levels of SHBG in aging humans in association with sexual activity, prostate hypertrophy and cancer, uterine leiomyoma, breast cancer, obesity and particularly the relationship between SHBG and HDL-cholesterol, Alzheimer's disease, osteoporosis, and cardiovascular disease. Starting with the idea that SHBG is an active participant in steroid action demands a re-evaluation of data demonstrating a primary change in blood SHBG levels in association with various pathologies. Here we discuss the postulate that SHBG may act at its own receptor at the plasma membrane level to influence other receptors such as scavenger receptors and HDL-cholesterol receptors. We will also suggest that SHBG is a critical marker for mating and thus may be an important physiological molecule in control of aging.
 ...
PMID:Sex hormone binding globulin and aging. 1895 1

Uterine fibroid admissions in the nation's hospitals have grown more than 20 percent over the past five years. Substantial variations exist in inpatient treatment patterns. In spite of this dramatic growth, there are no national studies of the hospital costs associated with the treatment of uterine fibroids in the hospital setting. Using 11 years of data (1993-2003) from the Healthcare Cost and Utilization Project, a nationally representative 20 percent sample of the nation's inpatient admissions, trends in hospital charges, costs, and lengths of stay (LOSs) are reported. For 2001 to 2003, determinants of hospital costs and LOS for inpatients with a primary diagnosis of uterine fibroids were analyzed using univariate analyses and regression techniques. Hysterectomies for women with a primary diagnosis of uterine fibroids have in-hospital costs of over $1.5 billion. Among the major procedures for treating uterine fibroids, in 2003, total abdominal hysterectomy had the longest LOS, averaging 2.9 days with a mean cost of $6331. In contrast, the treatment with the shortest LOS, 1.72 days, was laparoscopically assisted vaginal hysterectomy but it had the highest mean costs of $7108. In 2003, supracervical hysterectomies and myomectomies had mean costs of $6809 and $6707, respectively. Multivariate results show that patient characteristics and structural aspects of the hospital are strong predictors of lengths of stay and cost per day but there are major differences across some of the surgical procedures. Although the patient characteristics-insulin-dependent, non-insulin dependent diabetes, obesity, morbid obesity, smoker, hypertension, congestive heart failure, chronic obstructive pulmonary disease-all have significant impacts on LOS and cost per day for some of the major uterine fibroid treatments, they are not consistent. Compared with white women, black, Hispanic, and Asian/Pacific Island women all had higher lengths of stay and costs per day. Bedsize and teaching status are generally positively associated with lengths of stay and costs per day; for-profit status always had a significant positive association with LOS and cost per day. Hospital costs for treating women with uterine fibroids are continuing to grow. Further research on the determinants of the resource utilization could be helpful in predicting and alleviating these costs and improving patient care.
 ...
PMID:National trends and determinants of hospitalization costs and lengths-of-stay for uterine fibroids procedures. 1917 28

We here report a case of a 53-year-old woman requiring pulmonary embolectomy for acute massive pulmonary embolism caused by a huge uterine myoma compressing veins in the pelvis and extreme obesity. She was also diagnosed as having myomatous erythrocytosis syndrome, a rare disease associated with secondary polycythemia. The polycythemia improved after a hysterectomy which was performed after pulmonary embolectomy.
 ...
PMID:Pulmonary embolism with myomatous erythrocytosis syndrome and extreme obesity. 1962 99

At least one in four women will develop one or more fibroids during their lifetime. They occur most commonly in women aged 30-50 and are three times more common in women of Afro-Caribbean descent than in Caucasian women. Risk factors for fibroids include: age, nulliparity, race, family history and obesity. In two-thirds of cases there are no symptoms. If the tumours are small and not causing symptoms, they do not require treatment However, if they enlarge, they can cause abnormal bleeding, pressure on the bladderand/or bowel and the patient may have difficulty getting pregnant. Fibroids are often discovered as an incidental finding on ultrasound but may also present in the following ways: abnormal uterine bleeding and menorrhagia; infertility; pelvic mass; increasing girth; pressure symptoms (urinary frequency and/or constipation); urinary retention; acute pelvic pain due to torsion of a pedunculated fibroid. During pregnancy, fibroids enlarge and may undergo red degeneration causing pain. Medication can only be used to improve symptoms and/or shrink the fibroids prior to surgery. Women with fibroids >3 cm in diameter causing significant symptoms, pain or pressure and wishing to retain their uterus may consider myomectomy. Hysterectomy is the standard treatment for women with symptomatic fibroids who have not improved with medical treatment. If the woman's family is complete and the fibroids are multiple, hysterectomy provides a permanent cure. Uterine artery embolisation is only recommended if surgery was planned for symptomatic fibroids and if the fibroids are <20 weeks in size. Referral is recommended in the following cases: submucous fibroid and abnormal bleeding; fibroids >3 cm in diameter uterus palpable abdominally or >12 cm in size on scan; persistent intermenstrual bleeding; age >45 where treatment has failed or been ineffective. Sarcomatous change within fibroids is rare and is normally associated with rapid growth. Such cases should be referred urgently.
 ...
PMID:Management of fibroids should be tailored to the patient. 2151 May 5

Pulmonary thromboembolism (PE) may occur upon a patient's first postoperative attempt of ambulation. PE is a serious complication, often leading to shock or sudden death. Reported rates of PE following gynecologic surgery are between 0.3% and 0.8%, while the incidence of postoperative deep-vein thrombosis (DVT), the major cause of PE, is between 17% and 20%. Therefore, effective preventive measures, such as preoperative assessment for asymptomatic DVT, should be considered. It is well known that DVT and/or PE are associated with large uterine fibroids, the common, benign tumor of myometrium. Here, to establish the statistical relationship between DVT risk and uterine fibroid size/weight, we assessed the preoperative DVT rate with respect to three possible risk factors: age, obesity level, and uterine size/weight. A total of 361 patients with uterine fibroids undergoing hysterectomy between July, 2003 and December, 2009 were enrolled. All patients were evaluated for preoperative DVT; the results were stratified for statistical comparison by patient age, BMI, and uterine weight. There was no statistical difference in the DVT rate for patients stratified by age (below age 45 years or older) or BMI (below 25 or higher). By contrast, the rate of DVT was significantly higher for patients with uterine weights of 1,000 gm or more (11.5% [7/61]) compared with weights below 1,000 gm (3.0% [9/300]). None of the patients studied developed PE. In conclusion, the incidence of DVT is significantly higher in cases where uterine weight is 1,000 gm or more (ie, adult head size on pelvic examination).
 ...
PMID:Deep-vein thrombosis is associated with large uterine fibroids. 2157 92

From cards of follow-up of industrial contingent passing preventive medical examinations, the frequency of disorders of the reproductive sphere and the endocrine system in 208 women employed in shift work including the night shift was investigated in comparison with 102 female members of administrative and managerial staff The relative risk (RR) of all investigated pathologies associated with employment in night shifts, was 1.52 (95% confidence interval (CI): 1.06-2.18). The increased risk of mastitis (OR = 1.13, 95% CI 0.95-1.35), and a uterine myoma (RR = 1.16, 95% CI: 1.00-1.36) was on the border of statistical significance. Endometriosis was significantly more frequent in the study group: RR = 1.23 (1.04-1.45). The risk of developing ovarian cysts was not significantly lower: RR = 0.94 (95% CI: 0.72-1.24). In connection with the employment in night shifts increased risk of all endocrine diseases was observed on the border of statistical significance: RR = 1.18 (95% CI: 0.99-1.40), including the development of obesity: RR = 1.22 (95% CI 1.05-1.43). The frequency of diabetes in the group of workers with night shifts was statistically significantly higher (OR = 1.13, 95% CI: 0.84-1.51). The pathology of the thyroid gland in the study group occurred less frequently than in the control one: RR = 0.88 (95% CI: 0.73-1.07). These data are preliminary, but they are consistent with the available experimental and epidemiological data.
 ...
PMID:[Night shift and the risk of hormone-dependent diseases in women]. 2308 66

Uterine leiomyomas (or fibroids) are the most common tumors in women of reproductive age. Early studies of two familial cancer syndromes, the multiple cutaneous and uterine leiomyomatosis (MCUL1), and the hereditary leiomyomatosis and renal cell cancer (HLRCC), implicated FH, a gene on chromosome 1q43 encoding the tricarboxylic acid cycle fumarate hydratase enzyme. The role of this metabolic housekeeping gene in tumorigenesis is still a matter of debate and pseudo-hypoxia has been suggested as a pathological mechanism. Inactivating FH mutations have rarely been observed in the nonsyndromic and common form of fibroids; however, loss of heterozygosity across FH appeared as a significant event in the pathogenesis of a subset of these tumors. To assess the role of FH and the linked genes in nonsyndromic uterine fibroids, we explored a two-megabase interval spanning FH in the NIEHS Uterine fibroid study, a cross-sectional study of fibroids in 1152 premenopausal women. Association mapping with a dense set of single nucleotide polymorphisms revealed several peaks of association (p = 10(-2)-8.10(-5)) with the risk and/or growth of fibroids. In particular, genes encoding factors suspected (cytosolic FH) or known (EXO1 - exonuclease 1) to be involved in DNA mismatch repair emerged as candidate susceptibility genes whereas those acting in the autophagy/apoptosis (MAP1LC3C - microtubule-associated protein) or signal transduction (RGS7 - Regulator of G-protein and PLD5- Phospoholipase D) appeared to affect tumor growth. Furthermore, body mass index, a suspected confounder altered significantly but unpredictably the association with the candidate genes in the African and European American populations, suggesting the presence of a major obesity gene in the studied region. With the high potential for occult tumors in common conditions such as fibroids, validation of our data in family-based studies is needed.
 ...
PMID:Multiple hits for the association of uterine fibroids on human chromosome 1q43. 2578 53


<< Previous 1 2 3 4 Next >>