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

When adipose tissue enlarges in obesity, as the result of an imbalance between caloric intake and caloric expenditure, many changes occur in the cellular components of the adipose mass. A combination of increased cell size and number underlies the accretion of the adipose mass, however, only a reduction in cell size is possible with weight loss. Several metabolic abnormalities accompany obesity--most important--hyperinsulinemia, hyperlipidemia, insulin resistance, and carbohydrate intolerance. Clinical consequences of obesity include hypertension, venous insufficiency, gallbladder disease, osteoarthritis, pulmonary and cardiovascular insufficiency, diabetes, and atherosclerotic cardiovascular disease, and all are dependent on the severity and duration of the obesity. Once established, obesity is difficult to correct because of the development of many adaptive mechanisms by which obesity defends itself.
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PMID:Cellular, metabolic, and clinical consequences of adipose mass enlargement in obesity. 180 21

Obesity was confirmed as a possible aetiological and certainly promoting factor in the development of osteoarthritis (OA). One of the first clinical symptoms of OA is pain which does not always correspond with the X-ray picture of the damaged joint. The authors examined 11,124 obese subjects where they investigated X-ray changes of the hip joints, knees and heels and selected clinical symptoms. They correlated them with the degree of obesity, the duration of obesity and the subjects age. They revealed a direct correlation between the development of OA and all the investigated parameters. An alarming finding was that arthritis changes developed in the hip joints also in half the subjects with minor overweight and in particular that in one third of the obese subjects in the second and third decade pathological changes of the joints are present without causing subjects complaints. During a prolonged reducing regime attention must be paid to the possible development of osteopenia which may be also the source of pain. Obese subjects suffer pain also from nodes of non-inflammatory proliferated subcutaneous adipose tissue, venous insufficiency and trophic skin changes.
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PMID:[Pain and osteoarticular changes in obese persons]. 201 64

The authors carried out an epidemiological study on a group of 10032 patients with chronic venous insufficiency, composed of 2686 males (26.77%) and 7346 females (73.23%). The case report is divided into varicose diseases (83.30%) and sequelae of deep vein thrombosis (16.70%). As well as the relationship between sex and age is considered rate of dermatological complications, with regard both to the type of venous diseases (65.54% varicose and 34.46% post-thrombotic) and to their clinical manifestations. As well as any family connection, various environmental factors are taken into account such as the patient's work, noxae iatrogenic, pregnancy and obesity.
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PMID:[Epidemiologic observations on the subject of phlebopathy of the legs and its dermatologic complications]. 223 82

Pulmonary emboli, even small, cause irreparable lung damage. Recurrent pulmonary emboli further increase the amount of non functional lung tissue and may result in incapacitating respiratory disease or death. It is therefore mandatory that the disease be correctly diagnosed and adequately treated. As prevention is better than cure, every patient presenting with clinical signs of deep venous thrombosis (DVT) should be correctly explored. The site and size of thrombosis must be visualized preferably with contrast venography with imaging of the veins of the limbs, iliac veins and vena cava. Risk factors such as obesity, immobilization etc. must be taken into account. Underlying disease such as heart disease and venous insufficiency must be treated. Malignancy must be looked for as in a recent series of patients with primary DVT which were studied, 15% presented with an up till then unknown malignant disease. In patients presenting with recurrent DVT this percentage rose to 20%. When a patient presents with DVT of the femoro-iliac vena cava axis, aggressive treatment must be adopted. Fibrinolysis or if this is contra-indicated, thrombectomy will be used. A vena cava filter may be necessary and longterm anticoagulation is mandatory. The same rationale is applicable in cases of pulmonary embolus whether it is a primary event or a recurrence.
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PMID:Recurrent pulmonary embolism: importance, diagnosis, management and prevention. 352 Nov 67

In acute thrombosis of deep veins of the lower extremities, post-thrombotic syndrome develops in 75% of cases and leads to premature debilitation in 1/3 of the patients. Besides known thrombogenic causes, hormonal preparations more and more often are factors in occurrence of acute thrombosis. There is no doubt that hormonal contraceptive agents are the most reliable method of preventing pregnancy. Their widespread use has resulted in a significant decrease in septic abortions with serious consequences. The purpose of this article is not to discredit this method of preventing pregnancy, but merely to ascertain the presence or lack of a link between thromboembolic diseases and the use of hormonal contraceptive agents. Disturbance of the balance between clotting and anti-clotting systems contributes to development of thrombosis. Etiological factors include changes in vascular walls and functional impairment of hemodynamics. A decrease in the level of antithrombin III in the blood and also in the amount of heparinocytes after using hormonal contraceptive agents has also been proven. Postoperative and postnatal hypodynamics, thrombophlebitis with chronic venous insufficiency, neoplastic syndrome and trauma are causes of acute thrombosis. Age, obesity, hypertonic disease and smoking serve as other risk factors. From 1975 to 1981, 72 women were in the surgical clinic of the Mardeburg Medical Academy for treatment of acute thromboembolic diseases: 34 were using hormonal contraceptive agents before onset of the disease; 19 smoked up to 10 cigarettes a day; and 5 smoked occasionally. After operative intervention, 20 women developed acute thrombosis; only 2 of them were using hormonal contraceptives. No clear causes of thrombosis were found in 35 women, but 32 of them were using hormonal contraceptives. Trauma was the cause in 1 woman with thrombosis of the cartoid artery. On the average, the women used hormonal contraceptives for 4.1 years before onset of the disease (3.1 years in thrombosis of veins of the lower extremities and pelvis; 5.1 in arterial thrombosis). In 28 of 34 women with acute thromboses, they were localized in the veins of the lower extremities and pelvis after taking hormonal contraceptives. Women with thromboembolic diseases after taking hormonal contraceptives had general examinations at periods from 6 months to 5 years. Development of post-thrombotic syndrome was observed in 12 women with thrombosis of veins in the lower extremities and pelvis. Thromboses without any thrombogenic causes were observed in women under 30 after taking hormonal contraceptives. Although a direct link between the use of hormonal contraceptive agents and thromboembolic diseases cannot be proven presently, taking these preparations is believed to be 1 of the risk factors in the development of these diseases.
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PMID:[Hormonal contraceptive agents as a risk factor in the development of acute thromboembolic diseases]. 382 Oct 1

The spa of Bagnoles-de-l'Orne is one of the few French watering-places north of the Loire. It specializes in the treatment of complications of venous affections. The basic crenotherapeutic treatment consists of the main thermal bath, plus treatments such as showers, aero-massages, manual massages. The thermal water of Bagnoles-de-l'Orne is of medium temperature. It has the following recognized properties: -- sedative properties -- used in the treatment of pain associated with chronic venous insufficiency, cramps, sympatheticalgic phenomena; -- anti-oedematous properties, of prime importance in the treatment of oedema of postthrombotic illness and hydroplasmic obesity; -- anti-inflammation properties, especially anti-cellulitis, more particularly associated with post-thrombotic illness; -- a mitotic effect used in the healing of ulcers of circulatory origin in the lower limbs. The effect of the thermal water of Bagnoles-de-l'Orne is enhanced by a climatic factor: the cool climate of the Norman Bocage.
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PMID:[The thermal cure at Bagnoles-de-l'Orne]. 711 27

For many years knee arthrodesis has been recommended for patients with severe degenerative disease complicated by obesity, venous insufficiency or old sepsis. Recently, failed total knee arthroplasties are being treated by arthrodesis, but these new indications entail new and difficult circumstances. A biplane fixation frame, more rigid than the Charnley clamp, and the instrumentation for producing absolutely flat opposing surfaces are important. The frame provides the advantages of good access to the wound and permits early ambulation. Pin tract loosening and infection are potential disadvantages, but in this small series were not significant.
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PMID:The biplane frame: modified compression arthrodesis of the knee. 728 20

Congestive heart failure is a frequent complication of massive obesity and a major cause of death. Prior to the cardiac decompensation stage, infraclinical haemodynamic disturbances can be observed in obese subjects with normal blood pressure: the cardiac output and cardiac index increase, due to a rise in systolic ejection volume, the total peripheral resistance falls and the intravascular volume augments. Cardiac adjustment takes place in the form of excentric left ventricular hypertrophy. Ventricular extrasystoles, often associated with this hypertrophy, might be the cause of sudden death in some obese patients. Arterial hypertension is about 3 times more frequent in obese subjects than in subjects of normal weight, and even more frequent in those with massive obesity. To the high preload due to obesity hypertension adds an increased after-load. This results in augmentation of the mass and work of the left ventricle with progressive alteration of its function. The incidence of coronary disease is increased in obese subjects, notably those with abnormal adiposity. Finally, the return circulation is very often perturbed, notably in gynecoid obesity: there is venous insufficiency with a higher risk for thromboembolism, and lymphatic insufficiency or capillary permeability disorders. A low-calorie diet and a physical rehabilitation of sedentary obese subjects facilitate weight reduction and at the same time tend to correct the associated metabolic disturbances; they reduce blood pressure and also seem to reduce the left ventricular hypertrophy.
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PMID:[Hemodynamics of massive obesity]. 831 Feb 45

Massive obesity leads to nonspecific skin disorders. Skin folds are more numerous and deeper in the obese subject, and can become the site of various disorders. Hence the difficulty of diagnosis and treatment is increased. Acanthosis nigricans should be recognized, but not solely attributed to obesity, since other causes, particularly cancer, may be involved. Finally, leg ulcerations, a frequent consequence of the venous insufficiency inherent in obesity, should not lead to overlook other underlying causes, particularly in diabetic patients.
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PMID:[Cutaneous complications of massive obesity]. 831 Feb 47

We report a case of 47 years old patient who was admitted to hospital because of bilateral leg ulcers for 6 years. Chromosome analysis revealed XXY karyotype, confirming the clinical diagnosis of Klinefelter's syndrome. Testosterone level was low and Plasminogen Activator Inhibitor (PAI-1) was elevated. The patient was given androgen therapy which resulted in a normalization of the PAI-1 activity. The frequency of leg ulcers in patients with Klinefelter syndrome is between 6 and 12% according to studies. Different causes would explain the tendency towards leg ulcers in Klinefelter's syndrome: conjunctive tissues abnormalities were revealed in some studies. A higher frequency of venous insufficiency is reported in patients with Klinefelter's syndrome, either due to the particular morphology (obesity, taller size) or due to an androgen deficiency. A few arterial dysplasias cases of arteries's legs were described in patients with leg ulcers and Klinefelter syndrome. Haemostasis disorders presented in this case and normalized after androgen therapy will contribute to the physiopathologic discussion.
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PMID:[Leg ulcer and Klinefelter syndrome]. 854 3


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