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

Our objective was to investigate possible factors implicated in either early death from or scintigraphic resolution of pulmonary embolism. To that end we conducted a retrospective study of 116 patients with either a high likelihood of pulmonary thromboembolism (PTE) diagnosed by scintiscan or with a fair probability of PTE by scintiscan accompanied by a positive phlebograph. The images were taken upon admission, at 7 days, 10 days and 6 months. The factors analyzed were age, sex, trauma, immobility, surgery, obesity, hemiplegia, venous insufficiency, cardiopulmonary disease, neoplasia, chest X-ray and ECG alterations, D(A-a)O2 and size of perfusion defects upon admission and 7 to 10 days later. We performed single-variable analyses and multiple logical regression analyses using perfusion defect at 6 months as the dependent variable. The early mortality rate (13%) was higher in patients with neoplasms, a larger alveolar-arterial index and greater perfusion defects upon admission. Scintiscans became normal in 28%. Multivariate analysis to predict total or partial resolution at 6 months showed that size of perfusion defects at 7 to 10 days was the best predictive factor. A cutoff point was calculated by analyzing the ROC for this factor. Thus, when the defect at 7 to 10 days was equal to or greater than 1 segment, the probability of residual defects remaining after 6 months was twice as great (sensitivity 83%, specificity 57%). In conclusion, early death was more likely in PTE patients with neoplasms, larger defects upon admission and greater alveolar-arterial difference. Scintigrams showed resolution 6 months after admission in 28%. The size of perfusion defects 7 to 10 days after admission was the factor that best predicted total of partial resolution at 6 months.
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PMID:[The prognostic factors for early mortality and for total or partial gammagraphic resolution in venous thromboembolic disease]. 925 67

324 patients operated on the organs of abdominal cavity small pelvis and retroperitoneal space were examined by the method of I-125-fibrinogen accumulation and contrast phlebography. In 109 (33.6%) patients thrombosis of deep veins of lower extremities was diagnosed, among which in 24 cases (7.5%) it was proximal. In most cases thrombosis was predisposed by postthrombotic disease and chronic venous insufficiency of lower extremities, circulatory disturbances of the 2-3 degree, tumors, obesity, preoperative thrombophilia. Combination of 2 and more risk factors increased possibility of intravascular thrombosis. The rate of clinically registered pulmonary artery embolism (14,833 general surgical patients were avau label) made up 1.2%; in 54 (0.3%) of operated patients it was the cause of death. Postoperative lethality of embolism made up 13%. Four risk levels of development of thrombo-embolic complications were established: low (common rate of thrombosis--10.3%, proximal--1.4%, clinically evidenced pulmonary artery embolism--0.7%, with lethal outcome--0.02%), medium (28.5; 6.5; 2; 0.76%, respectively), high (80.4; 17.8; 6; 2.8%, respectively) and very high (93.3; 26.6; approximately 8; approximately 4, respectively). The prevalence of thrombo-embolic complications in patients urge surgeons and reanimatologists to carrying out prophylactic to reduce the risk of intravascular thrombosis in pre- and postoperative period.
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PMID:[Postoperative deep venous thrombosis of legs and pulmonary embolism]. 1021 60

A 44-year-old woman who weighed 130 kg (height 158 cm, BMI 52) with a complicated psychiatric history was referred for obesity surgery because of severe sleep apnea, obesity hypoventilation syndrome with frequent pneumonias, arterial hypertension, diabetes mellitus, polyarthralgia and back pain, venous insufficiency, dysmenorrhea, severe heartburn, and incisional hernia. From childhood until 1983, she had undergone 106 operations, mainly for septic/pyemic and intra-abdominal abscesses, 86 of them under general anesthesia. In the 4 years before undergoing bariatric surgery, she had gained 40 kg, nonoperative attempts at weight reduction had failed. Some months before obesity surgery she could fall asleep while standing, and she noticed an entire loss of capacity for work. Respiratory disturbance index measured during sleep by Mesam-4 device was 68 events per hour. Preoperative controlled positive airway pressure (C-PAP) therapy was used. Vital indications for weight reduction were established. Bariatric surgical steps included six operations: (1) vertical banded gastroplasty (VBG); (2) relaparotomy with suspicion of peritonitis, no complications found; (3) hernioplasty simultaneously with panniculectomy; (4) revision and removal of additional flap because of marginal skin necrosis; (5) bilateral thigh dermatolipectomy simultaneously with right-side saphenectomy; and (6) removal of intramammary abscess. Twenty-four months after VBG, she had lost 39 kg (56.5 % EWL) and was doing rather well. Obesity-related diseases except back pain were relieved.
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PMID:Successful bariatric surgery in a patient who underwent more than 100 various operations. 1048 18

Venous disease in the legs occurs very commonly in the general population in Western countries. Around one third of women have trunk varices. A lower prevalence has been observed in men but some recent surveys have suggested that the occurrence in men may be comparable to that in women. The prevalence increases with age but the incidence of new cases appears to be constant throughout adult life. Open venous ulcers occur in about 0.3% of the adult population and a history of open or healed ulceration occurs in around 1%. The etiology of chronic venous disease in the legs is unknown. A genetic predisposition may be present but evidence for this and for a mode of inheritance is lacking. There is some suggestion that prolonged standing may be a risk factor but studies are open to considerable bias. In women, obesity and previous pregnancy has been associated with the presence of varicose veins but the evidence is inconsistent. There have been few well-conducted studies examining diet and bowel habit as a risk factor. The risk of ulceration is related to the severity of varicosities and venous insufficiency, and is increased following deep vein thrombosis. Much further research is required to investigate the cause of this common condition in the general population.
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PMID:Prevalence and risk factors of chronic venous insufficiency. 1151 May 98

The present article focuses on the prevalence and risk factors for varicose veins and the severe stage of chronic venous insufficiency (CVI). The evaluation was made by reviewing the results of specific well-designed studies performed on the general population (case-control studies, cross-sectional studies, and large case series). Data from the literature were compared with the results of a recent multicenter cross-sectional study in Poland, in which 40,095 individuals from 803 registers of primary care physicians were clinically examined and assigned a clinical CEAP class. Analysis of the associations between varicose veins or severe CVI prevalence and factors that are usually considered as representing a risk for the development of CVI was performed. In Poland, a prevalence of varicose veins and severe CVI (skin changes, leg ulcer) similar to that observed in the other developed countries was reported. It was more common in women, but female sex was not found to be a strong risk factor. Among the risk factors most closely associated with CVI were age, family history of varicose veins, and constipation, whatever the sex. This is in keeping with findings from recent epidemiologic studies. Obesity and lack of physical activity were strongly associated with CVI in women, more so than in men. The number of pregnancies (more than 2 pregnancies) significantly distinguished between women with and without CVI. Regarding these latter risk factors, the Polish results do not contradict the commonly held beliefs that are found in the literature. A modest association was found with female sex, previous injury in legs (DVT), and remaining in the standing position for a long time, although these parameters are usually among those mostly agreed as being risk factors. The role of the prolonged sitting position was not established. The Polish epidemiologic survey provided updated figures on the prevalence of and risk factors for varicose veins and severe CVI, using clear and globally accepted clinical definitions for the venous disease based on the CEAP classification.
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PMID:The influence of environmental factors in chronic venous insufficiency. 1293 54

This article reviews several aspects of the association between obesity and cancer. Current perspectives of cancers of the breast, endometrium, colon and prostate are described. Obesity is a growing problem in contemporary societies, due to the rapid adoption of a modernized lifestyle that results in increased carbohydrate and fat-rich dietary intake, reduced physical activity and extended life expectancy. More than half of adult Americans are overweight or obese, and so is the population of many other countries. There are several definitions for the state of obesity. The body mass index (BMI), which measures overall adiposity, is universally available, the easiest to determine, and therefore the most commonly studied. Anthropometric measurements of subcutaneous fat distribution, such as measurement of girth, circumference of the arms, hips and thighs, or of skinfolds in various body regions are also often used. They allow to categorize the distribution of subcutaneous fat into android and gynoid types (den Tonkelaar, Seidell et al., 1994; Huang, Willett et al., 1999). The android, or abdominal, fat is determined from the waist to hip ratio, and is of particular relevance to cancer. Increased body weight and fat are associated with high health risks, and therefore body fat distribution and BMI are major predictors of obesity associated risks (Calle, Thun et al., 1999; "Overweight, obesity, and health risk," Yanovski, 2000). These include diabetes mellitus type 2, coronary heart disease, sleep apnea and pulmonary dysfunction, stroke, diseases of the gallbladder, liver and the musculoskeleton, reproductive dysfunction, venous insufficiency, deep vein thrombosis, poor wound healing, and more (Pi Sunyer, 1993; "Overweight, obesity, and health risk", Yanovski, 2000). All these are associated with increased mortality, especially in individuals with other risk factors (Calle, Thun et al., 1999). Cancer is also associated with obesity (Garfinkel, 1985), and the present paper attempts to summarize current perspectives of this association, especially in cancers of the breast, endometrium, colon and prostate.
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PMID:Obesity and cancer. 1293 6

The presented thromboprophylactic concept includes weight bearing and ankle motion as well as breathing therapy and drug prophylaxis (antiphlogistics, analgesic drugs, heparin). Routinely performed ultrasound screening of the deep veins (legs and pelvis) before release showed a low DVT incidence of 2.5% in a prospective clinical observation of 841 inpatients. Obesity, venous insufficiency, and a history of previous thromboembolic events were associated with a significantly increased risk of thrombosis (relative risk 4.1, 4,9, and 5.8, respectively) The duration of immobilization also had a relevant influence indicating that early postoperative physiotherapy in traumatology and orthopedic surgery has a widely underestimated thromboprophylactic effect.
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PMID:[Stationary thromboprophylaxis in casualty surgery. Relevance of postoperative mobility and preexisting risk factors]. 1499 70

The aim of the clinical study was to monitor and analyse possible causes of chronic venous insufficiency (CVI) in a randomised sample of patients with diagnosed CVI. There were 100 patients in the investigated sample, 82 women of an average age of 40.4 years and 18 men of an average age of 42.7 years. Monitoring of risk factors of development and advancement of CVI in our sample of patients showed following results: 1. frequent overweight and obesity (BMI > 25 kg/m2) in women (47.6%) and men (83%) with relatively frequent cases when a patient put on weight more than 5 kg within the last 5 years before development of CVI signs (24.4% of women and 22% of men); 2. a predominance of multiparas (68.3%) over women who have not given a birth or gave birth to 1 child (31.7%), we have found a big percentage of multiparas among both women younger than 40 (40%) and especially older women (> or = 40 years) where the percentage was 75.4%); 3. a positive family history in the majority of our patients with CVI (71%), in 88.7% in a first grade relative; 4. the major part of people in the sample were standing when working (59%), the number of people with sedentary work was high too (32%); 5. smoking admitted only minor part of the CVI patients (27%); 6. significant history of hormonal treatment in the female patients (37.8%), especially among women younger than 40 (48%); 7. other risk factors (accidents and surgeries of lower extremities, recurrent thrombophlebitis) appeared either in a very small percentage of the patients (lower limbs surgeries) or in significantly smaller percentage compared to risks in points 1 to 4 (accidents of lower extremities 20%), recurrent thrombophlebitis 22%).
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PMID:[Chronic venous insufficiency--outpatient study of risk factors]. 1501 25

Selective serotonin reuptake inhibitors (SSRIs) are well-established medications for the treatment of mood disorders including major depression. These agents are also known to exhibit potent antiplatelet and endothelium protective effects effects. Additionally, SSRIs can exacerbate the development of inflammation, and modulate the interleukin and interferon production. All of the above suggest that SSRIs therapy could be considered as a potential strategy for the wound healing treatment. We summarized some body of the available data on the history of serotonin metabolism, mechanism of action of ketanserin, and hypothesize why SSRIs may be beneficial in the wound repair natural history. Different pathophysiological considerations are also reflected in this review. Finally, we suggest that the topical use of SSRIs may represent a promising avenue for future strategies affecting wound repair in high-risk patients, especially those with diabetes mellitus, venous insufficiency, obesity, and other vascular disorders.
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PMID:Treatment with selective serotonin reuptake inhibitors for enhancing wound healing. 1519 59

Air passenger miles will likely double by year 2020. The altered and restrictive environment in an airliner cabin can influence haematological homeostasis in passengers and crew. Flight-related deep venous thromboemboli (DVT) have been associated with at least 577 deaths on 42 of 120 airlines from 1977 to 1984 (25 deaths/million departures), whereas many such cases go unreported. However, there are four major factors that could influence formation of possible flight-induced DVT: sleeping accommodations (via sitting immobilisation); travellers' medical history (via tissue injury); cabin environmental factors (via lower partial pressure of oxygen and lower relative humidity); and the more encompassing chair-rest deconditioning (C-RD) syndrome. There is ample evidence that recent injury and surgery (especially in deconditioned hospitalised patients) facilitate thrombophlebitis and formation of DVT that may be exacerbated by the immobilisation of prolonged air travel. In the healthy flying population, immobilisation factors associated with prolonged (>5 hours) C-RD such as total body dehydration, hypovolaemia and increased blood viscosity, and reduced venous blood flow (pooling) in the legs may facilitate formation of DVT. However, data from at least four case-controlled epidemiological studies did not confirm a direct causative relationship between air travel and DVT, but factors such as a history of vascular thromboemboli, venous insufficiency, chronic heart failure, obesity, immobile standing position, more than three pregnancies, infectious disease, long-distance travel, muscular trauma and violent physical effort were significantly more frequent in DVT patients than in controls. Thus, there is no clear, direct evidence yet that prolonged sitting in airliner seats, or prolonged experimental chair-rest or bed-rest deconditioning treatments cause DVT in healthy people.
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PMID:Airline chair-rest deconditioning: induction of immobilisation thromboemboli? 1545 46


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