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

Ten patients with fatty liver, distinct from the well known diffuse alcoholic variety, comprise this report. All patients had an initial ultrasound examination followed by 99mTc-sulfur colloid liver and computed tomography (CT) body scans. Six patients had focal fatty infiltration producing a space-occupying mass within the liver. Four had ultrasound evidence of diffuse fat occurring in association with focal masses. These masses were all echo poor relative to the adjacent fat, and were subsequently found to represent nodules of normal uninvolved liver in two patients, and metastatic neoplasm and multiple liver cysts in single patients respectively. The clinical picture associated with fatty liver is variable and may include, in addition to alcohol abuse, obesity, malnutrition, exogenous glucocorticoids, diabetes mellitus, and other less well defined factors. Dramatic improvement in fatty liver occurred in two patients following appropriate therapy. The spectrum of changes produced by fatty infiltration of the liver on ultrasonic, radionuclide, and CT scans is extremely varied depending on the amount of fat deposition, its focal or generalized nature, and the presence of associated liver disease.
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PMID:Fatty infiltration of the liver--an imaging challenge. 716

A questionnaire survey of residency trained graduates and nonresidency trained family physicians showed both groups reporting relatively infrequent practice of behavioral medicine. Referrals and counseling sessions/visits produce a combined total of 20 activities per month, or two to four percent of all patient encounters, even though the physicians in the sample reported that 33 percent of their diagnoses were behavioral/psychological. More than 85 percent of the physicians reported access to more than one mental health provider. The six most common health problems encountered in the office were depression, anxiety, obesity, marital discord, alcohol abuse, and sexual problems. Physicians responding to this survey expressed an interest in continuing education programs that emphasize individual, marital, and parenting counseling, and psychopharmacology. There is a major need to improve the mental health component of residency training, which will enable physicians to better manage psychosocial problems in practice settings.
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PMID:Mental health activities of family physicians. 720 71

A common reason for referring patients to hepatologists is persistently abnormal serum transaminase levels with vague constitutional symptoms. In the United Kingdom, these abnormalities are most often caused by a fatty liver either related to obesity or alcohol abuse; they are less commonly caused by chronic liver disease, particularly chronic viral hepatitis, autoimmune hepatitis, or chronic biliary disease. Endocrine disease is rarely a cause of these abnormalities, although hypothyroidism and hyperthyroidism are well-recognized causes. Addison's disease has been only reported once in the literature by R. G. Olsson as a cause of increased transaminase levels associated with constitutional symptoms; it is not mentioned in textbooks on hepatology. Three patients with Addison's disease are reported here, all of whom had increased serum transaminase levels for more than 6 months before the recognition of the hypoadrenalism with resolution to normal after steroid replacement. Hepatologists should consider subclinical Addison's disease as a cause of persistently increased transaminase levels with constitutional symptoms in the absence of evidence for fatty liver as well as viral and autoimmune markers.
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PMID:Subclinical Addison's disease: a cause of persistent abnormalities in transaminase values. 755 2

The aim of the study was to assess whether diabetic patients with autonomic neuropathy suffer from arterial oxygen desaturation during sleep. Two groups of subjects were evaluated: group I consisted of 12 patients with cardiovascular autonomic neuropathy (five with insulin-dependent diabetes mellitus (IDDM) and seven with non-insulin-dependent diabetes mellitus (NIDDM)). Group II consisted of 8 healthy subjects. Age, percentage male and body mass index (BMI) were similar in both groups. Exclusion criteria were abnormalities in arterial gas measurements, chest X-ray, spirometry or the presence of cardiac arrhythmias, obesity, uremia, alcohol abuse and use of drugs other than insulin and oral hypoglicemic agents. The results of arterial oximetry when the subjects were awake showed no differences between the two groups. However, during sleep, diabetics with autonomic neuropathy had an increased number of desaturation episodes under 85% and those episodes were more prolonged. The results suggest that diabetics with autonomic neuropathy might have abnormal control of respiration that is apparent only during sleep.
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PMID:Nocturnal oxygen desaturation in diabetic patients with severe autonomic neuropathy. 758 25

We reviewed 38 fractures of the humeral shaft which had been treated non-operatively to identify factors prognostic of nonunion. Of these, 23 healed uneventfully and 15 progressed to nonunion. Factors prognostic of nonunion included long oblique fracture pattern, alcohol abuse, and obesity. In patients with these risk factors, lack of clinical and radiographic evidence of healing 8 to 10 weeks post-injury suggests an impending nonunion, and operative intervention should be considered.
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PMID:Diaphyseal humerus fractures: natural history and occurrence of nonunion. 760 16

AIMS. 1) To evaluate the nutritional status of a group of alcohol abusers, relatively to their liver function and morphology, and 2) to compare these data with those of a previous study carried out by out team ten years ago. According to their body weight, 135 alcohol abusers were divided into three groups: normal-weight, over-weight and under-weight. The severity of their hepatopathy was defined as: 1. slight hepatopathy; 2. alcohol-induced hepatitis; 3. alcohol-induced hepatitis plus cirrhosis; 4 child A cirrhosis; 5. child B cirrhosis. RESULTS. 1. The overweight group was homogeneously distributed among the several degrees of compensated hepatopathy. 2. There was a marked reactivity to skin tests (Multitest) in patients with alcohol hepatitis without cirrhosis, independently of nutritional disorders. 3. Only decompensated cirrhosis may cause caloric-protein malnutrition; consequently, nutritional disorders due to alcohol abuse appear late and they are unlikely to play a leading role in the pathogenesis of liver disease due to alcohol abuse. Obesity, on the other hand, may facilitate the onset of liver steatosis.
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PMID:[Nutritional status of patients with alcoholic liver diseases: comparison of the situation in the seventies and at present]. 764 38

We investigated the hepatocellular peroxisomes in 27 patients with steatosis of the liver by means of catalase cytochemistry, light and electron microscopic study, and morphometry. Seven normal human livers were used as controls. In our patients, fatty liver was mainly associated with alcohol abuse or obesity. Indications for a slight decrease in catalase activity and for a proliferation were found in visual evaluation of the peroxisomes. Morphometric analysis showed a significant decrease in mean peroxisomal diameter (to 87%) and a simultaneous significant elevation to numerical density of the peroxisomes (to 188%); this resulted in a normal volume density and a significant increase to (133%) in surface density. However, individual differences were found. No differences in peroxisomal characteristics were found between fatty livers of different causes. A significant inverse linear correlation between mean peroxisomal diameter and numerical density was found in patients with fatty livers. Because a similar correlation was also found when control data were added to the fatty liver data, we hypothesize that the peroxisomal compartment in human fatty livers is adapted in such a way to permit the same metabolic efficiency as in control livers.
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PMID:Alterations of peroxisomes in steatosis of the human liver: a quantitative study. 765 78

Cerebrovascular accidents are responsible for killing or disabling half a million Americans every year and are the third leading cause of death in this country. Finding cost-effective means of decreasing stroke mortality and morbidity is of great humanitarian and economic importance. Panoramic dental radiography was done on 19 white men who had a recent cerebrovascular accident and who were hospitalized at a Department of Veteran Affairs medical center. Inclusion criteria included clinical suspicion or imaging study evidence that the stroke arose from atheroembolic disease of the carotid artery bifurcation. Women were omitted from the study because of their paucity in the patient pool, and African-Americans and Asian-Americans were omitted because strokes in those groups usually develop as a result of disease of intracranial vessels. Carotid arterial calcifications appearing as a radiopaque nodular mass adjacent to the cervical vertebrae at or below intervertebral space C3-4 were noted in seven persons (37%). These patients had an average age of 65 years and demonstrated multiple risk factors (prior transient ischemic attacks, prior stroke, hypertension, obesity, tobacco and alcohol abuse, hyperlipidemia) associated with occurrence of a stroke. We concluded that some white men at risk for a cerebrovascular accident may be identified in the dentist's office by appropriate review of the panoramic dental radiograph and medical history. The presence of carotid artery calcifications demands an expeditious referral to an appropriate practitioner who can assist in the control of risk factors and arrange prophylactic surgical removal of the carotid arterial plaque, which are both safe and reliable methods of reducing the incidence of stroke.
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PMID:Prevalence of detectable carotid artery calcifications on panoramic radiographs of recent stroke victims. 806 36

Cerebrovascular accidents (CVAs) are the third commonest cause of death in France. Approximately 15% of them are due to stenosis of the extracranial internal carotid. The fact that a third of CVAs are followed by death and another third by major handicaps leads to the need for careful prevention. This has three aspects: 1) Correction of risk factors: hypertension, smoking, hyperglycemia, hyperlipidemia, obesity, alcohol abuse, hematological abnormalities and oral contraception; 2) the prescription of one of two platelet anti-aggregants, the efficacy of which has been proved: acetylsalicylic acid or ticlopidine; 3) surgical elimination of tight carotid stenoses. The following require surgery: 1) more than 70% stenosis following cerebral or ocular TIA or minor CVA; 2) more than 75% stenosis in asymptomatic patients or with episodes of VBI as well as 70% in case of thrombosis of the contralateral internal carotid; 3) following a CVA leaving serious sequelae: tight stenosis when it is reasonable to assume that a further CVA could lead to clinical worsening or to a loss of independence; 4) symptomatic and/or more than 80% restenosis. The decision should be made only after confirmation of the diagnosis and of the degree of stenosis and verification of the absence of any local or systemic contra-indication. The surgical team must have a low cumulative mortality and perioperative CVA rate. These patients require ongoing medical monitoring, particularly from a cardiological standpoint.
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PMID:[Treatment of patients with atherosclerotic carotid stenosis in 1993. Indications and long-term results of surgery]. 807 24

As part of a larger prognostic study of anorexia nervosa, clinical features at presentation of 24 males with anorexia are described, and compared with a female group matched for date of admission. Data were extracted from the original case records and follow-up interview. The study confirms the view that males display the classical syndrome of anorexia nervosa, but differs from previous studies in several respects. Age at onset (mean 18.6 years) and at presentation (mean 20.2 years) is later, with a mean duration of illness at presentation of only 1.6 years. A premorbid tendency to obesity is confirmed; maximum weight loss during the illness amounted to 42% matched population mean weight (MPMW), and weight at presentation was 78.5% MPMW, somewhat higher than the female group. In keeping with earlier studies, binging and vomiting were noted commonly, in around half of sufferers, but laxative abuse was less frequent and excessive exercising more frequent in males. Depressive and obsessional symptoms are common in both groups, and a strong family history of affective disorders and alcohol abuse was noted in over one third.
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PMID:Clinical presentation of anorexia nervosa in males: 24 new cases. 817 58


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