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

Joint symptoms developed in six of 33 patients (18%) who had jejunoileostomy as treatment for intractable obesity. These consisted of single or recurrent attacks of polyarthritis or arthralgias, primarily in large joints. The histocompatibility antigen, HL-A B27, was not present in these patients. Most attacks responded to simple analgesic agents, but a trial of tetracycline in one patient failed to relieve joint symptoms. This arthropathy seems to differ from that which has been reported after jejunocolostomy.
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PMID:Arthritis after jejunoileostomy for intractable obesity. 88 89

The results of total hip replacement in 39 patients 30 years old or younger were evaluated including 67 Charnley low-friction arthroplasties and one McKee total hip arthroplasty. The average age was 25.9 years with an average follow-up of 39 months, the longest being 8 years, 3 months. The diagnoses included rheumatoid arthritis, ankylosing spondylitis, CDH, Still's disease, and a miscellaneous group. Over-all function did not improve as greatly as in the 9 to 10 year series, but this was due to a higher proportion of patients with severely disabling rheumatoid polyarthritis, hemiplegia, severe obesity, or cardiovascular disease. Wear did not seem to be any greater in this younger age group as compared to previous studies in older patients.
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PMID:Results of low friction arthroplasty in patients thirty years of age or younger. 119 31

The work analyses the results of treatment of 311 patients with extreme degrees of alimentary-constitutional obesity by formation of a small stomach. Fatal outcomes (1.9%) were encountered in the period of operative technique mastering. The late-term results were studied in 167 patients in follow-up periods of up to 3 years. The patients' average body weight was 149.4 kg, average height 166.2 cm, average body weight excess as compared to the ideal weight was 125.6%. Study of the late-term results of the operation showed that the postoperative weight loss depends on the initial weight excess and the diameter of the anastomosis formed between the proximal and distal parts of the stomach. The more the initial excess of weight as compared to the ideal value, the more the loss of body weight is. The diameter of the formed anastomosis should be no larger than 15 mm. Besides loss of weight, the activity of vital organs and systems is normalized after the operation, and arterial hypertension, diabetes mellitus, the Pickwickian syndrome, and metabolic polyarthritis take a milder course. The operation for formation of a small stomach made it possible for the patients to resume their customary occupation, freed them of the threat of invalidation, and reduced the duration of the disability period by 4.3 times. After surgical treatment the nature of the patients' life significantly improved; 95.8% of patients appraised the effect of the treatment as excellent and good.
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PMID:[Late results of the treatment of patients with the extreme degree of alimentary-constitutional obesity by the method of formation of a small stomach]. 180 96

An analysis of clinical symptoms and characteristic features of a course of gout in 10 women (3.4% of 290 gout patients) has shown that gout patients can represent a heterogeneous group in terms of age, predisposing causes (hereditary predisposition, change in a hormonal pattern, obesity and iatrogenic effects like the use of diuretics), concomitant pathology and variants of a disease course. Two clinical variants have been defined: classical in which disease develops during or after occurrence of menopause along a favorable course, without tophi and signs of chronic arthritis, and atypical which develops at a younger age, has a grave course and can rapidly progress (chronic polyarthritis with frequent recurrences can sometimes develop in the course of 2-3 yrs). No significant variations in the clinical picture were noted in comparison with those in men.
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PMID:[Gout in women]. 359 9

Postdysenteric Reiter's syndrome and the arthritis associated with jejunal bypass surgery for obesity suggest that the gastrointestinal tract is a possible source of bacterial products capable of initiating chronic inflammatory arthritis. Lactobacillus casei, a common component of the enteric flora, has a cell wall structure similar to that of arthritogenic streptococci. In this study we have demonstrated that a single intraperitoneal injection of an aqueous suspension of the cell walls of Lactobacillus casei induces a dose-dependent, chronic, symmetric, erosive, peripheral polyarthritis in inbred LEW/N female rats. This model suggests that bacteria in the "normal enteric flora" may be a source of inflammatory products capable of inducing chronic erosive polyarthritis.
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PMID:Polyarthritis in rats following the systemic injection of Lactobacillus casei cell walls in aqueous suspension. 641 86

Arthritis commonly accompanies clinical disturbances of metabolism, while diseases which are primarily articular may cause major general metabolic abnormalities. The relationship between diet, nutrition and joint diseases is complex and varies from simple mechanical factors (as in obesity) to complex metabolic processes. Current knowledge of these processes is extensive in some areas, such as in gout and hyperuricaemia, whereas in others, such as the arthropathy encountered after intestinal bypass surgery, it is very scant indeed. Joint disorders in hyperlipoproteinaemia and diabetes mellitus are varied and the pathogenesis of these articular problems is as yet ill understood. In view of the frequency with which these metabolic problems occur, these disorders offer no opportunities for the clinical study of the processes involved in joint inflammation and damage. In contrast, metabolic abnormalities such as hypergastrinaemia and elevated ionized calcium in rheumatoid arthritis are worthy of study, as they may offer clues to the underlying aetiology of the joint disease. This latter abnormality is suggestive of hyperparathyroidism, a condition which may present with polyarthritis and in which joint changes may be severe, although they are usually obscured by the more obvious bony problems in this disease. An illustrative historical vignette is included.
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PMID:Some metabolic aspects of arthritis. 703 19

Of the 31 patients who developed polyarthritis following jejunoileal bypass for obesity, 24 had cutaneous vasculitis (urticarial, pustular, and nodular), 11 paresthesias, 10 Raynaud's phenomenon, and 1 pericarditis. Blind loop symptoms (14 of 26 patients), cryoglobulinemia (10 of 28), and immune deposits in biopsied skin lesions (5 of 7) support the theory of a relationship between bowel bacteria and immune complexes. Treating the blind loop with antibiotics and sphincteroplasty to prevent bacterial reflux into the blind loop helped 5 of 10 and 6 of 9 patients, respectively. A comparison is made to other bowel associated arthritides.
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PMID:The intestinal bypass: arthritis-dermatitis syndrome. 723 24

Development of ankylosis of joints involved with gouty arthritis is an exceedingly rare event of which only ten examples have been reported. Most patients had chronic, tophaceous gout that had not received adequate medical attention. The authors report two new cases including one in a patient with no documented history of acute gout. The first patient was a 72 year old noninsulin-dependent diabetic male who had been given a diagnosis of gouty polyarthritis with tophi seven years earlier. The second was a 42 year old male with no history of acute gout in whom hyperuricemia had been diagnosed at the age of 22 years upon evaluation for obesity. Both patients had ankylosis of the ankles and proximal interphalangeal joints of the hands. A marked decrease in range of motion of the wrists was found in the second patient. Roentgenograms showed complete ankylosis of the tarsus and partial ankylosis of the tibiotarsal joints in both patients, as well as ankylosis of the carpus in the second patient. The pathophysiology of ankylosis during gouty arthritis is poorly understood. A pannus containing abundant urate crystals is found upon pathological examination. Antihyperuricemic agents can reverse urate deposition but have no effect on ankylosis.
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PMID:[Ankylosing gout. Apropos of 2 cases]. 800 Apr 1

Choice of diet is one way in which an individual can influence his/her own health, and it is to be expected that patients will seek their physician's expert opinion regarding dietary matters. Respect for the legitimacy of these enquiries and balanced informed discussion, which includes general advice for a prudent diet, as well as disease-specific recommendations when indicated, can be the key to a productive relationship between patients and physician. The issue of dietary advice has an impact on the management of most forms of arthritis including osteoarthritis (obesity/energy balance), gout (dietary purines, energy balance, alcohol, fluid intake) and rheumatoid arthritis (n-3 fatty acids). Food hypersensitivity appears to be a rare cause of polyarthritis, and elimination diets and fasting have little or no place in routine practice. Strategies under investigation include oral tolerization, the utility of which remains to be established.
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PMID:Diet and arthritis. 859 53

The incidence of rheumatoid arthritis in women is 4 times that in men, suggesting a possible relationship between this disease and ovarian functioning. A study was done to attempt ovarian control in the treatment of rheumatoid polyarthritis by the use of norethisterone in a dose of 20 mg/day for 1 month. 3 women between the ages of 40 and 50 were helped greatly. In 5 women between the ages of 50 and 60 results obtained were quite good. 4 women over 60 had poor results. It is logical to suppose that results would be better in younger women. In 4 cases where metrorrhagia supervened and in 3 others treatment was not properly used. Some patients complained of loss of hair and in some there was a tendency to obesity and hypertension which, however, was generally mild. No case of rheumatoid arthritis was cured. Response, when it occurred, was rapid but once obtained was not followed by further improvement.
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PMID:[Good results with Norethisterone in rheumatoid arthritis]. 1230 22


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