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

Benign symmetrical lipomatosis of the neck is a rare disease that has to be differentiated from goiter, sialadenitis, obesity or a lymphatic tumor. Most patients are severe alcoholics, but they may have other endocrine disorders, such as diabetes mellitus, hyperuricemia, or hyperlipidemia. Aside from the cosmetic disfigurement and consequent psychological stress, respiratory distress may be the indication for surgical treatment. Excision of the lipomatosis requires technical skill because the extensive and sometimes infiltrative growth makes dissection of muscle and nerves difficult. The computer tomogram provides good information on the extent of the disease. Three of our 5 patients died 2 1/2 to 6 years after the first operation because of their primary disease.
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PMID:Lipomatosis of the neck (Madelung's neck). 327 65

Prader-Willi syndrome is rather a rare disease. However, as it includes 4 features (hypogonadism, hypomentia, hypotonia, and obesity), urologist may see the patients with this syndrome for their gonadal problem. We studied all the 27 cases in our hospital of which data were precisely collected. Among males, 67% of patients had presented themselves first to the department of pediatric internal medicine. One third of the patients were not diagnosed as the syndrome and referred to our clinic because of urological abnormalities. Chromosomal abnormality was seen in 40.9%. We found cryptorchism in all the cases and micropenis in 56%. In females, delayed menarche over 15-year-old was seen in 75%. From endocrinological studies, 75% male showed low reaction against HCG stimulation. Low gonadotropin responses to LH-RH were seen in 80% of all patients. We performed orohiopexy for cryptorchism, but testicular development was poor. And we do not actively utilize hormonal therapies for these patients.
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PMID:[Urological problems in Prader-Willi syndrome]. 793 54

A literature review dealing with epidemiological and etiologic aspects of squamous cell carcinoma of the vulva is presented. It is a rare disease; the incidence is 1-2 per 100,000 women per year. Among women more than 75 years of age, the incidence is at least ten times higher. The cause of vulvar carcinoma is not known. In contrast to what has been stated for many years, in recent case-control studies no evidence was found that diabetes mellitus, obesity, vascular diseases, nulliparity, an early menopause and syphilis are risk factors for developing a vulvar carcinoma. The factors that play a role in the etiology of vulvar carcinoma are: vulvar dystrophy, a history of genital HPV-infection, a history of cervical neoplasia, advanced age, smoking and a compromised immunity. Usually, for the development of a vulvar carcinoma, more than one of the above mentioned factors have to be present.
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PMID:Epidemiology and etiology of squamous cell carcinoma of the vulva. 838 37

Ischemic heart disease in young women is a rare disease, but nowadays it is more frequently detected. The investigation involved 83 women up to the age of 19 with ischemic heart disease. The most frequent risk factors were as follows: hypertension, hyperlipoproteinaemia, smoking, stress and obesity. The association of three factors was most often observed. Electrocardiogram at rest pointed to the changes as follows: anteroseptal region, the whole anterior wall, postero-inferior region and subendocardial localization. Out of 11 exercise tests 36 (81.81%) of them were positive. Coronary arteriography was performed in 72 (86.71%), with positive changes in 61 (81.72%) patients. Occlusive changes were most frequently found on anterior descendent artery. Since a great number of risk factors in women may be easily corrected by an adequate diet and healthier way of life, their detection and implementation of measures of primary and secondary prevention have been attached a great importance.
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PMID:[Ischemic heart disease in young women. Its importance and possibilities of prevention]. 852 99

Classic Cushing's syndrome is a rare disease with an estimated incidence of 1 case per 100,000 persons. With routine use of imaging techniques such as ultrasound and CT, adrenal masses are being detected with increased frequency. A substantial percentage of these incidentalomas are hormonally active, with 5% to 20% of the tumors producing glucocorticoids. Autonomous glucocorticoid production without specific signs and symptoms of Cushing's syndrome is termed subclinical Cushing's syndrome. With an estimated prevalence of 79 cases per 100,000 persons, subclinical Cushing's syndrome is much more common than classic Cushing's syndrome. Depending on the amounts of glucocorticoids secreted by the tumor, the clinical spectrum ranges from slightly attenuated diurnal cortisol rhythm to complete atrophy of the contralateral adrenal gland with lasting adrenal insufficiency after unilateral adrenalectomy. Patients with subclinical Cushing's syndrome lack the classical stigmata of hypercortisolism but have a high prevalence of obesity, hypertension, and type 2 diabetes. All patients with incidentally detected adrenal masses scheduled for surgery must undergo testing for subclinical Cushing's syndrome to avoid postoperative adrenal crisis. The best screening test to uncover autonomous cortisol secretion is the short dexamethasone suppression test. Because the adrenal origin of a pathologic cortisol secretion is anticipated, the author prefers a higher dexamethasone dose (3 mg instead of 1 mg) to reduce false-positive results. A suppressed serum cortisol level of less than 3 micrograms/dL (80 nmol/L) after dexamethasone excludes significant cortisol secretion by the tumor. A serum cortisol level greater than 3 micrograms/dL requires further investigation, including confirmation by high-dose dexamethasone (8 mg) suppression testing, a CRH test, and analysis of diurnal rhythm. Determination of urinary free cortisol is less useful because increased values are a late finding usually associated with emerging clinical signs of Cushing's syndrome. Patients with suppressed plasma ACTH in response to CRH generally have adrenal insufficiency after surgery and require adequate perioperative and postoperative substitution therapy. Whether patients with subclinical Cushing's syndrome should undergo adrenalectomy is a matter of debate. The author performs surgery in young patients (< 50 years), in patients with suppressed plasma ACTH, and in patients with a recent history of weight gain, substantial obesity, arterial hypertension, diabetes mellitus, and osteopenia. In completely asymptomatic patients with normal plasma ACTH concentrations and in patients older than 75 years, the author recommends a nonsurgical approach. A large prospective randomized study is necessary to evaluate the benefits of surgery versus conservative treatment in patients with subclinical Cushing's syndrome.
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PMID:Subclinical Cushing's syndrome. 1073 63

Mesenteric panniculitis is a rare disease of the adipose tissue of mesentery. Ascites is an unusual presentation. We report a case of panniculitis whose initial presentation was an obesity-hypoventilation syndrome with pulmonary hypertension. Respiratory disorders were related to abundant ascites. Panniculitis cure and ascites disappearance allowed return to normal pulmonary function and pulmonary artery pressure.
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PMID:[Unusual cause of severe alveolar hypoventilation]. 1075 66

Little is known on the epidemiology of Cushing's disease (CD) as relevant data on such a rare disease can only be obtained from large-scale studies. We addressed this topic analyzing the data obtained in the Italian multicenter study which comprised nearly 300 patients with CD. The number of newly diagnosed patients with CD increased markedly in the second decade of the study (from 7.4 +/- 0.71 pts/year prior to 1987 to 26.4 +/- 4.12 after 1987) probably reflecting the heightened awareness of the disease and the increased availability of diagnostic tools. Urinary free cortisol (UFC) levels were significantly higher in men than in women and were inversely correlated with the time interval between appearance of symptoms and diagnosis. Recognition of CD among patients presenting with common diseases such as obesity, diabetes and hypertension requires highly sensitive screening tests (e.g. UFC, midnight cortisol in saliva, overnight dexamethasone suppression test) which however may yield false positive results. In doubt, second line testing using dex-CRH or desmopressin may distinguish between CD and pseudo Cushing. The different prevalence of CD and ectopic ACTH secretion (ES) undermines the diagnostic accuracy of tests used for the differential diagnosis of ACTH-dependent Cushing's syndrome (i.e. CRH, high dose dexamethasone, IPSS). Tests aimed at identifying ES rather than CD are needed to overcome this bias. Transsphenoidal surgery was the preferred choice of treatment for patients with CD, resulting in remission in 70% operated patients with a 15% relapse rate over 10 years follow-up. Definition of remission after surgery and parametres predictive of relapse, however, vary according to studies and long-term follow-up is required to establish their validity. Most clinical manifestations of hypercortisolism disappeared after remission although some long-lasting effects on the cardiovascular system had been observed. Finally, according to recent reports, mortality rates for patients cured of CD appear comparable to those of the general population.
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PMID:Epidemiology and follow-up of Cushing's disease. 1135 89

Necrotizing fasciitis is a rapidly progressive infection of the fascia and subcutaneous tissues accompanied by a high mortality rate approaching 80% to 100%. Factors that predispose patients to this life-threatening complication include obesity, malnutrition, malignancy, chronic alcoholism, drug abuse, peripheral vascular disease, diabetes mellitus, and immunosuppressive therapy. The pathomechanisms for the development of this rare disease still remain unclear. We report a case of necrotizing fasciitis with Clostridium perfringens after laparoscopic cholecystectomy. The patient left the hospital 5 months after admission. Early recognition based on clinical signs (pain, asymmetric abdominal thickening, crepitus) and computed tomography scanning (gas dissection along fascial planes), in conjunction with prompt, aggressive surgical therapy and debridement of all devitalized tissue, high-dose antibiotic therapy, and therapy at the intensive care unit, appears to afford patients the best chance of survival.
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PMID:Necrotizing fasciitis with Clostridium perfringens after laparoscopic cholecystectomy. 1197 28

Bardet-Biedl syndrome is a rare disease characterized by pigmentary retinopathy, dysmorphic extremities, obesity, renal abnormalities and hypogonadism only in men. The authors present a typical case and made a brief commentary about the disease's cardinal manifestations.
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PMID:[Bardet-Biedl syndrome]. 1202 54

The authors describe the case of a 14-year old girl with pseudohypoparathyroidism, who showed characteristic phenotypic features of Albright's hereditary osteodystrophy (short stature, round face, mild obesity, abnormal position of teeth, lack of canines, limb valgity) and biochemical disturbances--hypocalcemia, hyperphosphatemia. The nature of pseudohypoparathyroidism consists in a lack of response to the parathormone of effector organs, such as kidneys, bones, alimentary tract. The treatment of choice includes active metabolites of vitamin D3, calcium salts, phosphate-binding components. Pseudohypoparathyroidism is a rare disease. Worth noting is the fact that it can occur in a child with height deficiency.
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PMID:[Pseudohypoparathyroidism in a 14-year old girl]. 1281 2


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