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

We have previously shown that insulin attenuates vasoconstrictor responses to pressor agonists and accelerates vascular smooth muscle cell (VSMC) Ca(2+)-ATPase mediated Ca2+ efflux and vascular relaxation. We have now sought to determine if VSMC from insulin resistant (Zucker Obese, ZO) rats manifest exaggerated [Ca2+]i responses to pressor agonists and impaired [Ca2+]i recovery (rate of [Ca2+]i return to baseline) compared to their lean controls (ZL). Thoracic aortae from ZO and ZL were enzymatically digested to release VSMC (n = 16 animals/group and 8 determinations/group). Freshly dispersed cells were washed, counted, and loaded with Fura-2-AM. The [Ca2+]i responses to and rate of recovery from angiotensin II (AII; 200 nmol/L) and arginine vasopressin (AVP; 10 mumol/L) were studied fluorometrically in stirred suspension (10(6) cells/mL). Peak [Ca2+]i responses to AVP were not significantly different in ZO v ZL, while responses to AII were higher in ZL ([Ca2+]i, 180 +/- 7 v 160 +/- 4% of baseline in ZL and ZO, P < .02). Since we have recently shown insulin to increase AII-releasable Ca2+ stores in sarcoplasmic reticulum, this increase in peak [Ca2+]i response to AII in ZL may reflect relative VSMC insulin resistance in ZO. Despite their increased peak AII response, ZL exhibited a more rapid recovery from both the AII-stimulated load (recovery rate, 66.1 +/- 8.9 v 42.1 +/- 9.0 nmol/L/min in ZL and ZO, P < .02) and the AVP-stimulated [Ca2+]i load (22.2 +/- 2.3 v 18.4 +/- 4.6 nmol/L/min).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Impaired recovery of vascular smooth muscle intracellular calcium following agonist stimulation in insulin resistant (Zucker obese) rats. 834 33

Obesity is increasingly prevalent. Earlier studies indicated that there was a significant but small difference in spirometric values between sitting and standing position in the normal population. It is not known if this is true for obese individuals. The recommendations of the American Thoracic Society (ATS) are to document if a spirometry is done in a sitting or standing position. We performed a study in which we compared sitting and standing spirometric values in obese individuals. Patients with a body mass index (BMI) > or = 30 kg/m2 who were referred for spirometry were invited to participate. All tests were done according to American Thoracic Society recommendations. We studied 50 subjects (32 females and 18 males; mean age 45 yr [SD +/- 14.4]). Age range was 20-71 years. Average BMI was 39 (SD +/- 7, range 30 to 65). Twenty-two did the first testing in the sitting position and 28 standing. There was a small but statistically significant difference between forced vital capacity (FVC) in the standing versus sitting position (Wilcoxen test, p < or = 0.05). There was no significant difference in FEV1 between sitting and standing. Our conclusion is that body position is not important when performing spirometry in persons with BMI > or = 30 kg/m2.
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PMID:Spirometric values in obese individuals. Effects of body position. 931 25

A prospective study was undertaken to reconcile radiographic cardiomegaly and normal echocardiography in obese cats and to test a radiographic technique for better distinguishing between pericardial fat and the heart. Ten obese, but otherwise normal cats and 10 non-obese normal cats were used. A body condition scoring system was used to objectively group obese and non-obese normal cats. Two-dimensional echocardiograms were made to verify that all cats had a normal heart. Thoracic radiographs then were made using standard and altered exposure techniques. The hearts were measured on these radiographs using the metric and a vertebral scale system. Obese cats consistently had excessive fat around the heart especially if they also had a large amount of falciform fat. Altering exposure technique by increasing mAs and decreasing kVp sometimes enhanced the radiographic contrast between fat and myocardium. Enhanced radiographic contrast accentuated the double silhouette identifying the true cardiac silhouette within the fat expanded silhouette. Pericardial fat usually was distinguished more readily in lateral than in VD radiographs. In two cats, pericardial fat had a characteristic prominent square corner to the right cranial margin of the cardiac silhouette in VD radiographs. Obesity caused increased width and depth of the thoracic cage. 2D echocardiograms revealed normal cardiac dimensions in both groups of cats and increased precordial distance in the obese group.
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PMID:Radiographic and echocardiographic measurement of the heart in obese cats. 1095 93

The risk of surgical procedures is strongly affected by coexisting pulmonary disease. Patient related risk factors for pulmonary disorders in the perioperative period are poor medical condition, old age, obesity, smoking, COPD, and bronchial asthma. Thoracic surgery and upper abdominal surgery are the most important procedure related risk factors for pulmonary complications in the perioperative period. Preoperative evaluation of lung function, assessment of the perioperative pulmonary risk, identification of high risk patients, and preoperative improvement of lung function, if possible, result in an improved outcome of surgical procedures due to a reduction of perioperative pulmonary complications.
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PMID:[Surgically relevant comorbidity: lung function]. 1182 41

Thoracic radiographs of fifteen beagles with mild-to-moderate obesity revealed that oppression of the thoracic cavity increased with increasing degree of obesity. Oppression of the thoracic cavity was evaluated based on the length, depth, width and area of the thoracic cavity. To obtain thoracic radiographs at the terminal inspiration and expiration phases, thoracic fluororadiographs were recorded with a digital video camera. Bodyweight and the depth of the back fat layer at the seventh lumbar vertebra (DB, measured by ultrasonography) were used as indicators of the degree of obesity. The length of the thoracic cavity tended to become shorter and the depth and width of the thoracic cavity tended to increase as bodyweight increased and as DB increased. On the other hand, the area of the thoracic cavity was not clearly related to bodyweight or DB. These results suggest that oppression of the thoracic cavity due to the cranial shift of the diaphragm is compensated for by increases in the depth and width of the thoracic cavity in beagles with mild-to-moderate obesity.
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PMID:Radiographic evaluation of obesity-caused oppression of the thoracic cavity in beagles. 1518 57

Since the original clarification of the obstructive nature of obstructive sleep apnea (OSA) in 1965, much has been learned about the disorder. It is a condition with a high prevalence with obesity as a major risk factor. It aggregates in families, a relationship that is not simply explained by obesity. Premenopausal women are relatively protected from the disorder because OSA is uncommon in this group. Its prevalence in women rises after menopause. Although OSA is a risk factor for excessive sleepiness, there is developing evidence that it is also a risk factor for hypertension, acute cardiovascular events, and insulin resistance. The first line of therapy is nasal continuous positive airway pressure. Data as to the efficacy of continuous positive airway pressure in severe OSA have come from randomized, placebo-controlled clinical trials with the endpoints being sleepiness, quality of life, and 24-h ambulatory blood pressure. Data are currently less convincing for treatment outcomes in mild to moderate OSA, and new clinical trials to assess outcomes in this group are underway. Thus, even though this field only began toward the end of the first century of the American Thoracic Society, substantial progress has been made, and OSA has increasingly emerged as a major public health concern.
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PMID:Advances in sleep-disordered breathing. 1628 8

During these 10 last years, even though patients had a more and more severe condition, the results of coronary artery bypass surgery have continuously improved. According to Society of Thoracic Surgeons data, the operative risk increased by 1/3 (2.6% in 1990 vs. 3.4% in 1999), whereas the per-operative mortality was reduced by 1/4 (3.9% in 1990 vs. 3% in 1999), and is currently stabilized around 2.5-3%. The incidence of complications is a non-negligible marker. The complications observed are mostly neurological (2%), renal (4%), myocardial (4%), infectious (0.5 to 2%), and respiratory (10%). Their occurrence is related to the presence of preoperative risk factors: age (>60 years), sex (female), EF <50%, diabetes, severe obesity, lung disease, renal failure, recent myocardial infarction, redo and/or emergency surgery... The detection and peri-operative control of these factors permit a reduction of complications incidence and limit the length of stay; a better management of per-operative blood glucose in diabetic patients reduced significantly the morbidity. These factors are used in different scores, such as the Euroscore, which seems to be the best predictor of mortality. Patients stratification according to their risk profile permits to inform the patient and his/her family regarding the operative risk and take peri-operative therapeutic decisions, in order to reduce the morbidity and mortality during coronary artery bypass surgery.
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PMID:[Prognostic factors of coronary artery bypass surgery]. 1747 98

Obesity as a common health risk is increasing all over the world. The aim of this study was evaluation of standing and sitting positions on spirometric values in obese asthmatic patients, in comparison with normal obese subjects. The study included 49 obese asthmatic patients with mean age of 42.63 years and body mass index of 36.06 kg/m2, and 51 control obese normal subjects with mean age of 39.86 years and body mass index of 36.69 kg/m2. Subjects with body mass index of (BMI) > or =30 kg/m2 were enrolled in the study. Spirometric values were measured according to American Thoracic Society (ATS) recommendation. In both groups forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were measured in sitting and standing positions, and the results were compared. The mean+/-SD of FVC in sitting and standing positions in obese asthmatic patients were: 3.04+/-0.93 lit and 3.03+/-0.96 lit, p=0.37; and in control group: 3.68+/-1.12 lit and 3.72+/- 1.11 lit, p=0.39, respectively. The mean+/-SD of FEV1 in the sitting position and standing positions in obese asthmatic patients were: 2.38+/- 0.75 lit and 2.40+/- 0.81 lit, p=0.20; and in control subjects: 3.17+/- 0.92 lit and 3.21+/- 0.93 lit, p=0.07. This study showed that spirometric values in obese asthmatic patients with BMI> or =30 are not affected by the standing and sitting positions.
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PMID:The effect of positions on spirometric values in obese asthmatic patients. 1789 36

The impact of obesity on risk of atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is poorly understood. This study was performed to investigate the relation between body mass index (BMI; kilograms per square meter) or body surface area (BSA; square meters) and AF after CABG. Postoperative AF was assessed in a cohort of 7,027 consecutive patients without preoperative AF undergoing isolated CABG at Baylor University Medical Center from January 1, 1997 to December 31, 2006. Two propensity-adjusted models controlling for risk factors identified by the Society of Thoracic Surgeons and other clinical/nonclinical details were used. After adjustment, BMI and BSA (modeled using smoothing techniques to avoid categorization) were strongly associated (p <0.0001) with postoperative AF. Although evidence existed that gender was associated with AF (p <0.0001 and p = 0.1088 for BSA and BMI models, respectively), there was no indication that the effect of BMI or BSA on postoperative AF varied by gender. In conclusion, this study demonstrates that increased BMI and BSA are associated with a higher risk of AF after CABG and that risk for men is higher for the entire BSA spectrum and for extreme values of BMI.
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PMID:Relation of obesity to atrial fibrillation after isolated coronary artery bypass grafting. 1923 30

Small-cell carcinoma (SCC) of neuroendocrine type is an uncommon tumor of the endometrium. No previous report has documented Cushing's syndrome due to ectopic ACTH production by SCC of the endometrium. We describe a 56-year-old Japanese woman with SCC of the endometrium and multiple lung metastases presenting as Cushing's syndrome. The patient was referred to our hospital because of general fatigue with facial and leg edema, and multiple nodular lesions in the bilateral lungs on chest X-ray examination. A physical examination revealed that the patient had moon face, buffalo hump, and truncal obesity. Endocrinological examinations confirmed ACTH-dependent Cushing's syndrome. Thoracic computed tomography imaging showed multiple nodular lesions in the bilateral lungs. Abdominal magnetic resonance imaging suggested a malignant tumor of the uterus. The patient received a lung tumor biopsy and surgical hysterectomy. The endometrial carcinoma was histologically a SCC admixed with endometrioid adenocarcinoma. The SCC of the endometrium showed immunoreactivity for pro-opiomelanocortin, ACTH, and vimentin, but not for thyroid transcription factor-1. The lung biopsy specimen had the same features. These findings indicated that the SCC originated from the endometrium, and the ectopic ACTH-producing tumor caused Cushing's syndrome. This study provides the evidence that SCC of endometrial origin was an ectopic ACTH-producing tumor causing Cushing's syndrome.
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PMID:Small-cell carcinoma of the endometrium presenting as Cushing's syndrome. 1983 52


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