Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thiazolidinediones are currently indicated for the treatment of Type 2 Diabetes. This class of drugs has been associated with several adverse reactions associated with volume overload. This report describes a case of a 65 year old African-American female with a history of hypertension and obesity, and taking rosiglitazone (Avandia) for her Type 2 Diabetes whose evaluation for chest pain resulted in the incidental finding of pulmonary hypertension noted on echocardiogram. The subsequent evaluation, follow-up and treatment are discussed along with potential pitfalls and implications for clinical care.
 ...
PMID:Thiazolidinedione associated volume overload and pulmonary hypertension. 1912 40

Pulmonary embolism (PE) and deep venous thrombosis (DVT) are clinical manifestations of the same entity, venous thromboembolic disease (VTD). In approximately 25% of patients, the first manifestation of PE is sudden-unexpected death. We carried out a prospective study at the forensic pathology service of the Institute of Legal Medicine in Seville with the aim to know the incidence of PE as well as to describe the epidemiological, pathological and clinical characteristics of these deaths and associated risk factors. In the study period (32 months) 32 cases of PE were registered from a total of 2447 completed autopsies. Three cases were considered accidental deaths and the remaining 29 cases were sudden natural deaths, which represents 1.3% of the total autopsies, 2.6% of natural deaths and 4.3% of sudden deaths. Nineteen cases (59%) were men (mean age 50.3+/-13.8, range 22-74 years) and 13 cases (41%) were women (mean age 50.3+/-13.8, range 18-87 years). In 78% of cases death occurred at home or during transfer to a health care centre, mainly during the fall or winter (69%) and between 8a.m. and 4p.m. (47%). Pulmonary infarction was associated only in two cases (6%). Nine cases (28%) had been immobilized but only three (9%) received anticoagulant therapy. Surgical interventions had occurred in seven cases (22%). A history of psychiatric pathology was found in 31%. Overweight or obesity was found in 75%. The most frequent symptoms prior to death were dyspnea (31%) and chest pain (19%), and 19% of patients were examined in an Emergencies Department for symptoms compatible with deep vein thrombosis and/or PE, but this diagnosis was not suspected in any case. PE frequently makes its first appearance as sudden death. In addition to the classic risk factors, this study highlights that 75% of the cases were overweight/obese as well as 31% having had a history of psychiatric disorders and treatment as to support that this association should be considered as a risk factor. PE continues to be under diagnosed in Emergencies Department patients, which hinders the application of adequate therapeutic measures to prevent these deaths.
 ...
PMID:Pulmonary embolism and sudden-unexpected death: prospective study on 2477 forensic autopsies performed at the Institute of Legal Medicine in Seville. 1932 75

Several important longitudinal studies in the social sciences have omitted biomarkers that are routinely recorded today, including height and weight. To account for this shortcoming in the Wisconsin Longitudinal Study (WLS), an 11-point scale was developed to code high school senior class yearbook photographs of WLS participants for relative body mass (RBM). Our analyses show that although imperfect, the RBM scale is reliable (alpha = .91) and meets several criteria of validity as a measure of body mass. Measured at ages 17-18, the standardized relative body mass index (SRBMI) was moderately correlated (r = .31) with body mass index (BMI) at ages 53-54 and with maximum BMI reported between ages 16 and 30 (r = .48). Overweight adolescents (> or = 90th percentile of SRBMI) were about three times more likely than healthy-weight adolescents (10th-80th percentile of SRBMI) to be obese in adulthood and, as a likely consequence, significantly more likely to report health problems such as chest pain and diabetes. Overweight adolescents also suffered a twofold risk of premature death from all nonaccidental causes as well as a fourfold risk of heart disease mortality. The RBM scale has removed a serious obstacle to obesity research and lifelong analyses of health in the WLS. We suggest that other longitudinal studies may also be able to obtain photos of participants at younger ages and thus gain a prospectively useful substitute for direct measures of body mass.
 ...
PMID:Predicting adult health and mortality from adolescent facial characteristics in yearbook photographs. 1934 7

We report the case of a 50-year-old man admitted for cardiac tamponade. He was diagnosed with acute pneumonia. He had no previous medical history, but exhibited a body mass index of 41. Two days before admission, he complained of chest pain irradiating to the neck lateral side. Massive cardiac tamponade developed over 48 hours. There was no obvious cause for immunodepression. Pericardial puncture was ineffective, due to obesity and fluid high viscosity. Surgery was undertaken (Marfan intervention). Pericardial fluid was found to be purulent; direct examination revealed nocardia as bacteria with typical filamentous, branching rods. Despite adapted antibiotic treatment the patient died within a few hours. Acute pericarditis due to Nocardia is discussed.
 ...
PMID:Fatal systemic nocardia infection revealed by cardiac tamponade. 2007 77

The effect of body mass index (BMI) on outcomes after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is not well known. In patients registered in the Korean Acute Myocardial Infarction Registry (KAMIR) between November 2005 and November 2007, 3824 STEMI patients who arrived at hospital within 12h after onset of chest pain and underwent primary PCI were analyzed, and divided into four groups according to their BMI: underweight (BMI<18.5 kg/m(2), n=129); normal weight (18.5 < or =BMI <23.0 kg/m(2), n=1253); overweight (23.0 < or =BMI <27.5 kg/m(2), n=1959); and obese (BMI > or =27.5 kg/m(2), n=483). In-hospital mortality, revascularization in 1 year, mortality in 1 year, and overall mortality were compared between groups. Overweight and obese group were significantly younger, had normal left ventricular ejection fraction, and were more likely to be men with a higher incidence of hypertension, diabetes, and hyperlipidemia. There were no significant differences in symptom-to-door time and door-to-balloon time between groups. Obese patients had significantly lower in-hospital and overall mortalities. Major adverse cardiac events showed a bimodal pattern. Obese STEMI patients treated with primary PCI were associated with lower mortality, which may be explained by better use of medical treatment, hemodynamic stability, and younger age.
 ...
PMID:Obesity paradox in Korean patients undergoing primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. 2012 53

The incidence of myocardial ischaemia is increasing in the obstetric population. This has been attributed to several factors including greater maternal age, the increasing incidence of obesity and diabetes, and the growing population of patients with grown-up congenital heart disease who now reach adulthood and become pregnant. A number of cases of myocardial ischaemia in pregnant women have been documented, during and after delivery, for which no cause has been established. We present a case of a nulliparous woman who developed cardiac chest pain, bradycardia, hypertension and a raised troponin I after vaginal delivery of twin boys at 36 weeks of gestation. Ischaemic electrocardiogram changes were noted. Detailed investigations demonstrated a normal coronary circulation. A patent foramen ovale was found on bubble echocardiography.
 ...
PMID:Peripartum cardiac chest pain and troponin rise. 2083 26

We present a 16-year-old girl who presented with chest pain. Given her obesity and positive family history, she was felt to have atherosclerotic heart disease. However, an echocardiogram showed an atrial myxoma, which prompted surgical excision. This case supports the routine use of echocardiography and widened differential diagnosis when presented with pediatric chest pain.
 ...
PMID:Left atrial myxoma in a child with unique presentation: chest pain. 2108 72

Weight loss is a recognized alarm symptom for organic gastrointestinal (GI) disease, yet the association between obesity and specific GI symptoms remains poorly described. A meta-analysis was conducted to determine which GI symptoms predominate among obese individuals. A search of the literature using the databases MEDLINE, EMBASE PubMed and Current Contents (1950 - November 2011) was conducted. All studies assessing GI symptoms and increasing body mass index (BMI)/obesity were included. English and non-English articles were searched. A random effect model of the studies was undertaken. Overall, significant associations between GI symptoms and increasing BMI were found for upper abdominal pain (odds ratio [OR] = 2.65, 95% confidence interval [CI]: 1.23-5.72), gastroesophageal reflux (OR = 1.89, 95% CI: 1.70-2.09), diarrhoea (OR = 1.45, 95% CI: 1.26-1.64), chest pain/heartburn (OR = 1.74, 95% CI: 1.49-2.04), vomiting (OR = 1.76, 95% CI: 1.28-2.41), retching (OR = 1.33, 95% CI: 1.01-1.74) and incomplete evacuation (OR = 1.32, 95% CI: 1.03-1.71). However, no significant associations were found for all abdominal pain, lower abdominal pain, bloating, constipation/hard stools, fecal incontinence, nausea and anal blockage. Several key GI symptoms are associated with increasing BMI and obesity. In addition, there were a number of other GI symptoms that had no relationship with obesity. A greater knowledge of the GI symptoms associated with obesity along with the physiology will be important in the clinical management of these patients.
 ...
PMID:Gastrointestinal symptoms and obesity: a meta-analysis. 2218 20

Some external features serve as a warning sign for accelerated atherosclerosis. Their early recognition may help in early detection and primary prevention/preemptive treatment of coronary artery disease (CAD). A 35-year-old nonsmoker, nonalcoholic, nonhypertensive, nondiabetic male presented with chest pain and was diagnosed to have acute ST elevation inferior wall myocardial infarction. His father had died of CAD at 40 years of age. The patient had bilateral extensive xanthelasma and gynoid obesity. His mother and younger brother also had evidence of bilateral xanthelasma; both turned out to be dyslipidemic - the younger brother qualifying for therapeutic intervention for dyslipidemia at 26 years of age. This case highlights the importance of familial xanthelasma as a cutaneous marker for underlying dyslipidemia and accelerated atherosclerosis in the young.
 ...
PMID:Familial xanthelasma with dyslipidemia: just another family trait? 2265 85

The most common cause of morbidity and mortality all over the world is Coronary artery disease. The traditional risk factors for Coronary artery disease are hypertension, diabetes mellitus, family history, smoking, dyslipidaemia and obesity. Chest pain and dyspnoea are the two common complaints of patients with Coronary artery disease. The CAD patients are the largest to be recruited in exercise testing. Bruce protocol is most commonly used in exercise testing. Patients developing chest pain and ECG changes are considered ETT positive. Heart rate determines myocardial oxygen demand. The heart rate increases during exercise due to sympathetic activation and parasympathetic withdrawal. Dyspnoea and pain result from interactions between multiple physiological, psychological, social and environmental factors. Both these sensations strongly motivate adaptive behaviour to regain homeostasis, and patients often experience both conditions. Anterior insula has a strong role that activates in pain and dyspnoea. Pain and dyspnoea which are the major complaints of CAD, can be measured using verbal descriptor or VAS. There is a need of simultaneous recording of chest pain and dyspnoea in patients with CAD. This review includes the studies done previously to record dyspnoea, through VAS and to measure intercept and slope in healthy volunteers and in patients with CAD.
 ...
PMID:The intercept and slope of breathlessness/chest pain-heart rate relationship in patients with coronary artery disease using exercise tolerance test. 2275 85


<< Previous 1 2 3 4 5 6 7 8 Next >>