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

Abdominal wound dehiscence is a surgical complication with a high morbidity rate but which is associated with predictable and preventable factors. During a 10 year period (1966 to 1975) at the New York Lying-In Hospital, 70 cases were found on the obstetric-gynecologic service, and these cases were analyzed to see why dehiscence remains a problem. Those factors contributing to dehiscence include obesity, pre-existing pulmonary and cardiovascular problems, vertical incisions, the triad of ileus, vomiting, and coughing, and, to a lesser extent, hypoproteinemia, fluid and electrolyte imbalance, and wound infection. The incidence of abdominal wound dehiscence would be much lower if high-risk patients were identified, adequate pulmonary toilet was used, ileus was promptly treated with abdominal decompression, and strict attention was paid to electrolyte and protein balance in the pre- and post-operative period. The management of abdominal wound dehiscence is also discussed.
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PMID:Abdominal wound dehiscence. 87 48

We examined 56 patients with hernias and 49 patients with other diseases prior to operation. They were all above 50 years of age. The urological screening examination included the patients history of the frequency of urination during night and day time, dysuria, the common risk factors (smoking, coughing, obstipation), obesity, a sonographic measurement of the prostate diameters, a sonographic evaluation of residual urine and the determination of the urinary flow rate. None of the above parameters showed a significant difference between the two groups. Surprisingly more than 60% of all men showed a pathological voiding function (either residual urine and/or a pathological flow rate). Our conclusions are: 1. Patients with inguinal hernias do not show a greater incidence of pathological bladder function than patients of the control group. The benign prostatic hypertrophy as a risk factor for the development of inguinal hernias is most questionable. 2. Because the results showed no significant difference between the two groups, a determination of residual urine prior to operation is not necessary. 3. More than 60% of the men above 50 years showed a pathological voiding function. We recommend a urological screening test for all men above 50 years of age during hospitalisation.
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PMID:[Inguinal hernia as a sequela of disordered bladder emptying?]. 138 59

The paper is concerned with pathogenetic mechanisms of cough syncope, its diagnosis, evaluation of working ability in this disease. Obesity plays a substantial role in the onset of cough syncope. The severity of pulmonary insufficiency or hypotonic dyskinesia of the tracheobronchial free are not essential for the disease course. Treatment of cough syncope should be based on therapy of pulmonary process and its complications.
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PMID:[Cough-syncope syndrome]. 178 77

In order to study risk factors associated with snoring in a general adult population, 2,187 subjects in the Tucson Epidemiologic Study of Obstructive Airways Disease were surveyed to determine the prevalence of snoring. Major independent risk factors for snoring were male gender, age between 40 and 64 years, obesity, and current cigarette smoking. Furthermore, greater intensity of cigarette smoking also was associated with higher snoring prevalence rates. Snoring prevalence remained elevated in subjects who recently quit smoking, but declined in ex-smokers to the level of never smokers within four years of smoking cessation. The presence of cough or sputum production was associated with an increase in snoring prevalence especially in ex-smokers. Snoring prevalence was slightly increased in subjects who regularly used alcohol or medications as aids to sleep. We conclude that cigarette smoking, obesity, male gender, age over 40, and use of alcohol or sleep medications are important risk factors for snoring. We propose that the effect of smoking may be related to the production of upper airway inflammation and edema by cigarette smoke, and that smoking cessation may eventually reduce snoring risk.
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PMID:Risk factors in a general population for snoring. Importance of cigarette smoking and obesity. 325 26

The key to restoring urinary continence in the female is to raise the internal vesical neck of the bladder to a position behind the symphysis pubis. The operation which accomplishes this with the least morbidity, the most accuracy and the greatest permanency is endoscopic suspension; it is particularly applicable in patients with obesity, multiple operative failures, radiation incontinence, and severe pelvic fractures. Between December 1973 and May 1979, 203 patients underwent 211 operations with a minimum of six months of follow-up study at final review (November 1979). Twenty per cent of the patients were totally incontinent on referral, and 60 per cent lost urine with minimal activity; only 20 per cent of the patients had typical stress urinary incontinence, requiring coughing or sneezing to lose urine. Among the 203 patients, there were 188 previous operations for urinary incontinence, including 74 Marshall-Marchetti retropubic repairs. Forty-seven patients have been followed for over four years, and 156 patients have been followed for six months to four years. While 138 patients had a previous hysterectomy, 65 patients had not; the presence of the uterus did not affect the results. Urinary incontinence is not an indication for hysterectomy. Ninety-one per cent of the 203 patients were cured of their urinary incontinence by endoscopic suspension of the vesical neck. Technical advantages over the retropubic vesical neck suspensions include the use of monofilament heavy nylon (No. 2), a vaginally placed Dacron((R)) buttress to prevent tearing of the pubocervical fascia, less postoperative morbidity, minimal blood loss, functional measurements and anatomic visualization of a restored vesical neck during the operative procedure, easy access to a surgically difficult pelvis, and simultaneous repair of significant rectoceles or substantial cystoceles through the same operative field.
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PMID:Endoscopic suspension of the vesical neck for urinary incontinence in females. Report on 203 consecutive patients. 742 93

Post-poliomyelitis respiratory impairment is extremely common and entails considerable risk of morbidity and mortality. Respiratory muscle weakness is the primary etiological factor but post-poliomyelitis individuals (PPIs) also have a high incidence of scoliosis, obesity, sleep disordered breathing, and bulbar muscle dysfunction, all of which can add to the risk. One hundred forty-five PPIs were managed by noninvasive alternatives to intermittent positive pressure ventilation (IPPV) via an indwelling tracheostomy. When properly managed in this manner, acute respiratory failure requiring hospitalization, tracheal intubation, and bronchoscopies were avoided. Timely introduction of mouthpiece IPPV, nasal IPPV, manually and mechanically assisted coughing, and noninvasive blood gas monitoring in the home were the principal techniques used for optimizing quality of life and for avoiding complications.
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PMID:Management of post-polio respiratory sequelae. 761 64

Based on data obtained from the Tucson Epidemiologic Study of Chronic Lung Disease that included body weight, questionnaire responses, and spirometry, we found that among subjects with no respiratory symptoms, 28.0 percent reported insomnia (difficulty initiating or maintaining sleep) and 9.4 percent reported daytime sleepiness. Among subjects with respiratory symptoms, cough and/or wheeze, the rates of sleep complaints increased. With one symptom, 39.1 percent reported insomnia and 12.4 percent reported daytime sleepiness. With both symptoms, the rates were 52.8 percent and 22.8 percent, respectively. Overall, we found significant relationships between rates of respiratory symptoms and sleep complaints (trend chi 2 = 73.9, p < 0.001 for insomnia; trend chi 2 = 37.9, p < 0.001 for daytime sleepiness). In separate analyses, obesity, snoring, and a diagnosis of lung disease also influenced the rate of sleep complaints but, when we employed logistic regression, we found that obesity, respiratory symptoms, gender, and age were the only variables related to the risk of insomnia or daytime sleepiness.
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PMID:The relation of sleep complaints to respiratory symptoms in a general population. 827 23

Several disorders of the thoracic cage are known to cause respiratory failure, by means of relatively simple mechanisms, such as the increased work of breathing, which results in alveolar hypoventilation. A variety of pathogenic mechanisms may be considered, as functions of the types of thoracic disorders present. As causes of these additional potential mechanisms, we considered the following: 1) ventilation-perfusion (V/Q) inhomogeneity; 2) inability to cough; 3) malformation or acquired defect of the respiratory centres; and 4) excess blood volume and fluid retention, which aggravate work of breathing and V/Q inhomogeneity. All of these disorders can be grouped into two major categories (which nevertheless have some of the pathophysiology in common): the mechanical syndrome and the neuromuscular or paralytic syndrome. In this paper we discuss chest wall diseases falling into the first category; namely, kyphoscoliosis, fibrothorax, thoracoplasty, ankylosing spondylitis and obesity-hypoventilation. Congenital deformities of the thoracic cage, which do not have important effects on ventilatory apparatus (e.g. pectus excavatum and pectus carinatum), were also considered.
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PMID:Classification of chest wall diseases. 847 68

Efficacy and acceptability of perindopril (Coversyl) in general practice were evaluated in 23,460 hypertensive patients (52.9% women) during an open six month trial. Patients had essential mild to moderate hypertension (94 mmHg < supine DBP < 115 mmHg) associated or not with obesity (34%), diabetes (12%), hypercholesterolemia (36%), smoking habits (24%). Mean hypertension duration was 6.5 years, 70 p. cent of patients were 50 to 69 years old and 12 p. cent 70 years old or more. Perindopril was started at 4 mg except in older and patients with renal insufficiency (2 mg). If supine DBP remained > 90 mmHg the dose was doubled up to 8 mg/day, then a thiazide diuretic was added. Monotherapy was held in 90 p. cent of cases all along the study, more than 8 over 10 times at 2 or 4 mg/day. Normalized patients (DBP < or = 90 mmHg) were 69.87 and 95 p. cent respectively at the first, third and sixth month. Mean supine SBP and DBP decrease were 27.3 and 18.0 mmHg. Antihypertensive activity was similar in patients taking psychotrope or non steroidal anti-inflammatory agents and in others, as well as in older (> or = 70 years), diabetics and obeses, however with a significantly more frequent bitherapy in these last three sub-groups. Cough, a well known side effect of ACEI led to withdrawal in only 2.6 p. cent of cases. Withdrawals for side-effect were more frequent in older patients (6.1%), in those taking psychotrope (5.3%) or non steroidal anti-inflammatory agents (6.0%) than in diabetics (4.1%) or the others (4.1%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Antihypertensive action, clinical and biological acceptability of perindopril: main results in 23,460 patients with mild to moderate hypertension treated for 6 months in general practice]. 848 Sep 86

Involuntary urinary leakage due to a rise in abdominal pressure caused by stress (cough, laugh, change in position, walking, running or carrying heavy weight) is a clinical entity often experienced by women. Management can be based on physical therapy techniques, drugs or surgery but indications and results to be expected are still very largely debated. Cure of an underlying condition such as obesity, or chronic bronchitis may be sufficient in some cases and others may benefit from "preventive" physical therapy to reinforce the perineum after difficult pregnancy and delivery. Alpha-stimulating drugs have also been proposed to increase sphincter tone. Surgery gives the best results. Several procedures have been proposed, usually based on classical retropubic colposuspension and aponevrosis loops. Success rate is approximately 80 to 90% although the lack of a sufficient understanding of the underlying mechanism involved, makes it impossible to predict outcome. Results in women with recurrent incontinence are less satisfactory.
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PMID:[Treatment of stress urinary incontinence in women]. 854 51


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