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

The presenting signs, symptoms, roentgenographic findings, endocrine evaluations, treatment, and results in 68 cases of presumed pituitary adenomas treated over an 18-year period are discussed. The most common symptoms were headache, acromegalic changes, visual symptoms, and amenorrhea. Most common physical findings were obesity, acromegaly, and visual field defects, usually bitemporal hemianopsia. Roentgenographic evidence of sellar erosion was almost universal but angiography and pneumoencephalography were required to evaluate suprasellar extension. Brain scan was not considered a particularly useful diagnostic tool. Endocrine status was best evaluated by a battery of tests including 17-OH, 17-KS, T3, T4, PBI, ACTH stimulation, and FSH and STH levels. (Prolactin levels are currently being obtained, also). Surgical specimens were obtained in 29 patients, with subsequent diagnoses of 22 chromophobe adenomas, five eosinophilie adenomas, one cystic adenoma, and one necrotic tumor. All five eosinophilic tumors came from acromegalic patients. Patients treated by operation alone or operation followed by radiotherapy generally had less "medical morbidity" than did patients who received radiotherapy alone.
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PMID:Review of 18 years' experience with pituitary tumors. 19 48

Pathologically increased apetite is the most tormenting symptom of overweight conditions and therefore, along with dietetic treatment which plays an essential role, it is most expedient to resort to anorectic drugs also. Recently, the Sanorex preparation (Mazindol, Teronak, AN 448 degrees--imidazo-isoindole derivative having a tricyclic structure) is ever more extensively used. The action of the drug is studied in a series of 32 obesity individuals under sanatorial conditions and normocaloric diet, over a period of twenty seven days. The new preparation Sanorex which causes aversion to food, given in small doses, accounts for prompt and reliable control of the apetite--9590 kg reduction, 0,362 kg mean daily weight loss (p less than 0,05), and equal intensity of weight loss in either of the sexes (p less than 0,01). Side effects such as dryness in the mouth, very strong and moderate thurst, insomnia, superficial sleep, headache, elevated excitability, tachycardia, general feebleness are transitory, subside within two weeks, and are tolerated comparatively well by the patients included in the series. Sanorex administration may be recommended provided due consideration is given to the usual limitations implied by the continuous use of new drugs.
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PMID:[Treatment of obesity with the anoretic Sanorex]. 80 32

4 cases of thrombosis of the intracranial venous sinuses (TIVS) which occurred in patients 22-38 years of age who used oral contraceptives are discussed. Of the 29 reported cases of this type, 19 of the patients died. There are 3 stages in the evloution of TIVS: headache, hemispheric focus symptoms (e.g., Bravis-Jacksonian crises), and a phase of dramatic aggravation (e.g., severe headache, coma). Arteriography of the carotid artery and cerebral scintigraphy are the methods used to diagnose TIVS. Besides such predisposing factors as diabetes, obesity, migraines, etc., the use of oral contraceptives containing estrogen seem to be a factor in the development of TIVS, particularly within the 1st year of estrogen use. The reduction of cerebral volume seems to be the best treatment for TIVS: anticoagulants and thrombolytic compounds can cause fatal hemorrhaging
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PMID:[Thrombosis of the intracranial venous sinuses after ingestion of estroprogestative agents. 4 cases]. 88 3

The side effects of using estrogen treatments to relieve menopausal symptoms in women are presented. Estrogens are effective in relieving headaches, vertigo, palpitations, and nervous symptoms such as depression, as well as degeneration and atrophy of the genital organs. In Norway, 2.5% of women over 45 as compared with 50% in the U.S. use estrogens to relieve menopausal symptoms. The incidence of endometrial cancer has risen from 9.2/100,000 in 1955 to 15.4 in 1974. Increased susceptibility to endometrial cancer has been linked to long-term use of estrogens, obesity, hypertension, diabetes, and nulliparity. In American studies, Premarin has been associated with increased risk of cancer related to the chemical equilinine, which has a long half-life. After menopause, the need for estrogen is met by the conversion of androstenedione, which is produced by the adrenal gland. When estrogens are taken, it may result in an overstimulation of the endometrium, which could cause cancer. Estrogens have bene found useful and safe for short-term relief of menopausal symptoms, and any patient using estrogens should be under routine observation to prevent development of cancer.
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PMID:[From the Adverse Drug Reaction Committee. Can long-term estrogen treatment induce uterine neoplasms in post-climacteric women?]. 125 36

We describe seven patients with idiopathic intracranial hypertension (IIH), a disorder, mostly in young women, characterized by papilledema, elevated cerebrospinal fluid (CSF) pressure, normal CSF composition, and normal neuroradiologic studies. Obesity, the most consistent etiologic association, was present in two of our patients. Hypothalamic compression in IIH may induce increased appetite and result in weight gain. Use of trimethoprim/sulfamethoxazole has been reported to be associated with IIH and was seen in one of our patients. IIH is an important diagnostic consideration in the differential diagnosis for a patient with headache, visual disturbances, and papilledema.
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PMID:Idiopathic intracranial hypertension: report of seven cases. 805 91

Between February and October 1990, researchers analyzed data on 110 postmenopausal women attending the university women's clinic in Vienna, Austria to determine whether a relationship exists between fertility, body shape, and menopause. Fertility incorporated number of pregnancies and births and age at each birth and induced and spontaneous abortions. They did not find a significant correlation between fertility and age at menopause. Yet there was a slight positive correlation between age at individual pregnancies and age at menopause regardless of whether it was the 1st or last pregnancy. The more pregnancies a woman experienced the larger her body shape became (p.01-.05). Thus multiparous women had more subcutaneous fat. In fact, fat distribution increases sex hormone levels which, along with the changes in hormone levels induced by pregnancy, probably delayed menopause. In addition, fertility was also positively associated with severity of menopause symptoms (p.01-.05). These symptoms included hot flushes, weakness, breast tension, urine loss, mood changes, headache, palpitation, vaginal dryness, sleeplessness, and loss of libido. Even though higher numbers of pregnancies increase estrogen secretion during menopause, many menopausal symptoms should not be very severe in theory since the higher estrogen levels abate severity. Yet the somatic and psychological stress of large family size appears to offset any advantages of higher estrogen levels induced by subcutaneous fat. Obese women face greater psychological stress than slender women since they do not conform to the cultural definition of beauty.
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PMID:Relations between fertility, body shape and menopause in Austrian women. 142 82

This review focuses on the features of pseudotumor cerebri in the pediatric age group. There is no sex predilection in children, and obesity does not appear to be an important factor. Infants and young children may present with irritability, apathy, or somnolence, rather than headache. Dizziness and ataxia may also occur. Papilledema is infrequently noted in pediatric patients if the fontanelles are open or the sutures are split. Pre-adolescents appear more likely than adults or adolescents to have manifestations of their pseudotumor cerebri other than headache and papilledema, including lateral rectus pareses, vertical strabismus, facial paresis, back and neck pain. Among the etiologies that are particularly pertinent to children are tetracycline therapy, malnutrition or renutrition, and the correction of hypothyroidism. Children with pseudotumor cerebri are at risk for visual loss and their visual function must be closely monitored. Surgical intervention is imperative when vision is threatened.
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PMID:Pediatric pseudotumor cerebri (idiopathic intracranial hypertension). 147 50

A 39-year-old woman presented with a 2-month history of repeated severe headache, nausea and diplopia. On admission she was obese with bilateral papilledma and abducens weakness. Mass lesion and sinus thrombosis were ruled out by brain CT and angiography. CSF pressure was normal initially. CSF pressure fluctuated with menstrual cycle, sometimes showing over 600 mmH2O with worsening of the symptoms. She was diagnosed as benign intracranial hypertension (BIH). Diuretics did not improve the symptoms, and visual disturbances ensued and deteriorated. A spinal subarachnoid space-peritoneal shunt was inserted to control CSF pressure, showing rapid improvement of headache and diplopia but visual disturbances remained almost unchanged. Optic nerve sheath fenestration was performed without improvement of visual deterioration. We postulated multiple factors such as obesity, menstrual abnormality, iron deficiency anemia and analgesic drugs played important roles to produce BIH in this case. Careful quantitative perimetry should be done to decide a suitable time for surgical treatment in BIH.
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PMID:[A case of benign intracranial hypertension with fluctuated symptoms and CSF pressure synchronized with menstrual cycle]. 149 Mar 15

Fluoxetine is a highly specific serotonin reuptake inhibitor. In studies that used a dose of 60 mg once daily, fluoxetine-treated patients consistently had greater weight loss than placebo-treated patients. In six double-blind, placebo-controlled studies of 6-8 wk duration, mean weight changes on fluoxetine were approximately 0.5 kg/wk. Longer term studies have shown maximum mean weight loss to occur at 12-20 wk of therapy. Studies have consistently shown improvements in indices of glycemic control as well as weight loss in obese diabetic patients. Safety analysis has been performed on data from 3491 obese patients in controlled clinical trials of up to 52 wk duration. Adverse events with an incidence of greater than 5%, which were reported significantly more frequently by fluoxetine-treated patients, were headache, asthenia, nausea, diarrhea, somnolence, insomnia, nervousness, sweating, and tremor. Fluoxetine is effective, well tolerated, and safe in the treatment of obesity and obese diabetics.
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PMID:Clinical studies with fluoxetine in obesity. 172 31

The goal pursued has been to analyze clinical observations and hormonal studies of patients with empty sella turcica (EST), in order to review this disorder and determine if it can be considered a real syndrome. Fifteen patients with EST (3 men and 12 women) and mean age of 45.6 +/- 17.9 years have been prospectively studied. In the hypothalamus-hypophysis study, reserves of thyrotropin (TSH), prolactin (PRL), gonadotropins (FSH and LH), growth hormone (GH), adrenocorticotropin (ACTH) and cortisol were assessed. In addition, thyroid hormones and, for men, testosterone, were determined. The pathogenic mechanism was explained in two cases (13.3%). We registered headache in 10 patients, obesity in 8, arterial hypertension in 2 and diabetes mellitus in 2. Multiparity antecedent was found in 2 cases. The hormonal study was abnormal in two cases (40%). Most common abnormalities were hyperprolactinemia (3 cases), deficit of gonadotropins (3 cases), without coexisting both of them in any case, and deficit of GH (2 cases). EST is frequently associated with endocrine disfunction, although clinical implications are rare. The absence of common clinical manifestations in most cases questions the EST as a real syndrome.
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PMID:[Primary empty sella turcica: clinical aspects and hormonal study of 15 cases]. 179 Feb 77


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