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

Female hormonal contraceptives, introduced commercially in 1959, contained 10 mg of norethynodrel and .15 mg of mestranol. The estrogen and progesterone doses were progressively reduced over time. In 1989, approximately 60 million couples used oral contraceptives (OCs) ranging from 1% in Japan to 40% in the Netherlands. The monophasic pill contains .01 - .04 mg of ethinyl estradiol (EE), and the biphasic pill contains increasing doses of progesterone and estroprogesterone in the course of the menstrual cycle. Triphasic combined pills contain an initially dominant estrogen dose. In oral sequential pills, estrogen is given on days 14-16 followed by a estroprogesterone for 5-7 days. Micropills with progesterone, injectables with medroxyprogesterone, and 3rd-generation OCs such as gestoden with a low progesterone dose of .04 mg/day and reduced androgenic activity are among other OCs. The OCs are administered in 21-22 day packets. Absolute contraindications include history of venous thrombosis, atherogenic lipid profile, hormone-dependent cancer, and allergy. Relative contraindications include arterial ailments, smoking, hypertension, older age, obesity, and familial history of cardiovascular and cerebrovascular accidents. Interactions with antibiotics (ampicillin and tetracycline) occur as the modified intestinal flora reduces the level of deconjugated EE. Most frequent side effects are depression, modification of libido, ocular disorders, headache, and urinary infection. Benefits include favorable modification of menstrual cycle, and reduction of endometriosis and endometrial and ovarian cancer. Systemic risks such as cardiovascular and blood coagulation effects occur mainly with high-dose OCs. Further topics addressed are the cancer risk and protective effect of OCs, postcoital OCs, traditional contraception, the IUD, RU-486, implants, vaccination with the human antigonadotropine, and the vaginal ring.
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PMID:[Family planning with different contraceptive methods]. 182 14

To identify the symptoms and coexisting medical conditions associated with idiopathic intracranial hypertension (IIH), we administered an 83-item questionnaire at the time of diagnosis to 50 IIH patients and 100 aged-matched controls. Ninety percent of the IIH patients were women; the mean age was 33. Obesity and recent weight gain were much more common among patients than controls. Symptoms most commonly reported by IIH patients were headache (94%), transient visual obscurations (TVO) (68%), and intracranial noises (ICN) (58%). Daily occurrence of these symptoms was much more common among patients than controls. Controls also reported these and other IIH symptoms, but at lower frequencies. Several conditions previously associated with IIH were no more common in patients than controls including iron deficiency anemia, thyroid disease, pregnancy, antibiotic intake, and use of oral contraceptives. We conclude that previous studies of IIH, mostly uncontrolled and retrospective, have underestimated the frequency of symptoms in IIH patients and reported chance and spurious associations with common medical conditions and medications. The profile of a young obese woman with headaches and either TVO or ICN should alert the clinician to the diagnosis of IIH, especially when the symptoms occur daily.
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PMID:Symptoms and disease associations in idiopathic intracranial hypertension (pseudotumor cerebri): a case-control study. 199 68

We describe 10 patients with idiopathic intracranial hypertension who did not have papilledema. Idiopathic intracranial hypertension without papilledema, although rarely reported, may well be a clinically important headache syndrome. Historical and demographic features of patients with idiopathic intracranial hypertension without papilledema are similar to those of patients with papilledema. Obese women with chronic daily headache and symptoms of increased intracranial pressure, pulsatile tinnitus, history of head trauma or meningitis, an empty sella on imaging studies, or a headache that is unrelieved by standard therapy should have a diagnostic lumbar puncture. Findings from laboratory and neurologic investigations are normal in most patients with idiopathic intracranial hypertension without papilledema. Initial management should include removal of possible inciting agents, weight loss if applicable, and standard headache therapy. Lumbar puncture and diuretic therapy should precede a trial of corticosteroids. Surgery (lumboperitoneal or ventriculoperitoneal shunt or perhaps optic nerve sheath fenestration) may be indicated for prolonged incapacitating headache that is not responsive to medical management or lumbar puncture.
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PMID:Idiopathic intracranial hypertension without papilledema. 172 57

Idiopathic intracranial hypertension (pseudotumor cerebri) is a condition that occurs predominantly in obese women. It consists of elevated spinal fluid pressure, normal spinal fluid contents, papilledema, and headaches with normal imaging studies. Long lists of putative causes and associations have arisen, many consisting of individual case reports. We did a retrospective case-control study on 40 patients and 39 age- and sex-matched control subjects to examine the incidence of these associated conditions. Our results are only suggestive due to the small sample size; however, obesity and recent weight gain occurred more commonly in patients with idiopathic intracranial hypertension than in control subjects. All forms of menstrual abnormalities, incidence of pregnancy, antibiotic use, and oral contraceptive use were equal in both groups. A larger multicenter study will be needed to more completely characterize the risk factors for this condition.
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PMID:The search for causes of idiopathic intracranial hypertension. A preliminary case-control study. 231 Mar 15

The relationship of solvent exposure to self-reported neurologic and somatic symptoms as well as neuropsychological performance was examined in a sample of 567 female blue collar workers who were members of the International Brotherhood of Electrical Workers (IBEW). Structured interviews were conducted at IBEW offices. Five solvent exposure categories were derived--never exposed, exposed prior to but not during the past year, exposed during the past year but not currently, currently exposed less than 50% of the time, and currently exposed more than 50% of the time. No differences among the groups on neuropsychological performance were found. On the other hand, heightened exposure was significantly related to depression, severe headaches, light-headedness, room spinning, appetite difficulties, funny taste in mouth, weakness/fatigue, rashes, and abdominal pain after controlling for the effects of seven risk factors (age, smoking, moderate-heavy alcohol consumption, severe obesity, history of physician-diagnosed chronic illness, working in a clean room, and exposure to other chemicals). These findings are consistent with Scandinavian studies of solvent-exposed male workers and point to the need for careful prospective research.
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PMID:Health effects of long-term solvent exposure among women in blue-collar occupations. 234 72

The authors report two cases of pseudotumor cerebri in patients taking lithium for treatment of bipolar disorder. Pseudotumor cerebri is a poorly understood syndrome characterized by chronic headaches, bilateral papilledema, and increased intracranial pressure without localized neurologic signs or symptoms, intracranial mass, or hydrocephalus. Ventriculography, computed tomography, and nuclear magnetic resonance imaging reveal normal or small ventricles. Multiple etiologies may include Vitamin A toxicity, obesity, head trauma, hypothyroidism or hyperthyroidism, prolonged steroid therapy or its withdrawal, Addison's disease, Cushing's disease, pituitary insufficiency, and lithium therapy. Patients treated with lithium whose antidiuretic hormone-cyclic adenosine monophosphate mechanism is disturbed are most likely to develop pseudotumor cerebri via disregulation of sodium balance, thyroid-stimulating hormone production, and glucose metabolism. The authors recommend careful medical monitoring to avoid iatrogenic effects of lithium, including pseudotumor cerebri.
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PMID:Pseudotumor cerebri associated with lithium therapy in two patients. 203 32

The recent development of new drug therapies for headache disorders has allowed for the tailoring of treatment to specific patient needs. This paper reviews the pharmacologic management of patients with both headache and concomitant medical illness. The discussion specifically includes the treatment of hypertension, coronary artery disease, mitral valve prolapse, asthma, peptic ulcer disease, obesity, and chronic Epstein-Barr virus infection, occurring concomitantly in patients with headache. Medications that can exacerbate either the headache or concurrent medical condition are noted, and alternative therapies are advised.
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PMID:Management of the headache patient with medical illness. 252 Mar 92

A total of 126 children with chronic idiopathic thrombocytopenic purpura, including 35 splenectomized cases, were investigated in a long-term follow-up study, with regard to residual hematologic and immunologic abnormalities, complications and physical growth. Such hemorrhagic symptoms as petechiae, ecchymosis and epistaxis were still observed in about 22%-28% of the patients with a period of morbidity ranging from 3 to 15 years after onset. Residual thrombocytopenia below 150,000/microliters was found in 62% of patients within 5 years, 59% within 5 to 9 years and 57% within 10-14 years after onset. Other abnormalities were mild anemia, low serum level of IgA or IgM, positive antinuclear antibody, rheumatoid factor, and positive Coombs test in a small number of patients. Increased platelet-associated IgG was still obtained in patients with subnormal platelet counts whose morbid periods were 6 to 27 years after onset. Investigation of the patients by questionnaire revealed such complications as obesity, striae atrophicae, abdominal pain, headache, cataract, Perthes' disease, and cardiac complication in some patients. No apparent disturbances except for obesity were observed in their physical growth.
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PMID:Long-term follow-up study of children with chronic ITP. 275 63

Sleep apnoea syndromes are a frequent disease, with an incidence of more than 1% in the adult population, a strong male predominance, and a maximal frequency between 40 and 60 years. Their clinical manifestations are dominated by snoring and daytime sleepiness, at times associated with morning headaches, intellectual deficiency, sexual impotence. Obesity, hypertension and polycythemia are not uncommon. These patients are at risk for accidents due to sleepiness, sudden death due to sleep apnoea-related cardiac arrhythmias, ischemic attacks related to hypertension and polycythemia and right heart failure secondary to pulmonary hypertension and alveolar hypoventilation. The most frequent form of sleep apnoea syndromes include obstructive and mixed apnoeas. Their mechanism involves both anatomic factors (upper airway narrowing) and functional factors (defective activation of upper airways dilatory muscles) which lead to upper airway occlusion upon inspiration during sleep. Two therapeutic strategies are possible: a surgical one, uvulopalatopharyngoplasty, the efficacy of which is inconstant and unpredictable and nasal continuous positive airway pressure, which is constantly efficacious but constraining. Central sleep apnoea syndromes are rare, less clearly defined and more difficult to treat.
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PMID:[Sleep apnea syndromes in adults]. 332 Dec 51

Obstructive sleep apnea syndrome (OSAS) is a complex disorder characterized by a sleep-related collapse of the upper airway. The most likely candidate for the common pathway linking various abnormalities casually associated with OSAS (such as adenotonsillar hypertrophy, obesity, retro- or micrognathia, acromegaly, or more subtle structural anomalies) is an abnormally small upper airway lumen. Symptoms of OSAS that appear during sleep include snoring, abnormal motor activity, disturbed nocturnal sleep, a sensation of choking, heartburn, nocturia, nocturnal enuresis, and heavy sweating. Daytime waking symptoms are dominated by often profound sleepiness, which may secondarily be associated with automatic behavior, retrograde amnesia, hypnagogic hallucinations, personality changes, sexual difficulties, and headaches. Careful evaluation, both sleeping and waking, are essential to select appropriate treatment. Treatments include nasal continuous positive airway pressure, tracheostomy, weight loss, uvulopalatopharyngoplasty, mandibular advancement, and so forth.
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PMID:Obstructive sleep apnea syndrome. A review. 333 20


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