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

During the menopausal transition and the early postmenopausal stage diverse symptoms may appear, but only hot flashes and night sweats are inequivocally related to the hormonal changes, constituting the main indication for the use of systemic hormone therapy. In the absence of vasomotor symptoms, the prescription of hormone therapy to either ameliorate psychologic disorders or improve quality of life still is a controversial issue. In order to improve treatment individualization, more information regarding the hormonal effects on peri- and postmenopausal women suffering from chronic diseases such as high blood pressure, obesity and diabetes, is needed. The use of low doses of estrogens and progestins is highly desirable, but the lack of knowledge and availability of appropriate formulations seems to hinder it. Even though it has been demonstrated that hormone therapy does not prevent cardiovascular diseases in postmenopausal women, there are some products that are improperly promoted for this purpose. The benefits of hormone therapy on bone mineral density and osteoporosis prevention are unquestionable. However, because of its potentially deleterious effects on breast tissue its long-term use for bone protection has been restricted. Several studies to assess risks and benefits of low-dose formulations are ongoing. It is expected that better results will be obtained with these new formulations.
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PMID:[Controversies surrounding on hormone replacement therapy during menopause]. 1903 77

Kidney cancers account for 2-3% of all adult malignancies in the UK. Men are predominantly affected by renal cancer with an average age at diagnosis of 64 years. Renal (or clear) cell carcinoma (RCC) accounts for 90% of kidney cancers. Early diagnosis improves survival with five-year survival rates for renal cancer of 70-94% for localised tumours in the UK. RCC should be suspected in the presence of localising symptoms such as flank pain, a loin mass or haematuria; constitutional upset including weight loss, pyrexia and/or night sweats; or with unexplained laboratory tests. Smoking, obesity and hypertension are the most important and most common risk factors. Environmental exposure to asbestos, cadmium and trichloroethylene are less common risk factors. Patients on chronic dialysis and renal transplant recipients are at increased risk of RCC in their native kidneys. If kidney cancer is suspected on history, physical examination or initial screening tests then a red flag ultrasound examination of the renal tracts should be requested. Dipstick urinalysis is of great value as asymptomatic haematuria may be the only abnormal test in the presence of non-specific symptoms such as weight loss or loin pain. Visible or non-visible haematuria, in the absence of proteinuria, suggests an underlying structural abnormality is present in the kidneys, ureters or bladder. Surgical removal of RCCs, where feasible, may result in cure in up to 40-60% of cases. Individuals too frail for major surgery may benefit from thermal ablation and cryotherapy. Agents that target the VEGF and mTOR pathways are considered first line in the treatment of metastatic RCC. Sunitinib, recommended by NICE, is administered orally and acts by inhibiting the VEGF receptor.
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PMID:Early diagnosis improves survival in kidney cancer. 2249 3

Menopause is the interruption of menstrual and reproductive capacity, therefore, that occurs naturally in all women between 48 and 55 years, due to a lower production of gonadal steroids. The period becomes progressively irregular and lack of ovulation and menstrual flow decrease, and finally disappears. The time between the first symptoms and the cessation of the menstrual cycle is called menopause. With the onset of menopause the woman undergoes a series of changes related to estrogen deficiency, which occur in all tissues of the body. In this period one can distinguish an early stage, characterized by hot flashes, mood swings, night sweats and insomnia, and a late phase in which we highlight more symptoms related to the interruption of hormonal such as osteoporosis, obesity, at urogenital and increased incidence of cardiovascular disease. In Italy, only 5.2% of women aged 45-64 years used hormone replacement therapy, and only 20-30% follow a therapy for more than two years, both for psychological reasons, and for fear of side effects. Not surprisingly, therefore, phytoestrogens are given a high importance, as they are considered a natural alternative tank to to their plant origin. Interest in phytoestrogens was born from the observation that postmenopausal women who live in the East have a lower incidence of symptoms, cardiovascular disease, cancer and osteoporosis hormone use, compared to Western women.
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PMID:[Phytoestrogens and menopause]. 2388 90

Estrogen therapy is a well-known and commonly used symptomatic treatment of hot flashes, night sweats and vaginal dryness associated with menopause. The most active estrogen, estradiol, is also understood to have a protective effect against osteoporosis. Like many hormones, though, estradiol has many roles in the body, both in males and females, and studies of these roles continue to emerge. A major function of estradiol involves obesity, insulin resistance, and cardiovascular disease; studies have shown the beneficial effects of estradiol in these areas, and this is somewhat at variance with traditional belief. In recent years, many researchers have studied its protective, beneficial effect, and have arrived at convincing evidence. In females, and, to some extent in males, estradiol is very important in protecting against obesity and lessening the likelihood of insulin resistance and cardiovascular disease. For both menopausal women and hypogonadal men, estradiol levels should be monitored and considered for long-term healthcare benefits.
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PMID:Estradiol: THE EMERGING EVIDENCE FOR A PROTECTIVE ROLE AGAINST INSULIN RESISTANCE AND OBESITY. 2662 64

Lymphoma is a group of malignant neoplasms of lymphocytes with more than 90 subtypes. It is traditionally classified broadly as non-Hodgkin or Hodgkin lymphoma. Approximately 82,000 new U.S. patients are diagnosed with lymphoma annually. Any tobacco use and obesity are major modifiable risk factors, with genetic, infectious, and inflammatory etiologies also contributing. Lymphoma typically presents as painless adenopathy, with systemic symptoms of fever, unexplained weight loss, and night sweats occurring in more advanced stages of the disease. An open lymph node biopsy is preferred for diagnosis. The Lugano classification system incorporates symptoms and the extent of the disease as shown on positron emission tomography/computed tomography to stage lymphoma, which is then used to determine treatment. Chemotherapy treatment plans differ between the main subtypes of lymphoma. Non-Hodgkin lymphoma is treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) with or without rituximab (R-CHOP), bendamustine, and lenalidomide. Hodgkin lymphoma is treated with combined chemotherapy with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), Stanford V (a chemotherapy regimen consisting of mechlorethamine, doxorubicin, vinblastine, vincristine, bleomycin, etoposide, and prednisone), or BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) with radiotherapy. Subsequent chemotherapy toxicities include neuropathy, cardiotoxicity, and secondary cancers such as lung and breast, and should be considered in the shared decision-making process to select a treatment regimen. Once remission is achieved, patients need routine surveillance to monitor for complications and relapse, in addition to age-appropriate screenings recommended by the U.S. Preventive Services Task Force. Patients should receive a 13-valent pneumococcal conjugate vaccine followed by a 23-valent pneumococcal polysaccharide vaccine at least eight weeks later with additional age-appropriate vaccinations because lymphoma is an immunosuppressive condition. Household contacts should also be current with their immunizations.
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PMID:Lymphoma: Diagnosis and Treatment. 3189 37

Night sweats are a nonspecific symptom that patients commonly experience but rarely discuss with their physicians without prompting. Although many life-threatening causes such as malignancies or infections have been described, most patients who report persistent night sweats in the primary care setting do not have a serious underlying disorder. Conditions commonly associated with night sweats include menopause, mood disorders, gastroesophageal reflux disease, hyperthyroidism, and obesity. If a clinical diagnosis is apparent based on the initial history and physical examination, specific treatment for four to eight weeks may be offered. When the history and physical examination do not reveal a specific cause, physicians should proceed with a systematic and cost-conscious strategy that uses readily available laboratory and imaging studies, such as a complete blood count, tuberculosis testing, thyroid-stimulating hormone levels, HIV testing, C-reactive protein level, and chest radiography. Additional tests that could be considered selectively include computed tomography of the chest and/or abdomen, bone marrow biopsy, polysomnography, and/or additional laboratory studies if indicated. If these results are normal, and no additional disorders are suspected, reassurance and continued monitoring are recommended. The presence of night sweats alone does not indicate an increased risk of death.
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PMID:Persistent Night Sweats: Diagnostic Evaluation. 3299 56