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

Symptoms and clinical findings recorded from 379 patients (6.7 per cent of all cases of appendectomy) with perforated appendicitis, between 1970 and 1984, were retrospectively evaluated. Children up to 14 years of age accounted for 32.8 per cent, adults for 37.8 per cent, and adults above 50 years of age accounted for 30.2 per cent of the above group. More than three typical appendicitis symptoms were recordable from only 30 per cent of all patients. Decompressive and jolting pain was the most common clinical symptom and was recorded from 66.6 per cent of the above 379 patients. 50 per cent of the patients did not exhibit leucocytosis, and normal body temperatures were measured from 21.1 per cent in spite of perforated appendicitis. The event of perforation occurred both six hours after onset of complaints as well as four days later. Obesity, enteritis, and cardiovascular diseases were the most common diseases established in concomitance with perforated appendicitis. 9 patients (2.3 per cent) died of the consequences of peritonitis or accompanying diseases. In patients with suspected appendicitis it is not justified to delay surgery even in the presence of serious associated disease.
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PMID:[Preoperative examination findings in patients with a perforated appendix]. 376 28

The clinical features and course of 30 patients (26 men and 4 women) under 30 years of age (mean age 27.3 years) with an acute myocardial infarction (MI) are described. The most common risk factor among this group of patients was smoking in 20 patients (66%). The prevalence of the other risk factors was low: hyperlipidemia in four patients and family history of ischemic disease in another four patients, diabetes mellitus, hypertension, and obesity each in one patient. Seven patients (23%) had none of the conventional risk factors. Three patients were exerting themselves prior to the onset of their MI pain; all of them had normal coronaries. Five patients experienced chest pain prior to MI, among them only two experienced classical angina pectoris. Eighteen patients underwent uncomplicated MI. The complications in the other 12 during the acute MI were rhythm disturbances in eight and congestive heart failure in four. Cardiac catheterization was performed in 25 patients. The occurrence of zero, one, or multivessel disease was equal. The 30 patients were followed up from six months to 15 years (mean 7 years). In 18 patients circulating aggregated platelets were measured one year after the MI. Elevated values were found in all of them (mean +/- SD 34.9 +/- 9.1%). In 6 of the 18, all heavy smokers, extreme values were found in the range of 39-55%. Three out of the 30 patients died within five years after their first MI. The other 15 patients developed complications, most of them angina pectoris. Five patients were hospitalized for reinfarction. None of the 30 underwent aortocoronary bypass operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Myocardial infarction in young adults under 30 years: risk factors and clinical course. 381 21

The nutritional composition of diets and prevalence of obesity in 77 osteoarthritis patients were assessed biweekly for 12 weeks as part of a multidisciplinary approach to the management of osteoarthritis. Height was measured at the first visit, and weight was measured at each of the seven biweekly follow-up visits. A body mass index was calculated, based on height and weight, to determine obesity. Nutrient information was obtained by use of a 24-hour dietary recall and a food frequency questionnaire. Seventy-nine percent of the patients were obese. Obesity was positively related to pain from osteoarthritis and was more prevalent among these osteoarthritis patients than it is among the general geriatric population. Dietary intakes of vitamin D, folacin, vitamin B6, zinc, and pantothenic acid were below 80% of the recommended dietary allowance. Osteoarthritis patients may benefit from weight loss if they are obese and from eating more foods that supply the nutrients in which they are deficient. In addition to providing nutritional recommendations to avoid dietary deficiencies, a registered dietitian can assist in the multidisciplinary treatment of osteoarthritis by providing weight-control counseling and follow-up.
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PMID:Nutrient intake and obesity in a multidisciplinary assessment of osteoarthritis. 382 95

Pulmonary resection was performed electively through a median sternotomy in 174 patients. The first 61 of these patients were compared with an equal number having pulmonary resection through a lateral thoracotomy. Both groups were similar in regard to sex, age, pathological condition, and type of resection. The patients undergoing median sternotomy had a shorter operative time and less postoperative pain, and were discharged from the hospital sooner than the patients having resection through a lateral thoracotomy. The cardinal technical essentials to expeditious pulmonary resection through a median sternotomy involve unilateral pulmonary ventilation with a double-lumen endotracheal tube, arterial pressure and gas monitoring, and proper lung packing and retraction. Two patients died, 1 of infection and 1 of bleeding; neither death was related to the incision. Certain pulmonary procedures are better performed through a lateral thoracotomy, and these include resection of a superior sulcus carcinoma, pulmonary resection with posterior chest wall extension, and left lower lobe resection in patients who demonstrate obesity, cardiomegaly, or an elevated diaphragm.
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PMID:Median sternotomy as a standard approach for pulmonary resection. 394 62

During a 14-month period we used a left-flank, retroperitoneal, retrorenal approach in 23 high-risk patients with abdominal aortic aneurysm (AAA). Fourteen patients underwent suprarenal/celiac cross clamp for juxtarenal/suprarenal AAA and/or associated occlusive disease. Other indications for this approach included diminished cardiac and/or pulmonary reserve, previous extensive abdominal surgery, obesity, and inflammatory AAA. There was only one death (4%) in this high-risk group and minimal operative morbidity. The flexibility afforded by this approach for high aortic exposure allowed expeditious proximal anastomoses with minimal postoperative renal dysfunction. Pulmonary complications, ileus, and pain were reduced and patient mobilization was rapid despite the complex nature of the operative procedures. We believe that this approach offers significant advantages for all cases of AAA but particularly for anatomically complex lesions and medically high-risk patients.
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PMID:Retroperitoneal approach to high-risk abdominal aortic aneurysms. 395 89

The prevalence of diabetes, the interrelationship of blood glucose, serum insulin, and lipids, and their relationship to ischemic heart dise ase in a rural Jamaican community were investigated. The people were mo stly of West African descent. Occupations were primarily agricultural w ith much physical labor. Approximately 80% of total claories in their d iet were from carbohydrates. Of 696 25-64 year old persons, a response rate of 77.3% was achieved. The patients, after an overnight fast, drank a 7-oz bottle of Glucola which was the equivalent of a 100 gm glucose load. Electrocardiograms (EKGs), blood pressure readings, a chest X-ray, and skinfold tests for obesity were done. A family history was obtained. Blood and urine specimens were taken before the glucose was given. 1 hour after the glucose was given, blood and urine specimens were also taken. Those with blood glucose of 180 mg% or more were given a 3-hour glucose tolerance test. Of the 525 persons who had the 1-hour test, 23 were found to be glycosuric. Of these, 11 were not shown to be diabetic by the 3-hour glucose test. Of the 502 with negative urines, 34 were positive on blood tests. The rates increased with age, except in the oldest age groups (p less than .05 for males and p less than .001 for females). There was no relationship between the number of live births and the 1-hour blood glucose tests. There was neither increase in the diagnosis of diabetes nor increase in variance with number of children. The known diabetics were fatter and had higher triglycerides than others. Cholesterol was higher in all male diabetics but not in females. Only 2 persons experiencing effort pain had EKG changes. Data from this study indicate that no statistically significant association exists between levels of glycemia and blood pressure or prevalence of cardiovascular disease. The physical fitness acquired from walking and working in a hilly area may be a factor.
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PMID:The prevalence of diabetes in a rural population of Jamaican adults. 466 90

The pathophysiological basis of pulmonary atelectasis is reviewed and risk factors that enhance lung collapse are discussed. Management strategies to reduce or eliminate risk factors and to prevent collapse are discussed and the rational bases of these strategies are identified. Instability of lung alveoli is a consequence of surface tension and regional differences in alveolar size. The inherent tendency of alveoli to collapse is enhanced by the following risk factors; low lung volume, high closing volume, oxygen therapy, a rapid shallow ventilatory pattern, chronic lung disease, smoking, obesity, postoperative pain following abdominal or thoracic surgery, narcotic induced ventilatory depression, and neurological, neuromuscular, muscular and musculoskeletal diseases associated with mechanical impairment of respiratory function. The primary goal of perioperative respiratory management is prevention of atelectasis. Appropriate management strategies include physiotherapy and delay of elective surgery if substantial improvement in respiratory status can be achieved by specific treatments such as antibiotics, bronchodilators, steroids, and reduction of tobacco use and caloric intake. In selected cases, elective postoperative controlled ventilation may be indicated.
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PMID:Pulmonary atelectasis after anaesthesia: pathophysiology and management. 611 89

The first objective is to correct any existing coronary risk factors but this must be achieved with discrimination. Smoking should be strictly forbidden, hypertension reduced and a more active life style encouraged. However, a more nuanced approach should be adopted towards dietetic problems, obesity and disorders of lipid metabolism. It is also very important to teach the patient to use glyceryl trinitrate correctly in the double objective of relieving pain as quickly as possible and of preventing pain by using it in certain critical situations. Clinical practice shows that patients often use glyceryl trinitrate too sparingly. When these general measures have been settled, treatment must be adapted to each particular situation. The patient's age, the frequency of attacks, trigger factors, the repercussions of the disease on the patient's life all have to be considered before deciding on the individual's treatment. In younger patients, a controlled exercise ECG is essential for selecting patients for surgery. The drugs of choice for stable angina are the betablockers which have been shown to be effective and well tolerated. When this group of drugs cannot be used or is ineffective, other major anti-anginal drugs may be chosen according to the individual terrain and their known secondary effects.
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PMID:[Strategy of the medical treatment of angina pectoris]. 613 3

In 271 gynaecological or obstetrical patients a "combined anaesthesia method" was applied, consisting of lumbar catheter epidural analgesia and controlled ventilation with nitrous oxide/oxygen. We aim to show that by mere interaction of the local anaesthetic, with nitrous oxide, and the drugs used for premedication and during induction of anaesthesia a stage of sleep can be achieved, which, on the patient's behalf is identical with his idea of "full anaesthesia", while at the same time the use of centrally acting agents can be kept at a minimum. In incidents of sympatho-adrenergic-stimulation due to insufficient cephalad spread of the blockade and not amenable to additional doses of local anaesthetic, i.v. fentanyl or low concentrations of volatile anaesthetics were added. In the postoperative phase the patients showed a high degree of vigilance. Epidural morphine offered best pain relief with full mobility maintained. In cases with postoperative hypertensive crises, morphine was combined with bupivacaine injections. Even marked obesity or senile degenerative changes in the vertebral column proved not to constitute contraindications for this method.
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PMID:[Experiences with combined catheter-peridural anesthesia and nitrous oxide-oxygen ventilation in patients at risk in gynecology and obstetrics]. 649 87

Gastric partition with formation of a proximal pouch by staples and reinforced sutures is a well-accepted operation for obesity. Experience at this institution has included 2 cases of ulcers occurring at the partition line, a complication not well-described previously. These ulcers were located on the lesser curvature, appeared benign, and were characterized by chronic, severe pain. A suture associated with the ulcer was demonstrated endoscopically in 1 patient, although it could not be removed perorally.
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PMID:Suture line ulceration: a complication of gastric partitioning. 650 Feb 42


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