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

A series of 117 consecutive unselected patients with clinically reducible unilateral inguinal herniae were admitted for short-stay repair. Seven expressed a strong preference for one form of anaesthesia (6 general (GA)) local (LA) and 7 were unfit for GA; these were excluded from the trial. The remaining 103 patients were allocated at random to receive either LA or GA in order to compare the two methods of anaesthesia. The resulting groups (53 LA, 50 GA) were well matched for age and obesity. Perand postoperative symptoms were assessed with linear analogues self-assessment questionnaires. Statistically significant differences were demonstrated between the groups; those patients having LA were able to walk, eat, and pass urine earlier than those having GA, who experienced more nausea, vomiting, sore throat, and headache. The postoperative course and additional symptoms were otherwise similar. Forty-five LA patients experienced mild pain during the operation, but nevertheless 85% of the total group said they would consent to its use again. Ninety-three patients (90%) were discharged at 24 h. LA was applicable to all types of clinically reducible inguinal hernia and was an acceptable, safe, and satisfactory alternative to GA.
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PMID:A randomised controlled trial to compare local with general anaesthesia for short-stay inguinal hernia repair. 704 4

The spa of Bagnoles-de-l'Orne is one of the few French watering-places north of the Loire. It specializes in the treatment of complications of venous affections. The basic crenotherapeutic treatment consists of the main thermal bath, plus treatments such as showers, aero-massages, manual massages. The thermal water of Bagnoles-de-l'Orne is of medium temperature. It has the following recognized properties: -- sedative properties -- used in the treatment of pain associated with chronic venous insufficiency, cramps, sympatheticalgic phenomena; -- anti-oedematous properties, of prime importance in the treatment of oedema of postthrombotic illness and hydroplasmic obesity; -- anti-inflammation properties, especially anti-cellulitis, more particularly associated with post-thrombotic illness; -- a mitotic effect used in the healing of ulcers of circulatory origin in the lower limbs. The effect of the thermal water of Bagnoles-de-l'Orne is enhanced by a climatic factor: the cool climate of the Norman Bocage.
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PMID:[The thermal cure at Bagnoles-de-l'Orne]. 711 27

The multifactorial control of serum uric acid levels is discussed from an epidemiological point of view and the principles at issue related to the epidemiology of osteoarthrosis. It is shown that in osteoarthrosis the clinical characteristics vary from one joint group to another. Association of x-ray changes with pain varies between joints and between sexes for the various joints. The disease tends to be commoner in females but not in all age groups. There is an association between obesity and osteoarthrosis in the hands and knees but not the hips or ankles. These differences raise questions about the homogeneity of generalised osteoarthrosis. Such questions might be answered by epidemiological studies which consider individual joint groups and are carefully directed towards specific hypotheses, the development of which could be facilitated by the use of iconic models.
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PMID:Heberden Oration 1981: epidemiology and the arthritides. 711 14

Adiposis dolorosa (Dercum's disease) is a syndrome of painful adipose tissue which occurs most often in post-menopausal women and is associated with obesity, asthenia, and emotional disturbances. The etiology is uncertain, but is probably multifactorial. Numerous treatments to relieve the pain have generally been unsuccessful. A patient with adiposis dolorosa was treated with intravenous infusions of lidocaine over a two-year period. Relief from pain lasted from two to 12 months after each infusion. A single-blind placebo infusion did not relieve the pain. Lidocaine infusions did not relieve the pain of diabetic neuropathy or of angina in this patient. The mechanism of relief of pain of adiposis dolorosa by lidocaine is uncertain, but previously reported central effects of lidocaine suggest that alterations in the central nervous system may be responsible.
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PMID:Intravenous lidocaine for the treatment of intractable pain of adiposis dolorosa. 712 48

We have developed an outpatient technique for high-risk varicose patients, using local anesthesia and cryo-sclerosis of the vein wall. A flexible cryo-probe is introduced in the vessel lumen, and its tip refrigerated to --89 degrees C. Thrombosis is thus induced with a limited inflammatory reaction and no pain. The vein then undergoes a progressive fibrosis, and recanalisation was not observed. Clinical results have been excellent on 44 patients who could not be submitted to standard surgical techniques, due to age and obesity.
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PMID:[Cryosclerosis of the saphenous veins in varicose reflux in the obese and elderly]. 733 76

Forty-eight children, aged 5 to 15 years, were tested for their ability to raise and lower their index finger temperature with self-hypnosis and/or biofeedback. Group A (self-hypnosis only) and group B (self-hypnosis with biofeedback) were children who had previous successful experience with self-hypnosis (eg, for the treatment of enuresis, pain, asthma, or obesity). Group C (biofeedback only) were children with no experience with hypnosis. All three groups showed significant success with warming and cooling. The range of warming for the three groups was 0 to 3.7 F, and for cooling, 0 to 7.3 F or 0 to 8.8 F for attempts exceeding the ten-minute trial period. No significant difference in ability to warm or cool was noted when the children were compared by group, age, or sex. Some of the children in group A who had little or no success with hypnosis only were very successful with the addition of biofeedback monitoring, suggesting a synergistic effect between biofeedback and hypnosis. A significant temperature rise was also noted in groups A and B accompanying a neutral hypnotic induction relaxation-imagery exercise in which no mention of temperature change was made. This rise varied from 0 to 6 F, averaging 1.7 F. Possible therapeutic implications include the treatment of migraine headaches, Raynaud's syndrome, sickle cell anemia, and the use of temperature monitoring as a diagnostic and therapeutic adjunct to clinical hypnosis.
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PMID:Self-hypnosis, biofeedback, and voluntary peripheral temperature control in children. 742 23

An acute inflammatory exacerbation is the most frequent complication of lymphoedema. The provoking cause may be trauma. Favouring factors are obesity and heat. 1/3 of patients suffer from such acute inflammatory exacerbations. The onset is sudden, with fever, redness, pain and local heat. After repression of the acute, inflammatory episode, the oedema is often increased. Treatment involves antibiotics, corticosteroids, vaccinotherapy and bed rest. It is possible to prepare sequential treatment, drug prevention with general and dietary measures.
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PMID:[Clinical aspects of acute inflammatory exacerbations lymphoedema (author's transl)]. 746 43

A randomized placebo-controlled study was undertaken in 188 patients with severe intermittent claudication attending two vascular clinics in Manchester and Liverpool. After a 4-week run-in period, patients received active or placebo treatment for 24 weeks. Patients were assessed on a treadmill prior to the 4-week run-in period, at randomization, and at 8, 16, and 24 weeks. Outcome was measured in terms of change in pain-free walking distance, maximum walking distance, and pressure indices. In this severe claudication population, in which the patients presented with a mean pain-free walking distance of 60 m, an intention-to-treat analysis demonstrated that the outcome in the naftidrofuryl-treated group was significantly better than in the group receiving placebo (p = 0.045). Additionally, 7% of patients in the naftidrofuryl group deteriorated compared with 22% in the placebo group (p = 0.005). Of the various risk factors that were recorded during the study--smoking habits, the presence of hypertension, diabetes, obesity, and duration of illness--only duration of illness had a significant influence on outcome. Maximum walking distances alone were not significantly influenced by treatment, but the use of a combined index of pain-free walking distance, maximum walking distance, and pressure indices to record success or failure confirmed a significant treatment effect (p = 0.047). A higher incidence of minor gastrointestinal symptoms was recorded in the naftidrofuryl-treated group. Treatment with naftidrofuryl was shown to prevent or slow the deterioration observed in a group of patients with severe claudication over a 24-week period.
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PMID:An evaluation of patients with severe intermittent claudication and the effect of treatment with naftidrofuryl. 751 77

When an endogenous morphine, beta-endorphin was discovered ten years ago, the fact that this morphine is present in the brain and many other tissues suggested to neurobiologists that these peptide opiates play a role which goes beyond that of a simple modulator of the perception of pain. beta-endorphin is a neurohormone which is secreted by the pituitary gland and reaches all tissues present in the body by diffusion. Many laboratories have investigated variations in serum levels of beta-endorphin under widely varying physiological or pathological conditions. Many references to these studies in the literature have thus demonstrated that beta-endorphins play a role in certain behavioural patterns (stress, alcoholism), in obesity, diabetes and psychiatric diseases. In fact, the activity of beta-endorphins would appear to have an interesting role to play and are a promising feature in the treatment of cerebral aging; in this field, beta-endorphins act not only as neuroregulators of other neurotransmitting substances but also, via calcium channels, exert an effect on the walls of cerebral arterioles. In situ, the role of beta-endorphins at the ionic channel level has been studied using the patch-clamp technique. In 1991, E Neher and B Sakmann received the Nobel Medicine and Physiology Prize for this work. beta-endorphin, which may be the "missing link" between the neuron and the wall of the arteriole, must be considered as being a fundamental neurotransmitter in the same way as well-known substances such as noradrenaline, acetylcholine, serotonin, dopamine and the GABAergic system are also neurotransmitters.
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PMID:Physiology of beta-endorphins. A close-up view and a review of the literature. 752 Feb 95

Idiopathic spinal epidural lipomatosis rarely is found (8 reported cases) in the absence of steroid treatment or obvious endocrinopathy. One additional symptomatic case with gait difficulty is described here. The only common etiologic factor for all cases is their obesity. Magnetic resonance imaging is the most helpful diagnostic means and should be used initially. In a patient with radicular pain or progressive paralysis who is obese, spinal epidural lipomatosis may be the etiologic factor involved.
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PMID:Idiopathic spinal epidural lipomatosis. Case report and review of literature. 758 16


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