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

Conservative management of thoracic outlet syndrome is recommended as the initial treatment of choice, and yet few studies have evaluated patient outcome. This study evaluates patient subjective outcome following conservative management of thoracic outlet syndrome. Forty-two patients (37 women, 5 men), mean age 38 years, participated in a telephone questionnaire. Patients clinically diagnosed with thoracic outlet syndrome who had participated in physical therapy at least 6 months prior to the study were selected. Mean duration of symptoms before treatment was 38 months, and mean follow-up time after therapy was 1 year. Twenty-five patients reported symptomatic improvement, 10 were the same, and 7 had worse symptoms. Sixteen patients reported full work and recreational activities, and 8 patients reported restrictions in both work and recreational activities. Poor overall outcome was related to obesity (p < .04), workers' compensation (p < .04), and associated carpal or cubital tunnel syndrome (p < .04). Neck and shoulder symptoms were improved in 38 patients. Improvement in hand and arm pain was significantly better in those without concomitant distal nerve compression (p < .006).
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PMID:Outcome following conservative management of thoracic outlet syndrome. 872 98

Pseudotumor cerebri is a condition of intracranial hypertension without localizing signs except for papilledema with normal intracranial contents and normal cerebrospinal fluid constituents. It is seen more frequently in women than in men (8:1) especially women are of childbearing age, and in 90% of cases of obesity. The most common symptoms are headache and visual obscuration. Other symptoms include pulsatile tinnitus, shoulder and arm pain. The papilledema present in almost all PTC patients can lead to decreased vision and blindness. One third of the large series had substantial visual loss including loss of visual field. Treatment has been directed toward preserving vision. Medications that reduce intracranial pressure such as diuretics like Acetazolamide have some success. When vision is threatened, these individuals may undergo optic nerve sheath decompression or lumbar peritoneal shunt to preserve vision. Even with prompt intervention, visual loss can occur.
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PMID:[Pseudotumor cerebri (PTC--an update)]. 1194 27

An 85-year-old man was admitted to our hospital for swollen and painful bilateral lower legs and a high fever. He was initially diagnosed with acute cellulitis and treated with antibiotics. Several days after the improvement of his swollen legs, he complained of both shoulder and arm pain. The laboratory data at this time were as follow: C-reactive protein 10.7 mg/dL, uric acid 8.7 mg/dL, and creatinine 1.07 mg/dL. Both rheumatoid factor and anti-CCP antibody were negative. Whole-body gallium scintigraphy showed a high pathological accumulation in both the shoulders and left wrist. As polymyalgia rheumatica was suspected, oral prednisolone (PSL) of 10 mg/day was started. The patient's shoulder pain improved and he was discharged. However, he was hospitalized twice in the next month because of left shoulder, left knee, right arm, and right wrist pain. During the third hospitalization, we found a subcutaneous nodule on right toe. Aspiration material from the nodule was a white paste, showing acicular crystals under the microscope. According to these findings, the nodule was diagnosed as a tophaceous nodule, and recurrent episodes of polyarthritis were diagnosed as chronic tophaceous gout. Low-dose PSL was continued and febuxostat was added. This patient had multiple risk factors for chronic tophaceous gout: obesity, a habit of drinking, diabetes mellitus, hyperlipidemia, congestive heart failure, and interruption of allopurinol treatment. We herein discuss the clinical course of the patient, the interruption of allopurinol treatment and polypharmacy in elderly patients.
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PMID:[An elderly man presenting polyarthritis diagnosed as chronic tophaceous gout]. 2670 Jul 82