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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A knowledge of the layman's illness concepts is of value both for diagnosis and therapy in the practical application of the medical services. It is also valuable for the estimation of morbidity and of the need for medical assistance. The present article describes an investigation intended to throw light on the import of ten different illness concepts and on the implications these may have for the utilization of the medical services. The study is based on interviews with 100 middle-aged women. Most of the respondents considered that an illness may have many causes--a multifactorial aetiology. Great differences between the illnesses were noted with respect to the opinions as to whether examination by a doctor was necessary for diagnosis. The interpretations as to whether an illness needed treatment--medical attention, medicine, hospital care--seemed however to be more closely related to its duration than to its nature. A long duration was regarded by a surprisingly large number as a sign that hospitalization was required--even in the case of a common cold! Only 8% considered obesity 'serious'. As regards the choice of illness alternatives, earlier experience of illness influenced this only in the case of 'shortness of breath' and 'nervous symptoms'. Social class was not found to affect the type of answer.
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PMID:The layman's medical vocabulary. A study of illness definitions and perceived need for medical care. 127 49

This study evaluates the correlation between long-term weight history and health risks. One thousand three hundred and sixteen male subjects of normal weight (-5%(-)+5% by Broca's obesity index) at age twenty, were studied. The average age of the subjects was 43.7 +/- 6.5 (M. +/- S.D.) years old. According to their long-term weight history, the subjects were classified into four groups: weight lost (N = 35), weight stable (N = 502), mild weight gain (N = 187), severe weight gain (N = 592). Odds ratios for systolic blood pressure, diastolic blood pressure, glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, gamma glutamyl transpeptidase, uric acid, fasting blood sugar, total cholesterol, triglyceride, shortness of breath, hyperperspiration, angina pectoris, and hypertension were significantly higher in the severe weight gain group than in the stable weight group. Stepwise logistic regression analysis was performed by choosing weight history, obesity index, age, and smoking and drinking habits as the independent variables. Weight history was shown to be a significant variable in systolic blood pressure, diastolic blood pressure, glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, gamma glutamyl transpeptidase, fasting blood sugar, total cholesterol, triglyceride, shortness of breath, chronic hepatitis and liver cirrhosis. Odds ratios for factors suspected of promoting atherosclerosis were significantly higher in the severe weight gain group. Results of this study indicate that a weight gain of over 7 kilograms appears to be the critical level that is associated with health risks.
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PMID:[Health risk assessment of long-term weight history]. 213 52

A cross-sectional survey was made of the 25 men and 127 women attending a hospital obesity clinic over a period of 6 weeks. Among the men the mean (+/- s.d.) age was 37 (+/- 14) years, weight 115.2 (+/- 25.4) kg, height 1.70 (+/- 0.09) m, and Quetelet's index 39.6 (+/- 6.4) kg/m2. Among the women the corresponding values were 41 (+/- 15) years, 102.2 (+/- 22.3) kg, 1.60 (+/- 0.07) m, and 40.3 (+/- 9.2) kg/m2. The most common reasons for wishing to lose weight among both men and women was to improve appearance, shortness of breath and pain in weight-bearing joints. About one-third of the patients tested had raised fasting plasma triglyceride levels. Only one had tests indicating hypothyroidism, and two were hyperthyroid. None of these characteristics predicted how long the patient would continue to attend the clinic. Weight loss was calculated according to the duration of attendance at the clinic, and the method of treatment. Two men and 15 women were treated by jaw-wiring, and the remainder by dietary advice alone. No anorectic or thermogenic drugs were used. Among men treated by diet alone the mean weight loss after 1-3 months, 4-6 months, 7-12 months and greater than or equal to 13 months attendance was 5.0 +/- 6.2 kg, 12.4 +/- 11.0 kg, 12.4 +/- 10.2 kg and 13.0 +/- 5.2 kg respectively. Two men treated by jaw-wiring had lost 23.9 and 57.9 kg.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A cross-sectional cost/benefit audit in a hospital obesity clinic. 310 40

To assess the associations between job stress and somatic symptoms and to investigate the effect of individual coping on these associations. In July 2006, a cross-sectional study was conducted during a periodic health check-up of 185 Japanese male office workers (21-66 yr old) at a Japanese company. Job stress was measured by job demand, control, and strain (=job demand/control) based on the Job Content Questionnaire (JCQ). Major somatic symptoms studied were headache, dizziness, shoulder stiffness, back pain, shortness of breath, abdominal pain, general fatigue, sleep disturbance, and skin itching. Five kinds of coping were measured using the Job Stress Scale: active coping, escape, support seeking, reconciliation, and emotional suppression. Comorbidities of hypertension, diabetes, obesity, depression, and anxiety were also evaluated. The most frequently cited somatic symptom was general fatigue (66%), followed by shoulder stiffness (63%) and sleep disturbance (53%). Of the five kinds of coping, only "active coping" was significantly and negatively associated with the number of somatic symptoms. The generalized linear models showed that the number of somatic symptoms increased as job strain index (p=0.001) and job demand (p=0.001) became higher, and decreased as active coping (p=0.018) increased, after adjusting for age and comorbidities. There was no statistical interaction among active coping, the number of somatic symptoms, and the three JCQ scales. Reporting somatic symptoms may be a simple indicator of job stress, and active coping could be used to alleviate somatization induced by job stress.
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PMID:The association of the reporting of somatic symptoms with job stress and active coping among Japanese white-collar workers. 1795 68

Caring for super obese patients (body mass index > 50 kg/m(2)) presents a number of complex and unique clinical challenges, particularly when acute kidney injury is present. We describe our experience treating the heaviest individual with acute kidney injury requiring renal replacement therapy reported to date. A 24-year-old black man was admitted to our hospital with fever, vomiting, progressive weakness, shortness of breath, and hemoptysis. Admission weight was 1,024 lbs (466 kg), height was 6 ft 4 in (1.9 m), and body mass index was 125 kg/m(2). During hospitalization, the patient experienced oligoanuric acute kidney injury and required initiation of continuous and subsequently intermittent renal replacement therapy. This clinical scenario identifies the many challenges involved in caring for super obese patients with acute kidney injury and may be a harbinger of what awaits the nephrology community in the obesity pandemic era.
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PMID:Challenges of treating a 466-kilogram man with acute kidney injury. 1849 9

Obesity has been found to be associated with left ventricular (LV) hypertrophy (LVH). However, the occurrence of LVH in obese teenagers who are involved in sport programs has not been studied. The objective of this study was to evaluate the prevalence of LVH and its correlation with obesity, gender, and symptoms in teenage athletes. We used echocardiographic database of 1,500 adolescences between the ages of 12 and 20 years who were actively involved in school sport programs. We evaluated associations between obesity and LVH (defined as LV wall thickness (LVWT)) >12 mm, or LV mass (LVM) >215 g or relative wall thickness (RWT) >0.43) and physical symptoms. Using univariate and multivariate analysis, male gender was associated with increased LVWT (multivariate odds ratio (OR) 4.87, confidence interval (CI) 2.41-9.82). Obesity was associated with parameters of LVH using univariate and multivariate analysis. (LVM > 215 g) occurred in 10.32% of obese athletes vs. 0.2% (1/445) of controls, (OR 51.33, CI 6.05-433.8), P < 0.001, LVWT >12 mm occurred in 16.5% of obese students vs. 3.6% of controls (OR 5.2, CI 2.7-10.1, P < 0.001), RWT >0.43 occurred in 41.4% of obese students vs. 15.7% of controls (OR 3.78, CI 2.11-6.76, P < 0.001). After adjusting for age and gender, reported history of shortness of breath (SOB), fatigue and leg edema were also significantly more prevalent in obese students and in students with LVH. In conclusion obesity is associated with LVH in a population of healthy teenagers actively involved in sport programs. Furthermore, the presence of LVH was independently associated with many physical symptoms suggesting negative effect of LVH on myocardial function.
Obesity (Silver Spring) 2009 Mar
PMID:Left ventricular hypertrophy is associated with obesity, male gender, and symptoms in healthy adolescents. 1923 46

The aims of this study were to investigate the baseline prevalence of and risk factors associated with asthma, classify asthma severity, and describe medication use in a population-based sample of African American men and women 21 to 84 years of age from the Jackson Heart Study (JHS). Participants provided responses to respiratory and medical history questions and a medication inventory and underwent spirometry and other clinical examinations. These data were used to examine the extent to which novel and traditional risk factors were associated with asthma. Of the 4,098 participants included in this analysis, 9.4% reported lifetime asthma (5.7% current, 3.7% former), and current asthma was higher in women (6.8%) than in men (3.8%). An additional 9.8% reported an attack of wheeze with shortness of breath or non-doctor confirmed asthma (i.e., "probable" asthma). The mean forced expiratory volume in 1 second (FEV(1))% predicted was lower in those reporting current asthma (women: 83.7 +/- 18.0; men: 75.2 +/- 16.8) compared to those not reporting asthma (women: 95.6 +/- 16.7; men: 91.7 +/- 16.0). Current and probable asthma was associated with lower serum cortisol levels and hypertension medication use, along with traditional risk factors (i.e., lower socio-economic status, higher global stress scores, obesity, and fair to poor perceived general health). Severe asthma was low among participants reporting current (9.8%), former (3.3%), and probable (4.9%) asthma. Asthma medication use was reported by nearly 60% of the participants reporting current asthma. Asthma in African American adults is associated with decreased serum cortisol, hypertension medication use, and considerable lung function impairment compared to those who did not report asthma. The prevalence of asthma in the JHS is lower than state and national estimates, although the estimates are not directly comparable. Furthermore, asthma is drastically underdiagnosed in this population.
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PMID:Asthma and asthma severity among African American adults in the Jackson Heart Study. 1948 81

Weight-control drugs (known as anorexigens) such as fenfluramine have been linked with pulmonary hypertension in previous reports. In our case, a 29 year old woman was admitted for shortness of breath and was diagnosed with pulmonary hypertension. Three months ago, she had been taking phentermine for five weeks. Other factors that might have contributed to the development of pulmonary hypertension were excluded. With treatment, her symptoms improved. This is the first case that can suggest a possible connection between phenermine single medication with pulmonary hypertension. Phentermine has been considered a relatively safe drug to treat obesity, and further investigation is needed to decide the safety and dosage of phentermine.
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PMID:Pulmonary hypertension associated with use of phentermine. 2178 57

Asymptomatic Morgagni hernia can be discovered in adults as an incidental finding or because of acute gastrointestinal symptoms. We report a case of a 76-year-old man with an incidental diagnosis of seizure attack. Obesity and the increased abdominal pressure caused by abdominal muscles contraction during seizure could have contributed to the clinical presentation. The omentum, small bowel, and transverse colon were found in the right side of the chest using an open transabdominal approach. The hernia sac was excised and the diaphragmatic defect closed by direct suturing. The postoperative period was uneventful and the shortness of breath attributed to obesity disappeared.
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PMID:Seizure attack and Morgagni diaphragmatic hernia: incidental diagnosis or direct correlation? 2128 95

We examined the health status of women in relation to their body mass indices and waist-to-hip ratio (WHR) by analyzing data from a follow-up study of 325 women, selected from the Indian National Family Health Survey (NFHS-2/1998-99) Delhi samples, reinterviewed after 4 years (2003). Obese women were five times more likely (OR = 4.87; p <.0001) and women with a higher WHR (> 0.90) were two times more likely (OR = 1.70; p =.050) to perceive their health condition as worse than others. Arthritis, hypertension, and shortness of breath were found to be higher among obese women and women with a high WHR. Healthy lifestyle choices must be promoted to contain the growing burden of obesity-related health problems among Indian women.
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PMID:Women's health in India: the role of body mass index. 2456 48


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