Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

BACKGROUND: Prader-Willi Syndrome (PRWS) is an uncommon neuroendocrine disorder of genetic origin, described in 1956 by Prader, Labhart and Willi. The main clinical manifestations in the adult are mental retardation, hyperphagia with gross obesity, hypogonadismcriptorhismus and short stature. The life expectancy of the affected individual ranges between 20 and 30 years rarely beyond - due to complications related to excessive obesity. Sustained dieting combined with behavior modification programs, as well as gastric restrictive surgery for obesity, proved to have a high failure rate in PRWS, due to the patients' inability to cooperate in changing their eating habits. METHODS: Biliopancreatic Diversion (BPD), which does not require the patient's cooperation in changing eating habits after surgery, was performed in two PRWS patients (13- and 22-years-old), both with excessive obesity, severe respiratory distress, day sleepiness and limited mobility. RESULTS: Two years after surgery, the 13-year-old had lost 80% of her overweight, while the 22-year-old, after 1 year, had lost 34%. Recent laboratory tests showed normal data in both patients. Their respiratory distress had subsided completely, their mobility improved dramatically, and their self-image and alertness enhanced. CONCLUSION: BPD resulted in an improved quality of life in these patients.
 ...
PMID:Biliopancreatic Diversion in Prader-Willi Syndrome Associated with Obesity. 1073 Dec 52

Decreased libido is frequently reported in male patients with obstructive sleep apnea (OSA). The decline in morning serum testosterone levels previously reported in these patients was within the normal adult male range and does not explain the frequent association of OSA and sexual dysfunction. We determined serum LH and testosterone levels every 20 min between 2200-0700 h with simultaneous sleep recordings in 10 men with sleep apnea and in 5 normal men free of any breathing disorder in sleep. The mean levels and area under the curve of LH and testosterone were significantly lower in OSA patients compared with controls [LH, 24.9 +/- 10.2 IU/liter.h vs. 43.4 +/- 9.5 (P < 0.005); testosterone, 67.2 +/- 11.5 nmol/liter.h vs. 113.3 +/- 26.8 (P < 0.003)]. Four of 10 patients had hypogonadal morning (0700 h) serum testosterone levels. Analysis of covariance (ANCOVA) revealed that the 2 groups differed significantly in the amount of LH and testosterone secreted at night independent of age or degree of obesity. After partialing out body mass index, there was a significant negative correlation between the amounts of LH and testosterone secreted at night and the respiratory distress index, but not with degree of hypoxia. Our findings suggest that OSA in men is associated with dysfunction of the pituitary-gonadal axis. The relation between LH-testosterone profiles and the severity of OSA suggests that sleep fragmentation and, to a lesser extent, hypoxia in addition to the degree of obesity and aging may be responsible for the central suppression of testosterone in these patients.
 ...
PMID:Decreased pituitary-gonadal secretion in men with obstructive sleep apnea. 1210 56

Five callitrichids (three common marmosets -Callithrix jacchus -, a black tufted-eared marmoset -C. penicillata-, and a saddle-back tamarin -Saguinus fuscicollis) were diagnosed with islet hyperplasia by histopathology and immunohistochemistry. All were privately-owned, unrelated callitrichids ranging from 2- to 4-year-old. Relevant findings were anorexia (3/5), vomiting (2/5), ptyalism (1/5), polyuria/polydipsia (1/5), respiratory distress (1/5), hyperglycemia (2/3) and glycosuria (1/1); hyperglycemia and glycosuria were associated with pregnancy in a common marmoset and resolved after reducing simple carbohydrates in diet. All five animals died, three of them after few premonitory signs; in two cases, other concurrent diseases unrelated to islet hyperplasia were considered the cause of death. Additional animals from two facilities had high weight (4), physical obesity (3), polyuria/polydipsia/polyphagia/uriposia (1), hyperglycemia (1), and/or glycosuria (2). Pathologic findings in the deceased callitrichids were: islet hyperplasia (5/5); hemosiderosis (5/5); lipomatosis (4/5) of several tissues (atria, 3/5; pancreas, gall bladder, intestine, esophagus, and thyroid, 2/5; liver, 1/5); pancreatic necrosis or steatonecrosis, and/or acute pancreatitis (3/5); and vacuolation of hepatocytes and renal tubular cells most likely consistent with hepatorenal lipidosis (2/5). The islets of Langerhans were more numerous and larger than in a control, and morphologically normal in all cases, except in a common marmoset that had a few cells with a foamy cytoplasm and shrunken hyperchromatic or picknotic nucleus. Insulin (5/5), glucagon (3/5), and somatostatin (3/5) immunohistochemistry revealed that most cells stained positively for insulin diffusely in their cytoplasm (5/5) (staining restricted to the vascular pole of b-cells in the control). These findings suggest that obesity, insulin resistance and/or type II diabetes may be implicated and thus a prospective study on these diseases in callitrichids is necessary to determine their etiopathogenesis.
 ...
PMID:Islet hyperplasia in callitrichids. 1214 99

Factors that hinder breast feeding include the lack of knowledge of health personnel about the uniqueness of breast milk and the ease with which they and mothers have accepted formula feeding. These factors prevailed in Europe and North America until the 1960s, and they prevail today in developing countries. It is crucial to persuade health workers of the merits of breast feeding in order to promote it. Baby milk formula was developed in 1919 to provide a substitute for infants afflicted by the lack of their mothers milk. The search for the perfect human milk formula continues, but formula feeding is an experiment whose long-term effects are unknown. Its putative benefits are convenience, creation of employment, decreased perinatal mortality in affluent societies, and increased weight gain of premature low-birth-weight babies. However, formula feeding encourages less frequent child-mother contact. Employment opportunities in the manufacture of formula milk are only generated in the developed countries. The decline in perinatal mortality in developed countries since the advent of bottle feeding has been attributable to better obstetric care and improved management of such conditions as respiratory distress syndrome in infants. Most of the weight gain associated with formula use is caused by water and solute retention, which may be harmful to immature kidneys. On the other hand, the indisputable benefits of breast feeding include 1) prevention of infant malnutrition in the poor and obesity in the affluent 2) reduction in infection owing to protective factors in breast milk 3) reduced exposure to foreign allergens leading to a lower incidence of atopic conditions 4) convenience 5) enhancing the emotional bond between mother and child; and 6) helping to regulate appetite and satiety. Developing countries need health workers who are committed to encouraging exclusive breast feeding for 4 months, followed by breast feeding with supplements for at least 12 months.
 ...
PMID:Breastfeeding: an appeal. 1234 41

We report a 21-year-old woman with ectopic ACTH syndrome due to islet cell carcinoma with multiple liver metastases. On admission, she showed Cushingoid appearance (moon face, central obesity etc.) and had acute respiratory distress syndrome due to pneumocystis carinii pneumonia. Laboratory examination revealed marked elevations of plasma ACTH (735 pg/ml) and cortisol (145 microg/dl) with a profound hypokalemia (2.0 mEq/l). She was found to have multiple masses in the liver and a solid mass in the tail of pancreas by abdominal computerized tomography scanning. Treatment with octreotide successfully reduced elevated plasma ACTH and cortisol levels, and she received frequent transhepatic arterial embolization and chemotherapy. The primary pancreatic tumor was surgically removed, revealing islet cell carcinoma which contained high content of ACTH (100 microg/g wet weight) and abundantly expressed proopiomelanocortin and somatostatin receptor subtype-2 mRNAs as determined by Northern blot analysis. Postoperatively, she was free from symptoms for almost one year. However, progressive enlargement of multiple liver metastases refractory to chemotherapy led her to decide on total hepatectomy and liver transplantation from her father. After liver transplantation, she remained almost free from symptoms for almost one year. However, metastases developed to the mediastinal and paraaortic lymph nodes as detected by 111[In] pentetreotide scintigraphy. Eleven months after liver transplantation, she was again treated with octreotide and, 16 months after, with metyrapone, both of which were effective in reducing ACTH and cortisol levels, respectively, until she died of acute respiratory failure. This case of a young female patient with ectopic ACTH-producing islet cell carcinoma of the pancreas was quite unique in that she survived for 5 years despite the acute onset and rapid progression of the multiple liver metastases at least in part due to the long-lasting favorable response to octreotide and living-related liver transplantation.
 ...
PMID:Octreotide-sensitive ectopic ACTH production by islet cell carcinoma with multiple liver metastases. 1280 33

Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM is becoming an increasing health problem worldwide and one of the most common complications of pregnancy. The prevalence of GDM in Central Europe is 5-7%. GDM is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. The key symptom of GDM is the development of diabetic fetopathy. Fetal hyperinsulinism is associated with macrosomia and a higher rate of birth injuries and caesarean sections, neonatal hypoglycemia, respiratory distress and due to fetal programming the development of the sequelae of the metabolic syndrome in childhood or adolescence. GDM is commonly diagnosed by an oral glucose tolerance test (OGTT) between gestational weeks 24 and 28. In addition, in case of a high risk of GDM (history of poor obstetric outcome: stillbirth, congenital malformation, birth weight > or = 4500 g or a history of impaired glucose tolerance or impaired fasting glucose) impaired glucose metabolism or diabetes should be excluded in the first trimester. GDM shares the same pathophysiology and clinical signs as diabetes mellitus type 2. Thus maternal obesity, higher age, hypertension as well as a positive family history of type 2 diabetes are high risk factors for the development of GDM. If GDM is diagnosed, a strict metabolic control is mandatory. All women should receive nutritional counseling and be instructed in blood glucose self-monitoring. If blood glucose levels cannot be maintained in the normal range (fasting < 95 mg/dl and 1 h after meals < 130 mg/dl), insulin therapy should be initiated. Maternal and fetal monitoring is required in order to minimize maternal and fetal/neonatal morbidity and perinatal mortality. After delivery, all women with GDM have to be reevaluated as to their glucose tolerance by a 75 gOGTT (WHO criteria). While 85% of these women will return to normal glucose tolerance 8 weeks postpartum, those with persisting impaired glucose tolerance are at particularly high risk for diabetes.
 ...
PMID:[Gestational diabetes]. 1467 91

Rhabdomyolysis has been reported in all postoperative patients including those in prone, supine, lithotomy and lateral decubitus positions. Only a few reports suggest that bariatric surgical patients are at risk for rhabdomyolysis. We describe a male (BMI 69 kg/m2) who underwent an uneventful open Roux-en-Y gastric bypass for weight reduction lasting 5 hours. Postoperatively the patient suffered oliguria. Evaluation included subjective pain in both hips, a normal temperature and physical examination, creatinine increase to 3.5 mg/dl, CPK levels as high as 41,000 IU/L, and urinalysis showing a large amount of occult blood with 5-7 RBCs/HPF. Intravenous hydration with 0.9% normal saline, bicarbonate, and mannitol demonstrated initial success, but the patient eventually developed renal failure, respiratory distress, and tachycardia leading to cardiac arrest. Prior to his death, intraoperative evaluation demonstrated intact anastomoses. Obese patients undergoing bariatric surgery should be considered at risk for rhabdomyolysis, especially in view of prolonged surgeries, difficult physical examination, low volume status, and larger or immobile patients.
 ...
PMID:Postoperative rhabdomyolysis with bariatric surgery. 1473 87

Hypersensitivity reaction (HSR) is still a major concern during cancer chemotherapy with paclitaxel. In the present study, we investigated retrospectively the incidence of HSRs to paclitaxel and the risk factors in 105 patients (553 courses) who received adjuvant chemotherapy (paclitaxel and carboplatin) for ovarian cancer. Moderate to severe HSRs that led to cessation or discontinuation of the chemotherapy, including respiratory distress and hypotension, were observed in 14 patients (13.3%) and 16 courses (2.9%), regardless of the use of conventional premedication with glucocorticoid, and histamine H(1) and H(2) antagonists. The incidence of HSRs to paclitaxel in patients with ovarian cancer seemed to be considerably higher than those reported by other investigators in patients with other carcinomas such as non-small-cell lung cancer and breast cancer. Four risk factors were identified: (1) history of mild dermal reactions such as facial flushing and urticaria in previous courses, (2) presence of respiratory dysfunction, (3) obesity (body mass index >25), and (4) postmenopausal at the time of ovariectomy. The incidence of hypersensitivity increased linearly as the number of risk factors increased (r=0.992, P=0.008). It is likely that disappearance of the estrous cycle facilitates the occurrence of HSRs to paclitaxel.
 ...
PMID:Incidence and risk factors for paclitaxel hypersensitivity during ovarian cancer chemotherapy. 1579 61

News that a woman with diabetes is about to deliver brings up images of a macrosomic infant. This infant may experience birth injuries, asphyxia, respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia, polycvthemia/hyperviscosity syndrome, asymmetric sepral hypertrophy, and other congenital malformations. Uncontrolled diabetes has profound effects on embryogenesis, organogenesis, and fetal and neonatal growth, and evidence increasingly indicates that some of these effects are lifelong and may contribute to adult obesity. Preconception control of diabetes and monitoring throughout pregnancy are important in reducing the impact of diabetes on the fetus and newborn.
 ...
PMID:Infants of diabetic mothers: the effects of hyperglycemia on the fetus and neonate. 1792 58

The halo fixator may be used for the definitive treatment of cervical spine trauma, preoperative reduction in the patient with spinal deformity, and adjunctive postoperative stabilization following cervical spine surgery. Halo fixation decreases cervical motion by 30% to 96%. Absolute contraindications include cranial fracture, infection, and severe soft-tissue injury at the proposed pin sites. Relative contraindications include severe chest trauma, obesity, advanced age, and a barrel-shaped chest. In children, a computed tomography scan of the head should be obtained before pin placement to determine cranial bone thickness. Complications of halo fixation include pin loosening, pin site infection, and skin breakdown. A concerning rate of life-threatening complications, such as respiratory distress, has been reported in elderly patients. Despite a paucity of contemporary data, recent retrospective studies have demonstrated acceptable results for halo fixation in managing some upper and lower cervical spine injuries.
 ...
PMID:The halo fixator. 1806 13


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>