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

In the setting of suspected or confirmed nonmassive pulmonary embolism (PE), transthoracic echocardiography (TTE) is an important tool to identify patients who could benefit from thrombolytic therapy, because of right ventricle (RV) dysfunction, and to monitor the dynamic response of the RV to reperfusion therapy. Unfortunately, certain patient characteristics such as obesity, lung disease, postsurgical state, or respiratory distress often lead to inadequate ultrasonographic imaging quality. In such patients, multidetector-row spiral computed tomography (MSCT) may become even more important. We present a female obese patient with acute nonmassive PE in whom TTE did not allow a reliable evaluation of the RV. Conversely, MSCT, beyond a direct demonstration of intravascular thrombi, detected multiple signs suggesting RV dysfunction. According to these findings, thrombolysis was safely performed, obtaining a rapid clinical improvement and a regression of RV dysfunction.
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PMID:Thrombolysis in acute nonmassive pulmonary embolism: potential role of multidetector-row spiral computed tomography in decision making. 1860 83

Obesity is a major problem from a public health perspective and a difficult practical matter for intensivists. The obesity pandemic has required treating clinicians to develop an appreciation of the substantial pathophysiological effects of obesity on the various organ systems. The important physiological concepts are illustrated by focusing on obstructive sleep apnoea, obesity hypoventilation syndrome, abdominal compartment syndrome and ventilatory management of the obese patient with acute respiratory distress syndrome.
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PMID:Obesity and the lung: 3. Obesity, respiration and intensive care. 1882 Jan 19

Acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) are common indications for ICU admission and mechanical ventilation. ALI/ARDS also consumes significant health care resources and is a common cause of death in ICU patients. Obesity produces changes in respiratory system physiology that could affect outcomes for ALI/ARDS patients and their response to treatment. Additionally, the biochemical alterations seen in obese patients, such as increased inflammation and altered metabolism, could affect the risk of developing ALI/ARDS in patients with another risk factor (eg, sepsis). The few studies that have examined the influence of obesity on the outcomes from ALI/ARDS are inconclusive. Furthermore, observed results could be biased by disparities in provided care.
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PMID:Obesity and acute lung injury. 1970 48

Prader-Willi syndrome (PWS) is a multigenic disorder caused by the loss of paternal expression of genes in the 15q11-q13 region. It is a complex and progressive disease. From birth, patients present breathing disorders (apnea, rhythm instability, hypoventilation and blunted response to changes in CO(2) or O(2)). Recent advances allowing early diagnosis permitted to prevent obesity of PWS patients and to alleviate some symptoms mainly by growth hormone therapy but there is no therapy to alleviate all symptoms and respiratory distress in particular. To further understand PWS several mutant mice, in which each candidate gene has been separately inactivated, have been developed and shown variable symptoms depending on the genes inactivated. Among them the Necdin deficiency appears to be responsible for breathing disorders. In Necdin deficient mice, respiratory defects resembling PWS have been shown in vivo and in vitro. These defects are central from origin and are correlated with biochemical and anatomical anomalies of the respiratory regulatory systems including serotonergic alterations.
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PMID:Breathing deficits of the Prader-Willi syndrome. 1971 4

Novel influenza A (H1N1) at the origin of the 2009 pandemic flu developed mainly in subjects of less than 65 years contrary to the seasonal influenza, which usually developed in elderly patients of more than 65 years. Elderly subjects are partly protected by old meetings with close stocks. Influenza A(H1N1) can arise in serious forms within 60 to 80% of cases a fulminant acute respiratory distress syndrome (ARDS) "malignant and fulminant influenza" in subjects without any comorbidity, which makes the gravity and the fear of this influenza. The fact that this influenza A (H1N1) can develop in healthy young patients and evolve in few hours to a severe ARDS with a refractory hypoxemia gave to the foreground the possible interest of the recourse to extracorporeal oxygenation (ECMO) in some selected severe ARDS (5-10%). The first publications of patients admitted in intensive care unit (ICU) for severe influenza A (H1N1) often associated to an ARDS reported a mortality rate from 15 to 40%. This mortality variability may be explained in part by different studied populations, ARDS characteristics and human and material resources in the ICUs between the countries. Indeed, the highest mortality rates (30-40%) have been reported by in Mexico which were affected the first by pandemic flu and which were not prepared. A bacterial pneumonia was associated to H1N1 influenza in approximately 30% of the cases as at admission in ICU or following the days of the admission justifying an early antibiotherapy associated to the antiviral treatment by oseltamivir (Tamiflu). Obesity, pregnancy and respiratory diseases (asthma, COPD) seem to be associated to the development of a severe viral pneumonia due to influenza A (H1N1) often with ARDS. Older age, high APACHE II and SOFA scores and a delay of initiation of the antiviral treatment by oseltamivir are associated to higher morbidity and mortality. Other analyses of the results obtained from the first published papers included more patients and future studies would permitted to better define the role of therapeutics such as steroids and ECMO.
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PMID:[ARDS and influenza A (H1N1): patients' characteristics and management in intensive care unit. A literature review]. 2011 70

Obstructive sleep apnea (OSA) is an increasingly common disorder. It is characterized by frequent episodes of airway obstruction associated with a reduced caliber of the upper airway and is vulnerable to further narrowing and collapse. Acute and repetitive effects of apnea and hypopnea include oxygen desaturation, reduction in intrathoracic pressure, excessive daytime sleepiness, impaired executive function and central nervous system arousals. The apnea-hypopnea index and respiratory distress index help quantify the severity of the condition. The condition is associated with several clinical symptoms of which daytime sleepiness is considered the cardinal symptom. Obesity is one of the major predisposing factors. Three types of apneas have been recognized -obstructive, central and mixed; OSA is the commonest. This review will cover aspects of their radiologic features, diagnosis and management.
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PMID:Obstructive sleep apnea: clinical and diagnostic features. 2013 77

As the pandemic of 2009 H1N1 influenza A virus progressed, more patients required hospitalisation. The objective of this study is to describe the characteristics and clinical course of hospitalised patients with 2009 H1N1 virus infection in Chile. This was a prospective, observational study of 100 consecutive hospitalised patients with RT-PCR-confirmed 2009 H1N1 influenza A, admitted to Puerto Montt General Hospital (Puerto Montt, Chile). Information was obtained regarding contact history, demographics, laboratory values and clinical course. The primary reason for hospitalisation was pneumonia, in 75% of patients. Rapid influenza A test was positive in 51% of patients. Prior exposure to 2009 H1N1 virus was documented in 21% of patients. Clinical failure, documented in 18% of cases, was characterised by respiratory failure and acute respiratory distress syndrome. Failure was more common in patients with obesity, tachypnoea, confusion and multilobar infiltrates. When evaluating a patient hospitalised with influenza-like illness, a negative rapid test for influenza A or negative contact with a suspected case should not alter physicians' considerations regarding the likelihood of 2009 H1N1 virus infection. Patients with 2009 H1N1 virus infection with obesity, tachypnoea, confusion and multilobar infiltrates should be closely monitored since they are at high risk for clinical failure.
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PMID:Characteristics of hospitalised patients with 2009 H1N1 influenza in Chile. 2018 21

Obesity is defined as an accumulation of excessive amounts of adipose tissue in the body, and has been called the most common nutritional disease of dogs in Western countries. Most investigators agree that at least 33% of the dogs presented to veterinary clinics are obese, and that the incidence is increasing as human obesity increases in the overall population. Obesity is not just the accumulation of large amounts of adipose tissue, but is associated with important metabolic and hormonal changes in the body, which are the focus of this review. Obesity is associated with a variety of conditions, including osteoarthritis, respiratory distress, glucose intolerance and diabetes mellitus, hypertension, dystocia, decreased heat tolerance, some forms of cancer, and increased risk of anesthetic and surgical complications. Prevention and early recognition of obesity, as well as correcting obesity when it is present, are essential to appropriate health care, and increases both the quality and quantity of life for pets.
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PMID:Obesity in dogs and cats: a metabolic and endocrine disorder. 2021 85

Diagnostic or therapeutic flexible bronchoscopy is often necessary in severely ill patients. These patients often have comorbidities that increase the risk of bronchoscopy-related complications. Noninvasive ventilation might decrease the risk of these complications in patients with severe refractory hypoxemia, postoperative respiratory distress, or severe emphysema, and in pediatric patients. Noninvasive ventilation may prevent hypoventilation in patients with obstructive sleep apnea and obesity hypoventilation syndrome who require bronchoscopy, and may assist in the bronchoscopic evaluation of patients with expiratory central-airway collapse. We describe the indications, contraindications, and technique of flexible bronchoscopy during noninvasive ventilation.
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PMID:Bronchoscopy during noninvasive ventilation: indications and technique. 2042 Jul 31

Obstructive sleep apnea (OSA) is an increasingly common disorder. It is characterized by frequent episodes of airway obstruction associated with a reduced caliber of the upper airway and is vulnerable to further narrowing and collapse. Acute and repetitive effects of apnea and hypopnea include oxygen desaturation, reduction in intrathoracic pressure, excessive daytime sleepiness, impaired executive function and central nervous system arousals. The apnea-hypopnea index and respiratory distress index help quantify the severity of the condition. The condition is associated with several clinical symptoms of which daytime sleepiness is considered the cardinal symptom. Obesity is one of the major predisposing factors. Three types of apneas have been recognized--obstructive, central and mixed; OSA is the commonest. This review will cover aspects of their radiologic features, diagnosis and management.
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PMID:Obstructive sleep apnea and its management. 2042 21


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