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)

We report 16 adult men (age, 41 to 75 yr) with neuralgic amyotrophy (NA) who presented with dyspnea due to involvement of the diaphragm. All patients developed breathlessness after a prodrome of acute severe neck and shoulder pain. Bilateral diaphragm paralysis (BDP) was confirmed in 12 patients and unilateral diaphragm paralysis (UDP) in four by the absence of electrical and mechanical responses to percutaneous phrenic nerve stimulation. Global expiratory muscle strength was well preserved in all patients, but inspiratory muscle strength was reduced in proportion to the extent of diaphragmatic involvement. Lung function showed low lung volumes with preservation of carbon monoxide transfer coefficient in all patients. Two BDP patients were hypoxic (PaO2 = 67 and 54 mm Hg, respectively) on daytime arterial blood gas analysis; the latter patient with pre-existing chronic obstructive pulmonary disease and marked obesity also had borderline hypercapnia (PaO2 = 49 mm Hg). Overnight sleep studies in three BDP and two UDP patients showed frequent intermittent arterial oxygen desaturations apparently caused by obstructive sleep apneas, but there was no evidence of alveolar hypoventilation. Follow-up muscle studies in five BDP and four UDP patients between 2 and 4 yr after initial referral showed complete recovery of diaphragmatic function in only two UDP patients, one of whom relapsed a year later. We postulate that NA may be an important but underrecognized cause of diaphragmatic paralysis in otherwise normal patients. Diaphragmatic strength returns very slowly, if at all.
 ...
PMID:Diaphragmatic dysfunction in neuralgic amyotrophy: an electrophysiologic evaluation of 16 patients presenting with dyspnea. 842 Apr 34

To analyze problems with inserting, maintaining and removing a laryngeal mask in children, as well as to assess the possible involvement of certain factors (experience with the laryngeal mask, type of anesthesia, duration of surgery, type of surgery, obesity, etc.) in favoring the development of complications. One hundred eighty-nine children undergoing a variety of surgical procedures under general anesthesia were studied; patients with full stomachs and/or a history of hiatus hernia were excluded. The agent used for anesthetic induction and the method of ventilation were chosen by the anesthesiologist responsible for each case. Variables monitored in all patients were continuous ECG, heart rate, systolic and diastolic arterial pressure, capnography, pulse oximetry, airways pressure and respiratory rate. Values were recorded at five times: before induction (T1), immediately after induction (T2), after placement of the laryngeal mask (T3), before removing the laryngeal mask (T4) and after removing the laryngeal mask (T5). Correct insertion was achieved on the first try in 85%. The remaining 15% required 2 or more tries. There were no cases in which a tracheal tube or face mask were required. We found no correlation between type or duration of surgery and the occurrence of complications. Complications were more frequent when the laryngeal mask was placed by inexperienced personnel, when inhalational anesthetics were used for induction and maintenance, and when a No. 1 laryngeal mask was used. Adequate ventilation was provided for the patients who required it with an airways pressure between 8 and 18 cmH2O, arterial oxygen saturation over 98% and end-expiratory CO2 pressure under 35 mmHg. Cardiovascular repercussions were slight and hemodynamic stability was good.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Application of the laryngeal mask in pediatric anesthesiology]. 856 55

The arteriosclerotic diseases and their risk factors were retrospectively investigated in 44 patients with chronic state of acute carbon monoxide intoxication who had been admitted since November 1963. The lack of elevations of systolic and diastolic blood pressure, serum cholesterol, fasting blood glucose and obesity index with advancing age was shown in these patients. During the observation period (mean 23.3 years), cardiovascular diseases developed in three patients, (brain hemorrhage, brain infarction, and myocardial infarction in each) but none of the patients died from such diseases. Therefore, the morbidity and mortality of arteriosclerotic diseases were less frequent than those reported in the community population. This observation seems to be attributable to the dietary and environmental control of risk factors during the long-term hospitalization. On the other hand, total protein, hematocrit, cardiothoracic ratio and calcification of the aorta on the chest X-ray, echocardiographic findings, plasma renin activity and plasma aldosterone concentration at the final examination in 1993 were similar to those seen in the community population. These findings indicate that long-term control of risk factors by hospitalization results in the lack of blood pressure increase with age and less prevalence of arteriosclerotic diseases.
 ...
PMID:[Study on serial changes in blood pressure, obesity and blood chemistry and cardiovascular disease in the long-term hospitalized patients with sequela of acute carbon monoxide poisoning]. 858 58

The diffusing capacity for carbon monoxide is partially dependent on lung volume at which it is measured. As a consequence, the diffusing capacity for carbon monoxide is often indexed to the simultaneously measured lung volume (VA), giving rise to the term DL/VA. This reflects the diffusing capacity of carbon monoxide per unit area of lung parenchyma. The authors investigated the pulmonary function of 18 patients who had an elevated DL/VA in order to identify factors that could account for this abnormality. Sixteen of the 18 had a reduction in vital capacity. The vital capacity was reduced because of obesity, pleural disease, and diaphragmatic dysfunction. Eight of nine patients with a body mass index > 30 kg/m2 had a reduction in vital capacity. On the basis of these findings, we believe that an elevated DL/VA should alert the physician to the possibility of 1) an increase in pulmonary capillary blood volume (Vc) (obesity, polycythemia, negative pleural pressure), and 2) reduced VA that does not directly affect the pulmonary capillary bed (pleural disease, neuromuscular disease).
 ...
PMID:Clinical correlates of an elevated diffusing capacity for carbon monoxide corrected for alveolar volume. 865 53

The clinical course and changes in hypercapnic ventilatory drive over time were serially assessed before and after tracheostomy placement in a 14 year old, morbidly obese female patient with Prader-Willi syndrome, severe obstructive sleep apnoea, and obesity-hypoventilation syndrome. A tracheostomy became necessary after supplemental oxygen and continuous positive airway pressure (CPAP) had failed to improve the severity of nocturnal hypoventilation. Continued improvement in the slope to rebreathing hyperoxic hypercapnia occurred from 2-10 weeks after tracheotomy in conjunction with night-time bilevel pressure ventilation, and remained unchanged thereafter. In contrast, increases in mean resting minute ventilation at an end-tidal carbon dioxide tension (PET,CO2) of 8 kPa (60 mmHg) were documented even after 30 weeks. This case study illustrates the time-frame of dynamic ventilatory changes occurring after removal of upper airway resistance and normalization of nocturnal alveolar ventilation.
 ...
PMID:Longitudinal assessment of hypercapnic ventilatory drive after tracheotomy in a patient with the Prader-Willi syndrome. 883 75

The aim was to explore whether the origin of carbohydrate oxidation (exogenous compared with endogenous carbohydrate) after consumption of a mixed meal was influenced by obesity in children. Ten obese prepubertal children 8 y of age (44.2 +/- 3.6 kg) were studied over 9.5 h and compared with eight normal-weight, matched control children (28.5 +/- 1.6 kg). They were fed a mixed meal containing naturally enriched [13C]carbohydrate (cane sugar and popcorn) providing 55% of the daily energy requirement as measured by 24-h resting metabolic rate. Total carbohydrate oxidation was calculated by indirect calorimetry (hood system) whereas exogenous carbohydrate oxidation was estimated from carbon dioxide production (VCO2), the isotopic enrichment of breath 13CO2, and the abundance of [13C]carbohydrate in the meal ingested. The time course of 13CO2 in breath-measured over 570 min-followed a similar pattern in both groups. Although total carbohydrate oxidation was not significantly different among the two groups, exogenous carbohydrate utilization was significantly greater (P < 0.03) and endogenous carbohydrate oxidation was significantly lower (P < 0.05) in obese compared with control children. In addition, the rate of exogenous carbohydrate oxidation expressed as a proportion of total carbohydrate oxidation was positively related to the body fat of the children (r = 0.68, P < 0.01). The study suggests that in the postprandial phase, a smaller proportion of carbohydrate oxidation is accounted for by glycogen breakdown in obese children. The sparing of endogenous glycogen may result from decreased glycogen turnover already present at an early age.
 ...
PMID:Total and exogenous carbohydrate oxidation in obese prepubertal children. 894 6

The parameters used to assess aerobic exercise function by gas exchange are usually adjusted for body mass and are expressed as millilitres per minute per kilogram. In the case of obese children this could lead to overcorrection with an underestimation of their exercise capacity. The purpose of the present study was to assess cardiorespiratory exercise function in obese subjects using body mass-independent parameters. As both carbon dioxide output (VCO2) and oxygen uptake (VO2) are usually corrected for body mass, the slope of VCO2 versus VO2 can be considered to be independent of body mass. This slope was calculated below the ventilatory threshold (S1) and above the ventilatory threshold (S3). Exercise tests were performed on a treadmill and respiratory gas exchange was measured breath-by-breath. A group of 29 obese children [mean age 11 (SD 2.5) years] were compared to 16 normal controls of the same age range [mean age 10.8 (SD 2.2); P > 0.05]. The patients were overweight by 36 (SD 17.9)% and had a body mass index of 25.0 (SD 3.8). The results showed that S3 in the obese subjects was significantly steeper compared to the normal controls [1.30 (SD 0.20) vs 1.10 (SD 0.20); P < 0.05]. The steepest values for S3 were found in the subjects with the highest degree of obesity. This method has some limitations, since in a large proportion of the patients (48%) no ventilatory threshold could be detected, which is prerequisite for calculation of these slopes. The latter was already suppressed at the onset of exercise in 21% of the sample or could not be detected because of breathing irregularity in 27%. It is suggested from this study that cardiorespiratory exercise function in obese children is reduced, especially when assessed by parameters of aerobic exercise which cancel the confounding effect of body mass.
 ...
PMID:Assessment of cardiorespiratory exercise function in obese children and adolescents by body mass-independent parameters. 920 42

5 cases with obesity-hypoventilaion syndrome were reported. The clinical manifestations were obesity, palpitation, dyspnea, lethargy, cyanosis, distention of cervical vein, edema, enlargement of liver and hypertension. All of them were initially diagnosed as chronic bronchitis or heart diseases. Pulmonary function test showed restrictive ventilative defect and hypercapnia with hypoxemia. Mouth oclusion pressure at 0.1 second was higher than the normal value. The response to CO2 was decreased. Hypertrophy of right heart was shown in ECG and X-ray film improvement in symptoms and blood gases analyses were found to be associated with body weight decrease in a follow up period of one year.
 ...
PMID:[Obesity-hypoventilation syndrome]. 927 46

Polycystic Ovary Syndrome(PCOS) was originally reported by Stein and Leventhal in 1935, as an syndrome with bilateral polycystic ovaries, menstrual abnormality, hirsutism and obesity etc. After this report the diagnosis of "Polycystic Ovary" was abused for the patient only with polycystic change of ovaries, so that, the concept or definition of PCOS has became unclear and controversial. In this review, a classification of PCOS according to the presence of hyperandrogenemia and/or hirsutism will be shown to reconstruct the concept or definition of PCOS. And usefulness of this classification will be revealed by showing endocrinological and morphological aspect of each class. Furthermore, new therapeutic approaches for PCOS with pure FSH injection in combination with GnRH analog against the onset of OHSS, or drillings of antral follicles with CO2 or KTP laser will be also shown in this review.
 ...
PMID:[Polycystic ovary syndrome: PCOS]. 939 5

A series of untrained, healthy, obese women (body mass index 32.5 +/- 0.9 kg.m-2) were subjected to a protocol of intense exercise on a cycloergometer and compared with lean controls (body mass index 20. 9 +/- 0.5 kg.m-2). Physiological parameters, blood lactate, bicarbonate, plasma metabolites, oxygen consumption and CO2 production were measured. Impedance-derived extracellular water and plasma changes in lactate and bicarbonate were used to determine changes in bicarbonate pools and lactate-displaced CO2. From these and respiratory gases, the respiratory quotient was calculated and thence overall fuel consumption. Anaerobic energy during exercise accounted for about 1.8% of all energy consumed in the lean but only 0.7% in the obese. Obese women fatigued at lower workloads and energy expenditure levels than did the lean, and their lactate buildup was similar when compared on the basis of fat-free mass. The data support the postulation of fatigue being triggered by a combination of factors: stretched cardiovascular work would be the main factor for obese women, in part limiting lactate production. For lean women, the triggering factor for fatigue could be the loss of buffering capacity; but it is the combination of stretching cardiovascular capacity, exhaustion of glycogen and available glucose and increase in lactate/loss of bicarbonate buffer that determines the onset of fatigue.
 ...
PMID:During intense exercise, obese women rely more than lean women on aerobic energy. 944 96


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