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Query: UMLS:C0028754 (obesity)
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A study of the prevalence of arterial hypertension and obesity has been performed in the community of Hospitalet de Llobregat which is an industrial town of 289,000 inhabitants in the vicinity of Barcelona. We have studied a population sample of 801 individuals over the age of 19 years, randomly chosen from the elections lists from 1986, and who were classified according to age and sex. Four hundred and thirty two subjects (54%) had a Quetelet index (QI) of 25 or above. Out of these, 300 (38%) had a QI between 25-30 and 124 (16%) had a QI of 30 or above. Obesity prevalence defined as an QI greater than or = 25 was lower in the youngest group (20-39 years), both in males as in females, with a significant difference p less than 0.05). Arterial hypertension prevalence (SAP greater than 160 and/or DAP greater than 95 mmHg) was 19.8%. When individuals with DAP of 90-94 were included, prevalence was 25.7%. A positive correlation between QI and arterial blood pressure was found in the sample studied as a whole, both for systolic arterial pressure (r = 0.23; p less than 0.001; R2 = 0.053) as for diastolic arterial pressure (r = 0.23; p less than 0.001; R2 = 0.053). Arterial hypertension prevalence (SAP greater than 160 and or DAP greater than 90 mmHg plus those individuals with lower values but were on hypotensive treatment) was higher in obese individuals (QI greater than 25). The difference was statistically significant in males below 60. In females a tendency was observed in women below 40. (p = 0.054).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Obesity and arterial hypertension. A cross-sectional study of their prevalence in the population of L'Hospitalet de Llobregat]. 210 32

This is a report of a pilot program for laparoscopic sterilization with emphasis on surgical and anesthetic technics. In 1971 the program was developed at the North Carolina Memorial Hospital. Subjects were 129 private patients, mostly white, of middle income with 2 or more children, and from 19 to 47 years of age. Follow up of over 90% indicated high patient satisfaction. Complications were few but may occasionally require surgical management and the method should not be considered a minor procedure. At first patients were handled as inpatients for 1 day preceding surgery. Later an outpatient status was adopted. At an earlier visit a history is taken, instructions given by a nurse, the assigned physician (who may be a physician in training) reviews the history, performs a physical examination, and explains the operation to both the patient and her husband. Laboratory work is performed, operative permits are signed, and patients are asked at this time to agree to sterilization by laparotomy if the laparoscopic approach proves infeasible. On the morning of surgery suitable intravenous medication (Valium 5 mg), fentanyl, and atropine are given and followed by pure oxygen inhalation for 3-5 minutes. Pentothal followed by succinylcholine are given and the patient intubated. Anesthesia is maintained by succinylcholine drip and inhalation of nitrous oxide and oxygen. After surgical preparation with Betadine solution, a combination tenaculum-sound is placed in the cervical canal. Pneumoperitoneum is established with carbon dioxide gas through a Verres needle inserted through a small subumbilical incision. The laparoscopic trocar is introduced by enlarging the same incision. After inspection a second 6 mm trocar is inserted just about the tubes and biopsy forceps introduced. The tenaculum in the cervix is used to position the uterus and tubes. After cauterization tubes are divided with the biopsy forceps and a biopsy specimen obtained if possible without undue action on the tube. After inspection for bleeding or injury to other viscera, the instruments are withdrawn. The procedure can be completed in 15 minutes. After recovery from the anesthesia the patient is removed to the recovery area and then the holding area. After 2 or 3 hours she is seen by a physician and discharged if vital signs are stable. Oral and written instructions for her convalescence are given. Patients are requested to return in 2 weeks or to consult a physician in their home area. 30 patients required postoperative hospital admissions: 15 for non-medical reasons (i.e., distance to travel home) and 15 for observation at the physicians' request. These stayed 14 to 24 hours. Nausea and vomiting were indications in 5. :In one case nosebleed following intubation combined with slight elevation of temperature caused a stay of 48 hours. Retrospectively, only 8 of the 15 hospitalized or 6% of all cases required this extra service. In the initial series there was 1 technical failure due to obesity. The average time to resume normal activities was 3 1/2 days. 115 patients (97.4%) of those responding to a questionnaire stated they would recommend the procedure to a friend. The 3 dissatisfied respondents gave no specific reason. Thorough training of the physicians is urged. Use as an office procedure with local anesthesia is not recommended. Single-puncture technic is being tried. Subsequently over 100 additional procedures have been performed.
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PMID:An outpatient program for laparoscopic sterilization. 426 75

Serum protein and lipid concentrations as well as the serum protein binding of propranolol, diazepam and phenytoin were measured in normal weight and obese volunteers. Concentrations of alpha 1-acid glycoprotein (AAG) in the obese subjects were double that of the lean controls. Conversely, concentrations of high density lipoproteins (HDL) were decreased in the obese group. The serum binding of propranolol was increased in the obese subjects and correlated with serum AAG concentrations. Diazepam binding was slightly decreased in the obese as a result of lower serum albumin concentrations and elevated free fatty acids. The binding of phenytoin was comparable in all of the volunteers. These findings point out some of the complex pathophysiologic changes associated with obesity which may in turn influence drug disposition and hence drug therapy in the obese patient.
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PMID:Serum protein binding and the role of increased alpha 1-acid glycoprotein in moderately obese male subjects. 652 34

Effects of repeated intravenous (i.v.) administration of diazepam on food intake were investigated in freely moving rats implanted with a chronic i.v. cannula. Diazepam (0.2 and 2 mg/kg) was automatically injected i.v. at 3-h intervals for 3 consecutive days. Food intake was measured twice daily, ie for the light phase (7 00-19 00) and dark phase (19 00-7 00). Food intake during the light phase was increased in a dose-dependent manner following diazepam. Each injection of diazepam provoked hyperphagia, followed by a compensatory hypophagia until the next diazepam injection. Body weight, however, was increased significantly in rats treated with diazepam. When diazepam (2 mg/kg) was automatically injected at 3-h intervals for 10 consecutive days, tolerance did not develop to the hyperphagia and body weight was increased significantly following diazepam injection. After cessation of diazepam injection, both food intake and body weight decreased. These findings suggest that such excessive i.v. treatment with diazepam induces hyperphagia showing no tolerance accompanied by an increase in body weight, thus resulting in a trend toward obesity in rats.
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PMID:Effects of repeated intravenous administration of diazepam on food intake in rats. 785 44

The first part of this report on the Australian Health and Medical Research Congress, held November 25-29, 2002, in Melbourne, Australia, considers some of the symposia and three plenary lectures: Neurosteroids: Nature's Valium, G-Protein-Coupled Receptors and the Mike Rand Memorial Lecture. In the new era in relaxin research symposium, we learned that relaxin is a general antifibrotic agent rather than just a hormone of pregnancy. The drugs discussed in the drug discovery symposium included drugs from natural products, allosteric modulators, antibodies to cytokines and AM-336, an N-type Ca(2+) channel blocker. In the matrix proteases symposium, we learned of the importance of these enzymes in bone, endometrial remodeling and cardiovascular disease. The emphasis of the cytokine antagonist symposium was the involvement of cytokines in rheumatoid arthritis and how these effects could be inhibited with cytokine antagonists. The second part of this report is on the cardiovascular components of the meeting. One of the major strengths of Australian research is the cardiovascular area. Thus, it was not surprising that there were three major symposia with a cardiovascular theme this congress. Although the clinical trials of the NHE1 inhibitors in ischemia and reperfusion have been disappointing to date, evidence was presented in the sodium-hydrogen exchanger symposium that these agents might be beneficial in hypertrophy and heart failure. The discussion in the vessel wall biology in diabetes symposium ranged from molecular aspects to clinical trials. In this, and the NAD(P)H oxidases symposium, many new potential drug targets were discussed. The plenary lecture of the High Blood Pressure Research Council concerned the pathophysiology and management of obesity hypertension, and included a discussion of the drugs for weight reduction.
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PMID:Health and medical research down under in 2002. 1294 54

We report the concentrations of scheduled prescription drugs in blood samples from people arrested in Sweden for driving under the influence of drugs (DUID). The investigation covered a 2 year period 2004 (N = 7052 cases) and 2005 (N = 7759 cases) and was prompted by recent legislation stipulating zero-concentration limits in blood for controlled substances. However, prescription drugs are exempt from the zero-limit law provided that the medication was being used in accordance with a doctor's prescription. The blood concentrations of various psychoactive substances were compared with the limits of quantitation of the analytic method used and the so-called therapeutic concentration range according to various reference books and tabulations. Diazepam [N = 1950 (26%)] and nordazepam [N = 2168 (28%)] were the therapeutic agents most frequently identified in these forensic blood samples along with other benzodiazepines such as alprazolam [N = 430 (5.6%)], flunitrazepam [N = 308 (4.0%)], and nitrazepam [N = 222 (2.9%)]. The newer hypnotics, exemplified by zolpidem [N = 148 (1.9%)] and zopiclone [N = 111 (1.5%)], were also high on the list of psychoactive substances identified. Interpreting the concentration of a prescription drug in blood in relation to whether the person had taken an overdose or was abusing the substance in question is not always easy. The age, gender, degree of obesity, and ethnicity of the person concerned; the pharmacokinetic profile of the drug; polymorphism of drug-metabolizing enzymes as well as liver and kidney function and blood hematocrit need to be considered. Among preanalytic factors, stability of the drug in blood after sampling, the type of tubes and preservatives used, the dosage form and route of administration deserve consideration. When therapeutic drug monitoring concentrations are compared with forensic toxicology results, then the plasma-to-whole blood distribution ratio of the drug also needs to be considered. In blood samples from DUID suspects, the concentrations of many commonly used sedatives and hypnotics exceeded the accepted therapeutic limits, which gives an indication of the abuse potential of these types of medications.
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PMID:Concentrations of scheduled prescription drugs in blood of impaired drivers: considerations for interpreting the results. 1741 81

Current epidemiological data suggest that the number of preventive interventions aimed at controlling alcohol, drug, food abuse and smoking achieved only partial success, especially in young individuals. In order to improve preventive action efficacy, the literature suggests the adoption of contents and communication instruments specifically targeted to different groups of individuals. The Valentino Project is a comprehensive survey on the characteristics of abuse of a representative sample of 3000 young workers (aged 18-35 years)from the Abruzzo Region of Italy. This paper describes its main methodological issues and the complete version of the questionnaire HW-80 (Healthy-Worker 80), that will be administered. HW-80 questionnaire includes 80 items on demographic characteristics, self-reported health, job-related stress, work organization, pattern of abuse, physical activity and others, and several of these items have been taken or derived from repeatedly validated questionnaires (SF-12, CAGE, Job-Strain, Effort-Reward, EU-DAP, etc.). The aims of the Valentino Project are to quantify the prevalence of obesity, alcohol use, smoking and drug addiction in diverse typologies of workers, and to describe their pattern of use. The ultimate purpose is to provide the necessary knowledge for the development of preventive strategies targeted to different professions, in order to maximize their efficacy.
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PMID:[Drug, food, alcohol abuse and smoking in young workers. Methodology of a survey aimed at developing preventive interventions targeted to different type of workers: the Valentino Study]. 1765 11

With the increasing complexity of endovascular procedures, concern has grown regarding patient radiation exposure. Abdominal aortic aneurysm (AAA) repair represents the most common complex endovascular procedure currently performed by vascular specialists. Our study evaluates the patient radiation dose received during endovascular AAA repair. Over a 3-month period we prospectively monitored the radiation dose in a series of consecutive patients undergoing endovascular AAA repair. All patients underwent standard endovascular AAA repair with one of two commercially available grafts using the GE OEC 9800 unit. Direct measurement of maximum radiation dose at skin level (peak skin dose, PSD) was recorded using GAFCHROMIC radiographic dosimetry film. Indirect measurements of radiation dose (fluoroscopy time and dose-area-product [DAP]) were recorded with the C-arm dosimeter. A total of 12 consecutive patients undergoing standard endovascular AAA repair were evaluated. Mean PSD was 0.75 Gy (range 0.27-1.25). Mean total fluoroscopy time was 20.6 min (range 12.6-34.2) with an average of 92% spent in standard fluoroscopy and 8% spent in cinefluoroscopy. Regarding total fluoroscopy time, 49% was spent in normal field of view and 51% in magnified view. Mean DAP was 15,166 cGy x cm(2) (range 5,207-24,536). PSD correlated with DAP (r = 0.9, p < 0.05) but not total fluoroscopy time (r = 0.18, p > 0.05). PSD also correlated with body mass index (BMI; r = 0.82, p < 0.05). Obese patients had a mean PSD of 1.1 Gy compared to 0.5 Gy in nonobese patients. PSD of all patients was well below the accepted 2.0 Gy threshold for skin injury. PSD correlated with DAP but not total fluoroscopy time. PSD also correlated with BMI, and the mean PSD was significantly increased in obese compared to nonobese patients. Despite the complexity and duration of endovascular AAA repair, the procedure can be performed safely without excessive radiation exposure.
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PMID:Direct and indirect measurement of patient radiation exposure during endovascular aortic aneurysm repair. 1899 64

Condition prior to diabetes is designated as prediabetes. The use of this term is recommended if fasting plasma glucose exceeds normal level but does not reach the characteristic result of real diabetes. Prediabetes is often characterized by combination of visceral obesity, glucose and lipid metabolism disorders and changes in blood pressure. Change of life style is more important in the treatment of prediabetes associated hypertension than in other hypertensive diseases. In this case, metabolically neutral antihypertensive medication is the treatment of choice. The growing obesity epidemic underlines the significance of prediabetes associated hypertension in public health. While 25% of the adult population suffering from this kind of hypertensive disease, the optimal solution has to be found together with patients, physicians and the money lenders of the social security system.
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PMID:[Treatment of hypertension associated with prediabetes]. 1942 89

Previous research has related impulsivity to overeating and obesity. However, the precise nature of this relation has not been examined yet. One possibility is that impulsivity causes overeating and hence contributes to overweight. To test this possibility we induced impulsivity versus inhibition to see whether this would affect food intake. In the first study participants were cognitively primed with the concepts "impulsivity" or "inhibition". Caloric intake was significantly higher in the Impulsivity Condition compared to the Inhibition Condition. This effect was even stronger for highly restrained participants. In the second study impulsivity was manipulated via behavioural instructions. Restrained and unrestrained nondieters acted as expected: their caloric intake was significantly higher when impulsivity was induced compared to inhibition. Current dieters sharply reduced their caloric intake following the impulsivity induction. These results are in accordance with Lowe's model that, contrary to restraint theory, states that restraint and current dieting are different constructs that affect eating regulation differently. At least for nondieters it can be concluded that heightened impulsivity versus inhibition leads to a higher food intake in the lab.
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PMID:Inducing impulsivity leads high and low restrained eaters into overeating, whereas current dieters stick to their diet. 1946 78


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