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Query: UMLS:C0028754 (obesity)
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Problem of "obesity epidemic" is still very common, but the knowledge about this is limited and it develops very slowly. Probably it even concerns medical students who are in touch with health problems every day and who will watch over society's health in the future. Available literature estimating people's health is mainly connected with negative measures of human health condition. Positive measures are rarely used, although they are simply in use and accessible (including financial accessibility). This kind of measures should be used in widest range to epidemiological investigation of obesity. The aim of the study was to estimate the level of medical student's obesity and to compare declared self-assessment expressed by BMI. In the research 416 III-VI year students of Medical University of Silesia were involved. We used a number of anonymous questionnaires to receive required information. We analyzed objective value of BMI, fat tissue capacity, student's self-assessment and student's satisfaction of their state of nutrition. Statistic analyzes were done using Epi Info v.5.01b program. Distribution of abnormal body weight among students under research was following: underweight--10.3% of the students, overweight--12% and II degree obesity--1.9% of investigated population. Among people with confirmed obesity only 100% of women realized this fact and 44.2% of men found their overweight as normal. Student's satisfaction of state of nutrition independently if it was proper or not, was significantly higher among men. It is necessary to teach students how to properly estimate the state of nutrition.
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PMID:[Self-assessment of nutritinal status in medical students and objective measures of estimating somatic development]. 1500 66

Obesity is a serious health problem, and is becoming increasingly common in affluent societies. In 1998, an Expert Committee published guidelines regarding obesity evaluation and treatment. The purpose of this study was to assess the attitude of primary care physicians in Israel toward diagnosis and treatment of childhood obesity, as related to the recommended guidelines. Primary physicians caring for children and adolescents were asked to complete an anonymous questionnaire including personal and professional details, methods of diagnosis, documentation and treatment of childhood obesity, and familiarity with and implementation of the Expert Committee recommendations. One hundred forty-four physicians, treating approximately 100,000 children monthly, completed the questionnaire. Ninety-four percent were considered to have diagnosed obesity properly. Furthermore, only 19% reported weighing all children examined, while 99% of the physicians suggested some treatment for obesity. The most frequent recommendations for managing obesity were referral to a dietitian (92%), physical exercise (85%), and group treatment (27%). The majority of physicians (78%) were not familiar with the new Expert Committee recommendations regarding obesity treatment. This study suggests that the majority of primary physicians diagnose obesity properly and recommend accepted modalities to manage obesity. A comprehensive program to prevent and treat obesity is recommended to improve the health status of the population.
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PMID:Physicians' attitude toward identification and management of childhood obesity in Israel. 1549 81

This study surveyed all cardiologists in a large coalition of cardiology groups. A 1-page, 25-item anonymous questionnaire containing 3 sections (demographics, medical history, and current medications and supplements) was used. Data from returned questionnaires were analyzed and compared with those in national databases. Eight hundred surveys were sent, and complete data were available for analysis on 471 (59%). The average age of the participants was 48.6 years; 7.1% were women. The average body mass index (BMI) was 25 kg/m(2), and 8% were obese (BMI > or =30 kg/m(2)); 1.3% were active smokers; 89% exercised > or =1 time/week; and 72% had > or =1 alcoholic drink/week. Red wine was the most frequently consumed alcoholic beverage. Associated cardiovascular risks included dyslipidemia (28%), hypertension (14%), and diabetes mellitus (0.6%). Four percent had experienced coronary events. Compared with matched cohorts from the United States (US) population, cardiologists reported lower rates of hypertension, dyslipidemia, and diabetes mellitus, and the rates of smoking and obesity were 1/18 and 1/3 those of the US population, respectively. Aspirin and statins were each taken daily by about 1/3 of the participants. A cardiologist with dyslipidemia was 5 times as likely to be treated and a cardiologist with hypertension was almost twice as likely to be treated as an American adult man with either of these disorders, respectively. In conclusion, cardiologists appear to follow healthier lifestyles than the general adult US population.
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PMID:Personal health habits of American cardiologists. 1656 24

The paleopathological study of 31 Italian Renaissance mummies from the Basilica of S. Domenico Maggiore in Naples has allowed us to perform about 20 diagnoses, of which 5 concern infectious (smallpox, hepatitis, condyloma, syphilis and pneumonia), 3 metabolic (obesity, atherosclerosis, gallstones), I articular (DISH) and 2 neoplastic (colon adenocarcinoma and skin carcinoma) diseases. The mummy of an anonymous child, dated back to the 16th century (14C: 1569 +/- 60), presented a diffuse vesiculopustular exanthema. Macroscopic aspects and regional distribution suggested smallpox, while EM revealed many egg-shaped, virus-like particles (250 x 50 nm), with a central dense core. Following incubation with anti-smallpox virus antiserum and protein A-gold complex immunostaining, the particles resulted completely covered with protein A-gold. These results clearly show that this Neapolitan child died of a severe form of smallpox some four centuries ago. The mummy of Maria d'Aragona, Marquise of Vasto (1503-1568), revealed on the left arm an oval, cutaneous ulcer (15 x l0 mm) with linen dressing. Indirect immunofluorescence with anti-treponema pallidum antibody identified a large number of filaments with the morphological characteristics of fluorescent treponemes. Electron microscopy evidenced typical spirochetes, with axial fibril. These findings clearly demonstrate a treponemal, probably venereal, infection. Further examination of the mummy showed a large peduncolate arborescent neoformation (2 x 7 mm) of the right inguinal region, which was rehydrated and submitted to histology by hematoxylineosin, Van Gieson and Masson's trichromic staining. Light microscopy evidenced an exophytic, papillary skin lesion, with typical connective axis and pronounced parakeratosis. These macroscopic and histological aspects seemed peculiar of condyloma acuminatum, a papillomavirus-induced squamous lesion also called "venereal wart". Molecular study revealed the presence of HPV 18, a virus with high oncogenic potential. Automated sequencing of several clones revealed 100% similarity sequences of both HPV 18 and JC9813 DNA, a putative novel HPV with low oncogenic potential. This study represents the first molecular diagnosis of HPV in mummies and could pave the way for further research about the secular evolution of these viruses, very important in human oncology. The buccal surfaces of the teeth of Isabella d'Aragona, duchess of Milan ((1470-1524), covered by a black patina with high mercury levels, have been intensively and intentionally abraded. The black patina can be attributed to chronic mercury intoxication, used therapeutically in the treatment of syphilis. The mummy of Ferrante I d'Aragona, King of Naples (1431-1494), revealed an adenocarcinoma extensively infiltrating the muscles of the small pelvis. A molecular study of the neoplastic tissue evidenced a typical mutation of the K-ras gene codon 12: the normal sequence GGT (glycine) was altered into GAT (aspartic acid). At present this genetic change is the most frequent mutation of the K-ras gene in sporadic colorectal cancer. The alimentary "environment" of the Neapolitan court of the XV century, with its abundance of natural alimentary alkylating agents, well explains this acquired mutation. These and other diseases as, for example, a case of cirrhosis, some cases of anthracosis and other peculiar traumatic conditions, such as a mortal stab-wound, can elucidate the pathocenosis of this wealthy classes of the Italian Renaissance.
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PMID:[The Aragonese mummies of the Basilica of Saint Domenico Maggiore in Naples]. 1817 25

The authors test single nucleotide polymorphisms (SNPs) in coding sequences of 12 candidate genes involved in glucose metabolism and obesity for associations with spina bifida. Genotyping was performed on 507 children with spina bifida and their parents plus anonymous control DNAs from Hispanic and Caucasian individuals. The transmission disequilibrium test was performed to test for genetic associations between transmission of alleles and spina bifida in the offspring (P < .05). A statistically significant association between Lys481 of HK1 (G allele), Arg109Lys of LEPR (G allele), and Pro196 of GLUT1 (A allele) was found ( P = .019, .039, and .040, respectively). Three SNPs on 3 genes involved with glucose metabolism and obesity may be associated with increased susceptibility to spina bifida.
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PMID:Genes in glucose metabolism and association with spina bifida. 1821 54

Infants' rapid (catch-up) weight gain is associated with later obesity and chronic adult diseases. The aim of this study was to determine maternal and environmental factors related to rapid weight gain at one month and 18 months after full-term birth in Japan. Subjects were 1,524 infants and their mothers who visited the 18-month check-up in Niigata City between October 1, 2007 and September 30, 2008. An anonymous questionnaire elicited information on the infant's weight (at birth, 1 month, and 18 months), sex, feeding method, presence of food allergy, gestational age, and caregiver. Mother's information was height, pre-pregnancy weight, pregnancy weight gain, age at delivery, pregnancy toxicosis, number of daily meals during pregnancy, smoking and drinking habits. Some questionnaire items were obtained from a maternal and child health handbook. Independence of predictors for rapid weight gain (vs. slow or average weight gain), i.e. a score gain of 0.67 SD, during the first month and first 18 months was tested by multiple logistic regression analysis. In the first month, having a meal once or twice daily during pregnancy (P = 0.0016) and daily smoking in pre-pregnancy (P = 0.0175) were associated with rapid weight gain. In the first 18 months, use of daycare (P = 0.0083) and daily drinking in pre-pregnancy (P = 0.0130) were associated with rapid weight gain. We conclude that mother's pre-pregnancy smoking and drinking, dieting during pregnancy, and infant daycare attendance lead to rapid infant weight gain. Controlling these factors may prevent future chronic adult lifestyle-related diseases.
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PMID:Unhealthy maternal lifestyle leads to rapid infant weight gain: prevention of future chronic diseases. 1915 10

Specialist physicians may have prescribing habits that are different from nonspecialist physicians. Little is known about the prescribing habits of physicians specializing in the treatment of obesity. An anonymous survey was given to the physician members of the American Society of Bariatric Physicians (ASBP). There was a 35% response rate (266 physicians) to the questionnaire that was represented nationally. Almost all prescribed medications and all of them recommended phentermine. The average maximal dose of phentermine was above that approved in the package insert, and these physicians disagreed with the National Institutes of Health (NIH) Obesity Treatment Guidelines. Phendimetrazine, metformin, and phentermine plus L-5-hydroxytryptophan (5-HTP) with carbidopa were all used more frequently than either orlistat or sibutramine. The combination of sibutramine and orlistat as well as 5-HTP/carbidopa were prescribed by 14 and 20%, respectively. As 5-HTP-carbidopa was a combination not previously reported for the treatment of obesity, a retrospective chart review was performed in a single obesity practice, which may not be representative. Twenty-two subjects had a 16% weight loss with phentermine over 6 months and an additional 1% weight loss with the addition of 5-HTP/carbidopa for an additional 6 months. One subject who started on 5-HTP/carbidopa alone lost 24.4% of initial body weight over 6 months. This questionnaire revealed that 20% of the obesity specialists responding to the survey used phentermine plus of 5-HTP/carbidopa, an unreported combination. A controlled, randomized, clinical trial to evaluate the safety and efficacy of this combination in treating obesity should be considered.
Obesity (Silver Spring) 2009 Sep
PMID:How physician obesity specialists use drugs to treat obesity. 1930 Apr 34

The prevalence of obesity and its relationship to lifestyle habits was studied in Minami Furano Town, a small farming town in Hokkaido, Japan. All residents of Minami Furano Town over 18 years of age were given an anonymous, self-administered questionnaire in March, 2002. Logistic-regression analysis was performed separately for each gender with obesity as the dependent valuable, and lifestyle risk factors as explanatory variables. The prevalence of obesity (BMI > or = 25) was 30.2% in men and 29.2% in women. The risk factors for obesity included "smoking", "having no hobby", "low intake frequency of green vegetables", "high intake frequency of cooking oil" and eating "a large quantity at dinnertime" in men. For women the risk factors included "age", "stress", "drinking alcohol", "eating quickly", "low tooth brushing frequency" and "irregular health checks". Nearly one third of the adults in this town were obese when assessed using the Japanese criteria of BMI > or = 25. Few women were employed full-time and they had limited opportunity for periodic health checks. Improved community-based nutrition activities are needed for women.
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PMID:Gender differences in the relationships between obesity and lifestyle risk factors in a small farming town in Japan. 1953 87

Athletes have enjoyed almost a thirty year amnesty of rhGH abuse, which they consider has contributed to the winning of medals and the breaking of world records. Such a reprieve is almost at an end, since WADA have identified a method to detect rhGH abuse. Or have they? The anecdotal word "on the street" is that rhGH is still undetectable and athletes believe that the benefits, at the dosages they administer, far outweigh the risks! Scientists are aware that in a hormone deficiency condition, replacement can halt and in certain situations reverse some of the adverse effects. Growth hormone deficiency can lead to a loss of skeletal muscle mass and an increase in abdomino-visceral obesity, which is reversed on replacement with rhGH. Since the availability of GH, athletes have been trying to extrapolate these effects from the deficiency state to the healthy corpus and increase their sporting prowess. Past confessions from athletes, such as Ben Johnson, Kelly White, Tim Montgomery, Marion Jones and currently Dwain Chambers have demonstrated that they are prepared to tread the very fine lines that separate the "men from the boys". Rewards are so great, that anonymous surveys have identified that athletes will risk ill health, if they believe they can cheat, win and not get caught. The question that still needs to be answered is, "does growth hormone enhance performance"? Recent research suggests that it could. There is also a suspicion that in "cycled" low supraphysiological doses, it is no where near as harmful as WADA claim it to be.
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PMID:Potential benefits of recombinant human growth hormone (rhGH) to athletes. 1953 5

The aim of the study was to examine the relationship between the BMI of women living in rural areas and their dietary habits, taking into consideration the regularity and frequency of consumption as well as preferences in various groups of foodstuffs. The study included 60 women aged 23 - 69, living in one county. The women were divided into two groups according to nutritional status (BMI): group I with normal body weight and group II with overweight and obesity. Dietary habits were evaluated by using the anonymous and voluntary questionnaire. The questionnaire contained questions concerning dietary preferences. The results were statistically analyzed. The study indicated that a vast majority of overweight and obese women in rural areas prefer fried dishes, red meat and animal fats. However they do not consume vegetables and fruit frequently enough. Such dietary habits will only increase problems with obesity in rural communities. Thus it is important to start nutrition education as a significant strategy for non-pharmacological treatment of obesity and its health effects.
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PMID:Body mass index (BMI) and dietary preferences of women living in rural areas. 1957 74


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