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Query: UMLS:C0028754 (obesity)
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Most of type 2. diabetic patients require medication for several concomitant diseases, most important being, hypertension, ischaemic heart disease, heart failure, dyslipidaemias, obesity. Thus the risk of drug interactions is important, particularly in elderly patients. Oral antidiabetic drugs include hypoglycaemic agents (sulphonylureas, meglitenides) and biguanides (metformin), alpha-glucosidase inhibitors, tiazolinidediones. Drug interactions with antihyperglycaemic agents can be divided into pharmacokinetic and pharmacodynamic interactions. Numerous drugs due to interactions enhance hypoglycaemic action of sulphonylureas, thus increase the risk of hypoglycaemia. Several drugs may cause impairment of glycaemic control through various mechanisms in diabetic patients treated with oral antidiabetic drugs. Currently the most controversial problem is safety of combination therapy with sulphonylurea and metformin, as several observations indicated that it can increase mortality from cardio-vascular causes.
Pol Merkur Lekarski 2000 Sep
PMID:[Clinically important effects of oral antidiabetic drug interactions]. 1112 85

Obesity is one of the pathologies with ever-increasing prevalence in modern societies. Its occurrence is strongly associated with increased risk of developing diabetes mellitus, atherosclerosis, hypertension, stroke, heart and respiratory failure, breast, prostate and gut cancer, gall stones, arthropathy. Obesity is common in Polish population. Obesity treatment is difficult and frustrating. It consists of several parts like diet, increased physical activity, lifestyle changes, drug therapy and surgery. However, obesity treatment is very often a failure, mostly because of discouraging long-term results and the necessity of intensive patient's involvement in the therapy. For many patients and doctors weight-decreasing agents look promising. The groups of anti-obesity drugs are presented in the article, with special reference to serotoninergic agents and intestinal lipase inhibitors. The prospects for new anti-obesity agents are discussed. Nevertheless, despite intensive research on obesity, we are still waiting for the development of an effective and safe drugs helping lose weight.
Pol Merkur Lekarski 2000 Nov
PMID:[The role of pharmacotherapy for treatment of obesity in adults]. 1120 19

The aim of this study was to evaluate the occurrence of obesity and arterial hypertension in patients suffering from vertigo, and/or tinnitus and/or hearing loss of unknown origin. 48 patients (25 women and 23 men) were included into this study. All patients had a negative previous medical history of any metabolic, cardiovascular or neurological disorders. Our results were compared to the control group of 31 healthy persons (16 women and 15 men). All subjects had a complete neurootologic examination, appropriate audiometric and vestibular studies. In most cases inner ear pathology was recognised. BMI, systolic and diastolic blood pressure were measured in all cases. Patients were overweight significantly more often comparing to the control group. Systolic and diastolic hypertension was found significantly more often in men from the patients than control group.
Pol Merkur Lekarski 2000 Nov
PMID:[Risk factors for inner ear diseases]. 1120 21

Chronic stress is well known as a cardiovascular risk factor in men. There are few reports referred to the relationship between cardiovascular risk factors and level of neuroticism in the psychological examination. We analysed 77 healthy men in mean age of 33.3 +/- 7.4 years being at risk of chronic professional stress. Level of neuroticism was examined by Geras scale and expressed as: low (1-4 sten)--group 1, mean (5-6 sten)--group 2 and high (7-10 sten)--group 3 level of neuroticism. The common biochemical, clinical and environmental cardiovascular risk factors were examined. In the whole group of 77 probands we identified 24 (31%) (group 2) and 10 (13%) (group 3) persons with mean and high level of neuroticism. In the group 2 we find the highest cholesterol (222.7 +/- 39.4 mg/dl), LDL cholesterol (147 +/- 35.1 mg/dl, triglicerydes (144.9 +/- 93.8 mg/dl) and apolipoprotein B (1.11 +/- 0.31 g/l) levels statistically higher than in the other group of neuroticism. In group 3 we find the highest glucose (96.5 +/- 7.4 mg/dl) and fibrinogen (353.8 +/- 39.2 mg/dl) levels. The worst results of the environmental inquiry were obtained in the group 2 (obesity (BMI > 30 kg/m2) in 25%, hypertension in 12.5%, nicotinism in 54%, low physical activity in 79% and positive to cardiovascular disease family history in 91%). Because we found correlation mostly in the group of mean level of neuroticism these results must be confirmed in the larger group of probands using other psychological tests.
Pol Merkur Lekarski 2000 Dec
PMID:[Enhanced neuroticism in relation to cardiovascular risk factors in men]. 1125 50

The significance of mental stress in the etiology and pathogenesis of essential hypertension is still a matter of disputes and controversies. The authors wondered if normotensive children prone to stress reactions show significant abnormalities in their ABPM patterns. The aim of this study was comparison of blood pressure loads in children of high and low neuroticism levels. 121 healthy children underwent the psychometric test evaluating the level of neuroticism. From this group 43 children with the lowest and 33 children with the highest levels of neuroticism were selected. The groups were comparable in respect of age, gender, overweight, obesity and low birth weight. 24-hour ambulatory blood pressure monitoring was performed. Average systolic and diastolic blood pressure loads were calculated. In neurotic boys and girls considered together and girls analysed separately both systolic and diastolic blood pressure loads were significantly higher than in their low-neurotic counterparts. In boys only systolic blood pressure load difference between high and low-neurotic group was statistically significant. Diastolic blood pressure load only tended to be higher in neurotic boys, without statistical significance. In our study neurotic children demonstrated in general significantly higher blood pressure loads than low-neurotic children. The prognostic value of this difference has not yet been determined. Perhaps further investigation would prove risk of developing hypertension in neurotic children with levels of blood pressure loads as observed in our study. If so, introducing of hypertension preventive measures could be profitable in neurotic children.
Pol Merkur Lekarski 2001 Apr
PMID:[A comparison of blood pressure load in groups of children with high and low levels of neuroticism]. 1143 75

Snoring and excessive daytime somnolence (EDS) are very common in middle-age adults. The goal of the investigation was to assess links between those symptoms and risk for cardiovascular diseases (CVD). The population studied included 1186 inhabitants of Warsaw (mean age 52 years), participants of the international multicentre study of cardiovascular disease MONICA II, who completed the sleep disordered breathing (SDB) questionnaire. Snoring was reported by 78% of males (48% habitual and 30% occasional) and 59% of females (27% habitual and 32% occasional). Every fourth (26.8%) subject declared observed apnoeas, in 9.2% apnoeas were observed every night. EDS was declared by 28.7% of studied sample. The results of the questionnaire were compared to the results of MONICA study. Snorers had significantly higher systolic and diastolic blood pressure (133.2 +/- 23/84.6 +/- 13 mm Hg) compared to non-snorers (126.4 +/- 22/80.4 +/- +/- 12 mm Hg) (p < 0.0001). The high total serum cholesterol (> or = 200 mg%) and triglycerides (> or = 200 mg%) concentration, and also obesity (BMI > or = 30 kg/m2) were more prevalent in snorers. Subjects reporting apnoeas more often had coronary artery disease (p < 0.001) or history of stroke (p = 0.002) compared to non-apnoeics. There was no relationship between EDS and risk of cardiovascular disorders, and also between diabetes and SDB. In conclusion, snoring was strongly associated with hyperlipidaemia, obesity or hypertension, well known risk factors for development of cardiovascular disorders. Reported apnoeas were related to risk of coronary artery disease.
Pol Arch Med Wewn 2001 Jan
PMID:[Snoring and excessive daytime somnolence and risk of cardiovascular diseases]. 1150 94

The role of non-pharmacological methods in prevention and treatment of hypertension is well documented. Weight in patients with overweight and obesity, sodium intake restriction and alcohol drinking limitation are especially effective in arterial pressure reduction. The aim of this questionnaire study was to evaluate the knowledge and skills in that field of physicians working in primary health care. The study was done with 91 physicians working in Warsaw District. All of them declared that they give instructions about life style to their patients with hypertension. In majority it was oral consultation (36 persons, 39%) or oral consultation with distribution of booklets or brochures (48 persons, 52%). Six physicians (7%) sent patients to specialist. Pharmacological treatment was started most often from the systolic pressure 160 mmHg (59 persons, 64%) and diastolic pressure 100 mmHg (39 persons, 42%). Non-pharmacological advice was given most often at systolic pressure above 140 mmHg (44 persons, 48%) and diastolic pressure above 90 mmHg (67 persons, 73%). Salt intake reduction was advised always or usually by 82 physicians (90%), alcohol drinking reduction by 77 persons (85%) and tobacco smoking cessation by 86 persons (95%). Regular physical activity was advised always or usually by 75 persons (82%). Evaluation of nutrition was done predominantly by asking a few not-formal questions (62 persons, 67%). Only 1 physical used daily diary of nutrition. Similarly in evaluation of physical activity 62 persons (67%) used only not-formal questions. It is worthily to note that 36 persons (40%) considered that they need more skills to give advices of healthy life style, 49 persons (53%) did not enough time to do that and 30 persons (33%) thought that it is hard to give advices they can't keep themselves. All questionnaire physicians declared to use non-pharmacological treatment in patients with hypertension. Quite good knowledge of essential recommendations in that field was stated. The results of this questionnaire indicate that many physicians estimate their knowledge and skills as low in that sphere.
Pol Merkur Lekarski 2001 Jul
PMID:[Non-pharmacological treatment of hypertension in practice of primary care physicians]. 1157 23

The paper concerns the treatment results of 113 women with PCO-S by laparoscopic (102) and microlaparoscopic (11) ovarian electrocautery. All of them were qualified for operation on the basis of the following criteria: menstrual cycle disturbances (oligo-/amenorrhoea), anovulation, hirsutism, obesity, LH/FSH ratio > 2 and when more than 10 follicles of < 8 mm diameter are seen in the ovary under theca albuginea in USG examination. During the one year after operation these women were observed. In the first group (patients after laparoscopy) ovulation occurred in 86 (84%) and pregnancy in 54 (53%); accordingly in the second group (women after microlaparoscopy) ovulation occurred in 9 (83%) and pregnancy in 4 (45%). The treatment results by microlaparoscopic and laparoscopic ovarian electrocautery are similar, but the method by microlaparoscopy is easier to carry out in selected cases.
Ginekol Pol 2001 Aug
PMID:[The effects of micro-laparoscopic ovarian electrocautery as a method of polycystic ovary syndrome treatment]. 1159 50

Both clinical observations and in vitro studies reveal that sex steroids are essential factors affecting body fat accumulation and distribution of healthy men. An excessive adiposity and visceral obesity are frequently accompanied by an adrenal and gonadal andropenia among men aged 50 and over. The relationships between an age-related increase in BMI and WHR values and an altered androgen-estrogen activity in the course of normal male aging have not been firmly established, as not all studies have thus far produced consistent results. The effects of androgen substitutive therapy (testosterone and dehydroepiandrosterone) in elderly men suggest the possible relationship between androgens and male visceral adiposity; unfortunately the results of available studies on that issue are also not consistent. Therefore, nowadays there is an urgent need to comprehensively establish the androgen contribution in the pathogenesis of male visceral obesity.
Pol Merkur Lekarski 2001 Aug
PMID:[Testosterone and dehydroepiandrosterone deficiency, general adiposity and visceral obesity during normal male aging]. 1175 27

Peripheral facial paresis is a serious clinical and social problem. The effect of physical therapy in 44 patients aged 13-80 was studied. Idiopathic peripheral facial paresis was the cause of mimic muscles dysfunction in 75% of our patients. Medical treatment was conducted according to the established program, consisting in applying combined physical, thermal, electrotherapeutic procedures, exercises and massage. All the patients were examined before physical therapy and after I and II series of procedures, based on Pietruski's evolution table of paresis scored in point and percent scale. Patients between age 13-44 demonstrated 47-50% mimic facial muscles efficiency before the treatment, after I series of procedure it amounted to 80-90% and after the II series to 90-100%, so all the symptoms of paresis disappeared. Similar values were scored by patients aged 45-64 years. Minimal percentage of improvement of mimic facial muscles (57%) was noticed in patients aged 65-80 years The increase of the score was evaluated in the studied group after two stages of treatment. It seems to be best in the younger patients. In the examined group the best improvement evaluated as regression of the symptoms was found in patients with idiopathic peripheral facial paresis. The process of improvement was very slow and not full among patients who additionally suffered from co-existing diseases. Patients with diabetes improved by 57%, with arterial hypertension by 53%, the patients with obesity only by 43% after two cycles of treatment.
Neurol Neurochir Pol 2001
PMID:[Physical therapy in peripheral facial paresis]. 1187 10


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