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

The literature shows that obesity is a public health problem concerning especially the general paediatrician. While prevention has probably more chances of success than treatment, drugs or, in case of failure, the surgical approach are reserved for extreme cases. In the domain of infectiology the different laboratory tests allow only partially to diagnose severe infections. But in the context of a potential influenza pandemic rapid virologic tests become more and more important. They allow a more precise diagnosis and a reduction of hospitalisations and of antibiotic prescriptions. A review of the north American experience with the pneumococal vaccine shows that the heptavalent vaccine will change our approach in infants with fever in whom we suspect a severe infection.
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PMID:[Current progress in pediatrics: obesity and diagnosis approach to the febrile child]. 1646

A huge interest in the scientific community has been aroused since leptin's discovery (from greek leptos=thin), due to its important role in the body energetic balance regulation. This protein is synthesized from ob gene and secreted by the adipose tissue when fat mass increases, decreasing hunger and increasing energy expenditure in order to restore energetic balance. In the latest years many human genetic studies have been conducted showing that sometimes obesity may be due to mutations of genes involved in energetic balance mediated by leptin. These findings amplified the knowledge of obesity etiopathogenesis, thus arousing hopes and expectations for new therapeutic horizons in this disease. Latest researches also outlined many other functions of leptin, some of which are presented in this review. In this paper we collected the most significant data about leptin's physiology and its role in body energetic homeostasis, looking also to the effects on hypothalamus-hypophysis-endocrine axes regulation, on body thermoregulation, on the reproductive function and on foetus and child growth. A wide section is thus reserved to the most recent findings about the role of leptin in obesity and about its therapeutic applications in this field.
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PMID:[Obesity etiology: role of leptin]. 1649 Oct 55

Insulin resistance is considered a core component in the pathophysiology of the metabolic syndrome. Some clinicians measure serum insulin concentrations in the mistaken belief that they can be used to diagnose insulin resistance. Serum insulin levels are poor measures of insulin resistance. Furthermore, there is no clinical benefit in measuring insulin resistance in clinical practice. Measurements of fasting serum insulin levels should be reserved for large population-based epidemiological studies, where they can provide valuable data on the relationship of insulin sensitivity to risk factors for diabetes and cardiovascular disease. Clinicians should shift from identifying "insulin resistance" to identifying risk factors, such as fasting glucose and lipid levels, hypertension and central obesity. These proven risk factors converge within the metabolic syndrome. Individuals "at risk" of diabetes and atherosclerotic cardiac disease can be identified simply and inexpensively, using classic clinical techniques, such as history-taking, physical examination, and very basic investigations.
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PMID:Insulin levels in insulin resistance: phantom of the metabolic opera? 1739 Oct 99

A hypothetical role of glucocorticoids in human obesity has been suggested since the abdominal obesity phenotype and syndromes of endogenous or exogenous hypercortisolism share several clinical, metabolic, and cardiovascular similarities. An emerging body of evidence indicates that both neuroendocrine dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis as well as peripheral alterations of cortisol metabolism may play a role in the pathophysiology of abdominal obesity. Major alterations of the HPA axis in vivo may be identified in different ways. They include evaluation of hormone concentrations: (a) in basal conditions, in blood, urine, or saliva samples; (b) during dynamic studies following stimulation with different neuropeptides or psychological stress challenges, or suppression with inhibiting agents of the HPA axis at different levels; and (c) after mixed meals or meals containing different nutrient compositions. In addition, alteration of peripheral cortisol metabolism can be detected by direct measurement of cortisol metabolites in urine, although this is a matter of more complex investigation. Alterations of the HPA axis in abdominal obesity are associated with insulin resistance, which suggests a direct responsibility of these hormonal alterations in the susceptibility of affected patients to develop both metabolic and cardiovascular diseases. According to available data, no single marker probably has the power to detect subtle alterations of the HPA axis in conditions, such as the abdominal obesity and the metabolic syndrome. On the contrary, they indicate the need for multiple parameters. At present, evaluation of urinary free cortisol, particularly during the night-time, and salivary-free cortisol appear to be promising for these purposes, whereas dynamic tests should be reserved for specific clinical settings, involving well-characterized patients.
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PMID:The hypothalamic-pituitary-adrenal axis activity in obesity and the metabolic syndrome. 1714 36

Obesity is a common and preventable disease of clinical and public health importance. It is often a major risk factor for the development of several non-communicable diseases, significant disability and premature death. There is presently a global epidemic of obesity in all age groups and in both developed and developing countries. The increasing prevalence of obesity places a large burden on health care use and costs. Weight loss is associated with significant health and economic benefits. Effective weight loss strategies include dietary therapy, physical activity and lifestyle modification. Drug therapy is reserved for obese or overweight patients who have concomitant obesity-related risk factors or diseases. Population-wide prevention programmes have a greater potential of stemming the obesity epidemic and being more cost-effective than clinic-based weight-loss programmes. Ghana is going through an economic and nutrition transition and experiencing an increase in the prevalence of obesity and obesity-related illnesses, especially among women and urban dwellers. A national taskforce to address this epidemic and to draw up a national policy on related non-communicable diseases is urgently needed.
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PMID:Obesity - a preventable disease. 1729 52

Over the past two decades, inflammation has been recognized as a major driver in the pathogenesis of several common diseases, including atherosclerosis, diabetes, cancer, and asthma. Over the same period, there has been a steep rise in the incidence of obesity, a major risk factor for these disorders. Inflammation of adipose tissue is now recognized to accompany obesity and contribute to its sequelae. Thus, whereas obesity is primarily a disorder of energy balance, it may be helpful to consider it also as a form of epidemic inflammation that predisposes to other forms of epidemic inflammation. It is a fundamental biologic challenge to understand how a positive energy balance and inflammation are linked. This work reviews evidence that reactive oxygen and nitrogen intermediates (ROI and RNI) help drive chronic inflammation in the obese. This is proposed to be a maladaptive instance of our evolved dependence on ROI and RNI for both homeostatic signaling and host defense. ROI and RNI are well suited for these seemingly contradictory dual functions by their metabolic origin, high diffusibility in water and lipid, atomic specificity, and large number of molecular targets. When we eat so much and work so little that we repeatedly generate reactive compounds at levels normally reserved for emergencies, we treat our own cells like invading microbes.
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PMID:Epidemic inflammation: pondering obesity. 1843 63

The pelvic C-clamp traditionally is reserved for the temporizing stabilization of posterior ring injuries and reportedly has assisted in closed reduction of sacroiliac diastases, for patients who are in the supine position. We report a patient with a severely displaced Zone II sacral fracture and associated acetabular fracture who initially underwent fixation of the acetabulum in the prone position. By using the pelvic C-clamp as a tool for successfully reducing the sacrum, definitive closed fixation of the pelvic wing subsequently was performed without having to reposition the patient. In this case report, we review the literature on this device and for alternative reduction maneuvers for disrupted sacral injuries. The C-clamp may be a useful adjunct in select cases to facilitate closed reduction of sacral or sacroiliac joint disruptions, as may particularly apply in cases of severe displacement or when a reduction is hampered by obesity.
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PMID:Case report: The prone reduction of a sacroiliac disruption with a pelvic C-clamp. 1881 May 68

Many studies showed we have a visceral adipose tissue and a subcutaneous adipose tissue. Roles and risks of these fats are different. The purpose of this work is to demonstrate that there are at least two types of subcutaneous fat; one is "metabolic" and diet sensitive and another genetic which is diet resistant. The distribution of subcutaneous fats is also determined by genetic factors, and its study led to the description of segmental syndromes whose distribution and evolution were studied in women in our environment. It seems that no fundamental studies have been made on these two types of fat. We think there is also a genetic programming of our weight which varies with age. This programming may be modulated by the environment (physical activity, diet) but always on a temporary basis. In recent years, the surgical treatment of obesity by gastric rings or by gastric bypass was right to cite, while liposuction is still considered as an accessory process, reserved for purely cosmetic indications. In light of the above, we review the preventive and therapeutic indications of this technique.
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PMID:[Analytical study of the silhouette: the segmental syndromes and therapeutic options]. 1968 86

This article reviews factors that contribute to excessive weight gain in children and outlines current knowledge regarding approaches for treating pediatric obesity. Most of the known genetic causes of obesity primarily increase energy intake. Genes regulating the leptin signaling pathway are particularly important for human energy homeostasis. Obesity is a chronic disorder that requires long-term strategies for management. The foundation for all treatments for pediatric obesity remains restriction of energy intake with lifestyle modification. There are few long-term studies of pharmacotherapeutic interventions for pediatric obesity. Bariatric surgical approaches are the most efficacious treatment but, because of their potential risks, are reserved for those with the most significant complications of obesity.
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PMID:Pediatric obesity: etiology and treatment. 1971 3

The epidemic of overweight and obesity in youth is increasing the prevalence of prehypertension and hypertension among children and adolescents. The younger the child is at presentation and the more severe the blood pressure abnormality, the more likely a secondary cause of hypertension is to be present. Measurement of blood pressure in children requires adaptation to the age and size of the child. Interpretation must be related to normative values specific for age, sex, and height. Evaluation is primarily aimed at identifying secondary causes of hypertension, associated comorbidities, additional risk factors, and evidence of target-organ damage. Ambulatory blood pressure monitoring is emerging as a useful tool for evaluation of some patients, particularly for those with suspected 'white coat' hypertension. Management of prehypertension and hypertension is directed at the underlying cause, exacerbating factors, and the magnitude of the blood pressure abnormality. Healthy behavioral changes are a primary management tool for treating hypertension and, more particularly, prehypertension and for addressing other cardiovascular risk factors, such as obesity. Pharmacological management is reserved for patients with hypertension who do not respond to behavioral changes, have additional cardiovascular risk factors or diabetes, are symptomatic, or have developed target-organ damage.
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PMID:Assessment and management of hypertension in children and adolescents. 2006 50


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