Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0311277 (abdominal obesity)
 2,792 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Regional anesthesia has an expanding role in upper extremity surgery. Brachial plexus blocks offer several advantages including providing effective analgesia, reducing narcotic requirements, and facilitating ambulatory care surgery. Despite the popularity of nerve blocks, the surgeon must not forget the complications associated with regional anesthesia. This article describes a case of symptomatic phrenic nerve palsy after supraclavicular brachial plexus block in an obese man. A 46-year-old obese man underwent a left-sided supraclavicular block in preparation for decompression of Guyon's canal for ulnar mononeuropathy at the wrist. The patient experienced acute-onset dyspnea, chest discomfort, and anxiety, and physical examination demonstrated reduced breath sounds in the left hemithorax. Chest radiographs documented elevation of the left hemidiaphragm consistent with an iatrogenic phrenic nerve palsy. The patient was admitted for 23-hour observation and underwent an uncomplicated ulnar nerve decompression under Bier block anesthesia 1 week later. No long-term sequelae have been identified; however, there was a delay in surgical care, admission to the hospital, and transient pulmonary symptoms. We attribute this complication to significant abdominal obesity causing compromised pulmonary reserve and poor tolerance of transient hemidiaphragmatic paresis. In recent studies, waist circumference and abdominal height were inversely related to pulmonary function. We suspect that the incidence of symptomatic phrenic nerve palsy associated with brachial plexus blocks will increase as the prevalence of obesity increases in this country.
 ...
PMID:Symptomatic phrenic nerve palsy after supraclavicular block in an obese man. 1947 48

Peripheral arterial disease (PAD) is defined as an atherosclerotic disease in the lower extremities and is characterized by its symptom of intermittent claudication with discomfort and pain at posterior cruris. Various abnormalities of vascular endothelial cells, smooth muscle cells and platelets induced by risk factors of PAD are involved in its pathogenesis. The most important risk factors are ageing, smoking and diabetes mellitus. Dyslipidemia and hypertension are also classical risk factors of PAD. A lesion of PAD in the lower extremity is prone to be more distal in patients with diabetes than in non-diabetics and to be more proximal in smokers than in nonsmokers. In addition, race/ethnicity, increased inflammatory marker levels, homocysteinemia and abdominal obesity are known to be risk factors of PAD. Light-to-moderate alcohol drinking has been demonstrated to reduce the risks of coronary artery disease and ischemic type of stroke, while excessive alcohol drinking increases the risks of hemorrhagic type of stroke (cerebral hemorrhage and subarachnoid hemorrhage), hypertension, cardiac arrhythmia and sudden cardiac death. In most previous epidemiological studies, the risk of PAD has been shown to be lower in light-to-moderate drinkers than in abstainers. Moreover, drinkers with PAD reportedly showed lower mortality than did nondrinkers with PAD. On the other hand, heavy drinking has been reported to be positively associated with the risk of PAD. Increase in HDL cholesterol, decrease in LDL cholesterol, inhibition of platelet aggregation, decrease in blood coagulability, increase in blood fibrinolitic activity, and increase in insulin sensitivity are known as mechanisms for suppression of atherosclerosis by alcohol drinking. These mechanisms are also thought to contribute to reduction of the risk of PAD by alcohol drinking. Further studies are needed to clarify pathophysiological mechanisms for dose-dependent diverse effects of alcohol on the risk of PAD.
 ...
PMID:[Alcohol drinking and peripheral arterial disease of lower extremity]. 2481 55

Belching may result from transient lower esophageal sphincter relaxation; therefore, it has been proposed that belching may be a manifestation of gastroesophageal reflux disease (GERD). This study was conducted to investigate the frequency of belching during esophagogastroduodenoscopy (EGD) and its association with GERD. A retrospective review was performed on prospectively collected clinical and endoscopic data from 404 subjects who underwent EGD without sedation from December 2012 to May 2013 in a training hospital in Korea. All detectable belching events during endoscopy were counted. Frequency and severity of belching events were compared between the group with and without GERD using an ordinal logistic regression model. There were 145 GERD patients (26 erosive reflux disease and 119 nonerosive reflux disease [NERD]). In the multivariable analysis, GERD was significantly associated with a higher frequency of belching events (odds ratio = 6.59, P < 0.001). Central obesity, female, and younger age were also risk factors for frequent belching during EGD. Subgroup analyses were performed in subjects without erosive reflux disease (n = 378) and NERD (n = 293). NERD was also a predictive factor for frequent belching during EGD (odds ratio = 6.61, P < 0.001), and the frequency of belching was significantly correlated with GERD severity according to the Los Angeles classification (P < 0.05). Frequent belching during EGD was associated with GERD, including NERD. Future research should focus on its adjuvant role in the diagnosis of GERD/NERD and the necessity for applying differentiated endoscopy strategies for GERD patients, leading to less discomfort during EGD in patients at risk for intolerability.
...
PMID:Belching during gastroscopy and its association with gastroesophageal reflux disease. 2570 11