Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0497406 (overweight)
 26,365 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Silastic Ring Vertical Gastroplasty (SRVG) is a well-established method in obesity surgery. In the last 5 years we performed SRVG on 76 patients who suffered from morbid obesity. Not included are those patients who received an SRVG as second or third gastric segmentation operation. In performing the first 27 silastic ring vertical gastroplasties using the TA 90BNtrade mark we repeatedly experienced difficulties in guiding the nasal tube along the lesser curvature through the notch. This problem stimulated us to develop a more simplified procedure of setting the staple-line. In co-operation with AutoSuture Deutschland GmBH, the notched part of the TA 90 BNtrade mark was bent in a 90 degree angle to the left side of the instrument. This way it is much easier to place the nasal tube exactly at the lesser curvature and through the bent notch of the newly developed TA 90 BNK. Thus, we were able to create a sufficient pouch along the lesser curvature. Of 76 patients 27 underwent the SRVG with a TA 90 BNtrade mark and 49 with the TA 90 BNK. The average age of the patients was 39 years, 83% women, 17% men. The overweight ranged from 40 kg to 177 kg, the BMI from 39 to 94. In 12 cases a staple-line rupture occurred, 26% with the TA 90 BNtrade mark and 10% with the TA 90 BNK. In nine patients a reoperative because of stoma stenosis was necessary, 11% with the TA 90 BNtrade mark and 12% with the TA 90 BNK.
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PMID:Silastic Ring Vertical Gastroplasty Using a Modified TA 90 BNtrade mark. 1072 69

The widely propagated morbidity and mortality risks of obesity appear somewhat exaggerated, except for morbid obesity (BMI > 40 kg/m2) and for high risk obese subgroups concerning diabetes mellitus, hypertension, metabolic syndrome and obstructive sleep apnea syndrome. Non-medical reasons represent a major component of the social pressure that is presently experienced by obese persons in our society. Weight reduction represents the primary therapeutic approach in overweight patients with type 2 diabetes, hypertension, metabolic syndrome and obstructive sleep apnea, and it may be recommended in high-risk individuals for primary prevention of these diseases. Massive obesity is associated with excess mortality, especially in younger, physically inactive men with upper-body-segment obesity. It is widely assumed that weight reduction will lead to a reduction of excess mortality in these individuals; so far, however, there is no proof for this assumption. Non-medicamentous conservative therapeutic approaches to weight reduction have the advantage of safety, even though their long-term efficacy is generally disappointing. There are no randomized, controlled trials to prove a reduction of morbidity or mortality risks and of therapeutic safety for pharmacological, invasive or surgical methods to treat obesity.
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PMID:[Perspectives and limits in treatment of obesity]. 1073 79

Obesity is a prevalent health problem that has discernible impact on all fields of surgery. However, little attention is paid in the literature to the underlying relation of surgical, immunological and metabolic links between transplantation and morbid obesity. Pre-operative obesity has been reported to worsen the outcome of organ transplantation. Impairment of graft function as well as decreased patient and graft survival can contribute to this effect. Post-transplant weight gain is common and may be attributed to an imbalance of the adipostatic and appetite stimulating hormones. Reduction of obesity before transplantation has to cope with limited time, increased risk of therapeutic side-effects in patients with end-stage organ failure, and psychosocial stress. Overweight reduction following organ transplantation interferes with diverse effects associated with immunosuppressive therapy. A case of adjustable gastric banding following renal transplantation is presented.
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PMID:Organ transplantation and obesity: evaluation, risks and benefits of therapeutic strategies. 1105 53

Hormonal abnormalities of the reproductive axis have been described in obesity. In men, extreme obesity is associated with low serum testosterone (T) and high estrogen [estrone and estradiol (E(2))] levels. As changes in the sex steroid milieu may profoundly affect the carbohydrate heterogeneity and thus some of the biological and physicochemical properties of the LH molecule, we analyzed the relative distribution of LH isoforms circulating under baseline conditions (endogenous GnRH drive) as well as the forms discharged by exogenous GnRH stimulation from putative acutely releasable and reserve pituitary pools in overweight men. Secondarily, we determined the impact of the changes in LH terminal glycosylation on the in vitro bioactivity and endogenous half-life of the gonadotropin. Seven obese subjects with body mass indexes ranging from 35.7-45.5 kg/m(2) and seven normal men with body mass indexes from 22.5-24.2 kg/m(2) underwent blood sampling at 10-min intervals for a total of 10 h before and after the iv administration of 10 and 90 microg GnRH. Basally released and exogenous GnRH-stimulated serum LH isoforms were separated by preparative chromatofocusing and identified by RIA of eluent fractions. Serum pools of successive samples collected across 2-h intervals (five serum pools per subject) containing LH released under baseline and exogenous GnRH-stimulated conditions were tested for bioactivity employing a homologous in vitro bioassay. Mean serum T and E(2) levels were significantly lower and higher, respectively, in the obese men than in the control group [serum T, 13.5 +/- 2.4 vs. 19.4 +/- 1.4 nmol/L (mean +/- SEM; P: = 0.01); serum E(2), 0.184 +/- 0.01 vs. 0.153 +/- 0.01 nmol/L (P: < 0.05)]. Mean baseline serum LH levels were similar in obese subjects and normal controls (13.3 +/- 1.3 and 12.2 +/- 1.2 IU/L). Although multiple parameter deconvolution of the exogenous GnRH-induced LH pulses revealed that the magnitude of the pituitary response in terms of secretory burst mass, secretory amplitude, and half-duration of the LH pulses was similar in obese and control subjects, the apparent endogenous half-life of LH was significantly (P: < 0.05) shorter in the obese group (98 +/- 11 min) than in the normal controls (132 +/- 10 min). Under all conditions studied, the relative abundance of basic isoforms (those with pH >/=7.0) was significantly (P: < 0.05) increased in the obese subjects compared with the controls (percentages of LH immunoactivity recovered at pH >/=7.0: obese subjects, 34-57%; normal controls, 22-46%). The biological to immunological ratio of LH released in baseline and low dose (10 microg) GnRH-stimulated conditions were similar in obese subjects and normal controls, whereas LH released by obese subjects in response to the high (90 microg) GnRH dose exhibited significantly lower ratios than those detected in normal individuals (0.62 +/- 0.07 and 0.45 +/- 0.09 vs. 1.01 +/- 0.10 and 0.81 +/- 0.09 for LH released within 10-120 min and 130-240 min after GnRH administration in obese and controls, respectively; P: < 0.05). Collectively, these results indicate that the altered sex steroid hormone milieu characteristic of extreme obesity provokes a selective increase in the release of less acidic LH isoforms, which may potentially modify the intensity and duration of the blood LH signal delivered to the gonad. Altered glycosylation of LH may therefore represent an additional mechanism modulating the hypogonadal state prevailing in morbid obesity.
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PMID:A preponderance of circulating basic isoforms is associated with decreased plasma half-life and biological to immunological ratio of gonadotropin-releasing hormone-releasable luteinizing hormone in obese men. 1113 15

This study examined the effect a polymorphism (L162V) in the gene for peroxisome proliferator activated receptor (PPAR) alpha in the development of non-insulin-dependent diabetes mellitus (type 2 DM), obesity and hyperlipidaemia. The frequency of the L162V polymorphism in the PPARalpha gene was determined in 370 morbidly obese patients who underwent gastric banding surgery, 154 patients attending a type 2 DM clinic, 188 patients attending a lipid clinic and 199 healthy blood donors. The overall frequency of the V allele of the L162V polymorphism was 0.06. There were no significant differences in the allele frequency between patients with morbid obesity, hyperlipidaemia, type 2 DM and healthy controls, suggesting that it does not play a major role in the development of these conditions. The polymorphism was associated with a lower body mass index (BMI) in two independently recruited groups of patients with type 2 DM. There was no effect of the polymorphism on subjects without type 2 DM. Thus a polymorphism in PPARalpha protects type 2 DM patients from the overweight which is frequently associated with their condition.
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PMID:A polymorphism, L162V, in the peroxisome proliferator-activated receptor alpha (PPARalpha) gene is associated with lower body mass index in patients with non-insulin-dependent diabetes mellitus. 1140 11

The objective of this study was to investigate the prevalence of obesity among schoolchildren in the United Arab Emirates, using the body mass index (BMI) as the indicator. The sample included 1,787 males and 2,288 females 6-16 years. Physicians and trained nurses measured height and weight, and the BMI (kg/m(2)) was calculated. The 50(th) centile of the BMI was not different from that for the US. Similarly, the height and weight of UAE children approximate the US reference data. About 8% of UAE boys and girls have BMI's >/=95(th) percentile of US reference values. Using the 85(th) percentile as the criterion, 16.5% and 16.9% of males and females, respectively, are classified as overweight. This composite figure does not differ from the expected 15% based on reference data. The data thus indicate that high levels of obesity are present among UAE children and adolescents. These findings have public health implications for this generation of UAE youth during their adult years, including heart disease and diabetes, because the rate of morbid obesity is approximately twice that expected in reference data. Am. J. Hum. Biol. 12:498-502, 2000. Copyright 2000 Wiley-Liss, Inc.
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PMID:Prevalence of obesity among school children in the United Arab Emirates. 1153 41

The prevalence of obesity is increasing world wide, resulting in morbidity, mortality, and reduced quality of life. The aim of this study was to assess comorbidities and complaints of subjects with morbid obesity in comparison to milder forms of overweight. Therefore, 299 patients visiting our obesity consultation were examined and surveyed prospectively. 41% of the subjects were morbidly obese showing a significantly higher prevalence of arterial hypertension, edema, dyspnea, eczema and depression. Additionally, sleepiness, reduced work capacity, physical inactivity, disadvantages in social life and disturbed eating habits were observed more frequent. Evaluation of subjects with morbid obesity should include a large spectrum of complications, in order to be able to offer a comprehensive support and treatment.
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PMID:[Comorbidity and physical complaints in morbid obesity]. 1159 22

Studies assessing morbidity and mortality in obese patients undergoing orthotopic liver transplantation (OLT) have produced conflicting results, mainly because of the small sample size. The objective of our study was to determine graft and patient survival in obese adults receiving OLT in the U.S. between 1988 through 1996 using the United Network for Organ Sharing (UNOS) database. Among the 23,675 transplantations performed during the 9-year study period, 18,172 (75%) patients fulfilled the inclusion criteria. Of these, 8,382 (46%) were nonobese (body mass index [BMI] < 25 kg/m(2)), 5,913 (33%) were overweight (BMI, 25.1-30 kg/m(2)), 2,611 (14%) were obese (BMI, 30.1-35 kg/m(2)), 911 (5%) were severely obese (BMI, 35.1-40 kg/m(2)), and 355 (2%) were morbidly obese (BMI, 40.1-50 kg/m(2)). The outcome measures assessed were immediate (30-day), 1-, 2-, and 5-year patient survival. Obese groups had a higher proportion of women, a greater prevalence of cryptogenic cirrhosis (P <.05) and diabetes (P <.05), and a higher serum creatinine. Primary graft nonfunction, and immediate, 1-year, and 2-year mortality were significantly higher in the morbidly obese group (P <.05). Five-year mortality was significantly higher both in the severely and morbidly obese subjects (P <.05), mostly as a result of adverse cardiovascular events. Kaplan-Meier survival was significantly lower in morbidly obese patients, and morbid obesity was an independent predictor of mortality. Obesity is associated with a significant increase in long-term mortality, mostly as a result of cardiovascular events. Weight loss should be recommended for all patients awaiting a liver transplantation, especially if their BMI is more than 35 kg/m(2).
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PMID:Obesity and its effect on survival in patients undergoing orthotopic liver transplantation in the United States. 1248 Nov 72

Problems of extreme and morbid obesity take on constantly considerable relevance in 21st century. The prevalence of the obesity (BMI--Body Mass Index > 30 kg/m2) is still on the increase worldwide. In the Czech Republic approximately 16% of male and 20% of female in the age of 20-65 years are obese (BMI > 30 kg/m2). To begin with the effective cure is always indicate in case of the obesity over BMI > 30. The bariatric surgery is indicating in the occurrence of failure of conservative care of morbidly obese patients with recurrences of overweight. The morbid obesity with serious associate health complications often represents the vital danger of the patient's life. The development of the bariatric surgery passed from resections of the bowel, gastric bypasses, biliopancreatic diversions, horizontal gastroplasties to in the present the most frequently used methods as the vertical bandage gastroplasty (VBG) and the gastric bandage (GB). The standard applications of the miniinvasive laparoscopic methods with significant decrease of postoperative complications radical changes of the bariatric surgery in the present years.
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PMID:[History and present status of surgical treatment of morbid obesity]. 1209 93

Obesity recently has been called an epidemic. In the United States, more than 60% of adults are overweight. Although obesity and morbid obesity share numerous etiological factors (eg, genetic, environmental, psychosocial, economic), accepted treatment options differ. Morbid obesity requires urgent and definitive correction to treat both current and possible future complications and to help prevent a probable shortened lifespan. Generally, it is accepted that nonsurgical approaches to weight loss for a person who is morbidly obese are unsuccessful. This Home Study describes the major surgical procedures currently available to treat morbid obesity and discusses the information that nurses need to know about perioperative care of patients who are morbidly obese.
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PMID:Perioperative care of the patient with morbid obesity. 1270 35


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