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At least 793 records · Page 44Linked to original sources
PubMed2001

Leptin concentrations do not correlate with fat mass nor with metabolic risk factors in morbidly obese females.

AIMS: To investigate the determinants of leptinemia in a cohort of morbid obese females compared to those of normal weight and mild-to-moderate obesity, and the relationships between leptin and metabolic derangements associated with obesity. METHODS: Recruited females were: moderately obese [n=44; body mass index (BMI) 25-40 kg/m2], morbidly obese (n=34; BMI > or = 40 kg/m2) and normal weight volunteers (n=12; BMI 19-25 kg/m2). Fat mass assessed by bioelectrical impedance and fat distribution by waist-to-hip ratio (WHR) were determined in all subjects. Biochemical determinations included plasma leptin, lipoprotein profile, fasting insulin and cortisol. RESULTS: Plasma leptin values were significantly increased in morbid obese patients (54.95 +/- 1.8 ng/ml) compared to those moderately obese (30.2 +/- 1.7 ng/ml; p<0.001) and to controls (9.77 +/- 1.4 ng/ml; p<0.001). Fat and age-adjusted leptin values were not different between groups. When subjects with a BMI <40 kg/m2 were considered, plasma leptin was significantly and positively related to anthropometric variables (BMI, percentage body fat and WHR), total cholesterol, LDL-cholesterol, plasma triglycerides, AST, ALT and uric acid; and negatively with HDL-cholesterol. In contrast, when morbidly obese patients were analyzed separately, no relationships were observed between leptin concentrations and BMI, percentage of adiposity or biochemical variables. For obese patients no significant differences were observed in the adjusted leptin values with respect to the presence of diabetes, dyslipidemia or hypertension. CONCLUSIONS: In morbidly obese women, the plasma leptin concentrations, although increased, do not reflect the amount of adipose stores, and as such, factors other than simply adiposity need to be invoked to explain the variation in leptin values.

Adipose Tissue↗
PubMed2002

Cardiac surgery and morbid obesity.

OBJECTIVE: Obesity is considered a risk factor for the occurrence of complications after cardiac surgery. The objective of this study was to analyze mortality and morbidity in patients with morbid obesity following heart surgery. DESIGN: Retrospective study in a tertiary care setting. METHODS: Out of 1815 adult patients undergoing cardiac surgery, 50 consecutive patients (3%) with morbid obesity (defined by a body mass index (BMI) > 35 kg/m2) operated on between 7/98 and 3/01 were studied. Mean age was 61.9 +/- 10.4 years, mean BMI was 38.0 +/- 2.7 kg/m2 and mean Parsonnet score was 14.3. Thirty patients had CABG, 14 underwent valve surgery and 6 had combined valve and CABG. RESULTS: Three patients died in the first 30 days (hospital mortality = 6%). Four patients had myocardial infarction (8%), 4 patients had stroke (8%) and 13 required blood transfusion (29%). There were no deep sternal wound infections or reoperations but 9 patients (15%) presented superficial wound infections. Mean ICU and hospital stay were 2.2 +/- 2.2 and 6.8 +/- 4.1 days respectively. With a mean follow up of 13.9 +/- 8.9 months, 4 patients died; 38 (93%) out of the 41 patients reviewed are in NYHA class I or II and 27 (65%) have unrestricted physical activity. CONCLUSIONS: Cardiac surgery in patients with morbid obesity carries a higher morbidity and mortality risk. Short- and medium-term results were satisfactory with improvement in quality of life in two-thirds of the patients.

Cardiac Surgical Procedures↗
PubMedDate not supplied

Morbidity pattern of communicable diseases in an urban area of Uttar Pradesh.

The period prevalence rate of communicable diseases in Uttar Pradesh, India, in the present study was found to be 119.7 per thousand population. There were 1.08 communicable diseases per morbid person. The leading cause of morbidity was ascariasis (24.1 per 1000). The morbidity was significantly higher in young persons (below 14 years of age) and in those without spouse. The social class and educational status were found to have negative association with the morbidity. However, the sex did not show any influence on the morbidity.

Age Factors↗
PubMed2002

Effect of vitamin A supplementation on childhood morbidity and mortality: critical review of Indian studies.

OBJECTIVE: To review all published randomized trials concerned with linkage of vitamin A supplementation with reduction of mortality and morbidity in Indian children. METHOD: The studies were identified by searching the PubMed, review articles, references of available meta-analyses and bibliography of pertinent references. Studies were extracted and the quality of each study was reviewed with regards to 10 categories of parameters that in our opinion, were important for a vitamin A prophylaxis trial. These included background indicators, subjects, design, intervention, proximal measures, field-work, sources of bias, data analysis, interpretation and documentation. RESULTS: Out of 12 studies satisfying the inclusion criteria, the available 11 were examined. Two of the trials were concerned with mortality, 6 with morbidity, and 2 with both mortality and morbidity; 1 study assessed the impact of vitamin A on pneumococcal colonization. Out of 4 mortality trials, only one could satisfactorily report a significant reduction (54 percent) in child mortality following vitamin A supplementation. Of 8 morbidity studies, only 3 indicated some beneficial effect of vitamin A supplementation. None of the studies was perfect in methodology. We could not locate any study that addressed the issue of cost-effectiveness or dietary modifications. The results were not unequivocal and findings for mortality and morbidity were not corroborative. CONCLUSION: There is no definite evidence as yet in favor or against substantial benefit of universal vitamin A supplementation to children in India. There is a clear need to undertake a comprehensive trial with adequate sample size and a standardized methodology that could give clear, unbiased, and convincing evidence on the role of routine vitamin A supplementation.

Child↗
PubMed2002

[Methodological problems in studies of acute morbidity 1870-1900].

BACKGROUND: The use in medical history of morbidity data from national health statistics raises difficult issues concerning the quality of registration practice in the late nineteenth century. MATERIAL AND METHODS: Data on morbidity have been extracted from the annual medical reports from each of the seven health districts in Telemark County, Norway from 1870 to 1900. The incidence of epidemic diseases and general mortality is calculated. RESULTS: In Skien and Kragerø health districts, the occurrence of epidemic disease was higher than in the five adjacent rural districts. While illness increased in Skien during most of the period, it declined in Kragerø from about 1885. Throughout the period there is a clear tendency towards conformity in the patterns of development of acute morbidity and general mortality. INTERPRETATION: Health statistics are assumed to have been influenced to some extent by inaccurate diagnostics, varying numbers of doctors and their accessibility, and dissimilarities in general educational standards and in the ability and willingness to pay for medical treatment. However, these factors alone can not account for the considerable differences in morbidity between the seven health districts. It seems reasonable to conclude that variations in acute morbidity reflect differences in living conditions in the districts in question.

Disease Outbreaks↗
PubMed1992

The development and testing of a nursing model of morbidity in patients with cancer.

Although oncology nurses are concerned about patient morbidity associated with cancer and its treatment, a comprehensive morbidity model from the perspective of nursing has yet to be developed. The purpose of this study was to begin to develop a morbidity model relevant to patients with cancer receiving treatment in the ambulatory care setting. The model was empirically tested with a sample of 100 patients with cancer beginning chemotherapy. Three domains emerged from the model: physiologic/pathophysiologic, functional, and psychological. Indices of morbidity within each domain were tested to establish beginning reliability and validity of the model. The results that were obtained indicate significant correlations among many of the indices within each domain (e.g., performance status, mood disturbance, patients' ratings of their current health); other indices did not contribute significantly to the model (e.g., type of cancer, history of recurrent disease, and patients' assessments of their health prior to developing cancer). Although further testing and refinement of the model is indicated, these preliminary findings reflect the model's potential for significant clinical relevance. By using this model, nurses could more readily profile patients at risk for increased morbidity and target their interventions accordingly.

Activities of Daily Living↗
PubMedDate not supplied

[Morbidity: terminology, mechanisms of formation and classification].

In the 70-ies of the last century the evolution of the epidemic process doctrine resulted in developing population approach to morbidity analysis, in addition to the traditional focal approach. On the one hand, this led to the discussion on the possibility of applying such notion to non-infectious diseases and, on the other hand, to the discussion on the mechanisms of the development and formation of different manifestations in infectious diseases. In both cases the discussion was centered on the phenomenon of morbidity. The present article deals with the nature of morbidity as a phenomenon and the acceptability of general scientific approaches in the interpretation of seasonal and cyclic character of morbidity from the viewpoint of the wave process in an open system. On the basis of the data presented in this work the terms used in epidemiology in considering manifestations of the epidemic process are discussed. The improved classification of morbidity by qualitative and quantitative signs for infectious diseases is proposed.

Bacteria↗
PubMed2003

Morbidity of schistosomiasis mansoni in rural Alexandria, Egypt.

A parasitological survey of stool and urine of 2577 from 3281 individuals living in Abis villages, Alexandria was undertaken in 1998 in order to investigate the prevalence of schistosomiasis in this area and risk factors for hepatic morbidity. A random sample of 1082 individuals was interviewed using a questionnaire regarding risk factors for liver morbidity. All interviewed adults (total: 728) were clinically examined for evidence of organomegally (hepatomegally and/or splenomegally). Individuals with clinically detected organomegally were referred for detailed investigations (total: 65). The criteria for severe hepatic morbidity were AST/ALT ratio higher than 1, prothrombin activity < 70%, and evidence of portal hypertension. The results revealed that prevalence of S. mansoni accounted for 20.5%, with low intensity of infection and increased with age to reach a maximum of 40-46.3% at 15-30 years of age. Intensity of infection followed the same pattern. All tested urine samples were negative for S. haemato-bium. The prevalence of clinically detected organomegally was 10.3% among adults (75/728). Significant risk factors for developing organomegally were age > or = 35 years (2.2 folds), farming occupation (1.7 fold), history of parenteral anti-schisto-somal treatment (PAT) with or without tablets (2.03 folds), and heavy water canal exposure (2.85 folds). Detailed morbidity study on 65 individuals with clinically detected organomegally showed that 52.3% reported heavy score for water canal exposure, 33.8% were positive for HCV antibodies, and 7.7% for HBV antibodies. Procollagen level was higher than 5.5 microg/l in 26.2% of this group. The results of Doppler ultrasonography showed that 33.3% recorded a portal vein diameter > or = 13 mm, 26.2% periportal fibrosis more than grade 2 (> 5 mm), 19% hepatofugal direction of portal blood flow, 30.2% collaterals, 28.6% splenomegaly, and 17.5% hepatofugal direction of splenic blood flow. The burden of severe hepatic morbidity was alarming among this group: 33.8% with portal hypertension, 24.6% with prothrombin activity < 70, and 13.8% with AST/ALT ratio > 1. There was a 4.44 and 3.7 fold increased risk for portal hypertension with elevated levels of PIIIP and positive serologic tests for HCV and/or HBV infections, respectively. Similarly, a 4.58 and 18.35 fold increased risk for AST/ALT more than one was attributed to these two factors, respectively. Elevated procollagen level was significantly associated with viral infection (HCV and/or HbsAG). Seropositivity for HCV antibodies was found strikingly high in adults above 35 years (positive HCV antibodies in 45.9% of individuals). This indicates a high level of endemicity in the study area which is also endemic for S. mansoni. So, a heavy burden of severe liver disease exist in rural Alexandria is attributed to combined infection of S. mansoni and hepatitis viruses. This emphasizes the need for intervenetion strategies targeting these two main liver offenders.

Adolescent↗
PubMed2001

Tendencies in the oral cavity cancer morbidity in three regions of South Bulgaria for a period of 15 years (1985-1999).

INTRODUCTION: Oral cavity cancer constitutes 4% of all malignancies. In Bulgaria it is 2.21% of all malignancies. PURPOSE: In the present study we have set as an aim to investigate the tendencies of oral cavity cancer morbidity in three regions of South Bulgaria for a period of 15 years. METHODS: A retrospective epidemiological study of oral cavity cancer was performed. RESULTS: The calculated speed of growth is characterized with dynamic growth. Taking 1985 for a base, morbidity increases by 58.6% in 1999. Morbidity in men increased from 8.9 cases per 100 000 in 1985 to 10.12 cases per 100 000 in 1999; in women it increased from 1.4 cases per 100 000 in 1985 to 2.25 cases per 100 000 in 1999. We have found that morbidity in men over the age of 60 has increased more than 25 times and in women - more than 2 times. Mortality varies from 2.64 to 2.78 cases per 100 000. An important risk factor for oral cavity cancer development is poor oral hygiene. CONCLUSIONS: Oral cavity cancer morbidity increases from 3.6 to 8.08 cases per 100 000 in 1999. The risk is 6.9 times higher in men than in women. The risk factors are smoking, alcohol abuse and poor oral hygiene.

Bulgaria↗
PubMed2004

Urinary schistosomiasis in Zimbabwean school children: predictors of morbidity.

BACKGROUND: The morbid effects of urinary bilharziasis are becoming more evident with the advent of sophisticated diagnostics such as ultrasound. However, such diagnosis of Schistosoma haematobium morbidity is often hampered by lack of funds, proper equipment, or training. OBJECTIVE: We performed a cross-sectional investigation of schoolchildren in a highly endemic area of east central Zimbabwe in order to assess the utility of a number of simple clinical indicators to predict Schistosoma haematobium morbidity. METHODS: Prevalence and intensity of S. haematobium infection was determined in 551 schoolchildren, with ultrasound examination of the kidneys and bladder performed on 222. The association of a number of demographic, parasitological, and clinical parameters with clinical outcome was evaluated. RESULTS: Overall, 60% of the children were infected with S. haematobium . Although lacking specificity, proteinuria and parasite eggs count best predicted bladder pathology. Presence of kidney dilation was associated with fatigue and pain upon urination, but these variables were not very sensitive. CONCLUSIONS: None of the variables assessed were ideal predictors of morbidity. However, the results suggest that a combination of inexpensive, simple indicators may allow for improved targeting of S. haematobium treatment to those with severe morbidity and better monitoring of the progress of control campaigns when more expensive diagnostic methods are not available.

Adolescent↗
PubMedDate not supplied

[Effectiveness and complications of bariatric surgery in the treatment of morbid obesity].

INTRODUCTION AND OBJECTIVES: Bariatric surgery represents an affective therapeutic alternative for patients with morbid obesity refractory to medical treatment. However, these surgical techniques increase the risk of producing a protein-energy hyponutrition or a selective deficit of some micronutrient. The aim of this work has been to analyze the anthropometrical, nutritional, digestive and cardiovascular risk factors changes and quality of life in patients with morbid obesity submitted to bariatric surgery. MATERIAL AND METHODS: Retrospective descriptive study evaluating a group of patients with morbid obesity submitted to bariatric surgery (45 by means of biliopancreatic bypass according to Scopirano's procedure, and 25 by laparoscopic gastric bypass). Anthropometrics (height, weight, body mass index), cardiovascular risk factors (arterial blood pressure, lipid and glycemic profiles, serum uric acid) and nutritional parameters (serum albumin, complete blood count, and phosphorus and calcium) were assessed before the bariatric procedure and one and two years after surgical treatment. Quality of life was evaluated through the B.A.R.O.S. system. RESULTS: Seventy patients with morbid obesity have been analyzed (56 women and 14 men) with a mean age of 36.5 +/- 11 years. Mean pre-surgical weight was 129.7 +/- 25.6 kg and BMI 48.8 +/- 8.8 kg/m2. Two years after the surgical procedure BMI was 31.0 +/- 6.6 kg/m2, the ponderal reduction 47.7 kg and the percentage of weight loss 36.5%. Hundred percent of dislipidemic patients, 90% of diabetic patients, and 72% of hypertensive patients normalized their corresponding profiles after surgery. The most common nutritional complications were anemia and iron deficiency, which occurred in 54.4% and 36.6% of the cases, respectively. Other observed nutritional deficits were: mild hypoalbuminemia in 20.3% of the patients, hypothrombinemia in 14.9%, folic acid decrease in 17.8%, vitamin B12 deficiency in 12.5%, hypocalcaemia in 23.8%, and secondary hyperparathyroidism in 45.4% of the cases. All nutritional complications were more frequent in patients submitted to biliopancreatic bypass, with the exception for vitamin B12 deficiency that occurred more frequently in patients with gastric bypass. The most frequently observed digestive complication was diarrhea/steatorrhea in 39.1% of the cases. Sixty-four point two percent of the patients considered the surgery outcome as excellent or very good. CONCLUSION: In patients with morbid obesity, bariatric surgery is a technique by which a great improvement in anthropometrical parameters, cardiovascular risk factors, and quality of life of patients is achieved, but it associates an important percentage of nutritional complications that we should take into account in order to prevent them.

Adult↗
PubMedDate not supplied

[Morbidity in acute virus hepatitis B on the territory of Kabardin-Balkaria].

Morbidity in acute virus hepatitis B (AVHB) in Kabardin-Balkaria during the period of 1992 to 2003 was analyzed. The dynamics of changes in the age groups of AVHB patients, as well as in the structure of the transmission routes of the disease, was analyzed. The level of AVHB morbidity in the Kabardin-Balkar Republic was lower in recent years than the average level of such morbidity in the whole of Russia. The sharply defined irregularity in the territorial distribution of AVHB cases was established. The highest morbidity rates in AVHB were registered in Nalchik, as well as in Chegem and Prokhladnensk regions. The leading role in the formation of the morbidity in acute virus hepatitis B on the territory of Kabardin-Balkaria belongs to Nalchik, where 56.8% of AVHB cases were registered. In the structure of the transmission routes of AVHB the prevalence of artificial paths was noted; among them, the highest proportion belonged to parenteral medical manipulations in outpatient clinics (32.9%). The proportion of AVHB cases associated with the intravenous use of drugs was 6.9%. In the age structure of AVHB patients adults prevailed, and among them the highest number of cases was registered in the age groups of 20 - 29 years and 30 - 39 years. In 2002 the total proportion of AVHB cases among the patients of these age groups reached 68.3%.

Acute Disease↗
PubMedDate not supplied

[Problems of registration of morbidity and ways of its improvement].

New system of registration of primary morbidity was developed for the purpose of elimination of systemic error factors and decrease of human element input. The following principles are included: simplification of registration rules; more exact registration of acute conditions; unified rules of registration for out-patient and in-patient medical institutions; unified form of information fields in medical documentation for morbidity registration in out-patient and in-patient medical institutions; succession in basic parameters, indicators and terms of medical statistics in currently in force and modernized systems. New system includes following information fields: "stage of diagnostics", "urgency of condition"; "ICD-10 code", "diagnosis", "life identification", "calendar year identification". All fields, except field "diagnosis", are formalized and for them (except field "ICD-10 code") corresponding codings are developed. Rules for filling information fields, algorithms of validity control of primary information and receiving such indicators as first time identified morbidity", "chronic morbidity", "emergency (acute) morbidity", "chronic sickliness/morbidity identified for the first time in previous years", "chronic sickliness" are developed. This system is implemented experimentally in medical institutions of primary and secondary levels of health care system in Yakka-Saraysk district of City of Tashkent.

Humans↗
PubMed2006

[Intra gastric balloon for morbid obesity].

Obesity has become a severe health problem in the Western world, and is rapidly becoming the most common disease of the 21st century. Morbid obesity is resistant to treatment and is accompanied by considerable morbidity. Some morbidly obese patients do not manage to reduce their weight by diet alone, yet are unsuitable or unwilling to undergo bariatric surgery. Lately, a new intragastric bioenteric balloonR (BIB) was developed to treat these patients. This article summarizes the current knowledge and experience with this balloon, and its advantages and disadvantages. There are very few placebo controlled studies regarding the BIB, and the results are controversial. One study shows the advantage of using the balloon compared with diet alone while another study showed no advantage of the balloon compared with a strict diet regimen. Uncontrolled studies show that balloon treatment combined with diet and physical activity had favorable results achieving both weight reduction and reduction in obesity associated morbidity. Those results were maintained a year after the balloon was removed. Mild and common side effects included vomiting and heartburn, but the balloon also caused severe complications including bowel obstruction, perforation and even death. The total rate of severe complications is estimated to be about 3%. We conclude that the intragastric balloon may be an appropriate addition to the treatment of morbid obesity, but only if combined with a proper diet, physical activity and psychological support. Patients should be carefully selected and monitored to avoid complications.

Combined Modality Therapy↗
PubMedDate not supplied

The relationship between breast-feeding and early childhood morbidity in a general population.

This study investigated the relationship between breast-feeding and early childhood morbidity. Data on morbidity had been recorded in the Continuous Morbidity Registration of the Department of Family Medicine of the University of Nijmegen, the Netherlands, since 1967. Information on early childhood feeding was collected retrospectively by questionnaires mailed to the parents of all the children; the response rate was 94%. Exposure and outcome data of 1,347 children were available for analyses. Duration of breast-feeding was categorized as follows: 0 days (no breast-feeding), 1-14 days, 15-30 days, 31-90 days, 91-180 days, and more than 180 days. Two thirds of the children had been breast fed. Generally there was an inverse relationship between breast-feeding and morbidity. This was most prominent in the first year of life but was also present in the first three years. After adjustment for potential confounding variables, duration of breast-feeding was associated with fewer morbidity episodes and lower rates of several specific illnesses during the first three years of life. The findings suggest some modest health benefits of breast-feeding for children in the Netherlands.

Birth Order↗
PubMed1990

Genital infections and reproductive health: infertility and morbidity of mother and child in developing countries.

Genital infections in impoverished countries take a heavy toll both in the etiology of childlessness and in pregnancy-related morbidity, both for the carrier (mother) and the passenger (fetus/newborn). Tubal damage is by far the most common single etiology in cases of childlessness. Among the three factors principally contributing to childlessness, infertility, pregnancy wastage and child loss, tubal infertility is the predominant one. Prevalence figures of N. gonorrhoeae among women in reproductive ages range between 5 and 15% in several countries. Similar figures prevail among pregnant/puerperal women. Preliminary figures indicate that prevalence of Chlamydia trachomatis is similar. Genitally acquired infections during pregnancy contribute to pregnancy wastage in the second and third trimesters of pregnancy. There is virtually no data to support that HBV, HSV and HPV significantly contribute to transmitted intra-uterine disease leading to pregnancy wastage. In the third category of childlessness, child loss, HSV and HIV play a well-known role. Maternal and neonatal morbidity is adversely affected by genital infections acquired during pregnancy. While hepatitis in some places is an important contributor to maternal mortality and morbidity, other viral diseases like HSV and HPV do not appear important in pregnancy-related maternal morbidity. Gonorrhea and chlamydia infection give few maternal problems during pregnancy but may be more important as a cause of puerperal endometritis-myometritis, which constitutes one of the leading causes of maternal death in many developing countries. The fetal/neonatal infant morbidity is affected by gonorrhea and chlamydia infection, while HSV is less frequent but extremely serious when it appears.(ABSTRACT TRUNCATED AT 250 WORDS)

Developing Countries↗
PubMed1989

[Possibility of modeling regional characteristics of the level and structure of morbidity and the utilization of medical services by the population].

The feasibility of modelling the annual level and the pattern of gerenal morbidity (applications for aid) of the population according to the data on a single application for aid during one month of the year was based on the established regularities of seasonal changes in patients' applications for aid. It was established that an average day level of applications for aid each month in relation to average annual levels was a constant value governed by the peculiarities of seasonal distribution and irrespective of the value of the intensive morbidity indicator in the region. Distribution of applications for medical aid by week days also appeared to be constant. Proceeding from the data on population's applications for aid during 2-4 days the proposed system of coefficients enabled one to obtain the necessary information on the regional character of population's morbidity and various health care needs, thus it became possible to assess adequacy of the level of medical services to the population's health care needs in this region and also to supply information on various analytical, managerial, and planned standard problems. Experimental examination of feasibility and reliability of the model development of the level and pattern of general morbidity on the basis of a single registration of regional consultation rates was tackled by means of computer-based registration of the morbidity of 25,000 residents of Kineshma, the Ivanov Region.

Health Services↗
PubMed1989

[General and occupational morbidity among the personnel of the Bulgarian Medical Academy during the period of 1986-1987].

Extremely important for the character of the health status of the medical staff of the Bulgarian Medical Academy is tracing the level and dynamics of their morbidity (general, expressed by means of integral parameters of morbidity with temporary incapacity for work and of the professional, including the industrial traumatism). On the basis of a two-year study performed at the Medical Academy, with the assistance of the confidential medical staff was gathered the necessary information for the extent and noslogical structure of the morbidity with temporary work incapacity and the number and nosology of the professional diseases, poisonings and occupational accidents. By making use of the basic statistical analyses, the prepared information served to establish the status of morbidity (low for the cases and high for work loss), in order to arrange the Institutes and Departments according to the incidence of temporary work incapacity for work (in days), and give recommendations for undertakings directed on the one side to more profound study of the morbidity and on the other to its practical decrease.

Academies and Institutes↗