1/15. Access to TV contingent on physical activity: effects on reducing TV-viewing and body-weight.One child was recruited for a study assessing the effectiveness of a device aimed at reducing excessive television viewing and increasing exercising. The device was comprised of a control box which attaches to the electrical cord of a television set, and two sensors which attached to the wheel and corresponding wheel rim of a stationary bicycle. The child in this study was watching an excessive amount of TV (averaging over 4 hours per day), and she had a weight problem. An ABAB design was used in the study. After collecting baseline data, the child was required to ride a bicycle for 60 minutes to watch 60 minutes of TV, and this program successfully reduced TV viewing. Reductions in TV viewing and weight loss were found at a follow-up.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/15. binge-eating disorder and obesity. A combined treatment approach.patients presenting with both obesity and BED face multiple challenges: normalizing their eating, improving their physical health, and working to enhance their own acceptance of their body image. In an effort to feel better about themselves, they often have become trapped in a cycle of desperately attempting to diet, then losing control, binge eating, and gaining even more weight. Several psychological and pharmacologic treatment approaches have been used in this population. Most suppress binge eating in the short term, and some seem promising in the long term as well. However, sustained weight loss remains a largely unrealized goal. More recently, BED treatment programs have attempted to address these goals sequentially or in combination. In either approach, it is clear that adopting a long-term focus and promoting enhanced self-acceptance, which have so often been missing from these patients' previous attempts at recovery, are important tasks of treatment that are likely to lead to beneficial lifestyle changes and long-term improvements in physical and psychological health.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
3/15. An activity calendar program for children who are overweight.sedentary lifestyle activities, such as computer use and television viewing, are modifiable causes of overweight among children. There are many recommendations in the literature that suggest the number of children who are overweight must be decreased; however, none of the research describes an instrument to achieve this goal. This article describes the use of a home-based physical activity calendar and its successes and failures.- - - - - - - - - - ranking = 0.25keywords = physical (Clic here for more details about this article) |
4/15. Laparoscopically performed gastric banding in a 13 year-old girl with morbid obesity and end stage renal insufficiency allows lifesaving weight loss and hemodialysis.OBJECTIVE: In adults, laparoscopic gastric banding is applied to treat morbid obesity, usually in combination with dietary and psychological intervention and increased physical exercise. However, little information is available on gastric banding in children. PATIENT AND methods: The 13 year-old girl suffered from end stage renal failure. Complications with hemodialysis catheters due to her extensive subcutaneous fat pads led to a life-threatening deterioration of her uremia. Intensive conventional schedules for weight reduction failed to be effective, so the morbidly obese girl (body mass index [BMI] 37.7 kg/m2, 3.6 standard deviation score [SDS]) underwent laparoscopic gastric banding at the age of 13 years after informed parental consent was obtained. RESULTS: After laparoscopic gastric banding there was a notable weight loss of 14 kg and an eventually adequate hemodialysis was possible. Total weight loss of the now 15 year-old girl was 24 kg (present BMI 28.3 kg/m2, 2.2 SDS). CONCLUSION: Even in childhood, laparoscopic gastric banding may be considered in cases of morbid obesity in critically ill patients.- - - - - - - - - - ranking = 0.25keywords = physical (Clic here for more details about this article) |
5/15. Hyperactivity in anorexia nervosa: a case study using experience sampling methodology.Hyperactivity is frequently observed in eating disorders, and several biopsychological mechanisms have been proposed to explain its pathogenetic role. In view of the lack of a reliable method to study hyperactive behavior, we did an experiment with experience sampling methodology (ESM). During 1 week, an anorexia nervosa (AN) patient was asked at nine random times a day to report her momentary tendency to be physically active, her emotions and several other variables including calorie expenditure, drive for thinness, attractiveness, obsessions, compulsions, and attitudes towards hyperactivity. Results indicate that the patient's tendency to be hyperactive was (a) positively related to her weight preoccupation and her negative emotions, and (b) negatively related to her positive emotions and the absence of depression. In this patient, obsessions and compulsions were not related to hyperactivity. The usefulness of ESM for studying the role of hyperactivity in AN is discussed.- - - - - - - - - - ranking = 0.25keywords = physical (Clic here for more details about this article) |
6/15. Bacterial pituitary abscess: an unusual cause of panhypopituitarism.OBJECTIVE: To describe a case of primary bacterial pituitary abscess manifesting as hypopituitarism. methods: We present the case history, hormonal and bacteriologic data, and findings on imaging studies in a 34-year-old man. RESULTS: The patient had an 8-month history of intermittent fever, headache, nausea, vomiting, and weight loss. Because a computed tomographic scan of the head showed a cystic sellar mass with ring enhancement, he was referred to our medical center. On physical examination, he showed signs of meningeal irritation and had mild hypotension. Hormonal evaluation revealed evidence of hypocortisolism, hypothyroidism, and hypogonadism. Three weeks after treatment with antibiotics and hormonal replacement, he underwent transsphenoidal surgical exploration and evacuation of purulent material from the sella. On culture, this specimen grew coagulase-negative staphylococci and propionibacterium granulosum. Nine months later, dynamic testing showed persistent central hypocortisolism, hypothyroidism, and hypogonadism. CONCLUSION: Bacterial pituitary abscess is rare but manifests similar to other pituitary masses with headaches, visual field defects, and hormonal disturbances. For the correct preoperative diagnosis of this condition, the physician must have a high index of suspicion, and the characteristic ring enhancement must be present on imaging studies.- - - - - - - - - - ranking = 1.1583031031151keywords = physical examination, physical (Clic here for more details about this article) |
7/15. pathology case of the month. 39-year-old woman with abdominal pain and weight loss. Takayasu's arteritis (TA).A 39-year-old white woman presented with a history of aortoiliac occlusive disease diagnosed in 1992 attributed to oral contraceptive use. Shortly thereafter, aortoiliac replacement was performed. Mild hyperlipidemia was diagnosed in 2001. At the current clinic visit, she presented to her primary care physician with a 3-month history of postprandial midepigastric abdominal pain relieved by vomiting and a 30-pound weight loss. Her evaluation included an esophagogastroduodenoscopy, a colonoscopy, and an abdominal ultrasound, all of which were within normal limits. Because of her medical history, the patient underwent an arteriogram, which revealed brachiocephalic stenosis (Figure 1), occlusion of the left subclavian artery (Figures 2a and 2b), and narrowing of the superior and inferior mesenteric arteries (not shown). Since she had discontinued her oral contraceptives in 1992 and her hyperlipidemia was mild, the rheumatology service was consulted to evaluate this patient. On physical examination, she had decreased left brachial and radial pulses and a right carotid bruit. Laboratory evaluation revealed a normal complete blood count, comprehensive metabolic panel, erythrocyte sedimentation rate, and C - reactive protein. Subsequent testing included a prothrombin time, activated partial thromboplastin time, protein s, protein c, reptilase time, antithrombin iii, anticardiolipin antibody, antiphospholipid antibody, lupus anticoagulant, homocysteine, RPR, and a lipid profile. All test results were within normal limits. Due to the severity of her abdominal pain, the patient underwent superior mesenteric artery (SMA) bypass surgery. Sections from the aorta resected in 1992 are shown in Figures 3 and 4.- - - - - - - - - - ranking = 1.1583031031151keywords = physical examination, physical (Clic here for more details about this article) |
8/15. Gastrointestinal stromal tumor of the prostate.We present a unique case of an atypical prostate tumor in a 49-year-old man with acute urinary retention. digital rectal examination revealed a large prostate with a parenchymal mass on the left side. Radiologic imaging showed a 14.2 x 9.6 x 14.0-cm prostatic mass and multiple liver metastases. A pathologic diagnosis of a prostatic gastrointestinal stromal tumor was made and was confirmed by molecular analysis. Therapy consisted of a tyrosine kinase inhibitor, resulting in prostate mass reduction. After 100 weeks, the patient was in good physical condition with a continuing partial response with a reduced mass volume and liver nodules.- - - - - - - - - - ranking = 0.25keywords = physical (Clic here for more details about this article) |
9/15. Improvement of glycaemic control with rebound following orlistat initiation and cessation associated with minimal weight change.A 57-year-old Caucasian woman with Type 2 diabetes treated for seven years with diet and oral combination hypoglycaemic therapy was referred because of the progressive deterioration of glycaemic control. She was obese (77 kg, BMI = 39.9), hypertensive, hypercholesterolaemic with marked osmotic symptoms (HbA(1c) 12.2%), therefore she was started on insulin (Human Mixtard 30 b.d.) with metformin therapy. Dietary counselling, recommendations to increase physical activity, and supervised self-injection technique with titration of her insulin were also provided. She was routinely followed-up to assess her progress. Two years later, her glycaemic control remained suboptimal. Average HbA(1c) was 10.4% despite an increasingly high dose of insulin (94 units/day) although it improved when metformin was increased to 1 g t.d.s. (HbA(1c) = 9.3%). Her BMI progressively rose from 39.9 to 42.1 (77 to 82.5 kg) despite dietary advice. A trial of orlistat (three months) was commenced, after intensive dietary counselling, that reduced her body weight by 1.5 kg (2% reduction, BMI 41.3). However, her HbA(1c) improved by 0.5% (from 9.3 to 8.8%). Six months after orlistat was stopped her HbA(1c) rose to 10.5% and weight increased to 81.8 kg (BMI 41.8). Despite the orlistat treatment broaching NICE guidelines should it have been continued?- - - - - - - - - - ranking = 0.25keywords = physical (Clic here for more details about this article) |
10/15. Osler-Weber-Rendu syndrome as a cause of poor growth during adolescence.We report an adolescent boy with poor growth and delayed skeletal age who was found to have pulmonary arteriovenous malformations (PAVMs) consistent with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome). While a host of chronic diseases, including a number of cardiopulmonary diseases, have previously been associated with poor growth or short stature, to our knowledge this is the first documented case of PAVM presenting with poor growth, manifesting as weight loss and delayed adolescence. This case highlights the importance of a thorough physical examination for identifying rare, occult, chronic diseases in patients who present with poor growth.- - - - - - - - - - ranking = 1.1583031031151keywords = physical examination, physical (Clic here for more details about this article) |
| | Next -> |