[The place and role of physical activity in the treatment of obesity].

Treatment of obesity should primarily include diet and physical activity. Increased physical activity increases energy consumption with beneficial effects on the cardiovascular and metabolic-endocrine systems. It is of utmost importance to point out that simultaneous changes in physical activity and diet decrease both the total body fat mass and the viscelar fat.

[Fever of unknown origin--a case report of brucellar discitis].

Introduction: Febrile episodes of unknown origin lasting for two weeks require detailed investigation by various medical specialists. Fever of unknown origin is most commonly caused by infections, malignancy, colagenosis and in 5-10% of cases, despite detailed diagnostic assessmnet, the cause remains unknown. In cases of fever of unknown origin, the diagnostic procedures are difficult and complex.

[Characteristics of arterial hypertension in obesity].

Introduction: Arterial hypertension is the most frequent cardiovascular disease in obese persons, progressing with time to left ventricular hypertension, often associated with dilatation, diastolic disorders, hearth rhythm disturbance, and generalized atherosclerosis.

Etiology: The origin of this disease is related to hemodynamic disturbances (increased blood volume, minute volume, mainly due to increased stroke volume) accompanied with changes of peripheral resistance, which increases in a later phase. However, metabolic factors are presently considered as primarily responsible for appearance of hypertension, which has rightly obtained the attribute of metabolic hypertension.

[Development and differentiation of adipose tissue].

Introduction: For years adipose tissue has been considered inert, serving only as a depot of energy surplus. However, there have been recent changes, undoubtedly due to advancement of methods for studying the morphology and metabolic activities of adipose tissue (microdialysis and adipose tissue catheterization). In normal-weight subjects, adipose tissue makes 10-12% with males and 15-20% with females.

Body fat mass in normal weight subjects.

Obesity is characterized by excessive body fat accumulation which may lead to serious health problems and complications. Body mass index is the most optimal parameter to evaluate the level of nutritional status and diagnose obesity. However, modern techniques studying body composition can more accurately determine whether the gain of body weight was on the account of body fat, lean body mass or total body water.

[Are drugs necessary in the treatment of obesity?].

Introduction: The main principles of obesity treatment are dietetic nutrition, physical activity and psychotherapy. Drug therapy is adjuvant, time limited and can be applied only with the mentioned therapeutic measures. An ideal antiadipose agent induces a potent decrease of body mass on the account of fat depot, it can be administered for a prolonged time without developing resistance, it should not be accompanied by significant side effects, and it has no negative effects on the obesity-related diseases.

[Treatment of extreme obesity with a very low calorie diet].

Introduction: This paper presents the results of treatment of very obese persons with a very-low-calorie diet (VLCD).

Material And Methods: A group of 28 extremely obese subjects, average age 32 years, was treated in the course of one month by the following regime: 3-4 l of mineral water with "Enemon" pulv. 3 x 1 and vitamin substitution and allopurinol 300 mg/day.

[Obesity and respiratory tract disorders].

Introduction: Although in the shade of metabolic and cardiovascular complications, respiratory tract disorders are very frequent and are predominant in extremely obese subjects with body mass index (BMI > 4O kg/m2), most often of gynoid type.

Classification Of Disorders: These disorders can be classified into four groups: 1. Respiratory function disorders without alveolar hypovenitilation, 2.

[Current diagnostic methods of the specific distribution of adipose tissue].

Introduction: The classification of obesity into male or the android type and female or the gynoid type dates from the first clinical observations of J. Vague in the distant 1947. Researches carried out in the recent years show that in the android type of obesity there is an insulin resistance and hyperinsulinism as a metabolic bases for accelerated atherosclerosis.

[News in oral therapy of diabetes mellitus].

Introduction: Recent interest in regard to therapy of diabetes mellitus has focused on novelties in the field of insulin and other kinds of therapies disregarding the contemporary achievements in oral therapy.

Dietary Plant Fiber: Dietary habits and food preferences in developed countries reveal lack of dietary plant fiber associated with the epidemiologic expansion of widespread noninfectious diseases (metabolic, cardiovascular and some malignant neoplasms). INHIBITORS OF INTESTINAL ALPHA-GLYCOSIDASES: These are substances which competatively and reversibly inhibit the intestinal alpha-glycosidases.

Orlistat, a gastrointestinal lipase inhibitor, in therapy of obesity with concomitant hyperlipidemia.

Orlistat, a gastrointestinal lipase inhibitor, decreases fat absorption and thus it reduces caloric intake. The objectives of this placebo-controlled, double-blind, multicentre trial were to evaluate the efficacy of orlistat in terms of weight reduction, the effects on serum lipid levels and its tolerability profile. 119 obese patients (body mass index, BMI > or = 30 kg/m2) with hyperlipidemia (LDL-cholesterol > or = 4, 2 mmol/l) were randomized to receive either orlistat capsules 120 mg (n = 60) or placebo capsules (n = 59), three times daily, during 24 weeks.

[Hyperinsulinemia as a key factor in the development of many metabolic disorders].

Insulin resistance and consequent hyperinsulinemia present a frequent disorder and according to some investigations it is present in a quarter of whole population. Leaving aside numerous genetic syndromes caused by pronounced insulin resistance, this paper surveys the influence of specific arrangement of fat tissue in the development of this disorder, its role in insulin-independent form of diabetes, development of lipidic and lipoproteinic disorders, in the essential arterial hypertension, and finally, in the appearance of accelerated and premature atherosclerosis. Further intensive investigations of this problem will probably result in achieving a definite explanation of the importance of hyperinsulinemia as a marker of cardiovascular risk.

[Relation between the abdominal sagittal diameter, fat tissue distribution and metabolic complications].

Numerous epidemiological and clinical studies point to association of android type of obesity with metabolic complications, such as glyco-regulation, hyperlipoproteinemia, accelerated atherosclerosis which all lead to cardiovascular diseases. As the waist-hip ratio did not prove to be specific enough for determining association between fat tissue distribution and risk from development of obesity complications, measurement of the sagittal abdominal diameter has been established. Studies carried out up to now reveal that there is a better connection between these measurements and obesity complications.

[Modern principles of therapy of hypertension in diabetic patients].

Arterial hypertension is the most frequent cardiovascular complication of diabetes mellitus. Diabetes mellitus-type-1 occurs in about 30% of patients and it is connected to development of diabetic nephropathy, while type-2 occurs in as much as 70% of cases, having fast atherosclerosis as a base in its etiopathogenesis. The therapy of arterial hypertension in diabetic patients is specific and in some ways different depending on the type of diabetes mellitus as well as other complications characteristic for diabetes.

[The metabolic syndrome and hyper-Lp(a)-lipoproteinemia in peripheral obliterative atherosclerosis: 2 case reports].

One of the characteristics of peripheral vascular disease in diabetic patients is that it occurs at the time of detection of diabetes mellitus. As one of the possible pathogenic mechanisms, in non-smokers, is the sol-called metabolic syndrome (obesity, disorders in regard to metabolism of lipids and carbohydrates and hypertension). Lipoprotein Lp(a) is the most atherogenic among lipoproteins.

[The role and significance of sagittal abdominal diameter in the determination of adipose tissue distribution].

Up-to-now trials have pointed out the importance of determining the type of obesity because the central type of obesity is joined with glucose tolerance disturbance, hyperinsulinemia and insulin resistance. The sagittal abdominal diameter proved to be the method of choice in routine clinical practice for visceral fat tissue detection. We examined a group of 60 females in whom, apart from standard measures (body weight, height, body mass index, perimeters of waist and hips), the sagittal abdominal diameter was measured by means of specially constructed caliper (Holtain Kahn Abdominal Caliper).

[Epidemiologic analysis of emergency conditions in the diabetic population as observed in the work of emergency medical services in the area of Novi Sad].

The authors analyzed a group of 236 diabetic patients in the municipality of Novi Sad who asked for the help of the Emergency medical service of the Health Center "Novi Sad". A special emergency team which manages vitally endangered patients acted on their requests. After anamnestic data were gathered and physical examination done, electrocardiographic monitoring was performed.

[Prolactin secretion in hyperthyroid individuals].

Several endocrine and metabolic changes occur in hyperthyroidism, among which also changes in prolactin secretion are present. Causes are numerous. However, a decreased content of prolactin in secretory granules of the lactotrophic cells in the adeno-hypophysis gland, e.

[The metabolic X syndrome--4 case reports].

The study reviews current knowledge about metabolic X syndrome characterized by android obesity, arterial hypertension, insulin resistance with hyperinsulinemia and disturbed carbohydrate tolerance, a decrease of HDL cholesterol and an increase of the triglyceride rich VLDL particle level. The study describes 4 female patients having been diagnosed for this syndrome. Only an ontime and vigorous reduction of overweight, along with intensified physical activity can prevent later development of serious complications, first of all, in cardiovascular system.

[Psychological characteristics of obese persons with special reference to periods of modified fasting].

It is well known fact that the results of modified fasting can be improved if the basic therapeutic method is combined with psychotherapeutic procedures. We have analyzed the data taken by a poll from 55 extremely obese women treated by modified fasting regimen. The results absolutely justify the above mentioned remark that radical reduction cures may cause critical moments most frequently recognized in hunger crisis when patients feel a need for conversion with medical staff.

[Hypophyseal pseudomacroadenoma in primary hypothyroidism--2 case reports].

Primary hypothyroidism is often accompanied with hyperprolactinemia and if the untreated disease persists longer hypophyseal adenoma consisting of thyreotropic cells might develop. On the other hand, although rarely, simultaneous occurrence of primary hypothyroidism and hypophyseal prolactin adenoma might be encountered. If substitutional therapy, after the establishment of euthyroid status, does not eliminate clinical signs of hyperprolactinemia and normalize prolactin levels, a decision can be made in favor of hyperprolactinemia within primary hypothyroidism.

[Drug therapy of obesity--results of treatment with dexfenfluramine].

The paper presents the results of treatment in 22 obese persons with hypoenergetical nutrition of 4200 kJ with the simultaneous application of dexfenfluoramine in the daily dose of 30 mg in the course of three months. During this period of time an average weight loss of 7.5 kg was achieved, and a loss of 10 kg and more in one third of the patients.

[Case report of pheochromocytoma with an atypical localization].

One of the endocrine causes of arterial hypertension is pheochromocytoma, usually located in the adrenal gland medulla. Extra-adrenal tumor locations are seldom encountered, and this can considerably complicate the diagnostic procedure. If a distinct clinical manifestation exists, supported by the finding of elevated catecholamine values, it is essential to persistently and carefully search for the place of their increased production.