Obesity Medicine

For a week, a 39-year-old woman with a history of intravenous heroin use had generalized pain, fever, chills, and a nonproductive cough. She rated the pain at 10 on a scale of 1 to 10; it was sharp, constant, and unrelieved by heroin. She also reported dyspnea at rest, pleuritic chest pain, and a 15-lb weight loss over the past month. She had no significant medical history or drug allergies, smoked a half pack of cigarettes per day, and denied alcohol use.

For several days, the left eye and eyelids of a 60-year-old obese man had been red and irritated. The symptoms were worse in the morning after waking. The patient had recently started wearing a nighttime continuous positive airway pressure mask for obstructive sleep apnea (OSA). He slept exclusively on his left side.

SEATTLE -- Fine-particulate air pollution over time significantly increased the risk of a first heart attack or stroke, as well as cardiac mortality, in postmenopausal women, researchers here reported.

BOSTON -- Insofar as pain-free knees are concerned, recreational exercise is orthopedically irrelevant to middle-age and older persons, researchers here reported.

SAN DIEGO -- Although computed tomography angiography showed striking results in a small study reported here among patients with known heart disease, the decision to proceed with a coronary bypass still seems to need a visit by a catheter.

PORTLAND, Ore. -- A single bone mineral density scan to predict future fracture risk may be good for life for healthy older women, according to a large study.

ANN ARBOR, Mich. -- People who are cynically distrustful tend to have higher levels of inflammatory markers associated with atherosclerosis than those who believe the best of others' motives, investigators here suggested.

ANN ARBOR, Mich. -- Fatter, poorer, and less educated breast cancer patients are more likely to get partial-dose chemotherapy, which may jeopardize their survival, researchers reported.

LEICESTER, England -- Lifestyle changes appear to be at least as effective as drugs to prevent type 2 diabetes among patients with impaired glucose tolerance, according to a meta-analysis.

CAMBRIDGE, England -- Defects in the receptor for leptin are rare but should be considered when diagnosing obese patients with uncontrolled appetites, according to researchers here.

WATERTOWN, Mass. -- Instead of popping pills, men with erectile dysfunction may be able to improve their performance through weight loss and getting in shape.

STANFORD, Calif. -- The fact that Ponce de Leon grew old and died should have been an object lesson, but the search goes on for the fountain of youth. Take human growth hormone, a recent popular and expensive candidate. No way, say investigators here.

ROCKVILLE, Md. -- The demand for obesity surgery has swelled by nearly 2,000% from 1998 to 2004, according to the federal Agency for Healthcare Research and Quality.

LOS ANGELES -- For heart failure patients, the "obesity paradox" of better survival rates with increasing heft appears to hold true during acute hospitalization as well, according to a large registry study.

BETHESDA, Md. -- For men who have prostate cancer, extra poundage may increase the risk of dying from an aggressive form of it, according to investigators here.

BOSTON -- When soft-drink companies fund nutritional research, the result is quite likely to be a favorable outcome, according to sour researchers here.

VILLEJUIF, France -- Risk factors for new-onset diabetes following liver transplantation include hepatitis C status, weight, and impaired fasting glucose status, French investigators reported.

BALTIMORE -- The most vulnerable age for girls to initially put on too much weight is from nine to 12, and that may lead to high blood pressure and other cardiovascular risk factors, according to investigators here.

NEW YORK -- Pre-hypertension appears to increase the risk of developing an enlarged heart among teens and young adults, according to a study of American Indians.

BOSTON -- The interplay of genetic predisposition and modifiable risk factors, such as obesity and smoking, increases the risk for age-related macular degeneration, researchers reported.

MILAN, Italy -- An hour a week devoted by office workers to on-the-job stress management achieved small but significant improvements in both heart rate variability and arterial blood pressure after a year, researchers here reported.

ROCKVILLE, Md. -- Clinical and regulatory developments in psychiatry during the year included extended black box warnings about suicide for antidepressants, new insights for treating schizophrenia gleaned from an old trial, and the possibility of a "taste test" for selecting the best medicine.

SAN ANTONIO -- The thiazolidinedione Actos (pioglitazone) produced metabolic and histologic improvements in patients with nonalcoholic steatohepatitis, the most severe form of fatty liver disease, researchers here found.

ATLANTA -- Despite fortification of the food supply with folic acid, serum folate levels have fallen en masse among women in recent years, researchers said.

ROCKVILLE, Md. -- The FDA approved a diet drug today that it wants no one to even consider taking. Slentrol (dirlotapide), is an obesity agent for dogs, with nasty side effects if humans try it.

WASHINGTON -- The Federal Trade Commission announced today that it fined four makers of over-the-counter weight-loss products more than million for false advertising, including a .2 million civil penalty against Bayer for claims made for One-A-Day Weight Smart.

ANN ARBOR, Mich. -- African Americans with chronic hepatitis C (HCV) are significantly less likely than Caucasians to have a fatty liver, according to researchers here.

TOKYO -- Tremors and other symptoms associated with Parkinson's disease can be reduced significantly by the antiepileptic drug Zonegran (zonisamide) without an increase in dyskinesias, according to Japanese researchers.

PITTSBURGH -- Poor sleep is a frequent companion of depression in children, according to researchers here.

abstract: Pulmonary disease caused by nontuberculous mycobacteria (NTM) can be challenging to diagnose and manage. Patients typically present with nonspecific symptoms, such as cough and fever, and they often have underlying lung disease, which further complicates both diagnosis and treatment. To avoid treating pseudoinfection, the diagnosis should be based on a combination of the history and results of physical examination, radiographic imaging, and smears and cultures of at least 3 sputum samples. Occasionally, it is necessary to perform bronchoalveolar lavage or obtain tissue via transbronchial or open lung biopsy for histopathology and to assess for tissue invasion. Treatment involves a long course of often costly multiple antimycobacterial drugs. However, treatment with the second-generation macrolides, clarithromycin and azithromycin, has significantly improved cure rates for specific NTM infections. (J Respir Dis. 2007;28(1):7-18)