Obesity Medicine

A 49-year-old woman was referred for evaluation of cardiac valvular dysfunction. Years earlier, she had taken phentermine and fenfluramine for 3 to 6 months for weight loss. She had lost 6.75 kg (15 lb) during that interval without any cardiac symptoms or side effects. She stopped taking the drug on her own.

PHILADELPHIA -- Teens suffering from sleep apnea will doze off in class and teachers will label them lazy, but younger children with the condition usually don't act sleepy. They become hyperactive and tantrum-prone.

PHILADELPHIA -- More than half of patients with atrial fibrillation are also likely to have obstructive sleep apnea, investigators suggested here.

PHILADELPHIA -- The most obvious clinical feature of obstructive sleep apnea may be weariness of mind, but this breathing disorder also slowly and silently wears down the heart, according to researchers.

TOKYO -- Regular aerobic exercise of at least two hours a week produced a small increase in HDL, according to a meta-analysis.

BOSTON -- Substituting soy into an otherwise healthy diet may be cardioprotective for postmenopausal women, researchers found.

SAN FRANCISCO -- Pregnant women who have disordered breathing patterns during sleep may be at elevated risk of developing diabetes and high blood pressure -- including eclampsia and pre-eclampsia.

SAN FRANCISCO -- Obesity makes asthma not only more common but worse, researchers reported here.

SAN DIEGO -- Bifeprunox, an investigational atypical antipsychotic agent, was significantly better than placebo at preventing deterioration of schizophrenia over six months and had a good metabolic profile.

CHICAGO -- Obesity appears to be associated with an increased risk of diastolic rather than systolic hypertension subtypes, researchers said here.

WASHINGTON -- A small, high-fat appetizer such as cream soup may help curb overeating during the rest of the meal, a researcher here suggested.

WASHINGTON -- Overweight children with constipation tend to fare worse than their normal-weight counterparts, but the reasons may be more psychological than biological, researchers suggested here.

FRAMINGHAM, Mass. -- As serum phosphorus levels increase, so does the risk of cardiovascular disease, even among those with normal kidney function and no evidence of heart troubles, researchers reported here.

LONDON -- Unfair bossy government bureaucrats may be coronary risk factors, according to researchers here.

BOSTON -- A simple test of insulin secretion may predict which obese patients would be better off with a low-glycemic load diet than a low-fat one, researchers here found.

BATON ROUGE, La. -- For postmenopausal women who are sedentary, overweight, or obese, peddling an exercise bike for just a few minutes a week can improve cardiorespiratory fitness, researchers here reported.

ROCHESTER, Minn. -- Walking while you work may be an effective way to lose weight and improve physical conditioning.

HELSINKI, Finland -- When babies born prematurely with a low birth weight become young adults, they are likely to have higher levels of insulin resistance, glucose intolerance, and higher blood pressure than those born at term, researchers here reported.

OAKLAND, Calif. -- Supplementation with calcium and vitamin D may help some postmenopausal women avoid weight gain, researchers here reported.

BOSTON -- When an entire community bands together to increase exercise and improve the diets of children in first through third grade, the program can prevent and reverse childhood obesity.

WASHINGTON -- When the stroke is hemorrhagic, secondary prevention measures are significantly less likely to be initiated than when the event is ischemic, researchers said here.

WINSTON-SALEM, N.C. -- Advice from physicians and dietitians to parents about how to help heavy or obese children slim down doesn't seem to translate into significant weight loss.

TORONTO -- Children who drink 100% fruit juices are no more likely to be overweight than kids who drink none, and juice drinkers get considerably more nutritional benefits, researchers reported here.

SEATTLE -- Few geriatricians appear willing to try newer medications to treat chronic constipation in older adults, an informal survey here showed.

SEATTLE -- Shedding pounds with diet alone reduces muscle mass but does not increase disability for postmenopausal women, researchers found.

SEATTLE -- Emotional wellbeing protects physical health for older adults, researchers said here.

FLORENCE, Italy -- An ultrasound measurement of liver thickness predicted portal hypertension in patients with hepatitis C-related cirrhosis, researchers here found.

WASHINGTON -- Laparoscopic gastric banding reduced insulin resistance by 60% within six months, even though patients who underwent the procedure remained obese.

abstract: Pulmonary alveolar proteinosis (PAP) is characterized by the accumulation of lipoproteinaceous material in the alveoli. The most common symptoms are dyspnea on exertion and nonproductive cough. Weight loss, fatigue, chest pain, and hemoptysis have also been reported. Chest radiographs typically show bilateral, symmetrical airspace disease with an ill-defined nodular or confluent pattern, which gives a "bat wing" appearance, as is seen in heart failure. Pulmonary function tests usually demonstrate mild restrictive disease. Findings on examination of sputum specimens or bronchoalveolar lavage fluid can suggest the diagnosis; however, open lung biopsy is the diagnostic gold standard. Whole lung lavage remains the standard of care for PAP and is warranted in patients with severe dyspnea and hypoxemia. Subcutaneous human recombinant granulocyte-macrophage colony-stimulating factor appears to be a promising alternative to whole lung lavage for symptomatic patients. (J Respir Dis. 2007;28(5):177-184)

An obese 52-year-old woman with a 5-year history of type 2 diabetes mellitus had odynophagia and dysphagia for several days. She described the sensation as food "sticking" in her chest. She also complained of vaginal itching, polyuria, and polydipsia. The only remarkable finding on physical examination was candidal vaginitis. The patient did not smoke cigarettes or drink alcoholic beverages, and there was no history of recent weight loss.