Obesity Medicine

BETHESDA, Md. -- Women who began hormone replacement therapy within 10 years of starting menopause appear to be at a lower risk for coronary heart disease than women who start after a decade.

ROCKVILLE, Md. -- The FDA has approved the first type 2 diabetes treatment that includes a dipeptidyl peptidase-4 (DPP-4) inhibitor with metformin in a single tablet.

DENVER, April 2 -- The occurrence rate of asthma increases by 50% in adults who are overweight or obese, according to a small meta-analysis.

abstract: Low molecular weight heparins (LMWHs) have proved to be as safe and effective as unfractionated heparin for the treatment of venous thromboembolism. They have the advantage of not requiring frequent measurement of activated partial thromboplastin time and subsequent dosage adjustments. Patients who have deep venous thrombosis can be treated with once- or twice-daily subcutaneous doses. Hospital admission is necessary for patients with risk factors for major bleeding complications, for those with symptomatic pulmonary embolism, or when noncompliance is likely. Symptomatic proximal deep venous thrombosis and asymptomatic pulmonary embolism may be managed on an outpatient basis if there are no contraindications. Although heparin-induced thrombocytopenia occurs less frequently with LMWHs than with unfractionated heparin, the platelet count must still be monitored during therapy. (J Respir Dis. 2007;28(4):132-138)

abstract: Hemoptysis has many causes, including bronchiectasis, lung cancer, and bronchitis. The initial goals of the history and physical examination are to differentiate hemoptysis from epistaxis and hematemesis and then to establish its severity. A variety of signs and symptoms may suggest the underlying cause. For example, hematuria suggests vasculitis or an immunologically mediated disease, such as Wegener granulomatosis or systemic lupus erythematosus. The workup includes chest radiography and measurement of hemoglobin and hematocrit levels, platelet count, international normalized ratio, activated partial thromboplastin time, and creatinine level. Chest CT scanning often identifies sources of bleeding that are not apparent on radiographs and sometimes can be used in conjunction with bronchoscopy. Patients with massive hemoptysis should be hospitalized for rapid evaluation and intervention; treatment may include interventional bronchoscopy, angiography, or embolization. (J Respir Dis. 2007;28(4):139-148)

Oral Contraceptives: Five Vignettes Illustrate Dx and Rx Problems-- and Solutions

A 57-year-old woman presents with swelling of the hands that began several weeks earlier and is now worsening. She denies joint pain, and she has no history of trauma or significant vascular disease. She has had pneumonia several times; each episode was successfully treated with antibiotics. She has smoked 2 packs of cigarettes a day for the past 20 years

VANCOUVER, British Columbia -- An active lifestyle away from work protects against on-the-job upper-body repetitive strain injury, according to researchers here.

KOBE, Japan -- Fish-oil supplements added to statin therapy can further reduce the risk for major coronary events even among patients who already eat a diet heavy in fish, Japanese investigators reported.

Binge eating disorder is more common than anorexia and bulimia combined, according to a national survey, but many physicians are unaware of the problem. The guidance and evidence discussed here highlight the key issues in recognizing and managing the disorder.

DURHAM, N.C. -- Biopsies may underestimate the severity of prostate cancer in obese men, a team of investigators found.

NEW ORLEANS -- A cup of cocoa in the morning may improve endothelial function for overweight patients, a small study found, particularly if the dark chocolate powder is mixed with unsweetened water.

DALLAS -- When diet and exercise fail to lower cholesterol in children with high-risk lipid abnormalities, statins should be first- line drug therapy, declared the American Heart Association.

BOSTON -- For firefighters the odds of death from coronary heart disease within 24 hours of fighting a blaze are far higher than if they were on desk duty, researchers reported.

BRISTOL, England -- Even 15 minutes a day of extra moderate to vigorous running, jumping, or kicking a ball can dramatically cut the risk of childhood obesity, according to researchers here.

PARIS -- Atherosclerotic arterial disease seems to predict relatively high rates of myocardial infarction, stroke, or cardiovascular death within a year, according to a large, international registry study.

SEATTLE -- Obese men diagnosed with prostate cancer in middle age are at a 2.6-fold higher risk of dying from the disease than are patients of normal weight, according to a case-control study.

ATLANTA -- Adults in the U.S. need a major bolus of fruits and vegetable in their diets if they are to achieve the national objectives set by "Healthy People 2010," according to the CDC.

TOKYO -- Obstructive sleep apnea patients have a high rate of silent brain infarctions that can be seen by magnetic resonance imaging, according to researchers here.

BOSTON -- Middle-age volunteers whose parents survived to age 85 or older had significantly better Framingham risk scores than those whose parents died younger, suggesting that cardiovascular longevity may reside in the genes.

WINSTON-SALEM, N.C. -- For a few patients undergoing, weight-loss surgery, a thiamine deficiency may cause memory loss and other neurologic problems, easily correctable when recognized.

LOS ANGELES -- The higher the body mass index, the lower the likelihood that patients hospitalized for ischemic stroke would be discharged directly home, found UCLA researchers.

AARHUS, Denmark -- If would-be parents are fat, pregnancy may be a long time coming, according to a Danish study.

STANFORD, Calif. -- Women who followed the low-carbohydrate, high-protein Atkins diet for a year lost more weight than women assigned to three other diets with a high or higher carbohydrate intake, researchers here reported.

WASHINTON -- Doctors discovered a blood clot in Vice- President Dick Cheney's left calf today and started him on first-line therapy for deep vein thrombosis, his office said.

NEW BRUNSWICK, N.J. -- Bariatric surgery in morbidly obese teenagers more than tripled between 2000 and 2003, researchers here reported.

ORLANDO -- Three-year-olds pack away 46 calories, mostly in sugar-laden snacks and drinks, for every hour they spend watching television, researchers here reported. This can add up.

GENEVA -- Complications after hip replacement are more common for obese patients, particularly women, researchers here found.

NORWICH, England -- The way that toddlers and teens grow may protect them against high cholesterol levels in adulthood, researchers here found.

Case Report: Cytomegalovirus Encephalitis in an HIV-Seropositive Person