Obesity Medicine

BOSTON -- Incretin-based therapies offer an alternative to hypoglycemic agents for type 2 diabetes with little if any weight gain, a meta-analysis showed.

PHILADELPHIA -- Half of otherwise healthy children and adolescents in the northeastern United States don't get enough vitamin D, researchers found.

BOSTON -- A lack of fruit and fish in teenagers' diets may keep them from attaining full lung capacity and set them up for later respiratory problems, researchers here said.

NEEDLES, Calif. -- The temperature climbed toward a life-threatening 120degrees here today, with forecasters predicting that dangerous heat may stretch from coast-to-coast by next week. When temperatures rise so do health risks.

WASHINGTON -- For those who eat to combat stress, researchers here may have made a dream come true -- an injection that makes fat melt away, at least in mice.

GENEVA -- Airline travel that lasts four hours or longer is associated with a one in 6,000 absolute risk of developing venous thromboembolism, according to the World Health Organization.

abstract: Tuberculous pericarditis, while relatively rare in the United States, is an important cause of pericardial disease in countries where tuberculosis is prevalent. Patients are most likely to present with chronic disease--effusive and/or constrictive. Those with effusive pericarditis often present with tamponade. Patients with constrictive pericarditis exhibit features of systemic and pulmonary venous congestion. An elevated level of adenosine deaminase in pericardial fluid is a good marker for tuberculosis. The presence of granulomas or case-ation necrosis in pericardial tissue confirms the diagnosis. If treatment of effusive tuberculous pericarditis is delayed, constrictive or effusive-constrictive disease usually develops, resulting in a high mortality risk. In addition to a standard antituberculosis regimen, treatment of tuberculous pericarditis may include adjuvant therapy with corticosteroids, pericardiocentesis, and/or pericardiectomy. (J Respir Dis. 2007;28(7):278-282)

At a routine blood pressure check, a 63-year-old woman has 2 readings of 165/100 mm Hg. The patient has had essential hypertension since age 41 years. For more than a decade, it was easily controlled with a b-blocker; however, in recent years, her blood pressure has been more variable, with occasional readings of higher than 150/90 mm Hg.

Heart failure is prevalent in both primary care and cardiology practices. It develops in about 1 in 5 persons during their lifetime and in about 1 in 8 of those who have not sustained a myocardial infarction (MI). Heart failure is also the leading cause of hospitalization in the elderly.

Your Observations About the Man With the Tripod Sign

Lp(a) is a fascinating variant of low-density lipoprotein (LDL). It is basically an LDL molecule that has been modified by the covalent addition of apoprotein(a). Elevated levels of Lp(a) correlate with increased risk of acute coronary syndromes, cerebrovascular accident, peripheral arterial disease, and coronary mortality. This Q&A session answers some curiosities about Lipoprotein(a).

The diagnostic criteria for major depression are anhedonia, depressed mood, feelings of worthlessness or inappropriate guilt, inability to concentrate, fatigue, insomnia or hypersomnia, psychomotor agitation or retardation, significant weight loss or gain, and recurrent thoughts of death or suicide. Five or more of these symptoms must be present for at least 2 weeks, and one of them must be anhedonia or depressed mood. Conditions that can present with depression include dysthymia, bipolar disorder, cyclothymia, and adjustment disorder. Depression may also result from substance abuse or from the physiological conditions associated with a medical disorder, such as spinal or head injury, AIDS, or cancer.

A Photo Quiz to Hone Dermatologic Skills

Photo quiz

Clinical Images to Help You Hone Your Diagnoses

CHICAGO -- Painful neuropathy is more common with type 2 diabetes than with type 1, possibly, researchers suggest, because of a link with the metabolic syndrome.

CHICAGO -- Elevated glucose levels during pregnancy appear to increase risks to mother and baby even at levels below current criteria for gestational diabetes, researchers reported here.

CHICAGO -- Weight gain in type 1 diabetes is associated with coronary artery calcification, but, paradoxically, that may be a sign of better cardiovascular health, investigators here reported.

DENVER -- Type 2 diabetes is no longer the "adult-onset" disease it once was. More and more children with diabetes are type 2 these days, researchers found.

NEW HAVEN, Conn. -- Childhood obesity can be overcome by an intensive family-based program that includes supervised exercise and nutrition education, found researchers here. But dieting wasn't the answer.

CHICAGO -- When the spotlight here focused on rosiglitazone (Avandia) and its harshest critic, Steven E. Nissen, M.D., of the Cleveland Clinic, the cardiologist offered a mild apology to a room full of diabetologists for complicating their lives.

CHICAGO -- Fructose in sodas and other beverages -- but not glucose -- can set patients on the fast track to atherosclerosis, investigators here reported.

CALGARY, Alberta -- A plate and a cereal bowl marked for a portion size designed to limit calorie intake helped obese diabetic patients know when enough is enough, researchers reported.

CHICAGO -- The prevalence of diabetes of all types in the United States has risen by about 5% annually since 1990, keeping pace with the fattening of America, reported CDC investigators.

CAULFIELD, Australia -- The risk of cardiovascular mortality increases at the earliest sign of impaired glucose metabolism, researchers reported here.