Obesity Medicine

INDIANAPOLIS -- Each person metabolizes food differently, so the diet that works for one person won't work for another.

KROZINGEN, Germany -- Obese patients given early revascularization after acute myocardial ischemia are less than half as likely to die within three years than normal-weight patients, researchers here reported.

CLEVELAND -- Neither age nor Medicare status should be determinants for gastric bypass surgery, researchers here found.

SAN DIEGO -- Gastric bypass surgery alters alcohol metabolism -- as many surgeons and patients suspected -- leading to faster peaks and prolonged effects without an increase in symptoms, researchers found.

CHICAGO -- A child who has a body mass index in the range of the 85th to 95th percentile for age and sex should be considered overweight, not "at risk of overweight".

PORTLAND, Ore. -- As a group, white men who served in the U.S. armed forces are twice as likely to die by their own hands as non-veterans, researchers here found.

SAN DIEGO -- Breast cancer survivors who eat properly and exercise may halve their mortality risk regardless of obesity, researchers here found.

UNIVERSITY PARK, Pa. -- Eating more water-rich foods, especially fruits and vegetables, helped women drop more pounds than simply moderating fat intake.

PORTO, Portugal -- As metabolic syndrome becomes more severe, symptomatic heart failure and several cardiac structural and functional abnormalities may increase progressively, researchers here reported.

BOSTON -- In a discovery that may explain the successes of the Atkins diet, investigators have found that a single hormone may switch on the use of stored fat for fuel when all else fails.

SAN DIEGO -- Men older than 50 with androgen deficiency are at a greater risk for all-cause mortality than their peers with age-appropriate testosterone, reported investigators here.

BOSTON -- Folate and B vitamins from food, but not from supplements, may be of modest help in fending off cancer of the pancreas.

We present a case of a 35-year-old man with fever and pancytopenia, who had rapid progression to acute respiratory distress syndrome (ARDS), multiorgan failure, and disseminated intravascular coagulopathy secondary to disseminated tuberculosis (TB). Although both sputum and bronchoalveolar lavage (BAL) fluid smears were negative for acid-fast bacilli, the polymerase chain reaction (PCR) assay on the BAL fluid was positive for Mycobacterium tuberculosis. This case emphasizes the need to include TB in the differential for ARDS and the value of PCR testing of BAL fluid, especially in high-risk patients.

* The role of inflammation is well established in theories describing atherosclerotic disease. Virtually every step in atherogenesis is believed to involve cytokines and other bioactive molecules and cells that are characteristic of inflammation. Studies have shown that an elevated level of CRP, which is a serum marker of inflammation, in the high-normal range (0.2 to 1.0 mg/dL) in apparently healthy adults increases the relative risk of cardiovascular disease by 1.5.1

ABSTRACT: Undiagnosed or persistent Helicobacter pylori infection and surreptitious or unrecognized NSAID use are the most common causes of refractory peptic ulcers. The use of antibiotics, bismuth, or proton pump inhibitors (PPIs) suppresses the H pylori bacterial load and may obscure the diagnosis. H pylori infections have also become more difficult to cure because of increased antibiotic resistance. For refractory infection, select an antibiotic based on in vitro susceptibility testing. When this is not available, combination therapy with a PPI, tetracycline, metronidazole, and bismuth is often effective. To detect surreptitious or inadvertent NSAID use, review the drug history in detail. When there is any doubt about such use, check platelet cyclooxygenase function.

For several months, a 60-year-old woman has had weakness, lower extremity edema, and dysphagia. She denies fever, chest discomfort, and rash.

This infection is usually caused by Candida albicans, whichis often present in body folds. Candidiasis is common in persons with diabetes and in obese persons. Other predisposing factors are the use of antibiotics, topical corticosteroids, or immunosuppressive drugs; poor nutrition; and immunosuppression.

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.