Obesity Medicine

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.

ABSTRACT: In addition to appropriate pharmacotherapy and assistance with smoking cessation, a secondary prevention plan should include counseling about a heart-healthy diet, a structured exercise program and/or increased physical activity, and assessment of psychosocial risk factors, such as depression. Advise patients to reduce their intake of salt, sugars, refined carbohydrates, and saturated and trans fats; incorporate more fruits, vegetables, and fish into their diet; and balance caloric intake and physical activity to achieve and maintain a body mass index between 18.5 and 24.9 kg/m2. Cardiorespiratory fitness is the key to cardioprotection; the threshold for improving it in persons with coronary heart disease is about 70% of the mea-sured maximal heart rate. Encourage patients to engage in multiple short bouts of physical activity daily, such as taking the stairs instead of the elevator or walking the dog. Among previously sedentary persons, this approach has effects on cardiorespiratory fitness, body composition, and coronary risk factors similar to those of a structured exercise program.

o avoid the trauma to the fingers that can occur when you percuss a patient's chest or abdomen, use a reflex hammer to percuss the finger that is flush with the chest.

ABSTRACT: Patients who experience an acute myocardial infarction (MI) are at very high risk for recurrent cardiovascular events. Both site-supervised and home-based cardiac rehabilitation programs can effectively reduce all-cause and cardiovascular mortality. Start risk factor reduction as soon as possible; pharmacotherapy is best initiated while patients are still in the hospital. All patients who have had an MI should receive aspirin, an angiotensin-converting enzyme inhibitor, and a ß-blocker, unless these agents are contraindicated or are not tolerated. Prescribe aggressive lipid-lowering therapy to bring patients' low-density lipoprotein cholesterol levels to below 70 mg/dL. For smokers, quitting is the single most important change they can make to reduce future risk of MI.

A 45-year-old man sought medical advice after suffering for 6 months with recurrent pain and a purulent discharge at the sacrococcygeal region. Two weeks before this consultation, an abscess on the patient's right buttock had been drained by another physician. The patient had type 1 diabetes mellitus for 5 years; his medical history was otherwise unremarkable.

Obesity is a well-known risk factor for many diseases. Now it looks like asthma can be added to the list. A meta-analysis that was conducted by Beuther and Sutherland indicated that being overweight is associated with a 50% increase in the incidence of asthma. The risk applies to both men and women.

Frightened but lucid man who appears stated age. Vital signs are normal. No mass palpable in abdomen, though there is a faint suggestion of upper-abdominal distension. No supraclavicular lymphadenopathy, umbilical nodules, or upper-abdominal vascular bruit.

BETHESDA, Md. -- Heart disease risk factors in early adulthood presage atherosclerosis in middle age, suggesting that early intervention may be beneficial, researchers found.

BOSTON -- The gender gap in multiple sclerosis has doubled over the past six decades, reaching about four women with the disease for every affected man, investigators reported here.