Obesity Medicine

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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.

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

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.

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.

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.

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.

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)

Candidiasis

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.