Too many staff working in the NHS are worried about branding individuals fat, health minister Anne Milton has claimed (Source: Management in Practice)MedWorm Message: Register for MedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Senate Majority Leader Harry Reid (D-Nev.) said this week that Democrats are hoping to pass a child nutrition bill before lawmakers leave town for the August recess. The $4.5 billion proposal, sponsored by Sen. Blanche Lincoln (D-Ark.), would expand eligibility for school meal programs; establish nutrition standards for all foods sold in schools; and provide a 6-cent increase for each school lunch to help cafeterias serve healthier meals. (Source: RWJF News Digest - Childhood Obesity)

I read with interest the article “Impact of Obesity on Outcomes after Open Surgical and Endovascular Abdominal Aortic Aneurysm Repair” by Johnson and colleagues in the February 2010 issue of the Journal of the American College of Surgeons. My reading of the article indicates that there were 1,138 patients who underwent open aneurysm repair, 1,016 patients who underwent endovascular repair, and 47 patients in whom endovascular aneurysm repair was attempted and who then had open aneurysm repair because of complications of the endovascular approach. The authors included these 47 patients in the open repair group. I believe that these patients should have been handled differently during data analysis for several reasons. Most, if not all, of these 47 procedures were done on an urgent if no...

An intention-to-treat analysis would be appropriate for comparing 2 interventions prospectively. For example, failed attempts at endovascular repair of abdominal aortic aneurysms (EVAR) leading to a set of complications are most appropriately analyzed with other EVARs, rather than as open repair. This would be to avoid bias in favor of EVAR, or complication rates would be artificially tilted against open surgery. However, because the objective of this study was to examine the impact of obesity on surgical outcomes and consider operations of similar magnitude and physiologic insult, the 47 converted cases were grouped as open repairs. We found no significant differences in operative time, blood loss, or other measured variables. Additionally, pilot statistical reanalysis was performed with ...

Sacral fractures have been classified by Denis and colleagues as zone I (alar), zone II (transforaminal), and zone III (sacral canal) injuries, depending on the anatomic relationship between the fracture and the sacral neuroforamina. Unstable transforaminal sacral fractures, on which it is difficult to perform internal fixation, remain a challenge to the orthopaedic traumatologist. Iliosacral screw fixation for unstable transforaminal sacral fractures is an elegant method, but complications can arise under fluoroscopic guidance because of poor visualization. Intraoperative radiographic imaging is often inadequate because of obesity, bowel gas, intestinal discharge, dysplastic pelvis, and inadequate machinery. Iliosacral screw fixation of unstable sacral fractures and sacroiliac joint (SIJ)...

Conclusions: High-volume surgeons use a number of identifiable objective factors to determine the best candidates for unilateral versus bilateral parathyroid exploration. Localizing studies such as sestamibi scans ultimately play a minor role in determining how many parathyroid glands are evaluated. (Source: Journal of the American College of Surgeons)MedWorm Message: Register for MedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Conclusions: Given the massive increases in morbid obesity and bariatric surgery in women, surgeons could serve a vital role in educating patients about both gynecologic and nongynecologic malignancy risks. With appropriate referral for cancer screening, patient outcomes could improve. (Source: Journal of the American College of Surgeons)

The worldwide prevalence of obesity and its associated metabolic and cardiovascular disorders has risen dramatically within the past 2 decades. Our objective is to review the mechanisms that link obesity with altered kidney function. Current evidence suggests that excess weight gain may be responsible for 65–75% of the risk for arterial hypertension. Impaired renal pressure natriuresis, initially due to increased renal tubular sodium reabsorption, is a key factor linking obesity with hypertension. Obesity increases renal sodium reabsorption by activating the renin-angiotensin and sympathetic nervous systems, and by altering intrarenal physical forces. Adipose tissue functions as an endocrine organ, secreting hormones/cytokines (e.g., leptin) which may trigger sodium retention and hype...

Health minister, Anne Milton, has said that health professionals should tell overweight people they are fat and not obese (Source: Nursing in Practice)

The objective of this study was to determine predictors of weight loss among participants with knee OA in a clinical trial. A secondary analysis of data from a randomized clinical trial was used. Multiple regression analysis was used to predict weight loss after identification of predictor variables from the data. Hypothesized predictors of weight loss included demographic, clinical, and behavioral characteristics. The only baseline variable that was significantly related to weight loss was the Center for Epidemiologic Studies Depression Scale (CES-D) score. The CES-D score was an independent predictor of weight loss at 16 (p

Conclusions: While important health-promoting progress was made, there remain further opportunities for secondary schools to use a whole-of-school approach through the school curriculum, environment, policies and ethos to improve healthy eating, physical activity and healthy body perceptions in youth. To achieve this, significant, sustained leadership will be required within the education sector generally and within schools specifically. (Source: BMC Public Health - Latest articles)MedWorm Message: Register for MedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

Conclusions: The results suggest that insulin detemir has a greater effect on glycaemic control in subjects with poor glycaemic control using NPH; can reduce or maintain body weight in obese patients; and obtains perceptive stability for patients with unstable glycaemic control. (Source: International Journal of Clinical Practice)

WASHINGTON (Reuters) - Overweight volunteers who took Orexigen's experimental drug Contrave, designed to reduce cravings, lost about 13 pounds (6 kg) over a year, U.S. researchers reported on Thursday. (Source: Reuters: Health)

New randomized trial results suggest the combination of two "old" drugs might help obese patients lose weight, but one expert worries the blood-pressure effects of the two agents combined need to be... For complete story visit theheart.org. (Source: theHeart.org)

CONCLUSION:: Normal-weight and obese participants who were consistent OCP users experienced substantial and comparable ovarian suppression during OCP use. Higher OCP failure rates among obese women reported elsewhere are thus unlikely to be attributable to physiological differences in OCP effect. CLINICAL TRIAL REGISTRATION:: ClinicalTrials.gov, www.clinicaltrials.gov; NCT00827632. LEVEL OF EVIDENCE:: I. PMID: 20664386 [PubMed - in process] (Source: Obstetrics and Gynecology)

CONCLUSION:: Weight losses between 5% and 10% of body weight were sufficient for significant urinary incontinence benefits. Thus, weight loss should be considered as initial treatment for incontinence in overweight and obese women. CLINICAL TRIAL REGISTRATION:: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00091988. LEVEL OF EVIDENCE:: II. PMID: 20664387 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)MedWorm Message: Register for MedMatcha, MedWorm's medical advertising network, and receive $5 free advertising.

CONCLUSION:: Results indicate that functional polymorphisms in folate-related genes increase the risk of having a fetus with CHD when maternal lifestyle factors that alter folate metabolism are present. LEVEL OF EVIDENCE:: II. PMID: 20664391 [PubMed - in process] (Source: Obstetrics and Gynecology)

Authors: Haschke F, Klassen-Wigger P Marketing-driven innovation in the field of pediatric nutrition, in particular in the infant formula segment is not sustainable. New benefits of products must be scientifically proven and safety and efficacy of new formulae established in clinical trials. The scientific innovation process of three infant formulae is described. Improvement in protein quality allowed to reduce the protein concentration in whey-based infant formula. Weight gain and BMI of infants fed those formulae corresponds to breastfed infants and is lower than in infants fed traditional formulae with higher protein concentration. A meta-analysis indicates associations between rapid weight gain in infancy and obesity later in life. If infants cannot be exclusively breastfed until 4...

Authors: John J This chapter surveys two segments of the economic literature on pediatric obesity: first, research regarding the impact of childhood obesity on health care expenditure, and second, research evaluating the cost-effectiveness of programs to prevent pediatric obesity. Evidence in support of the hypothesis that obese children and adolescents have higher health care costs than their otherwise similar healthy-weight peers has been found for female adolescents. Studies trying to calculate the complete lifetime health care costs attributable to childhood obesity are missing. Only a small number of studies assessing the cost-effectiveness of preventive obesity interventions among children have been published until now. The results call for the inclusion of nutrition behavior as ...

Authors: Lönnerdal B Progress in research on human lactation and breast milk has advanced our knowledge about the significance of breast milk for the recipient infant and the effects of various components on long-term outcomes. Recent findings have expanded our knowledge in this area. Several growth factors and cytokines are present in breast milk and their capacity to persist in the infant gut and exert their activities is likely to affect maturation of immune function, possibly affecting the development of oral tolerance. A proper balance of polyunsaturated fatty acids (n-3/n-6 ratio) may also be of significance for allergy prevention in children, emphasizing the need for the mother to achieve a balance of these fatty acids in her diet. The recent findings that specific strains of...