Public Health
Extreme Obesity Can Be Treated in Primary Care
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Non-surgical weight-loss programs delivered in a primary care setting can yield results with extremely obese patients, according to a study in the Jan. 25 issue of the Archives of Internal Medicine.
Donna H. Ryan, M.D., of Louisiana State University System in Baton Rouge, La., and colleagues conducted a study of 390 participants, of whom 200 were randomized to receive an intense medical intervention, including a recommended 900-calorie liquid diet for up to 12 weeks, along with pharmacotherapy and group behavioral counseling, while 190 received usual care.
The study lasted for two years, by which time, 51 percent of the intervention group and 46 percent of the usual-care group had completed the program, the researchers note.
First lady backs childhood obesity screening
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New Hampshire’s first lady, a pediatrician, is backing legislation that would require the state’s schools to record children’s body mass index, an indicator of obesity.
Dr. Susan Lynch said she believes the measurement is more helpful than simply looking at a child’s weight to determine health risks of being under- or overweight. Lynch is a strong advocate for preventing and addressing childhood obesity.
“BMI is a poor man’s tool to give us an estimate of body fat content,” Dr. Lynch said Monday.
Peruvian doctors amputate wrong leg, then right one
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LIMA (Reuters) – Peruvian doctors amputated the healthy leg of an 86-year-old man, then amputated the other leg when they realized their mistake.
“I was shocked when I lifted the sheets and saw they had taken his left leg,” the man’s daughter, Carmen Villanueva, told Peruvian radio station RPP.
“The ulcer was on his right leg and they had to amputate that one too to keep the infection from spreading,” she said.
Weight-loss drug maker funding film on obesity
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GlaxoSmithKline, maker of the weight-loss drug Alli, is moving into the movie business.
The big pharma company plans to announce at the Sundance Film Festival today who will direct a documentary on obesity that the company will pay for. The film will be made by the Creative Coalition, a nonprofit arts group with an advocacy mission.
A Glaxo executive told the New York Times that the company had no expectations that Alli would be mentioned in the film and that the company simply wanted to educate Americans about obesity.
New tools and systems may help patients, primary care clinicians manage obesity
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Using combined and intensive treatments and restructuring care to treat obesity like other chronic diseases may help primary care clinicians and patients better address the condition, according to a commentary and three articles published in the January 25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Data suggest an extensive gap exists between recommended obesity care and current practice by primary care clinicians, notes Robert F. Kushner, M.D., of Northwestern University Feinberg School of Medicine, Chicago, in the commentary. “The reasons for the gap are complex owing to multiple physician, patient and medical system factors,” he writes. “Cited barriers include a lack of reimbursement, limited time during office visits, lack of training in counseling, competing demands, low confidence in the ability to treat and change patient behaviors, limited resources, the perception that patients are not motivated and a paucity of proven and effective interventions to treat obesity.”
“In this issue of the Archives, three articles on weight loss for overweight or obese patients have potential implications for primary care practice,” Dr. Kushner writes. The findings, outlined below, provide information on effective interventions for obesity and its complications in primary care settings.
Quantifying the number of pregnancies at risk of malaria in 2007: A demographic study
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Research published this week in PLoS Medicine concludes that at least 125.2 million women at risk of malaria become pregnant each year.
Most malaria deaths are caused by Plasmodium falciparum, which thrives in tropical and sub-tropical regions. But the most widespread type of malaria is P. vivax malaria, which also occurs in temperate regions. Most malaria deaths are among young children in sub-Saharan Africa but pregnant women and their unborn babies are highly vulnerable to malaria. About 10,000 women and 200,000 babies die annually because of malaria in pregnancy, which can cause miscarriages, preterm births, and low-birth-weight births. Estimates on the burden of malaria were previously only available for Africa.
The researchers estimated the sizes of populations at risk of malaria in 2007 by combining maps of the global limits of P. vivax and P. falciparum transmission with data on population densities. They used data from various sources to calculate the annual number of pregnancies (the sum of live births, induced abortions, miscarriages and still births) in each country.
Beijing fights obesity with tape measures
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Primary school students in China’s capital Beijing are being enlisted to help with the weighty issue of growing obesity.
The students have been given tape measures to size up the waistlines of their parents and themselves during the winter holiday, which starts Friday.
The move was initiated by Beijing educational and health authorities in an attempt to understand and combat obesity and encourage a healthier lifestyle.
The skinny on our obesity problem
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The Rowan County Health Department presented the 2009 Community Health Needs Assessment to the Rowan County Board of Health on Jan. 12. Leonard Wood, public health director, described how the department established a Community Health Assessment Committee (CHAC) in November 2008 to begin the process of evaluating citizen and agency responses to health related priorities for Rowan County. The CHAC was composed of 41 Rowan County citizens representing private and public agencies, public education, the medical community, the Board of Health, Cooperative Extension, Healthy Rowan, community foundations, Social Services, Piedmont Behavioral Healthcare, Catawba and Livingstone Colleges, the Hispanic Coalition and other agencies interested in participating in this assessment. In addition, 14 focus groups were held to collect primary health care data from citizens across the county. The themes that kept re-occurring from both the CHAC and the focus groups were in the following priority order: concerns about obesity, access to affordable health care/health insurance, diabetes and other chronic diseases, minority health disparities and individual responsibility for their own health care.
Obesity is not just a concern of how much you weigh; the problems of obesity lead to detrimental and life-threatening chronic diseases. These diseases include: heart disease, hypertension, stroke, Type II diabetes, infertility, gallbladder disease, cancer, osteoarthritis, sleep apnea and depression. Obese individuals have a 37.4 percent higher annual medical cost than their healthier peers, and according to the Health Affairs Web site, this will translate to an increase in the national cost of health care, both direct and indirect, of $75.64 billion for 2011 for adults 18 and over. For young people age 10-17, the cost of being overweight and obese is estimated to be $164.95 million for 2011. These cost figures are staggering.
Avalon | Hospitalization Program Offers Obesity Treatment In New YorkStanding as the first hospitali
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Standing as the first hospitalization program in New York for the treatment of eating disorders, Avalon Centers has been treating patients with programs since 1998. Avalon engages a group of highly skilled professions who are experts in treating patients diagnosed with Obesity, Binge Eating Disorders, Bulimia and Anorexia.
The facility offers a supportive, home like setting where patients work closely with Avalon clinicians, nutritionists, nurses, and psychiatrists to meet their unique mental health, emotional, nutritional, medical, and psychological needs. Avalon has become known for helping patients who suffer particularly from obesity. Obesity and Binging are considered eating disorders that effect how a person perceives and treats their body. Overweight and obesity are often interchangeable terms for describing weight that is greater than what is healthy for a given height, age, and gender. Obesity and being overweight identify ranges of weight that have been shown to increase the likelihood of other health problems, including heart disease, stress, depression, and so forth.
For adults, overweight and obesity ranges are determined by using weight and height to calculate a number called the “body mass index” (BMI). BMI is used because it correlates with their amount of body fat. An adult who has a BMI between 25 and 29.9 is considered overweight. An adult who has a BMI of 30 or higher is considered obese. It is important to remember that although BMI correlates with the amount of body fat, BMI does not directly measure body fat.
Obesity Rates Hit Plateau in U.S., Data Suggest
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Americans, at least as a group, may have reached their peak of obesity, according to data the Centers for Disease Control and Prevention released Wednesday.
The numbers indicate that obesity rates have remained constant for at least five years among men and for closer to 10 years among women and children — long enough for experts to say the percentage of very overweight people has leveled off.
But the percentages have topped out at very high numbers. Nearly 34 percent of adults are obese, more than double the percentage 30 years ago. The share of obese children tripled during that time, to 17 percent.
Some 390 tons of US ground beef recalled
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Some 390 tons of ground beef produced by a California meat packer, some of it nearly two years ago, is being recalled for fear of potentially deadly E. coli bacterium tainting, U.S. officials said on Monday.
California, and shipped mainly to California outlets, the U.S. Department of Agriculture’s food safety arm said.
An initial problem, in ground beef shipped by the plant from Jan. 5 to Jan. 15, was discovered during a regular safety check, the Food Safety and Inspection Service said.
For doctors in Haiti, worst is yet to come
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An earthquake killing up to 200,000 people would have been bad enough anywhere, but in Haiti, where AIDS, tuberculosis and malaria are rampant, children are malnourished and hygiene is already a challenge, it may create one of the worst medical disasters ever.
Medical teams pouring in to set up mobile hospitals say they are already overwhelmed by the casualties and fear the worst is yet to come as infection and disease take hold.
“The number one risk is always bacterial infections where they have open wounds,” said Josh Ruxin, a Columbia University public health expert living and working in Rwanda.
Democrats see progress in W. House healthcare talks
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With President Barack Obama urging them on, congressional Democratic leaders met for eight hours at the White House on Wednesday and reported significant progress on finding a final healthcare compromise.
In their first face-to-face talks on merging health bills in the Senate and House of Representatives, Democratic leaders worked through differences on how to pay for the overhaul, how to structure new insurance exchanges and a host of other issues.
In a joint statement afterward, House Speaker Nancy Pelosi, Senate Democratic leader Harry Reid and Obama said they were “encouraged and energized” by the discussions.
US parents on trial in 4-year-old’s overdose death
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The parents of a 4-year-old girl with psychiatric problems who died after overdosing on powerful drugs are about to face first-degree murder charges in a Boston area courtroom.
Prosecutors in the Brockton Superior Court charge that Michael and Carolyn Riley of Hull, Massachusetts, deliberately overmedicated their daughter to keep her quiet. The parents have said they are innocent and attribute her 2006 death to pneumonia.
The two will be tried separately. A 16-person jury was selected for Carolyn Riley’s trial on Wednesday and opening arguments are expected in that trial next week.
Sepsis campaign improving treatment of major killer
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A reduction in hospital mortality from severe sepsis and septic shock was associated with participation in the Surviving Sepsis Campaign performance improvement initiative, according to an article published simultaneously in the February issues of Critical Care Medicine and Intensive Care Medicine and posted ahead of print at http://www.ccmjournal.com.
“A multifaceted performance improvement initiative was successful in changing treatment behavior as evidenced by a significant increase in compliance with sepsis performance measures,” says lead author Mitchell M. Levy, M.D. “These results should encourage similar efforts with other evidence-based guidelines as a means of improving patient care and outcomes.”
“Application of two time-related bundles of care based on the Surviving Sepsis Campaign guidelines in a performance improvement program results in measurable behavior change in the care of patients with severe sepsis and septic shock,” adds Dr. Levy, a professor of medicine at Brown University School of Medicine in Providence, R.I. A “bundle” is a group of therapeutic actions, which applied together and measured for compliance, improve outcomes as compared to being applied individually.
