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Weight loss surgery reduces respiratory drug prescriptions

Sikka N, Wegienka G, Havstad S, Genaw J, Carlin AM, Zoratti E.. Respiratory medication prescriptions before and after bariatric surgery. Ann Allergy Asthma Immunol. 2010;104(4):326-330.

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Bariatric surgery produces dramatic weight loss results in a relatively short period of time. In addition to reducing the patient's risk for diabetes, cancer, and cardiovascular diseases, weight loss surgery also significantly reduces the patient's need for respiratory medication.


Obesity causes respiratory problems because the extra weight puts pressure on the airways and reduces lung volume. A recent retrospective analysis, published in the April 2010 issue of Annals of Allergy, Asthma & Immunology, showed that bariatric surgery patients filled 49% less respiratory medication prescriptions in the year following their procedures, than in the year prior. In fact, many of the patients who were on respiratory medications before the surgery were able to cease taking them completely in the year following the surgery.


The rapid weight loss associated with the surgery seems to be responsible for the reduction in need of respiratory medications, although researchers noted that the study did not include any objective lung function tests. They could not determine whether the respiratory improvement was a result of changes in cardiopulmonary physiology directly attributed to the rapid weight loss, or whether an improvement in preexisting asthma may have been a factor.


How long these benefits will last, however, remains to be seen.



One fast food meal equals an entire day's worth of sodium

Johnson CM, Angell SY, Lederer A, et al. Sodium content of lunchtime fast food purchases at major US chains. Arch Intern Med. 2010;170(8):732-734.

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A typical lunchtime meal from most major U.S. fast-food chains provide an entire day's allowance of sodium for most adults, according to new medical research. This research measured sodium content in entrees from nearly 170 locations of 11 different popular American fast-food chains. The April 26, 2010 issue of Archives of Internal Medicine contains the full report.


The researchers obtained fast-food customers' receipts from their fast-food lunch purchases by offering them $2 transit cards in exchange. They only included the receipts collected from people over age 18, which listed at least one entree item. Drinks, desserts, and side orders were excluded from the study. They then obtained the nutritional information about the meals from each chain and analyzed the sodium content of each meal.


According to the CDC, 69% of all adults are recommended to not consume any more than 1,500 mg of sodium daily. Approximately 57% of these lunchtime meals exceeded this limit, sometimes quite significantly.


The highest mean sodium content came from fried chicken chains, whereas pizza and hamburger chains contained lower amounts.


Excessive sodium intake is related to hypertension and cardiovascular disease. Most people get their salty food from restaurants and packaged foods. The findings of this study definitely call for fast-food restaurant chains to reduce the sodium levels in all of their menu items.


Multiple unhealthy lifestyle choices accelerate mortality

Kvaavik E, Batty GD, Ursin G, Huxley R, Gale CR.. Influence of individual and combined health behaviors on total and cause-specific mortality in men and women: The United Kingdom health and lifestyle survey. Arch Intern Med. 2010;170(8):711-718.


The four worst lifestyle choices a person can make are smoking, inactivity, poor diet, and excessive drinking. In fact, having any one of these vices raises a person's all-cause mortality risk to 85%. However, adding any or all of these other behaviors increases that already high risk severely. Engaging in all four of these behaviors could actually take away 12 years of a person's life, according to an investigation published in the April 26, 2010 issue of Archives of Internal Medicine.


It is not surprising because any of these behaviors alone can shorten a person's life span. However, having multiple risky bad habits sharply boosts a person's overall death risk from cardiovascular, cancer, and other causes. As previously stated, one risky behavior increases all-cause death risk by 85%. However:


* Two bad choices creates a 2.23 times higher risk


* Three bad choices equals a 2.76 times higher risk


* Four bad choices increases the risk 3.49 times



However, the researchers noted that even modestly improving lifestyle behaviors will have a positive effect both on the individual level, as well as for the entire population. However, this study could not measure the effect of cancer or other diseases that have a long latency period because there was only a 4-year follow-up time frame.



HSV-2 rates stable, yet underdiagnosed

Centers for Disease Control and Prevention. Seroprevalence of herpes simplex virus 2 among persons aged 14-49 years-United States, 2005-2008. MMWR Morb Mortal Wkly Rep. 2010;59(15):456-459.

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The CDC has published news about the present state of herpes simplex 2 (HSV-2) in the United States in the April 23, 2010 issue of Morbidity and Mortality Weekly Report. Based on information gathered from the National Health and Nutrition Examination Study (NHANES), the prevalence of HSV-2 has been roughly stable from 1999 to 2008. However, as many as four of five people may be infected and not know it.


Of the sera collected from the 2005 to 2008 NHANES study (7,293 participants ages 14 through 49), it was found that:


* Overall, the seroprevalence of HSV-2 was 16.2%, whereas the seroprevalence from the 1999 to 2004 NHANES was 17%.


* A staggering 81.1% of those infected with HSV-2 had never been diagnosed with the disease.


* Seroprevalence increased significantly with age.


* Women were significantly more likely to be infected than men, at 20.9% versus 11.5%.


* There were racial and ethnic differences in seroprevalence.


* Seroprevalence increased with the amount of lifetime partners.



Due to these findings, the CDC is recommending that HSV-2-infected individuals avoid sexual contact with uninfected partners when lesions or symptoms are present to avoid transmission. HSV-2 patients are also at increased risk for contracting HIV. Because it has been shown in previous studies that daily antiviral therapy to suppress HSV-2 does not reduce the patient's risk of becoming infected with HIV, primary prevention of HSV-2 is essential in reducing the increased risk of HIV infection.


Because so many infected people are unaware of their condition, the CDC also encourages healthcare providers to always consider HSV-2 infection when treating genital complaints.



Chronic pain sufferers process acute pain differently

Baliki MN, Geha PY, Fields HL, Apkarian AV. Predicting value of pain and analgesia: nucleus accumbens response to noxious stimuli changes in the presence of chronic pain. Neuron. 2010;66(1):149-160.

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Chronic pain sufferers seem to experience other types of pain differently than healthy individuals, according to a recent brain imaging study published in the April 15, 2010 issue of Neuron.


For this investigation, researchers took functional magnetic resonance imaging (MRI) brain images while administering a series of nine painful, thermal stimuli to 16 healthy adults and 16 patients who suffered from physician-diagnosed chronic back pain. In addition, eight other chronic back pain sufferers rated their chronic pain versus the pain from the stimuli, but did not undergo functional MRI.


The overall brain activity between the two groups was similar when the heat was applied, and both groups expressed similar feelings of pain. What was different, however, was the nucleus accumbens activity in these groups. The healthy group showed higher nucleus accumbens activity when the thermal pain was coming to an end, meaning that the removal of the painful sensation was registering as a reward. The chronic back pain group, however, had the opposite effect. The phasic activity in the nucleus accumbens at the end of the painful stimulus was unique. Instead of registering the sensation as a reward, it appeared to reflect a predicted punishment. The acute pain thermal stimulus reduced the existing chronic pain, and when it was over, the brain predicted the return of the chronic pain.


These results concur with previous studies that found that the brains of chronic pain patients have abnormal chemistries, regional gray matter atrophy, cognitive changes, and unique patterns of brain activity.