Research in brief

Abstract

In a prospective study, 49 patients with an average age of 61 years who had acromegaly controlled by surgery, radiotherapy, or medical treatment for about 17 years, and who did not use bisphosphonates, were assessed for vertebral fractures over a follow-up of 2·5 years. At baseline, the prevalence of vertebral fractures was 63%, and at the end of the study, 20% of patients had progressive vertebral fractures. The progression rate was highest in men and in those with two or more fractures at baseline, but was independent of bone mineral density. These results suggest that abnormal bone quality persists in patients with acromegaly even if this condition is controlled with treatment. Female gender and young age at onset of type 1 diabetes are associated with increased risk of mortality from ischaemic heart disease, suggest new data. In 17 306 Finnish patients with early-onset (0–14 years) or late-onset (15–29 years) type 1 diabetes, 478 deaths from heart disease were reported over 433 782 person-years. The average crude mortality was lower in women than in men, but the overall standardised mortality ratio was higher in women (21·6) than in men (5·8). In the early-onset cohort, this ratio was even higher in women (52·8) than in men (12·1), and women younger than 40 years had the highest relative risk of death from heart disease. Heavy metals such as lead, mercury, and cadmium can act additively to increase the prevalence of metabolic disease, according to the Korea National Health and Nutrition Examination Survey, with data collected in 2009–10 from 1961 men and 1989 women aged 20 years or older. Specifically, the blood concentration of lead was associated with hypertension and elevated levels of triglycerides. The cumulative effect of a mixture of heavy metals was higher than that of each individual metal. Dextrose gel has now been shown to be safe and more effective than feeding alone in treating neonatal hypoglycaemia. 237 hypoglycaemic babies born at 35 weeks of gestation or older and aged 48 h or younger were randomly allocated to receive 40% dextrose gel 200 mg/kg (118 babies) or placebo gel (119 babies) in a double-blind study. Babies who remained hypoglycaemic 30 min after the initial dose were treated with up to six doses over 48 h. In babies receiving dextrose gel, there were fewer cases of treatment failure (a blood glucose concentration of less than 2·6 mmol/L 30 min after two doses), admittance to a neonatal intensive care unit for hypoglycaemia, and recurrent hypoglycaemia than in those treated with placebo gel. Patients with obesity who undergo bariatric surgery continue to use prescription opioid medications after surgery, a new study reports. In a retrospective analysis of data from 11 719 obese individuals aged 21 years and older who had surgery between 2005 and 2009, 77% of patients who were chronic opioid users before surgery increased their use of opioids in the year after surgery. The amount of weight lost after surgery—and the presence of preoperative depression and chronic pain—did not affect the postoperative use of chronic opioids, which highlights the importance of pain management in obese patients, especially after surgery. Over the long term, about half of patients that undergo bariatric surgery regain some of the weight that they lose during the 2 years after surgery. A new study now shows that removal of excess skin with plastic surgery (body contouring) could help patients maintain weight loss for a longer time after surgery. Weight changes of 98 patients who had both bariatric and plastic surgery were compared with those in 102 matched controls who had bariatric surgery alone. During the first 2 years after surgery, patients in both groups achieved a mean weight loss of 45·2 kg. After 7 years, patients who had plastic surgery had 3·6% (6·2 kg) mean weight regain, whereas those who had bariatric surgery alone had 10·8% (22·9 kg) weight regain. Body contouring could help improve long-term weight control in patients with morbid obesity after bariatric surgery.