Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 physicians trained in internal medicine.
Weight Fluctuations May Increase Risk for Gallstones and Gallbladder Surgery
Data from a large, ongoing study found that weight fluctuation, or cycling, was common among middle-aged women and increased the risk for gallbladder surgery (Article, p. 471). While it is known that severely obese people who rapidly lose weight often develop gallstones, in this study, weight loss and gain cycles of 10 to 19 pounds increased women's risk of gallbladder surgery by 31 percent and one or more weight cycles of more than 20 pounds increased risk by 68 percent.
A cost-utility study of published data on three methods of diagnosing obstructive sleep apnea found that overnight study in a sleep laboratory (polysomnography) was cost effective (Article, p. 496). The analysis measured quality of life, survival and costs for three diagnostic strategies: polysomnography, a sleep study done at home, and no testing. An editorial says the study is small and "tentative" but, given the large number of people who may suffer from sleep apnea and consequences such as daytime sleepiness and risk for car accidents, there is "urgent need" for more studies to evaluate different diagnostic strategies for the disease (Editorial, p. 533).
A randomized, double-blind, placebo-controlled trial found that etanercept - a human tumor necrosis factor receptor - gave fast, and long-lasting relief to patients with active rheumatoid arthritis who had not responded to standard anti-arthritis drugs (Article, p. 478).