Obesity Is Associated With Acute Mountain Sickness
Obese men developed symptoms of acute mountain sickness (AMS) more often and had lower blood oxygen levels at night than normal-weight men in a study that simulated a rapid ascent to an altitude of 12,000 feet (Article, p. 253). Nine obese men and 10 non-obese men spent 24 hours in a hypobaric chamber. Obese men had worse symptoms of AMS and much lower blood oxygen levels during sleep at simulated high altitude. Obese people traveling to high altitudes should follow standard guidelines to ensure a slow, gradual ascent and should consider using a drug that eases breathing at high altitudes and facilitates acclimatization, the researchers say.
Marijuana Not Unsafe for People With HIV
Smoking a marijuana cigarette or taking a synthetic form of marijuana in capsule form did not affect key indicators of HIV treatment compared with placebo, a new study found (Article, p. 258). Sixty-two people with HIV who were receiving antiretroviral treatment were randomized into three groups. For 21 days, three times daily in an observed inpatient setting, one group smoked a marijuana cigarette; a second took three capsules containing dronabinol, a synthetic form of marijuana's main psychoactive component, and the third took three placebo capsules. Neither the smoked nor oral marijuana affected the patients' RNA levels, CD4 and CD8 cell counts or protease inhibitor levels. The authors say, "The discussion of medicinal marijuana … is confounded by emotion and politics, usually unsupported by data. Our short-duration clinical trial suggests acceptable safety in a vulnerable immune-compromised population."
United States Should Adopt a No-Fault Medical Malpractice System
A no-fault medical malpractice system, in which an injured patient shows only that a disability was caused by medical management, would encourage prevention of medical errors, provide fair compensation relative to severity of injury, would be less costly to administer than the current tort system, and provide an environment in which physicians who participate in patient safety and compensation initiatives do not risk "financial and professional ruin" (Improving Patient Care, p. 267).
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Journal
Annals of Internal Medicine