Obesity among patients with HIV: the latest epidemic.

Since the advent of highly active antiretroviral therapy (HAART), studies have been conflicting regarding weight information among patients with HIV. We performed a retrospective study among male patients with HIV between June 2004 and June 2005 at two large U.S. Navy HIV clinics to describe the prevalence and factors associated with being overweight/obese. Rates of obesity/overweight among HIV-positive patients were also compared to data from HIV-negative military personnel. Of the 661 HIV-infected patients, 419 (63%) were overweight/obese and only 5 (1%) were underweight. Patients with HIV had a mean age of 41.0 years (range, 20-73 years) and were racially diverse. The prevalence rates of being overweight/obese at the last visit were similar among both HIV-positive and -negative military members. Being overweight/obese at the last clinic visit was associated with gaining weight during the course of HIV infection (10.4 versus 4.0 pounds, p < 0.001), hypertension (36% versus 23%, p = 0.001), low high-density lipoprotein (HDL; 40% versus 31%, p < 0.001), and a higher CD4 cell count at last visit (592 versus 499 cells/mm(3), p < 0.001). These data demonstrate that patients with HIV in the HAART era are commonly overweight and/or obese with rates similar to the general population. Being overweight/obese is associated with hypertension and dyslipidemia. Weight assessment and management programs should be a part of routine HIV clinical care.

To investigate the influence of acute vestibular impairment following mild traumatic brain injury on subsequent ability to remain on activity duty 12 months later.

The objective of this study was to investigate the relationship between acute vestibular dysfunction as measured by the Dizziness Handicap Inventory and the Dynamic Visual Acuity Test and the ability to remain on active duty status in the U.S. military 1 year after mild traumatic brain injury. This longitudinal prospective study was conducted by the Defense and Veterans Brain Injury Clinic at Marine Corp Base, Camp Pendleton, California. Participants (n = 47, controls = 44) were referrals to the clinic who had sustained a mild traumatic brain injury and were initially seen within 6 days of injury, then weekly for 1 month, and for follow-up 12 months later. The results demonstrated that those on active duty at 12 months were older in age, had more years of service, and had no history of psychiatric illness or apparent secondary gain issues. Acute vestibular dysfunction and demographic and injury variables were not significantly correlated or predictive of work status at 12 months.