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In This Issue of Archives of Internal Medicine
Sep 24, 2012

In This Issue of Archives of Internal Medicine

Arch Intern Med. 2012;172(17):1281. doi:10.1001/archinternmed.2011.982

Physical activity is considered a cornerstone of diabetes management to prevent complications, but conclusive evidence is lacking. In this prospective study of 5859 individuals with diabetes, persons undertaking moderate amounts of activity were already at appreciably lower risk of early death compared with physically inactive persons. In a meta-analysis summarizing evidence from prospective studies, higher levels of total physical activity, leisure-time physical activity, and walking were associated with a lower risk of cardiovascular disease and total mortality.

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Using data from 18 670 healthy participants in the Cooper Center Longitudinal Study linked with Medicare claims data, this study examined the association between midlife cardiorespiratory fitness and the burden of 8 common chronic conditions among patients older than 65 years. After a median follow-up of 26 years, higher midlife fitness was associated with a lower risk of chronic conditions in later life. The authors also observed that higher midlife fitness was associated with the compression of morbidity at the end of life.

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This study, involving 1957 treatment-naive human immunodeficiency virus (HIV)-infected individuals who started combination antiretroviral therapy (cART) between 2005 and 2009 in the Swiss HIV Cohort Study, illustrates a trend toward individualized cART and large differences in the prescription of cART among study sites. This suggests that the choice of the initial regimen is driven by clinical and demographic patient characteristics as well as physicians' preferences. This study highlights the need for evidence-based data for determining the best initial regimen for different HIV-infected persons.

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In a nested cohort study of hospitalized older adults with Alzheimer disease, Gross et al examined the association of incident delirium with the long-term rate of cognitive deterioration. Delirium developed in 56% of the sample of hospitalized patients. The development of delirium during hospitalization was associated with a significant 2.2-fold increased rate of cognitive deterioration during the year following the index hospitalization and a 1.7-fold increased rate over the 5-year period following hospitalization. This association was independent of dementia severity, demographic characteristics, and level and rate of cognitive deterioration prior to hospitalization and persisted throughout the 5-year duration of follow-up.

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Grøntved et al examined the association of weight training with the risk of type 2 diabetes mellitus (T2DM) among 32 002 men from the Health Professionals Follow-up Study. During 508 332 person-years of follow-up (18 years), 2278 new cases of T2DM were documented. A graded inverse association of weight training with the risk of T2DM was observed. This association was independent of various confounding factors including participation in aerobic exercise. Combined weight training and aerobic exercise conferred a greater benefit.

Dose-response relationship between weight training and risk of T2DM.

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