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HEALTH MATTERS: Your health questions answered

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Q. My mother lives independently and is otherwise healthy, but recently she developed a fever, chills, and a cough, and was diagnosed with pneumonia. What is the best treatment for this?

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A. Pneumonia is an infection of the lungs that usually is caused by a bacterium, most commonly a bug called Streptococcus pneumoniae. It typically results in changes that can be seen on an X-ray of the chest, and usually responds to antibiotics. Although many cases can be successfully treated with oral antibiotics while the patient remains at home, serious cases require hospitalization and even intensive-care-unit management. Your mother became ill from so-called community-acquired pneumonia. Only a small number of those patients become very sick and die. Thus, sicker patients receive intravenous antibiotics and other specialized care in a hospital setting. Patients with other diseases such as heart failure, cancer, or existing lung disease from smoking or other causes are at particular risk if they develop pneumonia, and special antibiotics and management are required. One of the most feared complications of pneumonia is spread of the bacteria throughout the body with resulting multiple-organ failure and low blood pressure, a condition called sepsis; the risk of this devastating problem is reduced by prompt treatment of bacterial pneumonia with an antibiotic, especially in people who are really sick. And during the flu season, testing for influenza often is indicated, because a different type of medication is needed to treat the influenza virus.

Q. I’ve read about the obesity epidemic in children in the United States, and wondered what we know about its causes and treatment.

A. You are quite right that the number of overweight and obese children in the United States has skyrocketed in the last few decades, having increased nearly fourfold since the 1960s. For eighth-grade children, for example, about 1 in 5 is obese. As in adults, obesity in children is primarily caused by a high-calorie diet and not getting enough physical activity. For example, on a typical day, almost 80 percent of youth consume sugary drinks—the leading contributor of excess calories in children’s diets. And only about 18 percent of high school youth get the daily recommended level of physical activity. Other contributors include low rates of breastfeeding, parental obesity, lower socioeconomic level, and unhealthful food advertising targeted at children. There is also evidence that obese younger children are more likely to remain obese in adolescence and adulthood. As stated in a recent study, “Few children are born obese; rather, obesity develops over time, as children progress from infancy to childhood and adolescence.” Between the ages of 5 and 14 years old, for example, children who were overweight at the age of 5 years were four times as likely to be obese at the age of 14 as those who were of normal weight at the age of 5. This study suggests that one of the more important ways to reduce obesity is to focus on preventing unhealthful weight gain in early childhood. Faculty members at your UND School of Medicine and Health Sciences have been studying ways to reduce childhood obesity and have partnered with several schools and communities across North Dakota to provide more healthful environments for young children. Further information can be found at: http://www.med.und.edu/depts/chppr/.

Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.

Submit a question to Health Matters at healthmatters@med.und.edu or Health Matters, 501 North Columbia Road, Stop 9037, Grand Forks, ND 58202-9037. Remember, no personal details, please.

The content of this column is for informational purposes only and does not substitute for professional medical advice or care. The information provided herein should not be used for diagnosing or treating a health problem or disease. If you have or suspect you may have a health problem, you should consult your health care provider. Never disregard professional medical advice or delay in seeking it because of something you have read in this column.

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