Acute Weight Loss Research Articles

The effects of oral glutamine on clinical and survival outcomes of non-small cell lung cancer patients treated with chemoradiotherapy

To assess the efficacy of oral glutamine (Gln) supplementation on clinical and survival outcomes of patients with locally advanced non-small cell lung cancer (LA-NSCLC). Between 2010 and 2014, 122 stage III NSCLC patients were retrospectively analyzed. All patients received curative intent chemoradiotherapy (CRT). Prophylactic oral Gln powder was applied at a dose of 10g tid. Effect of oral Gln supplementation in the prevention of severe (≥grade 2-3) acute radiation-induced esophagitis (ARE) and weight loss, and their relation with overall survival (OS) and disease-free survival (DFS) was measured. Median follow-up was 13.14 months (range; 1.97-55.36). Fifty-six (46%) patients had received oral Gln. Severe ARE was significantly lower in Gln-supplemented group (30% vs 70%; p=0.002). Gln-free patients demonstrated a higher weight loss (p=0.0001). In multivariate analysis hemoglobin (hb) level (<12g/dL; p=0.01) and nodal stage (N3; p=0.01) were poor prognostic factors that affect OS; Weight loss (p=0.06) and Gln-free (p=0.05) reached nearly significant levels that poorly affect OS. Similarly, nodal stage (N3, p=0.014) and Gln-free (p=0.035) were poor prognostic factors that affect DFS. Weight loss (≥2%, p=0.06) and hb level (<12g/dL, p=0.07) reached borderline significance that poorly affect DFS. Nodal stage (N3) was the only poor prognostic factor that affect OS and DFS in univariate analysis (p=0.01, p=0.009; respectively). Oral Gln supplementation significantly reduces grade 2-3 esophagitis and weight loss and also no negative impact on tumor control and survival outcomes in patients with LA-NSCLC.

Morphology of the pancreas in type 2 diabetes: effect of weight loss with or without normalisation of insulin secretory capacity.

Aims/hypothesisThis study was designed to establish whether the low volume and irregular border of the pancreas in type 2 diabetes would be normalised after reversal of diabetes.MethodsA total of 29 individuals with type 2 diabetes undertook a very low energy (very low calorie) diet for 8 weeks followed by weight maintenance for 6 months. Methods were established to quantify the pancreas volume and degree of irregularity of the pancreas border. Three-dimensional volume-rendering and fractal dimension (FD) analysis of the MRI-acquired images were employed, as was three-point Dixon imaging to quantify the fat content.ResultsThere was no change in pancreas volume 6 months after reversal of diabetes compared with baseline (52.0 ± 4.9 cm3 and 51.4 ± 4.5 cm3, respectively; p = 0.69), nor was any volumetric change observed in the non-responders. There was an inverse relationship between the volume and fat content of the pancreas in the total study population (r =−0.50, p = 0.006). Reversal of diabetes was associated with an increase in irregularity of the pancreas borders between baseline and 8 weeks (FD 1.143 ± 0.013 and 1.169 ± 0.006, respectively; p = 0.05), followed by a decrease at 6 months (1.130 ± 0.012, p = 0.006). On the other hand, no changes in FD were seen in the non-reversed group.Conclusions/interpretationRestoration of normal insulin secretion did not increase the subnormal pancreas volume over 6 months in the study population. A significant change in irregularity of the pancreas borders occurred after acute weight loss only after reversal of diabetes. Pancreas morphology in type 2 diabetes may be prognostically important, and its relationship to change in beta cell function requires further study.Electronic supplementary materialThe online version of this article (doi:10.1007/s00125-016-3984-6) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

Preliminary Results of Gastric Restriction with phytobezoar in Rats

Obesity is considered a worldwide epidemic today. It is related to metabolic disorders and increased mortality. As an alternative to unsuccessful medical treatment, bariatric surgery promotes weight loss and reduction of associated diseases.The present study used animal models to analyze intestinal disorders as resulted from acute weight loss. We used Adult, male Wistar rats (Rattus norvegicus albicans) weighing between 250–350 grams. In order to reduce the gastric capacity and cause significant weight loss, without causing anemia, it was chosen to perform a surgical procedure. The rats Were submitted to laparotomy and gastrostomy to reduce gastric capacity by insertion of a cylindrical sleeve Luffa (loofah) (1.5cm in diameter) made of cylindrical luffa, producing experimental phytobezoar.The animals of Sham group (S) were exposed to the same surgical procedure described above, except for the implant of phytobezoar. From the first day after surgery, the animals were divided into six groups of 10 animals each, the first group of 10 days until euthanasia was subjected to the stomach reduction surgery (R10), the second group of 21 days until euthanasia under the same conditions above (R21), both with their respective controls sham (S10/S21) and normal controls (C10/C21) 10 and 21 days. Each animal was weighed every other day until the day of euthanasia. Sections of small intestine slides were stained with hematoxylin eosin and analyzed in order to measure length of the crypts and the number of goblet cells were recorded.Statistical analysis used Student t test and to compare weight, goblet cells and crypts length in the experimental, sham and control groups. The analysis of goblet cell count on C10 group indicated a statistically significant higher number compared to the R10. However, the length of C10 is significantly lower than the R10 group. The reduction verified on the Restriction group (R10) suggests that phytobezoar's presence causes a reduction in crypts height which clinically translates in to reduction of absorption and secretive capacity of the enteric mucosa.

A new comorbidities index for risk stratification for treatment of unruptured cerebral aneurysms.

OBJECTIVE Comorbidities have an impact on risk stratification for outcomes in analyses of large patient databases. Although the Charlson Comorbidity Index (CCI) and the Elixhauser Comorbidity Index (ECI) are the most commonly used comorbidity indexes, these have not been validated for patients with unruptured cerebral aneurysms; therefore, the authors created a comorbidity index specific to these patients. METHODS The authors extracted all records involving unruptured cerebral aneurysms treated with clipping, coiling, or both from the Nationwide Inpatient Sample (2002-2010). They assessed the effect of 37 variables on poor outcome and used the results to create a risk score for these patients. The authors used a validation data set and bootstrapping to evaluate the new index and compared it to CCI and ECI in prediction of poor outcome, mortality, length of stay, and hospital charges. RESULTS The index assigns integer values (-2 to 7) to 20 comorbidities: neurological disorder, renal insufficiency, gastrointestinal bleeding, paralysis, acute myocardial infarction, electrolyte disorder, weight loss, metastatic cancer, drug abuse, arrhythmia, coagulopathy, cerebrovascular accident, psychosis, alcoholism, perivascular disease, valvular disease, tobacco use, hypothyroidism, depression, and hypercholesterolemia. Values are summed to determine a patient's risk score. The new index was better at predicting poor outcome than CCI or ECI (area under the receiver operating characteristic curve [AUC] 0.814 [95% CI 0.798-0.830], vs 0.694 and 0.712, respectively, for the other indices), and it was also better at predicting mortality (AUC 0.775 [95% CI 0.754-0.792], vs 0.635 and 0.657, respectively, for CCI and ECI). CONCLUSIONS This new comorbidity index outperforms the CCI and ECI in predicting poor outcome, mortality, length of stay, and total charges for patients with unruptured cerebral aneurysm. Reevaluation of other patient cohorts is warranted to determine the impact of more accurate patient stratification.

The Duplicated Pancreas: Imaging Evaluation of a Rare Anomaly Presenting as Acute Pancreatitis

There are multiple variants of normal anatomy involving multiple organ systems, many of which are well documented throughout the medical community. Specifically, the pancreas can demonstrate a wide range of variants that include divisum, ectopic tissue, annular pancreas, ductal variation, and pancreatic rests. However, upon literature review, a complete duplication of the pancreas resulting in two separate pancreases is rarely documented. This case provides an interesting diagnosis of two individual pancreases in a patient whom initially presented clinically with recurrent bouts of acute pancreatitis and weight loss status post prior cholecystectomy. Dedicated CT, MRI, MRCP, and endoscopic ultrasound were able to delineate pertinent anatomy and acute findings. The resultant patient course is difficult to predict secondary to limited documentation of duplicated pancreases in the medical literature. Additionally, the case helps provide insight into complications that may arise from this embryologic anomaly, the best imaging techniques for evaluation, and future management of this patient.

Dynamics of Th17 associating cytokines in Cryptosporidium parvum-infected mice.

Cryptosporidium parvum commonly inhabits the intestinal tract of animals and humans and can cause acute watery diarrhea and weight loss. However, host immune responses to Cryptosporidium infections are not fully understood. IL-17 (also called IL-17A) is a pro-inflammatory cytokine of Th17 cells that plays a role in the host response to Cryptosporidium baileyi infection. The present study examined levels of IL-17-specific messenger RNA (mRNA) and Th17 associating cytokines in C. parvum-infected immune-suppressed BALB/c mice using real-time quantitative PCR (qPCR). Levels of IL-17 protein were determined by ELISA. The results showed that levels of IL-17 mRNA and Th17 cell-related cytokines, namely TGF-β, IL-6, STAT-3, RORγt, IL-22, TNF-α, and IL-23, were significantly increased (P < 0.05) in gut-associated lymphoid tissue (GALT) and spleen. IL-17 protein levels in GALT were also significantly increased (P < 0.05) after infection. The present study suggested that Th17 cells play a role in host-C. parvum interaction. These results could inform future studies of the immune response against C. parvum infection in transient immunosuppressed populations.

Vitamin D toxicity resulting from overzealous correction of vitamin D deficiency.

Vitamin D toxicity, often considered rare, can be life-threatening and associated with substantial morbidity, if not identified promptly. To describe clinical and biochemical features, risk factors and management of patients with vitamin D toxicity seen between January 2011 and January 2013. Patients presenting with vitamin D toxicity, between January 2011 and January 2013, at single tertiary care centre in Delhi-NCR, India, were included. Evaluation included detailed clinical history and biochemical tests including serum calcium, phosphorus, creatinine, intact parathyroid hormone and 25-hydroxyvitamin D (25(OH)D). Sixteen patients with vitamin D toxicity could be identified. Clinical manifestations included nausea, vomiting, altered sensorium, constipation, pancreatitis, acute kidney injury and weight loss. Median (range) age was 64·5 (42-86) years. Median (range) serum 25(OH)D level and median (range) serum total serum calcium level were 371 (175-1161) ng/ml and 13·0 (11·1-15·7) mg/dl, respectively. Overdose of vitamin D caused by prescription of mega-doses of vitamin D was the cause of vitamin D toxicity in all cases. Median (range) cumulative vitamin D dose was 3,600,000 (2,220,000-6,360,000) IU. Our data demonstrate an emergence of vitamin D toxicity as an increasingly common cause of symptomatic hypercalcaemia. Irrational use of vitamin D in mega-doses resulted in vitamin D toxicity in all cases. Awareness among healthcare providers regarding the toxic potential of high doses of vitamin D and cautious use of vitamin D supplements is the key to prevent this condition.

Systemic inflammation in early neonatal mice induces transient and lasting neurodegenerative effects.

BackgroundThe inflammatory mediator lipopolysaccharide (LPS) has been shown to induce acute gliosis in neonatal mice. However, the progressive effects on the murine neurodevelopmental program over the week that follows systemic inflammation are not known. Thus, we investigated the effects of repeated LPS administration in the first postnatal week in mice, a condition mimicking sepsis in late preterm infants, on the developing central nervous system (CNS).MethodsSystemic inflammation was induced by daily intraperitoneal administration (i.p.) of LPS (6 mg/kg) in newborn mice from postnatal day (PND) 4 to PND6. The effects on neurodevelopment were examined by staining the white matter and neurons with Luxol Fast Blue and Cresyl Violet, respectively. The inflammatory response was assessed by quantifying the expression/activity of matrix metalloproteinases (MMP), toll-like receptor (TLR)-4, high mobility group box (HMGB)-1, and autotaxin (ATX). In addition, B6 CX3CR1gfp/+ mice combined with cryo-immunofluorescence were used to determine the acute, delayed, and lasting effects on myelination, microglia, and astrocytes.ResultsLPS administration led to acute body and brain weight loss as well as overt structural changes in the brain such as cerebellar hypoplasia, neuronal loss/shrinkage, and delayed myelination. The impaired myelination was associated with alterations in the proliferation and differentiation of NG2 progenitor cells early after LPS administration, rather than with excessive phagocytosis by CNS myeloid cells. In addition to disruptions in brain architecture, a robust inflammatory response to LPS was observed. Quantification of inflammatory biomarkers revealed decreased expression of ATX with concurrent increases in HMGB1, TLR-4, and MMP-9 expression levels. Acute astrogliosis (GFAP+ cells) in the brain parenchyma and at the microvasculature interface together with parenchymal microgliosis (CX3CR1+ cells) were also observed. These changes preceded the migration/proliferation of CX3CR1+ cells around the vessels at later time points and the subsequent loss of GFAP+ astrocytes.ConclusionCollectively, our study has uncovered a complex innate inflammatory reaction and associated structural changes in the brains of neonatal mice challenged peripherally with LPS. These findings may explain some of the neurobehavioral abnormalities that develop following neonatal sepsis.

Abstract T P223: Post-stroke Body Weight Loss Predicts Acute Stroke Outcome In Mice

Background and Purpose: Longitudinal imaging studies in stroke demonstrated that infarct development is a dynamic process and it matures over several days, even weeks depending on the severity of stroke. However, due to high cost and multiple exposure of anesthesia associated with repeated imaging, infarct volume has been typically measured at a fixed time point in preclinical studies, which prevent further assessment of behaviors during stroke recovery. In identifying a non-invasive physiological parameter that predicts the extent of stroke-induced brain injury, the study investigated whether acute body weight loss predicts the extent of brain injury and swelling. Methods: C57 male mice (10-12 wk old, 25-30 gr) were subjected to the proximal middle cerebral artery (MCA) occlusion for 30 min. Body weight was recorded daily. Infarct volume corrected with swelling (IVInd) and percent hemispheric swelling (%SW) were determined at 1, 3 and 7d after MCAO. In a retrospective study, we analyzed correlations between 3d %body weight reduction (%BWred) and stroke outcomes (IVInd &amp; %SW) in C57 male animals that were subjected to MCAO by 3 different individuals over 8 years (n=91-96). Results: Stroke induced acute BW loss (%BWred; 1d, 88.9±3.3; 3d, 84.5±8.6; 5d, 86.8±10.6; 7d, 88.9±8.9). Correlation analyses in the post-ischemic time points showed IVind and %SW were significantly correlated with only at 3d BW reduction, but not 1d and 7d (Fig.1). A retrospective analysis in C57 mice also showed a significant correlation between 3d %BWred and IVInd &amp; %SW (Fig.2). Conclusions: The study showed that acute post-stroke BWred is a simple and suitable index to predict the extent of stroke injury in C57 mice. Whether the prediction can be generalized across different strains and in comorbid conditions warrant further investigation.

Gastric cancer prevention and early detection program for an at-risk population: A prospective study of the Korean American community.

42 Background: Gastric cancer development is multifactorial with varying incidence rates. People of Korean heritage have the highest rate of gastric cancer in the world and among Americans. While this gastric cancer disparity is well known, an evaluation of the population-specific risk factors and the effectiveness of selective screening in the Korean American communities have not been studied. Methods: Korean Americans living in Northern New Jersey over 40 years of age without a known history of gastric cancer were eligible to participate in this prospective study. Each participant received a 30-minute one-to-one consultation with a gastric cancer surgeon, given a 44-item questionnaire, and underwent an upper endoscopy with biopsies. The consultation included assessment for the presence of relevant history, symptoms, and signs. The questionnaire addressed patient-specific demographic, epidemiologic, and cultural information. Two gastroenterologists blinded to the consultation and questionnaire results performed the upper endoscopies. Results: Between September 2013 and September 2014, one hundred participants enrolled in our study. All participants denied the presence of alarm symptoms, such as acute weight loss, melena or persistent vomiting. Risk factors, including prior H. pylori infection (25%), family history of gastric cancer (15%), cigarette smoking (16%), and daily intake of salty and pickled foods (87%) were present. On upper endoscopy, 18% of the participants were found to have “moderate to severe H. pylori associated chronic active gastritis." Other endoscopic findings were mild gastritis (61%), severe erosive gastritis (4%), polyps (4%), and metaplasia (21%). Only 4 patients had normal mucosal pathology. Gastric dysplasia or cancer has not yet been identified. Conclusions: Korean Americans have high rates of modifiable risk factors for developing gastric cancer. Novel population-specific gastric cancer prevention and early detection strategies should be designed to eliminate gastric cancer from the Korean American Community.

Superior Mesenteric Artery Syndrome Associated with Rapid Weight Loss Attributed to Amphetamine Abuse.

Superior mesenteric artery (SMA) syndrome arises from a reduction in the angle formed between the SMA and the aorta, thereby compressing the third portion of the duodenum. This phenomenon may be caused by a number of factors, one of which being acute weight loss. We report a case of a female patient presenting with abdominal pain and vomiting who developed superior mesenteric artery (SMA) syndrome as a result of rapid weight loss, thought to be secondary to amphetamine abuse. This association can often be overlooked and, to our knowledge, has not been previously reported.

Oral calorie supplements for cystic fibrosis.

Poor nutrition occurs frequently in people with cystic fibrosis (CF) and is associated with other adverse outcomes. Oral calorie supplements are used to increase total daily calorie intake and improve weight gain. However, they are expensive and there are concerns they may reduce the amount of food eaten and not improve overall energy intake. To establish whether in people with CF, oral calorie supplements: increase daily calorie intake; and improve overall nutritional intake, nutritional indices, lung function, survival and quality of life. To assess adverse effects associated with using these supplements. We searched the Cochrane CF Trials Register comprising references from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings. We contacted companies marketing oral calorie supplements.Last search: 03 July 2014. Randomised or quasi-randomised controlled trials comparing use of oral calorie supplements for at least one month to increase calorie intake with no specific intervention or additional nutritional advice in people with CF. We independently selected the included trials, assessed risk of bias and extracted data. We contacted the authors of included trials and obtained additional information for two trials. We identified 21 trials and included three, reporting results from 131 participants lasting between three months and one year. Two trials compared supplements to additional nutritional advice and one to no intervention. Two of the included trials recruited only children. In one trial the risk of bias was low across all domains, in a second trial the risk of bias was largely unclear and in the third mainly low. Blinding of participants was unclear in two of the trials. Also, in one trial the clinical condition of groups appeared to be unevenly balanced at baseline and in another trial there were concerns surrounding allocation concealment. There were no significant differences between people receiving supplements or dietary advice alone for change in weight, height, body mass index, z score or other indices of nutrition or growth. Changes in weight (kg) at three, six and twelve months respectively were: MD 0.32 (95% CI -0.09 to 0.72); MD 0.47 (95% CI -0.07 to 1.02 ); and MD 0.16 (-0.68 to 1.00). Total calorie intake was greater in people taking supplements at 12 months, MD 265.70 (95% CI 42.94 to 488.46). There were no significant differences between the groups for anthropometric measures of body composition, lung function, gastrointestinal adverse effects or activity levels. Oral calorie supplements do not confer any additional benefit in the nutritional management of moderately malnourished children with CF over and above the use of dietary advice and monitoring alone. While nutritional supplements may be used, they should not be regarded as essential. Further randomised controlled trials are needed to establish the role of short-term oral protein energy supplements in people with CF and acute weight loss and also for the long-term nutritional management of adults with CF or advanced lung disease, or both.

Clinicopathologic features and outcome of mycophenolate-induced colitis in renal transplant recipients.

Reports on the clinical course of mycophenolic acid (MPA)-related colitis in kidney transplant recipients are scarce. This study aimed at assessing MPA-related colitis incidence, risk factors, and progression after kidney transplantation. All kidney transplant patients taking MPA who had colonic biopsies for persistent chronic diarrhea, between 2000 and 2012, at the Kidney Transplantation Unit of Botucatu Medical School Hospital, Brazil, were included. Cytomegalovirus (CMV) immunohistochemistry was performed in all biopsy specimens. Data on presenting symptoms, medications, immunosuppressive drugs, colonoscopic findings, and follow-up were obtained. Of 580 kidney transplant patients on MPA, 34 underwent colonoscopy. Colonoscopic findings were associated with MPA usage in 16 patients. The most frequent histologic patterns were non-specific colitis (31.3%), inflammatory bowel disease (IBD)-like colitis (25%), normal/near normal (18.8%), graft-versus-host disease-like (18.8%), and ischemia-like colitis (12.5%). All patients had persistent acute diarrhea and weight loss. Six of the 16 MPA-related diarrhea patients (37.5%) showed acute dehydration requiring hospitalization. Diarrhea resolved when MPA was switched to sirolimus (50%), discontinued (18.75%), switched to azathioprine (12.5%), or reduced by 50% (18.75%). No graft loss occurred. Four patients died during the study period. Late-onset MPA was more frequent, and no correlation with MPA dose or formulation was found.

Treatment of binge eating disorder in racially and ethnically diverse obese patients in primary care: Randomized placebo-controlled clinical trial of self-help and medication

The objective was to determine whether treatments with demonstrated efficacy for binge eating disorder (BED) in specialist treatment centers can be delivered effectively in primary care settings to racially/ethnically diverse obese patients with BED. This study compared the effectiveness of self-help cognitive-behavioral therapy (shCBT) and an anti-obesity medication (sibutramine), alone and in combination, and it is only the second placebo-controlled trial of any medication for BED to evaluate longer-term effects after treatment discontinuation. 104 obese patients with BED (73% female, 55% non-white) were randomly assigned to one of four 16-week treatments (balanced 2-by-2 factorial design): sibutramine (N = 26), placebo (N = 27), shCBT + sibutramine (N = 26), or shCBT + placebo (N = 25). Medications were administered in double-blind fashion. Independent assessments were performed monthly throughout treatment, post-treatment, and at 6- and 12-month follow-ups (16 months after randomization). Mixed-models analyses revealed significant time and medication-by-time interaction effects for percent weight loss, with sibutramine but not placebo associated with significant change over time. Percent weight loss differed significantly between sibutramine and placebo by the third month of treatment and at post-treatment. After the medication was discontinued at post-treatment, weight re-gain occurred in sibutramine groups and percent weight loss no longer differed among the four treatments at 6- and 12-month follow-ups. For binge-eating, mixed-models revealed significant time and shCBT-by-time interaction effects: shCBT had significantly lower binge-eating frequency at 6-month follow-up but the treatments did not differ significantly at any other time point. Demographic factors did not significantly predict or moderate clinical outcomes. Our findings suggest that pure self-help CBT and sibutramine did not show long-term effectiveness relative to placebo for treating BED in racially/ethnically diverse obese patients in primary care. Overall, the treatments differed little with respect to binge-eating and associated outcomes. Sibutramine was associated with significantly greater acute weight loss than placebo and the observed weight-regain following discontinuation of medication suggests that anti-obesity medications need to be continued for weight loss maintenance. Demographic factors did not predict/moderate clinical outcomes in this diverse patient group.

Comparative outcomes for three-dimensional conformal versus intensity-modulated radiation therapy for esophageal cancer

Emerging data suggests a benefit for using intensity modulated radiation therapy (IMRT) for the management of esophageal cancer. We retrospectively reviewed patients treated at our institution who received definitive or preoperative chemoradiation with either IMRT or 3D conformal radiation therapy (3DCRT) between October 2000 and January 2012. Kaplan Meier analysis and the Cox proportional hazard model were used to evaluate survival outcomes. We evaluated a total of 232 patients (138 IMRT, 94 3DCRT) who received a median dose of 50.4 Gy (range, 44-64.8) to gross disease. Median follow up for all patients, IMRT patients alone, and 3DCRT patients alone was 18.5 (range, 2.5-124.2), 16.5 (range, 3-59), and 25.9 months (range, 2.5-124.2), respectively. We observed no significant difference based on radiation technique (3DCRT vs. IMRT) with respect to median overall survival (OS) (median 29 vs. 32 months; P = 0.74) or median relapse free survival (median 20 vs. 25 months; P = 0.66). On multivariable analysis (MVA), surgical resection resulted in improved OS (HR 0.444; P < 0.0001). Superior OS was also associated on MVA with stage I/II disease (HR 0.523; P = 0.010) and tumor length ≤5 cm (HR 0.567; P = 0.006). IMRT was also associated on univariate analysis with a significant decrease in acute weight loss (mean 6% + 4.3% vs 9% + 7.4%, P = 0.012) and on MVA with a decrease in objective grade ≥3 toxicity, defined as any hospitalization, feeding tube, or >20% weight loss (OR 0.51; P = 0.050). Our data suggest that while IMRT-based chemoradiation for esophageal cancer does not impact survival there was significantly less toxicity. In the IMRT group there was significant decrease in weight loss and grade ≥3 toxicity compared to 3DCRT.

GRAFT-Versus-Host Disease Clinical Profile and Duration of Immunosuppression Among Patients WHO Received Cord Blood STEM CELL Transplant: A Single Center Experience

inflammatory cells, collagen deposition and expansion of airways in the lung despite showing no sign of acute illness or weight loss. Masson’s trichrome revealed increased fibrosis in the lung (Figure 2), but not in other organs. Conclusion: We have shown that in the NSG mouse, a combination of Cy/TBI with a lownumber of G-CSFmobilized human PBMCs causes chronic lung inflammation and fibrosis that can serve as an important pre-clinic model of lung cGVHD.

The challenge of rapid weight loss prior to competition for Muslim combat sport athletes during Ramadan

Muslim athletes observe the Ramadan intermittent fast (RIF) while training and/or competition are often maintained during this period. In combat sports, where contestants compete in different weight categories, some athletes often undertake a prescribed acute weight loss over 4–5 days prior to competition. On the day of competition, they normally restore the body water content lost during the pre-competition period between the weigh-in and the start of the matches. However, this is not possible for those who observe the RIF. Body water and energy decrements are exacerbated when Muslim combat sport athletes have to compete in the morning and afternoon during the same day when a competition is scheduled during Ramadan. This article focuses on the several challenges faced by Muslim combat sport athletes, especially those who undergo a rapid weight loss before a major competition during Ramadan. Suggestions that could limit the difficulties encountered by these athletes during the fasting month are presented.

The responses of white blood cells to weight loss among young male judoists

The purpose of this study was the assessment of white blood cells in response to acute and gradual weight loss among young male judoists. Material and Methods—Twenty four healthy young judoists aged 17.0±1.2 years (mean ± SD), with one year of experience in judo training, selected and they were randomly classified in two groups of acute weight loss and gradual weight loss. Blood sampling was conducted in three stages: 1) before weight loss, 2) 18 hours after weight loss, and 3) after the last phase of physical exercise performance tests. Results— The average amount of white blood cells in the phase 2 for both groups didn't increase meaningfully (Acute: P=0. 53, Gradual: P=0.48) but the increase in the phase 3 for both groups was significant (P<0.01). Conclusion— This study concludes that acute weight loss can result in changing the level of white blood cells which are determined in immunity system and related disease.

Body composition for health and performance: a survey of body composition assessment practice carried out by the Ad Hoc Research Working Group on Body Composition, Health and Performance under the auspices of the IOC Medical Commission

BackgroundSuccessful performers in weight-sensitive sports are characterised by low body mass (BM) and fat content. This often requires chronic energy restriction and acute weight loss practices.AimTo evaluate current use of...

Pulmonary exacerbations in CF patients with early lung disease

Current definitions of pulmonary exacerbation (PE) in cystic fibrosis are based on studies in participants with significant lung disease and may not reflect the spectrum of findings observed in younger patients with early lung disease. We used data from a recent trial assessing the efficacy of azithromycin in children to study signs and symptoms associated with PEs and related changes in lung function and weight. While increased cough was present in all PEs, acute weight loss and reduction in oxygen saturation were not observed. Changes in lung function did not differ between subjects who did experience a PE and those who were exacerbation-free. Cough was the predominant symptom in CF patients with early lung disease experiencing a PE. There was no significant difference in mean 6-month change in lung function or weight among subjects with one or more exacerbations and those without an exacerbation.