Percentage Of Body Weight Loss Research Articles

Achievement of Weight Loss and Other Requirements of the Diabetes Prevention and Recognition Program

The purpose of this report is (1) to describe the use of the American Association of Diabetes Educators' (AADE's) model of implementation of the National Diabetes Prevention Program through nationally certified diabetes self-management education (DSME) programs and (2) to report the aggregated program outcomes as defined by the Diabetes Prevention and Recognition Program standards of the Centers for Disease Control and Prevention (CDC). In 2012, the AADE worked with the CDC to select 30 certified DSME programs for National Diabetes Prevention Program delivery. For the following 3 years, the AADE continued to work with 25 of the 30 original programs. Results for all CDC recognition standards have been collected from these 25 programs and analyzed as aggregated data over the course of 36 months. At the end of the full-year program, average percentage body weight loss for participants across all 25 programs exceeded the CDC's minimum requirement of 5% weight loss. All programs on average met the CDC requirements for program attendance. Increasing access to the National Diabetes Prevention Program, through an array of networks, including certified DSME programs, will better ensure that people are able to engage in an effective approach to reducing their risk of diabetes.

Thermoregulation During Extended Exercise in the Heat: Comparisons of Fluid Volume and Temperature

This study aimed to determine the physiological and thermoregulatory responses of individuals exercising in the heat (US military red flag conditions, wet-bulb globe temperature 31.5-32.2ºC) while consuming varied volumes of ambient temperature water and ice slurry. Participants (N = 12) walked on a treadmill for 3 hours at approximately 40% peak aerobic capacity in a hot environment while consuming ambient temperature (35.5°C) water (W), ice slurry (0°C, two-thirds shaved ice and one-third water) at a ratio of 2 g·kg(-1) body mass every 10 minutes (FS), and reduced volume ice slurry as described at a rate of 1 g·kg(-1) body mass every 10 minutes (HS). Trials were completed at least 14 days apart, in a randomized, repeated measures design. Percent body weight loss was higher during the HS trial (1.8 ± 0.01%) compared with FS (0.5 ± 0.01%; P < .001) and W (0.6 ± 0.01%; P < .001). Mean rectal temperature at 3 hours was lower during FS (37.8 ± 0.7°C) compared with HS (38.1 ± 0.8°C) and W (38.2 ± 0.8°C) (P = .04 vs HS, and P = .005 vs W, main effect for trial). No differences were found in rectal temperature between HS and W. Heart rate was lower at the end of the third hour during FS (141 ± 10 beats/min) compared with HS (157 ± 19 beats/min) and W (154 ± 18 beats/min) (P = .001 and P = .007, respectively, time × trial interaction). There were no differences in heart rate between HS and W. The temperature of consumed fluids may be as important as the volume for the management of thermoregulation and other physiological responses for extended work in hot environments.

Effects of an Oral Elemental Nutritional Supplement on Post-gastrectomy Body Weight Loss in Gastric Cancer Patients: A Randomized Controlled Clinical Trial.

Post-gastrectomy weight loss is associated with deterioration in quality of life, and influences the long-term prognosis of gastric cancer patients. We conducted a prospective, randomized controlled, open-label study to examine whether an oral elemental diet (Elental(®), Ajinomoto Pharmaceuticals, Tokyo, Japan; hereafter referred to as ED) prevents postoperative weight loss in post-gastrectomy patients. Patients were randomly divided to receive the ED or control diet. The ED group received 300kcal of ED plus their regular diet for 6-8weeks after surgery, starting from the day the patient started a soft rice or equivalent diet after surgery, while the control group received the regular diet alone. The primary endpoint was the percentage of body weight loss (%BWL) from the presurgical body weight to that at 6-8weeks after surgery. Secondary endpoints were dietary adherence, nutrition-related blood parameters, and adverse events. This study included 112 patients in eight hospitals. The mean treatment compliance rate in the ED group was 68.7±30.4% (median 81.2%). The %BWL was significantly different between the ED and control groups (4.86±3.72 vs. 6.60±4.90%, respectively; p=0.047). In patients who underwent total gastrectomy, the %BWL was significantly different between the two groups (5.03±3.65 vs. 9.13±5.43%, respectively; p=0.012). In multivariate analysis, ED treatment, surgery type, and preoperative performance status were independently associated with %BWL. No significant differences were observed in the other clinical variables. ED supplementation reduced postoperative weight loss in gastric cancer patients undergoing gastrectomy.

Prophylactic Phosphate Supplementation for the Inpatient Treatment of Restrictive Eating Disorders

PurposeThe medical stabilization of adolescent patients with restrictive eating disorders can be associated with refeeding syndrome, a potentially fatal complication preceded by refeeding hypophosphatemia (RH). Whether RH can be prevented by routine prophylactic phosphate supplementation has not been previously examined. This study sought to determine the safety and efficacy of a refeeding strategy that incorporates prophylactic phosphate supplementation to prevent RH. MethodsRetrospective chart data were collected for patients aged younger than 18 years with restrictive eating disorders admitted to a tertiary pediatric inpatient ward between January 2011 and December 2014. All patients were refed with a standardized protocol that included prophylactic oral phosphate supplementation (1.0 ± .2 mmol/kg/day). ResultsDuring the 4-year study period, 75 admissions (70 patients) were included for analysis. The mean age and percent median body mass index of included patients were 15.3 years and 83.5%, respectively. Seven out of 75 (9%) had percent median body mass index of <70% and 26 out of 75 (35%) had percent body weight loss >20%. All patients were normophosphatemic at the time of admission (mean serum phosphate 1.24 ± .2 mmol/L). Serial laboratory evaluation revealed that all supplemented patients maintained serum phosphate levels >1.0 mmol/L during the initial 7 days of refeeding. Eleven patients became mildly hyperphosphatemic (range 1.81–2.17 mmol/L) with no associated clinical consequences. Additional analysis of 11 patients presenting with hypophosphatemia before refeeding revealed that with supplementation, phosphate values normalized by Day 1, and this group experienced no further RH episodes during initial refeeding. ConclusionsProphylactic oral phosphate supplementation appears safe, and no episodes of RH occurred in patients with restrictive eating disorders undergoing inpatient refeeding.

Laparoscopic sleeve gastrectomy for morbid obesity: does the size of the bougie matter?

Background Laparoscopic sleeve gastrectomy (LSG) is a safe and effective surgical treatment modality for morbid obesity. Variations in surgical technique could affect the results. The optimal size of the bougie remains controversial. The aim of this study was to evaluate the first-year outcome of LSG using two different sizes of bougies. Patients and methods Between March 2011 and January 2014, 102 morbidly obese patients underwent LSG. These patients were divided into two groups: group 1 (50 patients) and group 2 (52 patients). In group 1, 32-Fr bougies (orogastric calibration tube) were used, and in group 2 40-Fr bougies were used. Patients completed at least 6 months of follow-up visits. Results The excess body weight loss percentage in group 1 was 53.6 ± 10.96% at 6 months and 69.4 ± 15.6% at 1 year postoperatively, whereas in group 2 it was 52.7 ± 11.27% at 6 months and 66.4 ± 13.4% at 1 year postoperatively, with no statistically significant difference between the two groups. There were neither intraoperative complications nor postoperative mortalities. The overall complication rate was 14.7% (15 patients) with no statistically significant difference between the two groups (14% in group 1 vs. 15.4% in group 2). The postoperative hospital stay was 2.3 days in group 1 versus 2.2 days in group 2. There was 58.8% complete resolution of diabetes mellitus, 60% resolution of hypertension, and 87.5% resolution of sleep apnea 6 months after sleeve gastrectomy with no statistically significant difference between the two groups. Conclusion LSG is a safe and effective treatment method for morbid obesity. Bougie size does not affect the short-term outcomes.

Measurement of various respiratory dynamics parameters following acute inhalational exposure to soman vapor in conscious rats

Respiratory dynamics were investigated in head-out plethysmography chambers following inhalational exposure to soman in untreated, non-anesthetized rats. A multipass saturator cell was used to generate 520, 560 and 600 mg × min/m3 of soman vapor in a customized inhalational exposure system. Various respiratory dynamic parameters were collected from male Sprague-Dawley rats (300--350 g) during (20 min) and 24 h (10 min) after inhalational exposure. Signs of CWNA-induced cholinergic crisis were observed in all soman-exposed animals. Percentage body weight loss and lung edema were observed in all soman-exposed animals, with significant increases in both at 24 h following exposure to 600 mg × min/m3. Exposure to soman resulted in increases in respiratory frequency (RF) in animals exposed to 560 and 600 mg × min/m3 with significant increases following exposure to 560 mg × min/m3 at 24 h. No significant alterations in inspiratory time (IT) or expiratory time (ET) were observed in soman-exposed animals 24 h post-exposure. Prominent increases in tidal volume (TV) and minute volume (MV) were observed at 24 h post-exposure in animals exposed to 600 mg × min/m3. Peak inspiratory (PIF) and expiratory flow (PEF) followed similar patterns and increased 24 h post-exposure to 600 mg × min/m3 of soman. Results demonstrate that inhalational exposure to 600 mg × min/m3 soman produces notable alterations in various respiratory dynamic parameters at 24 h. The following multitude of physiological changes in respiratory dynamics highlights the need to develop countermeasures that protect against respiratory toxicity and lung injury.

Initial Weight Loss after Restrictive Bariatric Procedures May Predict Mid-Term Weight Maintenance: Results From a 12-Month Pilot Trial.

Background: Bariatric procedures are effective options for weight loss (WL) in the morbidly obese. However, some patients fail to lose any weight after bariatric surgery, and mid-term weight maintenance is variable. The aim of this study was to investigate whether initial WL could predict mid-term weight maintenance. Methods: Eighty patients were enrolled, of whom 44 were treated with the BioEnterics Intragastric Balloon (BIB), 21 with laparoscopic adjustable gastric lap-banding (LAGB), and 15 with laparoscopic sleeve gastrectomy (LSG). Percentage of body WL and percentage of excess weight loss (EWL) were calculated at baseline and after 1, 3, 6, and 12 months. Successful WL was defined as EWL >20% for patients treated with BIB and >50% for patients treated with LAGB and SG. Results: Success in the 6th and 12th month was achieved in 80% and 58% of patients in the BIB group, 33% and 40% in the LAGB group, and 60% and 73% in the LSG group. In the BIB group, WL in the 1st month correlated positively with WL at the 6th and 12th month, and an initial WL >6.5% best predicted success (sensitivity 50%, specificity 80%). A similar association was observed in the LAGB group at the 6th and 12th month and an initial WL >9.4% best predicted success (sensitivity 90.0%, specificity 81.2%). In patients treated with LSG, WL in the 3rd month correlated positively with EWL at the 6th and 12th month, with a cutoff value of 17% (sensitivity 66.7%, specificity 100%). Conclusions: WL in the 1st month in patients treated with BIB and LAGB and WL in the 3rd month in patients treated with LSG could be used as a prognostic factor to predict mid-term weight maintenance.

STAT3 Regulation In Cachectic Skeletal Muscle After Repeated Eccentric Contractions

Introduction The cachectic muscle's response to multiple bouts of eccentric contractions (ECC) has not been examined. We examined if 2 weeks of repeated ECC training could alter STAT3 regulation in cachectic muscle. Methods Male C57BL/6 (B6; N=9) and ApcMin/+ mice were subjected to 7 bouts of high-frequency electrical stimulation (100 Hz, 6-12V, 10 sets of 6 repetitions) over 2 weeks. The left tibialis anterior (TA) muscle performed ECC while the right TA served as an intra-animal control. ApcMin/+ mice were stratified into mild (7%; N=5) and severe (16% loss; N=4) cachexia based on the percentage of body weight loss at the end of the study. Results ApcMin/+ mice had smaller control TA muscle mass (-26%; P<.01) and type IIA and IIB myofiber cross-sectional area (CSA) compared to B6 mice. Cachexia increased control TA muscle STAT3 phosphorylation (9-fold; P<.05), p42/44 MAPK phosphorylation (8-fold; P<.05), and Atrogin-1 protein expression (9-fold; P<.05). Independent of cachexia ECC increased TA muscle mass and type IIA and IIB myofiber CSA. ECC had no effect on TA muscle STAT3 phosphorylation in mildly cachectic mice, but there was a 30% reduction (P<.01) in severely cachectic mice. ECC had no effect on muscle p42/p44 MAPK phosphorylation in ApcMin/+ mice. The induction of Atrogin-1 protein expression was attenuated 31% (P<.01) by ECC in severely cachectic mice. Conclusion These results suggest that repeated bouts of ECC can alter cachexia-induced muscle signaling. The contraction-induced regulation of STAT3 signaling during cachexia progression warrants further investigation. Supported by NIH/NCI R01CA121249 to JAC.

Tablet PC-enabled application intervention for patients with gastric cancer undergoing gastrectomy

BackgroundGastric cancer is among the most common gastrointestinal cancers worldwide. Patients who have undergone surgery for gastric cancer may suffer from malnutrition and potential consequences such as gastrointestinal complications, surgical stress, and cancer cachexia. A tablet PC-based intervention via a mobile application might enhance the early recovery of postgastrectomy patients. ObjectiveThe aim of this study was to develop and test a tablet personal computer (PC)-assisted intervention to hasten the recovery of postgastrectomy cancer patients with respect to nutritional status. MethodsThis single-arm pilot study investigated a tablet PC application developed to serve the functions of nutritional monitoring, medical information management, drainage follow-up, and wound care. All services were delivered by medical professionals. ResultsTwenty consecutive gastrectomy patients at the National Taiwan University Hospital received perioperative care via this application (App group). During the study period, we retrospectively collected an additional 20 demographically matched gastrectomy cases as a control group. The App group had a lower body weight loss percentage relative to the control group during a 6-month follow-up period (4.8±1.2% vs. 8.7±2.4%; p<0.01). However, the patients in the App group had more outpatient clinic (OPC) visits than did those in the control group (9.8±0.9 vs. 5.6±0.8; p<0.01). ConclusionsThis study supported the feasibility of a tablet PC-based application for the perioperative care of gastric cancer subjects to promote a lower body weight loss and the collection of comprehensive surgical records.

Analysis of subcutaneous and visceral fat after gastric balloon treatment.

Background and Objectives:This project is a continuation of a larger project entitled “Treatment with intragastric balloon (IGB) in patients with overweight and obesity in Recife” developed by Professor Dr. Gustavo Lopes de Carvalho. It is a project studying the effectiveness of treatment with IGB evaluating the loss of weight and body mass index and its impact on blood pressure, blood glucose, triglycerides, total cholesterol and fractions. It also assesses the lifestyle of patients studying whether treatment with IGB interferes in smoking, alcohol consumption, eating habits and physical exercises performed by patients.The present study added a larger project, the separate evaluation of the different types of abdominal fat—visceral fat and subcutaneous cell tissue fat — and was conducted to discover which of the 2 types of fat undergoes the greater reduction after IGB treatment. To measure these 2 types of fat, we used the ultrasonography technique, because it has been shown to be accurate and noninvasive.Methods:Twenty-five patients were evaluated before and after 6 months of IGB treatment.Results:The patients' ages ranged from 20 to 61 years, with 60% being 40 years of age or older. The majority (72%) were women. All variables (weight, body mass index [BMI], VF, and SCTF) showed a significant reduction (P < .05) in mean values after treatment. The difference was highest in the SCTF (17.5%) and ranged from an 11.4% to an 11.6% reduction in all other variables. The average loss of SCTF was highest among the patients who had lost up to 10.0% of their initial weight (19.2% for the ≤10.0% group vs 15.9% for the >10.0% group); however, the difference was not significant (P = .66). The average loss of VF was higher in the subgroup of patients who had lost >10.0% of their initial weight (16.2% vs 6.3%; P = .003). The Pearson correlation between the reductions in SCTF vs VF was negative, low, and nonsignificant (−0.17; P = .41).Conclusions:After 6 months of IGB treatment, there was no significant difference between the reduction in abdominal SCTF and VF, but the results signify a possible correlation between the percentage of body weight loss and the type of abdominal fat reduced, as the impact on the VF was higher when the patients lost >10.0% of their initial weight.

Clinical Efficacy of a Medically Supervised Low-Calorie Diet Program versus a Conventional Carbohydrate-Restricted Diet

Objective: To determine the effectiveness of a 6 month intensive medical intervention (IMI) with caloric restriction and high-protein meal replacements versus a conventional carbohydrate-restricted (CCR) diet. Methods: This is an observational study designed to determine weight outcomes at 6, 12, 18 and 24 months after completing the IMI or CCR treatment. Patients were also required to participate in at least 5 miles of walking and 240 minutes of overall exercise per week. The primary outcome was percent body weight loss (BWL). Results: A total of 604 patients with obesity or overweight were studied. Sixty-seven percent were in the IMI group, versus 33% in the CCR group. Initial BMI was similar in both groups (36.4 kg/m2 (SD=7.7) vs. 36.0 kg/m2 (SD=7.8), p=0.608). At 6 months, the IMI group had superior body weight loss (11.9% (SD=7.4) vs. 6.0% (SD=6.1), p<0.0001). However, the IMI group had greater weight regain than the CCR group, resulting in similar weight loss at two years (7.1% (SD=10.2) vs. 8.1% (SD=6.3), p=0.735). An adjusted analysis of outcomes averaged across 2 years demonstrated 2.8% greater BWL among the IMI group. Blood pressure significantly improved in both groups (p<0.001). Males (OR=1.77, 95% CI=(1.10,2.84), p=0.019) and patients with BMI ≥ 35 kg/m2 (OR=3.32, 95% CI=(1.95, 5.65), p<0.0001) were more likely to achieve weight loss success with the IMI. Conclusion: An Intensive Medical Intervention (IMI) characterized by high-protein meal replacements and caloric restriction can be highly effective in reducing body weight, even at two years post-intervention. This type of intervention should be strongly considered among obese patients who do not qualify for bariatric surgery, those with contraindications to weight loss medications, or those in need of weight loss prior to a medical procedure.

637P - Evaluation of Oral, Nutritional Support on Postoperative Body Weight in Gastric Cancer Patients Receiving Elemental Diet: a Randomized Study

ABSTRACT Aim: Postoperative weight loss causes deterioration in the patient's quality of ife and influences long-term prognosis in gastric cancer patients who have undergone gastrectomy. Moreover, recent retrospective studies indicated postoperative weight loss as a risk factor for premature interruption of S-1 adjuvant chemotherapy. In this prospective randomized controlled study, we aimed to examine whether the early institution of nutritional support comprising an oral elemental diet (ED) prepared for post-gastrectomy patients with depressed digestive/absorptive function would help prevent postoperative weight loss until the initiation of S-1 treatment. Methods: After surgery, patients were randomly assigned to the ED or control groups. The groups were divided according to the surgical methods used (total/distal gastrectomy), clinical stage of disease, and patients' body mass index( Results: The study included 112 patients from eight hospitals. There was a significant difference in the percentage of body weight loss (%BWL) between the ED and control groups (4.86 ± 3.72% and 6.60 ± 4.90%; p = 0.047). Multivariate analysis demonstrated ED treatment, surgery type and performance status as independent factors that affect body weight changes. No significant differences were observed in hematological and non-hematological adverse events, between the two groups. Conclusions: The oral ED product can prevent postoperative weight loss in gastric cancer patients undergoing gastrectomy. Disclosure: All authors have declared no conflicts of interest.

A comparison of hydration effect on body fluid and temperature regulation between Malaysian and Japanese males exercising at mild dehydration in humid heat.

BackgroundThis study investigated the effect of hydration differences on body fluid and temperature regulation between tropical and temperate indigenes exercising in the heat.MethodsTen Japanese and ten Malaysian males with matched physical characteristics (height, body weight, and peak oxygen consumption) participated in this study. Participants performed exercise for 60 min at 55% peak oxygen uptake followed by a 30-min recovery at 32°C and 70% relative air humidity with hydration (4 times each, 3 mL per kg body weight, 37°C) or without hydration. Rectal temperature, skin temperature, heart rate, skin blood flow, and blood pressure were measured continuously. The percentage of body weight loss and total sweat loss were calculated from body weight measurements. The percentage change in plasma volume was estimated from hemoglobin concentration and hematocrit.ResultsMalaysian participants had a significantly lower rectal temperature, a smaller reduction in plasma volume, and a lower heart rate in the hydrated condition than in the non-hydrated condition at the end of exercise (P <0.05), whereas Japanese participants showed no difference between the two hydration conditions. Hydration induced a greater total sweat loss in both groups (P <0.05), and the percentage of body weight loss in hydrated Malaysians was significantly less than in hydrated Japanese (P <0.05). A significant interaction between groups and hydration conditions was observed for the percentage of mean cutaneous vascular conductance during exercise relative to baseline (P <0.05).ConclusionsThe smaller reduction in plasma volume and percentage body weight loss in hydrated Malaysians indicated an advantage in body fluid regulation. This may enable Malaysians to reserve more blood for circulation and heat dissipation and thereby maintain lower rectal temperatures in a hydrated condition.

Evaluation of the effects of postoperative oral nutrition support on body weight in gastric cancer patients by using an elemental diet: A randomized study.

110 Background: Postoperative weight loss causes deterioration in the patient’s quality of life and influences long-term prognosis in gastric cancer patients who have undergone gastrectomy. Moreover, recent retrospective studies indicated postoperative weight loss as a risk factor for premature interruption of S-1 adjuvant chemotherapy. We conducted a prospective randomized controlled study to examine whether the early institution of nutritional support comprising an oral elemental diet (ED) prepared for post-gastrectomy patients with depressed digestive/absorptive function would help prevent postoperative weight loss. Methods: After surgery, patients were randomly assigned to the ED or control groups. The groups were divided according to the surgical methods used (total/distal gastrectomy), clinical stage (≤Ia/&gt;Ia), and patients’ body mass index (&lt;18.5/&gt;18.5). In patients assigned to the ED group (Elental, 300 kcal) was provided in addition to the regular diet from the day starting soft rice diet or equivalent diet to 6–8 weeks after surgery. The primary endpoint was the percentage of body weight change from the pre-surgical body weight to that at 6–8 weeks after surgery. The secondary endpoints were ED adherence, nutrition-related blood parameter changes, and adverse effects. Results: The study included 112 patients from eight hospitals. There was a significant difference in the percentage of body weight loss (%BWL) between the ED and control groups (4.88±3.41% and 6.91±5.06%; P=0.015). Sub-group analysis showed a significant difference in the %BWL in patients who underwent total gastrectomy (5.31±3.43% and 9.11±5.57%; P=0.016). Multivariate analysis demonstrated ED treatment and surgery type as independent factors that affect body weight changes. The mean treatment compliance rate in the 58 ED-group patients was 72.9±33.1%, with a favorable median value of 90.8%. No significant differences were observed in any parameter analyzed, including hematological and non-hematological adverse events, between the two groups. Conclusions: The ED product can prevent postoperative weight loss in gastric cancer patients undergoing gastrectomy. Clinical trial information: 000008056.

Comparative Response of SC CAKI-1 Renal Tumor to Treatment with Doxorubicin HCl and Doxorubicin Orotate

Background: Doxorubicin (DOX) is an effective treatment for many cancers across the age spectrum, but its therapeutic potential is limited because of dose-dependent relation to both progressive and irreversible cardiomyopathy leading to congestive heart failure. While decreases in cardiotoxicity have been reported with liposomal doxorubicin, the long-term cardiac effects are not known. Orotate salts of cytotoxic drugs have been shown to confer antitumor effects with a better safety profile than unconverted drug, and therefore may offer an improved approach to cancer treatment. Materials and Methods: Male, athymic NCr-nu/nu mice with subcutaneously implanted CAKI-1 human renal tumor xenografts were treated with DOX and its orotate salt (DOX-O) to evaluate antitumor activity, measured by median tumor mass doubling time and tumor weight. Nontumored male, athymic NCr-nu/nu mice were treated with DOX, DOX-O and liposomal doxorubicin formulations to determine DOX concentration in liver and heart; and to evaluate their effect on body weight. Non-tumored female, athymic NCr-nu/nu mice were treated with daunorubicin and daunorubicin orotate to evaluate tolerance. Results: DOX and DOX-O exhibited significant, similar levels of antitumor activity. Mice treated with DOX-O had a lower percentage body weight loss. In the animals treated with DOX, DOX-O, or liposomal doxorubicin, liposomal doxorubicin was associated with the lowest percentage of body weight loss, but the highest concentration of DOX in heart. In daunorubicin tolerance experiments, animals showed a better tolerance for daunorubicin orotate as measured by a smaller percentage change in body weight. Conclusions: DOX-O is effective as an antitumor therapy and may offer a less toxic alternative to DOX for maintaining therapy. The lower percentage of body weight loss in animals treated with DOX-O and daunorubicin orotate is a measure of improved tolerance and may translate into better patient outcomes.

Moderated-fat Diet Supplemented with Green Tea Reduces oxLDL Levels and Fat Mass in Obese Women

Background: Obesity is a chronic degenerative disease, considered as cardiovascular risk factor, and characterized by systemic inflammation and high levels of oxidized LDL (oxLDL). Clinical studies suggest that drink green tea could improve these complications. The aim of this study was analyze the effect of a moderate-fat diet supplemented with green tea on oxLDL, fat mass and Tumoral necrosis factor α (TNFα) in obese women. Methods: Obese women, without other chronic-degenerative disease, were divided into control group (n=32) and intervention group (n=32), and were instructed to consume a moderate-fat diet and intervention group was instructed to supplement the diet with green tea. Anthropometric and biochemical measurements were measured, and oxLDL and TNFα levels were determined by ELISA. All parameters were realized at baseline and at 1st, 2nd and 3rd months post-intervention. TNFα mRNA expression was determined by real-time RT-PCR. Results: The intervention group showed a significant reduction of oxLDL versus the control group in the 2nd month (p<0.05). At the end of the follow-up period, intervention group had a higher body weight loss percentage (84.2 ± 15.1%) in relation to fat mass (p < 0.05), and this group had less increment in serum TNFα than the control group. The intervention group demonstrated other metabolic improvements like a reduction in triglycerides (-39.0 ± 18.6mg/dL); while high density lipoprotein increased (4.2 ± 0.9mg/dL) versus control group (p<0.05). Conclusions: Our results demonstrate that consuming a moderate-fat diet supplemented with green tea reduce oxLDL, fat mass, and modulate TNFα expression. This therapy could aid reduces the cardiovascular risk in obese patients.

Undernutrition among HIV positive women in Humera hospital, Tigray, Ethiopia, 2013: antiretroviral therapy alone is not enough, cross sectional study.

BackgroundIn Ethiopia, undernutrition among women on antiretroviral therapy has been a major challenge to achieve the full impact of intervention. Twenty seven percent and 17% of reproductive age Ethiopian women are chronically malnourished and anemic, respectively. Most studies to examine risk factors have been limited to the general population and ART-naive HIV-positive women, making it difficult to generalize findings to ART-treated HIV-positive women. The objectives of this study were thus to assess nutritional status and associated factors among adult women (≥20 years) on antiretroviral therapy.MethodsFrom August to September we conducted an Institution based cross-sectional survey among 276 women on antiretroviral therapy in Humera Hospital, Tigray, Ethiopia. Data was collected using structured and standard face to face interview, anthropometric measurements, BD FACS (CD4 count machine) and Sysmex-21 (hemoglobin analyzer). Logistic regression was done using SPSS version 16 to identify factors that are associated with nutritional status.ResultsThe prevalence of under nutrition (Body mass index < 18.5 kg/m2) Was 42.3% (95% CI: 37.4% - 47.3%). Severe, moderate and mild under nutrition was detected on 12%, 10% and 20.3% respondents, respectively. The prevalence of wasting (percentage body weight loss >5%) was 75% (95% CI: 70.4% - 79.2%). Severe wasting was accounted for 26.9% of respondents.In the multivariate analysis, Household food insecurity [AOR = 1.85; 95%CI 1.16, 2.86], inadequate dietary diversity [AOR = 1.19; 95%CI 1.08, 1.75], anemia [AOR = 1.67; 95%CI 1.05, 2.65] and absence of nutritional support [AOR = 0.34 95%CI 0.22, 0.54) were found to be independent predictors of under-nutrition.ConclusionHIV/AIDS is associated with an increased burden of undernutrition even among ART treated women in Humera Hospital, Tigray, Ethiopia. In addition to ART among HIV positive women interventions to ameliorate poor nutritional status may be necessary in this and similar settings. Such interventions aimed at improving household food security, dietary diversity, micronutrient supplementation, proper use of therapeutic food, as well as treating oral candidiasis.

Long-term effectiveness of BioEnterics intragastric balloon in obese patients

The BioEnterics intragastric balloon has been considered an effective and less invasive method for weight loss. This study aimed to evaluate the effect of this method on long-term weight loss. From June 2009 to June 2011, 32 patients (14 male, 18 female) underwent BioEnterics intragastric balloon therapy for 6 months. The mean age of the subjects was 39,7±11,1 years and mean body mass index was 44,4±12 kg/m 2 . All patients were given a diet of 1100 kcal/day. Weight loss parameters [absolute weight loss, body mass index loss, percentage of body weight loss, and percentage of excess body massindex loss (excess body mass index loss%)] were recorded at baseline, after 1 month, after 6 months (time of BioEnterics intragastricballoon removal), and after 12 months from baseline. Successful weight loss was defined as ≥10% weight loss after 6 (end of treatment success) and 12 months (long-term success). Statistical analysis was done using SPSS computer program. The mean weight loss and body mass index loss were 12,4 kg (standart deviation, 13,5) and 4.3 kg/m 2 (standart deviation, 4,7), respectively (p<0.001). The mean percentage of body weight loss was 9.5% (standart deviation, 9,8). The percentage of excess body mass index loss reached 25,2% (standart deviation, 25,9). Fifteen patients (46,9%) achieved a percentage of body weight loss >10% at the end of treatment. Eleven of these patients (73%) were able to maintain weight loss of 10% at the completion of the study, resulting ina longterm success rate of 34.4%. Percentage of body weight loss and percentage of excess body mass index loss were inversely relatedto age (p< 0,05). BioEnterics intragastric balloon has been effective in long-term loss of body weight.

Immunization with Cholera Toxin B Subunit Induces High-Level Protection in the Suckling Mouse Model of Cholera

Cholera toxin (CT) is the primary virulence factor responsible for severe cholera. Vibrio cholerae strains unable to produce CT show severe attenuation of virulence in animals and humans. The pentameric B subunit of CT (CTB) contains the immunodominant epitopes recognized by antibodies that neutralize CT. Although CTB is a potent immunogen and a promising protective vaccine antigen in animal models, immunization of humans with detoxified CT failed to protect against cholera. We recently demonstrated however that pups reared from mice immunized intraperitoneally (IP) with 3 doses of recombinant CTB were well protected against a highly lethal challenge dose of V. cholerae N16961. The present study investigated how the route and number of immunizations with CTB could influence protective efficacy in the suckling mouse model of cholera. To this end female mice were immunized with CTB intranasally (IN), IP, and subcutaneously (SC). Serum and fecal extracts were analyzed for anti-CTB antibodies by quantitative ELISA, and pups born to immunized mothers were challenged orogastrically with a lethal dose of V. cholerae. Pups from all immunized groups were highly protected from death by 48 hours (64–100% survival). Cox regression showed that percent body weight loss at 24 hours predicted death by 48 hours, but we were unable to validate a specific amount of weight loss as a surrogate marker for protection. Although CTB was highly protective in all regimens, three parenteral immunizations showed trends toward higher survival and less weight loss at 24 hours post infection. These results demonstrate that immunization with CTB by any of several routes and dosing regimens can provide protection against live V. cholerae challenge in the suckling mouse model of cholera. Our data extend the results of previous studies and provide additional support for the inclusion of CTB in the development of a subunit vaccine against V. cholerae.

Five Percent Weight Lost in the First Month of Intragastric Balloon Treatment May Be a Predictor for Long-Term Weight Maintenance

Most of the weight loss with the BioEnterics intragastric balloon (BIB) has occurred during the first 3-4 months. This study aimed to evaluate the effect of initial weight loss on long-term weight maintenance. From 2008 to 2011, 50 patients who had mean body mass index (BMI) of 44.7 ± 12.4 kg/m(2) underwent BIB therapy for 6 months. All patients were given a diet of 1,100 kcal/day. Weight loss parameters [absolute weight loss, BMI loss, percentage of body weight loss (BWL%), and percentage of excess BMI loss] were recorded at the baseline, 1 month, 6 months (time of BIB removal), 12 months, and 18 months from the baseline. Successful weight loss was defined as ≥ 10 % weight loss after 6, 12, and 18 months. Twenty-seven patients (54 %) achieved a percentage of BWL ≥ 10 at the time of removal. Eighteen (36 %) and 12 (24 %) patients were able to maintain weight loss of 10 % at 12 and 18 months. Percentage of BWL after 1 month was positively correlated with BWL% after 6, 12, and 18 months (r = 0.77, 0.65, and 0.62, p < 0.001, respectively). Twenty-four patients who lost 5 % of the BWL after 1 month of treatment succeeded in maintaining a lasting percentage of BWL ≥ 10 after the BIB removal: more precisely, this cutoff point was achieved in 96 % at the time of removal and in 71 %, 50 % at 12 months, and 18 months of follow-up. Five percent BWL after 1 month of treatment may be a predictor for long-term weight maintenance.