Mean Weight Reduction Research Articles

Diallel analysis of resistance to Stagonospora nodorum in winter triticale

Stagonospora (Septoria) nodorum Berk. leaf and glume blotch can cause severe yield losses in triticale (xTriticosecale Wittm.). In diallel crosses the relationship between disease symptoms and grain yield losses were measured and general combining ability (GCA) and specific combining ability (SCA) for disease symptoms on leaves and spikes estimated. Seven parents and their 21 F 1 crosses were grown in micro-plots in two locations as a non-inoculated variant and also artificially inoculated with S. nodorum. Infection caused a mean reduction in kernel weight per spike of 18.1% in the parents and 12.6% in the F 1 crosses, which was mainly a result of a 13.1% and 8.2% reduced 1000-kernel weight, respectively. The number of kernels per spike and the 50-ml weight were little affected. The phenotypic correlations in F 1 crosses between symptom ratings and grain yield traits were low. Heritability was high to very high in parents and F 1 crosses. Both combining ability variances GCA accounted for most of the genetic variation for spike and leaf ratings, indicating predominantly additive gene effects for resistance. The close relationship between parental performance and their GCA effect allows in most cases a prediction of the resistance of F 1 crosses from parental values.

Developmental toxicity and genotoxicity studies of 1,1,1,3,3,3-hexachloropropane (HCC-230fa) in rats.

The potential developmental toxicity and the in vitro and in vivo genotoxicity of HCC-230fa were assessed. In the developmental toxicity study, groups of 25 mated Crl:CD(R)(SD)BR rats were exposed (whole body) by inhalation to HCC-230fa over days 7-21 of gestation; the day of confirmed mating was designated as gestation day 1 (GD1). Exposures were 6 h per day at concentrations of 0, 0.5, 2.5, or 25 ppm. Body weight, food consumption, and clinical observation data were collected during the study. On day 22 of gestation, the dams were euthanized and examined grossly. The fetuses were removed and subsequently weighed, sexed, and examined for external, visceral, head, and skeletal alterations. Evidence of maternal and developmental toxicity was observed at 25 ppm and was noted as significant, compound-related reductions in mean maternal body weight, weight change, and food consumption. Significant fetal effects also were observed at 25 ppm as compound-related reductions in mean fetal weight and increased fetal malformations (filamentous tail, situs inversus, absent vertebrae) and variations (rudimentary cervical ribs, delayed sternebral ossification). There was no evidence of either maternal or developmental toxicity at 0.5 or 2.5 ppm. The genotoxicity of HCC-230fa was examined in a bacterial reversion assay and in erythrocyte micronucleus studies in two species by different routes of administration. No increases in the number of revertants were observed in the bacterial reversion assay. In one micronucleus study, HCC-230fa was administered by inhalation to rats as part of a 90-day study at doses indicated above. For the second study, ICR mice were given a single ip dose at 0, 166, 330, or 660 mg/kg. In both micronucleus studies, a significant increase in micronucleated erythrocytes was observed. The results of these studies suggest that HCC-230fa affects rapidly dividing cells and may have long-term consequences for occupational exposures.

Four worksite weight loss programs with high-stress occupations using a meal replacement product.

The objective was to evaluate the efficacy of worksite weight reduction programs at high-stress worksites. We employed a longitudinal study based on two meal replacements daily with subjects choosing a third 'sensible' meal. The subjects were 492 healthy, overweight men and women working in high-stress occupations (police, hospital health professionals, flight crew members, firefighters). The mean group ages ranged from 32.17 +/- 5.70 to 44.50 +/- 16.40 years; the mean group body mass indexes (BMIs) ranged from 27.40 +/- 2.54 to 32.90 +/- 3.39 kg/m(2). The completion rate for the 12 weeks was 79.8%. Reductions in mean weight and mean BMI were greater than in medically supervised clinical trials with non-worksite adults. Firefighters lost the most weight and medical personnel the least. Follow-up found considerable retention of weight loss. Men lost significantly more weight than women (p < 0.006). We conclude that employees in some high-stress settings may participate productively in worksite weight reduction and maintenance programs that use meal replacements.

Continuous quality management of breast hypertrophy by the German Association of Plastic Surgeons: a preliminary report.

In 1998, the German Association of Plastic Surgeons started a new quality assurance program based on a standardized questionnaire to examine the tracer diagnosis "breast hypertrophy." The authors present the results of a pilot study evaluating 799 patients (mean age, 38 years). Breast reduction was performed as an inpatient procedure in 99% of patients. Mean weight reduction was 1,135 g (range, 140-3,870 g). The inverted-T scar technique was used in 45% of patients, the vertical scar technique in 52% of patients, and other techniques were restricted to 2% of patients. The selection of technique was based on the choice of the surgeon. The overall incidence of complications was 21.5%, and included predominantly wound dehiscence, without marked differences between the two techniques. Less than 10 years after the introduction of a new technique for breast reduction with reduced length of scar, it is now used as often as traditional methods.

Evaluation of the effects of exercise and a mild hypocaloric diet on cardiovascular risk factors in obese subjects.

A weight reduction program to improve cardiovascular risk factors was implemented in obese subjects. The program consisted of exercise training corresponding to the anaerobic threshold (AT) and a mild hypocaloric diet for 12 weeks. In this program, we evaluated the effects of a combination of exercise training and a diet on cardiovascular risk factors such as obesity, dyslipidemia, and poor exercise performance in obese subjects. In addition, we also evaluated the independent effects of exercise training and dietary modification. For this purpose, we adopted a relative training time and a diet score. A relative training time was calculated as the number of times that the subject performed exercises divided by all of the training sessions scheduled, and the diet score was calculated from information which each subject provided on a self-assessment questionnaire. Twenty three obese subjects (Age: 24-54 years old, 19 men and 4 women, body mass index (BMI) > 26 kg/m2) participated in this study. After the 12-week intervention, the mean reductions in body weight, body mass index and body fat were 4.7 kg, 1.7 kg/m2 and 2.9%, respectively (P < 0.0001). The % change in body weight was significantly associated with the diet score and with the relative training time. The mean reductions in total cholesterol, triglyceride and low density lipoprotein cholesterol were 21 mg/dl (P < 0.002), 34 mg/dl (P < 0.01) and 15.9 mg/dl (P < 0.01), respectively, and the % change in triglyceride was significantly associated with the diet score (P = 0.0056) and tended to correlate with the relative training time (P = 0.0596). Oxygen uptake at AT and at peak exercise were increased from 14.1 +/- 1.6 to 16.0 +/- 3.1 ml/min/kg (P < 0.005) and from 26.3 +/- 4.8 to 28.4 +/- 4.9 ml/min/kg (P < 0.002), respectively. A combination of aerobic exercise and a mild hypocaloric diet significantly contributed not only to weight loss but also to the improvement of dyslipidemia and exercise performance, but either hypocaloric diet or mild exercise independently did less. The diet score and the relative training time were useful for evaluating separately dietary modification and the quantity of exercise.

Telemedicine Improved Diabetic Management

Effective control of diabetes is known to delay or prevent the end-organ complications of this disease. Can telemedicine improve a patient's ability to self-manage diabetes? Twenty-eight patients entered a study comparing home telemedicine consultation with standard outpatient care. A nurse case manager contacted the telemedicine group once a week under the direction of a primary care physician, who contacted the telemedicine group once a month. Laboratory studies and total body weight were measured at the beginning and at the end of the 3-month study. The hemoglobin A1c (HbA1c) and total body weight improved significantly in the intervention (telemedicine) group, as shown by a 16% reduction in mean HbA1c level (from 9.5 to 8.2%) and a 4% mean weight reduction (from 214.3 to 206.7 pounds). Based on our experience, we present a functionally based telemedicine classification system to improve the application of electronic medicine in future studies.

Antipsychotic-induced weight gain: a comprehensive research synthesis.

The purpose of this study was to estimate and compare the effects of antipsychotics-both the newer ones and the conventional ones-on body weight. A comprehensive literature search identified 81 English- and non-English-language articles that included data on weight change in antipsychotic-treated patients. For each agent, a meta-analysis and random effects metaregression estimated the weight change after 10 weeks of treatment at a standard dose. A comprehensive narrative review was also conducted on all articles that did not yield quantitative information but did yield important qualitative information. Placebo was associated with a mean weight reduction of 0.74 kg. Among conventional agents, mean weight change ranged from a reduction of 0.39 kg with molindone to an increase of 3.19 kg with thioridazine. Among newer antipsychotic agents, mean increases were as follows: clozapine, 4.45 kg; olanzapine, 4.15 kg; sertindole, 2.92 kg; risperidone, 2.10 kg; and ziprasidone, 0.04 kg. Insufficient data were available to evaluate quetiapine at 10 weeks. Both conventional and newer antipsychotics are associated with weight gain. Among the newer agents, clozapine appears to have the greatest potential to induce weight gain, and ziprasidone the least. The differences among newer agents may affect compliance with medication and health risk.

A weight reduction and weight maintenance program with long-lasting improvement in left ventricular mass and blood pressure

Obesity is a major risk factor for cardiovascular disease and is associated with hypertension and increased left ventricular mass (LVM). Maintenance of reduced weight has been a matter of recent concerns in the treatment of obese subjects. This study was conducted to confirm the effect of the addition of exercise to diet on maintenance of body weight in a weight reduction program. In addition, this study was conducted to estimate whether LVM changes in parallel with a change in body weight during a long-term follow-up after a weight-reduction program. Twenty-two normotensive (NT) obese subjects and 14 mild hypertensive (HT) obese subjects ranging in age from 22 to 51 years participated in a 12-week supervised weight-reduction program involving mild exercise and a mild hypocaloric diet. After this 12-week intervention, they were advised to maintain their modified lifestyle during a 1-year follow-up period. After the 12-week intervention, the mean reductions in body weight (BW) in the NT and HT groups were 4.1 kg ( P < .0001) and 5.8 kg ( P < .0001), respectively. LVM in the NT and HT groups was significantly reduced from 154 g to 136 g ( P < .005) and from 169 g to 152 g ( P < .002), respectively. One year after intervention, the mean gains in BW in the NT and HT groups were 2.3 kg (not significant, NS) and 0.4 kg (NS), respectively. The mean gains in LVM in the NT and HT groups were 8 g (NS) and 7 g (NS), respectively. It was also shown that blood pressures in the HT group were significantly decreased after the 12-week intervention and there was no significant change in blood pressure in the HT group 1 year after intervention. In conclusion, reduced body weight was maintained for 1 year after a 12-week supervised weight-reduction program in both normotensive and mild hypertensive obese subjects. Reduced left ventricular mass was maintained for a long period in both normotensive and mild hypertensive obese subjects and lowered blood pressure was maintained in the mild hypertensive obese subjects.

Late-Summer Forage on Prairie Sandreed Dominated Range-Land after Spring Defoliation

The potential of using spring defoliation to improve late-summer nutritive value of prairie sandreed [Calamovilfa longifolia (Hook.) Scribn.] on rangeland was studied with a factorial array of replicated 1-year treatments that included clipping plots at ground level or at a 5 or 10 cm height on 1 April, 26 April, 20 May, or 14 June. Vegetative tillers accounted for 83% of prairie sandreed herbage on unclipped control plots. After spring treatments, late-summer crude protein content (CP) in vegetative tillers of prairie sandreed ranged from 5.0 to 7.9% and in vitro dry matter digestibility (IVDMD) ranged from 45 to 52% compared to 5.0% CP and 45% IVDMD for unclipped plots. Reductions in mean weight of prairie sandreed vegetative tillers after April and May treatments were offset by 20 to 30% increases in tiller density. Treatments that increased tiller density had little or no effect on forage nutritive value when applied more than 90 days before herbage was sampled. Nutritive value of prairie sandreed and total yield from all species in mid-September were unchanged after April treatments. After sandreed tillers began to emerge in early May, late-summer nutritive value improved as clipping was delayed and degree of defoliation increased during May and June, however, yield was inversely related to nutritive value. While mid-September nutritive value of prairie sandreed was comparable to mid-summer values after June treatments, clipping reduced projected, late-summer stocking rates by 58 to 100% compared to control. It may be possible to improve mid-September forage nutritive value with moderate stocking rates in June with less reduction of total late-summer herbage because of selective herbivory. Measurable increases in prairie sandreed yield after complete defoliation of associated species in late April indicated prairie sandreed populations might be increased by concentrating cattle in selected pastures during late April.

Herd-level economic analysis of the impact of paratuberculosis on dairy herds

Objective To perform a herd-level analysis of economic losses associated with paratuberculosis in dairy herds. Design Cross-sectional study. Sample Population A multistage stratified random sample of 121 dairy herds in Michigan. Procedure A 2-part questionnaire was used to gather data on management practices, herd productivity, labor use, and expenditures. Blood samples were collected from a random sample of cows ≥ 2 years old in each herd and tested for antibodies to Mycobacterium paratuberculosis. A herd was considered negative for paratuberculosis if results for all cows tested were negative. Multivariable linear regression was used to evaluate the data. Results A 10% increase in proportion of cows positive for paratuberculosis was associated with a 33.4 kg (73.5 Ib) decrease in mean weight of culled cows. Mortality rate among herds positive for paratuberculosis was 3% higher than rate among herds negative for paratuberculosis. Herds positive for paratuberculosis did not have a significantly higher annual number of hours of labor per cow than did herds negative for paratuberculosis. Clinical Implications For a herd of average size and cull rate, the reduction in mean weight of culled cows attributable to paratuberculosis represented a loss of approximately $1,150 annually for each 10% increase in herd prevalence of paratuberculosis. The increased mortality rate attributable to paratuberculosis represented a loss of between $1,607 and $4,400 on the basis of lost slaughter value and cost of replacement heifers. (J Am Vet Med Assoc 1999;214:822–825)

The fen-phen finale: a study of weight loss and valvular heart disease.

To assess weight loss, as well as the prevalence of valvular heart disease, in 21 obese women who completed 2 years of treatment by fenfluramine and phentermine (fen-phen) in June 1997. Patients were 21 of 22 women who had completed a 1-year, open-label trial of fen-phen combined with lifestyle modification. This study describes the results of a second year of treatment. The presence of valvular heart disease, defined as aortic regurgitation of mild or greater severity and/or mitral regurgitation of moderate or greater severity, was assessed using two-dimensional, color Doppler and pulsed- and continuous-wave Doppler examinations. At 2 years, the 21 patients had a mean reduction in initial weight of 13.9 + 10.0%, which was significantly (p<0.001) smaller than their 1-year loss of 17.1 +/- 8.7%. Nine of 21 patients reported that they took fen-phen irregularly during the last 4 months of the study because of fears of developing health complications. These nine patients had a 2-year weight loss of 8.7 +/- 7.5%, compared with a significantly (p<0.04) larger loss of 17.6 +/- 10.5% for participants who reported taking medication regularly. Six of 20 (30%) patients met criteria for valvular heart disease. None of the six had signs or symptoms of this condition. Fenfluramine was withdrawn from the market on September 15, 1997 because of concerns that it was associated with valvular heart disease. The present findings are discussed in terms of the potentially favorable long-term benefits of combining lifestyle modification with weight loss medications that are both safe and effective.

The relationship between maternal use of heroin and methadone and infant birth weight

AIMS/DESIGN: Reduction in mean birth weight and increased incidence of low birth weight are both associated with exposure to illicit heroin in pregnancy. Many studies examining neonatal outcomes in pregnant heroin users treated with methadone report improvements in birth weight. As a consequence, methadone treatment has become the 'gold standard' for the management of the pregnant heroin user. However, not all studies report significant birth weight increases associated with methadone. We undertook a number of meta-analyses on reduction in mean birth weight and incidence of low birth weight to estimate more precisely the effect of illicit heroin and methadone. Results showed mean reduction in birth weight associated with heroin use: 489 g (95% CI 284-693 g), compared with methadone: 279 g (229-328 g). Similarly, the pooled relative risk estimate for low birth weight for maternal heroin use was 4.61 (95% CI 2.78-7.65), compared with 1.36 (0.83-2.22) for methadone. Analysis of data on combined heroin and methadone use produced a pooled mean reduction in birth weight of 557 g (403-710 g), with a pooled relative risk estimate for low birth weight of 3.28 (2.47-4.39). Pooling 'any' methadone data, regardless of heroin use, produced an estimated reduction in birth weight of 395 g (311-478 g) and a relative risk estimate for low birth weight of 1.90 (1.29-2.81). Combining all data in an 'any' opiate use analysis also produced a mean reduction in birth weight of 483 g (386-583 g) and a relative risk estimate for low birth weight of 3.81 (2.57-5.65). The current findings suggest that heroin use while receiving methadone may counteract the birth weight advantage gained from methadone alone. Whether this is due to fetal exposure to heroin plus methadone, to reduced antenatal care, other behavioural and environmental factors associated with concurrent use of heroin and methadone or a combination of these is unclear. Nevertheless, these results challenge the current belief that the pregnant user is always better off receiving methadone than not, and suggests that methadone may not be the appropriate treatment for the pregnant women who continue to use illicit heroin.

Maternal cocaine use and low birth weight newborns: a meta‐analysis

Many epidemiological studies published on the association between maternal cocaine/crack use and birth weight have either lacked precision or failed to control for major confounding, predominantly by tobacco smoking. Meta-analysis enables a single summary measure of effect to be calculated by combining data from any number of individual studies, thus enhancing statistical power. We undertook a number of meta-analyses using only studies that had adjusted for tobacco smoking to estimate more precisely the effect of maternal cocaine use on birth weight. A meta-analysis of five studies presenting data for 'any' prenatal cocaine exposure, adjusted for tobacco smoking but unadjusted for gestational age, produced a pooled relative risk estimate from a fixed effects analysis of 2.15 (95% CI 1.75-2.64). However, there was substantial heterogeneity among studies (p < 0.001), and the relative risk from a random effects analysis was smaller (1.65) with a confidence interval that included unity (95% CI 0.94-2.83). Addition of a further study adjusted for gestational age had minimal effect on the pooled estimate: the fixed effects relative risk was 2.14 (1.77-2.60) and the random effects estimate 1.77 (1.15-2.71). When data on more intense prenatal exposure were analysed, the fixed and random effects analysis produced the same pooled estimate of the relative risk of 4.42 (2.24-8.71), suggesting that more frequent cocaine exposure was associated with a higher relative risk for low birth weight. Data from studies on mean reduction in birth weight produced a pooled estimate of 112 g (95% CI 62-161 g). The current study suggests that maternal cocaine use causes low birth weight, and that the effect is greater with heavier use. However, despite the adjustment for tobacco and the adjustment by some studies for other confounders such as race, maternal age, gravidity and socio-economic status, it could be argued that other life-style factors not controlled for may account for the observed effects. While this argument is not supported by some other types of study, the issue of residual confounding can only be finally addressed by analytical studies which adequately control for important variables.

Sibutramine (Meridia) Produces and Maintains Long-Term Weight Loss: Results of Two Pivotal Studies

LEARNING OUTCOME: To establish the efficacy of sibutramine (MERIDIA) for long-term weight management. Sibutramine hydrochloride (MERIDIA, Knoll Pharmaceutical Co.), a novel serotonin and norepinephrine reuptake inhibitor, was evaluated for the long-term treatment of obesity. Two multicenter, double-blind, placebo-controlled, parallel-group studies were conducted in uncomplicated obese patients to evaluate the weight-reducing efficacy of sibutramine in conjunction with dietary advice. The first study included 1047 adults with a body mass index (BMI) of 30 to 40 kg/m 2 who received once-daily sibutramine (1, 5, 10, 15, 20, or 30 mg) or placebo for 6 months. Study 2 included 485 adults with a BMI of 27 to 40 kg/m 2 who were randomized to receive once-daily sibutramine (10 or 15 mg) or placebo for 1 year. In the first study, a dose-response relationship was observed with sibutramine for absolute and percent weight loss, and BMI. Sibutramine significantly reduced weight at all doses ( p<0.05) and BMI ( p<0.05) (last-observation-carried-forward analyses, LOCF) at all doses except 1 mg compared with placebo. Paralleling weight loss were significant dose-related reductions in observed waist circumference at doses >10 mg compared with placebo ( p<0.05). Decreases in total cholesterol, LDL cholesterol, and triglycerides, and increases in HDL cholesterol also were seen in patients who lost weight with sibutramine. In study 2, treatment with sibutramine (10 and 15 mg) over 1 year produced a significant reduction in mean weight compared with placebo ( p<0.01). A statistically significant reduction in BMI ( p< 0.001) and waist circumference ( p<0.05) was observed at both doses. After 1 year (LOCF), 39% and 57% of patients taking sibutramine 10 and 15 mg, respectively, lost <5% of baseline body weight compared with 20% of the placebo group ( p< 0.001); 19% and 34% of patients taking sibutramine 10 and 15 mg, respectively, lost >10% of baseline body weight compared with 7% of patients in the placebo group ( p<0.01). These studies demonstrate the efficacy of once-daily sibutramine for long-term management of obesity, including weight loss and maintenance of weight loss.

Nutrient intake and weight development in children during chemotherapy for malignant disease

The aim of the study was to assess the actual daily oral intake of energy, protein, fat and carbohydrate in relation to current recommendations in children with malignant disease during chemotherapy and to follow their weight development. Dietary information was collected for 21 consecutive days via 7-day recording in 14 children, aged 5–16 years. The number of days with loss of appetite, vomiting, and the number of days on anti-emetic drugs were also recorded. The average daily energy intake decreased from 91% of the recommendation of the Swedish Nutrition Recommendations (SNR), before chemotherapy to 69% after start of chemotherapy. During days spent at home, the energy intake increased to 77% of SNR. Twenty-two per cent of the total energy intake during the hospital days came from sucrose. On average, the children experienced loss of appetite on 50% of the days, vomiting on 12%, and received anti-emetic drugs on 38%. On admission, the average SD score for body weight for the whole group was −0.09. The mean weight reduction after 1 week was 0.19 SD (P = 0.05) compared to the admission weight. The weight reduction 6 weeks (n = 10) and 3 months (n = 13) after the start of chemotherapy was 0.10 SD and 0.37 SD (P= 0.04), respectively.

Nutrient intake and weight development in children during chemotherapy for malignant disease.

The aim of the study was to assess the actual daily oral intake of energy, protein, fat and carbohydrate in relation to current recommendations in children with malignant disease during chemotherapy and to follow their weight development. Dietary information was collected for 21 consecutive days via 7-day recording in 14 children, aged 5-16 years. The number of days with loss of appetite, vomiting, and the number of days on anti-emetic drugs were also recorded. The average daily energy intake decreased from 91% of the recommendation of the Swedish Nutrition Recommendations (SNR), before chemotherapy to 69% after start of chemotherapy. During days spent at home, the energy intake increased to 77% of SNR. Twenty-two per cent of the total energy intake during the hospital days came from sucrose. On average, the children experienced loss of appetite on 50% of the days, vomiting on 12%, and received anti-emetic drugs on 38%. On admission, the average SD score for body weight for the whole group was -0.09. The mean weight reduction after 1 week was 0.19 SD (P = 0.05) compared to the admission weight. The weight reduction 6 weeks (n = 10) and 3 months (n = 13) after the start of chemotherapy was 0.10 SD and 0.37 SD (P = 0.04), respectively.

Weight reduction regresses left ventricular mass regardless of blood pressure level in obese subjects

The effects of weight reduction on left ventricular mass in obese normotensive and hypertensive subjects were investigated. Previous studies have shown that weight reduction in hypertensive (HT) obese patients in associated with decreased left ventricular mass (LVM) and decreased blood pressure (BP). This study was performed to examined whether weight reduction would also regress LVM in normotensive (NT) obese subjects and to clarify the mechanisms of these effects if they occurred. A weight-reduction program consisted of mild exercise and mild hypocaloric intake. M-mode echocardiography was performed to estimate the LVM. After the 12-week intervention, the mean reductions in body weight (BW) in the NT ( n = 11) and HT ( n = 11) groups were 4.9 kg ( p < 0.005) and 4.6 kg ( p < 0.0005), respectively. Systolic, diastolic, and mean BP were significantly reduced by 13, 9, and 11 mm Hg, respectively, in the HT group. By contrast, no significant changes in systolic, diastolic, or mean BP were observed in the NT group. LVM was significantly reduced from 176 ± 26 gm to 159 ± 26 gm ( p < 0.05) in the HT group and from 167 ± 33 gm to 145 ± 34 gm ( P < 0.02) in the NT group. These results suggest that weight reduction in obese subjects by mild exercise and mild hypocaloric intake can lead to a reduction in LVM, regardless of whether the subjects have normal or high blood pressure.

Effects of weight loss vs aerobic exercise training on risk factors for coronary disease in healthy, obese, middle-aged and older men. A randomized controlled trial

<h3>Objective.</h3> —To compare the effects of weight loss vs aerobic exercise training on coronary artery disease risk factors in healthy sedentary, obese, middle-aged and older men. <h3>Design.</h3> —Randomized controlled trial. <h3>Subjects.</h3> —A total of 170 obese (body mass index, 30±1 kg/m²[mean±SEM]), middle-aged and older (61 ±1 years) men. <h3>Interventions.</h3> —A 9-month diet-induced weight loss intervention, 9-month aerobic exercise training program, and a weight-maintenance control group. <h3>Main Outcome Measures.</h3> —Change in body composition, maximal aerobic capacity (Vo₂max), blood pressure, lipoprotein concentrations, and glucose tolerance. <h3>Results.</h3> —Forty-four of 73 men randomized to weight loss completed the intervention and had a 10% mean reduction in weight (-9.5±0.7 kg;<i>P</i>&lt;.001), with no change in Vo₂max. Forty-nine of 71 men randomized to aerobic exercise completed the intervention, increased their Vo₂max by a mean of 17% (<i>P</i>&lt;.001), and did not change their weight, whereas the 18 men who completed in the control group had no significant changes in body composition or Vo₂max. Weight loss decreased fasting glucose concentrations by 2%, insulin by 18%, and glucose and insulin areas during the oral glucose tolerance test (OGTT) by 8% and 26%, respectively (<i>P</i>&lt;.01). By contrast, aerobic exercise did not improve fasting glucose or insulin concentrations or glucose responses during the OGTT but decreased insulin areas by 17% (<i>P</i>&lt;.001). In analysis of variance, the decrement in fasting glucose and insulin levels and glucose areas with intervention differed between weight loss and aerobic exercise when compared with the control group (<i>P</i>&lt;.05). Similarly, weight loss but not aerobic exercise increased high-density lipoprotein cholesterol levels (+13%) and decreased blood pressure compared with the control group. In multiple regression analyses, the improvement in lipoproteins and glucose metabolism was related primarily to the reduction in obesity. <h3>Conclusions.</h3> —These results suggest that weight loss is the preferred treatment to improve coronary artery disease risk factors in overweight, middle-aged and older men. (<i>JAMA</i>. 1995;274:1915-1921)

Mefloquine Prophylaxis Prevents Malaria during Pregnancy: A Double-Blind, Placebo-Controlled Study

A double-blind, placebo-controlled study of mefloquine antimalarial prophylaxis in pregnancy (> 20 weeks of gestation) was conducted in 339 Karen women living in an area of multidrug-resistant malaria transmission on the Thai-Burmese border. Mefloquine gave > or = 86% (95% confidence interval [CI], 59%-94%) protection against Plasmodium falciparum and complete protection against Plasmodium vivax infections. Mefloquine prophylaxis was well tolerated; use of an initial loading dose (10 mg/kg) was associated with transient dizziness, but there were no other significant adverse effects on the mother, the pregnancy, or infant survival or development (followed for 2 years). Falciparum malaria was associated with maternal anemia and a mean reduction in birth weight in gravidae I, II, and III of 225 g (95% CI, 26-423). Maternal anemia at delivery (hematocrit < 30%) was associated with increased infant mortality: 26% versus 15% (relative risk, 1.9; 95% CI, 1.1-3.2). Mefloquine is safe and effective for antimalarial prophylaxis in the second half of pregnancy.

Age-dependent immune response of chickens to feeding by Argas persicus larvae

Chickens of the dwarf Velsum breed acquired immunity to Argas persicus larvae during repeated infestations with 100 larval ticks in 2-week intervals, when primarily infested at the age of 10 weeks. This immunity was manifested by 74.6% and 75.9% rejection of larvae during secondary and tertiary infestation ( P<0.01), respectively, in relation to controls. The mean weight reductions observed were 16.5% and 12.2% in secondary and tertiary infestations, respectively ( P < 0.05). Weak immunity also occured after secondary and tertiary infestations in chickens infested first at the age of 6 and 8 weeks, but not in chickens aged 2 or 4 weeks at first infestation. No changes were observed in mean feeding periods of larvae engorged on chickens of all age groups ( P > 0.05). A significant increase in the leucocyte counts in peripheral blood ( P < 0.01 or P < 0.05), mostly of lymphocytes and heterophil granulocytes, followed each infestation in chickens of all age groups. Specific anti-tick circulating antibodies were detected by ELISA in the sera of 10-week-old chickens after primary infestations, in the 4–8-week chicken groups following secondary infestations when aged 6–10 weeks, and in the 2-week chicken group only after tertiary infestations, when the chickens reached the age of 6 weeks. A 53 kDa protein was recognized in the whole-body extract of larval ticks by immune serum during immunoblotting. This was probably the antigenic protein responsible for eliciting the circulating antibodies. The acquired immunity to ticks seen in chickens aged 6 weeks or more may be connected with maturation of the bursa of Fabricius and the development of complete immunocompetence, which is believed to occur in chickens at the age of 4–5 weeks.