Weight Loss - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

WEIGHT LOSS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2003 by ICON Group International, Inc. Copyright 2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Weight Loss: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83723-6 1. Weight Loss-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on weight loss. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON WEIGHT LOSS ........................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Weight Loss................................................................................... 6 E-Journals: PubMed Central ....................................................................................................... 64 The National Library of Medicine: PubMed ................................................................................ 65 CHAPTER 2. NUTRITION AND WEIGHT LOSS................................................................................ 151 Overview.................................................................................................................................... 151 Finding Nutrition Studies on Weight Loss ............................................................................... 151 Federal Resources on Nutrition ................................................................................................. 155 Additional Web Resources ......................................................................................................... 155 CHAPTER 3. ALTERNATIVE MEDICINE AND WEIGHT LOSS ......................................................... 159 Overview.................................................................................................................................... 159 The Combined Health Information Database............................................................................. 159 National Center for Complementary and Alternative Medicine................................................ 160 Additional Web Resources ......................................................................................................... 168 General References ..................................................................................................................... 180 CHAPTER 4. DISSERTATIONS ON WEIGHT LOSS ........................................................................... 181 Overview.................................................................................................................................... 181 Dissertations on Weight Loss .................................................................................................... 181 Keeping Current ........................................................................................................................ 187 CHAPTER 5. CLINICAL TRIALS AND WEIGHT LOSS ...................................................................... 189 Overview.................................................................................................................................... 189 Recent Trials on Weight Loss .................................................................................................... 189 Keeping Current on Clinical Trials ........................................................................................... 199 CHAPTER 6. PATENTS ON WEIGHT LOSS ...................................................................................... 201 Overview.................................................................................................................................... 201 Patents on Weight Loss.............................................................................................................. 201 Patent Applications on Weight Loss.......................................................................................... 233 Keeping Current ........................................................................................................................ 265 CHAPTER 7. BOOKS ON WEIGHT LOSS .......................................................................................... 267 Overview.................................................................................................................................... 267 Book Summaries: Federal Agencies............................................................................................ 267 Book Summaries: Online Booksellers......................................................................................... 270 The National Library of Medicine Book Index ........................................................................... 277 Chapters on Weight Loss............................................................................................................ 278 Directories.................................................................................................................................. 279 CHAPTER 8. MULTIMEDIA ON WEIGHT LOSS ............................................................................... 281 Overview.................................................................................................................................... 281 Video Recordings ....................................................................................................................... 281 Audio Recordings....................................................................................................................... 294 Bibliography: Multimedia on Weight Loss ................................................................................ 295 CHAPTER 9. PERIODICALS AND NEWS ON WEIGHT LOSS ............................................................ 297 Overview.................................................................................................................................... 297 News Services and Press Releases.............................................................................................. 297 Newsletters on Weight Loss....................................................................................................... 300 Newsletter Articles .................................................................................................................... 301 Academic Periodicals covering Weight Loss .............................................................................. 304 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 305 Overview.................................................................................................................................... 305

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U.S. Pharmacopeia..................................................................................................................... 305 Commercial Databases ............................................................................................................... 306 Researching Orphan Drugs ....................................................................................................... 307 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 311 Overview.................................................................................................................................... 311 NIH Guidelines.......................................................................................................................... 311 NIH Databases........................................................................................................................... 313 Other Commercial Databases..................................................................................................... 318 APPENDIX B. PATIENT RESOURCES ............................................................................................... 319 Overview.................................................................................................................................... 319 Patient Guideline Sources.......................................................................................................... 319 Finding Associations.................................................................................................................. 332 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 335 Overview.................................................................................................................................... 335 Preparation................................................................................................................................. 335 Finding a Local Medical Library................................................................................................ 335 Medical Libraries in the U.S. and Canada ................................................................................. 335 ONLINE GLOSSARIES................................................................................................................ 341 Online Dictionary Directories ................................................................................................... 343 WEIGHT LOSS DICTIONARY................................................................................................... 345 INDEX .............................................................................................................................................. 431

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with weight loss is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about weight loss, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to weight loss, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on weight loss. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to weight loss, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on weight loss. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON WEIGHT LOSS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on weight loss.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and weight loss, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “weight loss” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Dronabinol As A Treatment for Anorexia Associated With Weight Loss in Patients With AIDS Source: Journal of Pain and Symptom Management; Vol. 10, No. 2, Feb. 1995. Contact: Elsevier Science, 655 Ave of the Americas, New York, NY, 10010, (212) 6333971, http://www.elsevier.com. Summary: Dronabinol and its effects on 139 patients with advanced HIV disease are the focus of this article. Patients rate their appetite, mood, and nausea in this random, double-blind, placebo- controlled study. All the patients receiving dronabinol show increased appetite. Mood and nausea improvements are other positive effects as well as weight stabilization. The authors conclude dronabinol is a safe, effective means of

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treating anorexia due to AIDS and recommend a study of prolonged treatment with the drug. •

Weight Loss in Alzheimer's Disease: An International Review of the Literature Source: International Psychogeriatrics. 6(2): 135-142. Fall 1994. Summary: The authors reviewed the existing literature to support the clinical observations of weight loss in Alzheimer's disease (AD) despite adequate food intake. To date, eight international studies have focused on nutrition in AD; all have found weight loss. It is not clear whether this weight loss is a component of or a consequence of the disease. Findings suggest systemic, metabolic alterations in AD. The authors believe these alterations require further study to determine their nature and appropriate recognition and management to retard the deteriorating effects of chronic weight loss and malnutrition. Some reports lead to speculation that nutritional strategies may improve cognitive function. 45 references. (AA-M).

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Maintenance of Weight Loss Using Taste and Smell Sensations Source: Journal of Women's Health. 8(1): 109-113. January-February 1999. Contact: Available from Mary Ann Liebert, Inc. 2 Madison Avenue, Larchmont, NY 10538. (914) 834-3100. Fax (914) 834-3582. E-mail: [email protected]. Website: www.liebertpub.com. Summary: The mechanism responsible for matching the intake and expenditure of nutrients in order to maintain body weight is not fully understood. This article reports on a study in which 7 females learned to terminate the act of eating when the pleasantness of flavor of food subsided during a meal. By the end of 1 month, significant weight loss took place in the study group compared with the baseline weight and was maintained throughout the study period of 1 year. The author concludes that focusing on the changes in oronasal sensory signals (taste and smell) during a meal could facilitate weight maintenance. The author discusses behavior modification strategies and calls for additional research investigating the role of taste and smell signals in weight maintenance. 1 figure. 3 tables. 26 references. (AA-M).

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Weight Loss and Senile Dementia in an Institutionalized Elderly Population Source: Journal of the American Dietetic Association. 89(6): 790-792. June 1989. Summary: The purpose of this study was to determine whether patients with Alzheimer's disease or senile dementia have a higher incidence of underweight and weight loss than non-demented patients. In a retrospective study, the admission weight and height and the current weight of 36 patients with Alzheimer's disease and senile dementia of the Alzheimer's type were compared with those of 31 non-demented patients. Patients with Alzheimer's disease or senile dementia were significantly below minimum acceptable body weight on admission and were significantly below minimum acceptable body weight after an average of 17 months in the institution in comparison with the control group. Additional research is needed to determine whether the weight loss seen in patients with Alzheimer's disease or senile dementia is due to a metabolic aberration inherent in the disease or to management issues in feeding those patients. 28 references. (AA).

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Preventing Precipitous Weight Loss in Demented Patients by Altering Food Texture Source: Journal of Nutrition for the Elderly. 15(3): 43-47. 1996.

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Summary: This article describes a study of Alzheimer's disease (AD) patients who displayed a behavioral intolerance to food texture. A feeding group was designed by a team of speech and language pathologists to assist clients with eating and to evaluate clients for possible feeding tube placement. The project evaluated the effectiveness of the feeding program for weight maintenance and developed guidelines to screen clients for future participation in the feeding group. The study was conducted by retrospectively reviewing patients' charts for weight, height, diet orders, and activities of daily living. Diet progression was rated from a variety of textures (regular diet) to a homogenous or smooth texture (puree). The authors conclude that the physical ability to eat must be considered when patients refuse to eat. Changing the texture of food may enable patients with dementia to eat and maintain their weight through oral intake and may postpone tube feeding. 1 table, 14 references. •

Weight Loss Precedes Dementia in Community-Dwelling Older Adults Source: Journal of the American Geriatrics Society. 44(10): 1147-1152. October 1996. Summary: This article describes a study supported by the National Institute on Aging to determine whether the weight loss associated with Alzheimer's disease (AD) precedes or follows the dementia. Participants were 134 older community-dwelling men and 165 older community-dwelling women who were followed for 20 years prior to diagnosis as being cognitively intact or having dementia. A repeated measures analysis was used to compare weight changes in those who developed AD with those who remained cognitively intact. Thirty-six men and 24 women were diagnosed with probable or possible AD (mild to moderate), and they were older than those diagnosed as cognitively intact. In age-adjusted analyses, both men and women who were later diagnosed with AD had a significant decrease in weight after the baseline visit, but there was no significant weight loss in men and women who remained cognitively intact. These differences were not explained by lifestyle, depression, or other illnesses. The authors conclude that weight loss may precede mild to moderate dementia; and early weight loss is, therefore, unlikely to be a consequence of AD patients being unable or unwilling to eat. 2 figures, 1 table, 36 references. (AA-M).

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Factors Contributing to Minimizing Weight Loss in Patients With Dementia Source: American Journal of Alzheimer's Disease. 10(4): 33-38. July-August 1995. Summary: This article discusses Alzheimer's disease patients and factors contributing to minimizing weight loss, the negative effect of dementia symptoms on normal eating patterns and nutritional intake, the eating environment and its effects on food intake, and communication techniques to encourage eating. It introduces interventions to minimize weight loss and discusses staff education and training. It describes Caring Hands, an assisted dining program, which creates a facility culture that emphasizes dining with dignity. According to the author, through caregiver/patient interaction, the program establishes better food intake, greater socializing during mealtime, and fewer behavioral problems. 6 references. (AA-M).

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Weight Loss in Alzheimer's Disease Source: Journal of Geriatric Psychiatry and Neurology. 6(1): 34-38. January-March 1993. Summary: This journal article describes a study that investigated the extent and pathogenesis of weight loss in persons with Alzheimer's disease. Data were collected prospectively for 81 outpatients with a diagnosis of probable Alzheimer's disease. All patients had dementia of mild to moderate severity. Over a mean observation period of

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2.9 years, there was a mean absolute weight loss of 1.9 kg and a mean weight loss per year of 0.7 kg. Although statistically significant, the mean weight loss was only 3 percent of initial body weight. Weight loss was significantly associated with a decline in ability to eat independently but was not associated with duration or severity of dementia, overall independence in activities of daily living, hyperactive behavior, or measures of depression. The authors conclude that weight loss is a secondary manifestation and not a core symptom of Alzheimer's disease. 13 references. •

Insight into Wasting May Lead to Better Treatment: Weight Loss Can Damage the Quality of Life of HIV - Positive Patients - and There Is More to the Problem Than Poor Caloric Intake and Severe Illness Source: Journal of the Physicians Association for AIDS Care; Oct. 1994. Contact: International Association of Physicians in AIDS Care, 33 N LaSalle St Ste 2600, Chicago, IL, 60602-2601, (312) 795-4930, http://www.iapac.org. Summary: This journal article focuses on involuntary weight loss or wasting, a common manifestation of HIV infection. It labels excessive basal metabolism, increased neopterin, and inappropriate thyroid function as risk factors identified in a study designed to estimate the influence of clinical, immunologic, and hormonal variables; and body composition on weight loss in 70 adults with AIDS. The article advocates providing HIV-infected individuals with nutritional supplements at the earliest possible stage of AIDS to inhibit the development of wasting syndrome. It examines the therapeutic value of mammalian cell-derived recombinant human growth hormone (r-hGHm) and summarizes findings from growth hormone treatment studies.

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Weight Loss in Alzheimer's Disease and Resting Energy Expenditure (REE): A Preliminary Report Source: Journal of the American Geriatrics Society. 45(11): 1414-1415. November 1997. Summary: This letter to the editor briefly summarizes a study that explored the cause of weight loss in Alzheimer's disease (AD). The participants were 12 patients with probable AD who were hospitalized for a history of weight loss without any other medical complication or nutritional or behavioral disorder. The patients were assessed with measures of daily energy intake, resting energy expenditure (REE), body composition, total body water, cognitive and functional status, and nutritional status. There was no correlation between history of weight loss and REE, daily caloric intake, fat-free mass, or body composition. Severity of dementia was not correlated with either weight loss or REE. In the authors' opinion, these findings suggest that central regulation of body composition, weight, and normal capacity of energy balance may be altered in AD. 1 table, 5 references.

Federally Funded Research on Weight Loss The U.S. Government supports a variety of research studies relating to weight loss. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable 2

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to weight loss. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore weight loss. The following is typical of the type of information found when searching the CRISP database for weight loss: •

Project Title: A BEHAVIORAL ECONOMIC APPROACH TO CHILDHOOD OBESITY Principal Investigator & Institution: Epstein, Leonard H.; Professor; Pediatrics; State University of New York at Buffalo 402 Crofts Hall Buffalo, Ny 14260 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2006 Summary: (adapted from Investigator's abstract) Food is a powerful primary and secondary reinforcer, and obese persons find food more reinforcing than nonobese persons. In addition, obese persons may find alternatives to food less reinforcing than nonobese persons, providing a mechanism to understand why obese persons consume excess calories. The food deprivation that is associated with a calorie reduced diet may increase the reinforcing value of food, paradoxically making it more difficult for some obese persons to maintain the decreased caloric levels needed for weight loss and maintenance. This study is designed to test an innovative program for pediatric obesity based on behavioral economic theory that provides reinforcement for obese children for alternatives to their usual high-fat/low nutrient density eating, reduces access to intake of high-fat foods, and teaches parents to reduce behaviors that may increase the reinforcing value of high-fat foods. One hundred twenty obese children will be randomized to one of two groups, an innovative experimental treatment based on behavioral economic principles, and our standard family-based behavioral intervention program. Children will be followed through 2 years after randomization. Dependent measures will include body mass index, changes in percent overweight, changes in the eating and activity environment, parent control and restriction of food intake, child perception of dietary restriction, caloric and nutrient intake, physical activity, and the reinforcing value of noneating alternatives to high-preference, palatable high-fat/low nutrient density foods. This study will yield important information on new ways to treat pediatric obesity, minimizing dietary restriction and maximizing children learning healthier eating habits. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: A WEIGHT LOSS PROGRAM FOR OBESE BLACK WOMEN WITH OA Principal Investigator & Institution: Henderson, Carol J.; Assistant Professor; Nutrition & Lab Technologies; Georgia State University University Plaza Atlanta, Ga 30303 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2005 Summary: (provided by applicant): African American (AA) women are at increased risk for obesity and the subsequent development of knee OA. A modest weight loss of 510% of baseline weight has been shown to reduce pain, functional disability, and

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improve gait in patients with knee OA. No culturally sensitive comprehensive weight loss programs combining diet and exercise have been developed for AA women with knee OA. We will test the hypothesis that overweight or obese, low socioeconomic (SES), urban AA women with knee OA who participate in a culturally sensitive dietary and physical activity behavior change pilot intervention for 3 months will experience at least a 5% reduction in their baseline body weight. It is also hypothesized that postintervention 6-minute walking distance will improve compared to baseline. Specific Aim 1: To gain an understanding of behavioral and psychosocial determinants of dietary intake, eating patterns, and physical activity, a review of the literature and discussions with researchers, practitioners, and local community leaders will be performed. Specific Aim 2: Conduct exploratory focus groups to qualitatively evaluate factors that influence fruit/vegetable (F&V), fat intake, calorie-containing beverage consumption (CCB), and physical activity. Specific Aim 3: Develop new or modify existing dietary and physical activity-related educational materials and evaluation instruments for use in the pilot weight loss intervention. Specific Aim 4: Conduct focus groups to pre-test the cultural sensitivity and potential salience of intervention messages and materials. Specific Aim 5: Perform a 3-month pilot intervention to assess weight and maximal walking distance and the feasibility of implementing the culturally sensitive weight loss program. Methodology: A pre-post repeated measures design will be implemented in at least 36 overweight or obese AA women with knee OA. Primary outcomes are % weight change from baseline body weight and % change in 6minute maximum walking distance from baseline. Daily walking distance will be determined using pedometers. Other outcomes include dietary, physical activity, pain, functional ability, and stage of change assessment that will be performed at baseline and 3 months. Long-term goals: Conduct a prospective RCT in overweight or obese, low SES, urban AA women with knee OA utilizing the newly developed culturally sensitive weight loss program, and study the longevity of sustained weight loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ANOREXIA INFLAMMATION

AND

WEIGHT

LOSS

DURING

ACUTE

Principal Investigator & Institution: Lennie, Terry A.; None; Ohio State University 1800 Cannon Dr, Rm 1210 Columbus, Oh 43210 Timing: Fiscal Year 2001; Project Start 15-AUG-1998; Project End 31-MAY-2003 Summary: (Adapted from the Investigator's Abstract): Anorexia and accelerated catabolism leading to marked loss of body weight are common manifestations of the systemic inflammatory response to traumatic injury, infection, and cancer. Loss of protein translates into loss of tissue function because body protein has no inactive storage form; thus, extended periods of inflammation have the potential of increasing morbidity and mortality. Much remains unknown about the in vivo interaction of proinflammatory cytokines with other host factors during the acute inflammatory response. This proposed research seeks to examine the interaction among factors believed to alter energy-regulatory systems during acute inflammation. These factors include proinflammatory cytokines (IL-1, IL-6, and TNF-tumor necrosis factor) which are thought to inhibit normal protein-energy conserving mechanisms, and hormones shown to be involved in long-term energy regulation (namely insulin, leptin, and glucocorticoids). Gender comparison will be made because reproductive hormones may act synergistically with multiple components of the inflammatory response to enhance anorexia and weight loss. An animal model of acute inflammation will be used in which body weight of the animal is normal, or has been experimentally increased or decreased

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at the time acute inflammation is induced. The interactive relationship of hormones and cytokines to food intake, meal pattern, micronutrient selection, and body weight at key time points following acute inflammation in male and female rats will be characterized. Because insulin, leptin, and glucocorticoid levels vary according to body weight, this approach provides an ideal in vivo method for studying the interaction among gender, hormones, and cytokines to determine their roles in inflammation-induced anorexia. Results of this research will provide information to guide the development of interventions that not only increase energy intake, but also promote maintenance of normal body composition during acute inflammation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BARIATIC PATHOPHYSIOLOGY

SURGERY:

OUTCOMES

&

IMPACT

ON

Principal Investigator & Institution: Berk, Paul D.; Chief, Division of Liver Diseases; Medicine; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): The increasing prevalence of obesity in the U.S. is well documented by a series of surveys conducted by the National Center for Health Statistics. Its 1999-2000 data revealed that a staggering 62.5 % of adult Americans aged = 20 were overweight (BMI >= 25), and 30.5 % were obese (BMI >= 30). Projections suggest that by the year 2025 45% of adult Americans will be frankly obese. The increasing prevalence of obesity has fueled an increase in obesity-associated healthcare costs that reached $100 billion annually (5.7% of our national health expenditure) by 1995, and is surely even greater today. Obesity is associated with markedly increased risks of many comorbidities, of which hypertension, non-insulin-dependent diabetes mellitus (NIDDM), dyslipidemias, and cardiovascular disease are major contributors to 300,000 obesity related deaths annually. Non-alcoholic fatty liver disease (NAFLD) has recently emerged as a serious complication of obesity, and its most severe form, nonalcoholic steatohepatitis (NASH), is now the third most common indication for liver transplantation. Medical therapies for obesity are of very limited success. The best results for long term control of weight and of the various co-morbidities of obesity derive from bariatric surgery. The Mount Sinai School of Medicine has a large and innovative bariatric surgery program, which has focused on the development of minimally invasive (laparoscopic) bariatric methods. In this application, we propose to study the efficacy and safety of a novel, two stage surgical treatment of morbid-and super-obesity (BMI = 60) that combines an initial restrictive operation (sleeve gastrectomy) with a subsequent malabsorptive procedure (biliopancreatic diversion with duodenal switch) performed after the loss of ca. 100 Ib, when the patient is a better operative risk. Preliminary data suggest the approach is both effective and safe, with an appreciable reduction in operative morbidity and mortality compared with conventional, open abdominal surgery in this population. The nature of the protocol allows collaborating scientists to conduct virtually unique studies of changes in adipose tissue fatty acid metabolism, hepatic histology, triglyceride accumulation and fibrogenesis, patterns of adipocyte and hepatocyte gene expression, alterations in levels of circulating hormones that modulate hunger and satiety, and changes in regional brain activity in response to food stimuli, that result from extensive weight loss. In a second protocol, effects of laparoscopic Roux-en-Y gastric bypass on short and long term control of weight and NIDDM in obese patients with initial BMIs = 35 will be compared with results of ADA-recommended optimal medical care. By conducting this as a

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cooperative study at multiple sites within the Bariatric Surgery Clinical Research Consortium, the results will make a compelling statement about the optimal approach to control of obesity and NIDDM in this population, that represents an ever-increasing subset of adult Americans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BARIATRIC SURGERY RESEARCH CONSORTIUM Principal Investigator & Institution: Flum, David R.; Surgery; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): Bariatric procedures offer sustained and significant weight reduction with the potential to effect general patient health, comorbid conditions, quality of life and the healthcare system. A Bariatric Surgery Clinical Research Consortium (BSCRC) wilt provide important prospective information about the true impact of the procedure on patients and opportunities to better explore the physiologic mechanisms that result in post-surgical weight loss. The BSCRC will prospectively collect clinical, demographic, epidemiological, laboratory and histological information. In addition to this database the BSCRC will complete the following studies: 1. A cross-sectional examination of the epidemiology of non-alcoholic steatohepatitis (NASH) in patients undergoing bariatric surgery and a prospective evaluation of the effect of surgically induced weight loss on the severity NASH and cellular markers of cytotoxic activity. There is a need for epidemiologic information about the prevalence, risk factors for, and impact of fatty liver disease in patients undergoing bariatric surgery. We propose a study to evaluate liver histology in a large group of patients undergoing bariatric procedures. Patients with evidence of NASH by biopsy will undergo subsequent liver biopsy at one year to determine if NASH improves with rapid weight loss. Patients with NASH who improve after weight loss represent an important model for evaluating the cellular mechanisms that are involved in the development of NASH. This study will evaluate markers of oxidative stress and hepatic mitochondrial structure to determine their relationship to NASH during and after rapid, surgical weight loss. 2. A prospective evaluation of the relationship between ghrelin, PYY3-36, appetite and weight loss outcomes after gastric bypass. Ghrelin and PYY3-36 are gutderived peptides that are involved in energy homeostasis principally through their effect on appetite. We propose a prospective study to determine the relationship of ghrelin and weight loss after gastric bypass and to determine if the degree of ghrelin suppression is correlated to hunger suppression and/or the amount of weight lost. This study will determine if inclusion of ghrelin producing cells in the gastric pouch is correlated to worsened weight loss outcomes. Lastly the study will begin to evaluate the relationship of PYY3-36 and ghrelin and determine if it is altered by or in response to the physiologic changes associated with gastric bypass. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BEHAVIOR MAINTENANCE

CHOICE

TREATMENT

PROMOTES

WEIGHT

Principal Investigator & Institution: Sbrocco, Tracy; Associate Professor; Henry M. Jackson Fdn for the Adv Mil/Med Rockville, Md 20852 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2004 Summary: (adapted from investigator's abstract): The purpose of this project is to compare the effectiveness of Behavior Choice Treatment (BCT), a new theoretically

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based dietary intervention, with Behavior Therapy in producing sustained behavior changes and weight maintenance over a two-year follow-up. The central hypothesis of the proposed research is that BCT, a cognitive-behavioral treatment for obesity based on principles of behavioral decision theory, can promote continuing weight loss and exercise maintenance over a 24-month follow-up. This hypothesis was formulated based on pilot data that demonstrated that Behavior Choice Treatment was successfully applied to promote continuing weight loss and exercise over 12-month follow-up (Sbrocco et al., 1999). Rather than showing regain at one-year follow-up, subjects in the BCT demonstrated a slow, continual weight loss totaling 22 lbs (10 kg) at follow-up. The objectives of this application are (1) to further evaluate the long-term efficacy of Behavior Choice Treatment compared to traditional behavior therapy among AfricanAmerican women, (2) to extend the follow-up to two years, and (3) to examine the impact of level of calorie prescription in promoting long-term weight maintenance. Two hundred forty African-American women from churches in Washington, D.C, will participate in 1 of 3 13-session treatments (BCT with 1800 kcal; BT with 1200 kcal; BT with 1800 kcal) and will be assessed using a multi-modal battery to evaluate treatment process and outcome (post, 3, 6, 12, 18, & 24 month follow-ups). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BEHAVIORAL & PHARMACOLOGIC THERAPY OF ADOLESCENT OBESITY Principal Investigator & Institution: Berkowitz, Robert I.; Associate Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 15-MAR-1999; Project End 31-MAY-2007 Summary: (provided by applicant): Obesity is a serious and growing health problem in America's youth. The prevalence of adolescent obesity, for example, increased from 11% to 13% in the past 5 years and shows no signs of abating. This increase has been accompanied by a dramatic rise in type 2 diabetes and other health complications. The goal of this renewal application is to continue efforts to improve the treatment of obese adolescents. In a study conducted during the past 36 months, we found that the addition of the weight loss medication sibutramine to a comprehensive program of diet and exercise significantly increased the induction of weight loss compared with behavioral treatment alone (7.9 kg vs. 3.4 kg, respectively). This renewal application builds on these findings by addressing two additional issues. First, we wish to show that the use of a 1200-1500 kcal/day liquid-meal replacement will induce significantly greater weight losses during the first 16 weeks of treatment than will a conventional diet of 1200-1500 kcal/day comprised of self-selected table foods with the same calorie goal. This result has been obtained in several studies of adults but has never been tested in adolescents. Second, we wish to show that long-term use of a liquid meal replacement will significantly improve the maintenance of weight loss from weeks 17-52, compared with the prescription of a conventional diet with the same calorie goal. The liquid meal replacement will facilitate the induction and maintenance of weight loss by providing participants with portion-controlled servings of a fixed calorie value. This stimulusnarrowing approach would appear to be an excellent antidote to the super-sized servings of high fat, high sugar foods found in America today. Participants in this study will be 110 teens (about 66% female), who are 13 to 17 years old, and have a body mass index (BMI) of 30 to 44 kg/m 2. The proposed study is the first randomized controlled trial to examine methods of improving the maintenance of weight loss in obese teens. We believe that the long-term use of liquid meal replacement will produce the best results obtained to date in this largely neglected population.

12 Weight Loss

Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BEHAVIORAL TREATMENT OF HIGH BLOOD PRESSURE Principal Investigator & Institution: Blumenthal, James A.; Professor; Psychiatry; Duke University Durham, Nc 27706 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2007 Summary: (provided by applicant): High Blood Pressure (HBP) is a major health problem in the United States, with most adults >35 years of age exhibiting BP above optimal levels. Persons with HBP exhibit subclinical vascular disease, which is associated with increased risk for cardiovascular and cerebrovascular morbidity and mortality. Although pharmacologic treatments have proven to be successful in reducing HBP in many patients, drug therapy is not always successful and may be associated with iatrogenic effects that compromise compliance and impair quality of life. Furthermore, abnormalities associated with HBP, including insulin resistance and dyslipidemia, may persist or may even be exacerbated by anti-hypertensive medications. Thus, there continues to be a need to develop behavioral treatments for reducing HBP. There is now good reason to believe that diet and exercise may be one such approach. The study proposed in this application will build upon our previous work in which we demonstrated that exercise, especially when combined with a behavioral weight loss program, resulted in clinically significant BP reductions. In addition, feeding studies have demonstrated that a diet high in low fat dairy products as well as fruits and vegetables (i.e., the DASH diet) may significantly reduce BP without weight loss. The present application seeks to extend these findings by (a) evaluating the efficacy of the DASH diet in a free-living situation; (b) considering the DASH diet alone and in combination with a cognitive-behavioral weight loss program including aerobic exercise; (c) examining the impact of diet and exercise on cardiac, metabolic, and vascular function, and (d) following patients for one year to determine the longer term impact of the interventions on BP, body weight, and cardiovascular function. One hundred twenty men and women with HBP will be randomly assigned to the DASH diet alone, the DASH diet combined with a behavioral weight loss program, or to a usual care control condition. Before and after 4 months of treatment, patients will undergo assessments of BP and measures of arterial stiffness, endothelial function, baroreflex control, body composition, insulin resistance, systemic hemodynamics, and left ventricular structure and function. Twelve month follow-up will assess maintenance of benefit. The data generated from this study will have important clinical significance by determining the extent to which the DASH diet, alone and combined with caloric restriction and exercise, may lower BP and improve associated risk factors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BENEFITS & HAZARDS OF KETOGENIC LOW CARBOHYDRATE DIETS Principal Investigator & Institution: Karanja, Njeri; Medicine; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001; Project Start 01-MAY-2001; Project End 31-MAR-2003 Summary: (APPLICANT'S ABSTRACT): Low-carbohydrate, high-fat, high-protein diets promoted by books, the Internet and other media are among the most enduring weightloss diets in the US and Europe. The public favors these diets because they include popular energy-rich foods like meat and cheese while at the same time promising to produce rapid weight loss. Without an evidence-based understanding the consequences

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of these diets, health care providers may find it difficult to evaluate these diets in advising clients who are choosing to use them to reduce weight in large numbers. The goal of this pilot project is to establish methodology for studying these diets in a clinical trial setting. A group of 24 overweight participants with BMIs between 27 and 39.9 Kg/m~ will be studied in a parallel group design for six weeks of controlled feeding and six weeks of follow-up. After screening, participants will be allocated to either a low-carbohydrate diet similar to the one marketed by Dr. Robert Atkins, or to an energy-matched, high carbohydrate, low fat diet similar to the combination diet used in the DASH study for six weeks. Participants will receive all foods and beverages in the General Clinical Research Center at Oregon Health Sciences University during the controlled feeding phase. Participants will first consume a standard American diet for one week to stabilize their energy requirements and acclimate to the demands of the study. This run-in week will be followed by a six-week period when participants consume either the Atkins diet or the DASH diet. Follow-up consists of following these same diets in the home setting for an additional six weeks. Measures of interest include markers of oxidative damage, cardiovascular disease (CVD) risk (lipids, blood pressure insulin, glucose), bone health, energy expenditure, substrate utilization and body composition. We will also conduct focus groups and individual interviews during the period when participants follow these diets at home to gain an understanding of how these diets affect the quality of their lives. This study will provide us with many tools to evaluate a variety of ways that low-carbohydrate weight-loss diets affect adherence, body weight and body composition, energy metabolism, and several markers of chronic diseases which may be affected by the altered nutrient intake. It will provide insights as to the nature of these changes, the time course of the changes, and variability of these measures. We will use information gained in this pilot study to design more comprehensive studies that evaluate these alternative diets in a more rigorous fashion. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BENEFITS & RISKS OF POPULAR WEIGHT LOSS DIETS Principal Investigator & Institution: Gardner, Christopher D.; Asst. Professor; Medicine; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-MAY-2004 Summary: (provided by applicant): BACKGROUND: Obesity is the single most significant nutrition-related health issue of the new millennium. Several "medical experts" have designed and promoted weight loss diets that dramatically differ from one another, and from the USDA Dietary Guidelines. These diets have gained surprisingly widespread and persistent popularity among Americans, despite a lack of evidence supporting their claims. OBJECTIVE: To conduct a preliminary/feasibility study for an intended full-scale study that will examine health outcomes (e.g. benefits, risks, success) of three popular weight loss diets with very different macronutrient composition, and compare them to a "usual care" dietary approach to weigh loss represented by the macronutrient distribution of the USDA Food Pyramid. We will investigate behavioral and physiological factors that influence adherence and retention to these diet plans. DESIGN: In this preliminary/feasibility study, 48 overweight women will be randomly assigned to one of four diets for 1 year - Atkins (extremely low carbohydrate), Zone (low-carbohydrate, high protein), Ornish (very low fat), and USDA/Food Pyramid (high carbohydrate/moderate-low fat) - and collect data on behavioral and physiological factors. These specific diets have been selected for their wide range of carbohydrate intake (from very-low to very-high carbohydrate: Atkins
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IMPLICATIONS: This examination of popular weight loss diets is designed to scientifically test the health claims being made by their proponents. Findings will fill important gaps in our knowledge, and have an impact on both consumer and health professionals who remain confused about the benefits and risks of these diets. The data generated from this preliminary/feasibility study will be used to strengthen the proposal and design of a future full-scale study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BODY WEIGHT REGULATIONS OF OLDER ADULETS Principal Investigator & Institution: Yukawa, Michi; Medicine; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): Dr Michi Yukawa completed her geriatric fellowship at the University of Washington (UW) in June 2000, and she is an Acting Instructor within the Division of Gerontology and Geriatric Medicine (DGGM) at the UW. Prior to her geriatric fellowship, she practiced in Boston MA for five years as an internist. The K-23 Award will give Dr Yukawa time and resources to acquire knowledge and technical skills to become an independent physician scientist. Dr Itamar B Abrass will guide her career development within Geriatric Medicine. Dr D Scott Weigle will be her research mentor and supervise her laboratory work and development of research protocols. Additional faculty members in the DGGM and the Department of Endocrinology of the UW will provide further guidance. She will attend advanced classes in biostatistics at the School of Public Health of the UW. Controlled dietary intervention and physiologic studies will be performed at the Clinical Research Center (CRC) of the University of Washington Medical Center (UWMC). The long-term objective of her research is to determine the underlying pathophysiology of involuntary weight loss and anorexia in the geriatric population. Understanding energy regulation and metabolism in healthy older adults is necessary prior to investigating older adults with involuntary weight loss and anorexia. Previous studies have reported dysregulation of energy intake in older subjects after calorie restriction. Other studies have suggested abnormalities in leptin homeostasis in older adults. Therefore, the specific aims of the proposed project are to test the hypothesis that elevated proinflammatory cytokines lead to elevated leptin levels in older adults, which in turn are associated with inability of older adults to recover after a period of moderate caloric restriction. 1) A cross-sectional comparison of healthy community dwelling older and younger adults before and after calorie restriction will be performed. 2) The same cohort of older subjects will be followed for two years to identify factors that predict weight loss in older adults. [3) The relationship between pro-inflammatory cytokines, leptin levels and involuntary weight loss in older adults will be investigated. Proinflammatory cytokines secreted from adipocytes of older adults with and without weight loss and healthy younger subjects will be compared. Leptin levels in culture media will be analyzed by radioimmunoassay, and leptin mRNA in adipocytes will be analyzed by real time RT-PCR. The goal of these studies is to define the relationship of pro-inflamlnatory cytokines and leptin levels to body weight regulation in older adults.] Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CLINICAL CENTER FOR LOOK AHEAD: HEALTH IN DIABETES Principal Investigator & Institution: Brancati, Frederick L.; Associate Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218

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15

Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2006 Summary: (Revised Abstract) Overweight and obesity are major health problems in the United States, affecting more than 50% of adults. The long-term consequences of being overweight or obese include increased mortality and increased morbidity from a variety of associated disease states. Short-term weight loss has been demonstrated to ameliorate obesity-related metabolic abnormalities and cardiovascular disease risk factors. However, observational studies have raised concerns about negative effects of weight loss and weight cycling over the long term, including increased mortality. Look AHEAD (Action For Health in Diabetes) is a 2-armed randomized controlled clinical trial studying overweight and obese volunteers with type 2 diabetes at 16 clinical centers. Approximately 5,000 volunteers with type 2 diabetes aged 45-75 years with body mass index > 25 kg/m will be recruited, including approximately equal numbers of men and women and at least 33% participants from ethnic minority groups. The primary objective of Look AHEAD is to examine the long-term health effects of an intensive Lifestyle Intervention designed to achieve and maintain weight loss by decreased caloric intake and increased physical activity. The Lifestyle intervention is implemented with individual supervision and group sessions and aims to achieve at least a 7% decrease in weight from baseline and 175 minutes per week in physical activity on average and to sustain these goals. This program will be compared to a control condition involving a program of Diabetes Support and Education. The primary hypothesis is that the incidence rate of the first post-randomization occurrence of a composite outcome, which includes cardiovascular death (including fatal myocardial infarction and stroke), non-fatal myocardial infarction, and non-fatal stroke, over a planned follow-up period of up to 11.5 years will be reduced among participants assigned to the Lifestyle Intervention compared to those assigned to Diabetes Support and Education. The study is projected to have 90% probability of detecting an 18% difference in this primary outcome between the 2 groups. A composite secondary outcome of all deaths, CVD events, and CVD procedures has been defined. Additional outcomes include: diabetes control and complications, fitness, general health, healthrelated quality of life, and psychological outcomes. The cost and cost effectiveness of the Lifestyle Intervention relative to Diabetes Support and Education will be assessed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CONSEQUENCES FLUCTUATIONS

AND

CORRELATES

OF

WEIGHT

Principal Investigator & Institution: Field, Alison E.; Assistant Professor; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 01-JAN-1998; Project End 31-DEC-2002 Summary: (Adapted from Investigator's Abstract) In the United States, approximately one third of adult women are trying to lose weight. Most weight losses are not sustained and in fact may be followed by gains of at least as much weight as was intentionally lost. It is unclear whether there are adverse outcomes associated with multiple intentional weight losses. The major aim of this project is to quantify the association between multiple intentional weight losses (i.e., weight fluctuations) and the development of hypertension and diabetes mellitus among 50,790 female nurses participating in the ongoing Nurses' Health Study II. In addition to assessing the consequences of weight fluctuations, their correlates and course will be identified. Among these women, 4.4% report losing 20 or more pounds three or more times or 50 or more pounds at least once. To prospectively assess the risk of developing hypertension the investigators state they will have greater than 90% power using the first 2-year follow-up cycle. Because

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diabetes mellitus is less common, they state that they will need three follow-up cycles to have sufficient power. A prospective study that assesses the intentionality of weight loss and does not rely on prevalent cases or long-term recall of weight, weight loss intentions, and disease diagnosis is necessary to elucidate the relation of weight fluctuations to chronic disease morbidity. No previous studies have assessed the risk of developing disease associated with multiple weight losses, independent of the effects of important confounders such as smoking, intentionality of the weight loss, physical activity, relative weight, and weight change. The investigators point out that if intentional weight loss, one time or multiple times, is associated with increased morbidity, the public health implications are enormous. Instead of counseling overweight people to lose weight, efforts would need to be placed on preventing weight gain because both excessive weight gain and weight loss would be associated with increased risk. Conversely, if only unintentional weight loss is associated with increased risk, then the current recommendations for overweight people to lose weight or at least not gain weight would be appropriate. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COORDINATING CENTER FOR LOOK AHEAD: HEALTH IN DIABETES Principal Investigator & Institution: Espeland, Mark A.; Professor; Public Health Sciences; Wake Forest University Health Sciences Winston-Salem, Nc 27157 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2006 Summary: (Revised Abstract) Overweight and obesity are major health problems in the United States, affecting more than 50% of adults. The long-term consequences of being overweight or obese include increased mortality and increased morbidity from a variety of associated disease states. Short-term weight loss has been demonstrated to ameliorate obesity-related metabolic abnormalities and cardiovascular disease risk factors. However, observational studies have raised concerns about negative effects of weight loss and weight cycling over the long term, including increased mortality. Look AHEAD (Action For Health in Diabetes) is a 2-armed randomized controlled clinical trial studying overweight and obese volunteers with type 2 diabetes at 16 clinical centers. Approximately 5,000 volunteers with type 2 diabetes aged 45-75 years with body mass index > 25 kg/m will be recruited, including approximately equal numbers of men and women and at least 33% participants from ethnic minority groups. The primary objective of Look AHEAD is to examine the long-term health effects of an intensive Lifestyle Intervention designed to achieve and maintain weight loss by decreased caloric intake and increased physical activity. The Lifestyle intervention is implemented with individual supervision and group sessions and aims to achieve at least a 7% decrease in weight from baseline and 175 minutes per week in physical activity on average and to sustain these goals. This program will be compared to a control condition involving a program of Diabetes Support and Education. The primary hypothesis is that the incidence rate of the first post-randomization occurrence of a composite outcome, which includes cardiovascular death (including fatal myocardial infarction and stroke), non-fatal myocardial infarction, and non-fatal stroke, over a planned follow-up period of up to 11.5 years will be reduced among participants assigned to the Lifestyle Intervention compared to those assigned to Diabetes Support and Education. The study is projected to have 90% probability of detecting an 18% difference in this primary outcome between the 2 groups. A composite secondary outcome of all deaths, CVD events, and CVD procedures has been defined. Additional outcomes include: diabetes control and complications, fitness, general health, health-

Studies

17

related quality of life, and psychological outcomes. The cost and cost effectiveness of the Lifestyle Intervention relative to Diabetes Support and Education will be assessed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COUPLES INTERVENTION FOR CARDIAC RISK REDUCTION Principal Investigator & Institution: Sher, Tamara G.; Psychology; Illinois Institute of Technology Main Building, Room 301 Chicago, Il 606163793 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2003 Summary: Long-term maintenance of behavioral change to reduce health risk factors is essential to producing a positive effect on medical outcomes. The proposed study will determine whether an on going, long-term relationship can help patients with recent cardiac events or symptoms adhere to three risk-reduction behavioral interventions and to maintain healthy behavioral changes. The couples intervention is designed to (a) change the patient's physical and social environment to facilitate cardiac risk- reducing behavioral changes, (b) optimize social reinforcement and motivation for behavior change between the partners, and (c) decrease relationship stress related to patient's illness and other factors. The state-of-the-risk-reducing behavioral interventions will target three areas of change for cardiac patients in which long-term adherence is problematic: exercise, weight management, and adherence to lipid-lowering medication. Participants will be randomized to standard behavioral treatment or standard treatment plus the couples intervention. Following a pilot study to refine the couples intervention, 160 patients will be enrolled form Rush-Presbyterian-St.Luke's Medical Center and Cook County Hospital in Chicago. To enhance the salience of their health risks, participants will have had a cardiovascular event or acute symptoms (e.g., MI or angina) or a riskreducing medical or surgical procedure (e.g., CABG or angioplasty). Participants will be referred to the study when their physician or medical caregiver determines that they require all three behavioral interventions to reduce their health risks (estimated as 50 percent of all patients eligible for cardiac rehabilitation). They must also have a partner (spouse or live- in-partner) who is willing to participate in the program should the participant be assigned to the couples component. Referral sources have been developed to obtain patients from diverse economic and social backgrounds. Patients will be followed in the study for 18 months. Behavioral outcomes to be assessed include adherence cardiac rehabilitation exercise regimen; exercise capacity; achievement of weight loss goals, maintenance of weight loss, and adherence to recommended dietary recommendations; and changes to lipid values and adherence to lipid-lowering medication. Psychosocial outcomes to be assessed include patient mood, illness coping, and quality of life. Health outcomes will also be monitored, including occurrence of acute events, hospitalizations, and changes in symptom patterns and medications. The study is intended to determine whether a short-term intervention to alter a long-term relationship can result in sustained behavioral change, improved quality of life, and ongoing health benefits for heart patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CREATINE: IS IT A BODY BUILDER FOR CANCER PATIENTS? Principal Investigator & Institution: Jatoi, Aminah; Assistant Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2003; Project Start 11-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): Over 60% of advanced cancer patients suffer weight loss. This weight loss predicts early death, is associated with lean tissue erosion and

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marked debility, and detracts from quality of life. To date, no treatment has been shown to reverse weight loss and its devastating consequences in patients with refractory, advanced cancer. Creatine offers a novel approach. Used by athletes and "body builders," creatine has been studied in over 50 clinical trials and appears to augment weight, musculature, and strength with an acceptable short-term toxicity profile. To our knowledge, no study has examined creatine in cancer patients. Building upon a decade's worth of clinical investigation into weight loss issues in cancer patients, we hypothesize that creatine may benefit cancer patients as well. We therefore propose a trial with creatine with the following specific aims: 1. To explore if creatine stabilizes weight in weight-losing cancer patients. We will compare the percentage of patients with continued weight loss (greater than or equal too 5% of baseline weight) over 6 weeks in a cohort of 25 creatine-treated and 25 placebo-treated patients, all of whom are receiving the same chemotherapy regimen. We will also compare time-to-weight loss between the two treatment arms. 2. To explore whether creatine augments lean tissue and improves strength in weight-losing cancer patients. We will measure lean tissue and handgrip strength at baseline and at 6 weeks in this same cohort of 50 patients. We will make direct comparisons of these 2 parameters between treatment arms. 3. To explore whether creatine's toxicity and quality of life profile is acceptable. We will obtain longitudinal toxicity and quality of life data on this same cohort of 50 patients and will make direct comparisons between treatment arms on toxicity incidence and severity and on maximal quality of life scores Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DIET METABOLISM

AND

EXERCISE:

RACE,

POSTMENOPAUSE

AND

Principal Investigator & Institution: Ryan, Alice S.; Associate Professor; Medicine; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2006 Summary: (Verbatim from application) African American women are more obese and insulin resistant than Caucasian women. This research is designed to determine whether overweight African American women respond differently to hypocaloric weight loss (WL) or aerobic exercise plus weight loss (AEX+WL) than do Caucasian women. The hypothesis is that ethnic differences (African American vs. Caucasian) in the mechanisms by which WL affects insulin sensitivity in overweight, insulin resistant African American postmenopausal women requires that the WL be accompanied by AEX in African American women to improve insulin sensitivity. Specific aims determine 1) the race effects of WL vs. AEX+WL on insulin action on glucose and fat metabolism in African American compared to Caucasian women by assessing insulin sensitivity (EC50), and FFA suppression during hyperinsulinemia; and 2) the cellular mechanisms by which the addition of AEX to WL affects insulin sensitivity in African American compared to Caucasian women by ascertaining the effects of WL vs. AEX+WL on proteins affecting insulin action (GLUT4, IRS 1 and Pl-3 kinase) in skeletal muscle, and insulin suppression of lipolysis in adipocytes. We will study healthy, overweight (Body Mass Index, 27-35 kg/rn2) 50-60 year old postmenopausal African American and Caucasian women. Metabolic studies will be performed before and after either hypocaloric weight loss treatment (n=30 per race) or aerobic exercise training plus weight loss (n=30 per race). Insulin sensitivity and free fatty acid concentrations will be determined during a 3-step hyperinsulinemic-euglycemic clamp. We will measure total body fat (DXA scans), visceral fat and mid-thigh low density lean tissue (CT scans), glucose and insulin responses during an oral glucose tolerance test, skeletal

Studies

19

muscle GLUT4, IRS 1, Pl 3-kinase, and insulin suppression of lipolysis in adipocytes. These findings may provide a rationale for targeting specific populations of women who might improve glucose and fat metabolism more from the addition of exercise to hypocaloric weight loss than weight loss alone. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DIETARY MACRONUTRIENTS AND WEIGHT LOSS Principal Investigator & Institution: Sacks, Frank M.; Associate Professor; Nutrition; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02460 Timing: Fiscal Year 2003; Project Start 28-SEP-2003; Project End 31-JUL-2007 Summary: (provided by applicant): There is a paucity of data on long-term results of dietary treatment for obesity. Diets emphasizing fat restriction, low carbohydrate or high protein intake are each promoted in popular books, but with little evidence to support one over the other for their short- or long-term use. The aims of the proposed research are to test the effectiveness for weight loss and weight maintenance of 4 diets differing in macronutrient composition: moderate in fat (35% energy) with two different protein levels (15% and 25%), and low in fat (20% energy), also with 15% and 25% protein. The moderate-fat diet will be patterned after a Mediterranean diet. All 4 dietary approaches will be low in saturated fat, and will involve reduction in total energy intake. All participants will receive a state-of-the-art behavioral therapy program standardized across the two centers. We will test the hypothesis that higher baseline insulin, RQ and VO2max will be associated with smaller weight loss and more difficulty maintaining the weight loss during maintenance. Dietary satisfaction and satiety will be assessed as potential predictors of success. 400 men and 400 women, BMI 27-39 kg/m2, will be randomized among the 4 dietary treatments. Each diet will be developed to be practical and suitable for public health recommendations, and would be expected to have a favorable effect on cardiovascular risk factors. The primary outcome variable will be change in total body weight from baseline to 2 years. Secondary outcomes related to obesity are total body fat, visceral fat mass, BMI, and waist and hip circumferences. Other outcomes include blood pressure, fasting blood lipids, apolipoproteins, insulin, glucose, and hemoglobin A1C. The results will be straightforwardly applicable to public health and clinical guidelines for obesity, and will increase our understanding of the biology of obesity and weight loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DOES WEIGHT LOSS REDUCE MORTALITY RATE AMONG OBESE RATS? Principal Investigator & Institution: Allison, David B.; Professor; Biostatistics; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2001; Project Start 01-MAR-2000; Project End 31-JAN-2003 Summary: Obesity is increasingly prevalent and associated with decreased longevity and adverse health conditions. Although intentional weight loss (WL) is conjectured to increase longevity, most epidemiologic studies find WL associated with decreased longevity. However, these nonexperimental studies remain open to multiple interpretations and unable to convincingly resolve questions about WL and mortality. A randomized controlled trial (RCT) of intentional WL and longevity is needed. However, an RCT in humans powered to detect effects on mortality would require enormous resources (were it possible at all). The conjecture that WL will increase longevity is bolstered by animal research showing that caloric restriction (CR) increases longevity

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even if started in mid-life. However, the effects of CR resulting in WL have not been established in animals after the development of obesity. Although extrapolating from rodents to humans is open to question, for the near future, such models may be the only way to experimentally test the effect of WL among obese organisms on mortality. This study is an RCT of the effects of intentional WL on mortality among obese rats. Specific aims are: 1) test the hypothesis that WL induced by CR among obese rats will reduce mortality rate; 2) evaluate the extent to which WL reduces mortality rate to that of never-obese animals; 3) evaluate the extent to which any WL induced reduction in mortality with WL is dependent on low fat diet composition; and 4) establish a protocol for testing the effects of intentional WL that can be used in future research to evaluate the conditions under which intentional WL does or does not reduce mortality rate. At weaning, 50 Sprague-Dawley rats will be randomized to a high fat (HF; 45 percent of kcal as fat) diet but have their energy intake restricted so that they remain non-obese. Another 50 will be randomized to a low-fat diet and also have their intake restricted to remain non-obese. An additional 225 rats will be fed the HF diet ad lib until 9 months of age to induce obesity. Following obesity induction, the 150 heaviest males and females will be randomized to: 1) a control group which continues to consume the HF diet ad lib; 2) a high-fat WL which receives the high-fat diet but will has their intake restricted to induce a 20 percent reduction in body weight; or 3) a low-fat WL group which is switched to a low-fat diet and has their intake restricted to induce a 20 percent reduction in body weight. Animals will be followed until death or 33 months of age. Differences in mortality rates among groups will be tested via Cox proportional hazards regression. This study will, for the first time, allow a rigorous experimental test of the hypothesis that among obese organisms, WL promotes longevity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DOSE-RESPONSE OF EXERCISE ON LONG-TERM WEIGHT LOSS Principal Investigator & Institution: Jakicic, John M.; Associate Professor; Miriam Hospital Providence, Ri 02906 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2003 Summary: (adapted from investigator's abstract): The primary goal of this study is to examine the dose-response of exercise on long-term weight loss in overweight adult women. Exercise is a key component of behavioral weight loss programs because of its effect on weight loss, body composition, cardiovascular disease risk factors, and other obesity related diseases such as type 2 diabetes mellitus. Despite these benefits, it is unclear whether there is an optimal exercise duration and/or intensity that will enhance long-term weight loss. The current public health recommendation for physical activity is for individuals to participate in at least 30 minutes of moderate intensity physical activity on most days of the week (approximately 150 minutes per week total). However, it is unclear whether this amount of exercise is adequate for long-term weight loss. Moreover, cross-sectional studies have shown that individuals that have been successful at long-term weight loss participate in levels of physical activity that are greater than the current public health recommendations. The researchers hypothesize that adopting higher levels of exercise duration and/or intensity, coupled with a strong behavioral intervention will enhance long-term weight loss. To test this hypothesis, they propose to recruit 200 overweight women and randomly assign them to one of four treatment groups: (1) moderate intensity, moderate 1000cal/wk duration exercise, (2) vigorous intensity moderate duration exercise, (3) moderate 2000cal/wk intensity, high duration exercise, and (4) vigorous intensity, high duration exercise. All subjects will participate in a 24-month behavioral weight loss program, with subjects attending

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group meetings and receiving periodic telephone contacts from the weight loss program, with subjects attending group meetings and receiving periodic telephone contacts from the interventionists. In addition, to facilitate the adoption of the exercise protocols, all subjects will be provided with a home treadmill. Assessment of body weight will occur at 0, 6, 12, and 24 months and exercise participation will be measured throughout the program. In addition, body composition, cardiorespiratory fitness, cardiovascular disease risk factors, and mediators of behavior change will occur at 0, 6, 12, and 24 months. The investigators believe that the proposed study will lead to improvements in the long-term treatment of obesity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECT OF BARIATRIC SURGERY ON INSULIN RESISTANCE & CVD Principal Investigator & Institution: Schauer, Philip R.; Surgery; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): The study of bariatric surgery offers unique opportunities to evaluate the effects of weight loss among very obese individuals and how this influences quality of life, including impact on co-morbidities of obesity. This proposal is submitted as a collaborative effort of the Department of Medicine, Obesity and Nutrition Research Center (ONRC) and the Department of Epidemiology Prevention Center and Preventive Cardiology Program. We believe that the future studies of bariatric surgery have three important components. First, what is the long term outcome of bariatric surgery in terms of quality of life, morbidity and mortality and are there differences in outcome by type of surgery and characteristics of individuals having the surgery, especially in relationship to distribution of body weight and insulin resistance (IR). The most important health risks for obese individuals are related to cardiovascular disease (CVD). Obesity has been reported to be an independent risk factor for congestive heart failure (CHF) and also for hypertension, type 2 diabetes mellitus, and their complications. Second, the study of bariatric patients offers a unique opportunity to study the metabolic changes associated with obesity and weight loss especially in relationship to carbohydrate and fat metabolism. Third, it is important to try and determine the reasons why many patients can successfully maintain substantial weight loss with minimal co-morbidity after bariatric surgery and especially the potential importance of gastrointestinal physiology and CNS effects on maintaining long-term weight loss. The University of Pittsburgh Bariatric Surgery Program is one of the largest and most successful in the United States. We have excellent follow up of participants and have developed a major collaborative program within the University of Pittsburgh and other institutions. The ONRC is a major National Institutes of Health (NIH)-funded research program dedicated to the study of the pathophysiology of obesity and diabetes and to behavioral research both related to enhancing weight loss and exercise and studying the long term behavioral aspects of these interventions. The Cardiovascular Epidemiology Program in the Department of Epidemiology has extensive experience in observational and clinical trials with a special interest in the measurement of vascular disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EFFECTIVENESS OF PSYCHOLOGICAL TREATMENT FOR BED Principal Investigator & Institution: Wilson, G T.; Professor; Clinical Psychology; Rutgers the St Univ of Nj New Brunswick Asb Iii New Brunswick, Nj 08901

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Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 31-MAR-2007 Description (provided by applicant): Binge Eating Disorder (BED) is characterized by frequent and persistent episodes of binge eating and associated eating disorder psychopathology as well as general psychiatric comorbidity, psychosocial impairment, and obesity. Although a distinct clinical syndrome, BED is indistinguishable from bulimia nervosa on core eating disorder features such as eating, weight, and shape concerns. To date there is no definitive answer as to what constitutes the most efficacious treatment of BED. Specialty treatments (e.g., interpersonal psychotherapy [IPT]) have demonstrated significant short- and long-term reductions in binge eating and associated psychopathology, but not body weight. Behavioral weight loss (BWL) interventions produce clinically significant short-tem weight loss and reductions in binge eating among obese BED individuals, but the long-term impact on binge eating and other outcomes remains unclear. Guided self-help (GSH) has also demonstrated efficacy for BED in the short-term. The overall aim of this study is to compare the longterm effectiveness of three conceptually and procedurally distinct BED treatments: IPT, BWL, and GSH. A primary question posed is whether BED participants require a specialty treatment (i.e., IM, or whether BWL by itself is sufficient. BWL has the potential advantages of producing weight loss, at least in the short term and being more disseminable as a non-specialty treatment widely administered to obese individuals. Previous tests of BWL for BED have lacked adequate sample sizes, valid measurement of binge eating, and sufficient long-term follow-up. The proposed study remedies these methodological shortcomings, while also evaluating whether IPT or BWL have specific effects beyond that of a credible, minimal treatment (GSH) that is briefer, less costly, and more broadly disseminable than the professionally administered therapies of IPT and BWL. Further, the proposed study tests the differential effectiveness of these BED treatments across levels of negative affect, a dimension along which BED participants reliably subtype. Because IPT targets negative affect, we predict that IPT will prove more effective than either BWL or GSH for the subset of participants with high negative affect. 210 overweight BED participants will be recruited and divided into low negative affect and high negative affect subtypes. Participants will be stratified by negative affect sub-type and randomized to receive one of the three 24-week interventions: IPT, BWL, or GSH. Two treatment sites are required to recruit the large sample needed and to establish generalizability of findings. A third site will serve the function of data coordination and assessment/treatment oversight. Binge eating and associated outcomes will be assessed pre-treatment, post-treatment, and at 6-, 12-, and 24-month follow-up. In addition, likely mediators of change will be assessed during treatment. This study promises to not only clarify the most efficacious overall treatment for individuals with BED, but also to identify sub-groups for whom specific treatments are indicated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECTIVENESS OF PSYCHOLOGICAL TREATMENTS FOR BED Principal Investigator & Institution: Agras, W. Stewart.; Professor; Psychiatry; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 31-MAR-2007 Description (provided by applicant): Binge Eating Disorder (BED) is characterized by frequent and persistent episodes of binge eating and associated eating disorder psychopathology as well as general psychiatric comorbidity, psychosocial impairment, and obesity. Although a distinct clinical syndrome, BED is indistinguishable from bulimia nervosa on core eating disorder features such as eating, weight, and shape

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concerns. To date there is no definitive answer as to what constitutes the most efficacious treatment of BED. Specialty treatments (e.g., interpersonal psychotherapy [IPT]) have demonstrated significant short- and long-term reductions in binge eating and associated psychopathology, but not body weight. Behavioral weight loss (BWL) interventions produce clinically significant short-tem weight loss and reductions in binge eating among obese BED individuals, but the long-term impact on binge eating and other outcomes remains unclear. Guided self-help (GSH) has also demonstrated efficacy for BED in the short-term. The overall aim of this study is to compare the longterm effectiveness of three conceptually and procedurally distinct BED treatments: IPT, BWL, and GSH. A primary question posed is whether BED participants require a specialty treatment (i.e., IM, or whether BWL by itself is sufficient. BWL has the potential advantages of producing weight loss, at least in the short term and being more disseminable as a non-specialty treatment widely administered to obese individuals. Previous tests of BWL for BED have lacked adequate sample sizes, valid measurement of binge eating, and sufficient long-term follow-up. The proposed study remedies these methodological shortcomings, while also evaluating whether IPT or BWL have specific effects beyond that of a credible, minimal treatment (GSH) that is briefer, less costly, and more broadly disseminable than the professionally administered therapies of IPT and BWL. Further, the proposed study tests the differential effectiveness of these BED treatments across levels of negative affect, a dimension along which BED participants reliably subtype. Because IPT targets negative affect, we predict that IPT will prove more effective than either BWL or GSH for the subset of participants with high negative affect. 210 overweight BED participants will be recruited and divided into low negative affect and high negative affect subtypes. Participants will be stratified by negative affect sub-type and randomized to receive one of the three 24-week interventions: IPT, BWL, or GSH. Two treatment sites are required to recruit the large sample needed and to establish generalizability of findings. A third site will serve the function of data coordination and assessment/treatment oversight. Binge eating and associated outcomes will be assessed pre-treatment, post-treatment, and at 6-, 12-, and 24-month follow-up. In addition, likely mediators of change will be assessed during treatment. This study promises to not only clarify the most efficacious overall treatment for individuals with BED, but also to identify sub-groups for whom specific treatments are indicated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECTS OF EPHEDRA ON HUMAN ADRENOCEPTOR SUBTYPES Principal Investigator & Institution: Feller, Dennis R.; Pharmacology; University of Mississippi P.O. Box 907 University, Ms 386770907 Timing: Fiscal Year 2001; Project Start 12-SEP-2001; Project End 31-AUG-2003 Summary: (APPLICANT'S ABSTRACT): A majority of Americans are overweight and 33% of our population is classified as obese. Ephedrine and related analogs are the major active components of Ephedra or ma huang (Ephedra sinica) herbal products that are proposed to cause weight loss. The mechanism of this effect is not well understood. The beneficial and adverse effects of ephedrine, including Ephedra herbal products are linked to interactions with alpha and beta-adrenergic receptors. Many of the previous pharmacological studies with ephedrine and Ephedra occurred prior to the discovery of cloned human adrenergic receptor subtypes. This project plans to systematically examine the pharmacological properties (receptor affinities and functional effects) of the compounds in herbal products on subtypes of human alpha- (alpha2a, alpha2b, alpha2c and alphala, alphalb and alphad) and beta-(beta1, beta2 and beta3) adrenergic receptors.

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The specifc aims are as follows: 1) To collect Ephedra samples, and through solvent extraction and chromatographic techniques, separate these preparations into fractions for biological testing. Active constituents in the fractions will be isolated, purified and characterized; and 2) To establish the binding potency, and functional activities of isolated compounds on human alpha- and beta-adrenergic receptors that are expressed in CHO, HEK and PAZ-6 cells. With the multiplicity of adrenergic receptor subtypes discovered, it will be important to establish the pharmacological adrenergic receptor selectivity (either as an agonist or antagonist) for each of the isolated Ephedra compounds. These studies will determine whether ephedrine alkaloids, or other components contribute to adverse and beneficial effects associated with herbal Ephedra use. Due to the abuse potential, it is clear that the evaluation of the safety and effectiveness of Ephedra herbal products needs greater scrutiny, and results of these studies will provide an understanding of the molecular and cellular basis for extrapolation to their observed in vivo actions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ENERGY RESTRICTION AND EXERCISE--A META-ANALYSIS Principal Investigator & Institution: Donnelly, Joseph E.; Professor and Director; Health Sport and Exercise Scis; University of Kansas Lawrence Lawrence, Ks 66045 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2003 Summary: (Adapted from Applicant's Abstract) Diet restriction and exercise not only affect body weight but also have profound effects on body composition, metabolism and aerobic fitness. There is little agreement in the literature regarding the magnitude and direction of these changes. Literature reviews have summarized research using chronological arrangement or arrangement by subtopic which results in subjective and often non-replicable conclusions. This results in a lack of agreement regarding variables such as level and type of diet restriction, length of intervention, quality and quantity of exercise, magnitude of body weight changes, and how they contribute to the outcomes of body composition, fat distribution, metabolism, and aerobic fitness. The metaanalysis approach will be used to collect and analyze research on the relationships among variables associated with diet restriction, weight loss, body composition, fat distribution, metabolism, and aerobic fitness. Meta-analysis is a technique for pooling results of separate studies in a systematic, explicit, comprehensive, and replicable manner. It is a quantitative approach for increasing statistical power, resolving uncertainty when studies disagree, improving estimates of effect size, and answering questions that were not originally answered by the respective trials. The specific aims of this study are to: 1. statistically integrate and analyze existing research studies on the effects of energy restriction on weight loss, body composition, fat distribution, metabolism, and aerobic fitness; 2. determine the magnitude and direction of the changes in these variables in response to the degree of energy restriction; 3. determine interactions among weight loss, body composition, fat distribution, metabolism, and aerobic fitness resulting from various degrees of energy restriction, weight loss, gender, race, ethnicity, energy expenditure, and experimental design quality; 4. compare similar levels of energy restriction between groups which employed exercise and those which used energy restriction alone on the variables of weight loss, body composition, fat distribution, metabolism, and aerobic fitness; and compare studies which use energy restriction or exercise to produce similar energy deficit on the above variables; 5. determine the influence that the type of obesity shows for weight loss, body composition, fat distribution, metabolism, and aerobic fitness; and 6. compile a database regarding the effects of energy restriction and/or exercise as they affect weight loss,

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body composition, fat distribution, metabolism, and aerobic fitness that will be available to interested researchers and clinicians. The investigators state that this investigation should provide clarification of the utility of exercise and/or energy restriction and provide direction for future research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ENHANCED INTERNET BEHAVIOR THERAPY FOR TREATING OBESITY Principal Investigator & Institution: Tate, Deborah F.; Assistant Professor; Miriam Hospital Providence, Ri 02906 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-JUL-2006 Summary: (provided by applicant): Given the increasing prevalence of obesity and fact that many adults have a strong preference to lose weight without attending weekly treatment meetings, there is need to develop effective alternatives to behavioral lifestyle interventions requiring less face-to-face contact. The Internet offers exciting opportunities to deliver behavior change interventions that minimize face-to-face interaction. We have recently developed and tested an Internet behavioral weight loss program compared with an Internet educational program in a randomized trial and found the behavioral program produced significantly better weight losses (4.1 kg) at 6 months. Our study clearly establishes the potential for using the Internet to deliver alternative treatment programs; however, treatment efficacy research is needed to further develop an Internet approach that will promote longer-term weight loss. The objectives of the proposed study are I) to enhance our Internet program to develop a state of the art Internet Cognitive-Behavior Therapy (I-CBT) program for obesity treatment; and 2) to conduct a randomized trial comparing the enhanced program with a Minimal CBT program also delivered via the Internet. We propose to recruit 100 overweight adults and randomly assign them to Enhanced Internet CBT or Minimal Internet CBT programs. The Minimal I-CBT condition will be given links to weight loss websites, weekly structured cognitive-behavioral lessons for weight loss, weekly prompting, and an on-line bulletin board. The Enhanced I-CBT program will have these same features plus weekly on-line group therapy sessions, computer-aided selfmonitoring diaries, and weekly individual e-mail feedback from a therapist. The primary outcome is weight loss from 0-12 months. Secondary outcomes will examine patterns of weight change and changes in waist, diet, physical activity, and social support. The proposed research has significant implications for expanding the audience served by obesity treatment program by using the Internet. This study utilizes an innovative approach and extends our programmatic research on the development of a cognitive-behavioral Internet treatment for obesity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EPIDEMIOLOGY AND CARE OF COMORBID OBESITY AND DEPRESSION Principal Investigator & Institution: Simon, Gregory E.; Associate Clinical Investigator; Center for Health Studies Seattle, Wa 98101 Timing: Fiscal Year 2002; Project Start 20-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): This application proposes two related studies: A population-based epidemiologic study of obesity and depression among women and a longitudinal study of obesity treatment among two cohorts (one with comorbid obesity and depression, one with obesity only) identified by the epidemiologic study. Study 1 -

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Epidemiologic Study: A population-based sample of approximately 6000 women aged 40-65 will be complete structured telephone assessment of weight, nutrient intake, physical activity, depression, functional impairment, and disability. Women with Body Mass Index (BMI) >30 will be oversampled. Insurance claims data will be used to measure health care costs. Aims of the epidemiologic study include: 1) Examine the association between obesity and depression among middle-aged women 2) Examine the specific contributions of obesity and depression to disability and health care costs. Study 2 - Treatment study: A cohort of approximately 100 women with obesity (BMI > 30) and no current depressive disorder will be enrolled in a 6-month state-of-the-art group weight loss treatment. Approximately 200 women with comorbid obesity and depression will be randomly assigned to either the identical weight loss treatment or to a combined cognitive-behavior group therapy program focused on both depression and weight loss. Aims of the treatment study will include: 1) Examine the effect of depression on success in weight loss treatment by comparing weight loss, diet, and exercise in depressed and non-depressed women enrolled in the identical weight loss program 2) Examine the benefits of a combined weight loss/depression intervention above those of weight loss treatment alone by comparing weight loss, nutrient intake, physical activity, depressive symptoms, functional impairment and disability in the two groups of women with comorbid obesity and depression randomly assigned to the two different intervention programs Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FAT CELL SIZE, MUSCLE LIPID AND INSULIN RESISTANCE Principal Investigator & Institution: Ravussin, Eric; Professor & Chief; None; Lsu Pennington Biomedical Research Ctr 6400 Perkins Rd Baton Rouge, La 70808 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): There is growing evidence that the development of Type 2 diabetes is precipitated by alterations in the partitioning of fat between the adipose tissue vs. muscle, liver and pancreas. Intracellular accumulation of triglyceride and fatty acid metabolites leads to acquired insulin signaling defect and insulin resistance. One can, therefore, hypothesize that the inability of the adipose organ to expand to accommodate excess calories results in adipose tissue hypertrophy and Type 2 diabetes in predisposed obese subject. Such a hypothesis is now clearly supported by the following data: 1) Pima Indians with larger abdominal fat cells are more likely to develop diabetes than obesity-matched subjects with smaller fat cells; 2) thiazolidinediones improve insulin sensitivity by inducing adipocyte differentiation; 3) subjects with acquired total lipodystrophy (like fatless mice) are severely diabetic; 4) insulin sensitivity is inversely proportional to the triglyceride content of the muscle. In this application, we want to test the following hypotheses: 1) muscle lipid content correlates positively with abdominal subcutaneous adipocyte size in Type 2 diabetics and obesity-, sex-, and age-matched nondiabetics; 2) larger adipocytes are associated with greater weight loss and better improvement in insulin sensitivity after one year of intensive lifestyle treatment; 3) expression of genes involved in adipocyte proliferation and differentiation correlates negatively with adipocyte size in Type 2 diabetic and obesity matched non-diabetics. In response to weight loss, the expression of these genes will increase. To test these hypotheses we will perform the following studies: 1) determine the relationship between abdominal subcutaneous fat cell size (biopsy) and muscle fat infiltration (CT scan) in 100 subjects from Look AHEAD Trial and 50 nondiabetic matched for sex, race, age and BMI; 2) identify the effect of abdominal fat cell size on weight loss and improvement in insulin sensitivity (hyperglycemic clamp) after

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one year of intensive lifestyle treatment in the 100 subjects from the Look AHEAD Trial; 3) quantify in subcutaneous abdominal adipose tissue the expression of genes involved in adipocyte proliferation/differentiation in 100 Type 2 diabetic subjects and 50 nondiabetic subjects. Gene expression will also be measured in Type 2 diabetics after one year of intensive lifestyle changes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FAT GAIN AND CARDIOVASCULAR DISEASE MECHANISMS Principal Investigator & Institution: Somers, Virend K.; Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2008 Summary: (provided by applicant): We propose a series of novel studies directed at establishing the effects of increased body fat in healthy individuals. We will determine the distribution patterns of increased body fat and how both increased body fat and fat distribution may affect blood pressure, as well as neural, vascular and inflammatory mechanisms which have been implicated in cardiac and vascular disease. We will study sedentary subjects with and without a family history of hypertension. These subjects will undergo a program of overfeeding with the objective of inducing a 2 kg fat gain. We will study these individuals before and after the 4-week fat gain program and subsequently after an 8-week period of weight loss and restoration of normal weight. Measurements will also be compared to those in a matched control group with and without a family history of hypertension, who continue their normal diet. We will test the following hypotheses: 1) Individuals with a family history of hypertension will gain more visceral and upper body fat and have greater blood pressure increases with overfeeding, compared to those without such a family history. 2) For all overfed subjects, increases in blood pressure, sympathetic activity and insulin resistance with fat gain will be most marked in those individuals with a predominantly upper body and visceral fat accumulation. 3) Upper body and visceral fat gain will also be associated with greater impairment in baroreflex sensitivity, endothelial function and chemoreflex function, and an increased likelihood of abnormalities during sleep, including higher nocturnal blood pressures and sleep disordered breathing. 4) Fat gain, particularly upper body and visceral, will be accompanied by enhanced production of inflammatory mediators linked to cardiovascular risk, including adhesion molecules and C-reactive protein. 5) The above changes will resolve with subsequent loss of weight and restoration of normal body fat. These studies build on established programs, one addressing obesity, sleep disordered breathing and cardiovascular disease directed by Dr. Somers, and the other examining mechanisms regulating body fat in humans, directed by Dr. Jensen. This integrated state-of-the-art approach will enable important and novel insights into interactions between fat gain and neural, vascular, and inflammatory cardiovascular disease mechanisms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: FATTY ACID SYNTHASE INHIBITORS: OVARIAN CANCER THERAPY Principal Investigator & Institution: Owens, Albert H.; Member; Fasgen, Inc. 5210 Eastern Ave Baltimore, Md 21224 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2004 Summary: (provided by applicant): Phase I Ovarian cancer is the fifth leading cause of cancer death among U.S. women and has the highest mortality rate of all gynecologic

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cancers, with 23,400 new cases and 13,900 deaths projected in 2001. Screening markers and therapies remain limited, and 5-year survival rates for the 60% of women diagnosed with Stage III or IV disease are less than 20%. Improved therapies for advanced disease, and, in particular, for recurrent disease that has failed initial therapy, are urgently needed. FASgen, Inc. is developing a novel set of antineoplastic agents, inhibitors of the enzyme fatty acid synthase (FAS), which is overproduced in 50-80% of ovarian cancers. In Phase I of this FAST TRACK application to the NCI FLAIR program, a lead compound will have been selected which at <90% of the MTD in normal mice increases the median survival time of athymic nude mice bearing the OVCAR-3 tumor in their peritoneal cavities by at least 25% with 25% is observed in the Phase II clinical trial. Completion of this work should produce a data package sufficient to interest a corporate partner in further development of the FASgen lead compound. Phase II Ovarian cancer is the fifth leading cause of cancer death among U.S. women and has the highest mortality rate of all gynecologic cancers, with 23,400 new cases and 13,900 deaths projected in 2001. Screening markers and therapies remain limited, and 5-year survival rates for the 60% of women diagnosed with Stage III or IV disease are less than 20%. Improved therapies for advanced disease, and in particular for recurrent disease that has failed initial therapy, are urgently needed. FASgen, Inc. is developing a novel set of antineoplastic agents based on inhibition of the enzyme fatty acid synthase (FAS), which is overproduced in 50-80% of ovarian cancers. The work proposed in SBIR Phase I of this FAST TRACK application to the NCI FLAIR program is designed to improve on a first generation inhibitor (C75) that had significant activity but also dose limiting anorexigenic effects in the OVCAR-3 model. Six candidate compounds have been identified that represent two different chemical families, have been shown to maintain anti-FAS potency, and cause minimal weight loss. Specific aims include: 1) a modest scale-up and resupply of the 6 candidate molecules and C75; 2) in vitro testing against the multidrug resistant ovarian cancer-derived cell line OVCAR-3; 3) a determination of the maximum tolerated dose (MTD) and dose limiting toxicity (DLT) in BALB/C mice on low and high fat diets; and, 4) efficacy studies using OVCAR-3 xenografts grown in athymic BALB/C mice. In addition, an assay will be developed to measure the blood concentration of the lead compound and used to evaluate plasma samples taken during the MTD determinations. Efficacy in the animal model will be assessed using improved survival time, alteration in the distribution of the tumor intraperitoneally, and changes in the serum levels of CA-125 and FAS. Success will be demonstrated if at least one compound is identified which at <90% of the MTD in normal mice increases the median survival time of athymic nude mice bearing the OVCAR-3 tumor in their peritoneal cavities by at least 25% with <10% weight loss. SBIR Phase II goals will be to address any formulation or scale-up issues identified in the SBIR Phase I work, complete preclinical pharmacology and safety studies using GMP material, and conduct a Phase I/II safety trial and a Phase II efficacy trial for the lead compound identified in SBIR Phase I. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FATTY LIVER DISEASE AND HEPATIC ENERGY HOMOSTATIS IN SH* Principal Investigator & Institution: Diehl, Anna M.; Associate Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 15-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): Obesity is associated with insulin resistance, diabetes mellitus, hypertension, and dyslipidemia; less well known is its association with non-alcoholic fatty liver disease (NAFLD). The prevalence of NAFLD is 14-21

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percent in some populations, is more common in those who are diabetic or over age 45, and can lead to fibrosis and cirrhosis. Recent evidence indicates that NAFLD is a consequence of disordered hepatic energy homeostasis. Several emerging lines of evidence suggest the overall hypothesis that disordered hepatic energy homeostasis and subsequent NAFLD may play a central role in mediating the adverse metabolic effects of obesity and may influence the success of weight loss interventions. Unfortunately, prior clinical studies have been limited. We, therefore, have the following specific hypotheses: 1) NAFLD and disordered hepatic energy homeostasis will be common in SHOW participants; 2) NAFLD will be associated with disordered energy homeostasis, AfricanAmerican race and male gender; 3) disordered hepatic energy homeostasis will be associated with a proinflammatory state, and adaptive decreases in normal energy requirements; 4) those with disordered hepatic energy homeostasis will have a weaker response to the SHOW intervention compared to those with normal hepatic energy homeostasis; and 5) the SHOW intervention will improve NAFLD and hepatic energy homeostasis in those with little or no defect in hepatic energy homeostasis but worsen it in those with moderate to severe defects. To test these hypotheses we propose a single center ancillary study to the SHOW trial. The study sample for the ancillary study would be the 313 SHOW participants enrolled at Johns Hopkins. We will measure symptoms of hunger and fatigue (0, 6, 12 mo.) and collect additional data including liver enzymes (0, 6, 12 mo.), MRI Spectroscopy (0, 12 mo.), and ketone bodies, insulin levels, and proinflammatory cytokines (0, 12 mo.) The main outcomes will be the prevalence, correlation, and 1-year progression of NAFLD and disordered hepatic energy homeostasis. Our secondary outcomes will be weight change, physical activity, dietary intake, and symptoms of hunger and fatigue in those with and without NAFLD and disordered hepatic energy homeostasis. If our hypotheses are confirmed, this study will establish blood and other clinical markers of NAFLD and disordered hepatic energy homeostasis, which will facilitate population based research; advance our understanding of the pathophysiology of NAFLD; establish disordered hepatic energy homeostasis as a biologic modifier of behavioral approaches to weight loss; and determine whether weight loss improves NAFLD or poses unsuspected risks. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HEAVY METALS, OBESITY AND CARDIOVASCULAR RISK Principal Investigator & Institution: Guallar, Eliseo; Epidemiology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): Heavy metals are a heterogeneous group of highly reactive substances, which may act as essential cofactors for physiologic processes and/or as toxic elements. Chromium, in particular, has been associated with obesity, diabetes, and weight loss. Other heavy metals have been associated with some of the consequences of obesity, including hypertension, hyperlipidemia, and cardiovascular disease. The Look AHEAD Study, a large randomized controlled trial of intensive lifestyle intervention for weight loss in obese patients with Type 2 diabetes mellitus, provides an excellent opportunity to address the impact of chromium on weight loss and diabetes control, as well as to assess the impact of other heavy metals on the physiologic consequences of weight loss. We propose an ancillary prospective observational study within the Look AHEAD trial to collect toenail clippings from all participants (n = 5,000) at baseline and at the 1-year visit, and to analyze a random subset of the toenails (1,150 baseline toenails and 480 1-year visit toenails) for their heavy metal content using instrumental neutron activation analysis. Toenails provide a

30 Weight Loss

time-integrated measure of heavy metal exposure, while instrumental neutron activation analysis provides the concentrations of about 50 heavy metals in the toenail samples, including chromium. This information will allow us to evaluate the relationship of baseline toenail chromium concentrations to weight loss, as well as the interaction between heavy metals and the beneficial effects of weight loss. The proposed study may provide, valuable insight into the determinants of the efficacy of weight loss interventions. In fact, the Look AHEAD trial, because of its size, may be one of the few studies in which these relationships can be measured reliably. In addition, the ancillary study will permit the setup of a specimen bank of toenails to be used in future casecohort or nested case-control studies of the association of heavy metals with Look AHEAD endpoints, especially myocardial infarction and cardiovascular death. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HOME VS CENTER-BASED WEIGHT LOSS & EXERCISE IN MENOPAUSE Principal Investigator & Institution: Dennis, Karen E.; Nursing; University of Central Florida 4000 Central Florida Blvd Orlando, Fl 32816 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Multi-faceted obesity treatment demonstrates the best weight loss (WL) outcomes, yet the most effective site and methods for treatment delivery and follow-up remain elusive. Compounding the persistent treatment enigmas, aging in women is associated with an increasingly sedentary lifestyle that reduces total daily energy expenditure, predisposing to obesity. Moreover, candidate genes that contribute to the heritability of body weight and body fat distribution also may influence the response to WL treatment. In a nation with an unrelenting epidemic of obesity, the need for treatment far exceeds the capacity of the health care system to provide care on an individual basis. The purpose of this study is to: 1) assess the effects of a multi-faceted HOME-versus CENTER-based WL program on WL, CVD risk factors, and psychosocial factors; 2) determine whether a multi-faceted HOME- or CENTERbased approach more effectively leads to sustained treatment enrollment; and 3) retrospectively determine whether women with one or more variants in selected obesity-energy expenditure or insulin-sensitivity candidate genes have different outcomes post-treatment and/or at follow-up than women without a genetic predisposition. Overweight or obese (BMI 25-40 kg/m2) women (n=100) at least one year postmenopausal but < 65 years of age will be randomized to receive CENTER- or HOME-based interventions for WL that include low intensity exercise (walking). All women will receive 2 weeks of orientation to CENTER or HOME programs onsite and have baseline data collected before 6-month CENTER or HOME-based programs begin. Evaluation will be in a stable diet and exercise status post intervention, and again after 6 months maintenance at CENTER or HOME. Multivariate analyses will be used to reduce error inflation from multiple comparisons, or Bonferonni corrections will be used when multivariate analyses are not possible. With its health promotion emphasis, nursing is an ideal discipline to conduct and translate research-based, lifestylemodification WL interventions into practice. WL interventions that postmenopausal women will accept and sustain are essential for promoting health and prevention disease during the period of major vulnerability in their lives. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HORMONE REPLACEMENT FOR PREVENTION OF VISCERAL OBESITY Principal Investigator & Institution: Cefalu, William T.; Associate Professor of Medicine; Medicine; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 31-AUG-2003 Summary: The goal of this study is to determine the therapeutic role of hormone replacement therapy (HRT) to prevent visceral obesity in postmenopausal women. The hypothesis is that HRT will augment the loss of visceral fat in postmenopausal women who undergo a 6-month weight reduction program, and that HRT will be useful in preventing visceral fat regain in women who continue HRT after a one-year follow-up. In addition, the study will examine whether changes in visceral fat are predictive of alterations in insulin sensitivity. postmenopausal women with abdominal obesity will be randomly assigned to either HRT or placebo intervention. All women will participate in a 6-month program of exercise and dietary restriction designed to induce a moderate fat loss. Women will be re-examined after a one-year follow-up period. Total abdominal and visceral fat will be measured with CT, body composition with DXA, insulin sensitivity with an euglycemic/hyperinsulinemic clamp, and energy balance with indirect calorimetry and doubly-labeled water before and after the weight reduction program, and after the one-year follow-up. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: IMPACT OF LIFESTYLE CHANGES ON INFLAMMATION & HEMOSTASIS Principal Investigator & Institution: Erlinger, Thomas; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: (provided by applicant): Dr. Erlinger completed residency training in Internal Medicine at the University of Chicago (1993-1996), an Internal Medicine fellowship at the Johns Hopkins Hospital (1997-2000), and a Master of Public Health degree at the Johns Hopkins School of Hygiene and Public Health (1998). He is currently an Assistant Professor in the Department of Medicine at Johns Hopkins. Dr. Erlinger was also asked to join the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins, one of the premier sites for mentored clinical research in the country. Dr. Erlinger is seeking this Mentored-Patient Oriented Research Career Development Award (K23) to study the impact of lifestyle modification on inflammatory and hemostatic markers and thereby facilitate his transition to an independent career in clinical research. During the award period, Dr. Lawrence Appel, an expert in the design and conduct of prevention-oriented clinical trials, will be Dr. Erlinger?s mentor. Markers of inflammation (e.g. C-reactive protein) and hemostasis (e.g. coagulation and fibrinolytic factors) have emerged as independent predictors of atherosclerotic cardiovascular disease (ASCVD). Efforts to prevent ASCVD have largely focused on lifestyle modifications that affect traditional risk factors, such as blood pressure and cholesterol. Little is known about the impact of lifestyle modification on inflammatory and hemostatic factors that increase the risk of ASCVD. The NHLBI-sponsored PREMIER study is a randomized controlled trial that will test the combined impact of weight loss, diet and physical activity on blood pressure. The PREMIER study provides the infrastructure for this project. In this setting, Dr. Erlinger has designed a three-phase career development plan. Specifically, he will: 1) conduct an ancillary study at the

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Hopkins center of the PREMIER trial, 2) conduct an extended follow-up of PREMIER participants to assess the impact of long-term weight loss on markers of inflammation and hemostasis, and 3) design a clinical trial to test the effect of hypocaloric feeding and hypocaloric feeding plus exercise on markers of inflammation and hemostasis. Together, the supportive environment of the Welch Center, the research infrastructure of the PREMIER study, and the mentorship of Dr. Appel will give Dr. Erlinger the experience and tools he needs to develop into an independent clinical scientist. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPACT OSTEOARTHRITIS

OF

WEIGHT

LOSS

&

EXERCISE

ON

KNEE

Principal Investigator & Institution: Bartlett, Susan J.; Assistant Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 31-MAR-2005 Summary: (Taken from the applicant's abstract): Dr. Susan Bartlett has a clinical background in weight loss and exercise. Her commitment to clinical research is said to be demonstrated by her investment of many years with the Obesity Research Group at the University of Pennsylvania, return to graduate school obtain Ph.D. training in research methodology and interventions as a clinical psychologist, as well as completion of a fellowship in Weight Management at the Johns Hopkins School of Medicine. Knee osteoarthritis (OA) is a major public health challenge affecting millions of people in the US. Obesity is a primary target for intervention since it accounts for up to 30% of knee OA, exacerbates symptoms and is associated with bi-lateral involvement and more rapid progression of the disease. While the American College of Rheumatology Practice Guidelines recommends modest weight loss as symptomatic therapy, to date no published clinical trials have investigated the impact of weight loss on knee OA. Physical activity has also been associated with pain reduction and increased mobility in individuals with knee OA and should included in treatment (ACR Practice Guidelines). Exercise may be especially helpful for overweight persons with knee OA as it is a potent predictor of maintenance of weight loss. Though adherence to traditional exercise programs has been poor, lifestyle in which exercise is accumulated throughout the day appears to be a promising new approach to physical activity. Lifestyle physical activity has been associated with both health and weight loss benefits. Lifestyle exercise may also enhance exercise adherence by increasing options to be active and reducing time barriers. Episodes of physical activity may be preferable to continuous exercise in reducing pain and avoiding injury. The primary objective of this proposal is to evaluate the impact of weight loss and lifestyle exercise on knee osteoarthritis. To accomplish this, 156 overweight persons with symptomatic knee OA will be randomized to receive a 16-week program of: 1 ) a weight loss + lifestyle physical activity; or 2) health education (control). The primary outcome measure will be knee pain. Secondary measures include physical disability, quality of life, performance measures and longterm adherence to behavior change. This study will provide data on integrating behavioral changes into the treatment of knee OA. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LIFESTYLE ACTIVITY FOR WEIGHT MANAGEMENT Principal Investigator & Institution: Wadden, Thomas A.; Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-JUL-2004

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Summary: Obesity is one our nation's most serious public health problems. Weight losses as little as 5-10 percent of initial weight are frequently sufficient to improve health complications of this disorder. Most obese individuals are able to achieve reductions of this size by following a program of diet and lifestyle modification. The great majority, however, regain one-third of their weight loss in the year following treatment, with increasing regain over time. Evidence from a variety of studies indicates that regular exercise is associated with improved maintenance of weight loss, as well as with enhanced fitness and health. Despite these benefits, obese (and average weight) individuals report numerous barriers to exercise, including inadequate time and beliefs that it is associated with exhaustion, physical discomfort, and potential embarrassment. As a result, adherence to structured exercise programs is far from optimal. Lifestyle activity may be a preferable alternative to traditional exercise. It offers a more flexible approach to increasing physical activity by increasing walking throughout the day, taking stairs rather than escalators, and generally decreasing reliance on energy-saving devices. Two studies of children showed that lifestyle activity was superior to structured exercise in facilitating the maintenance of weight loss. The goal of the proposed research is to improve the maintenance of weight loss by increasing physical activity in individuals who participate in a comprehensive behavioral weight loss program. A total of 216 obese adults (108 males, 108 females) will be randomly assigned to one of three conditions: 1) structured on- site exercise; 2) structured at-home exercise; or 3) lifestyle activity. Subjects will be treated for 40 weeks and then followed through week 104. We predict that, at week 104, subjects in the lifestyle condition will maintain their end-oftreatment weight losses significantly better than those in the two other conditions and will have significantly greater improvements in health and psychosocial status. This will result from their maintaining significantly higher levels of physical activity during the follow-up period. The predicted superiority of lifestyle activity is based on extensive pilot data and, if confirmed, should significantly improve the management of obesity and its associated health complications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LIPID METABOLISM IN OBESITY, WEIGHT LOSS AND EXERCISE Principal Investigator & Institution: Houmard, Joseph A.; Professor and Director; Human Performance Laboratory; East Carolina University 1000 E 5Th St Greenville, Nc 27858 Timing: Fiscal Year 2001; Project Start 15-AUG-2000; Project End 31-JUL-2005 Summary: (Adapted from the applicant's abstract):The long-term objective of this research is to better understand defects in human skeletal muscle that contribute to the morbidity and mortality evident with obesity. There is evidence that lipid metabolism in the skeletal muscle of obese individuals is altered in a manner favoring lipid storage. For example, some data indicate that obese skeletal muscle has a reduced capacity to oxidize lipid. There is also evidence that muscle-associated triglyceride concentration increases with obesity. These are important observations as the accumulation of lipid in skeletal muscle is associated with insulin resistance. The storage of lipid in skeletal muscle may thus predispose obese individuals toward insulin resistance and the many conditions linked with insulin resistance (hypertension, coronary artery disease, diabetes mellitus). Despite these important implications, the cellular mechanism that promotes lipid accretion in obese skeletal muscle is not evident. In the current application experiments are proposed that will determine the mechanism(s) responsible for promoting lipid storage in skeletal muscle with obesity and if intervention compensates or corrects the initial defect(s). The primary hypothesis is that postabsorptive (fasting) lipid metabolism

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in skeletal muscle is altered with obesity in a manner that promotes lipid accumulation in this tissue. This hypothesis is based upon preliminary work, where it was observed that lipid oxidation is depressed in the muscle of obese individuals in conjunction with reductions in oxidative enzyme activities. These preliminary data form the basis for the working hypothesis that lipid oxidation is depressed in skeletal muscle with obesity which promotes lipid storage. The secondary hypothesis is that weight loss does not enhance lipid oxidation, but reduces muscle triglyceride stores by an alternative mechanism. The tertiary hypothesis is that exercise training reverses the initial decrement in lipid oxidation evident with obesity, promoting lipid utilization. To test these hypotheses it will be determined: Specific Aim I - if postabsorptive lipid metabolism is impaired in skeletal muscle from obese individuals in a manner that promotes the accumulation of lipid; Specific Aim II - if the impairment in postabsorptive lipid metabolism in the skeletal muscle of obese individuals is corrected or compensated for with weight loss and; Specific Aim III - if exercise training enhances postabsorptive lipid metabolism in obese individuals and the cellular mechanisms responsible. Findings will be important as little is known concerning the mechanisms responsible for the defects in lipid metabolism with obesity and the impact of intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LONG TERM EXERCISE, WEIGHT LOSS AND ENERGY BALANCE Principal Investigator & Institution: Bessesen, Daniel H.; Associate Professor; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2001; Project Start 01-DEC-2000; Project End 31-MAR-2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MELANOCORTINS, ENERGY BALANCE AND CANCER ANOREXIA Principal Investigator & Institution: Wisse, Brent E.; Medicine; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2007 Summary: (provided by applicant) The purpose of this application is to define the central mechanisms that lead to decreased appetite and weight loss in conditions of pathologic anorexia. Our previous work supports the hypothesis that tumors and other inflammatory stimuli cause anorexia via a mechanism dependent on signaling by melanocortins, brain peptides that regulate food intake under physiologic conditions. Signals elaborated by the tumor cells are proposed to increase melanocortin receptor signaling, an inappropriate 'satiety' signal which causing negative energy balance, and leading to inexorable weight loss. The potency of the effect of cancer on energy homeostasis through the melanocortin system is highlighted by the fact that compensatory changes engendered by weight loss, such as decreases in serum leptin, are unable to effect the normal hypothalamic responses that stimulate a return to the baseline body weight. The first major objective of this application is to identify the components of the melanocortin system that are up-regulated in rodent models of cancer anorexia. This will be accomplished by 1) testing if pro-opiomelanocortin (POMC) in the arcuate nucleus (ARC) is both necessary and sufficient for cancer anorexia to occur, using both gene knock-out model and adenoviral gene therapy models, respectively; 2) determining if signaling by agouti-related peptide (Agrp), the endogenous melanocortin antagonist, is reduced, through in situ hybridization studies;

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and 3) determining if down-regulation of melanin concentrating hormone (MCH) is a consequence of melanocortin signaling and mediates anorexia, using in situ hybridization as well as adenoviral gene therapy studies. The second major objective is to investigate whether anorexia induced by an inflammatory stimulus, lipopolysaccharide (LPS) injection, involves the same melanocortin-dependent mechanism involved in cancer anorexia by using experimental strategies similar to the ones outlined above. By improving our understanding of the mechanism of cancer anorexia, these studies will help to identify potential central targets for the treatment of obesity as well as characterizing strategies for the treatment of anorexia in chronic disease states. This research will prepare the applicant for an academic career as an independent investigator in the field of energy homeostasis. The transition to independence will be facilitated by the rich training environment afforded by Dr. Schwartz and the Harborview Medical Center Energy Metabolism Laboratory, and by joining a large community of productive researchers in the field of energy homeostasis across the University of Washington campus. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MENOPAUSE, LPL GENOTYPE AND METABOLISM AFTER WEIGHT LOSS Principal Investigator & Institution: Goldberg, Andrew P.; Professor; Medicine; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-JUL-2005 Summary: This research is designed to determine whether obese postmenopausal women with a common polymorphism in the lipoprotein lipase (LPL) PvuII gene, i.e. the (+) allele have less favorable metabolic responses to weight loss (WL) treatment than women without the LPL PvuII cut-site (-/-). The hypothesis is that the LPL PvuII genotype affects fasting muscle and adipose tissue and LPL activity and the metabolic responses to hypocaloric feeding-induced WL in a dose-dependent manner to affect the magnitude of the reduction of total and visceral fat, and improvements in glucose/insulin and lipoprotein lipid metabolism following WL in postmenopausal women. Specific aims determine whether obese women who are homozygous for the LPL PvuII (+) cut-site, i.e. the (+/+) genotype, have greater increases in adipose tissue LPL and decreases in muscle LPL activity and larger decreases in resting metabolic rate (RMR) and fat oxidation than heterozygotes during hypocaloric diets, that are associated with: 1) the loss of less total body and visceral fat; and 2) smaller improvements in lipid and glucose metabolism than women without the cut-site, i.e., (/-). We will study healthy, obese (Body Mass Index, 30-40 kg/m2) 50-60 year old women within 5 years of menopause. The statistical power to test our hypothesis is based on preliminary data showing differences in adipose tissue LPL responses to WL between LPL PvuII (+/+) and (-/-) genotypes, and requires 27 women/genotype. Subjects will be entered prospectively based on their LPL genotype to ensure a homogeneous group of obese menopausal women are studied to eliminate confounding factors of gender, age, duration from menopause and body composition on the metabolic responses to WL treatment. Metabolic studies are performed on prepared calculated weight maintaining eucaloric diets for 2-3 weeks at baseline and after 6-mo WL to ensure metabolic stability, and on hypocaloric diets after the short-term study to assess metabolic responses to negative energy balance. We will measure muscle and adipose tissue LPL activity, RMR, fat oxidation, total and visceral body fat (DXA and CT scans) lipoprotein lipids and. glucose/insulin responses during an oral glucose tolerance test. Following the post-WL metabolic evaluations, subjects enter a 6- mo

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follow-up period followed by metabolic testing to assess long- term metabolic adaptations and weight regain by genotype. Collectively, these findings will enhance our understanding of obesity by assessing the gene-metabolic mechanisms underlying the predisposition of some obese women to more favorable metabolic health benefits from WL. This would allow the targeting of WL treatments to women more likely to respond, and pharmacologic and other treatments to those less likely to respond to WL. This optimistic outcome would reduce prevalence of obesity and risk for CVD in older women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MENTORED DEVELOPMENT AW

PATIENT-ORIENTED

RESEARCH

CAREER

Principal Investigator & Institution: Mclaughlin, Tracey L.; Medicine; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2005 Summary: PROPOSAL (Adapted from the applicant's abstract): The goal of the proposed research is to define the roles played by resistance to insulin-mediated glucose disposal (insulin resistance) and circulating insulin concentrations as factors affecting: 1) the ability of obese individuals to lose weight; and 2) risk for CHD in both non-diabetic individuals and patients with Type 2 diabetes. These issues are important, as the prevalence of obesity in the U.S. has reached epidemic proportions, and is contributing to an increase in Type 2 diabetes and CHD. While obesity, insulin resistance, and diabetes are highly associated, it is not clear whether insulin resistance and compensatory hyperinsulinemia play important roles in the tendency to gain weight and/or inability to lose weight. The role of hyperinsulinemia in CHD is also unclear. In this regard, the specific aims of the proposed research are as follows: 1) to compare insulin resistant versus insulin sensitive nondiabetic, overweight individuals with respect to their ability to lose weight on a low calorie diet. CHD risk factors before and after weight loss will also be assessed to determine the degree to which insulin resistance is associated with increased CHD risk in non-diabetic overweight individuals, as well as the impact that differences in insulin resistance have on the metabolic benefits of weight loss. 2) To determine if weight loss and its associated metabolic benefits vary as a function of the relative amounts of dietary fat and carbohydrate in hypocaloric diets. Because high carbohydrate diets increase insulin secretion, the relationship between dietary composition and change in circulating insulin concentrations will be analyzed with respect to both weight loss and CHD risk factors. 3) To quantify and compare the improvement in glycemic control and CHD risk factors associated with weight loss in obese Type 2 diabetics, while being treated with: a) an insulin secretagogue (sulfonylurea); or b) an insulin sensitizer (thiazolidenedione). Manipulation of plasma insulin concentrations with these medications will provide a mechanism by which to evaluate the impact of circulating insulin concentrations on the described outcome measurements. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MODULATION OF CASPASE PATHWAYS IN HUNTINGTON'S DISEASE Principal Investigator & Institution: Friedlander, Robert M.; Associate Director; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 01-JAN-2000; Project End 31-DEC-2004

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Summary: The interleukin-1beta converting enzyme (caspase-1 or caspase-1) cell death gene family, also known as the caspase family, plays an important role in apoptosis. Evidence indicates that caspase- 1 is involved in mediating brain damange in ischemia, trauma, and in amyotrophic lateral sclerosis. We have evidence implicating caspase-1 as an important mediator of cell dysfunction and disease progression in Huntington s disease (HD). The broad objective of this project is to evaluate the mechanisms of caspase-1-mediates disease progression in HD. Preliminary results indicate that caspase1 is activated in human and mouse HD brain specimens. In addition, inhibiting caspase function slows the progression and delays the mortality in a mouse model of HD. The specific aims are: 1) evaluate the expression and activation status of different members of the caspase family in human and mouse HD brain specimens, 2) evaluate the role of mature IL-1beta, a product of caspase-1 activation, in the pathogenesis of HD, 3) determine whether bc1-2 might be a neuroprotector in HD, and whether its effects might be synergistic with caspase-1 inhibition, 4) evaluate pharmacological approaches to slow the progression of HD, and 5) evaluate the mechanism of inhibition of weight loss in HD mice by caspase-1 inhibition, 6) evaluate the impact of HD on neural stem cell proliferation and differentiation. Significance: To elucidate the mechanistic pathways by which caspase-1 mediates disease progression and death in HD. Since caspase-1-mediated cell death is a common pathway shared by a variety of neurological disorders, understanding the mechanistic pathways mediating neurodegeneration in HD should provide important information for the development of treatments for diseases sharing this cell death pathway. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MORBIDITY & MORTALITY RELATED TO GASTRIC BYPASS SURGERY Principal Investigator & Institution: Hunt, Steven C.; Professor; Internal Medicine; University of Utah 200 S University St Salt Lake City, Ut 84112 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: Three important hypotheses will be tested related to gastric bypass surgery for the treatment of severe obesity: 1) Roux-en-Y gastric bypass surgery is an effective and safe procedure to reduce weight as shown by lower long-term total and diseasespecific mortality rates compared to severely obese patients who have not had gastric surgery for treatment of obesity; 2) Roux-en-Y surgery significantly lowers long-term morbidity compared to matched severely obese patients who have not had surgery; 3) Significant weight loss after Roux-en-Y surgery will be maintained over a three year follow-up period. To test the mortality hypothesis, a consecutive series of 8,139 Roux-enY gastric bypass surgery patients who had surgery between 1980-1997 will be used. Two control series each of 1,000 unrelated severely obese controls will be selected for mortality comparisons from: 1)a database of 120,000 Utah families collected from 19831997; and 2) persons desiring surgery but refused (mostly for lack of health insurance coverage). Mean length of follow-up will be 14 years (6-24 years). Also NHANES I and II mortality data for subjects with greater than or equal to 35 BMI kg/m2 will be used as a national population-based control group. To test the morbidity and weight loss hypotheses, 400 subjects undergoing bypass surgery will be prospectively followed. Two non-surgical control groups will also be prospectively followed: 400 subjects from the Utah family database and 400 surgical refusals. These three roups will have detailed clinical visits at baseline, yearly contact with ongoing medical chart abstraction and will be re-examined after 3 years of follow-up. Because of inadequate or nonexistent control groups and limited sample size of surgical patients in nearly all studies adequate

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estimates of risks and benefits of gastric restrictive surgery are not available. Other than the in-progress Swedish Obesity Study, this study will be the first to include a severely obese control group for morbidity and the first to include female severely obese controls for mortality comparisons to surgical patients. Long-term follow-up of an extremely large series of surgical patients with minimal lost-to-follow-up will help define risks and benefits of this surgery. With increasing use of gastric surgery for weight control for the severely obese, it is critical to assess how effective this surgery is to reduce weight loss, improve the quality of life, and reduce morbidity and mortality. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MRI DERIVED ORGAN & TISSUE MASS CHANGES WITH WEIGHT LOSS Principal Investigator & Institution: Gallagher, Dympna; Assistant Professor; St. Luke's Roosevelt Hosp Ctr (New York) 1111 Amsterdam Ave New York, Ny 10025 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): Advances in science are often achieved with the development of technology that allows scientists to differentiate and refine concepts which were previously undifferentiated. The field of obesity research has progressed from simple measurement of weight loss to multi-compartment models of fat, fat-free mass and regional distribution of fat. An opportunity for further refinement now presents itself in that magnetic resonance imaging technology can be used to image individual organs and tissues. This presents the opportunity to investigate important unresolved questions. For example, information is lacking on the effects of weight loss on individual organs and tissues. The loss of fat free mass (FFM) cannot fully explain the reported decrease in resting energy expenditure (REE) that accompanies weight loss. Since the FFM compartment consists of numerous tissues and organs, each with a different oxidative metabolic capacity, the possibility exists that individual vital organs may change disproportionately to the change in total FFM with weight loss, thereby explaining reductions in REE post weight loss. Complete organ-tissue volume and mass reconstruction of most major compartments is now possible, using magnetic resonance imaging (MRI). The proposed ancillary study will investigate the composition and nature of weight loss and weight maintenance during the Look AHEAD trial. Secondary research questions relate to modeling changes in resting energy expenditure and changes in cardiac structure and function associated with weight loss. The Specific Aims are to: 1) describe for the first time the composition of weight loss in diabetic subjects at the tissue/organ level of body composition, specifically, we wish to determine whether and to what degree different tissues and organs are conserved or lost in comparison to total FFM change during weight loss; 2) assess the effects of aging on organ and tissue mass in 50+ year old diabetic men and women in a control group, and 3) test whether a portion of weight loss related changes in REE can be explained by changes in the relative fractions of body mass as high (brain, heart, liver, kidney) and low (skeletal muscle, adipose tissue) metabolic activity tissues with respect to oxidative metabolism in 50 plus year old diabetic men and women. A secondary aim is to assess the effects of weight loss on cardiac structure and function using cardiac gated MRI. Consenting, eligible Look AHEAD participants at St. Luke's and at the University of Pittsburgh will participate in MRI and REE tests. Seventy men and women will be measured, equally distributed between the two sites, and equally distributed between Lifestyle Intervention group and a Community Care group. Measures will be acquired at baseline, following one year of intervention (Year 1), and following one year of maintenance (Year 2), to produce a 2 X 3 factorial design. The proposed studies promise

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to answer important body composition related questions regarding the composition of weight loss at the organ/tissue level. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NIDDM, EXERCISE REFERRAL, & OLDER AFRICAN AMERICAN WOMEN Principal Investigator & Institution: Clark, Daniel O.; Director of Behavioral Sciences; Medicine; Indiana Univ-Purdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, in 462025167 Timing: Fiscal Year 2001; Project Start 01-SEP-1998; Project End 31-JUL-2003 Summary: (Adapted from the Applicant's Abstract): With an estimated total cost of $90 billion ($12.5 Billion for medical care alone) and an overall prevalence of about 6%, diabetes has an impressive impact on the health care system. Between 90 and 95% of all diabetes cases consist of type 2 diabetes. the prevalence of type 2 diabetes among African-American women is particularly high and is estimated to be at least 30% for those over the age of 55. African-Americans are not only at greater risk of developing type 2 diabetes, but experience twice the rate of nephropathy, retinopathy, amputation, and in-hospital mortality related to amputations. Exercise, diet and weight control represent known and potentially modifiable risk factors for the management of complications related to type 2 diabetes. For many type 2 diabetes patients, however, moderate weight is very difficult to maintain and interventions to reduce weight have had limited success. Theoretically, exercise can improve metabolic control independent of weight loss, and a few small intervention studies have confirmed that moderateintensity exercise (55 to 70& of maximum heart rate) can improve HbA1c by at least 15% within 8 to 12 weeks with little or no weight loss. in addition, exercise holds great importance for cardiovascular health and overall quality of life. The vast majority (i.e. at least 80%) of persons with type 2 diabetes, however, do not exercise. for this reason, physician referral for exercise has been widely recommended. Its effectiveness has rarely been tested, but a small unpublished study using physician-initiated referral to a carefully designed group-based exercise program produced a 36% adoption rate among 22 African-American women over 50 years of age, and 7 of the 8 who adopted have participated for over 18 months. The primary aim of this study is to implement, support and evaluate a pragmatic physician-initiated exercise referral program for up to 24 months in three separate community based primary care clinics. The primary outcomes will be rates of group-based exercise adoption and maintenance and changes in overall physical activity level. The secondary aims will be to identify baseline predictors of exercise adoption and maintenance and overall physical activity level over the course of the intervention period and assess the effect of exercise on health and clinical outcomes. Measures for secondary aims include HbA1c, insulin and oral hypoglycemic dosages, blood pressure and heart rate at rest and at set workloads during progressive exercise testing, weight, anthropometrics, skinfold thicknesses, self-rated health and function and exercise self-efficacy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NURSE-MANAGED BP TELEMONITORING WITH AFRICAN AMERICANS Principal Investigator & Institution: Artinian, Nancy T.; None; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-MAY-2005

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Summary: There is an urgent need to find better ways to control and treat high blood pressure in African Americans. Although there is some evidence to suggest there may be advantages to home blood pressure (BP) telemonitoring, there is a need for more research since: a) we do not know about the effects of this strategy on long-term control of BP; and b) we do not know the mechanisms by which telemonitoring works to lower BP and achieve BP control. Accordingly, the specific aims of this "new investigator"-led randomized controlled trial are to: a) compare usual care only with home telemonitoring plus usual care to determine which has the greatest effect on change in blood pressure from baseline; and b) determine the extent to which the effects of the intervention are mediated by changes in dietary habits, physical activity level, weight loss, alcohol intake, compliance with an antihypertensive medication regimen, or contact with a primary care provider. Our study is one of the first of its kind using a community-based rather than clinic-based recruitment strategy, thereby expanding access to care. Otherwise healthy African American English speaking men and women (n=400) who are > 18 years with a SBP > 140 mmHG and a DBP > 90 mmHG (unless the individual self-identifies as a diabetic or with a history of a heart attack, then SBP> 130 mmHG, DBP > 85 mmHG) will be conveniently selected from specified community sites. Participants will be randomly assigned to one of two groups that are stratified by use or non-use of antihypertension medication: Group A--home telemonitoring plus usual care; or Group B--usual care only. Participants in Group A will receive usual care plus weekly telemonitoring for 12 months and 15 sessions of telecounseling which provide information about lifestyle modifications in accordance with JNC-VI guidelines. The proposed intervention is intended to increase the saliency of the hypertension for participants, provide a cue to take action and assist them to learn about what actions to take. Data (change in blood pressure from baseline, dietary habits, physical activity level, weight loss, alcohol intake, compliance with an antihypertensive medication regimen, and contact with a primary care provider) will be collected at baseline and at 3, 6 and 12 months. Analysis will include a general mixed linear model approach to repeated measures MANOVA and structural equation growth curve modeling. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NURSING HOME FACTORS AND WEIGHT LOSS IN RESIDENTS Principal Investigator & Institution: Collier, Eric J.; Social and Behavioral Sciences; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2008 Summary: (provided by applicant): The proportion of the United States (U.S.) population who will be older than age 65 is projected to increase from 13 to 20%, reaching 69.4 million individuals, by 2030. Projections indicate that as many as 3 million of these elderly persons (vs. today's 1.5 million) will need some formal type of costly institutionalized care by 2030. The poor quality of care in the nation's NHs has been widely addressed. The prevalence of malnutrition and dehydration has received substantial attention in the literature. Malnutrition and dehydration, if left untreated or undiagnosed, is associated with the following adverse outcomes: (1) unintentional, and in some cases life-threatening, weight loss; (2) greater rates of acute infections; (3) increased incidence of pressure ulcers; (4) higher rates of costly acute care hospitalization; (5) reduced functional status and, (6) in the most serious of circumstances, premature death. The primary goal of this proposal is to describe and analyze the prevalence of malnutrition and/or dehydration (measured by weight loss) for a sample of California nursing homes (NHs, n = approximately 1,600 NHs). The study will entail secondary analyses of facility, resident, financial and staffing-related

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variables that are available in nine databases maintained by (or derived from) four wellestablished state and federal programs. The target variables and the hypothesized relationships among the various independent and dependent variables are depicted in Figure 1 on page 9 of this proposal. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NUTRITIONAL HEALTH INFORMATION CD ROM FOR COLLEGE WOMEN Principal Investigator & Institution: Budman, Simon H.; Inflexxion, Inc. Newton, Ma 02464 Timing: Fiscal Year 2001; Project Start 01-JAN-1998; Project End 31-AUG-2003 Summary: We propose development of an interactive, multimedia program, RightStart, designed to provide health information targeted to freshmen women in their first semester at college. Intense dieting and weight loss practices among college women are reaching nearly "epidemic" proportions affecting physiological, psychological and behavioral functioning of college women. This, in turn, adversely impacts physical and emotional health, academic performance and college retention rates. RightStart focuses on primary and secondary prevention of disordered eating, but does not attempt to treat the diagnosable disorder. The program contains components related to healthy exercise, general nutrition, self-esteem, body image and other areas associated with establishing healthy attitudes toward weight, body image and healthy behaviors. RightStart is selfpaced and self-directed, which allows each person to explore the program environment and visit the areas of the virtual campus in ways that are of greatest interest to that unique user. The product speaks to increased interest in the potential of multimedia technology to impact public health, although few projects have been empirically tested for effectiveness. Phase 11 entails final production of the multimedia program and a comprehensive field test at two university campuses across the country. The field test also includes assessment of the program's acceptance, satisfaction, and safety. PROPOSED COMMERCIAL APPLICATIONS: The commercial impact of this project is very promising. Student affairs offices at universities and colleges around the country are under pressure to deal with a virtual "epidemic" of disordered eating practices engaged in by young college women. These practices result in an increase in physical and emotional health problems, decreased academic performance, and college retention rates. A relatively inexpensive, self- administered computer-based product, which has been shown to empirically reduce risk in a high risk population, should be highly marketable to universities and colleges around the country. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NUTRITIONAL STATUS IN HIV POSITIVE HISPANIC DRUG ABUSERS Principal Investigator & Institution: Forrester, Janet; Family Medicine & Cmty Health; Tufts University Boston Boston, Ma 02111 Timing: Fiscal Year 2003; Project Start 01-JAN-1999; Project End 31-DEC-2003 Summary: Progressive weight loss and wasting are common in HIV disease. The causes of wasting in HIV infection included reduced dietary intake, malabsorption and ineffective metabolism of nutrients. It is likely that the causes of wasting differ between drug abusers and non-drug abusers because of differences in diet and metabolism. There is little information on the natural history of HIV infection, including nutritional status and wasting, in HIV-positive drug abusers. This project will study the nutritional

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status and causes of wasting in HIV-positive drug abusers in the Hispanic community. Emphasis will be placed on the early stages of injection when malnutrition is most amenable to correction. Recruitment of women will receive high priority. Three groups will be studied: Hispanic HIV-positive drug abusers, Hispanic HIV-negative drug abusers and Hispanic HIV-positive non-drug abusers. The three groups will be followed every 6 months for three years during which they will be examined for changes in nutritional, immunological, and clinical status. Periodic measures of dietary intake, body composition, energy expenditure, serum vitamin levels, immunologic status, gastrointestinal function, functional status, and quality of life will be taken as the clinical course of the disease is tracked. Identify the causes of weight loss and wasting at different periods in the course of HIV disease progression will help in the design of targeted nutrition interventions that are appropriate to the drug abusing, HIV-infected population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OBESITY AND NEURAL CONTROL IN SLEEP DISORDERED BREATHING Principal Investigator & Institution: Smith, Philip L.; Professor of Pulmonary Medicine; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 20-JAN-1987; Project End 31-AUG-2003 Summary: (Applicant's abstract): Sleep disordered breathing is characterized by upper airway obstruction and hypoventilation during sleep. Obstructive sleep apnea is the most common form of sleep disordered breathing, and is due to recurrent collapse of the upper airway during sleep. The major risk factors for the development of sleep disordered breathing are obesity, male gender, and increasing age. The precise mechanism for upper airway obstruction and hypoventilation during sleep are unknown. Currently, it is believed that these events are due to alterations in mechanical factors or neuromuscular control precipitated by obesity. It is our overall hypothesis that obesity is associated with progressive defects in reflex mechanisms that lead to upper airway obstruction and hypoventilation during sleep. Moreover, we have evidence that weight loss ameliorates sleep disordered breathing, and we now wish to determine whether this improvement is due to restoration of reflex control mechanisms in the human and to determine the neurohumoral mechanisms in a murine model of the syndrome. In a series of cross sectional and longitudinal experiments, we will examine the effects of obesity on upper airway and ventilatory function, and its modulation by weight loss. In Specific Aim 1, we hypothesize that the response in upper airway pressure-flow relationships to electrical stimulation of the hypoglossal nerve is more effective (a) when the locus of collapse is in the oropharyngeal region and (b) in patients with a lower body mass index. In Specific Aim 2, we hypothesize that a defect in reflex responses to nasal pressure and CO2 exists in (a) patients with obstructive sleep apnea vs. normal controls, and (b) that this defect depends upon the degree of obesity. In Specific Aim 3, we hypothesize that weight loss will restore reflex responses to nasal pressure and CO2. In Specific Aim 4, we hypothesize that (a) changes in neuroventilatory control with weight loss requires an intact leptin axis, and (b) the protective effect of leptin is enhanced in females vs. males. This proposal develops and utilizes methods specifically to quantitate the mechanical and neuromuscular basis for disturbances in upper airway neuromuscular control in humans (Specific Aims 1-3). Complementary experiments in a murine model are proposed in order to probe neurohumoral mechanisms responsible for alterations in ventilatory control (Specific

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Aim 4). The proposed studies are designed to elucidate the pathophysiologic basis and to explore novel treatments for sleep disordered breathing. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DYSFUNCTION

OBESITY,

ADIPOCYTOKINES,

AND

ENDOTHELIAL

Principal Investigator & Institution: Gokce, Noyan; Boston Medical Center Gambro Bldg, 2Nd Fl, 660 Harrison Ave, Ste a Boston, Ma 02118 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JUL-2008 Summary: (provided by applicant): The obesity epidemic has become a major public health problem in this country with unprecedented exposure of individuals to cardiovascular risk. There is growing urgency to understand mechanisms of obesityrelated cardiovascular disease and the beneficial effects of weight modification. The overall objective is to investigate the relationships between obesity, vascular endothelial dysfunction, adipocyte metabolism, and oxidative stress, and the effect of weight loss on these parameters. The vascular endothelium regulates vasomotor tone, platelet activity, and inflammation through the synthesis and elaboration of paracrine factors such as endothelium-derived nitric oxide (EDNO). Endothelium-dependent vasodilation and platelet inhibition are impaired in atherosclerosis and associated risk factors, possibly due to increased vascular oxidative stress and reduced NO bioactivity. Loss of normal vascular endothelial function supports a local vasospastic, prothrombotic, and proinflammatory milieu, and is linked to the pathophysiology of cardiovascular events including myocardial infarction, stroke, and unstable angina. There is growing recogition that metabolic activity of adipose tissue, through release of proatherogenic factors, may play a pathophysiologic role in mechanisms of vascular dysfunction and cardiovascular disease. No prior study has examined the effect of obesity and weight loss interventions on adipocyte and vascular endothelial function. This project proposes in specific aim 1: to characterize the relationship between overweight or obesity and vascular endothelial dysfunction, in specific aim 2: to determine whether weight reduction and risk factor modification improves vascular endothelial function and markers of oxidative stress and inflammation, and in specific aim 3: to examine the metabolic role of adipose tissue for vascular dysfunction, and investigate the effects of weight loss on adipocyte expression of proatherogenic factors. The proposed studies have the potential to provide important insights into mechanisms of obesity -associated cardiovascular disease and examine whether weight loss mediates its cardioprotective action via phenotypic modification of adipocyte and vascular endothelial function. The proposed project takes advantage of Boston Medical Center's NIH funded Center for Obesity Research (C.O.R.E) and a tightly integrated Nutrition and Weight Loss Center. In addition, the investigators bring a unique combination of expertise that will greatly enhance the project's ability to address these important clinical questions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OBESITY, BODY IMAGE AND WEIGHT MAINTENANCE Principal Investigator & Institution: Sarwer, David B.; Assistant Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant) This application for a Mentored Patient-Oriented Research Career Development Award (K23) is an initial submission by a new

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investigator. The goal of this award is to provide me with further training in the field of obesity. As part of this training, I have proposed mentoring in the following areas: 1) behavioral treatment of obesity; 2) cognitive behavioral treatment of body image dissatisfaction in obese persons; 3) body composition analysis; and 4) nutrition. In addition, I would like to receive additional training in the conduct of clinical trials. The proposal builds upon my research in body image dissatisfaction of plastic surgery patients and bridges it with my developing interest in the treatment of obesity. Over the past decade, obesity has become a significant public health problem. Almost one-fourth of Americans are now obese, as judged by a body mass index (BMI) of 30 kg/m2 or greater. Weight losses of as little as 5%-10% of initial weight, which are the typical result of behavior modification programs, are thought to improve the health complications of obesity. The great majority of obese persons, however, regain at least one-third of their weight loss in the year following treatment. Thus, improving the maintenance of weight loss remains one of the greatest challenges in the field of obesity. One area of study that maybe related to successful long-term weight maintenance is body image. Obese persons frequently report that dissatisfaction with their appearance and body image is a primary motivation for weight loss. Furthermore, body image dissatisfaction increases during weight regain. Cognitive-behavioral therapy for body image following weight loss may enhance obese persons' body image and prevent weight regain by changing beliefs about successful long-term weight control. The research has two specific aims. The first is to compare long-term changes in weight and body image over 92 weeks in obese women with a BMI 40kg/m2) before and after bariatric surgery. Preoperative psychosocial status of these patients will be compared to that of patients in the body image trial to determine if psychosocial status, including body image, worsens with increasing weight. Pre- and postoperative psychosocial status in the bariatric surgery patients also will be compared to see if surgically induced weight loss is associated with improvements in psychosocial health. These studies have been selected to further develop my knowledge of the treatment of obesity, and the training program has been designed to facilitate my development as an independent investigator in the field of obesity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OBESITY, NITRIC OXIDE, OXIDATIVE STRESS, NA SENSITIVITY Principal Investigator & Institution: Flack, John M.; Professor; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2008 Summary: We propose a 39-week clinical study in healthy, normotensive, overweight (BMI equal to or more than 25 kg/m[2]) African American men and women aged 45 years and older that, after an initial screening and eligibility period (4 weeks), will be conducted in three phases. Phase 1 (9 weeks) begins the isocaloric 100 mmol dietary sodium diet phase. After the initial 3 weeks, a six-week period of 100 mmol/d sodium supplementation will be administered to determine salt sensitivity. Phase 2 (8 weeks) will maintain the 100 mmol sodium dietary intake and will additionally add a weight loss component to attain weight loss of about 1.5 - 2 pounds/week. Phase 3 (18 weeks) will consist of a two-period crossover trial consisting of randomization to the treatment sequence of dietary sodium supplementation of 100 mmol/d (6 weeks) followed by placebo (6 weeks) or vice versa. A 6-week placebo washout period will separate the two active periods. The 100 mmol sodium/weight loss diet from phase 2 will be maintained during this treatment phase. The difference in BP between the end of the sodium and placebo periods will determine salt sensitivty after weight loss. The overarching study

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hypothesis is that obesity-related salt sensitivity is attributable, in large degree, to oxidative-stress mediated reductions in nitric oxide [NO] availability. The destruction of NO is linked to obesity-related elevations of non-esterified fatty acids, leptin, and reninangiotensin-aldosterone system activity - all of which are known to increase oxidative stress. Genetic variation in the angiotensin converting enzyme, specifically homozygosity for the insertion [I] polymorphism, will predict higher levels of salt sensitivity, oxidative stress, and lesser NO production. Environmental stressors interact with obesity to augment salt sensitivity. We further hypothesize that the degree of reversibility of salt sensitivity will closely parallel weight loss-induced reductions in oxidative stress. The primary specific aim of the study is to determine the main and interactive effects of stressors, obesity, and genetic variation of the ACE and endothelial nitric oxide synthase (eNOS) genotypes on oxidative stress and salt sensitivity and, after weight loss, to re-examine these effects as well as to link changes in oxidative stress to persistence of salt sensitivity between study phases 2 and 3. This study will provide important new insights into the pathophysiology of salt sensitivity in African Americans who are at high risk for development of hypertension and related cardiovascular diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OBSERVATIONAL COHORT STUDY OF SODIUM, WEIGHT AND CVD Principal Investigator & Institution: Cook, Nancy R.; Associate Professor; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2004 Summary: Sodium reduction and weight loss lead to decreased blood pressure (BP). Among hypertensives, BP lowering leads to decreased risk of MI, stroke, and cardiovascular death. Nonetheless, concerns have been raised about increased numbers of cardiovascular events among individuals with low sodium intake or large weight changes. The proposed prospective observational follow-up of the Trials of Hypertension Prevention (TOHP) will include cardiovascular events among the 4, 507 surviving participants from the ten clinical centers involved in Phases I and II of TOHP. Phase I was a randomized trial of the effects of seen non- pharmacologic interventions, including sodium reduction and weight loss, on BP over 18 months of follow-up with 2,182 participants. Phase II examined the effects of sodium reduction and weight loss on BP over a longer 36-month period in a randomized 2X2 factorial design with 2,382 participants. During follow-up in Phases I and II of TOHP, several measures of both weight and sodium excretion were carefully obtained on all participants. The proposed prospective observational follow-up will specifically examine whether these values, with an emphasis on average level of sodium excretion and weight changes are predictive of later cardiovascular disease. The follow-up will be conducted centrally by mail from the Division of Preventive Medicine, which served as the Coordinating Center for Phases I and II, and which has been very successful in conducting such large-scale studies by mail. Information on cardiovascular events subsequent to the trial periods will be collected through June, 2003, representing an average follow-up of approximately fourteen years from the end of Phase I and eight years from the end of Phase II. This cohort provides a unique resource to address the impact in a normotensive population of salt restriction and weight change on subsequent cardiovascular events. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: OPTIMIZING LIFESTYLE ADJUSTMENT IN WEIGHT LOSS SURGERY Principal Investigator & Institution: Kalarchian, Melissa A.; Assistant Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Although surgery is the treatment of choice for severe obesity, very little is known about the relationship of lifestyle factors to patient outcomes after operation. This Mentored Patient-Oriented Research Career Development Award (K23) describes integrated training and research plans designed to prepare the candidate to pursue research on helping patients achieve optimal weight loss and lifestyle adjustment after bariatric surgery. A model of treatment is presented in which an intervention targeting behavioral (eating, activity, and compliance) and psychosocial factors (e.g., symptoms of binge eating and personality style) is expected to impact weight loss, health-related quality of life, and overall well-being. Advanced training in genetic and environmental influences on severe obesity, an expanded working knowledge of how surgeons treat severely obese patients, and consolidation of skills in longitudinal research methodology will assist in refining and developing this model. The research plan involves prospectively tracking weight-related variables, eating and activity, compliance and satisfaction, and psychosocial factors over time among a group severely obese patients undergoing surgery for weight loss (Study 1), and using the data to inform the development and evaluation of a lifestyle intervention geared to optimizing outcomes after operation (Study 2). The comprehensive lifestyle intervention will encompass 1) encouraging healthy eating habits, 2) increasing physical activity, 3) enhancing psychosocial adjustment. Adaptations to treatment will accommodate the unique needs of bariatric surgery patients. Specifically, a modular treatment format will address patients' changing needs in the preoperative, postoperative, and longer-term adjustment phases. Additionally, the intervention will be developed for delivery one-on-one at routine clinic visits with supplemental contact via the Internet. The data collected will contribute to the preparation of an R01 application that will involve conducting a full-scale randomized clinical trial to evaluate the modular, computer-aided lifestyle intervention. Future work may focus on adding adjunctive treatment components such as weight loss medication, the effects of which have not been adequately studied in bariatric surgery patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INFECTION

PATHOGENESIS

OF

FILAMENTOUS

INFLUENZA

VIRUS

Principal Investigator & Institution: Roberts, Paul C.; Immunology and Microbiology; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: We have recently shown that the specific amino acids in the M1 and M2 proteins of influenza A virus are important genetic determinants of filamentous virus morphology. In addition, we have demonstrated that the host cell cytoskeletal complex is an important cellular determinant of filamentous virus formation. The objectives of this proposal expand upon these recent observations and focus on determining the cell biological dynamics associated with filamentous influenza virus entry, and on the pathogenic potential of filamentous influenza virus as it relates to spread of infection and severity of disease. In specific aim 1, experiments are described to address specific

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questions relating to the mechanisms of filamentous virus attachment and entry. Employing radiolabeled and fluorochrome-labeled viral filaments, we will quantitatively examine whether viral filament entry occurs by partial or complete endocytosis or possibly by a phagocytosis-like mechanism. Membrane fusion assays will be used to determine pH requirements and extent of cell fusion of viral filaments. Live cell video microscopy, confocal and electron microscopy will be used to follow the fate of internalized viral filaments and examine whether budding viral filaments can mediate cell-to-cell spread of infection. In specific aim 2, we will focus on the pathogenic potential of filamentous influenza virus. Using primary human nasopharyngeal organ and epithelial cultures we will determine whether infection is restricted to a subpopulation of epithelial cells and determine whether filamentous virus strains have enhanced ciliopathic and tissue damaging capabilities. Using a fluorochrome-based binding assay, we will assess whether viral filaments can enhance bacterial binding to the mucosal epithelium. Using the mouse and ferret animal models, we will compare in vivo the pathogenic potential of genetically similar variants of influenza A/Udorn virus, which differ only in morphology. Pathogenic criteria that will be assessed include: i) the 50 percent minimal infectious dose, ii) tissue specific viral loads iii) tissue-specific histopathology, and iv) rates of weight loss recovery. In the animal studies, we will examine whether filamentous strains promote a descending spread of infection, from an initial localized infection in the nasal tract to the lower respiratory tract. These studies will set the foundation for establishing further determinants of influenza virus pathogenesis and severity of disease in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PERCEPTION OF RISK AND BEHAVIOR IN THE ELDERLY Principal Investigator & Institution: Taylor, Donald H.; Ctr/Hlth Policy Law & Mgmt; Duke University Durham, Nc 27706 Timing: Fiscal Year 2001; Project Start 15-SEP-1999; Project End 31-AUG-2003 Summary: (Adapted from the Applicant's Abstract): This application was initially submitted as an R29 FIRST Award, and is being re-submitted as an R01 in response to Program Announcement, PA-97-065 (NIA) entitled, "Social Cognition and Aging." The goal of this project is to determine how individual risk perceptions influence health behaviors among the near-elderly (51-61) and decisions regarding wealth holdings among the elderly (70+). Among the near-elderly, the following health behaviors will be studied: the use of preventive services (mammography, prostate screening, and cholesterol screening), weight loss and exercise. The preventive services are designed to reduce mortality from cancer and heart disease. Weight loss and exercise are both preventive measures as well as mitigators of harm that results from health shocks. Expanding the use of these preventive and mitigating measures are important to reduce morbidity and mortality from heart disease and cancer. Among the elderly, the behavior of interest relates to asset accumulation/dissaving, specifically focusing on housing decisions. The specific decisions will be selling a house, and changes in housing wealth holdings. The two decisions will be analyzed because housing assets likely have fewer measurement errors, and because housing is the major component of wealth for most elderly persons. Housing decisions are important from a policy perspective because they may represent precautionary savings to finance long-term care, a substantial risk the elderly face. The proposed conceptual model is an extension of the common Bayesian learning model whereby prior risk perceptions are updated on the basis of information. Our model holds that updated risk perceptions, in turn, influence behavior. Risk perceptions will be estimated as enodogenous explanatory variables simultaneously

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with health behaviors among the near-elderly and housing decisions among the elderly. The panel structure of the data bases to be used (4 waves of Health and Retirement Study; 3 waves of Asset and Health Dynamics Among the Oldest Old) will allow for the modeling of behaviors in time 3 or 4 as a function of changes in risk perceptions regarding longevity and of needing nursing home care between waves 1 and 2 and 1 and 3. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: POLYCYSTIC ADOLESCENTS

OVARIAN

SYNDROME

IN

OVERWEIGHT

Principal Investigator & Institution: Hoeger, Kathleen M.; Obstetrics and Gynecology; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2004 Summary: (provided by applicant): Polycystic Overy Syndrome (PCOS) is a broadspectrum disease characterized by chronic anovulation and androgen excess, affecting 48% of women. Onset of the disorder is recognized to occur around the time of puberty but is often not diagnosed until adulthood. More than half of women with PCOS are obese, and insulin resistance appears to be an important part of its underlying pathophysiology. Long-term consequences in PCOS are now recognized to include increased risk of development of type 2 diabetes mellitus and cardiovascular disease. This has led to an interest in reduction of insulin resistance as a long-term treatment strategy. This reduction in insulin resistance can be accomplished by weight reduction or by insulin sensitizers such as metformin. To date, however, there are limited data on the effectiveness of insulin sensitizers and no data on the impact of weight reduction in adolescents with PCOS. Adolescence is a time of tremendous physical and psychosocial change. Obesity in adolescence is often predictive of lifelong obesity. The constellation of hirsutism, irregular bleeding, and obesity, often seen in adolescents with PCOS, could potentially have lifelong social and health consequences. A successful weight reduction strategy with improvement in insulin sensitivity at the onset of the symptoms of PCOS could have substantial long-term health benefits. The applicant hypothesizes that weight loss and metformin in the overweight adolescent with PCOS can reduce insulin resistance and improve the symptoms and metabolic profile associated with PCOS. Accordingly, a randomized, placebo-controlled, parallel-group trial comparing metformin and intensive lifestyle modification is proposed to gather preliminary data on the rate of ovulation, changes in testosterone and insulin and impact on cardiovascular risk of weight reduction and metformin as compared to placebo in a total of 30 subjects. Data obtained from this pilot trial on recruitment rates, drop-out, compliance, and estimated treatment effect sizes will be used to refine power calculations for a large-scale randomized trial focused on a comparison of metformin and weight reduction in obese adolescents. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREMIER MAINTENANCE TRIAL Principal Investigator & Institution: Appel, Lawrence J.; Associate Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003; Project Start 20-JAN-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Overweight/obesity is the second leading cause of death in the US, and is growing in prevalence at an alarming rate. Control of overweight/obesity is increasingly recognized as a high national priority because of its

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contribution to cardiovascular (CVD) risk factors and ultimately to CVD itself. The short-term success of behavioral interventions for weight loss has been repeatedly documented. Unfortunately, because weight re-gain is extremely common, a disappointingly, small proportion of individuals achieve long-term weight control. Of the factors that are associated with sustained weight loss, one of the most important is continued intervention with frequent contacts. We propose a multi-center, randomized, controlled trial [Weight Loss Maintenance Trial (MAINTENANCE)] to determine the effects of two innovative behavioral interventions, each designed to maintain frequent contacts, compared to a usual care control group. Overweight and obese individuals (60% women, -40% African Americans) who are taking medication for hypertension, dyslipidemia and/or type 2 diabetes will enter a 6-month, weight loss program. Those individuals who lose at least 4 kg (N = 800) will then be randomized into one of three groups: a Personal Contact (PC) Intervention that provides monthly personal contacts with a trained interventionist, primarily via telephone; an Interactive Technology (IT) Intervention that provides frequent contacts through a state-of-the-art interactive webbased program supplemented by other communication technologies; or Usual Care (UC). The primary outcome will be weight change from the end of the initial weight loss program to the end of the 30-month weight maintenance intervention period. Other outcomes will include weight change in subgroups, prevalence of CVD risk factors, measures of behavior change, and cost of implementation. For each outcome, the PC and IT interventions will be compared to UC and, if different from UC, to each other. To successfully combat the obesity epidemic, clinicians and health care systems must have options that are effective and feasible and that can be provided to large numbers of individuals. The purpose of this proposal is to develop and test two such interventions, which, if effective, should complement ongoing efforts to stem the obesity epidemic and ultimately prevent obesity-related CVD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREMIER MAINTENANCE TRIAL(MAINTENANCE) Principal Investigator & Institution: Svetkey, Laura P.; Assistant Professor; Medicine; Duke University Durham, Nc 27706 Timing: Fiscal Year 2003; Project Start 15-FEB-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Overweight/obesity is the second leading cause of death in the US, and is growing in prevalence at an alarming rate. Control of overweight/obesity is increasingly recognized as a high national priority because of its contribution to cardiovascular (CVD) risk factors and ultimately to CVD itself. The short-term success of behavioral interventions for weight loss has been repeatedly documented. Unfortunately, because weight re-gain is extremely common, a disappointingly, small proportion of individuals achieve long-term weight control. Of the factors that are associated with sustained weight loss, one of the most important is continued intervention with frequent contacts. We propose a multi-center, randomized, controlled trial [Weight Loss Maintenance Trial (MAINTENANCE)] to determine the effects of two innovative behavioral interventions, each designed to maintain frequent contacts, compared to a usual care control group. Overweight and obese individuals (approximately 60% women, approximately 40% African Americans) who are taking medication for hypertension, dyslipidemia and/or type 2 diabetes will enter a 6-month, weight loss program. Those individuals who lose at least 4 kg (N = 800) will then be randomized into one of three groups: a Personal Contact (PC) Intervention that provides monthly personal contacts with a trained interventionist, primarily via telephone; an Interactive Technology (IT) Intervention that provides frequent contacts through a state-

50 Weight Loss

of-the-art interactive web-based program supplemented by other communication technologies; or Usual Care (UC). The primary outcome will be weight change from the end of the initial weight loss program to the end of the 30-month weight maintenance intervention period. Other outcomes will include weight change in subgroups, prevalence of CVD risk factors, measures of behavior change, and cost of implementation. For each outcome, the PC and IT interventions will be compared to UC and, if different from UC, to each other. To successfully combat the obesity epidemic, clinicians and health care systems must have options that are effective and feasible and that can be provided to large numbers of individuals. The purpose of this proposal is to develop and test two such interventions, which, if effective, should complement ongoing efforts to stem the obesity epidemic and ultimately prevent obesity-related CVD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREVENTION OF OVERWEIGHT IN PRESCHOOL MINORITY CHILDREN Principal Investigator & Institution: Fitzgibbon, Marian L.; Professor; Psychiatry and Behavioral Scis; Northwestern University Office of Sponsored Programs Chicago, Il 60611 Timing: Fiscal Year 2001; Project Start 01-AUG-1998; Project End 31-JUL-2003 Summary: The prevalence of overweight among preschool children in the U.S. is over 10 percent. Overweight in childhood is linked to overweight in adulthood, as well as earlier morbidity and mortality. This strongly suggests the need for primary prevention and intervention in children. Furthermore, in contrast to the disappointing weight loss outcome data for adults, weight loss studies with children report far more effective results. The inclusion of a parent in the intervention appears to contribute to the success. Thus, it seems vital that a successful overweight prevention and intervention program must include both children and parents. Finally, studies indicate that early prevention and intervention efforts may be particularly important for minority populations. For example, the prevalence of overweight among minority women approaches a staggering 50 percent compared to 33 percent for White women. Children often acquire a genetic predisposition toward overweight and model their eating patterns after their parents. Therefore, it follows that minority children from families where one or both parents are overweight are at greatest risk for becoming overweight themselves. The proposed research was designed to address the needs of the Black and Hispanic communities, focusing on intervention with preschool aged children. Twenty-four Head Start sites will be randomly assigned to intervention or no-intervention conditions. Of these 24 sites, 12 will serve a predominantly Black population, and 12 will serve a predominantly Hispanic population. The investigators anticipate enrolling an average of 35 Black or Hispanic children and parents per site. Parents and children will participate in health screenings at baseline, following the intervention, and 12 and 24 months later. The intervention consists of a 16-week nutrition and activity based weight control program that includes parental participation. The no-intervention control group will receive the standard curriculum provided by the Head Start preschool program. It is expected that children in the intervention group will show a greater mean reduction in the primary outcome measure, percent ideal body weight for height (%IBWH), as well as dietary fat intake; and an increase in dietary fiber and fruit and vegetable intake. It is expected that the parent intervention group will show a greater mean reduction in body mass index; decreased dietary fat; and increased dietary fiber, fruit and vegetable intake, physical

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activity, nutrition knowledge, nutrition attitudes, and support for healthy eating. These changes will be seen following the intervention and at 12 and 24 months later. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PRIMARY CARE OFFICE MANAGEMENT OF OBESITY Principal Investigator & Institution: Martin, Pamela D.; None; Lsu Pennington Biomedical Research Ctr 6400 Perkins Rd Baton Rouge, La 70808 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: Approximately 55% of the American Population is either overweight or obese. African American women in particular are at significant risk for becoming obese with as many as 49% currently qualifying for obesity (BMI greater than or equal to 30). Low-income, African American women appear less likely to engage in dietary and activity habits associated with weight maintenance and cultural factors may influence their acceptance of excessive body weight. Furthermore, traditional weight loss approaches have been minimally effective with low-income, African American women. Focus group research suggest that African-American women may be responsive to prevention programs which focus on the health b3enefits of weight management and which employ culturally sensitive educational materials. Preliminary research also suggests that a patient centered motivational intervention which uses messages targeted at patient's motivational level, knowledge and perceived barriers may enhance preention efforts. Primary care physicians who provide routine medical care to lowincome, African American women are in a unique position to offer preventive services to deter weight gain and promote maintenance of weight loss. This randomized, two arm treatment study will use culturally sensitive educational materials by trained primary care physicians. It will compare physicians directed education (standard care group) to another group who receive customized education plus patient centered messages by primary care physicians. It will attempt to determine a physician delivered patient centered intervention is more effective than standard cre in regard to prevention of weight gain and achievement of weight loss at 6 months. It will also examine whether the groups differ in regard to weight maintenance at 12 and 18 months follow up. It is hypothesized that patients in the patient centered group will demonstrate less weight gain, more weight loss at 6 months, greater maintenance of weight loss at 12 and 18 months as well as dietary and physical activity improvement throughout the observation period than patients receiving standard care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: PROFILE-BASED, INTERNET-LINKED, OBESITY PREVENTION TRIAL Principal Investigator & Institution: Going, Scott B.; Professor; Nutritional Sciences; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2003 Summary: The increasing prevalence of obesity and its co-morbidities and the limited success of previous weight loss/maintenance interventions argues the need for new approaches to prevent obesity. Peri-menopausal women are t high risk to develop overweight and obesity. Around that period, physiological and behavioral factors contribute to changes in energy expenditure which promote energy surfeit and progressive gain of total and abdominal fat, often exacerbated by loss of lean tissue Thus, we propose to develop and test an innovative individualized weight loss/maintenance program for overweight peri-menopausal women, driven by frequent

52 Weight Loss

assessment of subjects' biopsychosocial profiles (allowing timely intervention response to individual needs), and delivered through extensive use of new communication technologies (primarily and Internet-CD-ROM hybrid package) which have been largely unexplored in behavioral and biological research. To this end, overweight/obese perimenopausal (aged 45 to 55 years) women will be randomized to intervention (n=50) or control (n=50) after completing a 3-month core curriculum exercise, diet, and cognitivebehavior therapy. After a 3 months transition with computer training (intervention group only), intervention (15 months) will proceed via the internet only, except for laboratory measurements (intervention and control groups). Increased physical activity (approximately 1500 kcal/week), healthy eating and modest calorie restriction with adequate nutrients will be targeted, with special emphasis on promotion of self-directed behavior. Biopsychosocial "weight loss profiles" will be monitored through questionnaires on the web site and used to individualize intervention, respond to change needs, and assess their relationship with changes in body weight and composition measured by dual energy x-ray absorptiometry. We contend the internet/web site technology represents a potentially low cost and effective means for providing the continuous education, encouragement and social support to foster sustained behavior change and weight loss/maintenance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REGULATORY RESPONSES TO POSITIVE ENERGY BALANCE Principal Investigator & Institution: Seeley, Randy J.; Professor; Psychiatry; University of Cincinnati 2624 Clifton Ave Cincinnati, Oh 45221 Timing: Fiscal Year 2001; Project Start 30-SEP-1997; Project End 31-JAN-2002 Summary: After a period of involuntary overfeeding where calories are provided in excess of caloric expenditure, animals profoundly reduce food intake while body weight and adipes mass increase. Once the overfeeding regimen is terminated, animals continue to have suppressed food intake until body weight decreased to the level of controls. This ability of the body to suppress food intake and fac8litate its own weight loss represents an important regulatory response that is critical for the appropriate regulation of body weight. while we know a great deal about the neurobiological underpinnings of the regulatory responses to underfeeding, almost nothing is known about the endocrine or neuronal changes that mediate the hypohagic response to overfeeding. The hypothesis to be tested in this proposal is that the increase in body adipose mass produced by overfeeding results I high levels of two important negative feedback hormones, insulin and leptin. These two hormones gain access to the central nervous system and act to alter the balance between two opposing hypothalamic neuropeptides. Neuropeptide Y (NPY) increases food intake and decreases energy expenditure while corticotropin releasing hormone (CRH) causes the opposite, decreas4ed food intake and increased energy expenditure. Consequently, increased insulin and leptin are hypothesized to activate the hypothalamic CRH system while inhibiting thehypothalamic NPY system and thereby shift the balance of these two neuropeptides to produce low food intake and weight loss. To test this hypothesis, peripheral levels of insulin and leptin will be determined by radioimmunoassay while gene expression for hypothalmic NPY and CRH will be determined using in situ hybridization and content analysis of microdissected hypothalamic nuclei during and after an involuntary overfeeding regimen. To assess the role of elevated insulin and leptin in the behavioral and hypothalmic changes that occur during overfeeding in normal rats to rats with a genetic mutation that render them insensitive to the central effects of insulin and leptin (the obsess Zucker rat). To assess the role of activation of the

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CRH system, the effect of CRH receptor antagonists on the hypophagia that follows a period of overfeeding will be determined. Finally, the possibility that some of the same hypothalmic responses that mediate the hypophagia induced by overfeeding might mediate tumor-induced anorexia will be determined by measuring hypothalamic changes in hypophagic tumor-bearing rats. The experiments in this proposal are critical to a complete understanding of body weight regulation and may suggest novel therapeutic strategies for obesity that involve triggering or mimicking the regulatory responses that mediate weight loss after overfeeding. Additionally, if the serious complications of anorexia and body weight loss associates with some tumors and AIDS are produced by inappropriate activation of the regulatory responses to overfeeding, it would suggest therapeutic strategies that block or antagonize these hypothalamic neuropeptide systems. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RESISTANCE TRAINING FOR THE PREVENTION OF OBESITY Principal Investigator & Institution: Washburn, Richard A.; Associate Professor; Energy Balance Laboratory; University of Kansas Lawrence Lawrence, Ks 66045 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-MAY-2005 Summary: (provided by applicant): Obesity is associated with numerous co-morbidities, including cardiovascular disease, diabetes, hypertension and some cancers. Weight loss is difficult; therefore interventions to prevent the development of obesity are warranted. In this project we will evaluate the potential of resistance training (RT) to prevent the development of obesity in healthy, sedentary, overweight, young (18-25 yrs) college men and women, an accessible group at high risk for becoming obese. RT offers an innovative approach to obesity prevention that differs in concept from. Unlike aerobic exercise, RT results in a minimal increase in energy expenditure during exercise, but may result in significant increases in total daily energy expenditure resulting from increased resting metabolic rate (RMR) mainly as a result of increased fat-free mass (FFM). The efficacy of the RT protocols recommended as part of adult fitness programs to alter FFM and RMR is unknown. Therefore; this research project will determine the level of RT necessary to induce increases in muscle mass and RMR, which may, in turn be associated with weight maintenance or loss. All RT will be supervised and verified by the research team. We will compare changes in FFM and RMR elicited by 24 weeks of RT conducted as recommended by ACSM (1 set, 3 d/wk, resistance 8-12 repetitions maximum (RM), 9 exercises) with a higher intensity RT program (1 set, 3 d/wk, resistance 3-6 RM, 9 exercises) in a volunteer sample of 108 young adults (36 men, 72 women) matched on muscle mass and randomly assigned to the RT protocols or a nonexercise control condition within gender. Fat-free and muscle mass (DEXA), RMR (indirect calorimetry), and muscular strength (1-RM) will be assessed at baseline, and at 12 and 24 weeks. Dietary intake (24hr. recall) will be assessed monthly. If our pilot project proves successful, i.e., our RT program results in clinically significant increases in RMR, we will propose a larger and longer (18 m) randomized trial to assess the efficacy of RT for weight loss or prevention of weight gain. This trial will employ a complete energy balance model including detailed assessments of total energy intake and expenditure using state-of-the-science techniques (doublylabeled water, wholeroom calorimetry, visual plate waste), and will investigate potential mechanisms, such as changes in protein turnover and sympathetic nervous system activity, that may be associated with increased RMR resulting from RT. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ROLE MAINTENANCE

OF

HOME

ENVIRONMENT

IN

WEIGHT

LOSS

Principal Investigator & Institution: Gorin, Amy A.; Miriam Hospital Providence, Ri 02906 Timing: Fiscal Year 2001; Project Start 15-AUG-2001; Project End 31-MAY-2005 Summary: (provided by applicant): The proposed study examines the impact of an intensive weight loss program on untreated spouses and the home environment. Prior studies of weight control treatment have focused their assessments exclusively on the individual participant. This assessment strategy may underestimate the positive effects of weight control treatment and may miss important environmental predictors of weight loss outcomes. In the proposed study, 480 Look AHEAD participants and their spouses will be recruited from 3 clinical sites (Brown University, University of Alabama at Birmingham, University of Minnesota). Participants and spouses will be assessed at baseline and 1-year follow-up. Information on participants' weight, height, and demographics will be obtained from the Coordinating Center. In addition, participants will complete measures of dietary intake and physical activity (if not included in the core assessments) and social support. Spouses' weight and height will be measured and they will complete assessments of dietary intake and physical activity. Spouses will also be the primary reporter of the home environment and will complete measures of food availability, food storage, and amount of exercise equipment in the home. Our primary analysis will examine whether untreated spouses of intervention participants lose more weight than untreated spouses of standard care participants. Our secondary analyses will examine whether changes in participants' weight and weight-related behaviors from baseline to 1-year are correlated with changes on the same measures in spouses over the same time period. We will also examine whether more change is observed in the home environments of intervention participants than standard care participants and whether these changes predict participant and spouse weight loss. Finally, we will explore whether changes in the home environment mediate the relationship between participant and spouse weight loss. The data collected in the ancillary study will provide new information about the reach of behavioral weight loss treatment and about the role of the home environment in weight loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SECRETED PROTEIN FROM ADIPOCYTES AND PREADIPOCYTES Principal Investigator & Institution: Brooks, Cydney C.; Adipogenix, Inc. 801 Albany St, S112 Boston, Ma 021192511 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2003 Summary: (provided by applicant): Obesity is a well-established risk factor for a number of diseases, including type 2 diabetes and coronary heart disease. While weight loss is the most effective treatment of type 2 diabetes, current methods for reducing weight are typically insufficient for long-term weight loss. The mission of AdipoGenix, Inc. is to discover, develop, and license novel therapeutics acting at the level of the fat cell for the treatment of obesity and related disorders. Targets for use in drug discovery in the area of obesity are lacking, particularly at the level of the fat cell. Ideal targets are specific to the cell in question. In adipose tissue this would translate to differentiation-specific and depot-specific targets, especially those prominent in visceral adipocytes or preadipocytes, since the accumulation of visceral (mesenteric and omental) fat carries a greater risk of morbidity and mortality than peripherally distributed (subcutaneous) fat. Adipocytes are known to secrete a number of factors having autocrine, paracrine,

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and/or endocrine functions, and in many instances these factors are secreted at considerably different levels by preadipocytes. These secretion factors may represent valid targets in drug discovery, through either an interference with their natural function, or through modulation of their secretion levels. We will therefore identify targets through the comprehensive detection of depot- and differentiation-dependent secreted proteins and peptides using human adipocytes and preadipocytes from omental, mesenteric, and subcutaneous depots. We will use HPLC to compare protein and peptide secretion levels between each cell type and depot. We will test the effects of several exogenous agents relevant to obesity on the secretion levels of proteins and peptides that meet certain criteria across patient populations. Through the work proposed here, we expect to identify targets that are secreted in a depot- and differentiation-specific manner for subsequent use in the development of assays designed to measure secretion levels. This work will therefore produce commercially viable targets, assays, and eventual lead compounds for development into anti-obesity drugs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SELF-MONITORED MANAGEMENT

PHYSICAL

ACTIVITY

FOR

WEIGHT

Principal Investigator & Institution: Walker, Karen E.; Temple University 406 Usb, 08345 Philadelphia, Pa 19122 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2006 Summary: (provided by applicant): This application for a Mentored Research Scientist Development Award (K01) is a re-submission by a new investigator. The goal of the award is to provide the investigator further training in the fields of obesity and community health nursing. As part of this training, the investigator will receive mentoring and pursue academic study in the following areas: 1) etiology and complications of obesity; 2) behavioral treatment of obesity; 3) community health nursing; 4) conduct of clinical trials; 5) exercise physiology; 6) biostatistics; and 7) nutrition. The proposal builds on a background in cardiovascular research, clinical study of weight loss maintenance, and community-based activities. Recent data show that 61% of US adults are overweight or obese. As a result, there is an epidemic of obesity-related health problems such as diabetes, coronary artery disease, and high blood pressure. Losses of only 5% to 10% of body weight significantly improve health, and individuals in programs that modify diet and lifestyle typically achieve weight losses of this magnitude. Unfortunately, the great majority of people cannot maintain the loss. Regular exercise is crucial to the maintenance of weight loss, but most individuals have problems with adherence due to a variety of barriers to exercise. Typical barriers are lack of time, lack of childcare, and lack of access to facilities. The goal of the proposed research is to improve the maintenance of weight loss by increasing physical activity in a low-income, primarily African American population that participates in a community-based behavioral weight loss program. All participants (n=152) will be treated with a 20-week weight reduction program followed by 52 weeks of maintenance. At the outset of the study, subjects will be randomized to one of two physical activity conditions. The research has two specific aims: The first is to compare at week 72 the maintenance of weight loss and physical activity adherence in individuals who are prescribed a standard structured exercise program of walking (Condition 1) versus a lifestyle activity intervention self-monitored via pedometer (Condition 2). Adherence will be determined by obtaining a common measure of physical activity across both conditions using accelerometers. The second aim is to

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compare short- (week 20) and long-term (week 72) differences between the two conditions in measures of physical (serum lipids, glucose/insulin ratio, interleukin-6, Creactive protein, resting blood pressure, cardiorespiratory fitness) and psychosocial health (mood, quality of life). This study has been selected to further develop the investigator's knowledge of the treatment of obesity using principles of community health nursing, and the training has been designed to facilitate the investigator's development as an independent clinical scientist studying innovative ways of reducing cardiovascular risks within urban communities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SEXUAL DYSFUNCTION--EFFECTS OF WEIGHT LOSS Principal Investigator & Institution: Rosen, Raymond C.; Psychiatry; Univ of Med/Dent Nj-R W Johnson Med Sch Robert Wood Johnson Medical Sch Piscataway, Nj 08854 Timing: Fiscal Year 2001; Project Start 15-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): Sexual dysfunction is highly prevalent and a frequent source of distress. Despite the well-documented association between diabetes and sexual dysfunction, no sexual function data will be collected in the main Look AHEAD trial. Accordingly, the current application aims to provide ancillary data regarding sexual and hormonal function in 600 (300 male, 300 female) participants in the main trial. Approximately 125 subjects will be recruited at each of 5 sites (Miriam Hospital, St. Lukes-Roosevelt, the University of Alabama, the University of Pennsylvania, and Johns Hopkins University) during the first two years of the trial. Three key research questions are addressed: (i) The prevalence and distribution of sexual problems among male and female diabetics in the Look AHEAD trial will be evaluated at baseline, particularly the association between sexual functioning and other health characteristics of the sample (e.g. baseline BMI, hemoglobin A lc, fitness level). Hormonal levels at baseline will similarly be related to sexual function. (ii) The principal hypothesis for the proposed study is that male and female patients in the Look AHEAD weight loss/special intervention condition will have improved sexual function compared to controls. Secondary analyses will examine the effects on sexual functioning of changes in BMI, fitness level, improved glycemic control, and sex hormone alterations associated with the weight loss intervention. (iii) Finally, the proposed sub-study will investigate the relationship between changes in sexual function and quality of life outcomes. It is hypothesized that diabetic patients with improved sexual function will have significant improvements in mood state and overall quality of life. Taken together, these analyses will provide unique data on the prevalence and distribution of sexual and hormonal problems in diabetic men and women, the association of these problems to other demographic and health characteristics, and the effects of the special intervention condition on sexual and hormonal function in these patients. Additionally, the proposed study will provide data on the relationship between sexual function outcomes and other key measures of mood state and quality of life in the main Look AHEAD trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SKELETAL MUSCLE PROTEIN METABOLISM IN HEART FAILURE Principal Investigator & Institution: Toth, Michael J.; Assistant Professor; Medicine; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2004 Summary: The PI's short-term goal is to obtain the training required to complete the proposed studies. His long-term goal is to become an independent researcher and to

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develop his own research program investigating the mechanism of weight loss and skeletal muscle atrophy in healthy and diseased elderly. During this award, the PI will gain experience in several laboratory and clinical research techniques associated with the measurement of skeletal muscle protein metabolism in humans using stable isotopes, arterio-venous balance and skeletal muscle biopsy methodologies. The mentoring team and the facilities available within the College Of Medicine are an ideal environment for the training of junior scientists. Patients with chronic heart failure frequently experience skeletal muscle atrophy which limits functional Capacity by reducing muscular strength and endurance. Moreover, muscle atrophy is associated with increased morbidity and mortality. The primary goal of the proposed studies is to determine the pathophysiological mechanisms underlying the loss of skeletal muscle mass in patients with chronic heart failure. The primary hypothesis is that increased skeletal muscle protein Catabolism in the postabsorptive state and reduced skeletal muscle protein anabolism in the postprandial state promotes skeletal muscle atrophy in heart failure patients. We will measure skeletal muscle protein balance (i.e., difference between synthesis and breakdown) using a combination of arteriovenous balance and stable isotope tracer techniques under postabsorptive (24 hour fast) and simulatedpostprandial conditions (euglycemic hyperinsulinemia with concomitant hyperaminoacidemia) in cachectic and noncachectic heart failure patients and healthy controls. We will assess skeletal muscle protein balance during these experimental manipulations to probe for defects in postabsorptive and postprandial muscle protein balance that may contribute to skeletal muscle atrophy. In this design, noncachectic heart failure patients will serve as a diseased control group and healthy controls as a non-diseased control group. The secondary goal is to measure and compare the synthesis rate of skeletal muscle myosin heavy chain between heart failure patients and healthy controls and examine its relationship to reduced muscular strength in heart failure patients. Our secondary hypothesis is that reduced synthesis of myosin heavy chain in heart failure patients will be related to reduced muscular strength. The fractional synthetic rate of myosin heavy chain will be assessed by measuring the incorporation of [1,2- 13C2]leucine into skeletal muscle protein. These experiments will provide new information regarding the pathophysiological mechanisms responsible for the loss of skeletal muscle mass and strength in heart failure patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SLEEP APNEA IN LOOK AHEAD PARTICIPANTS Principal Investigator & Institution: Foster, Gary D.; Associate Professor of Psychiatry; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-JUL-2006 Summary: (provided by applicant): Weight loss is a frequently recommended treatment for obese patients with obstructive sleep apnea (OSA). The empirical support for this recommendation is lacking. Based on descriptive studies, weight loss appears to improve but not abolish sleep disordered breathing. Moreover, the degree of improvement in OSA is quite variable and not directly proportional to weight loss. The lack of randomized trials, the study of predominantly male samples, and the absence of follow-up evaluations leave physicians and patients unsure about the utility of weight loss treatment in obese OSA patients. The research proposed in this application will assess the effects of weight loss on sleep disordered breathing in 120 obese, Type 2 diabetics with OSA (RDI greater than or equal to 15) who are randomly assigned to either weight loss (n=60) or usual care (n=60) treatments within the context of the Look AHEAD study. Home polysomnography studies will be performed before treatment

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and at 1 and 2 years. Among the 60 weight loss subjects, we will assess the relative importance of changes in neck and abdominal fat in explaining the variability of changes in sleep disordered breathing after weight loss. Finally, we will examine the relationship between changes in sleep-disordered breathing and changes in blood pressure after weight loss in the 60 weight loss participants. Specifically, this research will: 1) determine the efficacy of a weight loss program in reducing sleep disordered breathing in obese Type 2 diabetics; 2) identify sources of variability in sleep disordered breathing associated with weight loss; and 3) examine the role of sleep disordered breathing in mediating changes in blood pressure associated with weight loss. The results of this study will provide an empirical basis for making recommendations about the effectiveness of weight loss in Type 2 diabetics with OSA. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STRENGTH TRAINING FOLLOWING GASTRIC BYPASS FOR OBESITY Principal Investigator & Institution: Geliebter, Allan; St. Luke's-Roosevelt Inst for Hlth Scis Health Sciences New York, Ny 10019 Timing: Fiscal Year 2003; Project Start 01-MAR-2003; Project End 31-DEC-2004 Summary: (provided by applicant): As the incidence of obesity rises dramatically in the United States, more and more severely obese individuals are undergoing surgical treatment to reduce body weight and associated risk factors. Roux-en-Y gastric bypass (RYGB) is now the most common operation to treat morbid obesity in the US. However, little is known about the effects of RYGB on body composition and resting energy expenditure (REE). The main objectives of this study are to determine: 1) the composition of weight loss following surgery, 2) whether protein supplementation and strength training can limit the expected reduction of lean mass and REE. The study candidates will be morbidly obese women with a body mass index (BMI) of 40-56 kg/m2, be 18 - 49 y.o. and premenopausal. Except for severe obesity, they will be relatively healthy with a history of diet failure. They will be sedentary except for walking. There will be 36 study participants who, after stratifying by race, will be randomly assigned to three treatment groups (n = 12): 1) standard postoperative nutritional counseling only, 2) protein supplementation and standard postoperative nutritional counseling, or 3) protein supplementation plus strength training and standard postoperative nutritional counseling. The protein supplementation will begin shortly after surgery and increase from 40 g/day to 80 g/d at 4 weeks. Strength training will begin 8 weeks postoperation, to allow for adequate wound healing, and will consist of twice weekly progressive resistance training for upper and lower body for a period of 12 weeks. A battery of test measurements following a 12 h overnight fast will be conducted prior to surgery and repeated postoperatively at 8 and 20 weeks. These tests will include measurement of REE and body composition using underwater weighing, air displacement (BODPOD), dual xray absorptiometry (DEXA), magnetic resonance imaging (MRI), isotope dilution (D20), sodium bromide, and regional anthropometrics. There also will be assessments of arm and leg strength. Additionally, there will be measures of fasting glucose and body weight related hormones insulin, leptin, cortisol, and the recently discovered ghrelin. The predictions are that during the dramatic weight loss after surgery, the loss of some lean tissue, which could adversely impact skeletal muscle and vital organs, will be reduced by enhanced protein intake and weight training. There also may be greater conservation of REE and bone density. Plasma glucose and hormones should all decrease, especially with exercise, except for ghrelin, which should increase. The findings should improve understanding of surgical weight

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loss in morbidly obese patients and have clinical applications in the postoperative care of such patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STUDIES OF REGIONAL FAT DISTRIBUTION AND ENERGY BALANCE Principal Investigator & Institution: Weigle, David S.; Associate Professor of Medicine; Medicine; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 01-MAR-2001; Project End 31-JAN-2006 Summary: The studies in this application are designed to better understand the regulation of body fat mass and the mechanisms determining body fat distribution in humans. Three Specific Aims are proposed: 1. To determine whether experimentallyinduced or spontaneous variations in plasma leptin levels predict subsequent changes in body composition. The protocols employed will also elucidate the mechanism by which high carbohydrate diets induce satiety and weight loss, and the mechanism of involuntary weight loss in the elderly. 2. To examine the relationships among central body fat redistribution, changes in adipogenic gene expression, and atherogenic changes in plasma lipids and insulin sensitivity. The model for this work will be the body fat redistribution that occurs in subjects receiving aggressive antiretroviral therapy for HIV infection. 3. To determine whether changes in uncoupling protein (UCP) gene expression act to attenuate diet-induced changes in body fat mass. This study will use the technology developed for Specific Aim 2 to ascertain whether muscle and fat UCP expression change in parallel with energy expenditure following experimental weight gain and weight loss in human subjects. The applicant has successfully trained several young physician investigators in patient-oriented and basic research, and a plan to continue doing so is presented. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: STUDY OF HEALTH OUTCOMES OF WEIGHT-LOSS (SHOW) Principal Investigator & Institution: Kahn, Steven E.; Medicine; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2006 Summary: (Revised Abstract) Overweight and obesity are major health problems in the United States, affecting more than 50% of adults. The long-term consequences of being overweight or obese include increased mortality and increased morbidity from a variety of associated disease states. Short-term weight loss has been demonstrated to ameliorate obesity-related metabolic abnormalities and cardiovascular disease risk factors. However, observational studies have raised concerns about negative effects of weight loss and weight cycling over the long term, including increased mortality. Look AHEAD (Action For Health in Diabetes) is a 2-armed randomized controlled clinical trial studying overweight and obese volunteers with type 2 diabetes at 16 clinical centers. Approximately 5,000 volunteers with type 2 diabetes aged 45-75 years with body mass index > 25 kg/m will be recruited, including approximately equal numbers of men and women and at least 33% participants from ethnic minority groups. The primary objective of Look AHEAD is to examine the long-term health effects of an intensive Lifestyle Intervention designed to achieve and maintain weight loss by decreased caloric intake and increased physical activity. The Lifestyle intervention is implemented with individual supervision and group sessions and aims to achieve at least a 7% decrease in weight from baseline and 175 minutes per week in physical

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activity on average and to sustain these goals. This program will be compared to a control condition involving a program of Diabetes Support and Education. The primary hypothesis is that the incidence rate of the first post-randomization occurrence of a composite outcome, which includes cardiovascular death (including fatal myocardial infarction and stroke), non-fatal myocardial infarction, and non-fatal stroke, over a planned follow-up period of up to 11.5 years will be reduced among participants assigned to the Lifestyle Intervention compared to those assigned to Diabetes Support and Education. The study is projected to have 90% probability of detecting an 18% difference in this primary outcome between the 2 groups. A composite secondary outcome of all deaths, CVD events, and CVD procedures has been defined. Additional outcomes include: diabetes control and complications, fitness, general health, healthrelated quality of life, and psychological outcomes. The cost and cost effectiveness of the Lifestyle Intervention relative to Diabetes Support and Education will be assessed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TELEHEALTH DELIVERY OF A WEIGHT LOSS PROGRAM IN DIABETES Principal Investigator & Institution: Lovejoy, Jennifer C.; Associate Professor; Nutrition; Bastyr University 14500 Juanita Dr Ne Kenmore, Wa 98028 Timing: Fiscal Year 2003; Project Start 25-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): Obesity and Type 2 diabetes are emerging epidemics in the U.S. Weight loss improves diabetes outcomes and reduces the need for anti-diabetic medication. However, implementation of behavioral weight loss programs in a primary care setting has proven to be a challenge. Internet-based weight loss programs have been shown to be effective, however, access to personal computers is limited among elderly and low-income populations. Additionally, computers require a degree of technical sophistication and access to the Internet poses a barrier for a significant portion of the at-risk diabetes population. A solution is required that offers the benefits of Internet-based weight loss programs without the technical challenges or cost. The overall goal of this study is to explore the human engineering issues of a homebased telehealth system, Healthium, utilizing an interactive television system over a broadband connection. The telehealth system to be tested support audio and video communications (synchronous or asynchronous), medical reminders, physiological monitoring (e.g. body weight) and diagnostic devices (e.g. glucometers), on screen health status tracking, patient education (audio, text and multimedia), and interactive health surveys. The program will be based on Internet-aided behavioral weight loss programs previously developed by the investigators. The proposed project will demonstrate how a diet and exercise program can be conducted with patients in their home via a television set and using the TV remote control. If the content can be successfully transposed from a PC/Internet environment to an interactive television platform, we would be able to demonstrate a convenient, intuitive and inexpensive way to conduct large-scale interventions related to obesity and nutrition. This could lead to a viable public health care initiative for prevention of obesity-associated chronic diseases. The Specific Aims to be addressed in this proposal are: 1) To transfer a successful Internet-based weight loss program onto the Healthium interactive platform and further develop the intervention for use in patients with Type 2 diabetes. 2) To conduct focus groups to determine consumer acceptance of the convenience and intuitiveness of the Healthium interface. 3) To perform a pilot study in patients with Type 2 diabetes to determine whether the Healthium interface improves weight loss and diabetes outcomes relative to standard clinic-based treatment.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE TREATMENT OF BINGE EATING DISORDER Principal Investigator & Institution: Crow, Scott J.; Associate Professor; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 15-FEB-2002; Project End 31-JAN-2005 Summary: (provided by applicant): Research over the last few decades has shown that a sub-group of overweight individuals have an abnormal eating pattern best characterized by discrete binge eating episodes. The presence of binge eating episodes in obese individuals is associated with increased rates of psychopathology, social dysfunction, early onset obesity, and greater severity of obesity. However, recent research suggests that binge eating can be effectively treated in obese individuals using certain forms of psychotherapy such as cognitive behavioral techniques, and certain antidepressant drugs, strategies that have also been shown to be useful in suppressing binge eating in individuals of normal weight with bulimia nervosa. Certain self-help techniques have also been shown to be quite useful in improving binge eating symptoms and in encouraging healthy eating behavior in individuals with disordered eating. Our research groups have demonstrated the utility of a self-help manual in working with individuals with bulimia nervosa and most recently the utility of a group self-help approach in targeting binge eating behavior in overweight individuals with binge eating. Therefore, as an extension of our prior research, and given the preliminary data that will be reported in the application, we propose to study the utility of treatments targeting binge eating in obese individuals who binge eat through a random assignment, parallel study wherein subjects who satisfy inclusion criteria will be assigned to one of 6 conditions: 1) manual-based self-help targeting binge eating without therapist involvement; 2) supervised manual-based self-help; 3) group self-help therapy, without contact with a psychotherapist; 4) group therapy delivered partially through videotapes and partially with therapist leadership; 5) a traditional therapist-led group psychotherapy, and 6) a wait list control to control for the effects of time and the non-specific effects of being involved in the protocol. Of note, the materials presented in the five treatment arms will be essentially identical, but are written for self-help vs. audio-visual vs. therapy presentation based on the treatment assignment. This protocol is not designed to test a weight loss strategy, but instead to focus on strategies for bingeeating. Such strategies could then be administered in combination with, or sequentially with, various weight loss strategies (e.g., behavioral, pharmacologic) in those who are overweight. Treatments for weight loss are currently undergoing significant evolution with the introduction of two new pharmacologic agents in the last 18 months. We believe that to attempt to address both strategies for binge eating and strategies for weight loss in this study would make it overly complex. The result of this study could inform the design of trials to treat both binge-eating and promote weight loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TREATMENT FOR OBESITY AND BINGE EATING DISORDER Principal Investigator & Institution: Grilo, Carlos M.; Associate Professor; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-AUG-1996; Project End 31-JUL-2007 Summary: (provided by applicant): This application seeks funds to conduct a study of cognitive behavioral and behavioral weight loss treatments for obese patients with binge eating disorder (BED). The proposed study builds directly upon the findings of

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the initial project that examined the efficacy of fluoxetine treatment and cognitive behavioral therapy (CBT) and the relative efficacy of the treatments alone and in combination for patients with BED (balanced 2 x 2 factorial design). CBT produced significant and clinically meaningful improvements in the behavioral (binge eating), cognitive (attitudinal features of eating disorders), and associated psychological (depression) features of BED, but not for the physical problem of obesity. In the 2 x 2 factorial design: (1) CBT was superior to treatment without CBT, treatment with fluoxetine was not superior to treatment without fluoxetine, and no interaction between treatments occurred; (2) Specific comparisons among specifc treatments revealed that fluoxetine was not superior to placebo, CBT + Placebo and CBT + Fluoxetine were similar, and CBT + Placebo and CBT + Fluoxetine were superior to Fluoxetine-only and Placebo-only. Findings suggest that CBT has efficacy for the behavioral, cognitive, associated psychological features of BED. The strong association between BED and obesity, and the major health risks associated with obesity highlight the need for developing interventions that also reduce weight. It remains uncertain whether behavioral weight loss (BWL) has efficacy for producing weight loss in BED or for reducing binge eating and its associated features. The proposed study involves a comparison of three treatment conditions: (1) CBT; (2) BWL, and (3) a sequential (twopart) treatment consisting of CBT followed by BWL. Assessments will occur at baseline, bimonthly during treatment, and 6-and 12-months post-treatment. The primary specific aim is to test the relative efficacy of CBT, BWL, and a sequential treatment consisting of CBT followed by BWL. Secondary aims are to (1) explore predictors and processes of change during the acute treatment and follow-up period, and (2) examine whether (a) BWL ("dieting") after the CBT produces weight loss, and (b) weight regain (if it occurs following BWL) is accompanied/followed by reoccurrence of binge eating, attitudinal features of eating disorders, psychological distress, or psychiatric disturbances. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: WEIGHT CONNECTION: WEIGHT LOSS MAINTANANCE USING THE WEB Principal Investigator & Institution: Kaplan, Lee M.; Associate Professor; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-AUG-2004 Summary: Despite widespread recognition of the increasing prevalence and medical sequelae of obesity, efforts to reverse these trends have met with limited success. Although 75 percent of obese individuals who enter a weight loss program are initially successful, more than 90 percent of these individuals regain the lost weight within 5 years, leading to renewal or even exacerbation of cardiopulmonary and vascular disease risks. The focus of this proposal is the prevention of weight regain in obese individuals after successful weight loss. The best predictor of weight loss maintenance is the duration and intensity of patient-provider contact, irrespective of practitioner specialty or the nature of the intervention. However, the high costs of intensive interventions over an extended period limit optimal management to a small number of patients. The hypothesis underlying the proposed study is that some of the benefits of intensive patient-provider interaction can be achieved in a cost-efficient manner through creative use of electronic communication. We propose to develop a three-part, web-based program ("WeightConnection") that includes mechanisms for (1) ongoing, patient selfmonitoring and graphical feedback about weight, eating and exercise behavior, (2) individual, electronic consultative advice from a weight counselor and (3) on-line group-based therapy and peer-to-peer communication. Our goals for this intervention

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are to achieve several benefits of intensive patient-provider interaction that appear to underlie successful weight loss maintenance, including sustained patient motivation, diminished attrition rates, and timely relapse management. Each component of the proposed program is designed to promote these goals by providing personal guidance, educational opportunities and psychological support. We will initially test and refine the WeightConnection program with a small group of patient volunteers recruited from MGH Weight Center patients. Thereafter, we will examine whether this intervention improves the success of a standard group-based program in maintaining weight loss. We will conduct a randomized, controlled study in 30-40 patients, comparing the combination of the WeightConnection program and standard therapy vs. standard therapy alone. The results of this pilot study, including effects on weight maintenance and patient retention, preliminary subgroup analysis and careful assessment of patient usage and feedback, will be used to design a more definitive study of the efficacy and cost-effectiveness of electronic communication for prevention of recurrent weight gain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: WEIGHT LOSS IN OBESE BREAST CANCER SURVIVORS Principal Investigator & Institution: Djuric, Zora; Associate Professor; Internal Medicine; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2001; Project Start 15-FEB-2001; Project End 31-JAN-2003 Summary: Obesity has been shown to be associated with a poor prognosis in breast cancer patients. Survival time is decreased and recurrence rates are increased with greater obesity. Whether or not weight loss can have favorable effects on prognosis in obese breast cancer survivors is not known, and that is the ultimate question we would like to ask. As a first step, effective methods for weight loss need to be established in this population. We started a pilot study with internal funds develop an individualized approach towards weight loss in obese breast cancer survivors, and preliminary data is encouraging. We would like to be able to extend this study for a full 18 months and analyze the blood samples that are being collected for markers of cancer risk. Forty eight obese cancer survivors have been enrolled. At baseline, a psychiatric evaluation was obtained for each women and questionnaires on diet, health, exercise and psychosocial factors were administered. Since we are asking women to make large lifestyle changes, we would like to extend the intervention for a full year (instead of 6 months) and add a 6-month follow-up point to examine maintenance of weight loss. A better understanding of the influence of behavioral factors on weight loss should help us design a successful larger study with recurrence as the endpoint. As a secondary aim, we propose to analyze the blood samples collected for markers of cancer risk which are expected to be affected by weight loss: oxidative DNA damage, insulin-like growth factor 1 (IGF-1), and IGF-binding protein 3. The extent of changes in these markers will be compared with other plasma measures that are known to be affected by weight loss: leptin, glucose, lipids and triglyceride levels. This study should be useful to determine certain psychosocial are associated with extent of weight loss, and in turn whether weight loss is associated with changes in selected markers of breast cancer risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: WEIGHT LOSS MOTIVATIONS AND LONG-TERM WEIGHT LOSS Principal Investigator & Institution: Klem, Mary L.; Assistant Professor of Psychiatry; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260

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Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2005 Summary: (adapted from investigator's abstract): Obesity and overweight affect one half of all American adults. Excess body weight has been found to be associated with an increased risk of several medical conditions including cardiovascular disease, Type 2 diabetes and certain cancers. Behavioral treatments have demonstrated successful shortterm weight loss, though long-term results are quite poor. The primary aim of the present study is to improve long-term weight loss by focusing on the primary motivations for weight loss (health and/or appearance) during treatment. Recent research suggests that dissatisfaction with weight loss upon completion of a weight loss program is associated with weight regain. Pilot data suggest that focusing on motivations for weight loss affects satisfaction with weight loss. Thus, a secondary aim of the proposed study is to investigate whether satisfaction with weight loss is a mediator of weight loss maintenance. Participants (N=180) will be randomly assigned to one of four groups: (1) Control, a standard behavioral weight loss treatment; (2) Appearance, the standard treatment plus an emphasis on physical appearance changes; (3) Health, the standard treatment plus an emphasis on health changes; and (4) Combined, the standard treatment with both a health and an appearance emphasis. All subjects will receive 6 months of treatment and will complete assessments at baseline, 6, 12, and 18 months. Primary outcome is weight change from 6 to 18 months. The proposed research is important because it seeks to examine three innovative weight loss treatment approaches designed to improve long-term weight loss, which is the major challenge in obesity treatment. If investigates whether taking the focus off actual pounds lost and emphasizing primary motivations for weight loss affects satisfaction with short-term weight loss and/or long-term success at weight loss. Thus, the results of the proposed study could potentially have a positive impact on the clinical treatment of obesity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “weight loss” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for weight loss in the PubMed Central database:

3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Anti-gamma interferon and anti-interleukin-6 antibodies affect staphylococcal enterotoxin B-induced weight loss, hypoglycemia, and cytokine release in Dgalactosamine-sensitized and unsensitized mice. by Matthys P, Mitera T, Heremans H, Van Damme J, Billiau A.; 1995 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=173128

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Proteolytic cleavage product of 30-kDa adipocyte complement-related protein increases fatty acid oxidation in muscle and causes weight loss in mice. by Fruebis J, Tsao TS, Javorschi S, Ebbets-Reed D, Erickson MR, Yen FT, Bihain BE, Lodish HF.; 2001 Feb 13; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=29372

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Weight loss maintenance in women two to eleven years after participating in a commercial program: a survey. by Gosselin C, Cote G.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=48152

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with weight loss, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “weight loss” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for weight loss (hyperlinks lead to article summaries): •

A 41-year-old man with fatigue, weight loss, hypercalcemia, and hepatosplenomegaly. Author(s): Hamilton BP, Daly BD, Furlong M. Source: The American Journal of the Medical Sciences. 2002 July; 324(1): 31-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12120822&dopt=Abstract

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A 75-year-old man with fever, diarrhea, weight loss and a mid-esophageal mass. Author(s): Weber T, Kirchgatterer A, Kronabethleitner G, Hobling W, Mannhalter C, Chott A, Knoflach P. Source: Endoscopy. 2002 August; 34(8): 678. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12173096&dopt=Abstract

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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A case with diarrhoea, hypotension, wasting and weight loss. Author(s): Chiam P, Tavintharan S, Poulose V, Fock KM. Source: Journal of Postgraduate Medicine. 2002 October-December; 48(4): 304-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12571390&dopt=Abstract

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A correlation method for weight loss after gastroplasty. Author(s): Lointier PH, Verdier PH, Verdier A. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 460-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841913&dopt=Abstract

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A new approach to multicultural item generation in the development of two obesityspecific measures: the Obesity and Weight Loss Quality of Life (OWLQOL) questionnaire and the Weight-Related Symptom Measure (WRSM). Author(s): Niero M, Martin M, Finger T, Lucas R, Mear I, Wild D, Glauda L, Patrick DL. Source: Clinical Therapeutics. 2002 April; 24(4): 690-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12017412&dopt=Abstract

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A nutritional education program could prevent weight loss and slow cognitive decline in Alzheimer's disease. Author(s): Riviere S, Gillette-Guyonnet S, Voisin T, Reynish E, Andrieu S, Lauque S, Salva A, Frisoni G, Nourhashemi F, Micas M, Vellas B. Source: J Nutr Health Aging. 2001; 5(4): 295-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11753499&dopt=Abstract

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A personal perspective on the needs of the weight loss surgery patient. Author(s): Sorensen RD. Source: Critical Care Nursing Quarterly. 2003 April-June; 26(2): 150-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12744595&dopt=Abstract

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A prospective study of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer. Author(s): Scott HR, McMillan DC, Brown DJ, Forrest LM, McArdle CS, Milroy R. Source: Lung Cancer (Amsterdam, Netherlands). 2003 June; 40(3): 295-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12781428&dopt=Abstract

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A randomised placebo-controlled clinical trial of an acupressure device for weight loss. Author(s): Allison DB, Kreibich K, Heshka S, Heymsfield SB. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1995 September; 19(9): 653-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8574276&dopt=Abstract

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A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. Author(s): Layman DK, Boileau RA, Erickson DJ, Painter JE, Shiue H, Sather C, Christou DD. Source: The Journal of Nutrition. 2003 February; 133(2): 411-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566476&dopt=Abstract

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A young woman with massive weight loss, neuropathy and cardiopathy. Author(s): Moschovitis A, Kobel DE, Calderoni A. Source: Swiss Medical Weekly : Official Journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology. 2002 May 18; 132(19-20): 265-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12148081&dopt=Abstract

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Accuracy of bioelectrical impedance spectroscopy in measuring changes in body composition during severe weight loss. Author(s): Cox-Reijven PL, van Kreel B, Soeters PB. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 2002 March-April; 26(2): 120-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11873761&dopt=Abstract

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Adiponectin levels do not change with moderate dietary induced weight loss and exercise in obese postmenopausal women. Author(s): Ryan AS, Nicklas BJ, Berman DM, Elahi D. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2003 September; 27(9): 1066-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12917712&dopt=Abstract

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African immigrant with weight loss and disseminated skin lesions. Author(s): Hasse B, Kronenberg A. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 September 1; 37(5): 692-3, 726-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12942402&dopt=Abstract

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Albumin concentrations are primarily determined by the body cell mass and the systemic inflammatory response in cancer patients with weight loss. Author(s): McMillan DC, Watson WS, O'Gorman P, Preston T, Scott HR, McArdle CS. Source: Nutrition and Cancer. 2001; 39(2): 210-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11759282&dopt=Abstract

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Altering therapy of type II diabetes mellitus from insulin to tolazamide increases blood pressure in spite of weight loss. Author(s): Schmitt JK, Johns SB. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 1995 May; 8(5 Pt 1): 520-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7662230&dopt=Abstract

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American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Author(s): Jakicic JM, Clark K, Coleman E, Donnelly JE, Foreyt J, Melanson E, Volek J, Volpe SL; American College of Sports Medicine. Source: Medicine and Science in Sports and Exercise. 2001 December; 33(12): 2145-56. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11740312&dopt=Abstract

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An 82-year-old woman with weight loss and eosinophilia. Author(s): Hanson LC, Dent G. Source: Journal of the American Geriatrics Society. 1995 October; 43(10): 1161-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7560710&dopt=Abstract

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An 8-year old boy with recurrent macroscopic hematuria, weight loss, and kidney failure. Author(s): Kemper MJ, Bergstrasser E, Pawlik H, Gaspert A, Neuhaus TJ. Source: The Journal of Pediatrics. 2003 March; 142(3): 342-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12640387&dopt=Abstract

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An African male with cough, haemoptysis, weight loss and hypercalcaemia: TB or not TB? Author(s): Al-Mobeireek AF, Arafah M, Siddiqui N. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 2002 October; 20(4): 1060-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12412704&dopt=Abstract

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Analysis of weight loss with the biliopancreatic diversion of Larrad: absolute failures or relative successes? Author(s): Sanchez-Cabezudo Diaz-Guerra C, Larrad Jimenez A. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 April; 12(2): 249-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11975222&dopt=Abstract

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Angiotensinogen genotype and blood pressure responses to reduced dietary NaCl and to weight loss. Author(s): Kotchen TA. Source: Hypertension. 1998 September; 32(3): 402-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9740602&dopt=Abstract

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Angiotensinogen genotype, sodium reduction, weight loss, and prevention of hypertension: trials of hypertension prevention, phase II. Author(s): Hunt SC, Cook NR, Oberman A, Cutler JA, Hennekens CH, Allender PS, Walker WG, Whelton PK, Williams RR. Source: Hypertension. 1998 September; 32(3): 393-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9740601&dopt=Abstract

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Anorexia and weight loss in older persons. Author(s): Morley JE. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2003 February; 58(2): 131-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12586850&dopt=Abstract

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Antibiotics for weight loss, osteolysis, hepatic and adrenal tumours. Author(s): Spyridonidis A, Otto F, Kraft A, von Kalle C. Source: Lancet. 2002 May 25; 359(9320): 1828. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12044379&dopt=Abstract

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Are low-fat diets better than other weight-reducing diets in achieving long-term weight loss? Author(s): Schooff M. Source: American Family Physician. 2003 February 1; 67(3): 507-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12588072&dopt=Abstract

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Are smaller weight losses or more achievable weight loss goals better in the long term for obese patients? Author(s): Jeffery RW, Wing RR, Mayer RR. Source: Journal of Consulting and Clinical Psychology. 1998 August; 66(4): 641-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9735580&dopt=Abstract

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Are soft tissue composition of bone and non-bone pixels in spinal bone mineral measurements by DXA similar? Impact of weight loss. Author(s): Svendsen OL, Hendel HW, Gotfredsen A, Pedersen BH, Andersen T. Source: Clinical Physiology and Functional Imaging. 2002 January; 22(1): 72-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12003104&dopt=Abstract

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Ask the doctor. I've been fighting obesity all my life. I'm a 62-year-old woman and every five years or so I lose about 20 pounds, then slowly gain it back. I've heard that this “yo-yo” pattern of weight loss, weight gain, weight loss, may be more dangerous than just staying heavy. Should I give up trying to lose weight? Author(s): Lee TH. Source: Harvard Heart Letter : from Harvard Medical School. 2001 January; 11(5): 7-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11136512&dopt=Abstract

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Association between a polymorphism of the 5-HT2C receptor and weight loss in teenage girls. Author(s): Westberg L, Bah J, Rastam M, Gillberg C, Wentz E, Melke J, Hellstrand M, Eriksson E. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2002 June; 26(6): 789-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12007749&dopt=Abstract

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Association between measures of insulin sensitivity and circulating levels of interleukin-8, interleukin-6 and tumor necrosis factor-alpha. Effect of weight loss in obese men. Author(s): Bruun JM, Verdich C, Toubro S, Astrup A, Richelsen B. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2003 May; 148(5): 535-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12720537&dopt=Abstract

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Association of angiotensin-converting enzyme DD genotype with blood pressure sensitivity to weight loss. Author(s): Kostis JB, Wilson AC, Hooper WC, Harrison KW, Philipp CS, Appel LJ, Espeland MA, Folmar S, Johnson KC; TONE Cooperative Research Group. Trial Of Nonpharmacologic interventions in the Elderly. Source: American Heart Journal. 2002 October; 144(4): 625-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12360157&dopt=Abstract

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Association of weight loss and weight fluctuation with mortality among Japanese American men. Author(s): Iribarren C, Sharp DS, Burchfiel CM, Petrovitch H. Source: The New England Journal of Medicine. 1995 September 14; 333(11): 686-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7637745&dopt=Abstract

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Associations between weight loss-induced changes in plasma organochlorine concentrations, serum T(3) concentration, and resting metabolic rate. Author(s): Pelletier C, Doucet E, Imbeault P, Tremblay A. Source: Toxicological Sciences : an Official Journal of the Society of Toxicology. 2002 May; 67(1): 46-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11961215&dopt=Abstract

Studies

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Associations of weight loss and changes in fat distribution with the remission of hypertension in a bi-ethnic cohort: the Atherosclerosis Risk in Communities Study. Author(s): Juhaeri, Stevens J, Chambless LE, Nieto FJ, Jones D, Schreiner P, Arnett D, Cai J. Source: Preventive Medicine. 2003 March; 36(3): 330-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12634024&dopt=Abstract

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Audio weight loss program curbs obesity. Author(s): Merisalo LJ. Source: Rep Med Guidel Outcomes Res. 2000 October 3; 11(20): 1-2, 5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11865894&dopt=Abstract

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Autonomic nervous system activity in weight gain and weight loss. Author(s): Arone LJ, Mackintosh R, Rosenbaum M, Leibel RL, Hirsch J. Source: The American Journal of Physiology. 1995 July; 269(1 Pt 2): R222-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7631897&dopt=Abstract

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Bariatric surgery. An option for long-term weight loss. Author(s): Craig J. Source: Diabetes Self Manag. 2002 September-October; 19(5): 14, 17-8, 20-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12561752&dopt=Abstract

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Bariatric weight loss surgery: patient education, preparation, and follow-up. Author(s): Garza SF. Source: Critical Care Nursing Quarterly. 2003 April-June; 26(2): 101-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12744590&dopt=Abstract

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Behavioral choice treatment promotes continuing weight loss: preliminary results of a cognitive-behavioral decision-based treatment for obesity. Author(s): Sbrocco T, Nedegaard RC, Stone JM, Lewis EL. Source: Journal of Consulting and Clinical Psychology. 1999 April; 67(2): 260-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10224737&dopt=Abstract

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Behavioral strategies to improve long-term weight loss and maintenance. Author(s): Wing RR. Source: Medicine and Health, Rhode Island. 1999 April; 82(4): 123. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10228337&dopt=Abstract

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Beneficial effect of hormone replacement therapy on weight loss in obese menopausal women. Author(s): Chmouliovsky L, Habicht F, James RW, Lehmann T, Campana A, Golay A. Source: Maturitas. 1999 August 16; 32(3): 147-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10515671&dopt=Abstract

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Beneficial effects of pharmacotherapy on weight loss, depressive symptoms, and eating patterns in obese binge eaters and non-binge eaters. Author(s): Alger SA, Malone M, Cerulli J, Fein S, Howard L. Source: Obesity Research. 1999 September; 7(5): 469-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10509604&dopt=Abstract

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Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Author(s): Dessein PH, Shipton EA, Stanwix AE, Joffe BI, Ramokgadi J. Source: Annals of the Rheumatic Diseases. 2000 July; 59(7): 539-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10873964&dopt=Abstract

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Beneficial effects of weight loss in overweight patients with chronic proteinuric nephropathies. Author(s): Morales E, Valero MA, Leon M, Hernandez E, Praga M. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2003 February; 41(2): 319-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12552492&dopt=Abstract

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Benefits of a dietary intervention on weight loss, body composition, and lipid profile after renal transplantation. Author(s): Lopes IM, Martin M, Errasti P, Martinez JA. Source: Nutrition (Burbank, Los Angeles County, Calif.). 1999 January; 15(1): 7-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9918055&dopt=Abstract

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Benefits of recruiting participants with friends and increasing social support for weight loss and maintenance. Author(s): Wing RR, Jeffery RW. Source: Journal of Consulting and Clinical Psychology. 1999 February; 67(1): 132-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10028217&dopt=Abstract

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Benefits of sustained moderate weight loss in obesity. Author(s): Pasanisi F, Contaldo F, de Simone G, Mancini M. Source: Nutr Metab Cardiovasc Dis. 2001 December; 11(6): 401-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12055705&dopt=Abstract

Studies

73

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Benefits of weight loss in the treatment of obesity. Author(s): Blackburn GL. Source: The American Journal of Clinical Nutrition. 1999 March; 69(3): 347-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10075314&dopt=Abstract

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Beta-adrenergically mediated thermogenic and heart rate responses: effect of obesity and weight loss. Author(s): Blaak EE, van Baak MA, Kester AD, Saris WH. Source: Metabolism: Clinical and Experimental. 1995 April; 44(4): 520-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7723676&dopt=Abstract

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Beta-oxidation of linoleate in obese men undergoing weight loss. Author(s): Cunnane SC, Ross R, Bannister JL, Jenkins DJ. Source: The American Journal of Clinical Nutrition. 2001 April; 73(4): 709-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11273844&dopt=Abstract

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Beyond calories and fat grams: am I deserving of successful weight loss? Author(s): Popkess-Vawter S, Turner J. Source: Nutrition (Burbank, Los Angeles County, Calif.). 2001 April; 17(4): 362-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11369184&dopt=Abstract

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Biexponential model for predicting weight loss after gastric surgery for obesity. Author(s): Livingston EH, Sebastian JL, Huerta S, Yip I, Heber D. Source: The Journal of Surgical Research. 2001 December; 101(2): 216-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11735279&dopt=Abstract

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Bilateral sciatic nerve entrapment due to weight loss. Author(s): Lee R, Fann AV, Sobus K. Source: J Ark Med Soc. 1998 September; 95(4): 153-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9757623&dopt=Abstract

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Binge status as a predictor of weight loss treatment outcome. Author(s): Sherwood NE, Jeffery RW, Wing RR. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1999 May; 23(5): 485-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10375051&dopt=Abstract

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Blood pressure and pulse pressure during long-term weight loss in the obese: the Swedish Obese Subjects (SOS) Intervention Study. Author(s): Sjostrom CD, Peltonen M, Sjostrom L. Source: Obesity Research. 2001 March; 9(3): 188-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11323444&dopt=Abstract

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Body composition and energy expenditure after weight loss following bariatric surgery. Author(s): Benedetti G, Mingrone G, Marcoccia S, Benedetti M, Giancaterini A, Greco AV, Castagneto M, Gasbarrini G. Source: Journal of the American College of Nutrition. 2000 April; 19(2): 270-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10763909&dopt=Abstract

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Body composition and muscle constituents during weight loss: studies in obese patients following gastroplasty. Author(s): Wadstrom C, Backman L, Forsberg AM, Nilsson E, Hultman E, Reizenstein P, Ekman M. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 June; 10(3): 203-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10932257&dopt=Abstract

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Body composition and source of weight loss after bariatric surgery. Author(s): Gahtan V, Goode SE, Kurto HZ, Schocken DD, Powers P, Rosemurgy AS. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1997 June; 7(3): 184-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9730546&dopt=Abstract

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Body composition assessment in extreme obesity and after massive weight loss induced by gastric bypass surgery. Author(s): Das SK, Roberts SB, Kehayias JJ, Wang J, Hsu LK, Shikora SA, Saltzman E, McCrory MA. Source: American Journal of Physiology. Endocrinology and Metabolism. 2003 June; 284(6): E1080-8. Epub 2003 February 25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12604503&dopt=Abstract

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Body composition changes in Caucasian and African American children and adolescents with obesity using dual-energy X-ray absorptiometry measurements after a 10-week weight loss program. Author(s): Figueroa-Colon R, Mayo MS, Aldridge RA, Winder T, Weinsier RL. Source: Obesity Research. 1998 September; 6(5): 326-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9738547&dopt=Abstract

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Body fat distribution in white and black women: different patterns of intraabdominal and subcutaneous abdominal adipose tissue utilization with weight loss. Author(s): Weinsier RL, Hunter GR, Gower BA, Schutz Y, Darnell BE, Zuckerman PA. Source: The American Journal of Clinical Nutrition. 2001 November; 74(5): 631-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11684531&dopt=Abstract

Studies

75

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Body image perception in relation to recent weight changes and strategies for weight loss in a nationally representative sample in the European Union. Author(s): McElhone S, Kearney JM, Giachetti I, Zunft HJ, Martinez JA. Source: Public Health Nutrition. 1999 March; 2(1A): 143-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10933634&dopt=Abstract

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Body image: appearance orientation and evaluation in the severely obese. Changes with weight loss. Author(s): Dixon JB, Dixon ME, O'Brien PE. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 February; 12(1): 65-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11868302&dopt=Abstract

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Body mass index, weight loss and energy intake of old Danish nursing home residents and home-care clients. Author(s): Beck AM, Ovesen L. Source: Scandinavian Journal of Caring Sciences. 2002 March; 16(1): 86-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11985754&dopt=Abstract

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Body weight loss and maintenance with physical activity and diet. Author(s): Doucet E, Tremblay A. Source: Coronary Artery Disease. 1998; 9(8): 495-501. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9847981&dopt=Abstract

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Body weight loss as an indicator of breast cancer recurrence. Author(s): Marinho LA, Rettori O, Vieira-Matos AN. Source: Acta Oncologica (Stockholm, Sweden). 2001; 40(7): 832-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11859982&dopt=Abstract

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Body weight loss increases plasma and adipose tissue concentrations of potentially toxic pollutants in obese individuals. Author(s): Chevrier J, Dewailly E, Ayotte P, Mauriege P, Despres JP, Tremblay A. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2000 October; 24(10): 1272-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11093288&dopt=Abstract

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Bone marrow changes in anorexia nervosa are correlated with the amount of weight loss and not with other clinical findings. Author(s): Abella E, Feliu E, Granada I, Milla F, Oriol A, Ribera JM, Sanchez-Planell L, Berga LI, Reverter JC, Rozman C. Source: American Journal of Clinical Pathology. 2002 October; 118(4): 582-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12375646&dopt=Abstract

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Bone mineral density (BMD) in obesity effect of weight loss. Author(s): Gossain VV, Rao DS, Carella MJ, Divine G, Rovner DR. Source: J Med. 1999; 30(5-6): 367-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10851569&dopt=Abstract

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Brain glucose metabolism in anorexia nervosa and affective disorders: influence of weight loss or depressive symptomatology. Author(s): Delvenne V, Goldman S, De Maertelaer V, Wikler D, Damhaut P, Lotstra F. Source: Psychiatry Research. 1997 May 16; 74(2): 83-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9204511&dopt=Abstract

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Bupropion for weight loss: an investigation of efficacy and tolerability in overweight and obese women. Author(s): Gadde KM, Parker CB, Maner LG, Wagner HR 2nd, Logue EJ, Drezner MK, Krishnan KR. Source: Obesity Research. 2001 September; 9(9): 544-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11557835&dopt=Abstract

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Bupropion SR enhances weight loss: a 48-week double-blind, placebo- controlled trial. Author(s): Anderson JW, Greenway FL, Fujioka K, Gadde KM, McKenney J, O'Neil PM. Source: Obesity Research. 2002 July; 10(7): 633-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12105285&dopt=Abstract

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Bupropion SR vs. placebo for weight loss in obese patients with depressive symptoms. Author(s): Jain AK, Kaplan RA, Gadde KM, Wadden TA, Allison DB, Brewer ER, Leadbetter RA, Richard N, Haight B, Jamerson BD, Buaron KS, Metz A. Source: Obesity Research. 2002 October; 10(10): 1049-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12376586&dopt=Abstract

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Caloric intake, not carbohydrate or fat consumption, determines weight loss. Author(s): Fleming RM. Source: The American Journal of Medicine. 2003 January; 114(1): 78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543299&dopt=Abstract

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Can changes in plasma insulin concentration explain the variability in leptin response to weight loss in obese women with normal glucose tolerance? Author(s): Carantoni M, Abbasi F, Azhar S, Schaaf P, Reaven GM. Source: The Journal of Clinical Endocrinology and Metabolism. 1999 March; 84(3): 86972. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10084563&dopt=Abstract

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77

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Can sustained weight loss in overweight individuals reduce the risk of diabetes mellitus? Author(s): Moore LL, Visioni AJ, Wilson PW, D'Agostino RB, Finkle WD, Ellison RC. Source: Epidemiology (Cambridge, Mass.). 2000 May; 11(3): 269-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10784242&dopt=Abstract

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Cardiac parasympathetic activity is increased by weight loss in healthy obese women. Author(s): Rissanen P, Franssila-Kallunki A, Rissanen A. Source: Obesity Research. 2001 October; 9(10): 637-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11595781&dopt=Abstract

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Cardiopulmonary adaptation to exercise after acute weight loss in severely obese subjects. Author(s): Boni E, Giustina A, Borra E, Bussi AR, Grassi V. Source: Monaldi Arch Chest Dis. 1995 August; 50(4): 264-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7550204&dopt=Abstract

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Case records of the Children's Hospital of Michigan: a 15-year-old with vomiting and weight loss. Author(s): Knapp JF, Sethuraman U, Stewart G, Mahajan P, Rosenberg N. Source: Pediatric Emergency Care. 2001 August; 17(4): 298-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11493835&dopt=Abstract

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CD-ROM nutrient analysis database assists self-monitoring behavior of active duty Air Force personnel receiving nutrition counseling for weight loss. Author(s): Heetderks-Cox MJ, Alford BB, Bednar CM, Heiss CJ, Tauai LA, Edgren KK. Source: Journal of the American Dietetic Association. 2001 September; 101(9): 1041-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11573756&dopt=Abstract

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Change in intra-abdominal adipose tissue volume during weight loss in obese men and women: correlation between magnetic resonance imaging and anthropometric measurements. Author(s): Kamel EG, McNeill G, Van Wijk MC. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2000 May; 24(5): 607-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10849583&dopt=Abstract

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Changes in abdominal subcutaneous fat water content with rapid weight loss and long-term weight maintenance in abdominally obese men and women. Author(s): Laaksonen DE, Nuutinen J, Lahtinen T, Rissanen A, Niskanen LK. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2003 June; 27(6): 677-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833111&dopt=Abstract

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Changes in energy expenditure and substrate oxidation resulting from weight loss in obese men and women: is there an important contribution of leptin? Author(s): Doucet E, St Pierre S, Almeras N, Mauriege P, Richard D, Tremblay A. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 April; 85(4): 1550-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10770196&dopt=Abstract

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Changes in lipid levels with percent of weight loss in morbid obesity. Author(s): Pizzocri P, Koprivec D, Folli F, Vedani P, Marchi M, Paganelli M, Pontiroli AE. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 October; 11(5): 649-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11594114&dopt=Abstract

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Changes in renal function during weight loss induced by high vs low-protein low-fat diets in overweight subjects. Author(s): Skov AR, Toubro S, Bulow J, Krabbe K, Parving HH, Astrup A. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1999 November; 23(11): 1170-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10578207&dopt=Abstract

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Changes in resting energy expenditure after weight loss in obese African American and white women. Author(s): Foster GD, Wadden TA, Swain RM, Anderson DA, Vogt RA. Source: The American Journal of Clinical Nutrition. 1999 January; 69(1): 13-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9925117&dopt=Abstract

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Chronic diarrhea and weight loss in HIV-infected patients. Author(s): Ehrenpreis E. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 1999 August 1; 21(4): 351-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10428118&dopt=Abstract

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Cigarette smoking for weight loss or control among adolescents: gender and racial/ethnic differences. Author(s): Fulkerson JA, French SA. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 2003 April; 32(4): 306-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12667735&dopt=Abstract

Studies

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Circulating leptin levels and weight loss in Alzheimer's disease patients. Author(s): Power DA, Noel J, Collins R, O'Neill D. Source: Dementia and Geriatric Cognitive Disorders. 2001 March-April; 12(2): 167-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11173891&dopt=Abstract

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Clinical evaluation for cancer in patients with involuntary weight loss without specific symptoms. Author(s): Hernandez JL, Riancho JA, Matorras P, Gonzalez-Macias J. Source: The American Journal of Medicine. 2003 June 1; 114(8): 631-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798450&dopt=Abstract

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Clinical indicators associated with unintentional weight loss and pressure ulcers in elderly residents of nursing facilities. Author(s): Gilmore SA, Robinson G, Posthauer ME, Raymond J. Source: Journal of the American Dietetic Association. 1995 September; 95(9): 984-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7657913&dopt=Abstract

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Clinical measures of obesity and weight loss in men. Author(s): Egger G, Dobson A. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2000 March; 24(3): 354-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10757630&dopt=Abstract

•

Clinical significance of weight loss in cancer patients: rationale for the use of anabolic agents in the treatment of cancer-related cachexia. Author(s): Langer CJ, Hoffman JP, Ottery FD. Source: Nutrition (Burbank, Los Angeles County, Calif.). 2001 January; 17(1 Suppl): S120. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11428126&dopt=Abstract

•

Closure of the “non-healing wound” corresponds with correction of weight loss using the anabolic agent oxandrolone. Author(s): Demling R, De Santi L. Source: Ostomy Wound Manage. 1998 October; 44(10): 58-62, 64, 66 Passim. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9866597&dopt=Abstract

•

Clozapine weight gain, plus topiramate weight loss. Author(s): Dursun SM, Devarajan S. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2000 March; 45(2): 198. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10742883&dopt=Abstract

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Cognitive appraisals of dietary transgressions by obese women: associations with self-reported eating behavior, depression, and actual weight loss. Author(s): Smith CF, O'Neil PM, Rhodes SK. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1999 March; 23(3): 231-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10193867&dopt=Abstract

•

Collagen metabolism in obesity: the effect of weight loss. Author(s): Rasmussen MH, Jensen LT, Andersen T, Breum L, Hilsted J. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1995 September; 19(9): 659-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8574277&dopt=Abstract

•

Combination of diet, exercise and intermittent treatment of cimetidine on body weight and maintenance of weight loss. A 42 months follow-up study. Author(s): Birketvedt GS, Thom E, Bernersen B, Florholmen J. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2000 July-August; 6(4): 699-703. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11208394&dopt=Abstract

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Comments on: Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies, Andreyev et al., Eur J Cancer 1998, 34, pp. 503-509. Author(s): Bozzetti F. Source: European Journal of Cancer (Oxford, England : 1990). 1998 December; 34(13): 2132-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10070324&dopt=Abstract

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Commercial weight loss products and programs: what consumers stand to gain and lose. A public conference on the information consumers need to evaluate weight loss products and programs. Author(s): Cleland R, Graybill DC, Hubbard V, Khan LK, Stern JS, Wadden TA, Weinsier R, Yanovski S, Gross WC, Daynard M. Source: Critical Reviews in Food Science and Nutrition. 2001 January; 41(1): 45-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11152047&dopt=Abstract

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Comparison of methods for assessing body composition changes during weight loss. Author(s): Weyers AM, Mazzetti SA, Love DM, Gomez AL, Kraemer WJ, Volek JS. Source: Medicine and Science in Sports and Exercise. 2002 March; 34(3): 497-502. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11880815&dopt=Abstract

Studies

81

•

Comparison of obese NIDDM and nondiabetic women: short- and long-term weight loss. Author(s): Guare JC, Wing RR, Grant A. Source: Obesity Research. 1995 July; 3(4): 329-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8521149&dopt=Abstract

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Composition of postnatal weight loss & subsequent weight gain in preterm infants. Author(s): Singhi S, Sood V, Bhakoo ON, Ganguly NK, Kaur A. Source: The Indian Journal of Medical Research. 1995 April; 101: 157-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7751046&dopt=Abstract

•

Computerized weight loss intervention optimizes staff time: the clinical and cost results of a controlled clinical trial conducted in a managed care setting. Author(s): Wylie-Rosett J, Swencionis C, Ginsberg M, Cimino C, Wassertheil-Smoller S, Caban A, Segal-Isaacson CJ, Martin T, Lewis J. Source: Journal of the American Dietetic Association. 2001 October; 101(10): 1155-62; Quiz 1163-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11678486&dopt=Abstract

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Concurrent reductions of serum leptin and lipids during weight loss in obese men with type II diabetes. Author(s): Halle M, Berg A, Garwers U, Grathwohl D, Knisel W, Keul J. Source: The American Journal of Physiology. 1999 August; 277(2 Pt 1): E277-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10444423&dopt=Abstract

•

Contour surgery in the patient with great weight loss. Author(s): Pitanguy I, Gontijo de Amorim NF, Radwanski HN. Source: Aesthetic Plastic Surgery. 2000 November-December; 24(6): 406-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11246427&dopt=Abstract

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Contribution of diet, tumour volume and patient-related factors to weight loss in patients with colorectal liver metastases. Author(s): Fordy C, Glover C, Henderson DC, Summerbell C, Wharton R, Allen-Mersh TG. Source: The British Journal of Surgery. 1999 May; 86(5): 639-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10361185&dopt=Abstract

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Correlates of body image dissatisfaction among overweight women seeking weight loss. Author(s): Matz PE, Foster GD, Faith MS, Wadden TA. Source: Journal of Consulting and Clinical Psychology. 2002 August; 70(4): 1040-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12182267&dopt=Abstract

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Cough, fever and weight loss in a young male. Author(s): Summer R, Zacks J, Ieong M, O'Regan A. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 2002 June; 19(6): 1210-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12108878&dopt=Abstract

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Culturally-sensitive weight loss program produces significant reduction in weight, blood pressure, and cholesterol in eight weeks. Author(s): Ard JD, Rosati R, Oddone EZ. Source: Journal of the National Medical Association. 2000 November; 92(11): 515-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11152083&dopt=Abstract

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Current management of cancer-associated anorexia and weight loss. Author(s): Jatoi A Jr, Loprinzi CL. Source: Oncology (Huntingt). 2001 April; 15(4): 497-502, 508; Discussion 508-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11346935&dopt=Abstract

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CYP2E1 activity before and after weight loss in morbidly obese subjects with nonalcoholic fatty liver disease. Author(s): Emery MG, Fisher JM, Chien JY, Kharasch ED, Dellinger EP, Kowdley KV, Thummel KE. Source: Hepatology (Baltimore, Md.). 2003 August; 38(2): 428-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12883487&dopt=Abstract

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Decreased energy and phosphorylation status in the liver of lung cancer patients with weight loss. Author(s): Leij-Halfwerk S, Dagneli PC, Kappert P, Oudkerk M, Sijens PE. Source: Journal of Hepatology. 2000 June; 32(6): 887-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10898308&dopt=Abstract

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Delayed chronic diarrhea and weight loss possibly due to ticlopidine therapy. Author(s): Mansoor GA, Aziz K. Source: The Annals of Pharmacotherapy. 1997 July-August; 31(7-8): 870-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9220049&dopt=Abstract

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Dermatitis, glossitis, stomatitis, cheilitis, anemia and weight loss: a classic presentation of pancreatic glucagonoma. Author(s): Povoski SP, Zaman SA, Ducatman BS, McFadden DW. Source: W V Med J. 2002 January-February; 98(1): 12-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11941895&dopt=Abstract

Studies

83

•

Dermolipectomies following weight loss after surgery for morbid obesity. Author(s): Fotopoulos L, Kehagias I, Kalfarentzos F. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 October; 10(5): 451-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11054251&dopt=Abstract

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Determinants of weight loss following ileogastrostomy. Author(s): Su W, Jones PJ, Cleator IG, Phang PT, Birmingham CL. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1996 May; 20(5): 481-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8696428&dopt=Abstract

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Developing weight loss interventions for African-American women: elements of successful models. Author(s): Bronner Y, Boyington JE. Source: Journal of the National Medical Association. 2002 April; 94(4): 224-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11991335&dopt=Abstract

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Development of the Impact of Weight Loss Scale (IWLS): a psychometric study in a sample of men with HIV/AIDS. Author(s): Wagner GJ, Rabkin JG. Source: Aids Care. 1999 August; 11(4): 453-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10533539&dopt=Abstract

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Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Author(s): Sugerman HJ, Wolfe LG, Sica DA, Clore JN. Source: Annals of Surgery. 2003 June; 237(6): 751-6; Discussion 757-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12796570&dopt=Abstract

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Diabetes disease stage predicts weight loss outcomes with long-term appetite suppressants. Author(s): Khan MA, St Peter JV, Breen GA, Hartley GG, Vessey JT. Source: Obesity Research. 2000 January; 8(1): 43-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10678258&dopt=Abstract

•

Diabetes mellitus type 2, obesity and weight loss. Author(s): Tremble J, Donaldson D. Source: J R Soc Health. 1999 June; 119(2): 73-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11042994&dopt=Abstract

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Diabetes, weight loss, and depression. Author(s): Papp JP, Larry JA, Mazzaferri EL. Source: Hosp Pract (Off Ed). 1996 March 15; 31(3): 41-2, 44. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8596008&dopt=Abstract

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Diagnosis and management of weight loss in the elderly. Author(s): Gazewood JD, Mehr DR. Source: The Journal of Family Practice. 1998 July; 47(1): 19-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9673603&dopt=Abstract

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Dietary carbohydrates and weight loss. Author(s): Ortega RM, Andres P. Source: The American Journal of Clinical Nutrition. 1996 November; 64(5): 823-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8901809&dopt=Abstract

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Dietary intake and resting energy expenditure in relation to weight loss in unselected cancer patients. Author(s): Bosaeus I, Daneryd P, Svanberg E, Lundholm K. Source: International Journal of Cancer. Journal International Du Cancer. 2001 August 1; 93(3): 380-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11433403&dopt=Abstract

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Dietary intake, resting energy expenditure, weight loss and survival in cancer patients. Author(s): Bosaeus I, Daneryd P, Lundholm K. Source: The Journal of Nutrition. 2002 November; 132(11 Suppl): 3465S-3466S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12421871&dopt=Abstract

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Dietary treatment and long-term weight loss and maintenance in type 2 diabetes. Author(s): Hensrud DD. Source: Obesity Research. 2001 November; 9 Suppl 4: 348S-353S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11707564&dopt=Abstract

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Dietary weight loss decreases serum angiotensin-converting enzyme activity in obese adults. Author(s): Harp JB, Henry SA, DiGirolamo M. Source: Obesity Research. 2002 October; 10(10): 985-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12376578&dopt=Abstract

Studies

85

•

Dieting and weight loss: the energy perspective. Author(s): Foreyt JP, Goodrick GK. Source: Nutrition Reviews. 2001 January; 59(1 Pt 2): S25-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255800&dopt=Abstract

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Dieting for weight loss: associations with nutrient intake among women. Author(s): Neumark-Sztainer D, French SA, Jeffery RW. Source: Journal of the American Dietetic Association. 1996 November; 96(11): 1172-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8906143&dopt=Abstract

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Dieting readiness test fails to predict enrollment in a weight loss program. Author(s): Fontaine KR, Wiersema L. Source: Journal of the American Dietetic Association. 1999 June; 99(6): 664. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10361523&dopt=Abstract

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Differences in corticotropin-releasing hormone-stimulated adrenocorticotropin and cortisol before and after weight loss. Author(s): Yanovski JA, Yanovski SZ, Gold PW, Chrousos GP. Source: The Journal of Clinical Endocrinology and Metabolism. 1997 June; 82(6): 1874-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9177399&dopt=Abstract

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Differences in diagnostic approach between family physicians and other specialists in patients with unintentional body weight loss. Author(s): Lin HW, Li CM, Lee YC, Lee LT, Leung KK. Source: Family Practice. 1999 December; 16(6): 586-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10625131&dopt=Abstract

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Differences in insulin resistance do not predict weight loss in response to hypocaloric diets in healthy obese women. Author(s): McLaughlin T, Abbasi F, Carantoni M, Schaaf P, Reaven G. Source: The Journal of Clinical Endocrinology and Metabolism. 1999 February; 84(2): 578-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10022419&dopt=Abstract

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Differences in mechanisms between weight loss-sensitive and -resistant blood pressure reduction in obese subjects. Author(s): Masuo K, Mikami H, Ogihara T, Tuck ML. Source: Hypertens Res. 2001 July; 24(4): 371-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11510749&dopt=Abstract

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Differential effects of IL-1ra on sickness behavior and weight loss induced by IL-1 in rats. Author(s): Bluthe RM, Beaudu C, Kelley KW, Dantzer R. Source: Brain Research. 1995 April 17; 677(1): 171-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7606464&dopt=Abstract

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Differential health benefits of weight loss in upper-body and lower-body obese women. Author(s): Kanaley JA, Andresen-Reid ML, Oenning L, Kottke BA, Jensen MD. Source: The American Journal of Clinical Nutrition. 1993 January; 57(1): 20-6. Erratum In: Am J Clin Nutr 1993 June; 57(6): 953. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8416660&dopt=Abstract

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Differentiated long-term effects of intentional weight loss on diabetes and hypertension. Author(s): Sjostrom CD, Peltonen M, Wedel H, Sjostrom L. Source: Hypertension. 2000 July; 36(1): 20-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10904007&dopt=Abstract

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Distinct effects of aerobic exercise training and weight loss on glucose homeostasis in obese sedentary men. Author(s): Dengel DR, Pratley RE, Hagberg JM, Rogus EM, Goldberg AP. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 1996 July; 81(1): 318-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8828680&dopt=Abstract

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Do polymorphisms of apoB, LPL or apoE affect the hypocholesterolemic response to weight loss? Author(s): Kee F, Young IS, Poirier O, McMaster D, McCrum E, McGeough J, Patterson CC, Dallongeville J, Cambien F, Evans AE. Source: Atherosclerosis. 2000 November; 153(1): 119-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11058706&dopt=Abstract

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Does exercise without weight loss improve insulin sensitivity? Author(s): Ross R. Source: Diabetes Care. 2003 March; 26(3): 944-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12610063&dopt=Abstract

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Does long-term use of sibutramine (Meridia) result in continued weight loss in shortterm responders? Author(s): Stevenson JH, Trojian T, Jackson EA. Source: The Journal of Family Practice. 2001 December; 50(12): 1084. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11742615&dopt=Abstract

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Does megestrol acetate down-regulate interleukin-6 in patients with cancerassociated anorexia and weight loss? A North Central Cancer Treatment Group investigation. Author(s): Jatoi A, Yamashita J, Sloan JA, Novotny PJ, Windschitl HE, Loprinzi CL. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 2002 January; 10(1): 71-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11777191&dopt=Abstract

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Does normalization of prolactin levels result in weight loss in patients with prolactin secreting pituitary adenomas? Author(s): Yermus R, Ezzat S. Source: Clinical Endocrinology. 2002 April; 56(4): 562. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11966752&dopt=Abstract

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Does weight loss improve incontinence in moderately obese women? Author(s): Subak LL, Johnson C, Whitcomb E, Boban D, Saxton J, Brown JS. Source: International Urogynecology Journal and Pelvic Floor Dysfunction. 2002; 13(1): 40-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11999205&dopt=Abstract

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Does weight loss maintenance become easier over time? Author(s): Klem ML, Wing RR, Lang W, McGuire MT, Hill JO. Source: Obesity Research. 2000 September; 8(6): 438-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11011910&dopt=Abstract

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Dose reduction of chemotherapeutic agents after weight loss. Author(s): O'Marcaigh AS, Gilchrist GS. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 1997 April; 20(2): 193-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9124199&dopt=Abstract

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Dose-response effect of walking exercise on weight loss. How much is enough? Author(s): Bond Brill J, Perry AC, Parker L, Robinson A, Burnett K. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 November; 26(11): 1484-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439651&dopt=Abstract

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Dyspnoea, anorexia and weight loss in a 74 year old man. Author(s): Heaney LG, Gleadhill IC. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 1997 June; 10(6): 1412-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9192952&dopt=Abstract

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Effect of a high-protein, energy-restricted diet on weight loss and energy expenditure after weight stabilization in hyperinsulinemic subjects. Author(s): Luscombe ND, Clifton PM, Noakes M, Farnsworth E, Wittert G. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2003 May; 27(5): 582-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12704402&dopt=Abstract

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Effect of acarbose on weight maintenance after dietary weight loss in obese subjects. Author(s): Hauner H, Petzinna D, Sommerauer B, Toplak H. Source: Diabetes, Obesity & Metabolism. 2001 December; 3(6): 423-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11903414&dopt=Abstract

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Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. Author(s): Jakicic JM, Marcus BH, Gallagher KI, Napolitano M, Lang W. Source: Jama : the Journal of the American Medical Association. 2003 September 10; 290(10): 1323-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12966123&dopt=Abstract

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Effect of meals with milk on body iron stores and improvement of dietary habit during weight loss in female rhythmic gymnasts. Author(s): Kawano Y, Ishizaki S, Sasamoto S, Katoh Y, Kobayashi S. Source: J Nutr Sci Vitaminol (Tokyo). 2002 October; 48(5): 395-400. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12656214&dopt=Abstract

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Effect of protein intake on bone mineralization during weight loss: a 6-month trial. Author(s): Skov AR, Haulrik N, Toubro S, Molgaard C, Astrup A. Source: Obesity Research. 2002 June; 10(6): 432-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12055318&dopt=Abstract

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Effect of surgical weight loss on free radical and antioxidant balance: a preliminary report. Author(s): Kisakol G, Guney E, Bayraktar F, Yilmaz C, Kabalak T, Ozmen D. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 December; 12(6): 795-800; Discussion 800-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568184&dopt=Abstract

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Effect of surgically-induced weight loss on leukocyte indicators of chronic inflammation in morbid obesity. Author(s): Cottam DR, Schaefer PA, Shaftan GW, Velcu L, Angus LD. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 June; 12(3): 335-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12082883&dopt=Abstract

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Effect of weight loss in congestive heart failure from idiopathic dilated cardiomyopathy on electrocardiographic QRS voltage. Author(s): Madias JE, Agarwal H, Win M, Medepalli L. Source: The American Journal of Cardiology. 2002 January 1; 89(1): 86-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11779533&dopt=Abstract

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Effect of weight loss on bone metabolism: comparison of vertical banded gastroplasty and medical intervention. Author(s): Guney E, Kisakol G, Ozgen G, Yilmaz C, Yilmaz R, Kabalak T. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 383-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841898&dopt=Abstract

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Effect of weight loss on muscle lipid content in morbidly obese subjects. Author(s): Gray RE, Tanner CJ, Pories WJ, MacDonald KG, Houmard JA. Source: American Journal of Physiology. Endocrinology and Metabolism. 2003 April; 284(4): E726-32. Epub 2002 December 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488242&dopt=Abstract

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Effect of weight loss on postprandial lipemia and low-density lipoprotein receptor binding in overweight men. Author(s): James AP, Watts GF, Barrett PH, Smith D, Pal S, Chan DC, Mamo JC. Source: Metabolism: Clinical and Experimental. 2003 February; 52(2): 136-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12601621&dopt=Abstract

•

Effect of weight loss on QT dispersion in obesity. Author(s): Gupta AK, Xie B, Thakur RK, Maheshwari A, Lokhandwala Y, Carella MJ. Source: Indian Heart J. 2002 July-August; 54(4): 399-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12462668&dopt=Abstract

•

Effect of weight loss on T-cell receptor-mediated T-cell function in elite athletes. Author(s): Imai T, Seki S, Dobashi H, Ohkawa T, Habu Y, Hiraide H. Source: Medicine and Science in Sports and Exercise. 2002 February; 34(2): 245-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11828233&dopt=Abstract

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Effect of weight loss on VLDL-triglyceride and apoB-100 kinetics in women with abdominal obesity. Author(s): Mittendorfer B, Patterson BW, Klein S. Source: American Journal of Physiology. Endocrinology and Metabolism. 2003 March; 284(3): E549-56. Epub 2002 December 10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12475754&dopt=Abstract

•

Effects of a hypocaloric, low-carbohydrate diet on weight loss, blood lipids, blood pressure, glucose tolerance, and body composition in free-living overweight women. Author(s): Meckling KA, Gauthier M, Grubb R, Sanford J. Source: Canadian Journal of Physiology and Pharmacology. 2002 November; 80(11): 1095-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12489929&dopt=Abstract

•

Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. Author(s): Sondike SB, Copperman N, Jacobson MS. Source: The Journal of Pediatrics. 2003 March; 142(3): 253-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12640371&dopt=Abstract

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Effects of energy-restricted diets containing increased protein on weight loss, resting energy expenditure, and the thermic effect of feeding in type 2 diabetes. Author(s): Luscombe ND, Clifton PM, Noakes M, Parker B, Wittert G. Source: Diabetes Care. 2002 April; 25(4): 652-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11919120&dopt=Abstract

•

Effects of exercise and weight loss on hypertension. Author(s): Beilin LJ, Burke V, Puddey IB. Source: Jama : the Journal of the American Medical Association. 2003 August 20; 290(7): 887; Author Reply 887-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12928461&dopt=Abstract

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Effects of exercise and weight loss on hypertension. Author(s): Yeo S. Source: Jama : the Journal of the American Medical Association. 2003 August 20; 290(7): 886; Author Reply 886-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12928460&dopt=Abstract

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Effects of exercise and weight loss on hypertension. Author(s): McCarthy WJ, Arpawong TE, Dietsch BJ, Yancey AK. Source: Jama : the Journal of the American Medical Association. 2003 August 20; 290(7): 885; Author Reply 886-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12928458&dopt=Abstract

Studies

91

•

Effects of exercise and weight loss on hypertension. Author(s): Blumenthal JA, Sherwood A, Bacon SL, Hinderliter A. Source: Jama : the Journal of the American Medical Association. 2003 August 20; 290(7): 885-6; Author Reply 886-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12928457&dopt=Abstract

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Effects of identical weight loss on body composition and features of insulin resistance in obese women with high and low liver fat content. Author(s): Tiikkainen M, Bergholm R, Vehkavaara S, Rissanen A, Hakkinen AM, Tamminen M, Teramo K, Yki-Jarvinen H. Source: Diabetes. 2003 March; 52(3): 701-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12606511&dopt=Abstract

•

Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. Author(s): Tate DF, Jackvony EH, Wing RR. Source: Jama : the Journal of the American Medical Association. 2003 April 9; 289(14): 1833-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684363&dopt=Abstract

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Effects of moderate weight loss on anginal symptoms and indices of coagulation and fibrinolysis in overweight patients with angina pectoris. Author(s): Hankey CR, Lean ME, Lowe GD, Rumley A, Woodward M. Source: European Journal of Clinical Nutrition. 2002 October; 56(10): 1039-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12373626&dopt=Abstract

•

Effects of obesity and weight loss on soluble CD40L levels. Author(s): Desideri G, Ferri C. Source: Jama : the Journal of the American Medical Association. 2003 April 9; 289(14): 1781-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684355&dopt=Abstract

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Effects of rapid weight loss on mood and performance among amateur boxers. Author(s): Hall CJ, Lane AM. Source: British Journal of Sports Medicine. 2001 December; 35(6): 390-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11726472&dopt=Abstract

•

Effects of short-term modest weight loss on fasting and post-prandial lipoprotein sub-fractions in type 2 diabetes mellitus patients. Author(s): Ybarra J, James RW, Makoundou V, Bioletto S, Golay A. Source: Diabetes & Metabolism. 2001 December; 27(6): 701-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11852380&dopt=Abstract

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Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial. Author(s): Borg P, Kukkonen-Harjula K, Fogelholm M, Pasanen M. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 May; 26(5): 676-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12032753&dopt=Abstract

•

Effects of weight loss on changes in insulin sensitivity and lipid concentrations in premenopausal African American and white women. Author(s): Gower BA, Weinsier RL, Jordan JM, Hunter GR, Desmond R. Source: The American Journal of Clinical Nutrition. 2002 November; 76(5): 923-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399261&dopt=Abstract

•

Efficacy and safety of sibutramine for weight loss in obese patients with hypertension well controlled by beta-adrenergic blocking agents: a placebocontrolled, double-blind, randomised trial. Author(s): Sramek JJ, Leibowitz MT, Weinstein SP, Rowe ED, Mendel CM, Levy B, McMahon FG, Mullican WS, Toth PD, Cutler NR. Source: Journal of Human Hypertension. 2002 January; 16(1): 13-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11840225&dopt=Abstract

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Ethnic comparison of weight loss in the Trial of Nonpharmacologic Interventions in the Elderly. Author(s): Kumanyika SK, Espeland MA, Bahnson JL, Bottom JB, Charleston JB, Folmar S, Wilson AC, Whelton PK; TONE Cooperative Research Group. Source: Obesity Research. 2002 February; 10(2): 96-106. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11836455&dopt=Abstract

•

Evaluating and treating unintentional weight loss in the elderly. Author(s): Huffman GB. Source: American Family Physician. 2002 February 15; 65(4): 640-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11871682&dopt=Abstract

•

Exercise and weight loss in obese postmenopausal women. Author(s): Otters HB, Roelofs PD, Verhagen AP. Source: Jama : the Journal of the American Medical Association. 2003 April 9; 289(14): 1778; Author Reply 1778. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684351&dopt=Abstract

Studies

93

•

Exercise training, without weight loss, increases insulin sensitivity and postheparin plasma lipase activity in previously sedentary adults. Author(s): Duncan GE, Perri MG, Theriaque DW, Hutson AD, Eckel RH, Stacpoole PW. Source: Diabetes Care. 2003 March; 26(3): 557-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12610001&dopt=Abstract

•

Exercise-induced weight loss preferentially reduces abdominal fat. Author(s): Mayo MJ, Grantham JR, Balasekaran G. Source: Medicine and Science in Sports and Exercise. 2003 February; 35(2): 207-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12569205&dopt=Abstract

•

Ex-smoker with productive cough, weight loss, and draining lesion. Author(s): Irwin RS. Source: Chest. 2002 November; 122(5): 1837-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12426289&dopt=Abstract

•

Factors associated with low body mass index and weight loss in nursing home residents. Author(s): Blaum CS, Fries BE, Fiatarone MA. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 1995 May; 50(3): M162-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7743402&dopt=Abstract

•

Factors associated with weight loss in Alzheimer's disease. Author(s): Guyonnet S, Nourhashemi F, Ousset PJ, Micas M, Ghisolfi A, Vellas B, Albarede JL. Source: J Nutr Health Aging. 1998; 2(2): 107-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10993577&dopt=Abstract

•

Factors differentiating women and men who successfully maintain weight loss from women and men who do not. Author(s): Dohm FA, Beattie JA, Aibel C, Striegel-Moore RH. Source: Journal of Clinical Psychology. 2001 January; 57(1): 105-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11211279&dopt=Abstract

•

Factors influencing energy intake and body weight loss after gastric bypass. Author(s): Bobbioni-Harsch E, Huber O, Morel P, Chassot G, Lehmann T, Volery M, Chliamovitch E, Muggler C, Golay A. Source: European Journal of Clinical Nutrition. 2002 June; 56(6): 551-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12032656&dopt=Abstract

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Factors influencing left ventricular systolic function in nonhypertensive morbidly obese patients, and effect of weight loss induced by gastroplasty. Author(s): Alpert MA, Terry BE, Lambert CR, Kelly DL, Panayiotou H, Mukerji V, Massey CV, Cohen MV. Source: The American Journal of Cardiology. 1993 March 15; 71(8): 733-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8447274&dopt=Abstract

•

Factors influencing participation in worksite smoking cessation and weight loss programs: the Healthy Worker Project. Author(s): Lando HA, Jeffery RW, McGovern PG, Forster JL, Baxter JE. Source: Am J Health Promot. 1993 September-October; 8(1): 22-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10146403&dopt=Abstract

•

Factors of weight loss in patients with HIV and chronic diarrhea. Author(s): Beaugerie L, Carbonnel F, Carrat F, Rached AA, Maslo C, Gendre JP, Rozenbaum W, Cosnes J. Source: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association. 1998 September 1; 19(1): 34-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9732066&dopt=Abstract

•

Factors that influence weight loss in the puerperium. Author(s): Schauberger CW, Rooney BL, Brimer LM. Source: Obstetrics and Gynecology. 1992 March; 79(3): 424-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1738527&dopt=Abstract

•

Failure of preoperative resting energy expenditure in predicting weight loss after gastroplasty. Author(s): Camerini G, Adami GF, Marinari GM, Campostano A, Ravera G, Scopinaro N. Source: Obesity Research. 2001 September; 9(9): 589-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11557840&dopt=Abstract

•

Familial Cushing's disease with severe weight loss occurring in late childhood. Author(s): Cameron FJ, Warne GL. Source: Journal of Paediatrics and Child Health. 1997 February; 33(1): 74-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9069050&dopt=Abstract

Studies

95

•

Family versus individually oriented intervention for weight loss in Mexican American women. Author(s): Cousins JH, Rubovits DS, Dunn JK, Reeves RS, Ramirez AG, Foreyt JP. Source: Public Health Reports (Washington, D.C. : 1974). 1992 September-October; 107(5): 549-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1410236&dopt=Abstract

•

Fetal postmortem weight loss in utero. Author(s): Sebire NJ. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 January; 110(1): 86-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12504950&dopt=Abstract

•

Fever, weight loss and night sweat on corticosteroid therapy for COPD. Author(s): Schreiber J, Greinert U, Rusch-Gerdes S, Lotz W, Schlaak M, MullerQuernheim J. Source: Respiration; International Review of Thoracic Diseases. 1999 NovemberDecember; 66(6): 559-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10575346&dopt=Abstract

•

Fever, weight loss, and night sweats: infection or malignancy? Author(s): Winter AJ, Wiselka MJ, Wilde JT, Radcliffe KW. Source: Sexually Transmitted Infections. 1998 December; 74(6): 439-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10195055&dopt=Abstract

•

Fever, weight loss, and pancytopenia in an elderly man. Author(s): Kemp WE, Tisdale J. Source: J Tenn Med Assoc. 1994 March; 87(3): 101-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8035592&dopt=Abstract

•

Fevers, weight loss, and bilateral peripheral infiltrates in a young man. Author(s): Lee FE, Caracta CF, Fine A, Berk JL. Source: Chest. 1999 April; 115(4): 1181-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10208226&dopt=Abstract

•

FFAs and QT intervals in obese women with visceral adiposity: effects of sustained weight loss over 1 year. Author(s): Corbi GM, Carbone S, Ziccardi P, Giugliano G, Marfella R, Nappo F, Paolisso G, Esposito K, Giugliano D. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 May; 87(5): 2080-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11994344&dopt=Abstract

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Financial status does not predict weight loss after bariatric surgery. Author(s): Durkin AJ, Bloomston M, Murr MM, Rosemurgy AS. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 December; 9(6): 524-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10638475&dopt=Abstract

•

Five year results of a prospective very low calorie diet or conventional weight loss programme in type 2 diabetes. Author(s): Paisey RB, Frost J, Harvey P, Paisey A, Bower L, Paisey RM, Taylor P, Belka I. Source: Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association. 2002 April; 15(2): 121-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11972741&dopt=Abstract

•

Fluctuating widespread erythematosquamous eruption and weight loss. Author(s): O'Brien TJ, Mason GH. Source: The Australasian Journal of Dermatology. 1994; 35(1): 48-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7998901&dopt=Abstract

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Fluoride release, weight loss and erosive wear of modern aesthetic restoratives. Author(s): Yip HK, Lam WT, Smales RJ. Source: British Dental Journal. 1999 September 11; 187(5): 265-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10520545&dopt=Abstract

•

Fluoxetine improves insulin sensitivity in obese patients with non-insulin-dependent diabetes mellitus independently of weight loss. Author(s): Maheux P, Ducros F, Bourque J, Garon J, Chiasson JL. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1997 February; 21(2): 97-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9043962&dopt=Abstract

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Fluoxetine induced weight loss: a pilot study in postpartum women. Author(s): Barak Y, Lampl Y, Achiron A, Sarova-Pinhas I, Elizur A. Source: The Israel Journal of Psychiatry and Related Sciences. 1995; 32(1): 51-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7622348&dopt=Abstract

•

Flushing away the fat. Weight loss during trials of orlistat was significant, but over half was due to diet. Author(s): Garrow J. Source: Bmj (Clinical Research Ed.). 1998 September 26; 317(7162): 830-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9748171&dopt=Abstract

Studies

97

•

Food provision as a strategy to promote weight loss. Author(s): Wing RR, Jeffery RW. Source: Obesity Research. 2001 November; 9 Suppl 4: 271S-275S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11707553&dopt=Abstract

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Four worksite weight loss programs with high-stress occupations using a meal replacement product. Author(s): Winick C, Rothacker DQ, Norman RL. Source: Occupational Medicine (Oxford, England). 2002 February; 52(1): 25-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11872791&dopt=Abstract

•

Freeman-Sheldon syndrome (whistling face syndrome) and cranio-vertebral junction malformation producing dysphagia and weight loss. Author(s): Song HR, Sarwark JF, Sauntry S, Grant J. Source: Pediatric Neurosurgery. 1996; 24(5): 272-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8933572&dopt=Abstract

•

Frequency of binge eating disorder in an outpatient weight loss clinic. Author(s): Kalman D, Cascarano H, Krieger DR, Incledon T, Woolsey M. Source: Journal of the American Dietetic Association. 2002 May; 102(5): 697-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12008996&dopt=Abstract

•

Gallbladder motility and lithogenesis in obese patients during diet-induced weight loss. Author(s): Zapata R, Severin C, Manriquez M, Valdivieso V. Source: Digestive Diseases and Sciences. 2000 February; 45(2): 421-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10711462&dopt=Abstract

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Gallstone formation and rapid weight loss: pounds for stones? Author(s): Lipsky H, Barkin JS. Source: The American Journal of Gastroenterology. 1993 July; 88(7): 1128-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8317422&dopt=Abstract

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Gallstones in obesity and weight loss. Author(s): Erlinger S. Source: European Journal of Gastroenterology & Hepatology. 2000 December; 12(12): 1347-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11192327&dopt=Abstract

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Gallstones in patients with morbid obesity. Relationship to body weight, weight loss and gallbladder bile cholesterol solubility. Author(s): Shiffman ML, Sugerman HJ, Kellum JH, Brewer WH, Moore EW. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1993 March; 17(3): 153-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8385075&dopt=Abstract

•

Garcinia cambogia for weight loss. Author(s): Firenzuoli F, Gori L. Source: Jama : the Journal of the American Medical Association. 1999 July 21; 282(3): 234; Author Reply 235. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10422988&dopt=Abstract

•

Garcinia cambogia for weight loss. Author(s): Schaller JL. Source: Jama : the Journal of the American Medical Association. 1999 July 21; 282(3): 234; Author Reply 235. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10422987&dopt=Abstract

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Garcinia cambogia for weight loss. Author(s): Badmaev V, Majeed M, Conte AA. Source: Jama : the Journal of the American Medical Association. 1999 July 21; 282(3): 233-4; Author Reply 235. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10422986&dopt=Abstract

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Gastro-oesophageal reflux in obese subjects: influence of overweight, weight loss and chronic gastric balloon distension. Author(s): Mathus-Vliegen EM, Tygat GN. Source: Scandinavian Journal of Gastroenterology. 2002 November; 37(11): 1246-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12465720&dopt=Abstract

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Gastroplasty for obesity: long-term weight loss improved by vagotomy. Author(s): Kral JG, Gortz L, Hermansson G, Wallin GS. Source: World Journal of Surgery. 1993 January-February; 17(1): 75-8; Discussion 79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8447144&dopt=Abstract

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Gender differences in obesity-related cardiovascular disease risk factors among participants in a weight loss programme. Author(s): Kotchen JM, Cox-Ganser J, Wright CJ, Kotchen TA. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1993 March; 17(3): 145-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8385074&dopt=Abstract

Studies

99

•

Gender differences in the response of plasma leptin concentrations to weight loss in obese older individuals. Author(s): Nicklas BJ, Katzel LI, Ryan AS, Dennis KE, Goldberg AP. Source: Obesity Research. 1997 January; 5(1): 62-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9061717&dopt=Abstract

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Gender, age, usual weight, and tobacco use as predictors of weight loss in patients with lung cancer. Author(s): Brown JK. Source: Oncology Nursing Forum. 1993 April; 20(3): 466-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8388561&dopt=Abstract

•

Genetic variation in the peroxisome proliferator-activated receptor-gamma2 gene (Pro12Ala) affects metabolic responses to weight loss and subsequent weight regain. Author(s): Nicklas BJ, van Rossum EF, Berman DM, Ryan AS, Dennis KE, Shuldiner AR. Source: Diabetes. 2001 September; 50(9): 2172-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11522688&dopt=Abstract

•

Ghrelin and gastric bypass: is there a hormonal contribution to surgical weight loss? Author(s): Cummings DE, Shannon MH. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 July; 88(7): 29993002. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12843132&dopt=Abstract

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Glossopharyngeal neuralgia associated with cardiac syncope and weight loss. Author(s): Odeh M, Oliven A. Source: Archives of Otolaryngology--Head & Neck Surgery. 1994 November; 120(11): 1283-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7917215&dopt=Abstract

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Glucose utilization in morbidly obese subjects before and after weight loss by gastric bypass operation. Author(s): Burstein R, Epstein Y, Charuzi I, Suessholz A, Karnieli E, Shapiro Y. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1995 August; 19(8): 558-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7489026&dopt=Abstract

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Glycerol-3-phosphate dehydrogenase activity in human lymphocytes: effects of insulin, obesity and weight loss. Author(s): Tu KY, Ju HS, Pettit F, Shive W, Topek NH, Matthews R, Matthews K. Source: Biochemical and Biophysical Research Communications. 1995 February 6; 207(1): 183-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7857262&dopt=Abstract

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Glycogen storage: illusions of easy weight loss, excessive weight regain, and distortions in estimates of body composition. Author(s): Kreitzman SN, Coxon AY, Szaz KF. Source: The American Journal of Clinical Nutrition. 1992 July; 56(1 Suppl): 292S-293S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1615908&dopt=Abstract

•

Gradual and rapid weight loss: effects on nutrition and performance in male athletes. Author(s): Fogelholm GM, Koskinen R, Laakso J, Rankinen T, Ruokonen I. Source: Medicine and Science in Sports and Exercise. 1993 March; 25(3): 371-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8455453&dopt=Abstract

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Greater than predicted decrease in energy expenditure during exercise after body weight loss in obese men. Author(s): Doucet E, Imbeault P, St-Pierre S, Almeras N, Mauriege P, Despres JP, Bouchard C, Tremblay A. Source: Clinical Science (London, England : 1979). 2003 July; 105(1): 89-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12617720&dopt=Abstract

•

Grouping participants for tailored work-site weight loss programs: a signal detection approach. Author(s): Hagihara A, Tarumi K, Nobutomo K. Source: American Journal of Industrial Medicine. 2002 April; 41(4): 269-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11920970&dopt=Abstract

•

Health risks, past usage, and intention to use weight loss products in normal weight women with high and low body dysphoria. Author(s): Whisenhunt BL, Williamson DA, Netemeyer RG, Andrews C. Source: Eat Weight Disord. 2003 June; 8(2): 114-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880188&dopt=Abstract

•

Heart rate variability in obesity and the effect of weight loss. Author(s): Karason K, Molgaard H, Wikstrand J, Sjostrom L. Source: The American Journal of Cardiology. 1999 April 15; 83(8): 1242-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10215292&dopt=Abstract

•

Heart risk associated with weight loss in anorexia nervosa and eating disorders: electrocardiographic changes during the early phase of refeeding. Author(s): Swenne I. Source: Acta Paediatrica (Oslo, Norway : 1992). 2000 April; 89(4): 447-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10830458&dopt=Abstract

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•

Heart risk associated with weight loss in anorexia nervosa and eating disorders: risk factors for QTc interval prolongation and dispersion. Author(s): Swenne I, Larsson PT. Source: Acta Paediatrica (Oslo, Norway : 1992). 1999 March; 88(3): 304-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10229042&dopt=Abstract

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Hepatic insulin clearance increases after weight loss in obese children and adolescents. Author(s): Escobar O, Mizuma H, Sothern MS, Blecker U, Udall JN Jr, Suskind RM, Hilton C, Vargas A. Source: The American Journal of the Medical Sciences. 1999 May; 317(5): 282-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10334114&dopt=Abstract

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Hereditary neuropathy with liability to pressure palsies (HNPP) revealed after weight loss. Author(s): Cruz-Martinez A, Bort S, Arpa J, Palau F. Source: European Neurology. 1997; 37(4): 257-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9208274&dopt=Abstract

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Histoplasma endocarditis on a stenosed aortic valve presenting as dysphagia and weight loss. Author(s): Wilmshurst PT, Venn GE, Eykyn SJ. Source: British Heart Journal. 1993 December; 70(6): 565-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8280527&dopt=Abstract

•

History of intentional and unintentional weight loss in a population-based sample of women aged 55 to 69 years. Author(s): French SA, Jeffery RW, Folsom AR, Williamson DF, Byers T. Source: Obesity Research. 1995 March; 3(2): 163-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7719962&dopt=Abstract

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Hormone sensitive lipase expression and adipose tissue metabolism show gender difference in obese subjects after weight loss. Author(s): Kolehmainen M, Vidal H, Ohisalo JJ, Pirinen E, Alhava E, Uusitupa MI. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 January; 26(1): 6-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11791141&dopt=Abstract

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How effective are traditional dietary and exercise interventions for weight loss? Author(s): Miller WC. Source: Medicine and Science in Sports and Exercise. 1999 August; 31(8): 1129-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10449014&dopt=Abstract

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How much weight loss is sufficient to overcome major co-morbidities? Author(s): Deitel M. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 December; 11(6): 659. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11775560&dopt=Abstract

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Hyperinsulinemia and autonomic nervous system dysfunction in obesity: effects of weight loss. Author(s): Emdin M, Gastaldelli A, Muscelli E, Macerata A, Natali A, Camastra S, Ferrannini E. Source: Circulation. 2001 January 30; 103(4): 513-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11157715&dopt=Abstract

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Hyperinsulinism and weight loss in obese children. Author(s): Kiortsis DN, Tsatsoulis A. Source: European Journal of Pediatrics. 1999 December; 158(12): 1011. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10592086&dopt=Abstract

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Hyperphagia and weight loss during fluoxetine treatment. Author(s): Fichtner CG, Braun BG. Source: The Annals of Pharmacotherapy. 1994 December; 28(12): 1350-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7696724&dopt=Abstract

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Hypertension: therapeutic approach to weight loss, exercise, and salt intake. Author(s): Butler RN, August P, Ferdinand KC, Phillips RA, Roccella EJ. Source: Geriatrics. 1999 May; 54(5): 42, 45-6, 49-50 Passim Contd. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10365185&dopt=Abstract

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Hypnotic enhancement of cognitive-behavioral weight loss treatments--another metareanalysis. Author(s): Kirsch I. Source: Journal of Consulting and Clinical Psychology. 1996 June; 64(3): 517-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8698945&dopt=Abstract

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Immunological effects of low-fat diets with and without weight loss. Author(s): Santos MS, Lichtenstein AH, Leka LS, Goldin B, Schaefer EJ, Meydani SN. Source: Journal of the American College of Nutrition. 2003 April; 22(2): 174-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12672714&dopt=Abstract

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Impact of body weight and weight loss on cardiovascular risk factors. Author(s): Hecker KD, Kris-Etherton PM, Zhao G, Coval S, St Jeor S. Source: Current Atherosclerosis Reports. 1999 November; 1(3): 236-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11122716&dopt=Abstract

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Impact of significant weight loss on maximal oxygen uptake in obese children and adolescents. Author(s): Sothern MS, Loftin M, Blecker U, Udall JN Jr. Source: Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research. 2000 November; 48(6): 411-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11094863&dopt=Abstract

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Impact of smoking status on weight loss and cardiovascular risk factors. Author(s): Wilson K, Clark H, Hotz S, Dent R. Source: Journal of Epidemiology and Community Health. 2001 March; 55(3): 213-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11160177&dopt=Abstract

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Impact of weight loss on the metabolic syndrome. Author(s): Case CC, Jones PH, Nelson K, O'Brian Smith E, Ballantyne CM. Source: Diabetes, Obesity & Metabolism. 2002 November; 4(6): 407-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12406040&dopt=Abstract

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Importance of learned resourcefulness to weight loss and early success during maintenance: preliminary evidence. Author(s): Kennett DJ, Ackerman M. Source: Patient Education and Counseling. 1995 May; 25(2): 197-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7659632&dopt=Abstract

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Importance of weight loss definition in the prognostic evaluation of non-small-cell lung cancer. Author(s): Buccheri G, Ferrigno D. Source: Lung Cancer (Amsterdam, Netherlands). 2001 December; 34(3): 433-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11714541&dopt=Abstract

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Improvement in co-morbidities following weight loss from gastric bypass surgery. Author(s): Dhabuwala A, Cannan RJ, Stubbs RS. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 October; 10(5): 428-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11054247&dopt=Abstract

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Improvement in hypertrophic cardiomyopathy after significant weight loss: case report. Author(s): Uwaifo GI, Fallon EM, Calis KA, Drinkard B, McDuffie JR, Yanovski JA. Source: Southern Medical Journal. 2003 June; 96(6): 626-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12938797&dopt=Abstract

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Improvement of weight loss and metabolic effects of vertical banded gastroplasty by an added duodenal switch procedure. Author(s): Yashkov YI, Oppel TA, Shishlo LA, Vinnitsky LI. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 October; 11(5): 635-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11594110&dopt=Abstract

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Improvements in blood pressure, glucose metabolism, and lipoprotein lipids after aerobic exercise plus weight loss in obese, hypertensive middle-aged men. Author(s): Dengel DR, Hagberg JM, Pratley RE, Rogus EM, Goldberg AP. Source: Metabolism: Clinical and Experimental. 1998 September; 47(9): 1075-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9751236&dopt=Abstract

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Improvements in insulin sensitivity and beta-cell function (HOMA) with weight loss in the severely obese. Homeostatic model assessment. Author(s): Dixon JB, Dixon AF, O'Brien PE. Source: Diabetic Medicine : a Journal of the British Diabetic Association. 2003 February; 20(2): 127-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12581264&dopt=Abstract

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Inactivity and weight loss: effective criteria to identify frailty. Author(s): Chin A Paw MJ, de Groot LC, van Gend SV, Schoterman MH, Schouten EG, Schroll M, van Staveren WA. Source: J Nutr Health Aging. 2003; 7(1): 55-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679841&dopt=Abstract

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Incorporation of non esterified fatty acids into QUICKI is not relevant in obese subjects during diet inducing weight loss. Author(s): Bastard JP, Jan V, Maachi M, Rabasa-Lhoret R, Jardel C, Bruckert E, Laville M, Hainque B. Source: Diabetes & Metabolism. 2002 September; 28(4 Pt 1): 333-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12442072&dopt=Abstract

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Increase in plasma pollutant levels in response to weight loss in humans is related to in vitro subcutaneous adipocyte basal lipolysis. Author(s): Imbeault P, Chevrier J, Dewailly E, Ayotte P, Despres JP, Tremblay A, Mauriege P. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2001 November; 25(11): 1585-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11753575&dopt=Abstract

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Increase in plasma pollutant levels in response to weight loss is associated with the reduction of fasting insulin levels in men but not in women. Author(s): Imbeault P, Chevrier J, Dewailly E, Ayotte P, Despres JP, Mauriege P, Tremblay A. Source: Metabolism: Clinical and Experimental. 2002 April; 51(4): 482-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11912558&dopt=Abstract

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Increase in skeletal muscle fatty acid binding protein (FABPC) content is directly related to weight loss and to changes in fat oxidation following a very low calorie diet. Author(s): Blaak EE, Glatz JF, Saris WH. Source: Diabetologia. 2001 November; 44(11): 2013-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11719832&dopt=Abstract

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Increased dietary protein modifies glucose and insulin homeostasis in adult women during weight loss. Author(s): Layman DK, Shiue H, Sather C, Erickson DJ, Baum J. Source: The Journal of Nutrition. 2003 February; 133(2): 405-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566475&dopt=Abstract

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Increasing dietary supervision can reduce weight loss in oral cancer patients. Author(s): Dawson ER, Morley SE, Robertson AG, Soutar DS. Source: Nutrition and Cancer. 2001; 41(1-2): 70-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12094631&dopt=Abstract

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Influence of dexamethasone and weight loss on the regulation of serum leptin levels in obese individuals. Author(s): Lerario DD, Ferreira SR, Miranda WL, Chacra AR. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 2001 April; 34(4): 479-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11285459&dopt=Abstract

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Influence of distribution of lean body mass on resting metabolic rate after weight loss and weight regain: comparison of responses in white and black women. Author(s): Byrne NM, Weinsier RL, Hunter GR, Desmond R, Patterson MA, Darnell BE, Zuckerman PA. Source: The American Journal of Clinical Nutrition. 2003 June; 77(6): 1368-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12791611&dopt=Abstract

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Influence of weight loss programmes on walking speed and relative oxygen cost (%VO2max) in obese women during walking. Author(s): Larsson UE, Mattsson E. Source: Journal of Rehabilitation Medicine : Official Journal of the Uems European Board of Physical and Rehabilitation Medicine. 2003 March; 35(2): 91-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691339&dopt=Abstract

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Insulin resistance precedes weight loss in adults without diabetes : the Rancho Bernardo Study. Author(s): Wedick NM, Mayer-Davis EJ, Wingard DL, Addy CL, Barrett-Connor E. Source: American Journal of Epidemiology. 2001 June 15; 153(12): 1199-205. Erratum In: Am J Epidemiol 2002 April 15; 155(8): 781. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11415955&dopt=Abstract

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Insulin-leptin-visceral fat relation during weight loss. Author(s): Yip I, Go VL, Hershman JM, Wang HJ, Elashoff R, DeShields S, Liu Y, Heber D. Source: Pancreas. 2001 August; 23(2): 197-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11484922&dopt=Abstract

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Intensive lifestyle intervention combined with the choice of pharmacotherapy improves weight loss and cardiac risk factors in the obese. Author(s): Frost G, Lyons F, Bovill-Taylor C, Carter L, Stuttard J, Dornhorst A. Source: Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association. 2002 August; 15(4): 287-95; Quiz 297-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12153502&dopt=Abstract

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Intentional weight loss and 13-year diabetes incidence in overweight adults. Author(s): Will JC, Williamson DF, Ford ES, Calle EE, Thun MJ. Source: American Journal of Public Health. 2002 August; 92(8): 1245-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12144977&dopt=Abstract

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Intentional weight loss and death in overweight and obese U.S. adults 35 years of age and older. Author(s): Gregg EW, Gerzoff RB, Thompson TJ, Williamson DF. Source: Annals of Internal Medicine. 2003 March 4; 138(5): 383-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12614090&dopt=Abstract

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Intentional weight loss and mortality among overweight individuals with diabetes. Author(s): Williamson DF, Thompson TJ, Thun M, Flanders D, Pamuk E, Byers T. Source: Diabetes Care. 2000 October; 23(10): 1499-504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11023143&dopt=Abstract

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Interface pressure and shear stress changes with amputee weight loss: case studies from two trans-tibial amputee subjects. Author(s): Sanders JE, Fergason JR, Zachariah SG, Jacobsen AK. Source: Prosthet Orthot Int. 2002 December; 26(3): 243-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562072&dopt=Abstract

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Interpreting incomplete data in studies of diet and weight loss. Author(s): Ware JH. Source: The New England Journal of Medicine. 2003 May 22; 348(21): 2136-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12761370&dopt=Abstract

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Interventions for weight loss and weight gain prevention among youth: current issues. Author(s): Fulton JE, McGuire MT, Caspersen CJ, Dietz WH. Source: Sports Medicine (Auckland, N.Z.). 2001; 31(3): 153-65. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11286354&dopt=Abstract

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Interventions to increase long-term exercise adherence and weight loss. Author(s): Macera CA. Source: Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine. 2000 October; 10(4): 306. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11086763&dopt=Abstract

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Involuntary weight loss and the nonhealing wound. Author(s): DeSanti L. Source: Advances in Skin & Wound Care. 2000 January-February; 13(1 Suppl): 11-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11061713&dopt=Abstract

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Involuntary weight loss in elderly individuals: assessment and treatment. Author(s): Moriguti JC, Moriguti EK, Ferriolli E, de Castilho Cacao J, Iucif N Jr, Marchini JS. Source: Sao Paulo Medical Journal = Revista Paulista De Medicina. 2001 March; 119(2): 72-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11276170&dopt=Abstract

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Involuntary weight loss in older outpatients: incidence and clinical significance. Author(s): Wallace JI, Schwartz RS, LaCroix AZ, Uhlmann RF, Pearlman RA. Source: Journal of the American Geriatrics Society. 1995 April; 43(4): 329-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7706619&dopt=Abstract

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Involuntary weight loss without specific symptoms: a clinical prediction score for malignant neoplasm. Author(s): Hernandez JL, Matorras P, Riancho JA, Gonzalez-Macias J. Source: Qjm : Monthly Journal of the Association of Physicians. 2003 September; 96(9): 649-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12925720&dopt=Abstract

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Is the relationship between adipose tissue and waist girth altered by weight loss in obese men? Author(s): Pare A, Dumont M, Lemieux I, Brochu M, Almeras N, Lemieux S, Prud'homme D, Despres JP. Source: Obesity Research. 2001 September; 9(9): 526-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11557833&dopt=Abstract

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Is weight loss a cure for type 2 diabetes? Author(s): Tayek JA. Source: Diabetes Care. 2002 February; 25(2): 397-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11815518&dopt=Abstract

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Isolated peroneal nerve palsy complicating weight loss due to anterior pituitary hypofunction. Author(s): Ishii K, Tamaoka A, Matsuno S, Shoji S. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 2003 March; 10(2): 187-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12603296&dopt=Abstract

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Japanese family with parkinsonism, depression, weight loss, and central hypoventilation. Author(s): Tsuboi Y, Wszolek ZK, Kusuhara T, Doh-ura K, Yamada T. Source: Neurology. 2002 April 9; 58(7): 1025-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11940687&dopt=Abstract

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Lack of correlation between diarrhea and weight loss in HIV-positive outpatients in Houston, Texas. Author(s): Mosavi AJ, Hussain MF, DuPont HL, Mathewson JJ, White AC Jr. Source: Journal of Clinical Gastroenterology. 1995 July; 21(1): 61-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7560836&dopt=Abstract

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Latin-American trial of orlistat for weight loss and improvement in glycaemic profile in obese diabetic patients. Author(s): Halpern A, Mancini MC, Suplicy H, Zanella MT, Repetto G, Gross J, Jadzinsky M, Barranco J, Aschner P, Ramirez L, Matos AG. Source: Diabetes, Obesity & Metabolism. 2003 May; 5(3): 180-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681025&dopt=Abstract

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Lean body mass changes in cancer patients with weight loss. Author(s): Mcmillan DC, Watson WS, Preston T, Mcardle CS. Source: Clinical Nutrition (Edinburgh, Lothian). 2000 December; 19(6): 403-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11104590&dopt=Abstract

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Leflunomide-associated weight loss in rheumatoid arthritis. Author(s): Coblyn JS, Shadick N, Helfgott S. Source: Arthritis and Rheumatism. 2001 May; 44(5): 1048-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11352235&dopt=Abstract

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Left ventricular mass and systolic function in human immunodeficiency virusinfected patients after weight loss. Author(s): Umana E, Panayiotou H, Ramsey KA, Bikkina M, Massey CV, Alpert MA. Source: The American Journal of Cardiology. 2000 November 1; 86(9): 1040-3, A11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11053726&dopt=Abstract

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Leisure-time activity is an important determinant of long-term weight maintenance after weight loss in the Sibutramine Trial on Obesity Reduction and Maintenance (STORM trial). Author(s): van Baak MA, van Mil E, Astrup AV, Finer N, Van Gaal LF, Hilsted J, Kopelman PG, Rossner S, James WP, Saris WH; STORM Study Group. Source: The American Journal of Clinical Nutrition. 2003 August; 78(2): 209-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12885699&dopt=Abstract

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Leptin and its relation to weight loss, ob gene expression and the acute-phase response in surgical patients. Author(s): Moses AG, Dowidar N, Holloway B, Waddell I, Fearon KC, Ross JA. Source: The British Journal of Surgery. 2001 April; 88(4): 588-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11298630&dopt=Abstract

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Leptin levels are appropriate for body mass index in older men who experience involuntary weight loss. Author(s): Yukawa M, McCormick WC, Rajan S, Matsumoto AM, Wallace JI, Pearlman RA, Weigle DS. Source: Journal of the American Geriatrics Society. 2002 September; 50(9): 1566-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12383156&dopt=Abstract

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Leptin levels are associated with fat oxidation and dietary-induced weight loss in obesity. Author(s): Verdich C, Toubro S, Buemann B, Holst JJ, Bulow J, Simonsen L, Sondergaard SB, Christensen NJ, Astrup A. Source: Obesity Research. 2001 August; 9(8): 452-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11500525&dopt=Abstract

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Leptin responses to weight loss in postmenopausal women: relationship to sexhormone binding globulin and visceral obesity. Author(s): van Rossum EF, Nicklas BJ, Dennis KE, Berman DM, Goldberg AP. Source: Obesity Research. 2000 January; 8(1): 29-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10678256&dopt=Abstract

•

Leptin, insulin and TNF-alpha in weight loss. Author(s): Xenachis C, Samojlik E, Raghuwanshi MP, Kirschner MA. Source: J Endocrinol Invest. 2001 December; 24(11): 865-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11817710&dopt=Abstract

•

Leptin-induced weight loss is not solely mediated by anorexia. Author(s): Dotsch J, Meissner U, Rascher W. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2003 January; 148(1): 11-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12534351&dopt=Abstract

•

Lessons from obesity management programmes: greater initial weight loss improves long-term maintenance. Author(s): Astrup A, Rossner S. Source: Obesity Reviews : an Official Journal of the International Association for the Study of Obesity. 2000 May; 1(1): 17-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12119640&dopt=Abstract

•

Lethal weight loss: the focus shifts to signal transduction. Author(s): Tracey KJ. Source: Science's Stke [electronic Resource] : Signal Transduction Knowledge Environment. 2002 April 30; 2002(130): Pe21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11983938&dopt=Abstract

Studies 111

•

Lifestyle modifications to prevent and control hypertension. 2. Recommendations on obesity and weight loss. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada. Author(s): Leiter LA, Abbott D, Campbell NR, Mendelson R, Ogilvie RI, Chockalingam A. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1999 May 4; 160(9 Suppl): S7-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10333848&dopt=Abstract

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Lipid profile in the severely obese: changes with weight loss after lap-band surgery. Author(s): Dixon JB, O'Brien PE. Source: Obesity Research. 2002 September; 10(9): 903-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12226139&dopt=Abstract

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Lipid profiles of obese children and adolescents before and after significant weight loss: differences according to sex. Author(s): Sothern MS, Despinasse B, Brown R, Suskind RM, Udall JN Jr, Blecker U. Source: Southern Medical Journal. 2000 March; 93(3): 278-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10728514&dopt=Abstract

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Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects. Author(s): Ditschuneit HH, Frier HI, Flechtner-Mors M. Source: European Journal of Clinical Nutrition. 2002 March; 56(3): 264-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11960302&dopt=Abstract

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Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. Author(s): Das SK, Roberts SB, McCrory MA, Hsu LK, Shikora SA, Kehayias JJ, Dallal GE, Saltzman E. Source: The American Journal of Clinical Nutrition. 2003 July; 78(1): 22-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12816767&dopt=Abstract

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Long-term effects of weight loss on pharmaceutical costs in obese subjects. A report from the SOS intervention study. Author(s): Agren G, Narbro K, Naslund I, Sjostrom L, Peltonen M. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 February; 26(2): 184-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11850749&dopt=Abstract

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Long-term follow-up after gastric surgery for morbid obesity: preoperative weight loss improves the long-term control of morbid obesity after vertical banded gastroplasty. Author(s): van de Weijgert EJ, Ruseler CH, Elte JW. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 October; 9(5): 426-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10605898&dopt=Abstract

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Long-term maintenance of weight loss after a very-low-calorie diet: a randomized blinded trial of the efficacy and tolerability of sibutramine. Author(s): Apfelbaum M, Vague P, Ziegler O, Hanotin C, Thomas F, Leutenegger E. Source: The American Journal of Medicine. 1999 February; 106(2): 179-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10230747&dopt=Abstract

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Long-term maintenance of weight loss: current status. Author(s): Jeffery RW, Drewnowski A, Epstein LH, Stunkard AJ, Wilson GT, Wing RR, Hill DR. Source: Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association. 2000 January; 19(1 Suppl): 5-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10709944&dopt=Abstract

•

Long-term medication use and weight loss maintenance: an observational study. Author(s): Womble LG, Wadden TA, Berkowitz RI, Sarwer DB, Rothman RA. Source: Obesity Research. 2001 October; 9(10): 652-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11595785&dopt=Abstract

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Long-term weight loss and breakfast in subjects in the National Weight Control Registry. Author(s): Wyatt HR, Grunwald GK, Mosca CL, Klem ML, Wing RR, Hill JO. Source: Obesity Research. 2002 February; 10(2): 78-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11836452&dopt=Abstract

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Long-term weight loss and changes in blood pressure. Author(s): Sharma AM. Source: Current Hypertension Reports. 2002 February; 4(1): 11-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11790285&dopt=Abstract

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Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Author(s): Stevens VJ, Obarzanek E, Cook NR, Lee IM, Appel LJ, Smith West D, Milas NC, Mattfeldt-Beman M, Belden L, Bragg C, Millstone M, Raczynski J, Brewer A, Singh B, Cohen J; Trials for the Hypertension Prevention Research Group. Source: Annals of Internal Medicine. 2001 January 2; 134(1): 1-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11187414&dopt=Abstract

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Long-term weight loss with sibutramine: a randomized controlled trial. Author(s): Wirth A, Krause J. Source: Jama : the Journal of the American Medical Association. 2001 September 19; 286(11): 1331-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11560538&dopt=Abstract

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Loss of total body potassium during rapid weight loss does not depend on the decrease of potassium concentration in muscles. Different methods to evaluate body composition during a low energy diet. Author(s): Krotkiewski M, Landin K, Mellstrom D, Tolli J. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2000 January; 24(1): 101-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10702758&dopt=Abstract

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Low serum leptin level in colon cancer patients without significant weight loss. Author(s): Arpaci F, Yilmaz MI, Ozet A, Ayta H, Ozturk B, Komurcu S, Ozata M. Source: Tumori. 2002 March-April; 88(2): 147-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12088256&dopt=Abstract

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Low-back pain in morbidly obese patients and the effect of weight loss following surgery. Author(s): Melissas J, Volakakis E, Hadjipavlou A. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 389-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841899&dopt=Abstract

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Low-calorie diets and sustained weight loss. Author(s): Finer N. Source: Obesity Research. 2001 November; 9 Suppl 4: 290S-294S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11707556&dopt=Abstract

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Low-carbohydrate diets and realities of weight loss. Author(s): Bray GA. Source: Jama : the Journal of the American Medical Association. 2003 April 9; 289(14): 1853-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684366&dopt=Abstract

•

Lower dosages of phentermine-fenfluramine given in the afternoon: five cases with significant weight loss. Author(s): Katz DA, Maloney MJ, Sutkamp JC, McConville BJ. Source: The International Journal of Eating Disorders. 1999 May; 25(4): 469-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10202659&dopt=Abstract

•

Maintenance of weight loss after obesity treatment: is continuous support necessary? Author(s): Leibbrand R, Fichter MM. Source: Behaviour Research and Therapy. 2002 November; 40(11): 1275-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12384323&dopt=Abstract

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Maintenance of weight loss: a needs assessment. Author(s): DePue JD, Clark MM, Ruggiero L, Medeiros ML, Pera V Jr. Source: Obesity Research. 1995 May; 3(3): 241-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7627772&dopt=Abstract

•

Malaise, weight loss, and respiratory symptoms. Author(s): Hadi HA, Arnold AG. Source: Postgraduate Medical Journal. 2002 January; 78(915): 55, 58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11796880&dopt=Abstract

•

Man with weight loss, fever, cough, and an abnormal spleen. Author(s): Ayi BS, Smith PW. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 September 15; 37(6): 805-6, 831-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12955655&dopt=Abstract

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Management of hyperemesis gravidarum: the importance of weight loss as a criterion for steroid therapy. Author(s): Moran P, Taylor R. Source: Qjm : Monthly Journal of the Association of Physicians. 2002 March; 95(3): 153-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11865170&dopt=Abstract

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•

Managing weight loss with nutritional supplements. Author(s): Vazquez E. Source: Posit Aware. 1998 March-April; 9(2): 49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11365227&dopt=Abstract

•

Markers of chronic inflammation and obesity: a prospective study on the reversibility of this association in middle-aged women undergoing weight loss by surgical intervention. Author(s): Laimer M, Ebenbichler CF, Kaser S, Sandhofer A, Weiss H, Nehoda H, Aigner F, Patsch JR. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 May; 26(5): 659-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12032750&dopt=Abstract

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Massive weight loss restores 24-hour growth hormone release profiles and serum insulin-like growth factor-I levels in obese subjects. Author(s): Rasmussen MH, Hvidberg A, Juul A, Main KM, Gotfredsen A, Skakkebaek NE, Hilsted J, Skakkebae NE. Source: The Journal of Clinical Endocrinology and Metabolism. 1995 April; 80(4): 140715. Erratum In: J Clin Endocrinol Metab 1995 August; 80(8): 2446. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7536210&dopt=Abstract

•

Measurement of percent body fat during weight loss in obese women. Comparison of four methods. Author(s): Funkhouser AB, Laferrere B, Wang J, Thornton J, Pi-Sunyer FX. Source: Annals of the New York Academy of Sciences. 2000 May; 904: 539-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10865801&dopt=Abstract

•

Measuring the effect of sibutramine for weight loss. Author(s): Ransom T, Ur E. Source: Jama : the Journal of the American Medical Association. 2002 January 23-30; 287(4): 449-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11798360&dopt=Abstract

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Measuring the prevalence of weight loss. The quality indicator process at Iowa Veterans Home. Author(s): Feilmann A. Source: Health Care Food & Nutrition Focus. 2000 October; 17(2): 8-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11143159&dopt=Abstract

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Mechanisms of weight loss after surgery for clinically severe obesity. Author(s): Flancbaum L. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1999 December; 9(6): 516-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10638474&dopt=Abstract

•

Medical nutrition therapy for the prevention and treatment of unintentional weight loss in residential healthcare facilities. Author(s): Splett PL, Roth-Yousey LL, Vogelzang JL. Source: Journal of the American Dietetic Association. 2003 March; 103(3): 352-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12616259&dopt=Abstract

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Medication cost savings associated with weight loss for obese non-insulin-dependent diabetic men and women. Author(s): Collins RW, Anderson JW. Source: Preventive Medicine. 1995 July; 24(4): 369-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7479627&dopt=Abstract

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Metabolic and weight loss effects of long-term dietary intervention in obese patients: four-year results. Author(s): Flechtner-Mors M, Ditschuneit HH, Johnson TD, Suchard MA, Adler G. Source: Obesity Research. 2000 August; 8(5): 399-402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10968732&dopt=Abstract

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Metabolic changes following sibutramine-assisted weight loss in obese individuals: role of plasma free fatty acids in the insulin resistance of obesity. Author(s): McLaughlin T, Abbasi F, Lamendola C, Kim HS, Reaven GM. Source: Metabolism: Clinical and Experimental. 2001 July; 50(7): 819-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11436188&dopt=Abstract

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Metabolic consequences of weight loss on glucose metabolism and insulin action in type 2 diabetes. Author(s): Williams KV, Kelley DE. Source: Diabetes, Obesity & Metabolism. 2000 June; 2(3): 121-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11220547&dopt=Abstract

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Metabolic response to weight loss. Author(s): Weinsier R, Hunter G, Schutz Y. Source: The American Journal of Clinical Nutrition. 2001 March; 73(3): 655-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11237948&dopt=Abstract

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•

Metformin for weight loss in pediatric patients taking psychotropic drugs. Author(s): Morrison JA, Cottingham EM, Barton BA. Source: The American Journal of Psychiatry. 2002 April; 159(4): 655-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11925306&dopt=Abstract

•

Metformin induced anorexia and weight loss. Author(s): Wong LL, Wong TC. Source: Hawaii Med J. 2003 May; 62(5): 104-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806790&dopt=Abstract

•

Modifications of alpha-tocopherol and fatty acid concentrations in blood and adipose tissue of obese patients during a weight loss programme. Author(s): Bonnefont-Rousselot D, Lepage S, Therond P, Bastard JP, Hainque B, Turpin G, Legrand A, Delattre J, Bruckert E. Source: Nutr Metab Cardiovasc Dis. 1999 February; 9(1): 25-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10726106&dopt=Abstract

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Modifications of blood pressure and IGF-I levels after weight loss in obesity. Author(s): Dall'Aglio E, Salimbeni I, Rocci A, Mazzoni S, Corradi F, Cattadori E, Visioli S, Banchini A, Valenti G, Ceda GP. Source: J Endocrinol Invest. 2002; 25(10 Suppl): 107-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12508940&dopt=Abstract

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Modifications of metabolic and cardiovascular risk factors after weight loss induced by laparoscopic gastric banding. Author(s): Bacci V, Basso MS, Greco F, Lamberti R, Elmore U, Restuccia A, Perrotta N, Silecchia G, Bucci A. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 February; 12(1): 77-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11868304&dopt=Abstract

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Monitoring and preventing weight loss. Author(s): Saccone B. Source: Provider. 2000 April; 26(4): 49-50, 52-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11183397&dopt=Abstract

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Motivations for exercise and weight loss among African-American women: focus group results and their contribution towards program development. Author(s): Young DR, Gittelsohn J, Charleston J, Felix-Aaron K, Appel LJ. Source: Ethnicity & Health. 2001 August-November; 6(3-4): 227-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11696933&dopt=Abstract

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msJAMA: Appearance vs health as motivators for weight loss. Author(s): Cheskin LJ, Donze LF. Source: Jama : the Journal of the American Medical Association. 2001 November 7; 286(17): 2160. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11694161&dopt=Abstract

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Muscle fiber type is associated with obesity and weight loss. Author(s): Tanner CJ, Barakat HA, Dohm GL, Pories WJ, MacDonald KG, Cunningham PR, Swanson MS, Houmard JA. Source: American Journal of Physiology. Endocrinology and Metabolism. 2002 June; 282(6): E1191-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12006347&dopt=Abstract

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Muscle UCP-3 mRNA levels are elevated in weight loss associated with gastrointestinal adenocarcinoma in humans. Author(s): Collins P, Bing C, McCulloch P, Williams G. Source: British Journal of Cancer. 2002 February 1; 86(3): 372-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11875702&dopt=Abstract

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Naltrexone treatment restores menstrual cycles in patients with weight loss-related amenorrhea. Author(s): Genazzani AD, Petraglia F, Gastaldi M, Volpogni C, Gamba O, Genazzani AR. Source: Fertility and Sterility. 1995 November; 64(5): 951-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7589640&dopt=Abstract

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Nasal continuous positive airway pressure and weight loss improve swallowing reflex in patients with obstructive sleep apnea syndrome. Author(s): Okada S, Ouchi Y, Teramoto S. Source: Respiration; International Review of Thoracic Diseases. 2000; 67(4): 464-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10940807&dopt=Abstract

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Nasal CPAP and weight loss in hypertensive patients with obstructive sleep apnoea. Author(s): Rauscher H, Formanek D, Popp W, Zwick H. Source: Thorax. 1993 May; 48(5): 529-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8322241&dopt=Abstract

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Neck circumference a good predictor of raised insulin and free androgen index in obese premenopausal women: changes with weight loss. Author(s): Dixon JB, O'Brien PE. Source: Clinical Endocrinology. 2002 December; 57(6): 769-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12460327&dopt=Abstract

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•

Neurocognitive function in HIV-infected patients with low weight and weight loss. Author(s): Dolan S, Montagno A, Wilkie S, Aliabadi N, Sullivan M, Zahka N, Sherman JC, Grinspoon S. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2003 October 1; 34(2): 155-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14526204&dopt=Abstract

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Neuropsychological consequences of extreme weight loss and dietary restriction in patients with anorexia nervosa. Author(s): Mathias JL, Kent PS. Source: J Clin Exp Neuropsychol. 1998 August; 20(4): 548-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9892058&dopt=Abstract

•

Night eating syndrome is associated with depression, low self-esteem, reduced daytime hunger, and less weight loss in obese outpatients. Author(s): Gluck ME, Geliebter A, Satov T. Source: Obesity Research. 2001 April; 9(4): 264-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11331430&dopt=Abstract

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No effect of the Trp64Arg beta(3)-adrenoceptor gene variant on weight loss, body composition, or energy expenditure in obese, caucasian postmenopausal women. Author(s): Rawson ES, Nolan A, Silver K, Shuldiner AR, Poehlman ET. Source: Metabolism: Clinical and Experimental. 2002 June; 51(6): 801-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12037740&dopt=Abstract

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Non-alcoholic steatohepatitis: association with obesity and insulin resistance, and influence of weight loss. Author(s): Luyckx FH, Lefebvre PJ, Scheen AJ. Source: Diabetes & Metabolism. 2000 April; 26(2): 98-106. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10804323&dopt=Abstract

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Nonproductive cough, weight loss and bilateral pulmonary infiltrates. Author(s): Loddenkemper R, Schoenfeld N. Source: Monaldi Arch Chest Dis. 1994 June; 49(3): 214-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8087117&dopt=Abstract

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Normal dexamethasone suppression in obese binge and nonbinge eaters with rapid weight loss. Author(s): Yanovski SZ, Yanovski JA, Gwirtsman HE, Bernat A, Gold PW, Chrousos GP. Source: The Journal of Clinical Endocrinology and Metabolism. 1993 March; 76(3): 675-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8445025&dopt=Abstract

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Normative beliefs of health behavior professionals regarding the psychosocial and environmental factors that influence health behavior change related to smoking cessation, regular exercise, and weight loss. Author(s): Love MB, Davoli GW, Thurman QC. Source: Am J Health Promot. 1996 May-June; 10(5): 371-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10163307&dopt=Abstract

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Nutrition and Alzheimer's disease: an European funded program to prevent weight loss in demented aged persons. Author(s): Vellas B, Riviere S. Source: J Nutr Health Aging. 1998; 2(2): 96. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10993574&dopt=Abstract

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Nutritional assessment, intervention, and evaluation of weight loss in patients with non-small cell lung cancer. Author(s): Brown JK, Radke KJ. Source: Oncology Nursing Forum. 1998 April; 25(3): 547-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9568609&dopt=Abstract

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Nutritional vitamin B12 deficiency and folate deficiency in an adolescent patient presenting with anemia, weight loss, and poor school performance. Author(s): Middleman AB, Emans SJ, Cox J. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 1996 July; 19(1): 76-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8842864&dopt=Abstract

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Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. Author(s): Rejeski WJ, Focht BC, Messier SP, Morgan T, Pahor M, Penninx B. Source: Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association. 2002 September; 21(5): 419-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211508&dopt=Abstract

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Obesity and disease management: effects of weight loss on comorbid conditions. Author(s): Anderson JW, Konz EC. Source: Obesity Research. 2001 November; 9 Suppl 4: 326S-334S. Review. Erratum In: Obes Res. 2003 January; 11(1): Following Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11707561&dopt=Abstract

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Obesity and lower urinary tract function in women: effect of surgically induced weight loss. Author(s): Bump RC, Sugerman HJ, Fantl JA, McClish DK. Source: American Journal of Obstetrics and Gynecology. 1992 August; 167(2): 392-7; Discussion 397-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1497041&dopt=Abstract

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Obesity and weight loss in obstructive sleep apnea: a critical review. Author(s): Strobel RJ, Rosen RC. Source: Sleep. 1996 February; 19(2): 104-15. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8855032&dopt=Abstract

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Obesity and weight loss in polycystic ovary syndrome. Author(s): Hoeger K. Source: Obstetrics and Gynecology Clinics of North America. 2001 March; 28(1): 85-97, Vi-Vii. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11293006&dopt=Abstract

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Obesity and weight loss. Author(s): D'Eramo-Melkus G. Source: Lippincott's Primary Care Practice. 1997 July-August; 1(3): 243-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9238947&dopt=Abstract

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Obesity, adiposity, and lengthening of the QT interval: improvement after weight loss. Author(s): Carella MJ, Mantz SL, Rovner DR, Willis PW 3rd, Gossain VV, Bouknight RR, Ferenchick GS. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1996 October; 20(10): 938-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8910099&dopt=Abstract

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Obesity, weight loss, and health. Author(s): Robison JI, Hoerr SL, Strandmark J, Mavis B. Source: Journal of the American Dietetic Association. 1993 April; 93(4): 445-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8454814&dopt=Abstract

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Oesophageal cancer and cachexia: the effect of short-term treatment with thalidomide on weight loss and lean body mass. Author(s): Khan ZH, Simpson EJ, Cole AT, Holt M, MacDonald I, Pye D, Austin A, Freeman JG. Source: Alimentary Pharmacology & Therapeutics. 2003 March 1; 17(5): 677-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12641516&dopt=Abstract

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Oligoarthritis in an elderly woman with diarrhoea and weight loss. Author(s): Hepburn AL, Kaye SA. Source: Postgraduate Medical Journal. 2001 July; 77(909): 475-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11423607&dopt=Abstract

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On a low calorie diet, are there separate and discrete effects of negative energy balance and weight loss on blood pressure? Author(s): Esler M. Source: Journal of Hypertension. 2003 February; 21(2): 261-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12569252&dopt=Abstract

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On call. I m a healthy 44-year-old man. I ve always been heavy, but eight months ago I started a diet and exercise program. I ve lost 26 pounds and I feel great. Now that I'm thinner, I thought it would be a good time to buy more life insurance, but a friend warned me that if I report the weight loss my premiums might go up. Why in the world should getting healthier cost me money? Author(s): Simon HB. Source: Harvard Men's Health Watch. 2001 November; 6(4): 8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11724704&dopt=Abstract

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Opioid dysregulation after biliopancreatic diversion: effect of naloxone on preprandial and postprandial growth hormone (GH)-releasing hormone-induced GH release in surgically induced weight loss. Author(s): Mancini A, Bianchi A, Tacchino RM, Perrelli M, Milardi D, Gentilella R, Giampietro A, Fusco A, Valle D, De Marinis L. Source: Metabolism: Clinical and Experimental. 2001 April; 50(4): 382-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11288030&dopt=Abstract

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Opposite regulation of interleukin-8 and tumor necrosis factor-alpha by weight loss. Author(s): Bruun JM, Pedersen SB, Kristensen K, Richelsen B. Source: Obesity Research. 2002 June; 10(6): 499-506. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12055326&dopt=Abstract

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Oral ganciclovir systemic exposure is enhanced in HIV-infected patients with diarrhea and weight loss. Author(s): Mouly S, Aymard G, Diquet B, Caulin C, Bergmann JF. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2000 August 1; 24(4): 344-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11015151&dopt=Abstract

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Oral health problems and involuntary weight loss in a population of frail elderly. Author(s): Sullivan DH, Martin W, Flaxman N, Hagen JE. Source: Journal of the American Geriatrics Society. 1993 July; 41(7): 725-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8315182&dopt=Abstract

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Oral health problems and significant weight loss among community-dwelling older adults. Author(s): Ritchie CS, Joshipura K, Silliman RA, Miller B, Douglas CW. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2000 July; 55(7): M366-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10898252&dopt=Abstract

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Organ/body weight loss with aging: evidence for co-ordinated involution. Author(s): Spencer RP. Source: Medical Hypotheses. 1996 February; 46(2): 59-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8692044&dopt=Abstract

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Orlistat and weight loss. Author(s): McCarthy WJ. Source: The American Journal of Clinical Nutrition. 2000 March; 71(3): 846-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10702185&dopt=Abstract

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Orlistat and weight loss. Author(s): Lekkerkerker JF, Diemont WL, Koopmans PP. Source: Lancet. 1998 October 31; 352(9138): 1473-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9808020&dopt=Abstract

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Orlistat and weight loss. Author(s): McCarthy WJ. Source: Lancet. 1998 October 31; 352(9138): 1473; Author Reply 1474. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9808019&dopt=Abstract

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Orlistat maintains biliary lipid composition and hepatobiliary function in obese subjects undergoing moderate weight loss. Author(s): Trouillot TE, Pace DG, McKinley C, Cockey L, Zhi J, Haeussler J, Guerciolini R, Showalter R, Everson GT. Source: The American Journal of Gastroenterology. 2001 June; 96(6): 1888-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11421247&dopt=Abstract

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Orlistat--a novel weight loss therapy. Author(s): Lucas KH, Kaplan-Machlis B. Source: The Annals of Pharmacotherapy. 2001 March; 35(3): 314-28. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11261530&dopt=Abstract

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Overweight, weight loss, and risk of coronary heart disease in older women. The NHANES I Epidemiologic Follow-up Study. Author(s): Harris TB, Ballard-Barbasch R, Madans J, Makuc DM, Feldman JJ. Source: American Journal of Epidemiology. 1993 June 15; 137(12): 1318-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8333413&dopt=Abstract

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Paradoxical weight loss with extra energy expenditure at brown adipose tissue in adolescent patients with Duchenne muscular dystrophy. Author(s): Satomura S, Yokota I, Tatara K, Naito E, Ito M, Kuroda Y. Source: Metabolism: Clinical and Experimental. 2001 October; 50(10): 1181-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11586490&dopt=Abstract

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Partitioned weight loss and body composition changes during a mountaineering expedition: a field study. Author(s): Tanner DA, Stager JM. Source: Wilderness Environ Med. 1998 Fall; 9(3): 143-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11990186&dopt=Abstract

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Pathologic quiz case: an 85-year-old woman with weight loss and pruritus. Author(s): Parwani AV, Gilkey FW, Ali SZ. Source: Archives of Pathology & Laboratory Medicine. 2003 May; 127(5): E263-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708931&dopt=Abstract

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Pathology case of the month. Abdominal pain and weight loss in a young adult. Anaplastic large cell lymphoma. Author(s): Sun W, Veillon DM, Nordberg ML, Nawas S, Cotelingam JD. Source: J La State Med Soc. 2002 November-December; 154(6): 289-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517023&dopt=Abstract

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Pegylated human recombinant leptin (PEG-OB) causes additional weight loss in severely energy-restricted, overweight men. Author(s): Hukshorn CJ, Westerterp-Plantenga MS, Saris WH. Source: The American Journal of Clinical Nutrition. 2003 April; 77(4): 771-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12663271&dopt=Abstract

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Percentage of weight loss: a basic indicator of surgical risk in patients with chronic peptic ulcer. 1936. Author(s): Studley HO. Source: Nutr Hosp. 2001 July-August; 16(4): 141-3; Discussion 140-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11680474&dopt=Abstract

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Phenylethanolamine N-methyltransferase G-148A genetic variant and weight loss in obese women. Author(s): Peters WR, MacMurry JP, Walker J, Giese RJ Jr, Comings DE. Source: Obesity Research. 2003 March; 11(3): 415-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12634439&dopt=Abstract

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Phenylpropanolamine appears not to promote weight loss in patients with schizophrenia who have gained weight during clozapine treatment. Author(s): Borovicka MC, Fuller MA, Konicki PE, White JC, Steele VM, Jaskiw GE. Source: The Journal of Clinical Psychiatry. 2002 April; 63(4): 345-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12000209&dopt=Abstract

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Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? Author(s): Jeffery RW, Wing RR, Sherwood NE, Tate DF. Source: The American Journal of Clinical Nutrition. 2003 October; 78(4): 684-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14522725&dopt=Abstract

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Physical activity in free-living, overweight white and black women: divergent responses by race to diet-induced weight loss. Author(s): Weinsier RL, Hunter GR, Schutz Y, Zuckerman PA, Darnell BE. Source: The American Journal of Clinical Nutrition. 2002 October; 76(4): 736-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12324285&dopt=Abstract

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Pickwickian syndrome and indications for surgically induced weight loss. Author(s): Sugerman HJ, Felton WL 3rd. Source: Survey of Ophthalmology. 1995 July-August; 40(1): 87-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8545813&dopt=Abstract

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Plasma acylation-stimulating protein, adiponectin, leptin, and ghrelin before and after weight loss induced by gastric bypass surgery in morbidly obese subjects. Author(s): Faraj M, Havel PJ, Phelis S, Blank D, Sniderman AD, Cianflone K. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 April; 88(4): 1594602. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679444&dopt=Abstract

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Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. Author(s): Cummings DE, Weigle DS, Frayo RS, Breen PA, Ma MK, Dellinger EP, Purnell JQ. Source: The New England Journal of Medicine. 2002 May 23; 346(21): 1623-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12023994&dopt=Abstract

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Plasma kinetics of a chylomicron-like emulsion in normolipidemic obese women after a short-period weight loss by energy-restricted diet. Author(s): Oliveira MR, Maranhao RC. Source: Metabolism: Clinical and Experimental. 2002 September; 51(9): 1097-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12200752&dopt=Abstract

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Plasma leptin and the cholesterol saturation of bile are correlated in obese women after weight loss. Author(s): Mendez-Sanchez N, Gonzalez V, King-Martinez AC, Sanchez H, Uribe M. Source: The Journal of Nutrition. 2002 August; 132(8): 2195-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12163661&dopt=Abstract

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Prader-Willi syndrome: effects of weight loss on sleep-disordered breathing, daytime sleepiness and REM sleep disturbance. Author(s): Vgontzas AN, Bixler EO, Kales A, Vela-Bueno A. Source: Acta Paediatrica (Oslo, Norway : 1992). 1995 July; 84(7): 813-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7549304&dopt=Abstract

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Predictive value of early weight loss in obesity management with orlistat: an evidence-based assessment of prescribing guidelines. Author(s): Rissanen A, Lean M, Rossner S, Segal KR, Sjostrom L. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2003 January; 27(1): 103-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12532161&dopt=Abstract

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Predictors of complication and suboptimal weight loss after laparoscopic Roux-en-Y gastric bypass: a series of 188 patients. Author(s): Perugini RA, Mason R, Czerniach DR, Novitsky YW, Baker S, Litwin DE, Kelly JJ. Source: Archives of Surgery (Chicago, Ill. : 1960). 2003 May; 138(5): 541-5; Discussion 545-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742960&dopt=Abstract

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Predictors of weight loss during radiation therapy. Author(s): Beaver ME, Matheny KE, Roberts DB, Myers JN. Source: Otolaryngology and Head and Neck Surgery. 2001 December; 125(6): 645-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11743469&dopt=Abstract

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Predictors of weight loss in adults with topiramate-treated epilepsy. Author(s): Ben-Menachem E, Axelsen M, Johanson EH, Stagge A, Smith U. Source: Obesity Research. 2003 April; 11(4): 556-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690085&dopt=Abstract

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Prevalence and predictors of HIV-associated weight loss in the era of highly active antiretroviral therapy. Author(s): Batterham MJ, Garsia R, Greenop P. Source: International Journal of Std & Aids. 2002 November; 13(11): 744-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12437893&dopt=Abstract

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Prevention of gallstone formation in morbidly obese patients undergoing rapid weight loss: results of a randomized controlled pilot study. Author(s): Wudel LJ Jr, Wright JK, Debelak JP, Allos TM, Shyr Y, Chapman WC. Source: The Journal of Surgical Research. 2002 January; 102(1): 50-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11792152&dopt=Abstract

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Prevention of weight loss in dementia with comprehensive nutritional treatment. Author(s): Keller HH, Gibbs AJ, Boudreau LD, Goy RE, Pattillo MS, Brown HM. Source: Journal of the American Geriatrics Society. 2003 July; 51(7): 945-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834514&dopt=Abstract

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Prognostic importance of weight loss in chronic heart failure and the effect of treatment with angiotensin-converting-enzyme inhibitors: an observational study. Author(s): Anker SD, Negassa A, Coats AJ, Afzal R, Poole-Wilson PA, Cohn JN, Yusuf S. Source: Lancet. 2003 March 29; 361(9363): 1077-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12672310&dopt=Abstract

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Prognostic markers for diet-induced weight loss in obese women. Author(s): Astrup A, Buemann B, Gluud C, Bennett P, Tjur T, Christensen N. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1995 April; 19(4): 275-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7627252&dopt=Abstract

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Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40-64 years. Author(s): Williamson DF, Pamuk E, Thun M, Flanders D, Byers T, Heath C. Source: American Journal of Epidemiology. 1995 June 15; 141(12): 1128-41. Erratum In: Am J Epidemiol 1995 August 1; 142(3): 369. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7771451&dopt=Abstract

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Protein-energy malnutrition and involuntary weight loss: nutritional and pharmacological strategies to enhance wound healing. Author(s): Collins N. Source: Expert Opinion on Pharmacotherapy. 2003 July; 4(7): 1121-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12831338&dopt=Abstract

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Psychobehavioral response and weight loss prediction in a hospital-based weight reduction program. Author(s): Tseng MC, Lee YJ, Chen SY, Lee MB, Lin KH, Chen PR, Lai JS. Source: J Formos Med Assoc. 2002 October; 101(10): 705-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517045&dopt=Abstract

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Psychopathological status and interpersonal functioning following weight loss in morbidly obese patients undergoing bariatric surgery. Author(s): Guisado JA, Vaz FJ, Alarcon J, Lopez-Ibor JJ Jr, Rubio MA, Gaite L. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 December; 12(6): 835-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568191&dopt=Abstract

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Psychosocial consequences of weight loss following gastric banding for morbid obesity. Author(s): Kinzl JF, Traweger C, Trefalt E, Biebl W. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 February; 13(1): 105-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12630623&dopt=Abstract

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Quality of life after lap-band placement: influence of time, weight loss, and comorbidities. Author(s): Dixon JB, Dixon ME, O'Brien PE. Source: Obesity Research. 2001 November; 9(11): 713-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11707538&dopt=Abstract

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Radiation arteritis following treatment for Wilms' tumor: an unusual case of weight loss. Author(s): Ghosh AK, Lundstrom CE, Edwards WD. Source: Vascular Medicine (London, England). 2002 February; 7(1): 19-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12083729&dopt=Abstract

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Randomized crossover study of 40% vs. 55% carbohydrate weight loss strategies in women with previous gestational diabetes mellitus and non-diabetic women of 130200% ideal body weight. Author(s): Peterson CM, Jovanovic-Peterson L. Source: Journal of the American College of Nutrition. 1995 August; 14(4): 369-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8568114&dopt=Abstract

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Rational approach to patients with unintentional weight loss. Author(s): Bouras EP, Lange SM, Scolapio JS. Source: Mayo Clinic Proceedings. 2001 September; 76(9): 923-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11560304&dopt=Abstract

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Recombinant variant of ciliary neurotrophic factor for weight loss in obese adults: a randomized, dose-ranging study. Author(s): Ettinger MP, Littlejohn TW, Schwartz SL, Weiss SR, McIlwain HH, Heymsfield SB, Bray GA, Roberts WG, Heyman ER, Stambler N, Heshka S, Vicary C, Guler HP. Source: Jama : the Journal of the American Medical Association. 2003 April 9; 289(14): 1826-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684362&dopt=Abstract

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Recommendations for reporting weight loss. Author(s): Deitel M, Greenstein RJ. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 April; 13(2): 159-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12760387&dopt=Abstract

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Recurrent diarrhoea and weight loss associated with cessation of smoking in a patient with undiagnosed coeliac disease. Author(s): Veldhuyzen van Zanten SJ. Source: Gut. 2001 October; 49(4): 588. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11559659&dopt=Abstract

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Recurrent diarrhoea and weight loss associated with cessation of smoking in undiagnosed coeliac disease. Author(s): Jolobe O. Source: Gut. 2002 April; 50(4): 582; Author Reply 582. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11889083&dopt=Abstract

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Reduced testosterone levels in human immunodeficiency virus-infected women with weight loss and low weight. Author(s): Huang JS, Wilkie SJ, Dolan S, Gallafent JH, Aliabadi N, Sullivan MP, Grinspoon S. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 February 15; 36(4): 499-506. Epub 2003 January 28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12567309&dopt=Abstract

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Reduction in fat intake is not associated with weight loss in most women after breast cancer diagnosis: evidence from a randomized controlled trial. Author(s): Rock CL, Thomson C, Caan BJ, Flatt SW, Newman V, Ritenbaugh C, Marshall JR, Hollenbach KA, Stefanick ML, Pierce JP. Source: Cancer. 2001 January 1; 91(1): 25-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11148556&dopt=Abstract

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Reduction of inflammatory cytokine concentrations and improvement of endothelial functions in obese women after weight loss over one year. Author(s): Ziccardi P, Nappo F, Giugliano G, Esposito K, Marfella R, Cioffi M, D'Andrea F, Molinari AM, Giugliano D. Source: Circulation. 2002 February 19; 105(7): 804-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11854119&dopt=Abstract

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Reduction of left ventricular hypertrophy after exercise and weight loss in overweight patients with mild hypertension. Author(s): Hinderliter A, Sherwood A, Gullette EC, Babyak M, Waugh R, Georgiades A, Blumenthal JA. Source: Archives of Internal Medicine. 2002 June 24; 162(12): 1333-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12076231&dopt=Abstract

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Reduction of visceral adipose tissue during weight loss. Author(s): Doucet E, St-Pierre S, Almeras N, Imbeault P, Mauriege P, Pascot A, Despres JP, Tremblay A. Source: European Journal of Clinical Nutrition. 2002 April; 56(4): 297-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11965505&dopt=Abstract

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Reductions in visceral fat during weight loss and walking are associated with improvements in VO(2 max). Author(s): Lynch NA, Nicklas BJ, Berman DM, Dennis KE, Goldberg AP. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 2001 January; 90(1): 99104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11133898&dopt=Abstract

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Relation of weight loss to changes in serum lipids and lipoproteins in obese women. Author(s): Andersen RE, Wadden TA, Bartlett SJ, Vogt RA, Weinstock RS. Source: The American Journal of Clinical Nutrition. 1995 August; 62(2): 350-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7625342&dopt=Abstract

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Relationship between changes in serum leptin levels and blood pressure after weight loss. Author(s): Itoh K, Imai K, Masuda T, Abe S, Tanaka M, Koga R, Itoh H, Matsuyama T, Nakamura M. Source: Hypertens Res. 2002 November; 25(6): 881-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12484512&dopt=Abstract

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Relationship of a large weight loss to long-term weight change among young and middle-aged US women. Author(s): Field AE, Wing RR, Manson JE, Spiegelman DL, Willett WC. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2001 August; 25(8): 1113-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11477495&dopt=Abstract

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Relationship of co-morbidities of obesity to weight loss and four-year weight maintenance/rebound. Author(s): Hensrud DD, Weinsier RL, Darnell BE, Hunter GR. Source: Obesity Research. 1995 September; 3 Suppl 2: 217S-222S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8581780&dopt=Abstract

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Relationship of physical activity to eating behaviors and weight loss in women. Author(s): Jakicic JM, Wing RR, Winters-Hart C. Source: Medicine and Science in Sports and Exercise. 2002 October; 34(10): 1653-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12370568&dopt=Abstract

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Resistin and adiponectin expression in visceral fat of obese rats: effect of weight loss. Author(s): Milan G, Granzotto M, Scarda A, Calcagno A, Pagano C, Federspil G, Vettor R. Source: Obesity Research. 2002 November; 10(11): 1095-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12429872&dopt=Abstract

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Resistive training increases fat-free mass and maintains RMR despite weight loss in postmenopausal women. Author(s): Ryan AS, Pratley RE, Elahi D, Goldberg AP. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 1995 September; 79(3): 818-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8567523&dopt=Abstract

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Responses to hypothetical high risk situations: do they predict weight loss in a behavioral treatment program or the context of dietary lapses? Author(s): Drapkin RG, Wing RR, Shiffman S. Source: Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association. 1995 September; 14(5): 427-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7498114&dopt=Abstract

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Restored insulin inhibition on insulin secretion in nondiabetic severely obese patients after weight loss induced by bariatric surgery. Author(s): Pereira JA, Claro BM, Pareja JC, Chaim EA, Astiarraga BD, Saad MJ, Muscelli E. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2003 April; 27(4): 463-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12698955&dopt=Abstract

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Restored insulin sensitivity but persistently increased early insulin secretion after weight loss in obese women with polycystic ovary syndrome. Author(s): Holte J, Bergh T, Berne C, Wide L, Lithell H. Source: The Journal of Clinical Endocrinology and Metabolism. 1995 September; 80(9): 2586-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7673399&dopt=Abstract

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Results of the Diet, Exercise, and Weight Loss Intervention Trial (DEW-IT). Author(s): Miller ER 3rd, Erlinger TP, Young DR, Jehn M, Charleston J, Rhodes D, Wasan SK, Appel LJ. Source: Hypertension. 2002 November; 40(5): 612-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411452&dopt=Abstract

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Reversal of COPD-associated weight loss using the anabolic agent oxandrolone. Author(s): Yeh SS, DeGuzman B, Kramer T; M012 Study Group. Source: Chest. 2002 August; 122(2): 421-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12171812&dopt=Abstract

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Risk factor modification through weight loss enhanced with pharmacotherapy. Author(s): Eisenberg D. Source: Current Atherosclerosis Reports. 2002 January; 4(1): 51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11772422&dopt=Abstract

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Risk factors associated with peri- and postmenopausal bone loss: does HRT prevent weight loss-related bone loss? Author(s): Sirola J, Kroger H, Honkanen R, Sandini L, Tuppurainen M, Jurvelin JS, Saarikoski S. Source: Osteoporosis International : a Journal Established As Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the Usa. 2003 January; 14(1): 27-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12577182&dopt=Abstract

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Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Author(s): Dewey KG, Nommsen-Rivers LA, Heinig MJ, Cohen RJ. Source: Pediatrics. 2003 September; 112(3 Pt 1): 607-19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12949292&dopt=Abstract

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Sarcopenia, weight loss, and nutritional frailty in the elderly. Author(s): Bales CW, Ritchie CS. Source: Annual Review of Nutrition. 2002; 22: 309-23. Epub 2002 January 04. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12055348&dopt=Abstract

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Self-efficacy targeted treatments for weight loss in postmenopausal women. Author(s): Dennis KE, Tomoyasu N, McCrone SH, Goldberg AP, Bunyard L, Qi BB. Source: Sch Inq Nurs Pract. 2001 Fall; 15(3): 259-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11871584&dopt=Abstract

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Self-help weight loss versus a structured commercial program after 26 weeks: a randomized controlled study. Author(s): Heshka S, Greenway F, Anderson JW, Atkinson RL, Hill JO, Phinney SD, Miller-Kovach K, Xavier Pi-Sunyer F. Source: The American Journal of Medicine. 2000 September; 109(4): 282-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10996578&dopt=Abstract

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Serum insulin but not leptin is associated with spontaneous and growth hormone (GH)-releasing hormone-stimulated GH secretion in normal volunteers with and without weight loss. Author(s): Manglik S, Cobanov B, Flores G, Nadjafi R, Tayek JA. Source: Metabolism: Clinical and Experimental. 1998 September; 47(9): 1127-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9751243&dopt=Abstract

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Serum leptin changes during weight loss in obese diabetic subjects with and without microalbuminuria. Author(s): Verrotti A, Basciani F, De Simone M, Morgese G, Chiarelli F. Source: Diabetes Nutr Metab. 2001 October; 14(5): 283-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11806469&dopt=Abstract

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Serum leptin concentrations and satiety in Parkinson's disease patients with and without weight loss. Author(s): Evidente VG, Caviness JN, Adler CH, Gwinn-Hardy KA, Pratley RE. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 2001 September; 16(5): 924-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11746624&dopt=Abstract

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Serum tumour necrosis factor-alpha levels in cancer patients are discontinuous and correlate with weight loss. Author(s): Bossola M, Muscaritoli M, Bellantone R, Pacelli F, Cascino A, Sgadari A, Battaglia F, Piccioni E, Scambia G, Doglietto GB, Rossi Fanelli F. Source: European Journal of Clinical Investigation. 2000 December; 30(12): 1107-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11122326&dopt=Abstract

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Severe weight loss: the predominant clinical presentation of tuberculosis in patients with HIV infection in India. Author(s): Hira SK, Dupont HL, Lanjewar DN, Dholakia YN. Source: Natl Med J India. 1998 November-December; 11(6): 256-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10083790&dopt=Abstract

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Short-term effects of weight loss with or without low-intensity exercise training on fat metabolism in obese men. Author(s): van Aggel-Leijssen DP, Saris WH, Hul GB, van Baak MA. Source: The American Journal of Clinical Nutrition. 2001 March; 73(3): 523-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11237927&dopt=Abstract

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Short-term moderate weight loss and resistance training do not affect insulinstimulated glucose disposal in postmenopausal women. Author(s): Joseph LJ, Trappe TA, Farrell PA, Campbell WW, Yarasheski KE, Lambert CP, Evans WJ. Source: Diabetes Care. 2001 November; 24(11): 1863-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11679448&dopt=Abstract

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Sibutramine is effective for weight loss and diabetic control in obesity with type 2 diabetes: a randomised, double-blind, placebo-controlled study. Author(s): Finer N, Bloom SR, Frost GS, Banks LM, Griffiths J. Source: Diabetes, Obesity & Metabolism. 2000 April; 2(2): 105-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11220522&dopt=Abstract

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Sibutramine is safe and effective for weight loss in obese patients whose hypertension is well controlled with angiotensin-converting enzyme inhibitors. Author(s): McMahon FG, Weinstein SP, Rowe E, Ernst KR, Johnson F, Fujioka K; Sibutramine in Hypertensives Clinical Study Group. Source: Journal of Human Hypertension. 2002 January; 16(1): 5-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11840224&dopt=Abstract

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Sibutramine produces dose-related weight loss. Author(s): Bray GA, Blackburn GL, Ferguson JM, Greenway FL, Jain AK, Mendel CM, Mendels J, Ryan DH, Schwartz SL, Scheinbaum ML, Seaton TB. Source: Obesity Research. 1999 March; 7(2): 189-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10102256&dopt=Abstract

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Significant improvement in HbA1c in a morbidly obese type 2 diabetic patient after gastric bypass surgery despite relatively small weight loss. Author(s): Khateeb NI, Roslin MS, Chin D, Khan N, Anhalt H. Source: Diabetes Care. 1999 April; 22(4): 651. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10189552&dopt=Abstract

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Similar weight loss with low-energy food combining or balanced diets. Author(s): Golay A, Allaz AF, Ybarra J, Bianchi P, Saraiva S, Mensi N, Gomis R, de Tonnac N. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2000 April; 24(4): 492-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10805507&dopt=Abstract

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Single-stage abdominoplasty and mastopexy after weight loss following gastric banding. Author(s): Rhomberg M, Pulzl P, Piza-Katzer H. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2003 June; 13(3): 418-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841904&dopt=Abstract

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Skeletal muscle apoptosis and weight loss in chronic obstructive pulmonary disease. Author(s): Agusti AG, Sauleda J, Miralles C, Gomez C, Togores B, Sala E, Batle S, Busquets X. Source: American Journal of Respiratory and Critical Care Medicine. 2002 August 15; 166(4): 485-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12186825&dopt=Abstract

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Skeletal muscle fatty acid metabolism in association with insulin resistance, obesity, and weight loss. Author(s): Kelley DE, Goodpaster B, Wing RR, Simoneau JA. Source: The American Journal of Physiology. 1999 December; 277(6 Pt 1): E1130-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10600804&dopt=Abstract

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Sleep disturbance and obesity: changes following surgically induced weight loss. Author(s): Dixon JB, Schachter LM, O'Brien PE. Source: Archives of Internal Medicine. 2001 January 8; 161(1): 102-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11146705&dopt=Abstract

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Smoking and weight loss attempts in overweight and normal-weight adolescents. Author(s): Strauss RS, Mir HM. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2001 September; 25(9): 1381-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11571603&dopt=Abstract

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Sodium reduction and weight loss for elderly patients with hypertension. Author(s): Alderman MH, Cohen H, Madhavan S. Source: Jama : the Journal of the American Medical Association. 1998 September 9; 280(10): 885-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9739970&dopt=Abstract

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Stages of change and weight loss among rural African American women. Author(s): Hawkins DS, Hornsby PP, Schorling JB. Source: Obesity Research. 2001 January; 9(1): 59-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11346668&dopt=Abstract

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Subcutaneous abdominal, but not femoral fat expression of plasminogen activator inhibitor-1 (PAI-1) is related to plasma PAI-1 levels and insulin resistance and decreases after weight loss. Author(s): Mavri A, Alessi MC, Bastelica D, Geel-Georgelin O, Fina F, Sentocnik JT, Stegnar M, Juhan-Vague I. Source: Diabetologia. 2001 November; 44(11): 2025-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11719834&dopt=Abstract

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Substance use and weight loss tactics among middle school youth. Author(s): Garry JP, Morrissey SL, Whetstone LM. Source: The International Journal of Eating Disorders. 2003 January; 33(1): 55-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12474199&dopt=Abstract

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Successful long-term maintenance of substantial weight loss: one program's experience. Author(s): Daly A, Konz EC, Soler N, Anderson JW, Yergler C, Carpenter P. Source: Journal of the American Dietetic Association. 2000 December; 100(12): 1456. Erratum In: J Am Diet Assoc 2001 February; 101(2): 180. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11138435&dopt=Abstract

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Successful losers. The habits of individuals who have maintained long-term weight loss. Author(s): Klem ML. Source: Minn Med. 2000 November; 83(11): 43-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11126481&dopt=Abstract

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Successful weight loss maintenance. Author(s): Wing RR, Hill JO. Source: Annual Review of Nutrition. 2001; 21: 323-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11375440&dopt=Abstract

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Suppression of insulin secretion is associated with weight loss and altered macronutrient intake and preference in a subset of obese adults. Author(s): Velasquez-Mieyer PA, Cowan PA, Arheart KL, Buffington CK, Spencer KA, Connelly BE, Cowan GW, Lustig RH. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2003 February; 27(2): 219-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587002&dopt=Abstract

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Sustain weight loss to downregulate inflammation. Author(s): SoRelle R. Source: Circulation. 2002 February 19; 105(7): E9075-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11854136&dopt=Abstract

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Technical skills for weight loss: preliminary data from a randomized trial. Author(s): Katz DL, Chan W, Gonzalez M, Larson D, Nawaz H, Abdulrahman M, Yeh MC. Source: Preventive Medicine. 2002 June; 34(6): 608-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12052021&dopt=Abstract

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The battle against deceptive weight loss ads. Author(s): Gross WC. Source: Critical Reviews in Food Science and Nutrition. 2001 January; 41(1): 41-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11152045&dopt=Abstract

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The Challenge study: theory-based interventions for smoking and weight loss. Author(s): King CM, Rothman AJ, Jeffery RW. Source: Health Education Research. 2002 October; 17(5): 522-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12408197&dopt=Abstract

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The effect of body weight and weight loss on thyroid volume and function in obese women. Author(s): Sari R, Balci MK, Altunbas H, Karayalcin U. Source: Clinical Endocrinology. 2003 August; 59(2): 258-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12864805&dopt=Abstract

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The effect of high-, moderate-, and low-fat diets on weight loss and cardiovascular disease risk factors. Author(s): Fleming RM. Source: Preventive Cardiology. 2002 Summer; 5(3): 110-8. Erratum In: Prev Cardiol 2002 Fall; 5(4): 203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12091753&dopt=Abstract

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The effect of orlistat-induced weight loss, without concomitant hypocaloric diet, on cardiovascular risk factors and insulin sensitivity in young obese Chinese subjects with or without type 2 diabetes. Author(s): Tong PC, Lee ZS, Sea MM, Chow CC, Ko GT, Chan WB, So WY, Ma RC, Ozaki R, Woo J, Cockram CS, Chan JC. Source: Archives of Internal Medicine. 2002 November 25; 162(21): 2428-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12437401&dopt=Abstract

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The effect of participation in a weight loss programme on short-term health resource utilization. Author(s): van Walraven C, Dent R. Source: Journal of Evaluation in Clinical Practice. 2002 February; 8(1): 37-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11882100&dopt=Abstract

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The effect of pegylated recombinant human leptin (PEG-OB) on weight loss and inflammatory status in obese subjects. Author(s): Hukshorn CJ, van Dielen FM, Buurman WA, Westerterp-Plantenga MS, Campfield LA, Saris WH. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 April; 26(4): 504-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12075577&dopt=Abstract

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The effect of rate and extent of weight loss on urea salvage in obese male subjects. Author(s): Faber P, Johnstone AM, Gibney ER, Elia M, Stubbs RJ, Roger PL, Milne E, Buchan W, Lobley GE. Source: The British Journal of Nutrition. 2003 July; 90(1): 221-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12844395&dopt=Abstract

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The effect of rate of weight loss on erythrocyte glutathione concentration and synthesis in healthy obese men. Author(s): Faber P, Johnstone AM, Gibney ER, Elia M, Stubbs RJ, Duthie GG, Calder AG, Lobley GE. Source: Clinical Science (London, England : 1979). 2002 May; 102(5): 569-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11980577&dopt=Abstract

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The effects of weight loss on renal function in patients with severe obesity. Author(s): Chagnac A, Weinstein T, Herman M, Hirsh J, Gafter U, Ori Y. Source: Journal of the American Society of Nephrology : Jasn. 2003 June; 14(6): 1480-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12761248&dopt=Abstract

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The energy cost of walking before and after significant weight loss. Author(s): Foster GD, Wadden TA, Kendrick ZV, Letizia KA, Lander DP, Conill AM. Source: Medicine and Science in Sports and Exercise. 1995 June; 27(6): 888-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7658951&dopt=Abstract

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The enigma of increased non-cancer mortality after weight loss in healthy men who are overweight or obese. Author(s): Nilsson PM, Nilsson JA, Hedblad B, Berglund G, Lindgarde F. Source: Journal of Internal Medicine. 2002 July; 252(1): 70-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12074741&dopt=Abstract

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The feasibility of using Internet support for the maintenance of weight loss. Author(s): Harvey-Berino J, Pintauro SJ, Gold EC. Source: Behavior Modification. 2002 January; 26(1): 103-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11799651&dopt=Abstract

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The key to curbing unintentional weight loss lies in identifying the problem. Author(s): Woods T. Source: Journal of the American Dietetic Association. 2003 March; 103(3): 362. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12616260&dopt=Abstract

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The relationship between weight loss and all-cause mortality in older men and women with and without diabetes mellitus: the Rancho Bernardo study. Author(s): Wedick NM, Barrett-Connor E, Knoke JD, Wingard DL. Source: Journal of the American Geriatrics Society. 2002 November; 50(11): 1810-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12410899&dopt=Abstract

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The relevance of weight loss for survival and quality of life in patients with advanced gastrointestinal cancer treated with palliative chemotherapy. Author(s): Persson C, Glimelius B. Source: Anticancer Res. 2002 November-December; 22(6B): 3661-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12552973&dopt=Abstract

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The role of leucine in weight loss diets and glucose homeostasis. Author(s): Layman DK. Source: The Journal of Nutrition. 2003 January; 133(1): 261S-267S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12514305&dopt=Abstract

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The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer. Author(s): Scott HR, McMillan DC, Forrest LM, Brown DJ, McArdle CS, Milroy R. Source: British Journal of Cancer. 2002 July 29; 87(3): 264-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12177792&dopt=Abstract

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The triad of weight loss, fever and night sweating: isolated bone marrow tuberculosis, a case report. Author(s): Sari R, Bayindir Y, Sevinc A, Bahceci F, Ozen S. Source: Journal of Chemotherapy (Florence, Italy). 2002 August; 14(4): 420-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420863&dopt=Abstract

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Thyroid function studies in patients with unintentional weight loss. Author(s): Zimmerman D. Source: Mayo Clinic Proceedings. 2002 February; 77(2): 201-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11838658&dopt=Abstract

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Thyroid hormones before and after weight loss in obesity. Author(s): Reinehr T, Andler W. Source: Archives of Disease in Childhood. 2002 October; 87(4): 320-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12244007&dopt=Abstract

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Topiramate and weight loss in patients with neurodevelopmental disabilities. Author(s): Brown RO, Orr CD, Hanna DL, Williams JE, Dickerson RN. Source: Pharmacotherapy. 2002 July; 22(7): 831-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12126216&dopt=Abstract

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Topiramate produced weight loss following olanzapine-induced weight gain in schizophrenia. Author(s): Levy E, Margolese HC, Chouinard G. Source: The Journal of Clinical Psychiatry. 2002 November; 63(11): 1045. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12469686&dopt=Abstract

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Treatment with cabergoline is associated with weight loss in patients with hyperprolactinemia. Author(s): Korner J, Lo J, Freda PU, Wardlaw SL. Source: Obesity Research. 2003 February; 11(2): 311-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12582229&dopt=Abstract

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Tumor necrosis factor-alpha serum levels, weight loss and tissue oxygenation in chronic obstructive pulmonary disease. Author(s): Pitsiou G, Kyriazis G, Hatzizisi O, Argyropoulou P, Mavrofridis E, Patakas D. Source: Respiratory Medicine. 2002 August; 96(8): 594-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195840&dopt=Abstract

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Uncoupling protein-3 gene expression: reduced skeletal muscle mRNA in obese humans during pronounced weight loss. Author(s): Esterbauer H, Oberkofler H, Dallinger G, Breban D, Hell E, Krempler F, Patsch W. Source: Diabetologia. 1999 March; 42(3): 302-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10096782&dopt=Abstract

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Understanding tumor-induced weight loss. Author(s): Guenter P, Ferguson M, Thrush K, Voss AC. Source: Medsurg Nursing : Official Journal of the Academy of Medical-Surgical Nurses. 2002 October; 11(5): 215-25; Quiz 226-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830744&dopt=Abstract

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Unexplained weight loss and a palpable abdominal mass in a middle aged woman. Abdominal tuberculosis. Author(s): Hawkes ND, Thomas GA. Source: Postgraduate Medical Journal. 2001 May; 77(907): 341, 348-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11320284&dopt=Abstract

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Unexplained weight loss and arterial thromboses. Author(s): Matfin G, Patel NV, Adelman HM. Source: Hosp Pract (Off Ed). 1998 March 15; 33(3): 35-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9522832&dopt=Abstract

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Unintentional weight loss in long-term care: predictor of mortality in the elderly. Author(s): Ryan C, Bryant E, Eleazer P, Rhodes A, Guest K. Source: Southern Medical Journal. 1995 July; 88(7): 721-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7597475&dopt=Abstract

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Unintentional weight loss in the United States. Author(s): Meltzer AA, Everhart JE. Source: American Journal of Epidemiology. 1995 November 15; 142(10): 1039-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7485049&dopt=Abstract

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Unintentional weight loss: diagnosis and prognosis. The first prospective follow-up study from a secondary referral centre. Author(s): Lankisch P, Gerzmann M, Gerzmann JF, Lehnick D. Source: Journal of Internal Medicine. 2001 January; 249(1): 41-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11168783&dopt=Abstract

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Updated review on the benefits of weight loss. Author(s): Vidal J. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 December; 26 Suppl 4: S25-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457296&dopt=Abstract

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Upright body position and weight loss improve respiratory mechanics and daytime oxygenation in obese patients with obstructive sleep apnoea. Author(s): Hakala K, Maasilta P, Sovijarvi AR. Source: Clinical Physiology (Oxford, England). 2000 January; 20(1): 50-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10651792&dopt=Abstract

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Ureteropelvic junction obstruction presenting as early satiety and weight loss. Author(s): Tebyani N, Candela J, Patel H, Bellman G. Source: Journal of Endourology / Endourological Society. 1999 July-August; 13(6): 4456. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10479012&dopt=Abstract

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Urinary recovery of lactulose compared to D-xylose absorption kinetics in HIV patients with diarrhea and weight loss. Author(s): Carlson SJ, Webster C, Craig RM. Source: Digestive Diseases and Sciences. 1997 December; 42(12): 2599-602. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9440644&dopt=Abstract

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Use of prescription weight loss pills among U.S. adults in 1996-1998. Author(s): Khan LK, Serdula MK, Bowman BA, Williamson DF. Source: Annals of Internal Medicine. 2001 February 20; 134(4): 282-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11182838&dopt=Abstract

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Use of very low-calorie diet in preoperative weight loss: efficacy and safety. Author(s): Pekkarinen T, Mustajoki P. Source: Obesity Research. 1997 November; 5(6): 595-602. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9449145&dopt=Abstract

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Using Internet technology to deliver a behavioral weight loss program. Author(s): Tate DF, Wing RR, Winett RA. Source: Jama : the Journal of the American Medical Association. 2001 March 7; 285(9): 1172-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11231746&dopt=Abstract

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Using the minimum data set to predict weight loss in nursing home residents. Author(s): Corbett CF, Crogan NL, Short RA. Source: Applied Nursing Research : Anr. 2002 November; 15(4): 249-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444584&dopt=Abstract

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Value conflict: the lived experiences of women in treatment for weight loss. Author(s): Lopez KM. Source: Health Care for Women International. 1997 November-December; 18(6): 603-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9416043&dopt=Abstract

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Variation in lipid levels in morbidly obese patients operated with the LAP-BAND adjustable gastric banding system: effects of different levels of weight loss. Author(s): Busetto L, Pisent C, Rinaldi D, Longhin PL, Segato G, De Marchi F, Foletto M, Favretti F, Lise M, Enzi G. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2000 December; 10(6): 569-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11175968&dopt=Abstract

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Variation in the practice of dose reduction of chemotherapeutic agents after weight loss or amputation. Author(s): O'Marcaigh AS, Betcher DL, Gilchrist GS. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 1995 May; 17(2): 172-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7749769&dopt=Abstract

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Variations in plasma soluble tumour necrosis factor receptors after diet-induced weight loss in obesity. Author(s): Bastard JP, Jardel C, Bruckert E, Vidal H, Hainque B. Source: Diabetes, Obesity & Metabolism. 2000 October; 2(5): 323-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11225749&dopt=Abstract

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Vertical banded gastroplasty for morbid obesity: weight loss at short and long-term follow up. Author(s): Ramsey-Stewart G. Source: The Australian and New Zealand Journal of Surgery. 1995 January; 65(1): 4-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7818421&dopt=Abstract

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Very low calorie diet-induced weight loss reverses exaggerated insulin secretion in response to glucose, arginine and glucagon in obesity. Author(s): Numata K, Tanaka K, Saito M, Shishido T, Inoue S. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1993 February; 17(2): 103-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8384164&dopt=Abstract

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Very-low-calorie diets and sustained weight loss. Author(s): Saris WH. Source: Obesity Research. 2001 November; 9 Suppl 4: 295S-301S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11707557&dopt=Abstract

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Virologic, immunologic, and immune activation markers as predictors of HIVassociated weight loss prior to AIDS. Multicenter AIDS Cohort Study. Author(s): Lyles RH, Tang AM, Smit E, Mellors JW, Margolick JB, Visscher BR, Phair JP, Graham NM. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 1999 December 1; 22(4): 386-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10634201&dopt=Abstract

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Visceral fat accumulation in obese subjects: relation to energy expenditure and response to weight loss. Author(s): Leenen R, van der Kooy K, Deurenberg P, Seidell JC, Weststrate JA, Schouten FJ, Hautvast JG. Source: The American Journal of Physiology. 1992 November; 263(5 Pt 1): E913-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1443124&dopt=Abstract

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Visceral fat accumulation in relation to sex hormones in obese men and women undergoing weight loss therapy. Author(s): Leenen R, van der Kooy K, Seidell JC, Deurenberg P, Koppeschaar HP. Source: The Journal of Clinical Endocrinology and Metabolism. 1994 June; 78(6): 1515-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8200956&dopt=Abstract

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Visceral obesity and the metabolic syndrome: effects of weight loss. Author(s): Busetto L. Source: Nutr Metab Cardiovasc Dis. 2001 June; 11(3): 195-204. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11590996&dopt=Abstract

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VLCD-induced weight loss improves heart rate variability in moderately obese Japanese. Author(s): Akehi Y, Yoshimatsu H, Kurokawa M, Sakata T, Eto H, Ito S, Ono J. Source: Experimental Biology and Medicine (Maywood, N.J.). 2001 May; 226(5): 440-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11393172&dopt=Abstract

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Voluntary and involuntary weight loss: associations with long term mortality in 9,228 middle-aged and elderly men. Author(s): Yaari S, Goldbourt U. Source: American Journal of Epidemiology. 1998 September 15; 148(6): 546-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9753009&dopt=Abstract

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Vomiting and weight loss. Author(s): Vazifdar K, Nagral A, Krishnamurthy S, Nagral S. Source: Postgraduate Medical Journal. 1997 April; 73(858): 247-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9156133&dopt=Abstract

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Weight loss after Swedish Adjustable Gastric Banding: relationships to insulin resistance and metabolic syndrome. Author(s): Gazzaruso C, Giordanetti S, La Manna A, Celsa M, De Amici E, Turpini C, Catona A, Fratino P. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 December; 12(6): 841-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12568192&dopt=Abstract

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Weight loss and body-composition changes in men and women infected with HIV. Author(s): Forrester JE, Spiegelman D, Tchetgen E, Knox TA, Gorbach SL. Source: The American Journal of Clinical Nutrition. 2002 December; 76(6): 1428-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12450913&dopt=Abstract

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Weight loss and bone mineral content. Author(s): Westerterp KR. Source: Obesity Research. 2002 June; 10(6): 559. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12055333&dopt=Abstract

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Weight loss and disease progression in HIV infection. Author(s): Wheeler DA. Source: Aids Read. 1999 August; 9(5): 347-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12737124&dopt=Abstract

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Weight loss and early and late complications--the international experience. Author(s): O'Brien PE, Dixon JB. Source: American Journal of Surgery. 2002 December; 184(6B): 42S-45S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12527350&dopt=Abstract

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Weight loss and gain in athletes. Author(s): Rankin JW. Source: Curr Sports Med Rep. 2002 August; 1(4): 208-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12831697&dopt=Abstract

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Weight loss and increased mortality: epidemiologists blinded by observations? Author(s): Astrup A. Source: Obesity Reviews : an Official Journal of the International Association for the Study of Obesity. 2003 February; 4(1): 1-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608521&dopt=Abstract

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Weight loss and plasma ghrelin levels. Author(s): Geliebter A. Source: The New England Journal of Medicine. 2002 October 24; 347(17): 1379-81; Author Reply 1379-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12400098&dopt=Abstract

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Weight loss and plasma ghrelin levels. Author(s): Camilleri M, Cremonini F. Source: The New England Journal of Medicine. 2002 October 24; 347(17): 1379-81; Author Reply 1379-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12400097&dopt=Abstract

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Weight loss and plasma ghrelin levels. Author(s): Rubino F, Gagner M. Source: The New England Journal of Medicine. 2002 October 24; 347(17): 1379-81; Author Reply 1379-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12397203&dopt=Abstract

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Weight loss and survival in HIV-positive patients in the era of highly active antiretroviral therapy. Author(s): Tang AM, Forrester J, Spiegelman D, Knox TA, Tchetgen E, Gorbach SL. Source: Journal of Acquired Immune Deficiency Syndromes (1999). 2002 October 1; 31(2): 230-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12394802&dopt=Abstract

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Weight loss and wasting in patients infected with human immunodeficiency virus. Author(s): Grinspoon S, Mulligan K; Department of Health and Human Services Working Group on the Prevention and Treatment of Wasting and Weight Loss. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 April 1; 36(Suppl 2): S69-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12652374&dopt=Abstract

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Weight loss and weight maintenance, ambulatory blood pressure and cardiac autonomic tone in obese persons with the metabolic syndrome. Author(s): Laaksonen DE, Laitinen T, Schonberg J, Rissanen A, Niskanen LK. Source: Journal of Hypertension. 2003 February; 21(2): 371-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12569268&dopt=Abstract

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Weight loss causes increased mortality: cons. Author(s): Yang D, Fontaine KR, Wang C, Allison DB. Source: Obesity Reviews : an Official Journal of the International Association for the Study of Obesity. 2003 February; 4(1): 9-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608523&dopt=Abstract

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Weight loss causes increased mortality: pros. Author(s): Sorensen TI. Source: Obesity Reviews : an Official Journal of the International Association for the Study of Obesity. 2003 February; 4(1): 3-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608522&dopt=Abstract

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Weight loss counseling revisited. Author(s): Serdula MK, Khan LK, Dietz WH. Source: Jama : the Journal of the American Medical Association. 2003 April 9; 289(14): 1747-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684339&dopt=Abstract

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Weight loss improves neurovascular and muscle metaboreflex control in obesity. Author(s): Trombetta IC, Batalha LT, Rondon MU, Laterza MC, Kuniyoshi FH, Gowdak MM, Barretto AC, Halpern A, Villares SM, Negrao CE. Source: American Journal of Physiology. Heart and Circulatory Physiology. 2003 September; 285(3): H974-82. Epub 2003 April 24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12714324&dopt=Abstract

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Weight loss in chronic obstructive pulmonary disease. Mechanisms and implications. Author(s): Agust AG, Gari PG, Sauleda J, Busquets X. Source: Pulmonary Pharmacology & Therapeutics. 2002; 15(5): 425-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12406664&dopt=Abstract

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Weight loss in early stage of Huntington's disease. Author(s): Djousse L, Knowlton B, Cupples LA, Marder K, Shoulson I, Myers RH. Source: Neurology. 2002 November 12; 59(9): 1325-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12427878&dopt=Abstract

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Weight loss in Parkinson's disease. Author(s): Chen H, Zhang SM, Hernan MA, Willett WC, Ascherio A. Source: Annals of Neurology. 2003 May; 53(5): 676-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12731005&dopt=Abstract

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Weight loss increases soluble leptin receptor levels and the soluble receptor bound fraction of leptin. Author(s): Laimer M, Ebenbichler CF, Kaser S, Sandhofer A, Weiss H, Nehoda H, Aigner F, Patsch JR. Source: Obesity Research. 2002 July; 10(7): 597-601. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12105280&dopt=Abstract

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Weight loss practices among Malaysian adults. Author(s): Wai-Theng Kong, Siew-Siang Chua, Syireen Alwi. Source: Asia Pac J Public Health. 2002; 14(2): 99-104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12862414&dopt=Abstract

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Weight loss practices of college wrestlers. Author(s): Oppliger RA, Steen SA, Scott JR. Source: International Journal of Sport Nutrition and Exercise Metabolism. 2003 March; 13(1): 29-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660404&dopt=Abstract

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Weight loss readiness in middle-aged women: psychosocial predictors of success for behavioral weight reduction. Author(s): Teixeira PJ, Going SB, Houtkooper LB, Cussler EC, Martin CJ, Metcalfe LL, Finkenthal NR, Blew RM, Sardinha LB, Lohman TG. Source: Journal of Behavioral Medicine. 2002 December; 25(6): 499-523. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12462956&dopt=Abstract

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Weight loss requires attention. Author(s): Malat B, Pettis DH, Judge-Ellis T. Source: Adv Nurse Pract. 2002 September; 10(9): 19. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12400306&dopt=Abstract

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Weight loss with self-help compared with a structured commercial program: a randomized trial. Author(s): Heshka S, Anderson JW, Atkinson RL, Greenway FL, Hill JO, Phinney SD, Kolotkin RL, Miller-Kovach K, Pi-Sunyer FX. Source: Jama : the Journal of the American Medical Association. 2003 April 9; 289(14): 1792-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684357&dopt=Abstract

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Weight loss, fever and a swollen elbow joint in a hemodialysis patient--a case of tuberculous arthritis. Author(s): Singh A, Webb AT. Source: Clinical Nephrology. 2003 May; 59(5): 391-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12779104&dopt=Abstract

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Weight loss-induced plasticity of glucose transport and phosphorylation in the insulin resistance of obesity and type 2 diabetes. Author(s): Williams KV, Bertoldo A, Kinahan P, Cobelli C, Kelley DE. Source: Diabetes. 2003 July; 52(7): 1619-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12829624&dopt=Abstract

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Why lose weight? Reasons for seeking weight loss by overweight but otherwise healthy men. Author(s): Hankey CR, Leslie WS, Lean ME. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 June; 26(6): 880-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12037662&dopt=Abstract

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Year-long weight loss treatment for obese patients with type II diabetes: does including an intermittent very-low-calorie diet improve outcome? Author(s): Wing RR, Blair E, Marcus M, Epstein LH, Harvey J. Source: The American Journal of Medicine. 1994 October; 97(4): 354-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7942937&dopt=Abstract

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Young man with progressive weight loss, fevers, and a hilar mass. Author(s): Sadikot RT, Milstone AP, Christman JW. Source: Postgraduate Medical Journal. 2002 November; 78(925): 690-1, 693-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12496331&dopt=Abstract

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Zonisamide for weight loss in obese adults: a randomized controlled trial. Author(s): Gadde KM, Franciscy DM, Wagner HR 2nd, Krishnan KR. Source: Jama : the Journal of the American Medical Association. 2003 April 9; 289(14): 1820-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684361&dopt=Abstract

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CHAPTER 2. NUTRITION AND WEIGHT LOSS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and weight loss.

Finding Nutrition Studies on Weight Loss The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “weight loss” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following is a typical result when searching for recently indexed consumer information on weight loss: •

Bariatric surgery. An option for long-term weight loss. Source: Craig, J Diabetes-Self-Manag. 2002 Sep-October; 19(5): 14, 17-8, 20-1 0741-6253

•

Benefits of sustained moderate weight loss in obesity. Author(s): Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. [email protected] Source: Pasanisi, F Contaldo, F de Simone, G Mancini, M Nutr-Metab-Cardiovasc-Dis. 2001 December; 11(6): 401-6 0939-4753

•

Effect of weight loss on QT dispersion in obesity. Author(s): Thoracic and Cardiovascular Institute and Sparrow Hospital Weight Management Center, Michigan State University, USA. [email protected] Source: Gupta, A K Xie, B Thakur, R K Maheshwari, A Lokhandwala, Y Carella, M J Indian-Heart-J. 2002 Jul-August; 54(4): 399-403 0019-4832

•

Effect of weight loss plans on body composition and diet duration. Author(s): Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, PO Box 26901-CHB 469, Oklahoma City, Oklahoma City, OK 73190, USA. Source: Landers, Patti Wolfe, Megan M Glore, Stephen Guild, Ralph Phillips, Lindsay JOkla-State-Med-Assoc. 2002 May; 95(5): 329-31 0030-1876

•

Effects of weight loss on leptin, sex hormones, and measures of adiposity in obese children. Author(s): Institute for Sport Sciences, Karl-Franzens University, Graz, Austria. [email protected] Source: Sudi, K M Gallistl, S Borkenstein, M H Payerl, D Aigner, R Moller, R Tafeit, E Endocrine. 2001 April; 14(3): 429-35 0969-711X

•

Ephedra and ephedrine for weight loss and athletic performance enhancement: clinical efficacy and side effects. Source: Evid-Rep-Technol-Assess-(Summ). 2003 March; (76): 1-4 1530-440x

•

Hypothalamic-pituitary-adrenal responses to weight loss in mice following diet restriction, activity or separation stress: effects of tyrosine. Author(s): Department of Human Nutrition and Metabolism, Hebrew UniversityHadassah Medical School, Jerusalem, Israel. Source: Avraham, Y Hao, S Mendelson, S Berry, E M Nutr-Neurosci. 2002 October; 5(5): 327-35 1028-415X

•

Impact of weight loss on the metabolic syndrome. Author(s): Department of Medicine, Baylor College of Medicine, Houston, Texas 77030, USA. Source: Case, C C Jones, P H Nelson, K O'Brian Smith, E Ballantyne, C M Diabetes-ObesMetab. 2002 November; 4(6): 407-14 1462-8902

•

Leptin, insulin and TNF-alpha in weight loss. Author(s): Division of Endocrinology, Diabetes and Metabolism, UMDNJ, New Jersey Medical School, Newark 07103, USA. Source: Xenachis, C Samojlik, E Raghuwanshi, M P Kirschner, M A J-Endocrinol-Invest. 2001 December; 24(11): 865-70 0391-4097

•

Lessons from obesity management programmes: greater initial weight loss improves long-term maintenance. Author(s): Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Rolighedsvej 30, DK-1958 Frederiksberg, Denmark. [email protected]

Nutrition 153

Source: Astrup, A Rossner, S Obes-Revolume 2000 May; 1(1): 17-9 1467-7881 •

Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. Author(s): Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina 27109, USA. [email protected] Source: Rejeski, W J Focht, B C Messier, S P Morgan, T Pahor, M Penninx, B HealthPsychol. 2002 September; 21(5): 419-26 0278-6133

•

Prevalence and predictors of HIV-associated weight loss in the era of highly active antiretroviral therapy. Author(s): Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW 2050, Australia. [email protected] Source: Batterham, M J Garsia, R Greenop, P Int-J-STD-AIDS. 2002 November; 13(11): 744-7 0956-4624

•

Steps to soulful living (steps): a weight loss program for African-American women. Author(s): Kaiser Permanente Center for Health Research, Portland, Oregon 97227-1098, USA. [email protected] Source: Karanja, N Stevens, V J Hollis, J F Kumanyika, S K Ethn-Dis. 2002 Summer; 12(3): 363-71 1049-510X

•

The effect of high-, moderate-, and low-fat diets on weight loss and cardiovascular disease risk factors. Author(s): Section of Preventive Cardiology, The Camelot Foundation at The Fleming Heart & Health Institute, and the Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE 68114, USA. [email protected] Source: Fleming, Richard M Prev-Cardiol. 2002 Summer; 5(3): 110-8 1520-037X

•

Weight loss following vertical banded gastroplasty: intermediate results of a prospective study. Author(s): Nutrition Support and Morbid Obesity Clinic, Surgical Department, University Hospital of Patras, Rio, Greece. [email protected] Source: Kalfarentzos, F Kechagias, I Soulikia, K Loukidi, A Mead, N Obes-Surg. 2001 June; 11(3): 265-70 0960-8923

The following information is typical of that found when using the “Full IBIDS Database” to search for “weight loss” (or a synonym): •

Bariatric surgery. An option for long-term weight loss. Source: Craig, J Diabetes-Self-Manag. 2002 Sep-October; 19(5): 14, 17-8, 20-1 0741-6253

•

Benefits of sustained moderate weight loss in obesity. Author(s): Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. [email protected] Source: Pasanisi, F Contaldo, F de Simone, G Mancini, M Nutr-Metab-Cardiovasc-Dis. 2001 December; 11(6): 401-6 0939-4753

•

Effect of weight loss on QT dispersion in obesity. Author(s): Thoracic and Cardiovascular Institute and Sparrow Hospital Weight Management Center, Michigan State University, USA. [email protected] Source: Gupta, A K Xie, B Thakur, R K Maheshwari, A Lokhandwala, Y Carella, M J Indian-Heart-J. 2002 Jul-August; 54(4): 399-403 0019-4832

•

Effects of weight loss on leptin, sex hormones, and measures of adiposity in obese children. Author(s): Institute for Sport Sciences, Karl-Franzens University, Graz, Austria. [email protected]

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Source: Sudi, K M Gallistl, S Borkenstein, M H Payerl, D Aigner, R Moller, R Tafeit, E Endocrine. 2001 April; 14(3): 429-35 0969-711X •

Ephedra and ephedrine for weight loss and athletic performance enhancement: clinical efficacy and side effects. Source: Evid-Rep-Technol-Assess-(Summ). 2003 March; (76): 1-4 1530-440x

•

Hypothalamic-pituitary-adrenal responses to weight loss in mice following diet restriction, activity or separation stress: effects of tyrosine. Author(s): Department of Human Nutrition and Metabolism, Hebrew UniversityHadassah Medical School, Jerusalem, Israel. Source: Avraham, Y Hao, S Mendelson, S Berry, E M Nutr-Neurosci. 2002 October; 5(5): 327-35 1028-415X

•

Impact of weight loss on the metabolic syndrome. Author(s): Department of Medicine, Baylor College of Medicine, Houston, Texas 77030, USA. Source: Case, C C Jones, P H Nelson, K O'Brian Smith, E Ballantyne, C M Diabetes-ObesMetab. 2002 November; 4(6): 407-14 1462-8902

•

Leptin, insulin and TNF-alpha in weight loss. Author(s): Division of Endocrinology, Diabetes and Metabolism, UMDNJ, New Jersey Medical School, Newark 07103, USA. Source: Xenachis, C Samojlik, E Raghuwanshi, M P Kirschner, M A J-Endocrinol-Invest. 2001 December; 24(11): 865-70 0391-4097

•

Lessons from obesity management programmes: greater initial weight loss improves long-term maintenance. Author(s): Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Rolighedsvej 30, DK-1958 Frederiksberg, Denmark. [email protected] Source: Astrup, A Rossner, S Obes-Revolume 2000 May; 1(1): 17-9 1467-7881

•

Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. Author(s): Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina 27109, USA. [email protected] Source: Rejeski, W J Focht, B C Messier, S P Morgan, T Pahor, M Penninx, B HealthPsychol. 2002 September; 21(5): 419-26 0278-6133

•

Prevalence and predictors of HIV-associated weight loss in the era of highly active antiretroviral therapy. Author(s): Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW 2050, Australia. [email protected] Source: Batterham, M J Garsia, R Greenop, P Int-J-STD-AIDS. 2002 November; 13(11): 744-7 0956-4624

•

Steps to soulful living (steps): a weight loss program for African-American women. Author(s): Kaiser Permanente Center for Health Research, Portland, Oregon 97227-1098, USA. [email protected] Source: Karanja, N Stevens, V J Hollis, J F Kumanyika, S K Ethn-Dis. 2002 Summer; 12(3): 363-71 1049-510X

•

The effect of high-, moderate-, and low-fat diets on weight loss and cardiovascular disease risk factors. Author(s): Section of Preventive Cardiology, The Camelot Foundation at The Fleming Heart & Health Institute, and the Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE 68114, USA. [email protected] Source: Fleming, Richard M Prev-Cardiol. 2002 Summer; 5(3): 110-8 1520-037X

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•

Weight loss following vertical banded gastroplasty: intermediate results of a prospective study. Author(s): Nutrition Support and Morbid Obesity Clinic, Surgical Department, University Hospital of Patras, Rio, Greece. [email protected] Source: Kalfarentzos, F Kechagias, I Soulikia, K Loukidi, A Mead, N Obes-Surg. 2001 June; 11(3): 265-70 0960-8923

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

•

The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

•

The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

•

Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

•

Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

•

Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

•

Google: http://directory.google.com/Top/Health/Nutrition/

•

Healthnotes: http://www.healthnotes.com/

•

Open Directory Project: http://dmoz.org/Health/Nutrition/

•

Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

•

WebMDHealth: http://my.webmd.com/nutrition

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•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to weight loss; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Provitamin a Alternative names: Beta-Carotene Source: Integrative Medicine Communications; www.drkoop.com Vitamin a Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10066,00.html Vitamin D Source: Healthnotes, Inc.; www.healthnotes.com Vitamin D Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,905,00.html

•

Minerals Carnitine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10012,00.html Chromium Source: Healthnotes, Inc.; www.healthnotes.com Chromium Source: Prima Communications, Inc.www.personalhealthzone.com Chromium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10018,00.html Creatine Source: Prima Communications, Inc.www.personalhealthzone.com L-carnitine Source: Healthnotes, Inc.; www.healthnotes.com

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•

Food and Diet Atkins Diet Source: Healthnotes, Inc.; www.healthnotes.com Blood Type Diet Source: Healthnotes, Inc.; www.healthnotes.com Diabetes Source: Healthnotes, Inc.; www.healthnotes.com Diet Drinks Source: Healthnotes, Inc.; www.healthnotes.com Energy Bars Source: Healthnotes, Inc.; www.healthnotes.com Fasting Diet Source: Healthnotes, Inc.; www.healthnotes.com Gluten-free Diet Source: Healthnotes, Inc.; www.healthnotes.com Low-allergen Diet Source: Healthnotes, Inc.; www.healthnotes.com Low-fat Diet Source: Healthnotes, Inc.; www.healthnotes.com Low-purine Diet Source: Healthnotes, Inc.; www.healthnotes.com Meal Substitutes Source: Healthnotes, Inc.; www.healthnotes.com Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Omega-3 Fatty Acids Source: Integrative Medicine Communications; www.drkoop.com Pain Source: Healthnotes, Inc.; www.healthnotes.com Special Diets Index Source: Healthnotes, Inc.; www.healthnotes.com Sports Drinks Source: Healthnotes, Inc.; www.healthnotes.com The Dean Ornish Diet Source: Healthnotes, Inc.; www.healthnotes.com

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The Pritikin Diet Program Source: Healthnotes, Inc.; www.healthnotes.com The Zone Diet Source: Healthnotes, Inc.; www.healthnotes.com Weight Management Index Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND WEIGHT LOSS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to weight loss. At the conclusion of this chapter, we will provide additional sources.

The Combined Health Information Database The Combined Health Information Database (CHID) is a bibliographic database produced by health-related agencies of the U.S. federal government (mostly from the National Institutes of Health) that can offer concise information for a targeted search. The CHID database is updated four times a year at the end of January, April, July, and October. Check the titles, summaries, and availability of CAM-related information by using the “Simple Search” option at the following Web site: http://chid.nih.gov/simple/simple.html. In the drop box at the top, select “Complementary and Alternative Medicine.” Then type “weight loss” (or synonyms) in the second search box. We recommend that you select 100 “documents per page” and to check the “whole records” options. The following was extracted using this technique: •

Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects Source: Rockville, MD: Food and Drug Administration. 2003. 6 p. Contact: Available from Agency for Healthcare Research and Quality. U.S. Department of Health and Human Services, 2101 East Jefferson Street, Rockville, MD 20852. (301) 594-1364. PRICE: Free. AHRQ Publication No. 03-E022. Summary: This Evidence Report/Technology Assessment, funded by the National Institutes of Health Office of Dietary Supplements, the National Center for Complementary and Alternative Medicine, and the Agency for Healthcare Research and Quality, addresses research questions regarding the efficacy of herbal ephedra and ephedrine for weight loss and athletic performance through a comprehensive literature review and synthesis of evidence. The report assesses the safety of these products through a review of clinical trials, as well as meta-analyses where appropriate. In

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addition, the ephedra- and ephedrine-related adverse events reports on file with the Food and Drug Administration, published case reports, and reports to a manufacturer of ephedra-containing products are reviewed. The report is divided into four major sections: reporting the evidence, methodology, findings, and future research.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to weight loss and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “weight loss” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to weight loss: •

A novel soy-based meal replacement formula for weight loss among obese individuals: a randomized controlled clinical trial. Author(s): Allison DB, Gadbury G, Schwartz LG, Murugesan R, Kraker JL, Heshka S, Fontaine KR, Heymsfield SB. Source: European Journal of Clinical Nutrition. 2003 April; 57(4): 514-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12700612&dopt=Abstract

•

A randomized controlled trial of a moderate-fat, low-energy diet compared with a low fat, low-energy diet for weight loss in overweight adults. Author(s): McManus K, Antinoro L, Sacks F. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2001 October; 25(10): 1503-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11673773&dopt=Abstract

•

Alternative treatments for weight loss: a critical review. Author(s): Allison DB, Fontaine KR, Heshka S, Mentore JL, Heymsfield SB. Source: Critical Reviews in Food Science and Nutrition. 2001 January; 41(1): 1-28; Discussion 39-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11152041&dopt=Abstract

•

An acute clinical trial evaluating the cardiovascular effects of an herbal ephedracaffeine weight loss product in healthy overweight adults. Author(s): Kalman D, Incledon T, Gaunaurd I, Schwartz H, Krieger D. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 October; 26(10): 1363-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12355332&dopt=Abstract

•

An herbal supplement containing Ma Huang-Guarana for weight loss: a randomized, double-blind trial. Author(s): Boozer CN, Nasser JA, Heymsfield SB, Wang V, Chen G, Solomon JL.

Alternative Medicine 161

Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2001 March; 25(3): 316-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11319627&dopt=Abstract •

Body image disturbance in obese outpatients before and after weight loss in relation to race, gender, binge eating, and age of onset of obesity. Author(s): Sorbara M, Geliebter A. Source: The International Journal of Eating Disorders. 2002 May; 31(4): 416-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11948646&dopt=Abstract

•

Bone minerals changes in obese women during a moderate weight loss with and without calcium supplementation. Author(s): Jensen LB, Kollerup G, Quaade F, Sorensen OH. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2001 January; 16(1): 141-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11149478&dopt=Abstract

•

Bone turnover and density in obese premenopausal women during moderate weight loss and calcium supplementation. Author(s): Shapses SA, Von Thun NL, Heymsfield SB, Ricci TA, Ospina M, Pierson RN Jr, Stahl T. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2001 July; 16(7): 1329-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11450709&dopt=Abstract

•

Chitosan for weight loss and cholesterol management. Author(s): Shields KM, Smock N, McQueen CE, Bryant PJ. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2003 July 1; 60(13): 1310-2, 1315-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12901030&dopt=Abstract

•

Comment: regulatory environment for dietary supplements and botanicals targeted to weight loss. Author(s): Lewis CJ. Source: Critical Reviews in Food Science and Nutrition. 2001 January; 41(1): 43-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11152046&dopt=Abstract

•

Dietary fat intake, supplements, and weight loss. Author(s): Dyck DJ. Source: Canadian Journal of Applied Physiology = Revue Canadienne De Physiologie Appliquee. 2000 December; 25(6): 495-523. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11187927&dopt=Abstract

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•

Does using the Internet facilitate the maintenance of weight loss? Author(s): Harvey-Berino J, Pintauro S, Buzzell P, DiGiulio M, Casey Gold B, Moldovan C, Ramirez E. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 September; 26(9): 1254-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12187404&dopt=Abstract

•

Effect of a high-protein, high-monounsaturated fat weight loss diet on glycemic control and lipid levels in type 2 diabetes. Author(s): Parker B, Noakes M, Luscombe N, Clifton P. Source: Diabetes Care. 2002 March; 25(3): 425-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11874925&dopt=Abstract

•

Effect of capsaicin on substrate oxidation and weight maintenance after modest bodyweight loss in human subjects. Author(s): Lejeune MP, Kovacs EM, Westerterp-Plantenga MS. Source: The British Journal of Nutrition. 2003 September; 90(3): 651-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13129472&dopt=Abstract

•

Effect of dietary protein quality and fatty acid composition on plasma lipoprotein concentrations and hepatic triglyceride fatty acid synthesis in obese cats undergoing rapid weight loss. Author(s): Ibrahim WH, Szabo J, Sunvold GD, Kelleher JK, Bruckner GG. Source: Am J Vet Res. 2000 May; 61(5): 566-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10803654&dopt=Abstract

•

Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. Author(s): Esposito K, Pontillo A, Di Palo C, Giugliano G, Masella M, Marfella R, Giugliano D. Source: Jama : the Journal of the American Medical Association. 2003 April 9; 289(14): 1799-804. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684358&dopt=Abstract

•

Effect of weight loss plans on body composition and diet duration. Author(s): Landers P, Wolfe MM, Glore S, Guild R, Phillips L. Source: J Okla State Med Assoc. 2002 May; 95(5): 329-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12043107&dopt=Abstract

•

Effects of weight loss on body composition and pulmonary function. Author(s): De Lorenzo A, Petrone-De Luca P, Sasso GF, Carbonelli MG, Rossi P, Brancati A.

Alternative Medicine 163

Source: Respiration; International Review of Thoracic Diseases. 1999; 66(5): 407-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10516536&dopt=Abstract •

Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. Author(s): Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, Rhodes SL, Jungvig L, Gagne J. Source: Jama : the Journal of the American Medical Association. 2003 March 26; 289(12): 1537-45. Epub 2003 Mar 10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12672771&dopt=Abstract

•

Elevated homocysteine levels with weight loss after Lap-Band surgery: higher folate and vitamin B12 levels required to maintain homocysteine level. Author(s): Dixon JB, Dixon ME, O'Brien PE. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2001 February; 25(2): 219-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11410823&dopt=Abstract

•

Elevated homocysteine with weight loss. Author(s): Dixon JB. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2001 October; 11(5): 537-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11594089&dopt=Abstract

•

Ephedra and ephedrine: modest short-term weight loss, at a price. Author(s): Worley C, Lindbloom E. Source: The Journal of Family Practice. 2003 July; 52(7): 518-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841963&dopt=Abstract

•

From Atkins to Zone: the truth about high-fat, high-protein diets for weight loss. Author(s): Vigilante KC, Flynn MM. Source: Medicine and Health, Rhode Island. 2000 November; 83(11): 337-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11107763&dopt=Abstract

•

Glutamine-antioxidant supplementation increases body cell mass in AIDS patients with weight loss: a randomized, double-blind controlled trial. Author(s): Shabert JK, Winslow C, Lacey JM, Wilmore DW. Source: Nutrition (Burbank, Los Angeles County, Calif.). 1999 November-December; 15(11-12): 860-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10575661&dopt=Abstract

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Group exercise reduces depression in obese women without weight loss. Author(s): Hayward LM, Sullivan AC, Libonati JR. Source: Percept Mot Skills. 2000 February; 90(1): 204-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10769900&dopt=Abstract

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Hepatic injury in 12 patients taking the herbal weight loss AIDS Chaso or Onshido. Author(s): Adachi M, Saito H, Kobayashi H, Horie Y, Kato S, Yoshioka M, Ishii H. Source: Annals of Internal Medicine. 2003 September 16; 139(6): 488-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13679326&dopt=Abstract

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Herbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial. Author(s): Boozer CN, Daly PA, Homel P, Solomon JL, Blanchard D, Nasser JA, Strauss R, Meredith T. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 May; 26(5): 593-604. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12032741&dopt=Abstract

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Influence of a combination of herbs on appetite suppression and weight loss in rats. Author(s): Talpur NA, Echard BW, Manohar V, Preuss HG. Source: Diabetes, Obesity & Metabolism. 2001 June; 3(3): 181-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11412282&dopt=Abstract

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Influence of dietary protein and lipid on weight loss in obese ovariohysterectomized cats. Author(s): Szabo J, Ibrahim WH, Sunvold GD, Dickey KM, Rodgers JB, Toth IE, Boissonneault GA, Bruckner GG. Source: Am J Vet Res. 2000 May; 61(5): 559-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10803653&dopt=Abstract

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Is weight loss in obese premenopausal women associated with a decline in bone mass? Author(s): Barker ME, Blumsohn A. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 2002 April; 17(4): 746-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11918232&dopt=Abstract

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L-Carnitine supplementation combined with aerobic training does not promote weight loss in moderately obese women. Author(s): Villani RG, Gannon J, Self M, Rich PA.

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Source: International Journal of Sport Nutrition and Exercise Metabolism. 2000 June; 10(2): 199-207. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10861338&dopt=Abstract •

Long-term effects of weight loss and dietary sodium reduction on incidence of hypertension. Author(s): He J, Whelton PK, Appel LJ, Charleston J, Klag MJ. Source: Hypertension. 2000 February; 35(2): 544-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10679495&dopt=Abstract

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Making good decisions about diet: weight loss is not weight maintenance. Author(s): Blackburn GL. Source: Cleve Clin J Med. 2002 November; 69(11): 864-5, 869. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12430971&dopt=Abstract

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Misconceptions and misleading information prevail--less regulation does not mean less danger to consumers: dangerous herbal weight loss products. Author(s): Sardina J. Source: J Law Health. 1999-00; 14(1): 107-32. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11187364&dopt=Abstract

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Modified rice bran beneficial for weight loss of mice as a major and acute adverse effect of Cisplatin. Author(s): Endo Y, Kanbayashi H. Source: Pharmacology & Toxicology. 2003 June; 92(6): 300-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12787263&dopt=Abstract

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Popular weight loss diets. Health and exercise implications. Author(s): Riley RE. Source: Clinics in Sports Medicine. 1999 July; 18(3): 691-701, Ix. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10410849&dopt=Abstract

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Pound for pound? Comparing the costs incurred by subjects following four commercially available weight loss programmes. Author(s): Hart K, Greenwood H, Truby H. Source: Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association. 2003 October; 16(5): 365. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14516383&dopt=Abstract

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Quick weight loss: sorting fad from fact. Author(s): Roberts DC.

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Source: The Medical Journal of Australia. 2001 December 3-17; 175(11-12): 637-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11837873&dopt=Abstract •

Ready-to-eat cereal used as a meal replacement promotes weight loss in humans. Author(s): Mattes RD. Source: Journal of the American College of Nutrition. 2002 December; 21(6): 570-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480804&dopt=Abstract

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Relative weight, weight loss efforts and nutrient intakes among health-conscious vegetarian, past vegetarian and nonvegetarian women ages 18 to 50. Author(s): Barr SI, Broughton TM. Source: Journal of the American College of Nutrition. 2000 November-December; 19(6): 781-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11194532&dopt=Abstract

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Role of weight loss and polyunsaturated fatty acids in improving metabolic fitness in moderately obese, moderately hypertensive subjects. Author(s): Kriketos AD, Robertson RM, Sharp TA, Drougas H, Reed GW, Storlien LH, Hill JO. Source: Journal of Hypertension. 2001 October; 19(10): 1745-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11593093&dopt=Abstract

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Steps to soulful living (steps): a weight loss program for African-American women. Author(s): Karanja N, Stevens VJ, Hollis JF, Kumanyika SK. Source: Ethn Dis. 2002 Summer; 12(3): 363-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12148707&dopt=Abstract

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The clinical and metabolic effects of rapid weight loss in obese pet cats and the influence of supplemental oral L-carnitine. Author(s): Center SA, Harte J, Watrous D, Reynolds A, Watson TD, Markwell PJ, Millington DS, Wood PA, Yeager AE, Erb HN. Source: J Vet Intern Med. 2000 November-December; 14(6): 598-608. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11110381&dopt=Abstract

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The effect of conjugated linoleic acid supplementation after weight loss on body weight regain, body composition, and resting metabolic rate in overweight subjects. Author(s): Kamphuis MM, Lejeune MP, Saris WH, Westerterp-Plantenga MS. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2003 July; 27(7): 840-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12821971&dopt=Abstract

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The effectiveness of popular, non-prescription weight loss supplements. Author(s): Egger G, Cameron-Smith D, Stanton R. Source: The Medical Journal of Australia. 1999 December 6-20; 171(11-12): 604-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10721343&dopt=Abstract

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The potential value and toxicity of chromium picolinate as a nutritional supplement, weight loss agent and muscle development agent. Author(s): Vincent JB. Source: Sports Medicine (Auckland, N.Z.). 2003; 33(3): 213-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12656641&dopt=Abstract

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The safety and efficacy of pharmaceutical and herbal caffeine and ephedrine use as a weight loss agent. Author(s): Greenway FL. Source: Obesity Reviews : an Official Journal of the International Association for the Study of Obesity. 2001 August; 2(3): 199-211. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12120105&dopt=Abstract

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Treating unintentional weight loss nutrition options: an important piece of the HIV puzzle. Author(s): DeTommaso D. Source: Posit Aware. 2002 July-August; 13(4): 28-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12171038&dopt=Abstract

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Use of nonprescription weight loss products: results from a multistate survey. Author(s): Blanck HM, Khan LK, Serdula MK. Source: Jama : the Journal of the American Medical Association. 2001 August 22-29; 286(8): 930-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11509057&dopt=Abstract

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Weight loss and delayed gastric emptying following a South American herbal preparation in overweight patients. Author(s): Andersen T, Fogh J. Source: Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association. 2001 June; 14(3): 243-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11424516&dopt=Abstract

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Weight loss associated with a daily intake of three apples or three pears among overweight women. Author(s): Conceicao de Oliveira M, Sichieri R, Sanchez Moura A. Source: Nutrition (Burbank, Los Angeles County, Calif.). 2003 March; 19(3): 253-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12620529&dopt=Abstract

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Weight loss in cancer and Alzheimer's disease is mediated by a similar pathway. Author(s): Knittweis J. Source: Medical Hypotheses. 1999 August; 53(2): 172-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10532714&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to weight loss; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview AIDS and HIV Source: Integrative Medicine Communications; www.drkoop.com Alzheimer's Disease Source: Integrative Medicine Communications; www.drkoop.com Amenorrhea Source: Integrative Medicine Communications; www.drkoop.com Amyloidosis Source: Integrative Medicine Communications; www.drkoop.com

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Anorexia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Ascariasis Source: Integrative Medicine Communications; www.drkoop.com Asthma Source: Healthnotes, Inc.; www.healthnotes.com Athletic Performance Source: Healthnotes, Inc.; www.healthnotes.com Bone Cancer Source: Integrative Medicine Communications; www.drkoop.com Bone Marrow Disorders Source: Integrative Medicine Communications; www.drkoop.com Breast Cancer Source: Healthnotes, Inc.; www.healthnotes.com Cancer Prevention (reducing the Risk) Source: Prima Communications, Inc.www.personalhealthzone.com Celiac Disease Source: Healthnotes, Inc.; www.healthnotes.com Cellulitis Source: Integrative Medicine Communications; www.drkoop.com Chronic Myelogenous Leukemia Source: Integrative Medicine Communications; www.drkoop.com Cirrhosis Source: Integrative Medicine Communications; www.drkoop.com Colorectal Cancer Source: Integrative Medicine Communications; www.drkoop.com Crohn's Disease Source: Healthnotes, Inc.; www.healthnotes.com Crohn's Disease Source: Integrative Medicine Communications; www.drkoop.com Cystic Fibrosis Source: Integrative Medicine Communications; www.drkoop.com Depression Source: Healthnotes, Inc.; www.healthnotes.com

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Depression Source: Integrative Medicine Communications; www.drkoop.com Depression (mild to Moderate) Source: Prima Communications, Inc.www.personalhealthzone.com Diabetes Source: Prima Communications, Inc.www.personalhealthzone.com Diabetes Mellitus Source: Integrative Medicine Communications; www.drkoop.com Diarrhea Source: Integrative Medicine Communications; www.drkoop.com Diverticular Disease Source: Healthnotes, Inc.; www.healthnotes.com Dysphagia Source: Integrative Medicine Communications; www.drkoop.com Eating Disorders Source: Healthnotes, Inc.; www.healthnotes.com Gallstones Source: Healthnotes, Inc.; www.healthnotes.com Gastroesophageal Reflux Disease Source: Healthnotes, Inc.; www.healthnotes.com Gout Source: Healthnotes, Inc.; www.healthnotes.com Gout Source: Integrative Medicine Communications; www.drkoop.com Guinea Worm Disease Source: Integrative Medicine Communications; www.drkoop.com High Blood Pressure Source: Integrative Medicine Communications; www.drkoop.com High Cholesterol Source: Healthnotes, Inc.; www.healthnotes.com High Cholesterol Source: Integrative Medicine Communications; www.drkoop.com Hirsuitism Source: Integrative Medicine Communications; www.drkoop.com

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Histoplasmosis Source: Integrative Medicine Communications; www.drkoop.com HIV and AIDS Source: Integrative Medicine Communications; www.drkoop.com HIV and AIDS Support Source: Healthnotes, Inc.; www.healthnotes.com Hookworm Source: Integrative Medicine Communications; www.drkoop.com Hypercholesterolemia Source: Integrative Medicine Communications; www.drkoop.com Hypertension Source: Healthnotes, Inc.; www.healthnotes.com Hypertension Source: Integrative Medicine Communications; www.drkoop.com Hypertension Alternative names: High Blood Pressure Source: Prima Communications, Inc.www.personalhealthzone.com Hyperthyroidism Source: Integrative Medicine Communications; www.drkoop.com Immune Function Source: Healthnotes, Inc.; www.healthnotes.com Inflammatory Bowel Disease Source: Integrative Medicine Communications; www.drkoop.com Insulin Resistance Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Intermittent Claudication Source: Healthnotes, Inc.; www.healthnotes.com Intestinal Parasites Source: Integrative Medicine Communications; www.drkoop.com Leukemia Source: Integrative Medicine Communications; www.drkoop.com Liver Cirrhosis Source: Healthnotes, Inc.; www.healthnotes.com Liver Disease Source: Integrative Medicine Communications; www.drkoop.com

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Loiasis Source: Integrative Medicine Communications; www.drkoop.com Lung Cancer Source: Healthnotes, Inc.; www.healthnotes.com Lung Cancer Source: Integrative Medicine Communications; www.drkoop.com Lymphatic Filariasis Source: Integrative Medicine Communications; www.drkoop.com Lymphoma Source: Integrative Medicine Communications; www.drkoop.com Malabsorption Source: Healthnotes, Inc.; www.healthnotes.com Myelofibrosis Source: Integrative Medicine Communications; www.drkoop.com Myeloproliferative Disorders Source: Integrative Medicine Communications; www.drkoop.com Obesity Source: Integrative Medicine Communications; www.drkoop.com Osteoarthritis Source: Healthnotes, Inc.; www.healthnotes.com Osteoarthritis Source: Integrative Medicine Communications; www.drkoop.com Pancreatitis Source: Integrative Medicine Communications; www.drkoop.com Parasites Source: Healthnotes, Inc.; www.healthnotes.com Peptic Ulcer Source: Healthnotes, Inc.; www.healthnotes.com Peripheral Vascular Disease Source: Healthnotes, Inc.; www.healthnotes.com Pinworm Source: Integrative Medicine Communications; www.drkoop.com Polycythemia Vera Source: Integrative Medicine Communications; www.drkoop.com

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Pregnancy and Postpartum Support Source: Healthnotes, Inc.; www.healthnotes.com Prostate Cancer Source: Healthnotes, Inc.; www.healthnotes.com Prostate Cancer Source: Integrative Medicine Communications; www.drkoop.com Pyloric Stenosis Source: Integrative Medicine Communications; www.drkoop.com Radiation Damage Source: Integrative Medicine Communications; www.drkoop.com Reiter's Syndrome Source: Integrative Medicine Communications; www.drkoop.com Rheumatoid Arthritis Source: Healthnotes, Inc.; www.healthnotes.com Rheumatoid Arthritis Source: Integrative Medicine Communications; www.drkoop.com River Blindness Source: Integrative Medicine Communications; www.drkoop.com Roundworms Source: Integrative Medicine Communications; www.drkoop.com Sarcoidosis Source: Integrative Medicine Communications; www.drkoop.com Skin Infection Source: Integrative Medicine Communications; www.drkoop.com Sleep Apnea Source: Integrative Medicine Communications; www.drkoop.com Stroke Source: Healthnotes, Inc.; www.healthnotes.com Systemic Lupus Erythematosus Source: Healthnotes, Inc.; www.healthnotes.com Threadworm Source: Integrative Medicine Communications; www.drkoop.com Thrombocytosis Source: Integrative Medicine Communications; www.drkoop.com

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Thyroid Inflammation Source: Integrative Medicine Communications; www.drkoop.com Thyroiditis Source: Integrative Medicine Communications; www.drkoop.com Trichinosis Source: Integrative Medicine Communications; www.drkoop.com Tuberculosis Source: Integrative Medicine Communications; www.drkoop.com Ulcerative Colitis Source: Healthnotes, Inc.; www.healthnotes.com Ulcerative Colitis Source: Integrative Medicine Communications; www.drkoop.com Varicose Veins Source: Integrative Medicine Communications; www.drkoop.com Visceral Larva Migrans Source: Integrative Medicine Communications; www.drkoop.com Vitamin B12 Deficiency Source: Healthnotes, Inc.; www.healthnotes.com Weight Loss and Obesity Source: Healthnotes, Inc.; www.healthnotes.com Whipworm Source: Integrative Medicine Communications; www.drkoop.com Wounds Source: Integrative Medicine Communications; www.drkoop.com •

Alternative Therapy Acu-diet Alternative names: Dr. Bahr's acu-diet Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/a.html Belly Bean Diet Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/b.html Chinese Diet for Weight Loss Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D.

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Hyperlink: http://www.canoe.ca/AltmedDictionary/c.html Dragon's Way Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/d.html Hypnotherapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,706,00.html Meta Fitness Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/m.html Numbers Diet Alternative names: Jean Simpson's Numbers Diet Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/n.html Oriental 7-day Quick Weight-off Diet Alternative names: Oriental Diet Oriental diet plan Oriental diet system Oriental Miracle Diet Oriental quick weight loss diet Oriental quick weight loss plan Oriental 7-day diet Oriental 7-day miracle diet Oriental 7-day plan 7 miracle diet 7 Oriental diet 7 Oriental food plan 7 Oriental miracle diet 7 Oriental quick weight loss diet 7 Oriental reducing diet Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/o.html Supershape Psychological Conditioning System Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/s.html Weigh Down Workshop Alternative names: Weight Down Workshop approach Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/w.html Weight No More Alternative names: Body Mind and Spirit Diet; Weight No More approach to weight loss; Weight No More program Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/w.html

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Zone Diet Alternative names: Zone-favorable diet Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/z.html •

Herbs and Supplements 5-htp Source: Integrative Medicine Communications; www.drkoop.com 5-htp (5-hydroxytryptophan) Source: Prima Communications, Inc.www.personalhealthzone.com 5-hydroxytryptophan Source: Healthnotes, Inc.; www.healthnotes.com 5-hydroxytryptophan (5-htp) Source: Integrative Medicine Communications; www.drkoop.com 7-keto Source: Healthnotes, Inc.; www.healthnotes.com Amino Acids Overview Source: Healthnotes, Inc.; www.healthnotes.com B-carotene Alternative names: Beta-Carotene Source: Integrative Medicine Communications; www.drkoop.com Bee Products Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,756,00.html Beta-carotene Alternative names: b-carotene Source: Integrative Medicine Communications; www.drkoop.com Betacarotenum Alternative names: b-carotene Source: Integrative Medicine Communications; www.drkoop.com Blue-green Algae Source: Healthnotes, Inc.; www.healthnotes.com Brewer's Yeast Alternative names: Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Caffeine Source: Healthnotes, Inc.; www.healthnotes.com

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Cardec Dm Source: Healthnotes, Inc.; www.healthnotes.com Chitosan Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10016,00.html Coenzyme Q Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,768,00.html Dehydroepiandrosterone (dhea) Source: Healthnotes, Inc.; www.healthnotes.com Dha Source: Integrative Medicine Communications; www.drkoop.com Dhea Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10022,00.html Docosahexaenoic Acid (dha) Source: Integrative Medicine Communications; www.drkoop.com Ephedra Source: Healthnotes, Inc.; www.healthnotes.com Ephedra Alternative names: Ephedra sinensis Source: Integrative Medicine Communications; www.drkoop.com Ephedra (ma Huang) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,777,00.html Ephedra Sinensis Alternative names: Ephedra Source: Integrative Medicine Communications; www.drkoop.com Ephedrine and Pseudoephedrine Source: Healthnotes, Inc.; www.healthnotes.com Epinephrine Source: Healthnotes, Inc.; www.healthnotes.com Fenofibrate Source: Healthnotes, Inc.; www.healthnotes.com

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Fiber Source: Healthnotes, Inc.; www.healthnotes.com Garcinia Cambogia Alternative names: Citrin, Gambooge Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Gla (gamma-linolenic Acid) Source: Prima Communications, Inc.www.personalhealthzone.com Glucomannan Source: Healthnotes, Inc.; www.healthnotes.com Glutamine Source: Healthnotes, Inc.; www.healthnotes.com Glutamine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10030,00.html Green Tea Alternative names: Camellia sinensis Source: Healthnotes, Inc.; www.healthnotes.com Guaraná Alternative names: Paullinia cupana Source: Healthnotes, Inc.; www.healthnotes.com Guggul Alternative names: Commiphora mukul Source: Healthnotes, Inc.; www.healthnotes.com Gugulipid Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10033,00.html Herbal Decongestant Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,949,00.html Horsetail Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10105,00.html Hydroxycitric Acid Source: Healthnotes, Inc.; www.healthnotes.com

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Hydroxycitric Acid Source: Prima Communications, Inc.www.personalhealthzone.com Juniperus Alternative names: Juniper; Juniperus sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Ma Huang Alternative names: Ephedra Source: Integrative Medicine Communications; www.drkoop.com Medium-chain Triglycerides Source: Prima Communications, Inc.www.personalhealthzone.com Orlistat Source: Healthnotes, Inc.; www.healthnotes.com Phentermine Source: Healthnotes, Inc.; www.healthnotes.com Phenylpropanolamine Source: Healthnotes, Inc.; www.healthnotes.com Plantago Psyllium Alternative names: Psyllium, Ispaghula; Plantago psyllium/ovata Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Pregnenolone Source: Prima Communications, Inc.www.personalhealthzone.com Psyllium Alternative names: Plantago ovata, Plantago ispaghula Source: Healthnotes, Inc.; www.healthnotes.com Psyllium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,814,00.html Pyruvate Source: Healthnotes, Inc.; www.healthnotes.com Pyruvate Source: Prima Communications, Inc.www.personalhealthzone.com Rosiglitazone Source: Healthnotes, Inc.; www.healthnotes.com Selective Serotonin Reuptake Inhibitors (ssris) Source: Integrative Medicine Communications; www.drkoop.com

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Selegiline Source: Healthnotes, Inc.; www.healthnotes.com Sibutramine Source: Healthnotes, Inc.; www.healthnotes.com St. John's Wort Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,824,00.html Thyroid Hormones Source: Healthnotes, Inc.; www.healthnotes.com Trans-beta-carotene Alternative names: Beta-Carotene Source: Integrative Medicine Communications; www.drkoop.com Tyrosine Source: Integrative Medicine Communications; www.drkoop.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON WEIGHT LOSS Overview In this chapter, we will give you a bibliography on recent dissertations relating to weight loss. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “weight loss” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on weight loss, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Weight Loss ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to weight loss. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

A Comparative Study of Three Weight Loss Programs: Physical Exercise, Psychoeducation, and Combined Physical Exercise/psychoeducation by Kraslin, Harvey A., Edd from Clark University, 1989, 177 pages http://wwwlib.umi.com/dissertations/fullcit/8920374

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A Comparison of Different Exercise Prescriptions Combined with a Low-fat Ad Libitum Diet: Effects on Weight Loss, Health-related Variables and Psychological Well-being in Premenopausal Overweight Women by Brill, Janet Bond; Phd from University of Miami, 2001, 164 pages http://wwwlib.umi.com/dissertations/fullcit/3008195

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A Comparison of Holistic and Behavioral Group Approaches in Facilitating Weight Loss, Personality Change and Self-concept Change in Adult Women by Wolf, Patricia Rice, Edd from New Mexico State University, 1982, 122 pages http://wwwlib.umi.com/dissertations/fullcit/8302113

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A Comparison of Instructional Methods for Weight Loss and Curriculum Comprehension in Women by Jones, Katherine S., Phd from Arizona State University, 1997, 90 pages http://wwwlib.umi.com/dissertations/fullcit/9721011

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A Programmatic Evaluation of the Pathways to a Sensible Weight Loss Program by Stratton, Kathryn Elise, Psyd from Rutgers the State University of New Jersey, G.s.a.p.p., 1988, 253 pages http://wwwlib.umi.com/dissertations/fullcit/8813672

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A Study of Weight Loss in Nursing Personnel by Gordon, Marva Loretta, Phd from St. John's University (new York), 1983, 147 pages http://wwwlib.umi.com/dissertations/fullcit/8408622

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A Weight Loss Program for Overweight Adolescent Girls and Its Effects on Selfconcept by Welch, Robert Neil, Edd from The University of Tennessee, 1971, 85 pages http://wwwlib.umi.com/dissertations/fullcit/7205499

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An Outcome Study of Two Short-term Weight Loss Methods: Bibliotherapy and Interpersonal Growth Group Therapy by Rucker, John Paul, Edd from Texas Tech University, 1983 http://wwwlib.umi.com/dissertations/fullcit/f2697461

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Continual Monitoring: a Theoretical Model of the Weight Loss Maintenance Process by Hamilton, Doreen Ruth, Phd from University of California, Berkeley, 1988, 143 pages http://wwwlib.umi.com/dissertations/fullcit/8916688

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Coping As a Predictor of Weight Loss: the Use of Hypothetical High-risk Situations by Drapkin, Rita Gail, Phd from University of Pittsburgh, 1990, 177 pages http://wwwlib.umi.com/dissertations/fullcit/9028442

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Dead-weight Loss from Tax-induced Distortion of Capital Mix by Jeremias, Ronald Alan, Phd from Virginia Polytechnic Institute and State University, 1980, 180 pages http://wwwlib.umi.com/dissertations/fullcit/8005217

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Education and Self-efficacy As Predictors of Weight Loss among Older Obese Females (older Women) by Vaiani, Livia Lee, Edd from Rutgers the State University of New Jersey - New Brunswick, 1991, 174 pages http://wwwlib.umi.com/dissertations/fullcit/9130059

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Effectiveness of a Self-administered Assertiveness Training Manual As a Component of a Counselor-directed Weight Loss Program (obesity, Bibliotherapy) by Mishou, Lucretia Virginia, Edd from University of Maine, 1985, 156 pages http://wwwlib.umi.com/dissertations/fullcit/8614146

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Effects of Client Perceived Need and the Balance Sheet Procedure on Commitment to Weight Loss by Billings Tenney, Meribeth, Phd from The University of Nebraska Lincoln, 1987, 90 pages http://wwwlib.umi.com/dissertations/fullcit/8810309

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Effects of Exercise in Cool Water on Body Weight Loss and Thermoregulation of Women. by Sheldahl, Lois Marie, Phd from The Pennsylvania State University, 1978, 153 pages http://wwwlib.umi.com/dissertations/fullcit/7902647

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Effects of Exercise on Dietary Induced Weight Loss by Cesare, William F., Edd from Boston University, 1985, 140 pages http://wwwlib.umi.com/dissertations/fullcit/8602335

Dissertations 183

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Effects of Moderate Altitude and Weight Loss on Exercise Performance and Hemoglobin Concentration in Adult Males. by Pavlisko, Jon Joseph, Phd from The University of Utah, 1974, 124 pages http://wwwlib.umi.com/dissertations/fullcit/7421244

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Effects of Rapid Weight Loss by Dehydration and Starvation on Performance of Heat Acclimatized Subjects under Heat Stress (110 Degrees F.) As Determined by Selected Psychomotor, Strength, Mental, and Physiological Parameters by Williams, William Redden, Phd from The University of North Carolina at Chapel Hill, 1967, 182 pages http://wwwlib.umi.com/dissertations/fullcit/6802252

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Evaluation of a Problem-solving Approach to Weight Loss. by Black, David Randall, Phd from Stanford University, 1978, 573 pages http://wwwlib.umi.com/dissertations/fullcit/7905820

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Hardiness and Coping Strategies of Adults in Weight Loss Programs by Hanson, Carolyn Schmidt, Phd from University of Florida, 1995, 123 pages http://wwwlib.umi.com/dissertations/fullcit/9607517

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Health Related Quality of Life and Health Care Utilization: a Pilot Study with Women in a Behavioural Weight Loss Program by Toews, Helen Patricia; Msc from University of Guelph (canada), 2003, 404 pages http://wwwlib.umi.com/dissertations/fullcit/MQ76126

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Hormonal, Metabolic, and Skeletal Muscle Adaptations Following Weight Loss: Effect of Dietary Fat Type by Calsbeek, Dean Joseph; Phd from Colorado State University, 2003, 186 pages http://wwwlib.umi.com/dissertations/fullcit/3092659

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Identity Transformation due to Weight Loss by Granberg, Ellen Marie; Phd from Vanderbilt University, 2001, 303 pages http://wwwlib.umi.com/dissertations/fullcit/3038808

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Logoanalysis As a Group Treatment for Existential Vacuum and Weight Loss in Obese Women by Horton, Robert Craig, Phd from University of Southern California, 1983 http://wwwlib.umi.com/dissertations/fullcit/f2688741

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Marital Influences on the Successful Maintenance of Weight Loss: Family-systems and Cognitive-behavioral Analyses by Tirado, Mildred Catalina, Phd from Columbia University, 1984, 133 pages http://wwwlib.umi.com/dissertations/fullcit/8427486

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Mexican American College Women's Beliefs, Attitudes and Practices Related to Weight Loss by Gonzalez, Matiana Clarissa; Edd from The University of Texas at Austin, 2000, 252 pages http://wwwlib.umi.com/dissertations/fullcit/3004412

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Newman's Theory of Health As Expanding Consciousness in Women Maintaining Weight Loss by Berry, Diane Cheryl; Phd from Boston College, 2002, 237 pages http://wwwlib.umi.com/dissertations/fullcit/3053652

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Obesity and Weight Loss in Weight Watchers: a Study of Deviance and Resocialization by Wernick, Sarah, Phd from Columbia University, 1973, 212 pages http://wwwlib.umi.com/dissertations/fullcit/7329875

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Perceived Changes in the Quality of Life after Weight Loss/gastric Restriction Surgery by Andrelis, Jo Ann; Phd from Capella University, 2002, 124 pages http://wwwlib.umi.com/dissertations/fullcit/3037361

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Perceptions of Desirable Body Size: Implications for Worksite Health Promotion (weight Loss) by Goldfein, Kristan Dana, Edd from Columbia University Teachers College, 1993, 116 pages http://wwwlib.umi.com/dissertations/fullcit/9400562

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Physical, Psychological, Behavioral and Family Factors Predicting Weight Loss and Weight Loss Maintenance in Morbidly Obese Children and Adolescents (obesity, Childhood Obesity) by Miller, Lisa Alison, Phd from Depaul University, 1991, 325 pages http://wwwlib.umi.com/dissertations/fullcit/9136823

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Predicting Adherence to a Weight Loss Regimen Using the Neo Personality Inventory - Revised by Galluccio Richardson, Roberta M.; Phd from Fairleigh Dickinson University, 2003, 153 pages http://wwwlib.umi.com/dissertations/fullcit/3082848

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Predicting Success in a Behavior Modification Weight Loss Program Using the Minnesota Multiphasic Personality Inventory by Ayoob, Keith-thomas, Edd from Columbia University Teachers College, 1983, 65 pages http://wwwlib.umi.com/dissertations/fullcit/8404081

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Predictors of Attrition in a Predominantly Caucasian Middle-class Clinic-based Weight Loss Program by Rabinowitz, Dena C.; Phd from St. John's University (new York), 2002, 121 pages http://wwwlib.umi.com/dissertations/fullcit/3035742

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Psychological Predictors/moderators of Weight Loss Outcome by Ardito, Diane Anita; Phd from Yeshiva University, 2002, 85 pages http://wwwlib.umi.com/dissertations/fullcit/3077174

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Relationship between Weight Loss and Body Image in Obese Individuals Seeking Weight Loss Treatment by Reas, Deborah Lynn; Phd from Louisiana State University and Agricultural & Mechanical College, 2002, 85 pages http://wwwlib.umi.com/dissertations/fullcit/3069730

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Relationship of Self-efficacy, Locus of Control and Weeks in Program to Weight Loss Outcomes by Weyer, Mary Gleason, Edd from Northern Illinois University, 1988, 161 pages http://wwwlib.umi.com/dissertations/fullcit/8900484

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Relationship of Weight Loss to Selected Physiological, Strength, and Motor Performance Measures of College Boxers by Virgets, Thomas Claude, Edd from The University of Alabama, 1985, 98 pages http://wwwlib.umi.com/dissertations/fullcit/8519422

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Rigid and Flexible Control of Eating: Prospective Relation to Weight Loss and Maintenance by Timko, C. Alix; Phd from Drexel University, 2003, 145 pages http://wwwlib.umi.com/dissertations/fullcit/3076565

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Shedding the Obese Role: a Three-year Study of Twenty Obese Females, Ages 13-53, Who Had Surgery for Weight Loss (gastric Bypass, Intestinal Bypass) by Wrobel, Sylvia Burroughs, Phd from University of Kentucky, 1989, 221 pages http://wwwlib.umi.com/dissertations/fullcit/9014238

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Successful Intentional Weight Loss among Mexican-american Women Dieters: Educational Implications for Success by Lichten, Joanne V., Phd from Texas A&m University, 1989, 219 pages http://wwwlib.umi.com/dissertations/fullcit/9015533

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Successful Maintenance of Weight Loss in Women (weight Loss Maintenance) by Pilcher, Linda Sue, Phd from Washington University, 1991, 301 pages http://wwwlib.umi.com/dissertations/fullcit/9134397

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The Correlates of Long-term Weight Loss in Females Following a 26-day Weight Education Program by Bratton, Susan Query, Phd from University of South Carolina, 1990, 344 pages http://wwwlib.umi.com/dissertations/fullcit/9101440

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The Difference in Cognitive and Emotional Coping Skills Used by Successful and Unsuccessful Weight Loss Maintainers by Rudolph, Marie Joanne, Edd from Columbia University Teachers College, 1995, 231 pages http://wwwlib.umi.com/dissertations/fullcit/9539860

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The Effect of Different Reinforcement Schedules on the Maintenance of Weight Loss with Retarded Overweight Adults Previously Exposed to a Behavioral Weight Reduction Treatment Package. by Rotatori, Anthony Francis, Phd from The University of Wisconsin - Madison, 1977, 133 pages http://wwwlib.umi.com/dissertations/fullcit/7719782

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The Effect of Frequency of Therapist Contact and Client Locus-of-control on Weight Loss. by Voogt, Robert Dale, Phd from The University of Michigan, 1978, 155 pages http://wwwlib.umi.com/dissertations/fullcit/7813750

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The Effect of Relaxation and Mental Imagery on Perceived Self-efficacy, Weight Loss, Body Composition, and Eating and Exercise Behavior (eating Behavior, Relaxation Training) by Smith, Ruth Anne Seaman, Phd from University of Maryland College Park, 1991, 171 pages http://wwwlib.umi.com/dissertations/fullcit/9222764

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The Effect of Support Groups upon Weight Loss and Self-concepts of Participants in a Multi-dimensional Weight Reduction Program. by Dobbins, Susan Jane, Edd from Indiana University, 1977, 94 pages http://wwwlib.umi.com/dissertations/fullcit/7727024

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The Effects of a Lottery Reinforcement Strategy on Client Self-monitoring in Two Weight Loss Programs by Noelting, Dale Carlon, Phd from University of Pittsburgh, 1987, 94 pages http://wwwlib.umi.com/dissertations/fullcit/8809182

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The Effects of Aerobic Exercise and Slow-speed Strength Training on Body Composition and Weight Loss in Obese Women by Silver, Francine J.; Phd from Fairleigh Dickinson University, 2002, 176 pages http://wwwlib.umi.com/dissertations/fullcit/3036299

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The Effects of Training in Decision-making on an Individual's Locus-of-control and Ability to Lose Weight (weight Loss) by Ishee, Allyson Scoggin, Phd from Mississippi State University, 1991, 82 pages http://wwwlib.umi.com/dissertations/fullcit/9131217

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The Impact of Strength Training on the Neuromuscular Function and Physical Performance of Obese Elderly Women after Weight Loss by Kim, Jae Hee; Edd from Columbia University Teachers College, 2003, 45 pages http://wwwlib.umi.com/dissertations/fullcit/3091265

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The Implementation of an Interpersonal Coping Skills Programme to Facilitate Weight Loss by Vigna, Carlo M; Phd from University of Toronto (canada), 1981 http://wwwlib.umi.com/dissertations/fullcit/NK53169

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The Influence of a Special Camp Program for Obese Boys on Weight Loss, Selfconcept and Body Image by Rohrbacher, Richard, Edd from Boston University School of Education, 1971, 211 pages http://wwwlib.umi.com/dissertations/fullcit/7126732

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The Life Change Process: Weight Loss and Other Enterprises of Personal Transformation, with Particular Emphasis on Hypnosis, Behavior Modification, and Scientology. by Straus, Roger Austin, Phd from University of California, Davis, 1977, 323 pages http://wwwlib.umi.com/dissertations/fullcit/7727412

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The Management of Privacy Boundaries after Weight Loss by Beavers, Lynnda Sue, Phd from University of Kentucky, 1996, 124 pages http://wwwlib.umi.com/dissertations/fullcit/9709178

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The Physiological Effects of Rapid Weight Loss among Wrestlers by Elfenbaum, Louis, Phd from The Ohio State University, 1966, 121 pages http://wwwlib.umi.com/dissertations/fullcit/6702436

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The Process of Personal Change: a Case Study of Adults Who Have Maintained Weight Loss by Ross, Susan Tucker, Edd from Northern Illinois University, 1985, 262 pages http://wwwlib.umi.com/dissertations/fullcit/8518727

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The Relationship and Predictive Ability of Self-efficacy and Locus of Control among Females in a Weight Loss Health Education Intervention (promotion) by Lindsay, Gordon Bangerter, Phd from The Ohio State University, 1984, 119 pages http://wwwlib.umi.com/dissertations/fullcit/8426434

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The Relationship of Locus of Control on Weight Loss and Maintenance of Weight Loss by Rothstein, Sandra J., Edd from Florida Atlantic University, 1986, 138 pages http://wwwlib.umi.com/dissertations/fullcit/8612855

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The Relationship of Sense of Coherence, Depression, Functional Ability, and Comorbidity to Weight Loss in Residents of Long Term Care Facilities by Cole, Catherine Sue; Dnsc from The Catholic University of America, 2002, 165 pages http://wwwlib.umi.com/dissertations/fullcit/3047132

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The Relationship of Social Support Contracting to Worksite Weight Control (weight Loss, Obesity Treatment) by Wynne, Kathleen Louise, Edd from University of South Carolina, 1986, 188 pages http://wwwlib.umi.com/dissertations/fullcit/8704657

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The Relationship of Success in a Weight Loss - Fitness Program and Locus of Control of Reinforcement by Langley, Thomas Donald, Edd from University of South Carolina, 1983, 270 pages http://wwwlib.umi.com/dissertations/fullcit/8319270

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The Relationship of Weight Loss in an Obesity Treatment Program to Expectancy of Success and to Selected Attribution Constructs by Niemeier, Dianne Frances, Phd from University of Southern California, 1982 http://wwwlib.umi.com/dissertations/fullcit/f91110

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The Relationship of Weight Loss to Strength Changes in Obese Adult Females by Pargman, David, Phd from New York University, 1966, 95 pages http://wwwlib.umi.com/dissertations/fullcit/6704904

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The Role of Attributional Style in Predicting Success at Continuing and Maintaining Weight Loss by Steinberg, Naomi, Phd from The Pennsylvania State University, 1990, 173 pages http://wwwlib.umi.com/dissertations/fullcit/9104974

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The Role of Cognitive Thought Processes in the Maintenance of Weight Loss (obesity, Relapse) by Herb, Ellyn D., Phd from The Fielding Institute, 1985, 240 pages http://wwwlib.umi.com/dissertations/fullcit/8602957

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The Role of Learning and Motivation in Change: a Case Study of Females Who Were Involved in Weight Loss Programs by Rahe, Sandra Jean, Phd from The University of Nebraska - Lincoln, 1991, 125 pages http://wwwlib.umi.com/dissertations/fullcit/9133313

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The Role of Patient Preference for Treatment Type in the Modification of Weight Loss Behavior by Fuller, Thomas Charles, Phd from Michigan State University, 1988, 308 pages http://wwwlib.umi.com/dissertations/fullcit/8900038

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The Use of Computer Technology in Teaching Weight Loss by Sartor, Martha Ray, Phd from The University of Mississippi, 1990, 124 pages http://wwwlib.umi.com/dissertations/fullcit/9120292

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Use of Behavioral Stage-of-change and Preference for Weight Loss Interventions As a System for Client-matching Treatment of Obesity by Ostendorf, Wendy R., Edd from University of Sarasota, 1999, 187 pages http://wwwlib.umi.com/dissertations/fullcit/9929538

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Weight Loss and Associated Energy Expenditure of American Shad Alosa Sapidissima, Wilson during the Freshwater Spawning Migration by Glebe, Brian Douglas; Phd from Mcgill University (canada), 1977 http://wwwlib.umi.com/dissertations/fullcit/NK35719

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Weight Loss and Lean Body Weight Maintenance (exercise, Diet, Weight Training) by Ballor, Douglas Leroy, Phd from The University of Michigan, 1986, 92 pages http://wwwlib.umi.com/dissertations/fullcit/8702677

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Weight Loss Effects on Growth, Maturation, Growth-related Hormones, Protein Nutrition Markers, and Body Composition of Adolescent Wrestlers by Roemmich, James Norman, Phd from Kent State University, 1994, 246 pages http://wwwlib.umi.com/dissertations/fullcit/9509438

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Weight Loss Maintenance in a Multicomponent Behavioral Treatment of Obesity by Barger, Sharon Ann, Phd from The University of Wisconsin - Madison, 1987, 383 pages http://wwwlib.umi.com/dissertations/fullcit/8712405

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What Are the Food Behaviors, Attitudes, and Beliefs in Relation to Body Size and Weight Loss of Postpartum Urban Working Black American Women? by Claywilliams, Gaynelle; Edd from Columbia University Teachers College, 2002, 214 pages http://wwwlib.umi.com/dissertations/fullcit/3042335

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. CLINICAL TRIALS AND WEIGHT LOSS Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning weight loss.

Recent Trials on Weight Loss The following is a list of recent trials dedicated to weight loss.8 Further information on a trial is available at the Web site indicated. •

Comparison of Nutritional Supplements in Preventing Weight Loss in Patients With Cancer Condition(s): adult solid tumor; Cachexia; Lymphoma Study Status: This study is currently recruiting patients. Sponsor(s): Radiation Therapy Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Nutritional supplements may help prevent loss of appetite, weight loss, and fatigue in patients with advanced cancer. PURPOSE: Randomized phase III trial to compare the effectiveness of two nutritional supplements in preventing loss of appetite, weight loss, and fatigue in patients who have stage III or stage IV solid tumors. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00053053

8

These are listed at www.ClinicalTrials.gov.

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Cyproheptadine and Megestrol in Preventing Weight Loss in Children With Cachexia Caused By Cancer or Cancer Treatment Condition(s): Cachexia; childhood Hodgkin's lymphoma; childhood brain tumor; childhood non-Hodgkin's lymphoma; childhood solid tumor; hematopoietic and lymphoid cancer Study Status: This study is currently recruiting patients. Sponsor(s): CCOP - H. Lee Moffitt Research Base; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Cyproheptadine and megestrol may improve appetite and help prevent weight loss in children with cancer. PURPOSE: Clinical trial to study the effectiveness of cyproheptadine and megestrol in improving appetite and preventing weight loss in children who have cachexia caused by cancer or cancer treatment. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00066248

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Effects of Leptin Treatment on Weight Loss Condition(s): Obesity Study Status: This study is currently recruiting patients. Sponsor(s): Rockefeller University Purpose - Excerpt: This is a double blind placebo controlled clinical study designed to determine the effects of leptin on the changes that occur in the body during weight loss achieved by a very low calorie diet. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00050791

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Etanercept in Treating Cancer-Related Weight Loss and Lack of Appetite in Patients With Advanced Cancer Condition(s): unspecified adult solid tumor, protocol specific; Anorexia; Cachexia Study Status: This study is currently recruiting patients. Sponsor(s): North Central Cancer Treatment Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Etanercept is a substance that is being studied as a treatment for lack of appetite and weight loss in patients who have cancer. It is not yet known if etanercept is effective in improving cancer-related weight loss and lack of appetite. PURPOSE: Randomized phase III trial to determine the effectiveness of etanercept in treating cancer-related weight loss and lack of appetite in patients who have advanced cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00046904

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Genetics, Metabolism and Weight Loss in Older, Obese Veterans Condition(s): Obesity Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Medical Research Service Purpose - Excerpt: This study is designed to determine whether sequence variation in the lipoprotein lipase (LPQ) gene affects the amount of weight loss and metabolic responses during a hypocaloric diet treatment for overweight and obese (BMI=25-35 kg/m2), older (50-65 yrs), sedentary veterans. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00018330

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The Effect of Weight Loss and Exercise on Knee Osteoarthritis Condition(s): Osteoarthritis, Knee Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Purpose - Excerpt: This study will evaluate whether a program of weight loss and exercise can help individuals with knee osteoarthritis (OA). Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00061490

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A Comparison of Two Caloric Supplements in the Prevention of Weight Loss in Patients with AIDS Who Take Daily Multivitamin and Mineral Supplements Condition(s): HIV Infections; HIV Wasting Syndrome Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: To compare a caloric supplement containing peptides and mediumchain triglycerides, a caloric supplement containing whole protein and long-chain triglycerides, and no caloric supplement for the prevention of weight loss in individuals with AIDS who take a daily multivitamin and mineral supplement. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001077

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Comparison of Megestrol and/or Omega-3 Fatty Acid-Enriched Nutritional Supplement in Treating Patients With Cancer-Related Weight Loss and Lack of Appetite Condition(s): Anorexia; Cachexia Study Status: This study is no longer recruiting patients.

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Sponsor(s): National Cancer Institute (NCI); National Cancer Institute of Canada; North Central Cancer Treatment Group Purpose - Excerpt: RATIONALE: Megestrol and /or an omega-3 fatty acid -enriched nutritional supplement may improve cancer-related weight loss and lack of appetite. It is not yet known whether megestrol alone, an omega-3 fatty acid-enriched nutritional supplement alone, or a combination of both is most effective in treating cancer-related weight loss and loss of appetite. PURPOSE: Randomized phase III trial to compare the effectiveness of megestrol with or without an omega-3 fatty acid-enriched nutritional supplement to that of the omega-3 fatty acid-enriched nutritional supplement alone in treating patients who have cancer-related weight loss and lack of appetite. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00031707 •

Dose/Response of Exercise on Long Term Weight Loss Condition(s): Cardiovascular Diseases; Heart Diseases; Obesity Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To examine the dose-response of exercise on long-term weight loss in overweight adult women. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006315

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Effectiveness of Atkins diet for weight loss Condition(s): Obesity Study Status: This study is no longer recruiting patients. Sponsor(s): National Center for Research Resources (NCRR) Purpose - Excerpt: Dr. Atkins' New Diet Revolution has sold over 10 million copies and has been on the New York Times best seller list for 158 weeks. This and other lowcarbohydrate diets, such as the ZONE, Sugar Busters, and the Carbohydrate Addicts Diet, have attracted much popular attention but little scientific evaluation. Given the widespread use of these diets, it seems prudent to evaluate them both for safety and efficacy. Therefore, the purpose of the study is to compare the effectiveness of two different weight control programs over the course of 52 weeks. These two programs are 1) the Atkins' New Diet Revolution, a low-carbohydrate, high-protein diet, and 2) Brownell's LEARN Program, a high carbohydrate, low fat diet based on behavior modification. Specifically, this study will compare short-term changes in weight, food intake, blood chemistries and mood in adult males (n=10) and females (n=10) who are randomized to either the Atkins' Diet or the LEARN Program for a period of one year. During this year, they will be under medical supervision. We will examine the effect of the two weight loss plans on changes in lipids, blood pressure, insulin sensitivity and ketones, and eating behavior. This is a feasibility study and thus the data will ultimately be used to design a large randomized trial with adequate statistical power.

Clinical Trials 193

Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006193 •

Megestrol to Limit Weight Loss and Improve Quality of Life in Treating Patients With Head and Neck Cancer Condition(s): lip and oral cavity cancer; Head and Neck Cancer; Oropharyngeal Cancer Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Comprehensive Cancer Center of Wake Forest University Purpose - Excerpt: RATIONALE: Megestrol helps improve appetite. It is not yet known if megestrol is effective in limiting weight loss caused by cancer. PURPOSE: Randomized phase III trial to determine the effectiveness of megestrol in limiting weight loss and improving quality of life in patients who have head and neck cancer and are undergoing radiation therapy. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006799

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Motivations for weight loss Condition(s): Obesity Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Purpose - Excerpt: This study tests the effects of emphasizing different motivations for wanting to lose weight on weight loss maintenance in women. At the start of the study, participants will be weighed and will complete questionnaires about their health, weight history, eating and exercise habits, body satisfaction and mood. Participants will then be randomly assigned to 1 of 4 treatments. Participants in all 4 groups will receive information on topics related to eating and exercise, and will receive calorie and fat intake goals, and exercise goals. The 4 treatments will differ in the emphasis given to various reasons for wanting to lose weight. At 6, 12 and 18 months after enrollment, participants will again have weights measured and fill out questionnaires. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00011115

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MRI Derived Organ & Tissue Mass Changes with Weight Loss - Ancillary to Look AHEAD Condition(s): Cardiovascular Diseases; Atherosclerosis; Obesity; Diabetes Mellitus, noninsulin dependent; Heart Diseases; Myocardial Infarction; Diabetes Mellitus Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI)

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Purpose - Excerpt: To investigate the composition and nature of weight loss and weight maintenance during the Look AHEAD trial. Also, to model changes in resting energy expenditure and changes in cardiac structure and function associated with weight loss. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00031200 •

Obesity Treatment in a Managed Care Setting Condition(s): Obesity; Weight Loss Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Purpose - Excerpt: The aim of the present study is to evaluate the effectiveness of two different delivery formats for weight management in a managed care setting. Mailbased weight counseling and phone-based weight counseling will be compared to each other and a control condition. Primary outcomes are participation rates in programs, weight change, and cost. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00062985

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Omega-3 Fatty Acids in Treating Patients With Advanced Cancer Who Have Significant Weight Loss Condition(s): Leukemia; Lymphoma; Multiple Myeloma Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Cancer and Leukemia Group B Purpose - Excerpt: RATIONALE: Omega-3 fatty acids are used by the body for energy and tissue development and may be an effective treatment for patients with advanced cancer who are unable to maintain their body weight. PURPOSE: Phase I/II trial to study the effectiveness of omega-3 fatty acids in treating patients with advanced cancer who have significant weight loss. Phase(s): Phase I; Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003077

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A Phase II, Parallel Group, Randomized, Placebo-Controlled Study of the Safety and Efficacy of Thalidomide in Reducing Weight Loss in Adults With HIV Wasting Syndrome Condition(s): HIV Infections; HIV Wasting Syndrome Study Status: This study is completed. Sponsor(s): Celgene Corporation

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Purpose - Excerpt: To evaluate the safety, antiviral and anti-TNF-alpha activity, and preliminary efficacy of thalidomide in reducing weight loss in patients with HIV wasting syndrome. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002127 •

A Study of Megestrol Acetate Alone or in Combination with Testosterone Enanthate Drug in the Treatment of HIV-Associated Weight Loss Condition(s): HIV Infections; HIV Wasting Syndrome Study Status: This study is completed. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: To test the hypothesis that the predominant accrual of fat rather than lean body mass (LBM) that occurs during treatment of HIV-associated wasting with megestrol acetate may be improved by treatment with megestrol acetate and testosterone enanthate in combination. Body wasting is an increasingly frequent AIDSdefining condition in individuals infected with HIV. Increasing caloric intake fails to consistently restore lean tissue patients with HIV associated weight loss. Megestrol acetate has been shown to stimulate appetite and weight gain in subjects with cancer and in those with HIV associated weight loss. However, the weight gained during treatment with megestrol acetate was predominantly or exclusively fat. An important factor is the preferential increase in body fat seen in both of these studies may have been due to hypogonadism that occurs as a result of treatment with megestrol acetate, a progestational agent. Hypogonadism is associated with an increase in body fat and a decrease in LBM. Concomitant testosterone replacement should substantially increase the amount of LBM accrued during megestrol acetate therapy. This study will determine whether anabolic potential can be realized when caloric intake is increased in the absence of concomitant hypogonadism. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001079

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A Study to Evaluate High Protein Supplementation in HIV-Positive Patients with Stable Weight Loss Condition(s): HIV Infections; HIV Wasting Syndrome Study Status: This study is completed. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: The purpose of this study is to determine whether a high-quality protein food supplement will help HIV-positive patients maintain, and possibly gain, muscle mass. Many HIV-positive patients lose weight that they are then unable to regain. This may be because patients are not eating enough protein or are not eating the right kinds of protein. The protein eaten in foods (such as meat, eggs, or beans) may not be able to make up for the amount of protein lost due to HIV infection. This study gives

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patients high-quality protein food supplements to help them maintain and/or gain weight. Phase(s): Phase II Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000925 •

A Study to Evaluate the Effect of Nandrolone Decanoate in Women with HIVAssociated Weight Loss Condition(s): HIV Infections; HIV Wasting Syndrome Study Status: This study is completed. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: The purpose of this study is to see if giving nandrolone decanoate (a hormonal drug) will cause weight gain in HIV-positive women who have HIVassociated weight loss (wasting). Wasting has become an AIDS-defining condition. In the past, most studies that examined wasting treatments were limited to men. However, it appears that wasting in HIV-positive men is linked to levels of testosterone (a hormone which affects men's bodies more than women's). This study has been designed for women only, in order to best treat wasting in HIV-positive women. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000854

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Docetaxel With or Without Infliximab in Treating Weight Loss, Loss of Appetite, and Fatigue in Patients with Advanced Non-Small Cell Lung Cancer Condition(s): Anorexia; Cachexia; Fatigue; Non-small cell lung cancer; Quality of Life Study Status: This study is suspended. Sponsor(s): North Central Cancer Treatment Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Infliximab may improve cancer-related weight loss, lack of appetite, and fatigue. It is not yet known whether docetaxel is more effective with or without infliximab in preventing weight loss and fatigue in patients with advanced cancer. PURPOSE: Randomized phase III trial to determine the effectiveness of docetaxel with or without infliximab in preventing weight loss, loss of appetite, and fatigue in patients who have advanced non-small cell lung cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00040885

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Exercise Adherence in a Behavioral Weight Loss Program Condition(s): Cardiovascular Diseases; Heart Diseases; Obesity Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To develop intervention strategies that improve long-term exercise adherence in obese adults in in order to improve long-term weight loss. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005743

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NEW DAY: Nutrition, Exercise, Weight loss, Diabetes And You Condition(s): Diabetes Mellitus, Type 2; Obesity Study Status: This study is completed. Sponsor(s): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Purpose - Excerpt: This clinical trial examines whether the addition of individual sessions of a motivational intervention to a state-of-the art behavioral group weight loss intervention for overweight women with Type 2 diabetes improves the weight losses and glycemic control outcomes. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00007800

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Obese Patients with or without Comorbidities Condition(s): Obesity; Weight Loss Study Status: This study is completed. Sponsor(s): Sanofi-Synthelabo Purpose - Excerpt: To assess the effects of weight loss and weight maintenance over a period of two years when prescribed with a hypocaloric diet in obese patients with or without comorbidities Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00029861

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Oxandrolone Compared With Megestrol in Preventing Weight Loss in Patients Receiving Chemotherapy for Cancer Condition(s): Quality of Life; weight changes; unspecified adult solid tumor, protocol specific Study Status: This study is not yet open for patient recruitment. Sponsor(s): CCOP - Wake Forest University Research Base; National Cancer Institute (NCI)

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Purpose - Excerpt: RATIONALE: Oxandrolone and megestrol may help prevent weight loss and improve quality of life in patients with cancer. It is not yet known whether oxandrolone is more effective than megestrol in preventing weight loss and improving quality of life in patients who are receiving chemotherapy for solid tumors. PURPOSE: Randomized phase III trial to compare the effectiveness of oxandrolone with that of megestrol in preventing weight loss and improving quality of life in patients who are receiving chemotherapy for solid tumors. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00070148 •

Peer-Based Skills Training to Enhance Teen Weight Loss Condition(s): Cardiovascular Diseases; Heart Diseases; Obesity Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To evaluate the efficacy of peer-based skills training to enhance weight control and improve psychosocial functioning in overweight adolescents. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00024830

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Study of Two Complementary and Alternative Medical Treatments for Maintenance of Weight Loss Condition(s): Obesity Study Status: This study is not yet open for patient recruitment. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: The goal of this study is to pilot test in a group of overweight-obese individuals the feasibility and acceptability and indications of efficacy of two CAM treatments, qigong, and acupressure-TAT, for improving long term maintenance of weight loss. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00069732

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The use of the Internet to facilitate weight loss and maintenance. Condition(s): Obesity Study Status: This study is completed. Sponsor(s): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Purpose - Excerpt: This project is assessing the effectiveness of using the Internet as a tool to facilitate the maintenance of weight lost in a behavioral weight control program. Participants attend a standard behavioral weight control intervention via Interactive

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Television and after 6 months are randomly assigned to one of three groups; a control group, an in-person weight maintenance group and a maintenance group that meets over the Internet. This research project is being conducted in Vermont. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00008827 •

Weight Loss Maintenance Condition(s): Cardiovascular Diseases; Heart Diseases; Obesity; Diabetes Mellitus, noninsulin dependent; Hypertension Study Status: This study is not yet open for patient recruitment. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To determine the effectiveness of continuous patient contact on weight loss maintenance. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00054925

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “weight loss” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 6. PATENTS ON WEIGHT LOSS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “weight loss” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on weight loss, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Weight Loss By performing a patent search focusing on weight loss, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on weight loss: •

Adrenergically-mediated weight loss product Inventor(s): Llewellyn; William Charles (P.O. Box 1162, Sound Beach, NY 11789) Assignee(s): none reported Patent Number: 6,531,162 Date filed: July 30, 2002 Abstract: This invention discloses a new and unique combination of octopamine, yohimbine, bergenin and decaffeinated green tea extract useful as an oral supplement for increasing weight loss in humans. Excerpt(s): Prior art relating to this invention concerns distinct areas previously not combined to create new and useful formula sets regarding a solid-dosage form of a weight loss product. This invention relates a new and unique combination of octopamine, yohimbine, bergenin and decaffeinated green tea extract useful for increasing weight loss. Octopamine is a naturally-occurring catecholamine structurally related to norephinephrine, and has been proven in in-vitro studies to be a potent selective beta-3 agonist (C R Acad Sci III 1993;316(5):519-23). Beta-3 receptors can be found in both human white and brown adipose tissues, and play an important role in lipolysis and thermogenesis in our bodies. They are vastly more important than previously thought by scientists, who often had difficulty in the past discerning the contribution of each beta-receptor subtype (1,2 and 3) without having agents selective for each to investigate. Various techniques were devised to try, but for a long time reports were not in favor of beta-3 receptors having much of a role in humans. It was not until a study conducted with ephedrine in 1995, however, that surprising new data started to arise in support of a beta-3-mediated pathway to fat loss. Using beta blocking agents investigators were able to demonstrate that beta-3 agonist activity likely accounted for at least 40% of the thermogenesis induced by this popular weight loss drug. Web site: http://www.delphion.com/details?pn=US06531162__

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Adult-onset diabetes treatment method Inventor(s): Lazarus; Douglas D. (17 Winter St., Apt. 17, Watertown, MA 02472) Assignee(s): none reported Patent Number: 6,562,379 Date filed: April 20, 2001 Abstract: Methods of inducing weight loss and treating adult-onset diabetes in a mammal in need thereof by administering to the mammal Momordica lectin or pokeweed mitogen chloroform precipitatable fraction. Lectin pharmaceutical compositions are also disclosed. Excerpt(s): The present invention relates to methods of treating adult onset diabetes by administering to a patient in need thereof an effective amount of a lectin capable of inducing a decline in food intake and inducing hypoglycemia. The present invention also relates to methods of inducing weight loss by administering an effective amount of

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a lectin capable of inducing a decline in food intake and repeating the administering step to maintain the decline in food intake. In particular, the present invention relates to methods of treating adult-onset diabetes and inducing weight loss with the mixture of lectins known as pokeweed mitogen and the bitter pear melon lectin. Adult-onset Type II diabetes mellitus is a major health problem in this country. Because it is exacerbated by obesity, treatment of this disease is often two-pronged, using drugs to maintain normal blood glucose concentrations and diet therapy to promote weight loss. However, current hypoglycemia drugs are not always effective, and adherence to diet therapy is generally poor. Lectins are a general class of proteins that bind to carbohydrates. The binding of these lectins to carbohydrates that are part of cell membrane receptors can result in cell activation. This is particularly well characterized with cells of the immune system. Lectins are widely used to stimulate immune function in in vitro studies. Web site: http://www.delphion.com/details?pn=US06562379__ •

Antistatic resin composition Inventor(s): Watabe; Teruhide (Fukushima-ken, JP), Arai; Shiro (Fukushima-ken, JP) Assignee(s): Kureha Kagaku Kogyo Kabushiki Kaisha (Tokyo, JP) Patent Number: 6,528,567 Date filed: May 3, 2001 Abstract: An anionic surfactant having a thermal weight loss initiation temperature of at least 250.degree. C. is incorporated with a thermoplastic resin comprising a graft copolymer formed by graft-polymerizing an ethylenically unsaturated monomer onto a rubber trunk polymer obtained by emulsion polymerization using a carboxylic acidtype surfactant. As a result, it is possible to obtain an antistatic resin composition which can be effectively produced on an industrial scale and can provide a shaped product excellent in permanent antistatic property and free from haze or discoloration even when processed under severe processing conditions. Excerpt(s): This application is a 371 application of PCT/JP99/06100, filed Nov. 2, 1999. The present invention relates to an improvement in resin composition having permanent antistatic property. As plastics generally have a large electrical resistivity and a strong chargeability, static electricity induced thereon by contact, friction, peeling, etc., is difficult to dissipate and thus attracts dust and dirt, thus resulting in troubles, such as impaired appearance on shaped articles, sheets, films and fibers formed from the plastics. For obviating these drawbacks, the following methods, roughly classified, have been investigated. Web site: http://www.delphion.com/details?pn=US06528567__

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Apparatus and method for determining weight loss of a heated material Inventor(s): Troxler; Robert Ernest (Raleigh, NC) Assignee(s): Troxler Electronic Laboratories, Inc. (Research Triangle Park, NC) Patent Number: 6,579,500 Date filed: June 25, 2002 Abstract: The present invention provides a method and apparatus for accurately determining weight loss of a sample during heating in a furnace. The method includes

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the steps of placing a sample in a heated furnace, heating the sample while measurements of sample weight are made, determining rate function from the sample weight measurements, producing a weight loss correction factor using the rate function and using the weight loss correction factor to obtain a corrected weight loss for the sample. Excerpt(s): This invention is concerned with accurately weighing heated materials, and is especially applicable to a pyrolysis furnace and to the measurement of weight loss in such a furnace. Certain industrial processes require accurate measurement of the weight or mass of a material before it is in a state of thermal equilibrium. In some cases, it is necessary to achieve accuracy on the order of tenths of a gram with samples larger than 3 kg. For example, the construction industry requires the measurement of asphalt content for quality control purposes. Asphalt is a mixture of asphalt binder and aggregate and is used heavily in the construction of roads. The mechanical properties of this mixture depend on many parameters, such as the asphalt binder content by weight and the gradation of the aggregate. In order to measure the quality of these materials, the contractor needs a process to separate the binder from the aggregate. In the past, there have been several accepted methods to obtain this information. Two such methods involved chemical solvents and nuclear isotopes. The nuclear asphalt content gauge can be used to accurately measure the binder content of asphalt in just a few minutes. Although this method is fast, the drawback is that gradation analysis cannot be obtained. Chemical solvents can give both asphalt content and gradation analysis. However this method is laborious, time consuming, and the waste solvent poses environmental problems. Web site: http://www.delphion.com/details?pn=US06579500__ •

Buffing tools and methods of making Inventor(s): Weber; Robert J. (Hickory, NC) Assignee(s): Jason Incorporated (Conover, NC) Patent Number: 6,595,843 Date filed: October 31, 2000 Abstract: A buff is made from a non-woven fabric where the fibers are first carded and formed into a fairly thick fleece. The fleece is passed over a topographical surface on, for example, a moving belt or a drum. The fleece is subject to a bow-tie hydroentanglement process where many fine jets of water entangle the fibers on the topographical surface. Excess water is vacuumed from the system. The fabric is dried and chemically treated. With the fabric a variety of buffing tools are made, in wheel, belt or roll form. Tests against standard and mill treatment buffs show a remarkably lower fabric weight loss percentage and lower or normal operating temperatures. The fabric has exceptional mechanical strength having a tensile strength in excess of 650 N/50 mm according to DIN 29073/3. Preferably the fabric has a tensile strength of at least 1,000 N/50 mm in the machine direction and in excess of 900 N/50 mm in the cross direction according to such DIN. Excerpt(s): This invention relates generally as indicated to a buffing tools and methods of making such tools, and more particulary to buffing tools having improved fabric or cloth greatly enhancing the efficiency, useful life, and productivity of the tool. Buffing tools probably are embodied most commonly in the form of a wheel. The wheel includes one or more discs or plates providing an arbor hole. The cloth or fabric is secured to and

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projects radially from the discs. The projecting edge of the fabric is the working face of the tool. Several layers or plys of fabric may be provided for each wheel and the fabric may be folded, bunched, puckered, or pleated so that the fabric edge zig-zags back and forth at the face, and the working face of the tool may be substantial axially wider than the discs or plates, from which the fabric projects. The wheels may be stacked on arbors with or without spacers to form buffing rolls or units which are mounted to the required axial length. The rolls may be of substantial axial length. Web site: http://www.delphion.com/details?pn=US06595843__ •

Cathodic electrocoating compositions polyisocyanate crosslinking agent

containing

hydroxyl-carbonate

blocked

Inventor(s): Gam; Allisa (Troy, MI) Assignee(s): E. I. du Pont de Nemours and Company (Wilmington, DE) Patent Number: 6,607,646 Date filed: September 12, 2001 Abstract: An improved aqueous cathodic electrocoating composition having a binder of an epoxy-amine adduct and a blocked polyisocyanate crosslinking agent; wherein the improvement is the use of a hydoxyl-carbonate blocked polyisocyanate crosslinking agent. Electrodeposited finishes are formed that have reduced weight loss when heated to cure. Excerpt(s): This invention is directed to a cathodic electrocoating composition and in particular to a cathodic electrocoating composition containing a blocked polyisocyanate cross-linking agent which significantly reduces bake-off loss occurring from the coating film during cure. The coating of electrically conductive substrates by an electrodeposition process, also called an electrocoating process, is a well known and important industrial process. Electrodeposition of primers to metal automotive substrates is widely used in the automotive industry. In this process, a conductive article, such as an autobody or an auto part, is immersed in a bath of a coating composition of an aqueous emulsion of film forming polymer and the article acts as an electrode in the electrodeposition process. An electric current is passed between the article and a counter-electrode in electrical contact with the coating composition, until a coating of a desired thickness is deposited on the article. In a cathodic electrocoating process, the article to be coated is the cathode and the counter-electrode is the anode. Film forming resin compositions used in the bath of a typical cathodic electrodeposition process also are well known in the art. These resins typically are made from polyepoxide resins which have been chain extended and then an adduct is formed to include amine groups in the resin. Amine groups typically are introduced through a reaction of the resin with an amine compound. These resins are blended with a crosslinking agent usually a blocked polyisocyanate and then neutralized with an acid to form a water emulsion which is usually referred to as a principal emulsion. Web site: http://www.delphion.com/details?pn=US06607646__

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Chemical composition for aiding the absorption, binding and elimination of undigested fat Inventor(s): Naranjo; Eduardo M. (5009 SW. 71st Pl., Miami, FL 33155), Diaz; Jose A. (2950 Jackson Ave., Coconut Grove, FL 33133) Assignee(s): none reported Patent Number: 6,447,812 Date filed: March 13, 2001 Abstract: A composition and method for reducing cholesterol, facilitating weight loss and aiding in the maintenance of a stable weight in humans, wherein the composition includes at least one preferred embodiment comprising a mixture of oat bran generally in an amount of about 83% to 85% by weight, glucosamine HCL generally in an amount about 6% to 8% by weight, glucomannan generally in an amount of 5% to 6% by weight, an amount of apple pectin or other fruit or vegetable pectin generally in an amount of about 2% by weight. Stearic acid may also be included in the composition in an amount of generally about 1% to 2% by weight of the composition. Excerpt(s): The present invention relates to a chemical composition and a method for reducing cholesterol as well accomplishing weight loss in humans, whereby a human ingests the chemical composition in recommended dosages prior to eating a meal, and thereby facilitates the binding of undigested fat to a fibrous agent for rapid elimination from the human body. In this day and age, many people's lifestyles have become less physically active. A natural result of a sedentary lifestyle is the tendency to gain weight. Indeed, it is commonly thought that many people are now over-weight with obesity being a growing problem. Due to this trend, countless efforts have been made to help people control their weight. As a few examples, many have proclaimed to have won the "battle of the bulge" with a specific diet program or a particular exercise program. Others have explored hypnosis and other mechanisms for controlling the appetite of an individual. Still others in the scientific arena have formulated sugar substitutes and are pursuing fat substitutes as methods to reduce the caloric intake of an individual hopefully, without sacrificing the taste of otherwise highly fattening foods. While these efforts are generally capable of aiding many in their fight to lose weight or to maintain a desired weight, many are in general, ineffective or simply not practical. For example, some good meaning souls have tried in earnest to follow a particular diet plan but eventually, fall off the plan lacking will-power to continue for weeks and months at a time. This is equally true of those who try hypnosis and similar weight-loss gimmicks. Finally, some view sugar substitutes as being tasteless or worse, as carrying an intolerable health risk, given that some studies have linked them to carcinogens and/or the formation of brain tumors. It has been appreciated in recent years that the fat content of foods eaten are a major culprit behind human weight gain. For example, regardless of the type of fat present in a food product, fat has the highest caloric value per gram-about 9 calories per gram--of any food group. It is understood that the body tends to store fat for future use, rather than to utilize it immediately, and this factor helps lead to weight-gain. However, in recent years it has been recognized, that there is a connection between the amount of fat stored in the body and the level of cholesterol in the body. A diet high in fat is more likely to result in the development of higher cholesterol levels. As cholesterol has been indicated as a factor in arteriosclerosis or hardening of the arteries, the risk for heart disease and/or a heart attack is elevated when a diet high in fat is followed. Unfortunately, fat also makes many food items more tasty--whether butter on bread, dressings on salads, sour cream on potatoes, or frosting on cake--and are therefore, difficult to eliminate entirely from one's diet. Thus, fat usually finds its

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way into the body. Once it does so, a healthy body automatically secretes lipase, an enzyme that accelerates synthesis of fats, i.e., breaking down the fat molecule. The majority of all fats in foods are present in "triglyceride form", which the body seeks to break down by removing the glycerol molecule from the triglyceride and thereby, release the free fatty acids. Once this occurs, the body is well on its way to absorbing the fat and likely, storing same instead of utilizing it for energy. Web site: http://www.delphion.com/details?pn=US06447812__ •

Composition that regulates and diminishes appetite and methods relating thereto Inventor(s): Mann; Morris A. (21669 N. 57th Ave., Glendale, AZ 85308) Assignee(s): none reported Patent Number: 6,468,988 Date filed: February 29, 2000 Abstract: A balanced composition of complex carbohydrate, protein, simple sugars, and lipids in the weight proportion of 3:2:1:1 substantially reduces appetite, even though the caloric composition is very low (about 240 cal per serving). This composition substantially facilitates weight loss, and increases exercise tolerance. It is designed for oral administration. Excerpt(s): This invention relates generally to appetite suppression and, more specifically, to a composition of a complex carbohydrate, protein, simple sugar and lipid in a proportion of about 3:2:1:1, which increases satiation, thereby resulting in a reduction of food and caloric intake and leading to a decrease in weight. Obesity caused by excessively high caloric intake and accumulation of surplus fat often leads to various types of degenerative diseases. Dieting, bariatrics, and cytotherapy are of major concern to patients who suffer from obesity-caused diseases, as well as to healthy people who, for cosmetic reasons, wish to control their caloric intake and thereby modify their appearance. Dieting often requires that significant limitations be placed on caloric intake, and the amount of fat and carbohydrates consumed are invariably diminished in a successful dietary plan. However, most diets invariably fail because of a lack of satiation on the part of the dieting individual who is accustomed to a higher caloric intake. Accordingly, there is a need in the art for a low calorie composition capable of inducing satiation for a substantial period of time. This invention fulfills these needs and provides other related advantages. Web site: http://www.delphion.com/details?pn=US06468988__

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Compositions containing compounds with adrenergic activity and vegetable extracts of Crataegus and gingko biloba for the treatment of overweight and obesity Inventor(s): Stankov; Bojidar M. (Milan, IT) Assignee(s): Ambros Pharma S.R.L. (Milan, IT) Patent Number: 6,447,818 Date filed: October 10, 2000 Abstract: Compositions containing compounds with adrenergic activity and an extract of Crataegus standardized in flavonoids, combined with an extract of Gingko biloba standardized in flavonglucosides in appropriate weight ratios are suitable for

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pharmaceutical administration or as food supplements for the treatment of weight loss and obesity in humans. The formulations are appropriate for the administration of the active ingredients in a form that increases patient compliance and the efficacy of the therapeutic or dietary intervention, but reduces the untoward effects of the compounds with adrenergic activity. Excerpt(s): This invention relates to compositions for the treatment of overweight and obesity. The management of body weight is a complex phenomenon that generally varies according to nutritive equilibrium. The amount of energy introduced with the intake of food and that used by the organism for the maintenance of vital functions (metabolism, respiration, thermoregulation, movement etc.) determines the energetic balance, which, if positive for long-term periods, inevitably leads to increased body weight and obesity. a) The loss of weight, obtained by a low-calorie diet, gives rise, as a defense mechanism, to an exacerbated attraction for food, especially carbohydrates which are transformed into fat by the organism. Subsequently, the temporary weight loss is replaced by a fast and often uncontrolled weight increase. Web site: http://www.delphion.com/details?pn=US06447818__ •

Comprehensive pharmacologic therapy for treatment of obesity Inventor(s): Hinz; Martin C. (1150 - 88th Ave. W., Duluth, MN 55808) Assignee(s): none reported Patent Number: 6,548,551 Date filed: August 30, 2001 Abstract: The comprehensive pharmacologic therapy for treatment of obesity is a procedure which involves the administration of a desired therapeutic range of Diethylpropion and/or Phentermine in combination with a SSRI medication and nutritional supplementation for brief and long durations which may be 12 months or more. The preferred procedure involves the administration of drugs in combination which are identified as: Citalopram (Celexa) and Phentermine; Citalopram (Celexa) and Diethylpropion; Citalopram (Celexa), Phentermine, and Diethylpropion. In addition nutritional supplementation such as a multivitamin, 5-Hydroxytryptophan, vitamin B6, vitamin C, Tyrosine, Calcium, and Lysine may be used to enhance the performance of the weight loss treatment program. Excerpt(s): The medications stop working during therapy where at least 40% to 50% of patients quit losing weight (plateau) on an average of 3.3 months into therapy; and 5% to 8% of patients who receive drug therapy for weight problems experience the complication where the medications fail to assist in appetite suppression where the patient therefore does not lose significant weight. In the past long term treatment, defined as treatment longer than 3 months to many years, with drugs has been a problem due to long term safety issues including, medication intolerability by the patient, medication side effects and most important ineffectiveness of the drugs or the cessation of benefit of the drugs which in turn causes the patient to fall out of appetite suppression and terminate weight loss. A weight loss procedure using SSRI medication is disclosed in U.S. Pat. No. 5,795,895. The potential for patients to obtain goal weight loss under the process of U.S. Pat. No. 5,795,895 is low, and the failure of the drugs to provide a desired level of performance is at the heart of the problem. Web site: http://www.delphion.com/details?pn=US06548551__

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Drinking water additive for birds and method of administering the same Inventor(s): Horikawa; Hiroshi (117-924, Awacho, Kuroiso-shi, Tochigi 325-0073, JP), Miyazaki; Hiroshi (2-22-11, Kamishakujii, Nerima-ku, Tokyo 177-0044, JP), Marubashi; Toshihiro (1928-9, Hashiecho, Isezaki-shi, Gunma 372-0001, JP), Iwasaki; Kazuya (Kopo S1 211, 77-192, Suehirocho, Kuroiso-shi, Tochigi 325-0061, JP) Assignee(s): none reported Patent Number: 6,422,174 Date filed: April 10, 2000 Abstract: Disclosed is a poultry drinking water additive containing live bacteria of the genus Bacillus and monosaccharides, which can alleviate body weight loss of poultry for meat production after feed withdrawal before slaughter, and which can reduce harmful bacteria such as of the genus Salmonella in the intestine of poultry for meat production and layers during the period of fasting by feed withdrawal. Also disclosed are a method for orally administering the poultry drinking water additive to poultry, a method for alleviating body weight loss of poultry for meat production using this method, and a method for reducing harmful bacteria in the intestine of poultry for meat production or layers. Excerpt(s): The present invention relates to a poultry drinking water additive which is effective in alleviating body weight loss of poultry, in particular poultry for meat production, after feed withdrawal before slaughter of the poultry, and which is effective in reducing harmful bacteria, such as of the genus Salmonella, in the intestine of poultry. The present invention also relates to a method for administering such an additive to poultry, a method for alleviating body weight loss of poultry for meat production, as well as a method for reducing harmful bacteria in the intestine of poultry for meat production or layers. It is known that live bacteria of the genus Bacillus have effects of improving physical condition of poultry (JP-B-61-59092) and suppressing pathogenic bacteria (JP-A-9-163937). In particular, it is already known that Bacillus subtilis C-3102 (FERM BP-1096) is useful for promoting weight gain of poultry (JP-B-3-79988) and for reducing bacteria of the genus Salmonella in the intestine of poultry (Japanese Patent No. 2528055). However, it is merely known that live bacteria of the genus Bacillus exhibit such effect when the bacteria are mixed in with powdered feed. It is not known to add the live bacteria to drinking water, much less to administer the live bacteria to poultry for meat production after feed withdrawal before slaughter. Web site: http://www.delphion.com/details?pn=US06422174__

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Electrical system for weight loss and laparoscopic implanation thereof Inventor(s): Zikria; Bashir A. (Norwood, NJ) Assignee(s): The Trustees of Columbia University in the City of New York (New York, NY) Patent Number: 6,564,101 Date filed: August 2, 2000 Abstract: An electrical device utilized to control the body weight of a medically overweight human being comprises of at least two electrical leads for implanting on the fundus of the stomach. An electrical generator/controller (pacemaker) generates and

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regulates the frequency and degree of electrical stimulation. The device can be used surgically, laproscopically, and/or endoscopically. Excerpt(s): The present invention relates generally to the field of weight loss devices and more particular to the field of electrical devices employed in the treatment of seriously overweight human beings. The treatment of obesity has taken many different forms. Among these is the use of prescription or non-prescription drugs or other ingestible preparations designed to suppress the appetite or to induce satiety. Another type of treatment comprises dietary menus selected to reduce caloric intake, often in combination with a regimen of exercise. In advance or extreme cases, the treatment of obesity has included more radical techniques such as stapling or re-sectioning of the stomach or wiring the jaws shut. In general, these and other prior techniques for treating obesity have intended to produce only a temporary effect. After the initial weight loss and typical plateauing of further loss, the individual usually becomes discouraged and reverts to previous behavior. The more radical techniques employed for treating extreme cases are sufficiently drastic to warrant consideration of methods which are less intrusive and more easily tolerated by the patient. Web site: http://www.delphion.com/details?pn=US06564101__ •

Formulations and use of controlled-release indole alkaloids Inventor(s): Jacobs; Irwin C. (Eureka, MO), Zeligs; Michael A. (Boulder, CO) Assignee(s): BioResponse, L.L.C. (Boulder, CO) Patent Number: 6,416,793 Date filed: July 11, 2000 Abstract: The present invention relates to spray dried hydrophobic phytochemical (i.e., yohimbine and ibogaine) compositions, a process for making such compositions and a method of using such compositions for, e.g., the promotion of weight loss. Typically, the hydrophobic dietary compositions of the present invention exhibit enhanced absorptivity when taken orally. Excerpt(s): This invention relates to the use of a new formulation of indole phytochemicals to promote their absorption. In particular, the phytochemicals suitable for use according to the present invention are the indoles found in extracts of the bark of Pausinystalia yohimbe (yohimbine, corynanthine and rauwolscine) and ibogaine, a chemical derived from the rain forest shrub Tabernanthe iboga. The compositions of the invention may be formulated starting from the natural material in which the indole phytochemical is naturally found (i.e., bark or bark extracts) or from the pure dietary indoles themselves. Preparations of such phytochemicals are described which promote improved absorption of insoluble dietary substances and promote the effects of said phytochemicals. This facilitated absorption of poorly soluble dietary substances amplifies the useful dietary influences of such substances. Some phytochemicals found in edible plants have importance in health promotion due to activity which promotes improved fat metabolism. This activity results from support for the action of catecholamine hormones which trigger the release of stored fatty acids from fat cells. Yohimbine is a dietary indole and one of a family of stereoisomers (i.e., yohimbine, corynanthine and rauwolscine) found in extracts from the bark of Pausinystalia yohimbe. This group of compounds posses a number of uses as modulators of catecholamine hormone action. Apart from possible medical uses as an anti-depressant, as a therapy for male impotence, and to promote salivation, an important application of

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yohimbe alkaloids is as a means of inducing mobilization of stored fat through blocking the action of catecholamines at.alpha.-adrenergic receptors. Blocking the.alpha.2adrenergic receptors on the surface of fat cells (adipocytes) results in greater influence of competing.beta.-adrenergic receptors promoting more active breakdown and release of stored triglycerides. This causes the release of non-esterified free fatty acids into the general circulation for use as a metabolic energy source during dieting and exercise (Lafontan and Betuing, "Regulation of Fat-Cell Function by.alpha.-2 Adrenergic Receptors," Advances in Pharmacology, 42, 496-8 (1998)). This peripheral action of yohimbe alkaloids combines with a separate central nervous system activity and the subsequent.alpha. adrenergic blocking results in suppression of appetite. Together these actions make Pausinystalia yohimbe alkaloids desirable as compounds to facilitate weight loss in overweight and obese individuals. Web site: http://www.delphion.com/details?pn=US06416793__ •

Health monitoring and diagnostic device and network-based health assessment and medical records maintenance system Inventor(s): Moody; James L. (Wilsonville, OR), Clegg; Kenneth D. (Mead, WA), Nesbitt; Kenn A. (Spokane, WA), Connolly; Jackson B. (Post Falls, ID), Maus; Christopher T. (Sagle, ID), Coad; Noah M. (Cataldo, ID), Coad; Craig A. (Cataldo, ID) Assignee(s): Lifestream Technologies, Inc. (Post Falls, ID) Patent Number: 6,602,469 Date filed: November 8, 1999 Abstract: A health monitoring and diagnostic device (LIFESTREAM cholesterol meter) configured as a self-contained testing and diagnostic unit in a clam-shell type case. One side of the case includes a spring-loaded finger stick and a compartment for carrying one or more packages of disposable items including a test strip, a needle for the finger stick, and an alcohol swipe. The other half of the case includes a test strip reader, a key pad, and a liquid crystal display. The meter reads a test strip carrying a droplet of blood and receives additional diagnostic information from the patient, such as age, gender, weight, and family history of heart disease. Within minutes, the meter displays test results, including total cholesterol levels. The meter also displays additional diagnostic results, such as the patient's "cardiac age," recommended weight loss, and a cardiac risk assessment. The meter also works in connection with a network-based comprehensive health analysis and reporting system. The meter writes patient data to a smartcard. This patient data typically includes patient identification information, the test results, the diagnostic information, and the diagnostic results. A computer station reads the smartcard and establishes a network connection with a health report server over the Internet. The computer then downloads the patient data to the health report server, which prepares a comprehensive health report. Within minutes, this report is transmitted back to the computer station, where it is printed out and delivered to the patient. Excerpt(s): The hand-held LIFESTREAM cholesterol meter drastically reduces the costs and inconvenience associated with obtaining cholesterol tests by performing total cholesterol tests in virtually any location, including a physician's office, a pharmacy, a clinic, or in the privacy of the patient's home. The meter produces the test results within minutes using on-board circuitry and programming. The meter also includes an onboard diagnostic program that prompts for additional diagnostic information, such as the patient's age, gender, weight, family history of heart disease, blood pressure, and so

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forth. The meter then translates this diagnostic information, along with the test results, into diagnostic results that may be more meaningful to the user than the test results alone. For example, the meter may use a well-known methodology, such as the Framingham Medical Study, to produce diagnostic results including the user's cardiac age (as compared to chronological age), recommended weight loss, 5-year risk of heart attack, 10-year risk of heart attack, an assessment of stroke risk, and other results that will be easily and immediately understood by the patient. Like the test results themselves, these more meaningful diagnostic results are displayed on the meter within minutes. Producing diagnostic results like "cardiac age" and "5-year risk of heart attack" rather than total cholesterol levels alone may motivate more people to change their lifestyles and reduce their cholesterol levels. Moreover, producing these diagnostic results instantaneously, inexpensively, and in a convenient location encourages frequent testing and provides patients with the positive feedback necessary to encourage continued compliance with drug therapies and lifestyle changes. Ultimately, widespread use of the LIFESTREAM cholesterol meter can be expected to improve cardiac health nationwide, shift the focus of cardiac treatment from corrective to preventative, improve the cardiac health of the population in general, and reduce medical costs and health insurance rates. Web site: http://www.delphion.com/details?pn=US06602469__ •

Herbal composition and method for controlling body weight and composition Inventor(s): Xu; Xiurong (Building Li Ze San Lou, Apt. 6-401, Dormitory of Beijing Normal University, Beijing, CN), Wei; Kaiyuan (late of Beijing, CN) Assignee(s): none reported Patent Number: 6,541,046 Date filed: January 17, 2002 Abstract: The present invention relates to a dietary supplement for the treatment of obesity, including both weight loss and reduction of weight gain. Pursuant to the invention, a decoction of a herbal mixture, comprising rhubarb, red saga root, astragalus, turmeric, and dried ginger and various combinations thereof, provides therapeutic weight loss as well as lipid reduction and change body composition. The invention includes methods of manufacture and administration and also includes the herbal decoction in various forms of administration and in combination with food. Excerpt(s): This application claims priority to Chinese Patent Application No. 01103777.6 filed Feb. 12, 2001, entitled "COMPOSITION AND METHOD FOR EFFECTING WEIGHT REDUCTION" and the disclosure is hereby incorporated by reference. The present invention generally relates to dietary supplements and foods for reducing weight gain, effecting weight loss and causing favorable changes in body composition. More specifically, the invention relates to the field of herbal compositions, especially decoctions for oral administration containing rhubarb and other herbal ingredients. Body weight and body composition is determined by the competing balance of food intake and energy expenditure. Although both genetic and environmental factors can contribute to obesity, the most common cause of weight gain and an overweight body composition is excessively high caloric intake accompanied by a lack of physical activity. The resulting accumulation of surplus fat places overweight or obese individuals at increased risk of illness from hypertension, lipid disorders, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, certain cancers, and a wide variety of other diseases and undesired

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physiological conditions, as well as overall mortality. According to a study, the proportion of overweight individuals in the United States increased from 25% in 1980 to 33% in 1991. (Third National Health and Nutrition Examination Survey, 1991). In 1998 the National Institutes of Health reported that over 55 percent of the U.S. population are now considered overweight or obese. (Obesity Clinical Guidelines: NIH Statement Jun. 3, 1998, press release). Web site: http://www.delphion.com/details?pn=US06541046__ •

Herbal weight loss supplement Inventor(s): Vital; Odilza (Av. Ary Parreiras N.degree. 327, Niteroi, RJ 24230-320, BR), Kurk; Mitchell (310 Broadway, Lawrence, NY 11559) Assignee(s): none reported Patent Number: 6,428,806 Date filed: September 19, 2001 Abstract: A dietary supplement composition includes an effective amount of garcinia cambogia, glucomanan, guar gum, and chromium picolinate in a freely soluble powder form which can be added to a variety foods and water. Alternately, the composition includes an effective amount of chitosan. Preferably, the composition is administered three times per day by mixing it with liquid-based foods and water. Excerpt(s): The present invention relates to compositions for reducing weight, maintaining weight loss over an extended period of time, and diminishing the appetite. It finds particular application in conjunction with herbal compositions for reducing weight in humans and will be described with particular reference thereto. However, it is to be appreciated that the present invention will also find application in reducing weight in domestic animals. It is a well-established fact that being overweight and obesity are unhealthy conditions. These conditions are associated not only with social stigma, but are also associated with decreased longevity and numerous medical problems, such as diabetes, reproductive disorders, dermatological disorders, varicose veins, and heart disease. Existing therapies for people who are overweight or obese include treatments to establish a negative energy balance. This may be accomplished by reduction of energy intake, such as a low calorie diet, or an increase in energy expenditure, such as increased physical exercise. In addition, treatments include ingestion of sympathomimetic drugs which stimulates thermogenesis, i.e. increases the metabolic rate. Known thermogenic drugs include ephedrine, phenylpropanolamine, and caffeine. However, such drugs are rather ineffective. Web site: http://www.delphion.com/details?pn=US06428806__

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Ink composition for inkjet recording and inkjet recording process Inventor(s): Ouchi; Akemi (Ibaraki, JP), Maekawa; Tsutomu (Ibaraki, JP), Kakuta; Atsushi (Ibaraki, JP) Assignee(s): Hitachi Printing Solutions, Ltd. (Ebina, JP) Patent Number: 6,641,652 Date filed: March 23, 2001

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Abstract: An ink composition for use in an on-demand inkjet printer capable of printing on plain paper at a recording rate of 10 ips or higher, which ink composition comprises at least a pigment and non-pigment components including at least water and a thickening agent and shows a weight loss ratio at 25.degree. C. and 60 RH % for 30 minutes of 5 to 25% based on the total weight of the ink. Also disclosed is an on-demand inkjet recording process using the ink composition. Excerpt(s): This invention relates to an inkjet ink composition for use in an inkjet recording apparatus for conducting recording on plain paper at a high speed. As an ink composition for use in inkjet recording, there have so far been widely used watersoluble liquid ink compositions. However, when printing is conducted on plain paper popularly used in offices such as copying paper, the printed ink spreads along fibers of the paper, thus shape of dots becoming irregular to generate so-called blurring which deteriorates quality of printed products. Various improvements have so far been made in order to remove blurring and improve drying properties. For example, Japanese Patent Publication No. 34992/1985 proposes to reduce surface tension of ink and enhance drying properties of ink by using a large quantity of a surface active agent. Japanese Patent Laid-Open No. 108271/1983 describes a method of recording by using a hot-melt ink composition containing a substance which is solid at room temperature, such as wax. Further, U.S. Pat. Nos. 4,391,369 and 4,484,948 describe an ink composition which provide good printing quality regardless of the properties of paper. Web site: http://www.delphion.com/details?pn=US06641652__ •

Intermediate film for laminated glass and laminated glass Inventor(s): Miyai; Jiro (Shiga, JP), Shohi; Hajime (Shiga, JP), Hattori; Tsuyoshi (Mie, JP) Assignee(s): Sekisui Chemical Co., Ltd. (Osaka, JP) Patent Number: 6,586,103 Date filed: March 22, 2002 Abstract: This invention has its object to provide an interlayer film for laminated glass an interlayer film for laminated glass which, when assembled into laminated glass, offers good transparency, weathering resistance, adhesion, penetration resistance and other characteristics, does not cause marginal whitening of laminated glass even exposed to a highly humid atmosphere, and free from the risk for a fire hazard in autoclaving or the problem associated with edge trimming and a laminate glass comprising said interlayer film.This invention is related to an interlayer film for laminated glass comprising a plasticized poly(vinyl acetal) resin film,wherein, when a laminated glass fabricated by interposing said interlayer film between a pair of glass sheets each 2.0 to 4.0 mm thick is allowed to sit in an environment of 80.degree. C. and 95% relative humidity for 2 weeks, the distance of whitening from its edge is not greater than 7 mm, andwhen said interlayer film for laminated glass is allowed to sit at 150.degree. C. for 1 hour, its weight loss is not greater than 3 weight %. Excerpt(s): The present invention relates to an interlayer film for laminated glass characterized by high moisture resistance and small plasticizer vapor emanation, and a laminated glass in which said interlayer film is used. Laminated glass comprising at least two glass sheets with a plasticized poly(vinyl acetal) resin interlayer film interposed has the fundamental characteristics required of laminated glass, namely good transparency, high weathering resistance, and high penetration resistance scarcely allowing its fragments to scatter and, as such, has been used extensively as the

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laminated glass for automotive and architectural use. Although such laminated glass is satisfactory in said fundamental characteristics and safety, it is not only poor in moisture resistance but has the drawback of emanating a substantial amount of vapor due to the plasticizer contained. Web site: http://www.delphion.com/details?pn=US06586103__ •

Magnetic nerve stimulation seat device Inventor(s): Davey; Kent R. (New Smyrna Beach, FL), Epstein; Charles M. (Atlanta, GA) Assignee(s): Neotonus, Inc. (Marietta, GA) Patent Number: 6,500,110 Date filed: February 10, 2000 Abstract: A magnetic nerve stimulator system is comprised of a core constructed from a material having a high field saturation with a coil winding. A thyrister capacitive discharge circuit pulses the device. A rapidly changing magnetic field is guided by the core, preferably vanadium permendur. For task specific excitation of various nerve groups, specially constructed cores allow for excitation of nerves at deeper levels with higher efficiency than is possible with air-core stimulators. Among the applications possible with this invention are treatment of incontinence, rehabilitation of large muscle groups in the leg and arm, and excitation of abdominal wall muscle groups to aid in weight loss and metabolic rate increase. A C-shape is employed for focussing the stimulation as desired. Excerpt(s): A nerve cell can be excited in a number of different ways, but one direct method is to increase the electrical charge within the nerve, thus increasing the membrane potential inside the nerve with respect to the surrounding extracellular fluid. One class of devices that falls under the umbrella of Functional Electrical Stimulation (FES) realizes the excitation of the nerves by directly injecting charges into the nerves via electrodes which are either placed on the skin or in vivo next to the nerve group of interest. The electric fields necessary for the charge transfer are simply impressed via the wires of the electrodes. The advantage of FES is that the stimulation can usually be accomplished from extremely small electrodes with very modest current and voltage levels. The disadvantage however, is that it involves half-cell reactions. Most rehabilitation programs using FES place the electrodes directly on the skin. A conductive gel or buffering solution must be in place between the electrodes and the skin surface. Long term excitation of nerve or muscle tissue is often accompanied by skin irritation due to the current concentration at the electrode/skin interface. This problem is especially aggravated when larger excitation levels are required for more complete stimulation or recruitment of the nerve group. The present invention is especially targeted at applications that are not suited for the use of implanted electrodes. The invention is designed for non-invasive external stimulation of selected nerve or nerve groups, particularly in certain applications. In these applications, which include incontinence and rehabilitation of muscle groups as well as potential weight loss treatment, the desired excitation levels using FES often fall outside of what might be considered comfortable limits. That is, the electrical current that ideally would be injected through the skin to excite the muscle groups of interest often leads to some skin irritation with time. The invention can also be used even in applications where this is not the case, as the use of gels and direct electrode/skin placement is inconvenient and is often resisted by the patient.

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Web site: http://www.delphion.com/details?pn=US06500110__ •

Master batch pigment, toner including the master batch pigment and method for manufacturing the toner Inventor(s): Sugiyama; Shoichi (Gotemba, JP), Kuroda; Noboru (Tagata-gun, JP) Assignee(s): Ricoh Company Limited (Tokyo, JP) Patent Number: 6,569,590 Date filed: August 24, 2001 Abstract: A method is provided for manufacturing a master batch pigment fora toner, including the steps of mixing a dry pigment powder, a binder resin and water to prepare a mixture thereof; and kneading the mixture upon application of heat to prepare the master batch pigment, wherein the master batch pigment has a weight loss of from 0.01 to 1.0% when heated at 110.degree. C. for 2 hrs. Excerpt(s): The present invention relates to a master batch pigment and a toner including the master batch pigment as well as a method for manufacturing the toner. (2) the composition is cooled, pulverized and classified into toner having a volume average diameter of from about 6 to about 10.mu.m. Particularly, a color toner for electrophotography, which is used to form a colored image, is typically formed from a binder resin, in which various coloring dyes or pigments are dispersed. Requisites for such a color toner are more severe than that for a black toner. Namely, a color toner is required to have color reproducibility and optical transmittance (i.e., transparency) when used for an over head projector (OHP) in addition to mechanical and electrical stability. Web site: http://www.delphion.com/details?pn=US06569590__

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Method and apparatus for analyzing casing wear and retrieval of metallic fragments Inventor(s): Holland; Don (Bakersfield, CA), Cesmat; Mark (Bakersfield, CA) Assignee(s): Cesmat Service Company, Inc. (Bakersfield, CA) Patent Number: 6,453,738 Date filed: April 10, 2001 Abstract: A method and apparatus for retrieving magnetic casing fragments from a well using a shrouded magnet are disclosed. Retrieving casing fragments allows the determination of weight loss from the casing to assist in analyzing the integrity and the condition of the casing and to determine whether more expensive analysis is required. The shrouded magnet, that is formed by a non-magnetic container enclosing a source of magnetic field, recovers metal casing fragments by attracting them and other magnetic materials from oil and gas well fluids passing by the shrouded magnet device, which fragments are easily separated from the device by removing the source of magnetic field from the container. Excerpt(s): The present invention relates to an apparatus and method for removing magnetic materials from fluids discharged from a well, and more particularly to an apparatus and method for removing casing fragments from drilling and workover fluids which are circulated in oil and gas wells to ascertain the metal loss from the casing lining the bore of the well. In the drilling of oil and gas wells, drilling fluid, commonly

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referred to as "mud," is used for a variety of purposes, including: (1) maintaining hydrostatic pressure on the zones being drilled to maintain control over high pressure zones; (2) removing drill cuttings from the well and the face of the bit; and (3) to assist in drilling by the jetting action of the drilling fluid through the nozzles of the bit. Drilling fluid is commonly circulated down the string of drill pipe, pumped through the nozzles of the bit, and circulated out of the well through the annulus between the drill pipe and the casing and/or open hole. Once the drilling fluid returns to the surface, the fluid is circulated through various pieces of equipment to remove cuttings and solids so that the drilling fluid may be recirculated back into the wellbore. As a well is drilled, steel casing is commonly inserted and cemented in the well to line those portions of the well already drilled. The casing protects the well from collapse, cave-in, and provides control over pressurized zones. In the course of drilling a well, multiple strings of casing may be inserted into the well, each subsequently installed casing string a smaller diameter than the previously installed casing string. Once a casing string is cemented in place, drilling operations may continue by drilling out through the casing "shoe." In some cases, such as when the lower portion of a well is lost, or if a well is being redrilled, the casing wall will be intentionally drilled through or milled in order to side-track the well, and drill in a different direction. However, at other times the casing wall is penetrated unintentionally. It is known that when drilling, and when completion and workover tools are run through or operated inside of the casing, casing damage may occur. Often, the tolerances between the inside diameter of the casing and the outside diameter of the drill bit, drilling assembly, or other tools are tight, causing casing wear or puncture. Casing may also be damaged from continued rotation of the drilling assembly or drill pipe inside the casing, repeated trips of tools, the drilling assembly and drill pipe through the casing, or down hole conditions which result in the drill bit penetrating the wall of the casing rather than drilling through the casing shoe or formation. Because the casing protects the integrity of an oil and gas well, and protects the surrounding environment from releases of hydrocarbons from the well bore, it is important and useful to monitor the condition of the casing strings, particularly during drilling and workover operations. Web site: http://www.delphion.com/details?pn=US06453738__ •

Method for detecting anaerobic threshold and prescribing a training zone to maximize fat utilization or improved cardiovascular fitness Inventor(s): Snow; Michael G. (White Bear Lake, MN), Kaeferlein; Bernhard H. (Brooklyn Park, MN), Thieret; Jeffrey G. (Shoreview, MN) Assignee(s): Medical Graphics Corporation (St. Paul, MN) Patent Number: 6,554,776 Date filed: November 21, 2001 Abstract: A method for prescribing an exercise regimen for a particular subject to either maximize cardiovascular performance or to lose weight involves the use of a microprocessor-based cardiopulmonary exercise system to measure oxygen uptake and carbon dioxide production on a breath-by-breath basis. These measured quantities are used to calculate energy expenditure and a subject's respiratory exchange ratio from which a fat metabolization curve can be plotted. By examining the length of a plateau in the curve where the fat substrate utilization is maximized, and noting the average heart rate in this zone, a target heart rate for optimal weight loss is arrived at. If the goal of the exercise is cardiovascular improvement, the anaerobic threshold can readily be

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determined as the midpoint between maximal fat utilization and the maximum acceleration towards the point where the respiratory exchange ratio becomes equal to 1 or the fat metabolism goes to 0. By noting the average heart rate at the anaerobic threshold, a target heart rate for optimizing cardiovascular fitness may be arrived at. Excerpt(s): This invention relates generally to a method for prescribing an exercise regimen for a particular subject, and more particularly to a method for correlating a heart rate or work rate to be maintained throughout an exercise session if the desired goal of the exercise is to reduce fat or to improve cardiovascular performance. As is explained in the Acorn et al. U.S. Pat. No. 5,297,558, which is assigned to applicant's assignee, it is well recognized that frequent exercise is beneficial to most individuals so long as it is properly engaged in, taking into account the individual's own physiologic condition. It is important that the exercise regimen not be so intensive that it adversely affects the general well being of the subject, yet not too light that it provides little or no benefit. It is well understood that with increasing exercise, muscles need to bum metabolic fuels to perform mechanical work. Carbohydrates and fat are the typical sources of fuel and must be oxidized, using molecular O.sub.2 from the atmosphere to effectively provide energy. A normal response to exercise is to increase the blood flow to the working muscles, which carries oxygen and removes carbon dioxide, the bi-product of biologic metabolism. The increasing demands for oxygenated blood are met by increasing the cardiac output (increased heart rate and increased stroke volume) and redistributing the blood flow to the working muscles and away from the abdominal area. Web site: http://www.delphion.com/details?pn=US06554776__ •

Method for reducing adverse effects of a weight loss regimen Inventor(s): Pariza; Michael W. (Madison, WI), Atkinson, Jr.; Richard L. (Fitchburg, WI) Assignee(s): Wisconsin Alumni Research Foundation (Madison, WI) Patent Number: 6,482,434 Date filed: April 4, 2000 Abstract: A method for reducing certain effects associated with a negative calorie balance in a human includes the step of administering conjugated linoleic acid to a human in an amount effective to reduce at least one of the effects. Excerpt(s): Not applicable. Not applicable. The percentage of persons whose health is jeopardized by too much weight is increasing. Evidence suggests that body weight is multifactorial in origin, reflecting inherited, environmental, cultural, socioeconomic, and psychological conditions. Increasing evidence suggests that being overweight is not a simple problem of will power, as is sometimes implied, but is a complex disorder of appetite regulation and energy metabolism. Many persons have a chronic tendency for becoming overweight that needs lifelong attention. Strategies employed to lose weight include caloric restriction, exercise, behavior modification, drugs, or combinations thereof, with or without medial supervision. Some attempts may be successful in the short term, but often the weight lost is regained. Efforts to lose weight voluntarily encompass a continuum of individuals including those of normal or low weight who wish to lose weight for cultural, social, or psychological reasons to severely overweight persons who suffer resulting adverse medical consequences. Web site: http://www.delphion.com/details?pn=US06482434__

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Method of weight reduction in human beings Inventor(s): Raider; Stanley (462 Hacienda Ave., Campbell, CA 95008) Assignee(s): none reported Patent Number: 6,573,083 Date filed: August 24, 2000 Abstract: A method of weight reduction in human beings, wherein a human ingests a laxative effective dosage of non-pathogenic Escherichia coli to produce a weight loss of up to two pounds within one week. Excerpt(s): There are many different systems available to the individual seeking to lose weight. They run the gamut from ingesting drugs, both prescription and over-thecounter, to single component diets, i.e. `low fat`, `high protein`, `low carbohydrate`, with exercise. All of the foregoing regimens require some form of life-style change. This invention, utilizing a bacteriological agent only, which is an integral part of the GastroIntestinal Tract, will create a measureable loss of weight in a given time period, i.e. up to two [2] pounds in one week. A laxative effective dose of this bacteriological agent [Prototrophic E. coli] taken with a meal will cause an accelerated laxation within two [2] hours. This phenomenon will create the weight loss. Web site: http://www.delphion.com/details?pn=US06573083__

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Methods and compositions for producing weight loss Inventor(s): Kuhrts; Eric H. (P.O. Box 387, 1109 Tannery Creek Rd., Bodega, CA 94922) Assignee(s): none reported Patent Number: 6,475,530 Date filed: October 4, 2000 Abstract: Dislcosed are methods and compositions for producing weight loss in a mammal by administration of a composition containing a weight loss effective amount of a noradrenaline stimulating compound such as ephedrine, mahuang (a plant source of ephedrine alkaloids), citrus aurantium (bitter orange), synephrine, norephedrine, psuedophedrine, a methylxanthine, such as caffeine or guarana, and a botanical COX inhibitor such as resveratrol polygonum cuspidatum, scutellaria baicalensis, turmeric, curcumin, rosmary, green tea, ocimum sanctum (holy basil), or ginger, instead of an NSAID such as aspirin, and optionally a free fatty acid reducing compound. The thermogenic formula is coupled with a growth hormone stimulating formulation containing L-arginine or L-omithine, L-lysine, and a free fatty acid reducing agent such as nicotinic acid. The thermogenic formula would preferably be administered in the daytime, and the growth hormone producing formula at nighttime. The two compositions form a system of AM and PM weight loss strategy for the therapeutic intervention of obesity. Excerpt(s): This invention relates to methods and compositions for producing weight loss in mammals. One of the greatest problems confronting modem society in economically successful countries today is obesity. Unfortunately, obesity brings with it the conditions that are ripe for the more serious disease of diabetes. Among the many possible solutions for treating obesity are formulations of weight loss products that work with some of the basic biochemical processes involved in fat metabolism. This process has been exploited through pharmaceutical intervention at the neurocrine level

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as well as at the level of fat cells themselves, or the way fat cells metabolize fats in brown adipose tissue. Web site: http://www.delphion.com/details?pn=US06475530__ •

Methods of treatment with compounds having RAR.alpha. receptor specific or selective activity Inventor(s): Duong; Tien T. (Irvine, CA), Chandraratna; Roshantha A. (Mission Viejo, CA), Teng; Min (Aliso Viejo, CA) Assignee(s): Allergan, Inc. (Irvine, CA) Patent Number: 6,610,744 Date filed: November 29, 2001 Abstract: Retinoid compounds which act specifically or selectively on RAR.sub.alpha. receptor subtypes in preference over RAR.sub.beta. and RAR.sub.GAMMA. receptor subtypes, posses desirable pharmaceutical properties associated with retinoids, and are particularly suitable for treatment of tumors, such as acute monocytic leukemia, cervical carcinoma, myeloma, ovarian carcinomas and head and neck carcinomas, without having one or more undesirable side effects of retinoids, such as inducement of weight loss, mucocutaneous toxicity, skin irritation and teratogenecity. Excerpt(s): The present invention relates to the use of compounds which have specific or selective agonist like activity on RAR.sub.alpha. retinoid receptors for treatment of diseases and conditions which respond to treatment by such retinoids. More particularly the present invention is directed to the use of RAR.sub.alpha. receptor specific or selective agents for the treatment of tumors. Compounds which have retinoid-like activity are well known in the art, and are described in numerous United States and other patents and in scientific publications. It is generally known and accepted in the art that retinoid-like activity is useful for treating animals of the mammalian species, including humans, for curing or alleviating the symptoms and conditions of numerous diseases and conditions. In other words, it is generally accepted in the art that pharmaceutical compositions having a retinoid-like compound or compounds as the active ingredient are useful as regulators of cell proliferation and differentiation, and particularly as agents for treating skin-related diseases, including, actinic keratoses, arsenic keratoses, inflammatory and non-inflammatory acne, psoriasis, ichthyoses and other keratinization and hyperproliferative disorders of the skin, eczema, atopic dermatitis, Darriers disease, lichen planus, prevention and reversal of glucocorticoid damage (steroid atrophy), as a topical anti-microbial, as skin anti-pigmentation agents and to treat and reverse the effects of age and photo damage to the skin. Retinoid compounds are also useful for the prevention and treatment of cancerous and precancerous conditions, including, premalignant and malignant hyperproliferative diseases such as cancers of the breast, skin, prostate, cervix, uterus, colon, bladder, esophagus, stomach, lung, larynx, oral cavity, blood and lymphatic system, metaplasias, dysplasias, neoplasias, leukoplakias and papillomas of the mucous membranes and in the treatment of Kaposi's sarcoma. In addition, retinoid compounds can be used as agents to treat diseases of the eye, including, without limitation, proliferative vitreoretinopathy (PVR), retinal detachment, dry eye and other corneopathies, as well as in the treatment and prevention of various cardiovascular diseases, including, without limitation, diseases associated with lipid metabolism such as dyslipidemias, prevention of post-angioplasty restenosis and as an agent to increase the level of circulating tissue plasminogen activator (TPA). Other uses for retinoid compounds include the prevention

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and treatment of conditions and diseases associated with human papilloma virus (HPV), including warts and genital warts, various inflammatory diseases such as pulmonary fibrosis, ileitis, colitis and Krohn's disease, neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease and stroke, improper pituitary function, including insufficient production of growth hormone, modulation of apoptosis, including both the induction of apoptosis and inhibition of T-cell activated apoptosis, restoration of hair growth, including combination therapies with the present compounds and other agents such as Minoxidil.sup.R, diseases associated with the immune system, including use of the present compounds as immunosuppressants and immunostimulants, modulation of organ transplant rejection and facilitation of wound healing, including modulation of chelosis. U.S. Pat. No. 4,740,519 (Shroot et al.), U.S. Pat. No. 4,826,969 (Maignan et al.), U.S. Pat. No. 4,326,055 (Loeliger et al.), U.S. Pat. No. 5,130,335 (Chandraratna et al.), U.S. Pat. No. 5,037,825 (Klaus et al.), U.S. Pat. No. 5,231,113 (Chandraratna et al.), U.S. Pat. No. 5,324,840 (Chandraratna), U.S. Pat. No. 5,344,959 (Chandraratna), U.S. Pat. No. 5,130,335 (Chandraratna et al.), Published European Patent Application Nos. 0 170 105 (Shudo), 0 176 034 A (Wuest et al.), 0 350 846 A (Klaus et al.), 0 176 032 A (Frickel et al.), 0 176 033 A (Frickel et al.), 0 253 302 A (Klaus et al.), 0 303 915 A (Bryce et al.), UK Patent Application GB 2190378 A (Klaus et al.), German Patent Application Nos. DE 3715955 A1 (Klaus et al.), DE 3602473 A1 (Wuest et al., and the articles J. Amer. Acad. Derm. 15: 756-764 (1986) (Sporn et al.), Chem. Pharm. Bull. 33: 404-407 (1985) (Shudo et al.), J. Med Chem. 1988 31, 2182-2192 (Kagechika et al.), Chemistry and Biology of Synthetic Retinoids CRC Press Inc. 1990 p 334-335, 354 (Dawson et al.), describe or relate to compounds which include a tetrahydronaphthyl moiety and have retinoid-like or related biological activity. Web site: http://www.delphion.com/details?pn=US06610744__ •

Personal computer breath analyzer for health-related behavior modification and method Inventor(s): Cranley; Paul E. (Lake Jackson, TX), Strickland; Alan D. (Lake Jackson, TX), McDonald; Charles J. (Midland, MI), Schrock; Alan K. (Lake Jackson, TX), Miller; Ted E. (Midland, MI), Crane; Scott P. (San Diego, CA), Bartels; Michael J. (Midland, MI), Tate; James D. (Lake Jackson, TX) Assignee(s): Dow Global Technologies Inc. (Midland, MI) Patent Number: 6,609,068 Date filed: March 5, 2001 Abstract: A medical breath component analyzer which maintains a data-base profile of a patient over time. The apparatus may be used chronically by a patient so that a baseline status for that patient may be determined. Acute variations from the baseline are identified as clinically significant. The acquired data can be reported to the patient using the device at home and transmitted electronically to a physician or health care provider. The method and apparatus helps a patient modify health related behaviors, particularly weight loss for diabetic patients. A breath component and information on the psychological or emotional state of the patient are correlated, and information is provided to the patient based on the correlation between the breath component and the patient's emotional state. Other physiologic parameter may also be measured, such as a blood component, temperature, cardiovascular condition or pulse rate, a urine component, a physical activity sensor, weight, or body fat composition sensor. The parameters and the information on the patient's emotional state may be correlated

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through a computer system. Correlation may comprise selecting a response likely to reenforce positive behavioral change in the patient. Preferably, remote sources of information may also be accessed, as, for example, through a communications connection or the Internet. Information may be provided directly from the apparatus, or by contact through a physician, health-care provider or support group. Excerpt(s): This invention relates generally to methods and medical apparatus and in particular to methods and apparatus for modifying health-related behavior, such as weight control for diabetes or general health. More particularly the invention relates to apparatus for analyzing medically significant components in exhaled breath. Diabetes is a chronic disease affecting many organs and body functions. The disease is caused either by a lack of the hormone insulin or by the body's inability to use insulin. Diabetes is the most common endocrine disorder. In the United States, for instance, as many as 10 million persons have diagnosed diabetes mellitus, and it has been estimated that an additional 10 million may have the disease without diagnosis. Although there is no cure, most cases can now be controlled adequately by a combination of medication and life style modification, including exercise, diet and weight loss. Unfortunately, many people with diabetes have difficulty coping with the constraints that the disease puts on their lives. People find it difficult to lose weight, to maintain weight loss, to exercise regularly, to regularly take drugs, or to self-administer tests for blood glucose levels. In general, patients do not receive sufficient positive support for their efforts and can become discouraged. They experience "diabetes burn-out", a feeling of hopelessness or powerlessness that contributes to abandoning efforts to manage their disease. People who are simply overweight or obese can experience similar barriers when attempting to control their diet and weight. See, for example, Diabetes Burnout, What to Do When You Can't Take It Anymore, W. H. Polonsky, 1999, American Diabetes Association. Web site: http://www.delphion.com/details?pn=US06609068__ •

Pharmaceutical composition containing tetrahydrocannabinol transdermal/transcutaneous delivery method thereof

and

a

Inventor(s): Murty; Ram B. (Lexington, KY), Mangena; Murty (Lexington, KY), Chowdhury; Dipak K. (Lexington, KY) Assignee(s): Murty Pharmaceuticals, Inc. (Lexington, KY) Patent Number: 6,503,532 Date filed: April 15, 2002 Abstract: A transdermal/transcutaneous delivery system to deliver Tetrahydrocannabinol (THC) and related compounds, comprising of gel, film and reconstituted liquid for topical application. The delivery system may contain polymethacrylic acid (PMA), carbopol, polyethylene glycol 8000 (PEG), propylene glycol (PG), water, alcohol, acetone, caprylic acid, caproic acid, oleic acid, lauric acid, isopropyl myristate, triethanolamine, and mixtures thereof. This formulation can be used as an analgesic, antiemetic, antiglaucoma medication, arthritis treatment and prevention of weight loss treatment associated with AIDS. It can also be used for treating dementia and multiple sclerosis. The present formulation avoids the problems associated with oral administration, patient compliance and potential abuse associated with other routes of administration of THC. Excerpt(s): The present invention provides a pharmaceutical composition containing Tetrahydro Cannabinol (THC), having analgesic, anti-emetic, anti-nausea and anti-

Patents 223

glaucoma properties, which is easily absorbed into the body at a steady rate to achieve a desired concentration in the bloodstream. Further, methods are provided for forming the pharmaceutical composition into a gel or powder, and for applying the gel or powder to form of the pharmaceutical composition to a transdermal patch for application to a human or animal body. Marijuana contains many compounds. The major active compound thereof has been identified as DELTA.Sup Tetrahydrocannabinol (THC), also known as DELTA 9-THC depending on the carbon numbering convention used. THC and other compounds in marijuana have, in addition to promoting psychoactivity, been reported to provide beneficial effects. There are many research publications reporting beneficial activities like analgesic, antiemetic, and antiglaucoma effects. It has also been found that a major contributor of these beneficial effects is THC. In addition, it has been noted that fasting or food deprivation could decrease the rate of absorption of THC from sesame oil capsules currently available in the market. Previous studies have also reported that another limitation of orally administered THC is the large intersubject variability in absorption. For this reason it would be important to titrate the THC dose on an individual basis, since the drug has biphasic activity and a relatively narrow therapeutic index. Web site: http://www.delphion.com/details?pn=US06503532__ •

Pharmaceutical formulation with controlled release of active substances Inventor(s): Venturini; Peter (Ljubljana, SI), Rebic; Ljubomira Barbara (Ljubljana, SI), Sirca; Judita (Ljubljana, SI), Kofler; Bojan (Skofja Loka, SI) Assignee(s): Lek, Tovarna Farmacevtskih In Kemicnih Izdelkov, D.D. (SI) Patent Number: 6,576,258 Date filed: January 12, 2000 Abstract: There is disclosed a method for stabilizing active substances that are unstable in acidic medium, unstable when stored for longer periods of time in the presence of water and at the same time sensitive to heating, by means of anhydrous granulation of active substances and dried pharmaceutically acceptable auxiliary substances for the preparation of pellet cores or granules. All pharmaceutically acceptable auxiliary substances employed are dried before use so that their weight loss at drying is less than 1.0% of the total weight of the pharmaceutically acceptable auxiliary substance, preferably less than 0.5%. Organic solvents used in process of anhydrous granulation should contain less than 0.2% of water. A novel pharmaceutical formulation with controlled release of active substances that are unstable in acidic medium, unstable when stored for longer periods of time in the presence of water and at the same time sensitive to heating, is disclosed as well. Excerpt(s): The invention belongs to the field of pharmaceutical industry and relates to a novel medicinal formulation with controlled release of active substances on the basis of anhydrous (i.e. non-aqueous) granulation of the active substances and dried pharmaceutically acceptable auxiliary substances. By the invention a technologically simple manufacture of a stable pharmaceutical formulation with controlled release of active substances is made possible. More specifically, the invention relates to a novel pharmaceutical formulation with controlled release of active substances that are unstable in acidic medium, unstable when stored for longer periods of time in the presence of water and at the same time sensitive to heating. Further, the invention relates to a novel method of stabilization of such unstable active substances and to a process for the preparation of the novel pharmaceutical formulation of such unstable

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active substances. There exists a constant need for developing pharmaceutical formulations wherein in a technologically simple way there would be achieved a good stability of active substances that are unstable in acidic medium unstable when stored for longer periods of time in the presence of water and at the same time sensitive to hearing. For the manufacture of hitherto known pharmaceutical formulations containing such active substances, technological processes have been used, wherein also water, wherein such active substances are not stable, has been used as a solvent and therefore the required stability has been achieved especially by the addition of basic substances to the active substance or by using the active substance in the form of a salt thereof. Namely, basic substances create a basic pH in the environment of the active substance, whereat such active substances are more stable. Web site: http://www.delphion.com/details?pn=US06576258__ •

Phytochemicals for promoting weight loss Inventor(s): Zeligs; Michael A. (Boulder, CO) Assignee(s): BioResponse L.L.C. (Boulder, CO) Patent Number: 6,534,085 Date filed: September 23, 1999 Abstract: New dietary supplement compositions are disclosed that comprise the phytochemical Diindolylmethane (DIM), as well as its precursor, Indole-3-carbinol (I3C), and cogener, 2-(Indol-3-ylmethyl)-3,3' diindolylmethane (LTR-1), dietary supplement acceptable carriers and/or excipients. The use of these dietary supplement compositions facilitate weight loss as part of a nutritional system targeting release and metabolism of stored fat. Excerpt(s): The present invention relates to compositions and methods for promoting weight loss and/or preventing weight gain in mammals by administering phytochemicals. Among the phytochemicals useful in the compositions and methods of the invention are dietary indole, Diindolylmethane (DIM), as well as its precursor, Indole-3-carbinol (I3C), and cogener, 2-(Indol-3-ylmethyl)-3,3'-diindolylmethane (LTR1). When used as described, these natural substances, alone and in combination with other substances, facilitate weight loss as part of a nutritional system targeting release and metabolism of stored fat. The term "overweight" describes an excessive accumulation of body fat or "adiposity". "Overweight" is defined as an elevation in the Body Mass Index (BMI) beyond desirable standards due to increased body fat. The BMI expresses an individual's degree of overweight independent of height by dividing weight in kilograms (Kg) by height squared (m.sup.2). In overweight men a BMI above 25 Kg/m.sup.2 and in overweight women a BMI above 26 Kg/m.sup.2 defines a level of adiposity which negatively impacts health (Simopoulos, A.P., Body Weight Reference Standards, In Van Itallie, T.B. and Simopoulos, A.P. (Eds), Obesity: New Directions in Assessment and Management, The Charles Press, Inc., Philadelphia, Pa., 1995). The increasing prevalence of overweight is one of the major health problems of industrialized countries. Overweight occurs as a result of an imbalance between energy intake as food and energy expenditure through physical activity. Most importantly, the trend to increased consumption of sugar and refined carbohydrate in excess of energy needs results in a metabolic and hormonal status favoring the formation and storage of fat. Weight loss depends on mobilization and metabolism of fat at the cellular level. This requires the metabolic process of lipolysis and encompasses the release of stored fat from fat cells. In all mammals the process and rate of lipolysis are highly regulated by

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the system of catecholamine hormones. Increased carbohydrate consumption in modern society is the result of the introduction of refined sugar and processed carbohydrate in various forms. The addition of high fructose corn syrup in 1967 is a prime example of this shift in dietary composition which has contributed to the further increase of the sugar component of the average diet to about 8% of total calories (Raper, N., and Marston, R., "Content of the U.S. food supply (tables of nutrients and foods)", Human Nutrition Information Service: Washington, D.C., U.S. Department of Agriculture, 1988). The presence of sugar and other "high glycemic" processed carbohydrates found in bread and pasta, increases blood insulin levels, inhibits lipolysis, and promotes new fat synthesis. This raises serum triglycerides, serum cholesterol, and increases the risk of atherosclerosis and coronary heart disease. Strategies to decrease our daily intake of processed carbohydrate and increase the release and metabolism of stored fat are clearly needed. Web site: http://www.delphion.com/details?pn=US06534085__ •

Porcelain composition, porcelain and method of producing the same, and wiring board and method of producing the same Inventor(s): Kawai; Shinya (Kagoshima, JP), Iwachi; Hiromi (Kagoshima, JP), Terashi; Yoshitake (Kagoshima, JP) Assignee(s): Kyocera Corporation (Kyoto, JP) Patent Number: 6,630,417 Date filed: May 30, 2001 Abstract: The porcelain of the present invention comprises 5 to 70% by weight of a nonoxide ceramic filler and 30 to 95% by weight of a borosilicate glass having a glass transition temperature of 800.degree. C. or lower, wherein a weight loss per unit surface area of said non-oxide ceramics is not more than 0.15 g/cm.sup.2 after dipping said nonoxide ceramic having purity of not less than 96% by weight for five minutes in a glass melt obtained by melting said borosilicate glass with heating at 1200.degree. C. Since the porcelain composition can be fired at a low temperature together with a low-resistance metal, the resulting porcelain has a high thermal conductivity, a low dielectric constant, a high heat dissipation property and a reduced apparent signal delay in a high frequency signal and is suited for use as an insulating board in a wiring board. Excerpt(s): The present invention relates to a porcelain composition capable of being fired at a low temperature and is best suited for use in a semiconductor element housing package, a wiring board applied to a multi-layer wiring board or the like, to a porcelain and a method of producing the same, and to a wiring board and a method of producing the same. More particularly, the present invention relates to an improvement of a porcelain which can be fired together with a low-resistance conductor material such as copper, silver or gold and has a low dielectric constant, and also is capable of efficiently dissipating heat generated by the operation of an active element such as semiconductor element, for the purpose of reducing signal delay. Recently, as the information processing technology and communication technology advance in an ever faster rate and are increasingly utilized in everyday life, semiconductor elements are becoming faster in operation and larger in size. As the operation speeds of the semiconductor elements increase, the problem of delay in signal transmission caused by the package, board or the like becomes serious. At the same time, heat resistance of the package and the board poses a significant problem as more heat is generated by the larger semiconductor elements. In the field of ceramic multi-layer wiring board in the prior art,

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the most commonly used is an alumina wiring board comprising an insulating layer made of alumina ceramics and a wiring layer made of a high-melting point metal such as tungsten or molybdenum formed on the surface of inside of the insulating layer. Web site: http://www.delphion.com/details?pn=US06630417__ •

Potassium (-)-hydroxycitric acid methods for pharmaceutical preparations for stable and controlled delivery Inventor(s): Clouatre; Dallas L. (275 Willow Rd., Menlo Park, CA 94025), Dunn; James M. (3236 Hinsdale Pl., Littleton, CO 80112) Assignee(s): none reported Patent Number: 6,447,807 Date filed: September 14, 2000 Abstract: A method for making the potassium and sodium salts of (-)-hydroxycitric acid and mixtures thereof workable, non-hygroscopic and non-reactive in acidic media by encasement in hydrophobic and acidophobic polymers. The calcium and magnesium salts of (-)-hydroxycitric acid likewise can be rendered nonreactive in acidic media. The resulting products are suitable for tableting, encapsulation and use in other dry media for weight loss, appetite suppression, improvements in fat metabolism and postprandial lipemia and other pharmaceutical purposes. Further, the products of this invention can be made nonreactive as components of acidic liquid drink mixes and snack bars and can be used in the production of controlled release administration formats. Excerpt(s): The invention is directed toward a novel process by which the salts of (-)hydroxycitric acid, either potassium (-)-hydroxycitrate, the preferred salt of (-)hydroxycitric acid, or, alternatively, sodium (-)-hydroxycitrate, can be rendered suitable for tableting, encapsulation and use in other dry media for weight loss and other pharmaceutical purposes. Furthermore, the product of this invention can be made nonreactive as a part of acidic drink mixes and acidic snack bars. This invention is further directed toward the production of controlled release versions of potassium or sodium (-)-hydroxycitrate which can be used to provide multi-hour controlled release of the compound. (-)-Hydroxycitric acid (abbreviated herein as HCA) a naturally-occurring substance found chiefly in fruits of the species of Garcinia, and several synthetic derivatives of citric acid have been investigated extensively in regard to their ability to inhibit the production of fatty acids from carbohydrates, to suppress appetite, and to inhibit weight gain. (Sullivan, A. C., et al., American Journal of Clinical Nutrition 1977;30:767.) Numerous other benefits have been attributed to the use of HCA, including, but not limited to an increase in the metabolism of fat stores for energy and an increase in thermogenesis (the metabolism of energy sources to produce body heat in an otherwise wasteful cycle). One commonly offered explanation for the effects of HCA is that this compound inhibits the actions of cytoplasmic (cytosolic) ATP:citrate lyase. (D. Clouatre and M. E. Rosenbaum, The Diet and Health Benefits of HCA (Hydroxicitric Acid), 1994.) Weight loss benefits are ascribed to HCA, its salts and its lactone in U.S. Pat. No. 3,764,692 granted to John M. Lowenstein in 1973. Lowenstein described a variety of possible pharmaceutical salts of HCA based upon alkali metals, e.g., potassium and sodium, and alkaline earth metals, e.g., calcium,. The production of the potassium salt of HCA had been described in the scientific literature previous to Lowenstein's patent, but not in regard to its weight-loss properties. Research into HCA by scientists at the pharmaceutical firm of Hoffman-La Roche revealed that the lactone form of HCA is far less effective than is the sodium salt of HCA for weight loss

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purposes, in part because the lactone form lacks the proper affinity for the receptor which is the target of the actions of HCA. However, the sodium salt has disadvantages for long-term administration, both because sodium possesses no positive metabolic effects with regard to obesity and because sodium has potential hypertensive actions as well as other drawbacks. Potassium, as a ligand for HCA, does not possess the disadvantages associated with sodium. Moreover, the absorption of the potassium salt of HCA is considered to be superior to that of the sodium salt owing to the greater rate of uptake of potassium in relation to sodium in most tissues. Free (-)-hydroxycitric acid, calcium, magnesium and potassium salts of HCA and poorly characterized mixtures of two or more of these minerals, usually substantially contaminated with sodium, currently exist on the American market. Most of the HCA sold consists of calcium salts of varying purity. Aside from the potassium salt, all of these HCA forms suffer from problems in assimilation, a fact attested to by poor performance in controlled weight loss trials. For instance, the free acid form of (-)-hydroxycitric acid is extremely ionic and does not pass readily through the gut membranes. Free HCA has several further disadvantages. It undergoes rapid lacontonization, and, again, the lactone form has no appreciable physiological activity. Indeed, inclusion of any of the currently available mineral salts of HCA in a prepared beverage of acidic pH will lead to the development of the HCA lactone over time. The free acid form, moreover, has a tendency to be bound up and made unavailable to the body by soluble and insoluble fibers as well as by many other compounds. Likewise the potassium and sodium salts, if placed even only briefly in acidic or flavored beverages, typically will undergo color change or exhibit other signs of having undergone chemical interaction with the contents of the beverage. Thus although a patent exists for the use of free (-)-hydroxycitric acid concentrate in food products (U.S. Pat. No. 5,536,516), the art taught therein offers no particular advantages for weight loss nor for other medicinal purposes. Web site: http://www.delphion.com/details?pn=US06447807__ •

Radical polymerizable compositions containing polycyclic olefins Inventor(s): Dershem; Stephen M. (San Diego, CA), Forrestal; Kevin J. (Poway, CA) Assignee(s): Henkel Loctite Corporation (Rocky Hill, CT) Patent Number: 6,521,731 Date filed: February 7, 2001 Abstract: In accordance with the present invention, there are provided free-radical polymerizable compositions comprising polycyclic olefins, wherein the polycyclic olefins contain little, if any, cyclopentenyl unsaturation. As a result, these olefins are sufficiently reactive with the propagating free-radicals during cure to provide a highly crosslinked thermoset resin. Moreover, invention compositions comprise high molecular weight polycyclic olefins having low volatility. Accordingly, the observed undesirable weight loss upon cure of prior art thermosetting compositions is considerably reduced. Further provided by the present invention are compositions comprising functionalized polycyclic olefin monomers. These functionalized olefin monomers provide additional benefits such as increased adhesion to a variety of surfaces and greater control over glass transition temperatures. Excerpt(s): The present invention relates to compositions containing polycyclic olefins which polymerize under free-radical conditions to generate crosslinked polymers and copolymers. The invention relates particularly to polycyclic olefins which primarily contain bicycloheptenyl unsaturation units. Polymers and copolymers synthesized from

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polycyclic olefin monomers have attracted much interest from the scientific community due to the desirable properties often exhibited by these materials. Cyclic olefin copolymers (COC's) possess a unique combination of properties such as low density, low moisture absorption, low birefringence, high transparency, and high strength. Depending on the polycyclic olefin monomer and the polymerization conditions, materials can also be produced having a wide range of glass transition temperatures. As a result, these materials are being tested for use in diverse applications such as electronics, CD-ROM disks, optical lenses, barrier films, and medical appliances. A particularly attractive characteristic displayed by polycyclic olefin monomers is the ability to polymerize via a variety of reaction mechanisms. It is well-known that polycyclic olefins can be polymerized and/or copolymerized free-radically, cationically, or coordinatively using organometallic catalysts. Due to this mechanistic flexibility, a wide variety of functionalized comonomers can be incorporated into the cyclic olefin copolymer, which provides further control over the bulk properties of the material. Web site: http://www.delphion.com/details?pn=US06521731__ •

System and method for weight-loss goal visualization and planning and business method for use therefor Inventor(s): Bravomalo; Mario J. (2315 Eagle Park, Arlington, TX 76001) Assignee(s): none reported Patent Number: 6,643,385 Date filed: April 27, 2000 Abstract: The visual fitness planner combines image morphing technology, exercise programming, supplement sales, and motivational techniques; into one product. Users begin by entering their current measurements, measurement goals and current picture into the system, preferably via a Web site. The picture is segmented into body components, and each segment is morphed based upon the goal measurement and the segment's responsiveness to weight loss using physiological tables and formulae. The resulting modified "after view"image is then returned to the user, preferably by online communications such as e-mail. In the business use for the disclosed system, the visual fitness planner helps the fitness industry overcome two of their biggest problems: obtaining new members and retaining current members. By showing members how they will look after following a specific regimen, client may accurately visualize their future appearance, resulting in increased client loyalty and satisfaction. Excerpt(s): This invention relates to the arts of visual image processing to predict a subject's appearance after a given amount of weight loss. This invention relates to the business methods employing a predictive image visualization system to attract and retain clients of service provides in the weight loss food program, fitness center, physical therapy and sports medicine, and weight control medical industries. Not applicable. This invention was not developed in conjunction with any Federallysponsored contract. Web site: http://www.delphion.com/details?pn=US06643385__

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•

Thermogenic weight management composition Inventor(s): Gorsek; Wayne F. (Boynton Beach, FL) Assignee(s): Vitacost.com, Inc. (Boynton Beach, FL) Patent Number: 6,565,847 Date filed: July 3, 2002 Abstract: A powerful formulation for weight loss containing Green Tea extract, hydroxycitric acid, thermogenic herbs, glucomannan, chromium, and a probiotic. The formulation boasts metabolic rates, suppresses appetite and helps burn fat without having adverse cardiovascular effects. Excerpt(s): The invention relates to a composition for permanent weight management. The composition burns fat, boosts metabolic rate, controls appetite, eliminates sugar cravings and eating binges. An orally ingested composition is provided which contains effective amounts of vitamins, minerals, herbs and natural extracts with the adverse effects to the cardiovascular system. The composition contains no dangerous stimulants like Ephedrine, commonly known as Ma Huang. The process by which weight is controlled is so complex that even most talented scientists do not understand it. Prior formulations such as those disclosed in U.S. Pat. No. 5,626,849 fall short of the unique blend which requires Citrus Aurantium L and Guarana Extract as a key nutrient to provide a feeling of satiation and a calming effect for healthy weight management. Web site: http://www.delphion.com/details?pn=US06565847__

•

Treatment of obesity by bilateral sub-diaphragmatic nerve stimulation Inventor(s): Roslin; Mitchell S. (New York, NY), Barrett; Burke T. (Houston, TX) Assignee(s): Cyberonics, Inc. (Houston, TX) Patent Number: 6,609,025 Date filed: January 2, 2001 Abstract: A method and apparatus for treating obese or other patients with compulsive overeating disorder includes unilaterally or bilaterally stimulating one or both of the left and right branches of a patient's vagus nerve directly or indirectly with an electrical pulse signal generated by an implantable neurostimulator with at least one operatively coupled nerve electrode to apply the pulse signal to the selected nerve branch at a location below the patient's diaphragm. The implantable neurostimulator is programmable to enable physician programming of electrical and timing parameters of the pulse signal, to induce weight loss of the patient. Excerpt(s): The present invention relates generally to methods and apparatus for treating eating disorders by application of modulating electrical signals to a selected cranial nerve, nerve branch or nerve bundle, and more particularly to techniques for treating patients with overeating disorders, especially obese patients, by application of such signals unilaterally or bilaterally to the patient's vagus nerve with one or more neurostimulating devices. Increasing prevalence of obesity is one of the most serious and widespread health problems facing the world community. It is estimated that, currently, about 6% of the total population of the United States is morbidly obese and a much larger percentage is either obese or significantly overweight. Morbid obesity is defined as having a body mass index of more than forty, or, as is more commonly understood, being more than one hundred pounds overweight for a person of average

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height. Aside from what may be an epidemic of obesity, it is believed by many health experts that obesity is one of the first two leading causes of preventable deaths in the United States, either ahead of or just behind cigarette smoking. Whether or not that is an accurate assessment, studies have indicated that morbid obesity dramatically increases health care costs. It is a major cause of adult onset diabetes in the United States, up to approximately eighty percent of the cases. It may be a leading factor in as many as ninety percent of sleep apnea cases. Obesity is also a substantial risk factor for coronary artery disease, stroke, chronic venous abnormalities, numerous orthopedic problems and esophageal reflux disease. Researchers have documented a link between obesity, infertility and miscarriages, as well as post menopausal breast cancer. Web site: http://www.delphion.com/details?pn=US06609025__ •

Use of oxandrolone in the treatment of burns an other wounds Inventor(s): Fishbein; Don (Westfield, NJ) Assignee(s): Bio-Technology General Corp. (Middlesex, NJ) Patent Number: 6,576,659 Date filed: December 5, 1997 Abstract: The subject invention provides a method of treating burn-induced weight loss in a burn patient which comprises administering a therapeutically effective amount of an oxandrolone to the patient. The invention also provides a method of treating a wound in a patient suffering from a wound which comprises administering a therapeutically effective amount of an oxandrolone to the patient. The subject invention further provides a method of treating burn-induced weight loss in a burn patient which comprises administering a therapeutically effective amount of an oxandrolone in conjunction with a protein supplement to the patient. Excerpt(s): Throughout this specification, various publications are referenced by Arabic numerals within parentheses. Full citations for these references may be found at the end of the specification immediately preceding the claims. The disclosure of these publications in their entireties are hereby incorporated by reference into this specification in order to more fully describe the state of the art to which this invention pertains. Over one million people are involved in burn accidents in the United States each year. Approximately 150,000 of these patients are hospitalized and over 6000 of these die each year (1). Following thermal injury, severe protein and fat wasting occurs (1). Loss of as much as 20% of body protein may occur in the first two weeks following major burn injury (2). Increased oxygen consumption, metabolic rate, urinary nitrogen excretion, fat breakdown and steady erosion of body mass are all directly related to burn size and return to normal as the burn wound heals or is covered (1). The metabolic rate in patients with burns covering more than 40% of total body surface is twice as high as the metabolic rate in people without burns (1). Web site: http://www.delphion.com/details?pn=US06576659__

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•

Uses of avian interferon gamma (IFN-.gamma.) Inventor(s): York; Jennifer J. (Clifton Hill, AU), Lowenthal; John W. (Belmont, AU), O'Neil; Terri E. (Highton, AU), Johnson; Michael A. (Thornbury, AU) Assignee(s): Commonwealth Scientific and Industrial Research Organisation (Australian Capital Territory, AU) Patent Number: 6,642,032 Date filed: November 19, 1999 Abstract: The present invention provides compositions comprising recombinant avian IFN-.gamma. polypeptides and methods using said recombinant avian IFN-.gamma. polypeptides and compositions to enhance the immune responses of birds, and to enhance growth and/or prevent weight loss in birds. The present invention is particularly useful in the prophylactic and therapeutic treatment of birds against coccidiosis and the causative agent thereof. Excerpt(s): The present invention relates generally to recombinant avian interferon polypeptides and genetic sequences encoding same, and uses therefor. In particular, the present invention is directed to the use of recombinant avian IFN-.gamma. polypeptides as an immune response modulator and as a growth enhancing agent in avian species. The present invention is particularly useful in the prophylactic and therapeutic treatment of birds against coccidiosis and the causative agent thereof. The rapidly increasing sophistication of recombinant DNA technology is greatly facilitating research into the medical and veterinary fields. Cytokine research is of particular importance, especially as these molecules regulate the proliferation, differentiation and function of a great variety of cells, such as cells involved in mediating an immune response. Administration of recombinant cytokines or regulating cytokine function and/or synthesis is becoming, increasingly, the focus of medical research into the treatment of a range of disease conditions in humans and animals. The present invention seeks to provide novel reagents and methods that employ recombinant cytokine polypeptides, for the treatment of disease conditions in birds. In mammals, interferons (IFN) represent a family of cytokines that share the capacity to inhibit viral replication and to exert effects on immune function. There are two distinct types of IFN. Type I IFN is produced by a variety of cell types in response to viral infection and includes IFN-.alpha. and .beta. Typically, IFN-.alpha. is produced by leukocytes such as monocytes and macrophages while fibroblasts and epithelial cells are the major source of IFN-.beta. Type I IFNs share a high degree of amino acid homology, bind to the same cell surface receptor and there biological functions are resistant to heat and low pH treatment. (Weissmann and Weber, 1986). Web site: http://www.delphion.com/details?pn=US06642032__

•

Vinyl 4-t-butoxycarbonyloxybenzal-vinyl acetate copolymer

4-hydroxybenzal-vinyl

alcohol-vinyl

Inventor(s): Kim; Jin Baek (Seoul, KR), Kim; Hyun Woo (Seoul, KR) Assignee(s): Hyundai Electronics Industries Co. Ltd. (Kyoungki-do, KR), Korea Advanced Institute of Science and Technology ("KAIST") (Taejon, KR) Patent Number: 6,559,228 Date filed: March 21, 2001

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Abstract: There is a vinyl 4-hydroxybenzal-vinylalcohol-vinyl acetate copolymer, a 4-tbutoxycarbonyloxybenzal-vinyl alcohol-vinyl acetate copolymer and a vinyl 4-tbutoxycarbonyloxybenzal-vinyl 4-hydroxybenzal-vinyl alcohol-vinyl acetate copolymer suitable for photoresist and methods for preparing the same. The latter two polymers contain 4-hydroxybenzal groups all or parts of which are protected with tbutoxycarbonyl group. Superior in transparency, thermal stability, mechanical strength, and adhesiveness to silicon wafer, the photoresists prepared from the protected copolymers can enhance the resolution of fine circuit by virtue of low weight loss upon the thermal treatment after exposure. Excerpt(s): The present invention relates to a copolymer suitable for photoresist. More particularly, the present invention relates to a vinyl 4-hydroxybenzal-vinyl alcohol-vinyl acetate copolymer, a vinyl 4-t-butoxycarbonyloxybenzal-vinyl alcohol-vinyl acetate copolymer and a vinyl 4-t-butoxycarbonyloxybenzal-vinyl 4-hydroxybenzal-vinyl alcohol-vinyl acetate copolymer. In the last two copolymers, all or part of the vinyl 4hydroxybenzal groups are protected with t-butoxycarbonyl group. Also, the present invention is concerned with methods for preparing the copolymers. A significant advance has been made for the photoresist used in microlithography, which is one of the most essential techniques to achieve the high integration of semiconductor integrated circuits. As higher integration degree of a semiconductor integrated circuit has been required, various photoresist materials are now developed and reported. Among them, polyvinylphenol resins protected by t-butoxycarbonyl group and poly(4-tbutoxycarbonyloxystyrene) resins are expected to be the most useful and are being used in practice. These resins are very advantageous in that they are directly applied for such techniques advanced in microlithography as utilizes deep uv as a light source for exposure, as disclosed in U.S. Pat. Nos. 4,491,628, 4,405,708 and 4,670,507. However, the polyvinylphenol resins show high optical absorbance at around 250 nm due to the benzene rings contained. Because deep uv, a light source for the microlithography in current use, has a frequency of around 250 nm, the polyvinylphenol resins are low in transparency at the frequency. Web site: http://www.delphion.com/details?pn=US06559228__ •

Weight loss medication and method Inventor(s): Vlahakos; Victor (1740 W. 27th St., Houston, TX 77008) Assignee(s): none reported Patent Number: 6,613,356 Date filed: October 10, 2000 Abstract: The invention involves a medication for weight loss by means of appetite suppression and a method for administering this medication to humans and other mammals. The medication comprises potassium butyrate or closely related chemical compounds, together with chemicals which facilitate the dispersion of the medication in the stomach. Excerpt(s): The invention is a medication for weight loss in mammals through appetite suppression and a method for administering this medication. Many methods and medications for weight reduction have been developed in the art. The following patents are representative of methods previously used. U.S. Pat. No. 5,783,603, Jul. 21, 1998 to M. Majeed and V. Badmaev discloses a method of appetite suppression and weight loss by

Patents 233

administering hydroxycitric acid in a form of a potassium salt extracted from Garcinia fruit. The patent also describes a method of increasing fat metabolism in the patient. Web site: http://www.delphion.com/details?pn=US06613356__ •

Weight loss product Inventor(s): Fleischner; Albert M (Westwood, NJ) Assignee(s): Goen Group, Inc. (Cedar Knolls, NJ) Patent Number: 6,420,350 Date filed: August 13, 2001 Abstract: Supplement compositions designed to support weight loss and increase energy. Excerpt(s): The prior art regarding this invention arises from distinct areas not heretofore combined to create new and useful formula sets or new and useful improvements thereof regarding a Solid-dosage Form of a Weight Loss Product. This invention relates to the evolving science that a new and unique combination of ma huang extract (ephedrine alkaloids), caffeine and glucosamine sulfate results in increased weight loss and energy. Epigallocatechin gallate from green tea polyphenols significantly reduced food intake, body weight, blood cholesterol and triglyceride, as well as growth of the prostate, uterus, and ovary; it may interact specifically with a component of a leptin-independent appetite control pathway.sup.12 Green tea clearly has thermogenic properties, promotes fat oxidation.sup.13 and plays a role in the control of body composition via sympathetic activation of thermogenesis, fat oxidation or both. Web site: http://www.delphion.com/details?pn=US06420350__

Patent Applications on Weight Loss As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to weight loss: •

Antagonists of HMG1 for treating inflammatory conditions Inventor(s): Wang, Haichao; (Edison, NJ), Tracey, Kevin J.; (Old Greenwich, CT) Correspondence: HAMILTON, BROOK, SMITH & REYNOLDS, P.C.; 530 VIRGINIA ROAD; P.O. BOX 9133; CONCORD; MA; 01742-9133; US Patent Application Number: 20030143194 Date filed: November 20, 2002 Abstract: There is disclosed a pharmaceutical composition and method for treating sepsis, including, septic shock and ARDS (acute respiratory distress syndrome), comprising administering an effective amount of a HMG1 antagonist. There is further disclosed a diagnostic method for monitoring the severity or potential lethality of sepsis

10

This has been a common practice outside the United States prior to December 2000.

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or septic shock, comprising measuring the serum concentration of HMG1 in a patient exhibiting or at risk or exhibit sepsis or septic shock symptoms. Lastly, there is disclosed a pharmaceutical composition and method for effecting weight loss or treating obesity, comprising administering an effective amount of HMG1 or a therapeutically active HMG1 fragment. Excerpt(s): This application is a continuation-in-part of co-pending U.S. application Ser. No. 10/210,747, filed Jul. 31, 2002, which is a continuation of U.S. application Ser. No. 09/503,632, filed Feb. 14, 2000, now issued as U.S. Pat. No. 6,468,533, which is a divisional of U.S. application Ser. No. 09/248,574, filed Feb. 11, 1999, now issued as U.S. Pat. No. 6,303,321. The entire teachings of the above applications are incorporated herein by reference. The present invention provides a pharmaceutical composition and method for treating diseases characterized by activation of an inflammatory cytokine cascade, particularly sepsis, including septic shock and ARDS (acute respiratory distress syndrome), comprising administering an effective amount of an antagonist to the high mobility group 1 protein (HMG1). The present invention further provides a diagnostic method for monitoring the severity of sepsis and related conditions, comprising measuring the serum concentration of HMG1 in a patient exhibiting symptoms of a disease characterized by activation of inflammatory cytokine cascade. Lastly, the present invention provides a pharmaceutical composition and method for effecting weight loss or treating obesity, comprising administering an effective amount of an HMG1 protein or a therapeutically active fragment of the gene product of an HMG1 gene. Sepsis is an often fatal clinical syndrome that develops after infection or injury. Sepsis is the most frequent cause of mortality in hospitalized patients. Experimental models of gram negative sepsis based on administration of bacterial endotoxin (lipopolysaccharide, LPS) have led to an improved understanding of the pathogenic mechanisms of lethal sepsis and conditions related to sepsis by virtue of the activation of a common underlying inflammatory cytokine cascade. This cascade of host-response mediators includes TNF, IL-1, PAF and other macrophage-derived factors that have been widely studied as acute, early mediators of eventual lethality in severe endotoxemia (Zhang and Tracey, In The Cytokine Handbook, 3rd ed. Ed. Thompson (Academic Press Limited, USA). 515547,1998). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

APPETITE STIMULATION AND REDUCTION OF WEIGHT LOSS IN PATIENTS SUFFERING FROM SYMPTOMATIC HIV INFECTION Inventor(s): PLASSE, TERRY F.; (NEW YORK, NY) Correspondence: Joseph A Mahoney; Mayer Brown & Platt; P O Box 2828; Chicago; IL; 60690; US Patent Application Number: 20030100602 Date filed: June 3, 1992 Abstract: Patients with symptomatic HIV infection, including AIDS and ARC are treated to increase appetite and to cause a reduction in loss of weight. The delta-9tetrahydrocannabinol may be administered orally, in capsules, or in tablets, or by injection, suppository, intranasal, transdermal, inhalant or sublingual administration. Excerpt(s): Among the many problems endured by patients suffering from symptomatic HIV infection, which includes inter alia AIDS (Acquired Immune Deficiency Syndrome) and ARC (AIDS Related Complex), are loss of appetite with consequent loss of weight.

Patents 235

This loss of appetite and loss of weight further debilitates the patients and increases the many problems associated with the HIV infection. The compound delta-9tetrahydrocannabinol, which is the active ingredient in marijuana and which was produced chemically as described in U.S. Pat. No. 3,668,224, has been used as an antiemetic to relieve nausea and vomiting in patients receiving cancer chemotherapy. A number of cancer investigators have used delta-9-tetrahydrocannab- inol to attempt to increase appetite and modify weight loss in cancer patients. For example, in a randomized double-blind crossover study employing oral delta-9-tetrahydrocannabinol and prochlorperazine, 50% of the subjects on delta-9-tetrahydrocannabinol reported an increased food intake while only 29% had a similar response on the prochlorperazine.sup.1 In another study of similar design and using the same medications, patients on delta-9-tetrahydrocannabinol reported feeling more hungry than patients on prochlorperazine.sup.2 Results suggestive of an appetite stimulating effect were also noted by Ekert, et al.sup.3 in groups of children and adolescents 6-19 years of age administered delta-9-tetrahydrocannabinol, prochlorperazine or metaclopramide in crossover design studies.sup.1Sallan, S E; Cronin, C; Zelen, M; and Zinberg, N E (Sidney Farber Cancer Institute, Boston, Mass.): Antiemetics in patients receiving chemotherapy for cancer. A randomized comparison of delta-9tetrahydrocannabinol and prochlorperazine. N. Engl. J. Med. 301:135-138 (Jan. 17) 1980, No. 3.sup.2 Ungerleider, J T; Andrysiak, T; Fairbanks, L; Gooodnight, J; Sarna, G; and Jamison, K. (UCLA Center for the Health Sciences, Los Angeles, Calif.): Cannabis and cancer chemotherapy. A comparison of oral delta-9-THC and prochlorperazine. Cancer 50:636-645 (Aug. 15) 1982, No. 4.sup.3 Ekert, H; Waters, K D; Jurk, I H; Mobilia, J; and Loughnan, P. (Royal Children's Hospital, Melbourne, Australia): Amerlioration of cancer chemotherapy-induced nausea and vomiting by delta-9-tetrahydrocannabinol. Med. J. Aust. 2:657-659 (Dec. 15) 1979. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Appetite suppressant for oral ingestion Inventor(s): Nietupski, Ronald S.; (Lockport, IL) Correspondence: Todd S. Parkhurst; Holland & Knight LLP; Suite 800; 55 West Monroe Street; Chicago; IL; 60603-5144; US Patent Application Number: 20030185883 Date filed: March 28, 2002 Abstract: A method of suppressing human appetite, and a material therefore, are disclosed in the claims. The method includes the step of inducing body weight loss in a human by providing that human with material containing, as an active ingredient, 2AcetylPyridine for human oral consumption. The material can be provided in the form of a lozenge. A related aspect of the invention relates to material for human ingestion to encourage body weight loss, the material comprising about 1% 2-AcetylPyridine volume/volume. Excerpt(s): U.S. Pat. No. 4,521,427, entitled APPETITE SUPPRESSANT AND METHOD OF APPLICATION THEREOF describes and claims the use of 2-AcetylPyridine (2AP.TM.) in controlling human appetite for food. The present invention involves an improved method of delivering that active material to a human, and an improved delivery vehicle for that material. The improved method includes the step of inducing body weight loss in a human by providing that human with material containing, as an active ingredient, 2-AcetylPyridine for human oral consumption. The material can be

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provided in the form of a lozenge. A related aspect of the invention relates to material for human ingestion to encourage body weight loss, the material comprising about 1% 2-AcetylPyridine volume/volume. Accordingly, it is a general object of this invention to provide, to the consumer, an appetite suppressant which is novel in nature, convenient and effective in use. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Buffing tools and methods of making Inventor(s): Weber, Robert J.; (Hickory, NC) Correspondence: John W. Renner; Renner, Otto, Boisselle & Sklar, LLP; Nineteenth Floor; 1621 Euclid Avenue; Cleveland; OH; 44115-2191; US Patent Application Number: 20030194962 Date filed: May 8, 2003 Abstract: A buff is made from a non-woven fabric where the fibers are first carded and formed into a fairly thick fleece. The fleece is passed over a topographical surface on, for example, a moving belt or a drum. The fleece is subject to a bow-tie hydroentanglement process where many fine jets of water entangle the fibers on the topographical surface. Excess water is vacuumed from the system. The fabric is dried and chemically treated. With the fabric a variety of buffing tools are made, in wheel, belt or roll form. Tests against standard and mill treatment buffs show a remarkably lower fabric weight loss percentage and lower or normal operating temperatures. The fabric has exceptional mechanical strength having a tensile strength in excess of 650 N/50 mm according to DIN 29073/3. Preferably the fabric has a tensile strength of at least 1,000 N/50 mm in the machine direction and in excess of 900 N/50 mm in the cross direction according to such DIN. Excerpt(s): This application is a division of U.S. patent application Ser. No. 09/703,087, filed Oct. 31, 2000. This invention relates generally as indicated to a buffing tools and methods of making such tools, and more particularly to buffing tools having improved fabric or cloth greatly enhancing the efficiency, useful life, and productivity of the tool. Buffing tools probably are embodied most commonly in the form of a wheel. The wheel includes one or more discs or plates providing an arbor hole. The cloth or fabric is secured to and projects radially from the discs. The projecting edge of the fabric is the working face of the tool. Several layers or plys of fabric may be provided for each wheel and the fabric may be folded, bunched, puckered, or pleated so that the fabric edge zigzags back and forth at the face, and the working face of the tool may be substantial axially wider than the discs or plates, from which the fabric projects. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents 237

•

Cathodic electrocoating compositions polyisocyanate crosslinking agent

containing

hydroxyl-carbonate

blocked

Inventor(s): Gam, Allisa; (Troy, MI) Correspondence: E I DU PONT DE NEMOURS AND COMPANY; LEGAL PATENT RECORDS CENTER; BARLEY MILL PLAZA 25/1128; 4417 LANCASTER PIKE; WILMINGTON; DE; 19805; US Patent Application Number: 20030064227 Date filed: September 12, 2001 Abstract: An improved aqueous cathodic electrocoating composition having a binder of an epoxy-amine adduct and a blocked polyisocyanate crosslinking agent; wherein the improvement is the use of a hydoxyl-carbonate blocked polyisocyanate crosslinking agent. Electrodeposited finishes are formed that have reduced weight loss when heated to cure. Excerpt(s): This invention is directed to a cathodic electrocoating composition and in particular to a cathodic electrocoating composition containing a blocked polyisocyanate cross-linking agent which significantly reduces bake-off loss occurring from the coating film during cure. The coating of electrically conductive substrates by an electrodeposition process, also called an electrocoating process, is a well known and important industrial process. Electrodeposition of primers to metal automotive substrates is widely used in the automotive industry. In this process, a conductive article, such as an autobody or an auto part, is immersed in a bath of a coating composition of an aqueous emulsion of film forming polymer and the article acts as an electrode in the electrodeposition process. An electric current is passed between the article and a counter-electrode in electrical contact with the coating composition, until a coating of a desired thickness is deposited on the article. In a cathodic electrocoating process, the article to be coated is the cathode and the counter-electrode is the anode. Film forming resin compositions used in the bath of a typical cathodic electrodeposition process also are well known in the art. These resins typically are made from polyepoxide resins which have been chain extended and then an adduct is formed to include amine groups in the resin. Amine groups typically are introduced through a reaction of the resin with an amine compound. These resins are blended with a crosslinking agent usually a blocked polyisocyanate and then neutralized with an acid to form a water emulsion which is usually referred to as a principal emulsion. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Chemotherapy treatment Inventor(s): Boushey, Robin P; (Mississauga, CA), Drucker, Daniel J; (Toronto, CA) Correspondence: FOLEY AND LARDNER; SUITE 500; 3000 K STREET NW; WASHINGTON; DC; 20007; US Patent Application Number: 20030040478 Date filed: July 22, 2002 Abstract: This invention provides a treatment regimen that is effective in inhibiting chemotherapy-induced apoptosis and promoting cell survival. The invention also relates to a treatment regimen that confers resistance to caspase activation, thereby inhibiting caspase-mediated, proteolytic cleavage of functional cellular enzymes.

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Specifically, subjects undergoing chemotherapy are first exposed to a pretreatment regimen. Under this regimen, a GLP-2 receptor activator, such as h[GLY2]-GLP2, is administered each day for a predetermined beneficial period, e.g., three consecutive days. Approximately about 1 week following pretreatment, the subjects are exposed to an appropriate chemotherapy treatment regimen. Pretreatment with a GLP-2 receptor activator followed by administration of chemotherapeutic agents improves cell survival, reduces bacteremia, attenuates epithelial injury, and inhibits cellular apoptosis. Moreover, it does not impair the effectiveness of chemotherapy nor result in weight loss. The anti-apoptotic effects of GLP-2 may be useful in the reduction of cytoxicity and bacterial infection induced by chemotherapeutic agents. Excerpt(s): The invention relates to methods useful to overcome the damage and adverse effects of chemotherapeutic agents. More particularly, the invention relates to the use of a GLP-2 receptor activator to inhibit chemotherapy-induced apoptosis and promote cell survival in subjects undergoing chemotherapeutic treatment. Chemotherapeutic agents exert their cytoablative actions on rapidly proliferating cells via several different mechanisms, ultimately leading to cell cycle arrest and/or cellular apoptosis. The cytotoxic actions of chemotherapeutic agents are not tumour-specific and injury to rapidly dividing cells in the bone marrow and intestinal crypt often complicates the treatment of patients with neoplastic disease. Gastrointestinal toxicity following the administration of chemotherapeutic agents is characterized by severe mucositis, weight loss and systemic infection. Limitation in dose and treatment of chemotherapeutic agents due to gastrointestinal toxicity impair the effectiveness of chemotherapy in susceptible patients. Wadler, S. et al., J. Clin Oncol. 16: 3169-78, 1998. Van Huyen, J. P. et al., Dig. Dis. Sci. 43: 2649-51, 1998. Patients undergoing chemotherapy exhibit a low white blood cell count and can be managed clinically with antibiotics to prevent bacterial infection. Molecules such as granulocyte macrophagecolony stimulating factor (GM-CSF) can also be used to promote restoration of white blood cell count and to attenuate bone marrow toxicity following chemotherapy. Dombret, H. et al., N. Engl. J. Med. 332: 1678-83, 1995. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Compositions and methods for facilitating weight loss Inventor(s): Yegorova, Inna; (Northridge, CA) Correspondence: Nancy Lord Johnson, Ltd.; 1970 N. Leslie Rd. No. 204; Pahrump; NV; 89060; US Patent Application Number: 20030082168 Date filed: October 22, 2001 Abstract: Compositions and methods for facilitating weight loss by inhibiting carbohydrate absorption, enhancing lipolysis, and modulating the metabolism of glucose in a human. The compositions comprise wheat alpha amylase, conjugated linoleic acid, Momordica charantia, lipotrophic vitamins and green tea. Excerpt(s): The present invention relates to the administration of novel compositions and related methods using wheat alpha amylase, conjugated linoleic acid and Momordica charantia, lipotrophic vitamins and green tea to facilitating weight loss by inhibiting carbohydrate absorption, enhancing lipolysis, and normalizing the metabolism of glucose in a human. Obesity is a serious heath problem both in the United States as well as world-wide. Results from the National Health and Nutrition

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Examination Survey III show that one in three Americans are at least twenty percent overweight. Kuczmarski et al., 272 JAMA 205-211 (1994). Other studies have shown that the prevalence of obesity increases threefold between the ages of 20 and 50, however, this varies for men and women. In particular, the weights of men appear to stabilize after age 50 and then begin to decline around age 60. Women, however, generally continue to gain weight until age 60, and it is not until after age 60 that their weight begins to decline. Kaplan and Sadock, SYNOPSIS OF PSYCHIATRY 731 (1998). Obesity is a condition characterized by excessive accumulation of fat on the body. Obesity can be measured by either body weight or by body mass index (BMI). By convention, obesity is said to be present when body weight exceeds by 20 percent the weight listed in typical height-weight index tables. The other measurement of obesity, BMI, is the amount of fat present in the body and is considered a reliable indication of fatness in non-athletic adults. The BMI may be calculated by using the following formula: BMI equals [body weight in kg] divided by [height in meters].sup.2. In general, a normal BMI is between the range of 20 to 25, whereas the BMI of obese individuals is greater than or equal to 30. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Compositions and methods for promoting lipid mobilization in humans Inventor(s): Schacter, Lee P.; (Wilmington, DE), Schacter, Bernice; (Wilmington, DE) Correspondence: DUANE MORRIS, LLP; ATTN: WILLIAM H. MURRAY; ONE LIBERTY PLACE; 1650 MARKET STREET; PHILADELPHIA; PA; 19103-7396; US Patent Application Number: 20030162717 Date filed: February 7, 2002 Abstract: The invention provides methods of using polypeptide compounds based on the structures of insect peptides of the adipokinetic hormone family to mobilize lipids in humans. The compositions and methods described in the application are useful for modulating human body weight, such as inducing weight loss. The invention also includes screening methods for identifying other compounds effective for modulating lipid mobilization in humans. Excerpt(s): Not applicable. Not applicable. Not applicable. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Compositions and methods for treatment of body weight conditions Inventor(s): Bastian, Eric Douglas; (Twin Falls, ID), Ward, Loren Spencer; (Twin Falls, ID), Paulsen, Starla Joyce; (Twin Falls, ID) Correspondence: BANNER & WITCOFF, LTD.; TEN SOUTH WACKER DRIVE; SUITE 3000; CHICAGO; IL; 60606; US Patent Application Number: 20030165574 Date filed: February 21, 2003 Abstract: A nutritional supplement composition having therapeutically effective amounts of milk minerals including calcium, a protein source including.kappa.-casein fragment 106-169, and enzyme-inhibiting peptides is provided for the treatment of body weight conditions. The nutritional supplement composition is administered in amounts effective for limiting weight gain and/or enhancing weight loss, as well as promoting

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overall good health, in the treatment of body weight conditions, including overweight and obesity. Excerpt(s): This application is based on, and claims the benefit of co-pending U.S. Provisional Application Serial No. 60/360,709, filed on Mar. 1, 2002, the disclosure of which is incorporated herein by reference. The present invention is directed to compositions and methods for treatment of body weight conditions by administering a therapeutically effective nutritional supplement composition. More particularly, the nutritional composition, which includes a milk mineral blend and protein components, is effective for enhancing weight loss and/or limiting weight gain. In 2000, almost 20% of the population fell into the obese category as defined by a BMI of greater than or equal to 30. Problems associated with obesity include cardiovascular disease, diabetes mellitus, certain types of cancer, osteoarthritis and sleeping disorders. Obesity and related disorders account for almost 10% of US health care expenditures. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Compositions and methods relating to glucose metabolism, weight control, and food intake Inventor(s): Desir, Gary; (Woodbridge, CT), Xu, Jianchao; (Bethany, CT) Correspondence: MORGAN, LEWIS & BOCKIUS LLP; 1701 MARKET STREET; PHILADELPHIA; PA; 19103-2921; US Patent Application Number: 20030032595 Date filed: June 11, 2002 Abstract: The present invention relates to weight control, control of body fat and food intake, and provides useful methods for treating, inter alia, obesity, diabetes and insulin insensitivity, and conditions, diseases, and disorders relating thereto. The invention also relates to methods of identifying useful compounds relating to weight loss, food intake, diabetes, and obesity, among other things, based on the discovery that inhibiting Kv1.3 activity mediates decreased food intake, weight loss, decreased body fat, increase glucose uptake, and increased insulin sensitivity, among other things. Excerpt(s): This application is entitled to priority, pursuant to 35 U.S.C.sctn.119(e), to U.S. provisional patent application No. 60/297,547, which was filed on Jun. 12, 2001. Obesity is arguably the greatest public health threat in modem Western society, and it is an increasing threat throughout the world. A recent Surgeon General's report underscores the impact of obesity on human health. According to the report, approximately 61% of adults in the United States are overweight or obese, and the prevalence of overweight children and adolescents has doubled in the past two decades. The estimated economic burden of obesity to the United States alone is about $117 billion annually, and obesity is associated with an estimated 300,000 deaths per year. Further, numerous diseases have been correlated to obesity: Heart disease, certain types of cancer, sleep apnea, asthma, arthritis, pregnancy complications, depression and type II diabetes mellitus are all associated with excess weight. In light of the health dangers attributed to obesity, many treatments, both pharmacological and non-pharmacological, have been developed to combat this enormous problem. Non-pharmacological approaches include diet, exercise and surgical intervention. While a well-balanced diet consumed in moderation coupled with regular physical activity is the most easily applied method of controlling or losing weight, the aforementioned facts indicate that this method has not reversed the trend towards increasing obesity. Reasons for lack of

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exercise may include cardiovascular problems or physical imparities that limit aerobic exercise, or lack of discipline, motivation, or time. Thus, behavior modification methods have proven unsuccessful in reversing the trend towards increasing obesity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Computer program, method, and system for monitoring nutrition content of consumables and for facilitating menu planning Inventor(s): Bisogno, Joesph J.; (Lenexa, KS) Correspondence: HOVEY, WILLIAMS, TIMMONS & COLLINS; Suite 400; 2400 Grand; Kansas City; MO; 64108; US Patent Application Number: 20030165799 Date filed: June 11, 2001 Abstract: A computer program, method, and system for dynamically and interactively providing nutrition content information for consumables such that a user may monitor, tailor, plan, and review their intake thereof in light of a health-related interest or concern, such as, for example, weight-loss, food allergies, or diabetes or other nutrition affected illnesses or disabilities. Consumables are categorized and displayed in lists associated with an appropriate color to draw attention to relative nutrition content and to facilitate quicker and easier evaluation of a consumable of interest. Summaries are provided of a user's actual intake in light of a pre-established target intake for a particular day. Detailed reports may be generated showing consumption over a userspecifiable time period. Excerpt(s): The present invention relates to a computer program, method, or system for providing nutrition content information for consumables. More particularly, the present invention relates to a computer program, method, or method for dynamically and interactively providing nutrition content information for consumables such that a user may monitor, tailor, plan, and review their intake thereof in light of a health-related interest or concern, such as, for example, weight loss, food allergies, or diabetes or other nutrition-affected illnesses or disabilities. It is often desirable to monitor nutrition content of consumables, including, for example, calories, fat, sugar, protein, or carbohydrates. This is particularly true where such nutrition content may affect a healthrelated interest or concern, including, for example, weight loss, food allergies, or diabetes or other nutrition-affected illnesses or disabilities. Relatedly, it is further desirable to plan future consumption based upon nutrition content, and to review past consumption summarized for a specifiable time period. Various print resources exist to facilitate monitoring nutrition content. Books, for example, provide long lists of consumables and related nutrition information. Furthermore, most packaged consumables provide nutrition information on the packaging. Unfortunately, print resources suffer from a number of limitations and disadvantages. Books, for example, are bulky and difficult to conveniently tailor for efficient use by any particular person (short of adding or removing pages), which reduces likelihood of consistent use. Package-based information is, of course, limited to packaged foods. Furthermore, print resources are generally unable to practically present nutrition information in a visually descriptive manner operable to conveniently impart to a user a sense of a particular consumable's place in an overall monitoring scheme. Additionally, print resources are generally unable to practically provide a convenient mechanism whereby future consumption can be dynamically planned and past consumption can be reviewed.

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Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

CO-OLIGOMERIZATION OF 1-DODECENE AND 1-DECENE Inventor(s): Clarembeau, Michel; (Temploux, BE) Correspondence: CAROL WILSON; BP AMERICA INC.; MAIL CODE 5 EAST; 4101 WINFIELD ROAD; WARRENVILLE; IL; 60555; US Patent Application Number: 20030166986 Date filed: March 4, 2002 Abstract: A process for the co-oligomerization of 1-dodecene and 1-decene to produce a polyalphaolefin having a kinetic viscosity of 4 to 6 cSt at 100.degree. C., a Noack weight loss of 4 to 9%, a viscosity index of 130 to 145, and a pour point of -60.degree. C. to 50.degree. C. Excerpt(s): The present invention relates generally to the co-oligomerization of 1dodecene and 1-decene and more particularly concerns the production of a polyalphaolefin having a kinetic viscosity at 100.degree. C. in the range of from about 4 to about 6 cSt, a Noack weight loss in the range of from about 4 to about 9%, a viscosity index in the range of from about 130 to about 145, and a pour point in the range of from about -60.degree. C. to about -50.degree. C. Oligomers of alpha olefins and their use as synthetic lubricants are well known. A large market exists for synthetic lubricants that have a viscosity in the range of from 4 to 6 cSt. A low Noack weight loss, a high viscosity index and a low pour point are also desired properties. The use of a hydrogenated oligomer as a synthetic lubricant depends to a large extent on the viscosity of the hydrogenated oligomer. Isoparaffinic oils with kinetic viscosities at 100.degree. C. in the range of from 4 to 6 cSt that are used as synthetic lubricant base stocks, are typically made by oligomerization of 1-decene using a BF.sub.3 catalyst and an alcohol promoter. The range of properties for these polyalphaolefins generally include a kinematic viscosity in the range of 4 to 6 cSt at 100.degree. C., a Noack weight loss in the range of about 6 to 15%, a viscosity index in the range of 120-135, and a pour point of less than 55.degree. C. It is possible to prepare a polyalphaolefin with a kinematic viscosity at 100.degree. C. of 5 cSt with a better viscosity index and Noack weight loss by using 1dodecene instead of 1-decene as the raw material for such base stocks. When 1-dodecene is used as the raw material, the isoparaffinic oil so prepared typically has a Noack weight loss of 5.5% to 7% and a viscosity index of 143 but a pour point of only 45.degree. C. to about -50.degree. C. Another drawback to the use of 1-dodecene as the raw material is that it does not permit the product of isoparaffinic oils having viscosity below 5 cSt without an unacceptably high Noack weight loss. For instance, an isoparaffinic oil having a 4.5 cSt kinematic viscosity could be prepared by blending a 5 cSt oil made from 1-dodecene with a 4 cSt oil made from 1-decene, but the blend would have a Noack weight loss of 10-11%. Furthermore, using pure 1-dodecene as the raw material in a typical synthesis generally affords large amounts of heavier co-product besides the desired 4-6 cSt material. For example, typically about 70% of a 7 cSt isoparaffinic oil is produced in addition to the desired 5 cSt isoparaffinic oil. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Crystalline polyglycolic acid, polyglycolic acid composition and production process thereof Inventor(s): Miura, Hiromitsu; (Fukushima, JP), Yamane, Kazuyuki; (Fukushima, JP), Itoh, Daisuke; (Ibaraki, JP), Ono, Toshihiko; (Fukushima, JP), Nakajima, Junji; (Ibaraki, JP) Correspondence: DINSMORE & SHOHL, LLP; 1900 CHEMED CENTER; 255 EAST FIFTH STREET; CINCINNATI; OH; 45202; US Patent Application Number: 20030125508 Date filed: November 2, 2001 Abstract: Crystalline polyglycolic acid wherein a difference between the melting point Tm and the crystallization temperature Tc.sub.2 is not lower than 35.degree. C., and a difference between the crystallization temperature Tc.sub.1 and the glass transition temperature Tg is not lower than 40.degree. C. A production process of polyglycolic acid modified in crystallinity, comprising applying heat history to crystalline polyglycolic acid at a temperature of not lower than (the melting point Tm of the crystalline polyglycolic acid+38.degree. C.). A polyglycolic acid composition comprising crystalline polyglycolic acid and a heat stabilizer, wherein a difference (T.sub.2-T.sub.1) between the temperature T.sub.2 at 3%-weight loss on heating of the polyglycolic acid composition and the temperature T.sub.1 at 3%-weight loss on heating of the crystalline polyglycolic acid is not lower than 5.degree. C. Excerpt(s): The present invention relates to polyglycolic acid (including polyglycolide) modified in thermal properties such as crystallinity, and a production process thereof. The polyglycolic acid according to the present invention is excellent in melt processability, stretch processability, etc., and is suitable for use as a polymer material for, for example, sheets, films, fibers, blow molded products, composite materials (multi-layer films, multi-layer containers, etc.) and other molded or formed products. The present invention also relates to a polyglycolic acid composition which is so excellent in melt stability that generation of gasses attributable to low-molecular weight products produced upon melting is prevented, and a production process thereof. The present invention further relates to a process for controlling the crystallinity of polyglycolic acid. Polyglycolic acid is known to be degraded by microorganisms or enzymes present in the natural world such as soil and sea because it contains aliphatic ester linkages in its molecular chain. In recent years, the disposal of plastic waste has become a great problem with the increase of plastic products. Polyglycolic acid attracts attention as a biodegradable polymer material which scarcely imposes burden on the environment. The polyglycolic acid has intravital absorbability and is also utilized as a medical polymer material for surgical sutures, artificial skins, etc. (U.S. Pat. No. 3,297,033). Polyglycolic acid can be produced by dehydration polycondensation of glycolic acid, dealcoholization polycondensation of an alkyl glycolate, desalting polycondensation of a glycolic acid salt or the like. Polyglycolic acid can also be produced by a process comprising synthesizing glycolide, which is a bimolecular cyclic ester (also referred to as "cyclic dimer") of glycolic acid and subjecting the glycolide to ring-opening polymerization. According to the ring-opening polymerization process of glycolide, high-molecular weight polyglycolic acid can be produced with good efficiency. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Dishwashing compositions containing alkylbenzenesulfonate surfactants Inventor(s): Vinson, Phillip Kyle; (Faiffield, OH), Kott, Kevin Lee; (Cincinnati, OH), Connor, Daniel Stedman; (Cincinnati, OH), Scheibel, Jeffrey John; (Loveland, OH), Scheper, William Michael; (Lawrenceburg, IN), Cripe, Thomas Anthony; (Loveland, OH), Kasturi, Chandria; (Cincinnati, OH) Correspondence: THE PROCTER & GAMBLE COMPANY; INTELLECTUAL PROPERTY DIVISION; WINTON HILL TECHNICAL CENTER - BOX 161; 6110 CENTER HILL AVENUE; CINCINNATI; OH; 45224; US Patent Application Number: 20030100464 Date filed: July 19, 2001 Abstract: A hand dishwashing composition comprising i) from about 0.01% to about 99.99% by weight of composition of a surfactant mixture, said surfactant mixture comprising an alkylarylsulfonate surfactant system comprising at least two isomers of the alkylarylsulfonate surfactant of formula (a) wherein L is an acyclic aliphatic hydrocarbyl of from 6 to 18 carbon atoms in total; M is a cation or cation mixture and q is the valence thereof; a and b are numbers selected such that said surfactant mixture is electroneutral; R' is selected from H and C 1 to C 3 alkyl; R" is selected from H and C 1 to C 3 alkyl; R"' is selected from H and C 1 to C 3 alkyl; both R' and R" are nonterminally attached to L and at least one of R' and R" is C 1 to C 3 alkyl, and A is aryl, and wherein: said alkylarylsulfonate surfactant system comprises two or more isomers with respect to positions of attachment of R', R" and A to L; in at least about 60% of said alkylarylsulfonate surfactant system, A is attached to L in the position which is selected from positions alpha– and beta&ndash, to either of the two terminal carbon atoms thereof; and wherein further said alkylarylsulfonate surfactant system has at least one of the following properties said alkylarylsulfonate surfactant system has a ratio of nonquaternary to quaternary carbon atoms in L of at least about 10:1 by weight, when said quaternary carbon atoms are present; and there is no more than 40% by weight loss as measured by Hardness Tolerance Test; ii) from about 0.0001% to about 99.99% by weight of composition of a conventional hand dishwashing adjunct, and iii) from about 0.01% to about 7% by weight of composition of a divalent ion selected from the group consisting of magnesium, calcium and mixtures thereof Excerpt(s): The present invention relates to hand dishwashing compositions containing particular types of alkylarylsulfonate surfactants. More particularly, these alkylarylsulfonates have chemical compositions which differ both from the highly branched nonbiodegradable or "hard" alkylbenzenesulfonates still commercially available in certain countries; and which differ also from the so-called linear alkylbenzenesulfonates which have replaced them in most geographies, including the most recently introduced so-called "high 2-phenyl" types. Typical commercial hand dishwashing compositions incorporate divalent ions (Mg, Ca) to ensure adequate grease performance in soft water. However, the presence of divalent ions in formulas containing anionic, nonionic, or additional surfactants (e.g., amine oxide, alkyl ethoxylate, LAS, alkanoyl glucose amide, alkyl betaines) leads to slower rates of product mixing with water (and hence poor flash foam), poor rinsing, and poor low temperature stability properties. Moreover, preparation of stable dishwashing detergents containing Ca/Mg is very difficult due to the precipitation issues associated with Ca and Mg as pH increases. Consequently, there remains the need for a detergent composition suitable for hand dishwashing, which is stable at low temperatures, and additionally can provide grease removal and tough food cleaning benefits, in hard water and at pH's, typically pH 9 or lower, where a conventional Ca/Mg system would be unstable and not provide

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grease removal and tough food cleaning benefits. U.S. Pat. No. 5,026,933; U.S. Pat. No. 4,990,718; U.S. Pat. No. 4,301,316; U.S. Pat. No. 4,301,317; U.S. Pat. No. 4,855,527; U.S. Pat. No. 4,870,038; U.S. Pat. No. 2,477,382; EP 466,558, Jan. 15, 1992; EP 469,940, Feb. 5, 1992; FR 2,697,246, Apr. 29, 1994; SU 793,972, Jan. 7, 1981; U.S. Pat. No. 2,564,072; U.S. Pat. No. 3,196,174; U.S. Pat. No. 3,238,249; U.S. Pat. No. 3,355,484; U.S. Pat. No. 3,442,964; U.S. Pat. No. 3,492,364; U.S. Pat. No. 4,959,491; WO 88/07030, Sep. 25, 1990; U.S. Pat. No. 4,962,256, U.S. Pat. No. 5,196,624; U.S. Pat. No. 5,196,625; EP 364,012 B, Feb. 15, 1990; U.S. Pat. No. 3,312,745; U.S. Pat. No. 3,341,614; U.S. Pat. No. 3,442,965; U.S. Pat. No. 3,674,885; U.S. Pat. No. 4,447,664; U.S. Pat. No. 4,533,651; U.S. Pat. No. 4,587,374; U.S. Pat. No. 4,996,386; U.S. Pat. No. 5,210,060; U.S. Pat. No. 5,510,306; WO 95/17961, Jul. 6, 1995; WO 95/18084; U.S. Pat. No. 5,510,306; U.S. Pat. Nos. 5,087,788; 4,301,316; 4,301,317; 4,855,527; 4,870,038; 5,026,933; 5,625,105 and 4,973,788. The manufacture of alkylbenzenesulfonate surfactants has recently been reviewed. See Vol 56 in "Surfactant Science" series, Marcel Dekker, New York, 1996, including in particular Chapter 2 entitled "Alkylarylsulfonates: History, Manufacture, Analysis and Environmental Properties", pages 39-108 which includes 297 literature references. Documents referenced herein are incorporated in their entirety. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Fiber-water with added value delivery systems/elements/additives, addressing specific dietary use(s), and/or medical use(s) for humans and animals Inventor(s): Stillman, Suzanne Jaffe; (Los Angeles, CA) Correspondence: CROSBY HEAFEY ROACH & MAY; 1901 AVENUE OF THE STARS, SUITE 700; LOS ANGELES; CA; 90067; US Patent Application Number: 20030064104 Date filed: September 16, 2002 Abstract: A shelf-stable, ready to use, water-like composition for humans/animals; as an adjunct to fiber-water, and/or safe drinking water, consumed directly, tube feedings, or in the preparation/reconstitution of food(s)/beverage(s). Fortified Fiber-Water is fiberwater, with added delivery systems: Encapsulations/particles, of different size(s), shape(s), material(s), colors, non-visible, serving one or more functions: improved taste, odor-masking; controlled release applications; bio-availability of actives, avoid hygroscopicity; minimized interactions, improved thermal, oxidative, and shelf-life; decorative. Viscosity changing elements, (with one or more viscosity changing additives, with or without encapsulations, particles) to enhance delivery of active medicants/ingredients of categories: pharmaceuticals, nutraceuticals, dietary supplements, therapeutics, diagnostics, etc. Composition ensures hydration, simultaneously providing soluble fiber (fiber-water), with additives contained within the delivery systems, having the ability to target specific health goals/needs: weight loss, diabetes, cholesterol/heart, gastrointestinal tract disorders/improvement, osteoporosis, cancer, pain, stress, relaxant, stimulant etc. Excerpt(s): The present application is a continuation-in-part application of, and claims priority from, U.S. Ser. No. 10/204,572, filed Aug. 21, 2002 which was a continuation of, and claims priority from, PCT/US01/05630 filed Feb. 22, 2001, which in turn claims priority from U.S. Ser. No. 09/510,400, filed Feb. 22, 2000 and issued Jun. 19, 2001 as U.S. Pat. No. 6,248,390. In modern society, regardless of age, people are obliged to live with a multiplicity of various injurious, and stressful, conditions that affect the body. Moreover, as we extend "life span" there is a remarkable, and rapid, increase in the

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population of the elderly (seniors) living under these circumstances, and further there exists a high incidence of acute, and/or chronic, diseases therefore providing an increasing need for addressing health desires and challenges, ameliorating and/or preventing disease, and/or maintaining and promoting health, and establishing well being and wellness. It is therefore the goal of the inventor, with all the aforesaid in mind, taken to heart, and being a focus, while noticing with keen observance, that there must be new delivery systems by which to deliver active ingredients that is acceptable, desirable, and foremost ethical for which to deliver target specific, and target general, substances that will offer the greatest return on investment. an investment in health. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Herbal compositions and methods for diabetes and weight loss management. Inventor(s): Naguib, Yousry M.A.; (Arcadia, CA) Correspondence: YOUSRY M.A. NAGUIB; 602 Fairview Avenue, Apt. # 31; Arcadia; CA; 91007; US Patent Application Number: 20030143291 Date filed: January 31, 2002 Abstract: Herbal compositions and methods suitable for weight loss management and for treating diabetes are disclosed. The compositions comprise Ferula hermonis or an extract thereof, or Ferula hermonis with selected herbs, extracts thereof, and mixture thereof. The methods of reducing weight, and treating diabetes in patients involve oral administration of the compositions. The invention further relates to a method of extracting and standardizing Ferula hermonis extracts and tincture useful for human health. Excerpt(s): The invention relates to herbal compositions for weight loss management and treating diabetes in humans. The invention further relates to a method comprising the composition for reducing weight and treating diabetes in humans. The invention further relates to a method for extraction and standardization of a Ferula hermonis extract useful for human health. Obesity and overweight are associated with diabetes, hypertension and other diseases that cause morbidity, mortality and high health-care expenditure. Obesity is the number one nutritional problem in the U.S. An estimated one third of Americans are overweight, with an additional 25 percent being classified as obese. Being overweight significantly increases a person's risk of developing diabetes, heart disease, stroke, and other diseases. Diabetes is a chronic disease that affects 16 million people in the U.S., and more than 125 million people worldwide. Diabetes is the fourth-leading cause of death by disease in the United States. About two-thirds of the nearly 16 million people with type II diabetes in the U.S. are overweight, according to the American Diabetes Association. This form of the disease occurs when the body does not properly respond to insulin. The body uses insulin, a hormone, to help regulate the blood level of glucose, or blood sugar. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Intragastric device for treating obesity Inventor(s): Hashiba, Kiyoshi; (Sao Paulo, BR), Surti, Vihar C.; (Winston-Salem, NC) Correspondence: BRINKS HOFER GILSON & LIONE; P.O. BOX 10395; CHICAGO; IL; 60611; US Patent Application Number: 20030078611 Date filed: May 17, 2002 Abstract: An apparatus and method comprising at least one intragastric member or artificial bezoar made of a digestive-resistant or substantially indigestible material that is introduced into a gastric lumen of a mammal for the treatment of obesity. The intragastric member or artificial bezoar is typically at inserted into the gastric lumen in a partially compacted configuration, whereby it is then manipulated into, or allowed to assume, a second expanded configuration sufficiently large to remain within the reservoir of the stomach during normal activities and not be passed through the pylorus into the intestines. In animals, the present invention has been found to be effective in achieving weight loss over a several month period, while being easy to place and retrieve. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/291,790 filed May 17, 2001, and U.S. Provisional Application No. 60/360,353 filed Feb. 27, 2002, both entitled "Intragastric Device For Treating Obesity". This invention relates to medical devices, and more particularly to obesity treatment devices that can be placed in the stomach of a patient to reduce the size of the stomach reservoir. It is well known that obesity is a very difficult condition to treat. Methods of treatment are varied, and include drugs, behavior therapy, and physical exercise, or often a combinational approach involving two or more of these methods. Unfortunately, results are seldom long term, with many patients eventually returning to their original weight over time. For that reason, obesity, particularly morbid obesity, is often considered an incurable condition. More invasive approaches have been available which have yielded good results in many patients. These include surgical options such as bypass operations or gastroplasty. However, these procedures carry high risks, and are therefore not appropriate for most patients. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Intragastric stent for duodenum bypass Inventor(s): Geitz, Kurt; (Sudbury, MA) Correspondence: CHRISTENSEN, O'CONNOR, JOHNSON, KINDNESS, PLLC; 1420 FIFTH AVENUE; SUITE 2800; SEATTLE; WA; 98101-2347; US Patent Application Number: 20030109931 Date filed: January 25, 2002 Abstract: A porous weave of bioabsorbable filaments is encased in an elastic membrane to form a thin-walled stent. The stent is sized to be snugly fitted in the proximate portion of the duodenum of a patient, to induce weight loss by limiting uptake of food passing through the stent. After a predetermined period, the stent degrades and passes from the body without surgical intervention. Excerpt(s): The present invention relates to an impervious, resilient, flexible, biocompatible stent that can be secured in the duodenum adjacent to the pylorus to

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effect weight loss over a controlled period. The incidence of obesity and its associated health-related problems have reached epidemic proportions in the United States. See, for example, P. C. Mun et al., "Current Status of Medical and Surgical Therapy for Obesity" Gastroenterology 120:669-681 (2001). Recent investigations suggest that the causes of obesity involve a complex interplay of genetic, environmental, psychobehavioral, endocrine, metabolic, cultural, and socio-economic factors. Severe obesity is frequently associated with significant comorbid medical conditions, including coronary artery disease, hypertension, type II diabetes mellitus, gallstones, nonalcoholic steatohepatitis, pulmonary hypertension, and sleep apnea. Estimates of the incidence of morbid obesity are approximately 2% of the U.S. population and 0.5% worldwide. Current treatments range from diet, exercise, behavioral modification, and pharmacotherapy to various types of surgery, with varying risks and efficacy. In general, nonsurgical modalities, although less invasive, achieve only relatively shortterm and limited weight loss in most patients. Surgical treatments include gastroplasty to restrict the capacity of the stomach to hold large amounts of food, such as by stapling or "gastric banding." Other surgical procedures include gastric bypass and gastric "balloons" which, when deflated, may be inserted into the stomach and then are distended by filling with saline solution. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Low viscosity-increment fumed-silica and its slurry Inventor(s): Kobayashi, Hitoshi; (Yokkaichi-shi, JP), Murota, Masamichi; (Yokkaichi-shi, JP), Shirono, Hirokuni; (Yokkaichi-shi, JP) Correspondence: OBLON, SPIVAK, MCCLELLAND, MAIER & NEUSTADT, P.C.; 1940 DUKE STREET; ALEXANDRIA; VA; 22314; US Patent Application Number: 20030124045 Date filed: December 23, 2002 Abstract: A fumed-silica, which can make a slurry having sufficient wettability to a polar liquid, excellent dispersibility, and low viscosity even in the high concentration, and a slurry thereof. A fumed-silica and its slurry are provided, wherein the water content is controlled so that a weight loss after drying Y, and a dynamic wetting rate to water Z, have specified values. Excerpt(s): The present invention relates to a low viscosity-increment fumed-silica and a slurry thereof. The fumed-silica may be used as a component of a chemical-mechanical polishing (CMP), a coating material, a printing ink, an adhesive, a sealant, and an ink-jet recording paper etc., and can also be used to prepare a silica slurry having high flowability and dispersibility even at a high concentration of silica in the slurry. Fumedsilica is classified as a silicic acid anhydride, has small absorption ability for water content, and is used for the purpose of increasing the viscosity of a liquid. In addition, the fumed silica has an advantage of being able to increase the viscosity of a solution with the addition of only a small amount. However, when the fumed-silica is used at a high concentration with slurry, there is a problem in the dispersibility since the viscosity-increment is too high. Accordingly, there remains a need for fumed-silica which overcomes this difficulty. The present invention solves the problem associated with the conventional fumed-silica discussed above, and provides a fumed-silica, which can be used to make the slurry having excellent dispersibility, sufficient wettability to a polar liquid, and low viscosity-increment even in the high concentration, by absorbing water uniformly and compulsorily on the surface of the fumed-silica without existing

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aggregated particles. The present invention also provides a slurry of the inventive fumed-silica. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method and apparatus for producing metal oxide Inventor(s): Arii, Tadashi; (Tokyo, JP), Kishi, Akira; (Tokyo, JP) Correspondence: FRISHAUF, HOLTZ, GOODMAN & CHICK, PC; 767 THIRD AVENUE; 25TH FLOOR; NEW YORK; NY; 10017-2023; US Patent Application Number: 20030087516 Date filed: October 31, 2002 Abstract: Metal oxide is produced by heating a metal salt of a carboxylic acid to a predetermined temperature, which varies with a raw material, lower than 300.degree. C. In the case of using zinc acetate as the raw material, when heated in dry helium gas, it is sublimated and decomposed to produce no zinc oxide. In contrast, when heated in a mixture gas of nitrogen gas and water vapor with a programming rate of 5.degree. C./min, the weight loss begins around 110.degree. C. and has been completed around 230.degree. C., at a water vapor partial pressure of 17.9 kPa, to produce zinc oxide. If keeping the temperature approximately constant when the weight loss begins, zinc oxide is produced around 115.degree. C. with a high degree of crystallinity. A metal may be any one of zinc, cadmium, indium and copper. A carboxylic acid may be any one of formic acid, acetic acid, propionic acid and 2-ethylhexanoic acid. Excerpt(s): This invention relates to a method for producing a metal oxide, and especially to a method for producing a metal oxide at a temperature lower than that in the conventional method with the use of a metal salt of a carboxylic acid as a raw material and apparatus for producing such a metal oxide. This invention further relates to a semiconductor device having such a metal oxide produced by such a method. There has been a strong need for producing a metal oxide thin film for an electronic use at the lowest temperature possible and at high efficiency. Accordingly, various methods have been investigated. The typical methods for producing a metal oxide thin film can be roughly classified to first a coating method including a sol-gel process and an MOD (Metallo-Organic Decomposition) process, and second a vapor deposition method including a CVD (Chemical Vapor Deposition) process and a sputtering process. Of these processes, the sol-gel process, the MOD process and the CVD process have been developed and put to practical use for the mass production. In the CVD process, an organometallic compound, a metal complex or a metal alkoxide may be used as a raw material. An ideal raw material for the CVD must satisfy the requirements: (1) with a high vapor pressure at a low temperature, (2) less poisonous, and (3) able to maintain a stable vapor pressure for a long time. There are no many materials satisfying the requirements. Especially, there are very few materials with a high vapor pressure at a low temperature. Explaining the vapor pressure requirement of the raw material, the CVD process makes the raw material sublimate or vaporize and uses vapor-phase precursor molecules. Therefore, materials with a low vapor pressure can not be used as raw materials in the CVD process because they can not become a vapor phase. Further, the CVD process often requires a temperature higher than 500.degree. C. for producing a thin film with a high degree of crystallinity. Furthermore, the vapor deposition method including the CVD process requires expensive vacuum equipment and exhaust equipment.

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Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method and composition for enhancing weight loss Inventor(s): Hirsch, Alan R.; (Riverwoods, IL) Correspondence: WHYTE HIRSCHBOECK DUDEK S C; 111 EAST WISCONSIN AVENUE; SUITE 2100; MILWAUKEE; WI; 53202 Patent Application Number: 20030147938 Date filed: November 27, 2002 Abstract: Compositions for enhancing satiety and weight loss in an individual, assays for assessing a tastant for enhancing satiety and weight loss, and methods of using the composition to suppress appetite and enhance weight loss are provided. Excerpt(s): This application claims the benefit of U.S. Provisional Application Serial No. 60/334,401, filed Nov. 30, 2001. The present invention relates generally to appetite suppression and weight loss, and more particularly to a composition that enhances satiety during a meal and methods of using the composition to achieve body weight loss. With a third to a quarter of the American population overweight, obesity is rampant in contemporary society. At any given time, 40% of women and 24% of men are trying to lose weight and of these, 84% of women and 76-78% of men are dieting for this purpose. In the USA, losing weight has become a national obsession. Over 30 billion dollars are spent each year devising a plethora of new diets and methods for losing weight, none of which have been demonstrated to be effective over a long term (2 years). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method for the treatment and prevention of cachexia Inventor(s): Muglia, Louis; (St. Louis, MO) Correspondence: SONNENSCHEIN NATH & ROSENTHAL; P.O. BOX 061080; WACKER DRIVE STATION; CHICAGO; IL; 60606-1080; US Patent Application Number: 20030087942 Date filed: August 30, 2002 Abstract: Cachexia, including anorexia and other forms of weight loss, is a frequent complication of acute and chronic infections, and result from induction of cytokines, prostaglandins, and other inflammatory mediators that are critical for pathogen elimination. The present invention includes methods for the treatment or prevention of cachexic conditions while maintaining the production of factors essential for infection control through the administration of an effective amount of a cyclooxygenase-2 selective inhibiting compound. Excerpt(s): Activation of the immune system during acute bacterial or viral infections results in generation of cytokines and other inflammatory mediators that are essential for infection control. These inflammatory mediators result in mononuclear cell chemotaxis and activation, and local changes in blood flow and vascular permeability that facilitate pathogen eradication. In addition to these beneficial actions, factors induced during infection or other systemic inflammation also exhibit detrimental actions. One important consequence of inflammation is anorexia, accompanied by acute weight loss. This phenomenon is described, for example, by Langhans and Hrupka

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(Neuropeptides 33: 415-24, 1999). Additional work in this area was performed by Langhans and Hrupka (Neuropeptides 33: 415-24, 1999). This phenomenon is further described by Sonti et al. (Am J Physiol Regulatory Integrative Comp Physiol 270: R1394402, 1996). With severe or prolonged infection or inflammation, these changes in nutrition can adversely affect resolution of infection, wound healing, and growth. Lipopolysaccharide (LPS), a major component of the outer cell wall of gram-negative bacteria, has been extensively utilized as a model for acute sepsis. Similar to bacterial infection, LPS administration results in fever, robust cytokine production, and anorexia in rodents. See for example, Li et al., Brain Res 825: 86-94, 1999. As a further example, see Porter et al., Am J Physiol Regulatory Integrative Comp Physiol 279: R2113-20, 2000. Inhibition of cytokine production or action after LPS, specifically TNF-.alpha. and IL1.beta., attenuates LPS-induced anorexia. See for example Porter et al., Am J Physiol Regulatory Integrative Comp Physiol 274: R741-5, 1998. However, inhibition of these proximal mediators of the inflammatory cascade would be expected to compromise survival in the setting of a live, replicating pathogen as suggested by the increased susceptibility of mice with genetic deficiency of TNF receptor 1, IL-6, and interferon.gamma. to infection with bacterial agents such as Listeria monocytogenes. See for example Rothe et al., Nature 364: 798-802, 1993. Further work in this area was performed by Kopf et al., Nature 369: 339-42, 1994. Inhibition of prostaglandin production has also been shown to attenuate the anorectic response to LPS or IL-1.beta., but the mechanism by which this occurs and the consequences for generation of a protective inflammatory response remain unclear. For example, Langhans et al. (Physiol Behav 46: 535-9, 1989) described experiments in which the non-selective cyclooxygenase inhibitor indomethacin attenuated anorectic response caused by LPS. Shimomura et al. (Life Sci 51: 1419-26, 1992) described the use of a cyclooxygenase and lipoxygenase inhibitor to partially attenuate anorexia induced by IL-1.beta. The first committed step in prostaglandin synthesis, catalyzed by prostaglandin H synthases, or cyclooxygenases, has served as an important therapeutic target for treatment of inflammatory disease (Smith and Dewitt, Advances in Immunology 62: 167-215, 1996). Recently developed non-steroidal anti-inflammatory drugs (NSAIDs) are capable of selectively inhibiting the function of one of the two cyclooxygenase (COX) isoforms COX-1 or COX-2. For example, Masferrer et al. describe the selective inhibition of COX-2 in vivo is antiinflammatory and nonulcerogenic (Proc Natl Acad Sci USA 91: 3228-3232, 1994). Masferrer et al. further describe COX-2 inhibitors and their properties in Gastroenterology Clinics of North America 25: 363-72, 1996. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method of treating weight loss using creatine Inventor(s): Bessman, Samuel; (Los Angeles, CA) Correspondence: ROBERT BERLINER; FULBRIGHT & JAWORSKI LLP; 865 S. Figueroa St. #2900; Los Angeles; CA; 90017; US Patent Application Number: 20030013767 Date filed: July 11, 2002 Abstract: A method of using a creatine compound to treat muscle loss associated with liver and kidney diseases. In preferred embodiments, creatine monohydrate is administered by dialysis. The method can be extended to other diseases or conditions associated with muscle loss. Also provided is a composition comprising a dialysis fluid containing a creatine compound.

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Excerpt(s): This invention relates generally to a treatment for muscle loss, and in particular to the use of creatine to counteract muscle loss associated with liver and kidney diseases. Creatine is synthesized by the normal body and employed primarily in heart and skeletal muscle for growth and function. The normal human adult body contains about 100 grams of creatine, 95% of which is found in these two organs. About two-thirds of the creatine in muscle and heart is combined with inorganic phosphate to form creatine phosphate. In this form, creatine phosphate contains energy utilizable for contraction or synthesis of protein equal to the well known adenosine triphosphate ("ATP"), which is used for almost all energy requiring reactions of the organism. In contrast to ATP, creatine phosphate is used primarily for motion and growth of skeletal muscle. Three natural amino acids, glycine, arginine and methionine, all of which are non-essential amino acids which can be synthesized by the normal body, provide the building blocks for creatine biosynthesis. About 2 grams of creatine are made every day. The first step of synthesis occurs primarily in the kidney, the second step in the liver. First, a guanidine group is transferred from arginine to glycine to form guanidoacetic acid, which enters the general circulation through the renal veins. Second, in liver cells, guanidoacetic acid receives a methyl group from methionine to become methylguanidoacetic acid, or creatine. This second step is catalyzed by the enzyme guanidoacetic methyltransferase. The creatine thus synthesized is carried by the blood to skeletal muscle, the heart, and in small amounts to the brain. It is noteworthy that creatine is not used in anyway by the organs in which it is made, nor is it made in the organs in which it is used, nor is it consumed during the performance of its function. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Monounsaturated fatty acids of at least 20 carbon atoms and perhydrocyclopentanophenanthrene nucleus combination molecules and their use as weight-loss agents Inventor(s): Girouard, Michael P.; (Cornelius, NC) Correspondence: GARVEY SMITH NEHRBASS & DOODY, LLC; THREE LAKEWAY CENTER; 3838 NORTH CAUSEWAY BLVD., SUITE 3290; METAIRIE; LA; 70002 Patent Application Number: 20030114431 Date filed: August 26, 2002 Abstract: The pharmaceutical and/or cosmetic compositions for treatment of obesity and/or overweight contain an effective amount of a fatty-acid monoester of an estrogen and a fatty acid wherein the estrogen is preferably estrone, diethylstilbestrol, estriol, estradiol or ethinyl estradiol and the fatty acid is eicosenoic acid, especially cis 11 eicosenoic, although cis 5, cis 8, and cis 13 eicosenoic acid are also effective. The C-22 fatty acid monoester of estrogen, cis 13 docosenoic acid (Erucic acid), and the C-24 fatty acid monoester of estrogen, cis 15 tetracosenoic acid (Nervonic acid) are also effective and are included in this disclosure. In addition, synthesized combination molecules formed when a monounsaturated fatty acid of 20 carbon atoms or more is joined via an ester, ether, or amide bond to either a steroid or any molecule containing a perhydrocyclopentanophenanthrene nucleus or perhydrocyclopentanophenanthrene nucleus derivative are also included in this invention. The fatty-acid monoesters mimic the function of estrone monooleate, as a signal that informs the brain of the size of fat tissue mass. In preferred pharmaceutical and/or cosmetic compositions for intravenous injection the monoester is incorporated in a lipidic suspension, prepared from lipoproteins or from liposome components, such as soy oil and egg phospholipids.

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When administered to rats with a 15% of total adipose tissue, they produce weight reduction of about 10%, by a new and unexpected mechanism. They are useful for the treatment of obesity and/or overweight in mammals, with the advantages of high efficacy and low toxicity. Excerpt(s): Priority of my U.S. Provisional Patent Application, Serial No. 60/314,995, filed Aug. 24, 2001, incorporated herein by reference, is hereby claimed. The present invention relates to weight loss. More particularly, the present invention relates to medication-aided weight loss treatments. Since treating patients for weight loss since 1981, the present inventor has observed that roughly seventy-five percent of his patients have little or absolutely no history of overweight or obesity prior to a major event associated with estrogen hormonal changes. The most common estrogen hormonal events are pregnancy (especially second and late pregnancies), hysterectomy, tubal ligation, or peri-menopause/menopause. Usually, the change is dramatic. Interestingly, these patients do not report a change in eating or exercise habits. Furthermore, exercise and strict weight loss produce only modest weight loss in many if not most of these patients, indicating that some aspect of fat metabolism has been altered as a result of the hormonal situations noted above. Because the genetic makeup of these patients has not changed, the present inventor has recognized the role of hormones in producing changes in body fat metabolism in humans. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

NON-MA HUANG HERB WEIGHT LOSS PRODUCT Inventor(s): Fleischner, Albert M.; (Westwood, NJ) Correspondence: PHARMACEUTICAL PATENT ATTORNEYS; POHL & ASSOC. LLC; 55 MADISON AVENUE; 4TH FLOOR (P4014); MORRISTOWN; NJ; 07960-6397; US Patent Application Number: 20030039708 Date filed: August 13, 2001 Abstract: Supplement compositions designed to support weight loss and increase energy while suppressing appetite. 1 Chromium (as chromium dinicotinate glycinate) 25 mcg to 200 mg Vanadium (as vanadium amino acid chelate) 25 mcg to 100 mg Glucomannan 100 mg to 500 mg Green tea leaf extract (supplying 60 mg caffeine) 50 mg to 500 mg Coleus forskohlii extract (10% forskolin) (tuber) 50 mg to 500 mg Sodium carboxymethyl cellulose 25 mg to 250 mg Excipients: aa of each to produce a Gelatin, Magnesium Stearate, Silica suitable tablet Excerpt(s): The prior art regarding this invention arises from distinct areas not heretofore combined to create new and useful formula sets or new and useful improvements thereof regarding a Solid-dosage Form of a Weight Loss Product. This invention relates to the evolving science that a new and unique combination of coleus forskohlii extract (10% forskolin) (tuber), green tea extract (supplying 60 mg. caffeine), chromium (as chromium dinicotinate glycinate), vanadium (as vanadium amino acid chelate), and glucomannan, results in increased weight loss, increased energy and suppressed appetite without losing lean body mass. Forskolin is an adenylyl cyclase activator that fully mimics thyroid-stimulating hormone and induces lipolysis, the breakdown of fat, in fat cells. The net result is the release of fatty acids from stored fat cells. Forskolin increases lean body mass while simultaneously reducing body fat and weight, thereby helping to optimize body composition. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Novel pharmaceutical formulation with controlled release of active substances Inventor(s): Venturini, Peter; (Ljubljana, SI), Rebic, Ljubomira Barbara; (Ljubljana, SI), Kofler, Bojan; (Skofja Loka, SI), Sirca, Judita; (Ljubljana, SI) Correspondence: T. Gene Dillahunty; BURNS, DOANE, SWECKER & MATHIS, L.L.P.; P.O. Box 1404; Alexandria; VA; 22313-1404; US Patent Application Number: 20030175348 Date filed: March 28, 2003 Abstract: There is disclosed a method for stabilizing active substances that are unstable in acidic medium, unstable when stored for longer periods of time in the presence of water and at the same time sensitive to heating, by means of anhydrous granulation of active substances and dried pharmaceutically acceptable auxiliary substances for the preparation of pellet cores or granules. All pharmaceutically acceptable auxiliary substances employed are dried before use so that their weight loss at drying is less than 1.0% of the total weight of the pharmaceutically acceptable auxiliary substance, preferably less than 0.5%. Organic solvents used in process of anhydrous granulation should contain less than 0.2% of water. A novel pharmaceutical formulation with controlled release of active substances that are unstable in acidic medium, unstable when stored for longer periods of time in the presence of water and at the same time sensitive to heating, is disclosed as well. Excerpt(s): The invention belongs to the field of pharmaceutical industry and relates to a novel medicinal formulation with controlled release of active substances on the basis of anhydrous granulation of the active substances and dried pharmaceutically acceptable auxiliary substances. By the invention a technologically simple manufacture of a stable pharmaceutical formulation with controlled release of active substances is made possible. More specifically, the invention relates to a novel pharmaceutical formulation with controlled release of active substances that are unstable in acidic medium, unstable when stored for longer periods of time in the presence of water and at the same time sensitive to heating. Further, the invention relates to a novel method of stabilization of such unstable active substances and to a process for the preparation of the novel pharmaceutical formulation of such unstable active substances. There exists a constant need for developing pharmaceutical formulations wherein in a technologically simple way there would be achieved a good stability of active substances that are unstable in acidic medium, unstable when stored for longer periods of time in the presence of water and at the same time sensitive to heating. For the manufacture of hitherto known pharmaceutical formulations containing such active substances, technological processes have been used, wherein also water, wherein such active substances are not stable, has been used as a solvent and therefore the required stability has been achieved especially by the addition of basic substances to the active substance or by using the active substance in the form of a-salt thereof. Namely, basic substances create a basic pH in the environment of the active substance, whereat such active substances are more stable. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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NOVEL USES OF AVIAN INTERFERON GAMMA (IFN-Y) Inventor(s): YORK, JENNIFER J.; (CLIFTON HILL, AU), LOWENTHAL, JOHN W.; (BELMONT, AU), JOHNSON, MICHAEL A.; (THORNBURY, AU), O'NEIL, TERRI E.; (HIGHTON, AU) Correspondence: GREENLEE WINNER AND SULLIVAN P C; 5370 MANHATTAN CIRCLE; SUITE 201; BOULDER; CO; 80303; US Patent Application Number: 20030099610 Date filed: November 19, 1999 Abstract: The present invention provides compositions comprising recombinant avian IFN-.gamma. polypeptides and methods using said recombinant avian IFN-.gamma. polypeptides and compositions to enhance the immune responses of birds, and to enhance growth and/or prevent weight loss in birds. The present invention is particularly useful in the prophylactic and therapeutic treatment of birds against coccidiosis and the causative agent thereof. Excerpt(s): The present application is a continuation-in-part application of U.S. Ser. No. 08/765,381, filed Dec. 19, 1996, and U.S. Ser. No. 091272,032 filed Mar. 18, 1999. U.S. Ser. No. 08/765,381 is the United States national phase application of International application No. PCT/AU96/00114 filed on Mar. 5, 1996, which claims priority from Australian Patent Application No. PN 1542/95, filed Mar. 6, 1995. U.S. Ser. No. 09/272,032 is a continuation-in-part application of U.S. Ser. No. 08/448,617, filed Sep. 8, 1995, which is the United States national phase application of International application No. PCT/AU94/00189 filed Apr. 14, 1994, which claims priority from Australian Patent Application No. PL 8297, filed Apr. 14, 1993. The present invention relates generally to recombinant avian interferon polypeptides and genetic sequences encoding same, and uses therefor. In particular, the present invention is directed to the use of recombinant avian IFN-.gamma. polypeptides as an immune response modulator and as a growth enhancing agent in avian species. The present invention is particularly useful in the prophylactic and therapeutic treatment of birds against coccidiosis and the causative agent thereof. The rapidly increasing sophistication of recombinant DNA technology is greatly facilitating research into the medical and veterinary fields. Cytokine research is of particular importance, especially as these molecules regulate the proliferation, differentiation and function of a great variety of cells, such as cells involved in mediating an immune response. Administration of recombinant cytokines or regulating cytokine function and/or synthesis is becoming, increasingly, the focus of medical research into the treatment of a range of disease conditions in humans and animals. The present invention seeks to provide novel reagents and methods that employ recombinant cytokine polypeptides, for the treatment of disease conditions in birds. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Nutritional supplement for the management of weight Inventor(s): Bell, Stacey J.; (Belmont, MA) Correspondence: HAMILTON, BROOK, SMITH & REYNOLDS, P.C.; 530 VIRGINIA ROAD; P.O. BOX 9133; CONCORD; MA; 01742-9133; US Patent Application Number: 20030143287 Date filed: February 6, 2003

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Abstract: Described herein is a nutritional supplement to be incorporated into the diet of an overweight or obese patient comprising a low glycemic index carbohydrate source, a source of protein, and a source of fat, and further comprising a source of green tea extract, a source of 5-hydroxytryptophan (5-HTP), and a source of chromium. The supplement provides active food-grade ingredients to improve the management weight loss, prevention of weight gain, and a feeling of satiety. Excerpt(s): This application is a continuation of International Application No. PCT/US01/24465, which designated the United States and was filed on Aug. 2, 2001, published in English, which is a continuation-in-part of U.S. application Ser. Nos. 09/634,246, filed Aug. 8, 2000 (now abandoned) and 09/783,724, filed Feb. 14, 2001, the entire teachings of which are incorporated herein by reference. The prevalence of obesity in adults, children and adolescents has increased rapidly over the past 30 years in the United States and globally and continues to rise. Obesity is classically defined based on the percentage of body fat or, more recently, the body mass index (BMI), also called Quetlet index (National Task Force on the Prevention and Treatment of Obesity, Arch. Intern. Med., 160: 898-904 (2000); Khaodhiar, L. et al., Clin. Cornerstone, 2: 17-31 (1999)). The BMI is defined as the ratio of weight (kg) divided by height (in meters) squared. Overweight and obesity are associated with increasing the risk of developing many chronic diseases of aging seen in the U.S. (Must, A. et al., JAMA, 282: 1523-9 (1999)). Such co-morbidities include type 2 diabetes mellitus, hypertension, coronary heart diseases and dyslipidemia, gallstones and cholecystectomy, osteoarthritis, cancer (of the breast, colon, endometrial, prostate, and gallbladder), and sleep apnea. It is estimated that there are around 325,00 deaths annually that are attributable to obesity. The key to reducing the severity of the diseases is to lose weight effectively. Although about 30 to 40% claim to be trying to lose weight or maintain lost weight, current therapies appear not to be working. Besides dietary manipulation, pharmacological management and in extreme cases, surgery, are sanctioned adjunctive therapies to treat overweight and obese patients (Expert Panel, National Institute of Health, Heart, Lung, and Blood Institute, 1-42 (June 1998); Bray, G. A., Contemporary Diagnosis and Management of Obesity, 246-273 (1998)). Drugs have side effects, and surgery, although effective, is a drastic measure and reserved for morbidly obese. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Optical glass for molding Inventor(s): Yamamoto, Yoshinori; (Saitama-ken, JP), Tsuchiya, Koichi; (Saitama-ken, JP), Sawanobori, Naruhito; (Saitama-ken, JP), Nagahama, Shinobu; (Saitama-ken, JP), Otsuka, Masaaki; (Saitama-ken, JP) Correspondence: McDERMOTT, WILL & EMERY; 600 13th Street, N.W.; Washington; DC; 20005-3096; US Patent Application Number: 20030153450 Date filed: July 12, 2002 Abstract: The present invention provides an optical glass for press molding, in particular, a low softening point glass which contains, in an oxide glass of phosphate type, a durability improving component in addition to glass forming components, and has a weight loss of at most 0.15 weight % in a durability test, and which is represented, in term of elements for making up the glass, by the following chemical composition (mol %): 1 P.sub.2O.sub.5 32 to 40% Li.sub.2O 6 to 21% Na.sub.2O 8 to 31% K.sub.2O 4 to 22%

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Al.sub.2O.sub.3 7.4 to 16% ZnO 0 to 19.6% BaO 0 to 12% and Sum of Li.sub.2O + Na.sub.2O + K.sub.2O 35.1 to 49% Excerpt(s): This invention relates to an optical glass for molding, in particular, an optical glass for a precision molding lens capable of carrying out molding at most 400.degree. C. Of late, aspherical lenses or micro optical lenses used in the optical lens system have often been produced by a molding technique using a high precision metallic mold without polishing. However, the quality of a metallic mold suitable for molding is subject to various limitations from the respect of workability, durability and mass production property. This teaches that the property of a glass to be molded is also limited. The most important property limited is a softening temperature. Molding of a glass having a softening temperature of 600 to 700.degree. C. or higher, for example, has a large influence upon the life of a metallic mold and thus results in lowering of the mass production property of lenses. Accordingly, it has been considered difficult from the standpoint of mass productivity to press-mold commercially available optical glasses of all kinds having been marketed and consequently, it becomes a subject of research to develop a glass excellent in press molding property. In JP-A-02-124743, for example, there is disclosed a low softening point, medium refractive index and low dispersion optical glass for precision molding lens, having a yielding temperature (At) of at most 500.degree. C., referactive index (nd) of 1.53 to 1.62 and Abbe number (.nu.d) of 59.0 to 64.0, and comprising P.sub.2O.sub.5 and ZnO, as an essential element, and 28 to 49 weight % of ZnO+BaO+SrO+CaO+MgO. This optical glass has such a feature that grinding or polishing after molding is not required because of having a low yielding temperature (At) and excellent stability, chemical durability, weather proof property as well as softening property. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Oral appliance and method for use in weight loss and control Inventor(s): Florman, Michael J.; (New York, NY) Correspondence: FAY, SHARPE, FAGAN, MINNICH & McKEE, LLP; Seventh Floor; 1100 Superior Avenue; Cleveland; OH; 44114-2518; US Patent Application Number: 20030075186 Date filed: October 1, 2002 Abstract: An oral appliance device and method are provided for slowing the ingestion of food thereby triggering an increase in the feeling of satiety for a given amount of food. The appliance affixes to the maxillary teeth and mandibular teeth, and restricts the distance the wearer can open the mouth. The appliance includes upper and lower attachable portions which affix to the upper and lower teeth, and a flexible element that connects the upper and lower parts. The restricted opening distance can be adjusted, by either lengthening the flexible part of the appliance, or re-positioning the upper and lower affixable part(s). The appliance allows the patient to perform oral hygiene and speak normally. The appliance allows patients to chew food, but at a slower rate. The appliance decreases the amount of food a wearer can put into his/her mouth at any single time, increasing the amount of time it takes to eat. Excerpt(s): This application claims the benefit of U.S. Provisional Patent Application No. 60/326,417 filed Oct. 1, 2001. The invention is related to the art of weight control devices and more specifically, dental appliances operative to assist a patient in reducing the intake of food. The invention restricts mandibular movement and therefore slows the

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rate of food ingestion. The device also decreases the amount of food in the mouth at any given time, due to the constriction of opening, resulting in a decrease in volume. Slowing the rate of food ingestion allows the body time to respond to the ingestion of food with a sensation of satiety. The patient feels full after consuming a reduced amount of food. Therefore, the patient eats less and loses weight. A number of dental appliances have been described as aiding a patient in achieving weight loss through the restriction of mandibular movements. For example, U.S. Pat. No. 6,138,679 to Renders, et al. discloses a mandibular restraint that includes a pain-inducing device. The pain-inducing device can be a bar shaped element with a thickened portion that is said to press against a gum or jaw of the patient as the patient attempts to open the mouth beyond a threshold position. Alternatively, or additionally, the pain-inducing device delivers a painful electric shock to the gum or tooth of the patient. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Pharmaceutical composition for the treatment of obesity or to facilitate or promote weight loss Inventor(s): Coe, Jotham Wadsworth; (Niantic, CT), Dow, Robert L.; (Waterford, CT), Watsky, Eric Jacob; (Stonington, CT), Harrigan, Edmund Patrick; (Old Lyme, CT), O'Neill, Brian Thomas; (Old Saybrook, CT), Sands, Steven Bradley; (Stonington, CT) Correspondence: PFIZER INC; 150 EAST 42ND STREET; 5TH FLOOR - STOP 49; NEW YORK; NY; 10017-5612; US Patent Application Number: 20030176457 Date filed: February 13, 2003 Abstract: Pharmaceutical compositions are disclosed for the treatment of obesity, an overweight condition and compulsive overeating. The pharmaceutical compositions are comprised of a therapeutically effective combination of a nicotine receptor partial agonist and an anti-obesity agent or weight loss facilitator or promoter and a pharmaceutically acceptable carrier. The method of using these compounds is also disclosed. Excerpt(s): The present invention relates to pharmaceutical compositions for the treatment of obesity, compulsive overeating; or to facilitate or promote weight loss in a mammal (e.g. human) comprising a nicotine receptor partial agonist (NRPA) and an anti-obesity or weight loss promoting agent. The term NRPA refers to all chemical compounds which bind at neuronal nicotinic acetylcholine specific receptor sites in mammalian tissue and elicit a partial agonist response. A partial agonist response is defined here to mean a partial, or incomplete functional effect in a given functional assay. Additionally, a partial agonist will also exhibit some degree of antagonist activity by its ability to block the action of a full agonist (Feldman, R. S., Meyer, J. S. & Quenzer, L. F. Principles of Neuropsychopharmacology, 1997; Sinauer Assoc. Inc.). The present invention may be used to treat mammals (e.g. humans) for obesity, an overweight condition or compulsive overeating with a decrease in the severity of unwanted side effects such as causing nausea and/or stomach upset. Obesity is a major health risk that leads to increased mortality and incidence of Type 2 diabetes mellitus, hypertension and dyslipidemia. It is the second leading cause of preventable death in the United States, and contributes to>300,000 deaths per year. The estimated direct annual health cost associated with obesity is $70 billion, while the total overall cost to the U.S. economy has been estimated to be over $140 billion. In the U.S., more than 50% of the adult population is overweight, and almost 1/4 of the population is considered to be obese

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(BMI greater than or equal to 30). Furthermore, the prevalence of obesity in the United States has increased by about 50% in the past 10 years. While the vast majority of obesity occurs in the industrialized world, particularly in U.S. and Europe, the prevalence of obesity is also increasing in Japan. The prevalence of obesity in adults is 10%-25% in most countries of Western Europe. The rise in the incidence of obesity has promoted the WHO to recognize obesity as a significant disease. What is needed are orally active agents that induce sustained weight loss of 10-15% of initial body weight, due to selective loss of body fat in moderately obese patients. These orally active agents should increase energy expenditure, decrease food intake and partition energy away from adipose tissue. This degree of sustained weight loss would then improve comorbidities including hyperglycemia, hypertension and hyperlipidemia, all of which are exacerbated by obesity. However, even though weight loss agents have therapeutic utility in the treatment of obesity, there are significant liabilities to the use of weight loss compounds. Specifically, many of these compounds that have been tested in humans can cause potentially serious side effects such as gastrointestinal complications including nausea, emesis, ulcers, constipation, flatulence, diarrhea, hypertension, respiratory depression, and psychological and physical dependence. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Phaseolamin compositions and methods for using the same Inventor(s): Chokshi, Dilip; (Parsippany, NJ) Correspondence: Ronald J. Baron Esq.; HOFFMANN & BARON, LLP; 6900 Jericho Turnpike; Syosset; NY; 11791; US Patent Application Number: 20030059457 Date filed: September 25, 2001 Abstract: The present invention is for compositions containing phaseolamin and a mineral, such as chromium or vanadium or both, where the mineral is bound by a glycoprotein matrix. The present invention is also directed to methods for controlling carbohydrate cravings, inducing weight loss, reducing insulin requirements in a diabetic, and inhibiting the absorption of dietary starch by administering a composition of the invention. Excerpt(s): Glycoproteins (glycosylated proteins) are organic compounds composed of both a protein and a carbohydrate joined together by a covalent linkage. Glycosylated proteins are present on extracellular matrices and cellular surfaces of many cells. Oligosaccharides consist of a few covalently linked monosaccharide units, such as glucose and ribulose. The oligosaccharide moieties of glycoproteins are implicated in a wide range of cell-cell and cell-matrix recognition events. The addition of carbohydrates such as oligosaccharides, on a protein involves a complex series of reactions that are catalyzed by membrane-bound glycosyltransferases and glycosidases. Glycosyltransferases are enzymes that transfer sugar groups to an acceptor, such as another sugar or a protein. Glycosidases are enzymes that remove sugar groups. The types and amounts of sugars that are attached to a given protein depend on the cell type in which the glycoprotein is expressed. In addition, the types of linkage used to join various sugar groups together also confound the complexity of glycosylation. The biological activities of many glycoproteins are not detectably different if the carbohydrates are removed. However, glycosylation of proteins may have several effects. Carbohydrates often lengthen the biological life of a protein by decreasing the protein's rate of clearance from the blood. In addition, carbohydrates may help a protein

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to fold properly, stabilize a protein, or affect physical properties such as solubility or viscosity of a protein. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Satiation devices and methods Inventor(s): Moody, Trevor J.; (Seattle, WA), Stack, Richard S.; (Chapel Hill, NC), Glenn, Richard A.; (Chapel Hill, NC), Eubanks, William S. JR.; (Durham, NC), Every, Nathan; (Seattle, WA), Silverstein, Fred E.; (Seattle, WA) Correspondence: STALLMAN & POLLOCK LLP; Suite 290; 121 Spear Street; San Francisco; CA; 94105; US Patent Application Number: 20030199991 Date filed: June 9, 2003 Abstract: A device for inducing weight loss in a patient includes a tubular prosthesis self-expandable from a collapsed position in which the prosthesis has a first diameter to an expanded position in which the prosthesis has a second, larger, diameter. In a method for inducing weight loss, the prosthesis is placed in the collapsed position and inserted into a stomach of a patient. The prosthesis is allowed to self-expand from the collapsed position to the expanded position and into contact with the walls of the stomach, where it induces feelings of satiety and/or inhibits modulation of satietycontrolling factors such as Ghrelin. Excerpt(s): The present invention relates generally to the field of devices and methods for achieving weight loss in humans, and specifically to the use of devices implantable within the human stomach for controlling feelings of hunger. Various medical approaches are used for controlling obesity. These approaches include diet, medication, and surgical procedures. One of the more successful surgical procedures is the vertical banded gastroplexy or the proximal gastric pouch with a Roux-en-Y anastomosis. However, known complications are present with each of these procedures and more successful options are desired. Other alternatives include implantation of gastric balloons that prevent overeating by occupying volume within the stomach. Unfortunately, gastric balloons can migrate down the GI tract, causing obstruction and thus necessitating removal. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Ultraviolet radiation absorbents for thermoplastic polymers and methods of producing same Inventor(s): Osaki, Tatsuhiko; (Gamagori, JP), Ichihashi, Tetsuo; (Sagamihara, JP) Correspondence: BEYER WEAVER & THOMAS LLP; P.O. BOX 778; BERKELEY; CA; 94704-0778; US Patent Application Number: 20030130383 Date filed: November 14, 2002 Abstract: An ultraviolet radiation absorbent for thermoplastic polymer materials such as polyethylene terephthalate or polycarbonate contains cyclic imino ester compound of a specified structure in an amount of over 99.5 weight % and less than 100 weight %, having the melt beginning temperature obtained by melting point measurement in

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differential thermal analysis within the range of 300-310.degree. C. and/or the weight loss beginning temperature obtained by thermogravimetric measurement within the range of 270-305.degree. C. Excerpt(s): This invention relates to ultraviolet radiation absorbents for thermoplastic polymers and method of producing such absorbents. Films and various kinds of molded products such as boxes made of thermoplastic polymer materials undergo quality degradation such as discoloration and fading when exposed to ultraviolet radiation. Different kinds of ultraviolet radiation absorbents have therefore been in use for preventing such quality degradation for thermoplastic polymers as well as products made from them. The present invention relates to improvement in such ultraviolet radiation absorbents and methods of producing such improved absorbents. Benzophenone compounds, benzotriazole compounds and salicylic acid compounds have been generally used as an ultraviolet radiation absorbent for thermoplastic polymers but it has been a problem that these absorbents are usually low in resistance against heat. In view of this problem, cyclic imino ester compounds have been proposed as ultraviolet radiation absorbents with improved heat resistance (U.S. Pat. No. 4,446,262, Japanese Patent Publications Tokko 62-5944 and 62-31027). These absorbents are themselves more resistant against heat but still have the problem that, when they are added or mixed to a thermoplastic polymer material such as polyethylene terephthalate or polycarbonate, they tend to adversely affect the original material characteristics of these thermoplastic polymers such as transparency. They also have the problem of sublimating and adversely affecting the workability and the environmental conditions during the mixing and molding processes when used for such thermoplastic polymer materials having high mixing and molding temperatures. It is therefore an object of this invention to provide improved infrared radiation absorbents which are themselves highly resistant against heat, capable of producing products having the original material characteristics of thermoplastic polymers such as transparency when added and mixed with them without adversely affecting the workability or the environmental conditions. The invention also relates to methods of producing such absorbents. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Visual feedback methods and apparatus for weight loss and other forms of physical improvement Inventor(s): Posa, John G.; (Ann Arbor, MI) Correspondence: John G. Posa; Gifford, Krass, Groh; Suite 400; 280 N. Old Woodward Ave.; Birmingham; MI; 48009; US Patent Application Number: 20030108851 Date filed: December 11, 2001 Abstract: A health-related monitoring system and method provides visual feedback in the form of a computer-generated display of changes which will likely occur in a participant's body, if the person does, or does not, stay on a particular regime. A preferred method of assisting a person to achieve a desired body shape includes the steps of forming an initial image of the person (either in 2 or 3 dimensions) at an initial time; determining a progress level at intervals during a desired program, for example by imaging the person and comparing this image with the initial image so as to determine an image difference; and displaying a probable future image representative of a probable future body shape of the person based on the progress level of the person, for example as determined by the image difference and/or the body parameter difference,

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and displaying the ideal image to the person for comparison with the probable future image. Excerpt(s): This invention relates generally to physique improvement including weight loss, body-building and the like, and, in particular, to apparatus and methods providing visual feedback to encourage those engaged in such regimes. It has long been recognized that feedback, both positive and negative, can be helpful in behavior modification programs of the type used to lose weight, quit smoking, and so forth. In terms of weight control, individuals occasionally plant pictures of themselves in an overweight condition on the refrigerator, or in their wallet or purse, to which they refer prior to eating in an effort to avoid over-indulging. With modem computer technology and miniaturized electronic devices, new methods have become available to assist in diet/exercise programs and behavior modification in general. Various patents and pending applications are directed to the use of portable electronic devices acting as physiological monitors, which are then networked to expert systems or websites to analyze progress on a health-related activity or program. It has been proposed to use these remote sites to analyze various health-related phenomena input by multiple participants, to provide feedback in relation to progress toward better eating habits, weight control, cholesterol reduction, salt/sugar intake, and so forth. While such feedback may be provided in the form of textual messages or even charts/graphs highlighting historical or forward-looking trends, it would be advantageous to provide more realistic, explicit and compelling results in a visual, yet personalized form. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Weight loss compositions and methods for individuals who may have gastric hyperacidity Inventor(s): Wurtman, Judith J.; (Boston, MA), Wurtman, Richard J.; (Boston, MA) Correspondence: PATENT ADMINSTRATOR; KATTEN MUCHIN ZAVIS ROSENMAN; 525 WEST MONROE STREET; SUITE 1600; CHICAGO; IL; 60661-3693; US Patent Application Number: 20030039739 Date filed: March 13, 2002 Abstract: Compositions and methods of losing weight are described that are suitable for individuals susceptible to gastric hyperacidity or gastroesophageal reflux. The compositions include in part a snack food having two or more rapidly digestible carbohydrates, in which the foodstuff or an aqueous mixture of the foodstuff and water has a pH equal to or greater than about 6, and in which the snack is substantially protein-free. The method of weight loss suitable for an individual with gastric hyperacidity includes substantially limiting the individual's caloric intake to about 1400 calories or less for women and 1800 calories or less for men in which the caloric intake includes one or more substantially protein-free snack foodstuffs having two or more rapidly digestible carbohydrates, in which an aqueous mixture of the foodstuff with water has a pH equal to or greater than about 6 and in which the individual loses weight. Excerpt(s): This application claims priority to U.S. Provisional Application No. 60/275,127, filed Mar. 13, 2001, which is incorporated herein by reference. The present invention relates to an appetite suppressant and/or snack food composition and methods for inducing weight loss and/or preventing weight gain suitable for

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individuals who may have gastric hyperacidity. Individuals with gastric hyperacidity are restricted in choice of diet. For those who are obese or who need to control their weight for other reasons, such a restriction in food options makes desirable weight loss yet more difficult. Further, gastric hyperacidity and gastroesophageal reflux are thought to be associated with obesity, as the sensation of hyperacidity is often confused with that of hunger. Since eating relieves the discomfort, even if the person is not hungry, eating often occurs. Thus "false hunger" produced by the hyperacidity may cause many obese individuals to discontinue adherence to a calorie restricted diet. S"Patients with esophageal pH<4 for more than 5% of observed time weighed more than those with normal acid exposure." Fisher et al. Dig Dis Sci 1999; 44:2290, abstract only. Moreover, obese patients produce more gastric acid in response to pentagastrin than do normalweight control individuals. Wisen et al. Dig Dis Sci 1987; 32: 968, abstract only. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Weight management system for obese animals Inventor(s): Bierer, Tiffany L.; (Fullerton, CA), Chow, Claudia; (Verden, DE) Correspondence: FULBRIGHT & JAWORSKI, LLP; 1301 MCKINNEY; SUITE 5100; HOUSTON; TX; 77010-3095; US Patent Application Number: 20030138548 Date filed: October 4, 2002 Abstract: A diet system for promoting comprehensive weight management in companion animals. The diet system includes a stage I pet food product for promoting weight loss and building lean body mass and a stage II pet food product for maintaining the weight loss and the lean body mass. Excerpt(s): This application is a continuation-in-part of and claims priority to U.S. application Ser. No. 10/054,093, filed on Jan. 22, 2002. The invention generally relates to a pet food for use in a comprehensive weight management system for companion animals. More particularly, the weight management system includes two stages: a weight loss stage (stage I) and a weight maintenance stage (stage II). Stage I involves a pet food comprising a high protein, low calorie daily diet that includes a functional ingredient, which further modulates metabolism and builds lean body mass in companion animals. Stage II involves a pet food comprising a low calorie daily diet that maintains the leaner weight of the animal and improves health for the life of the animal. In westernized societies the most prevalent form of malnutrition in humans is overconsumption of calories resulting in excess body fat. Studies have shown that greater than 20-30% of dog and cat populations are overweight or obese (over-fat). Obesity in domesticated dogs and cats has been linked to the development of numerous diseases including renal failure, diabetes, and arthritis. Overweight dogs have an increased risk of developing transitional cell carcinoma of the bladder. Further, it is well established that obesity is a predisposing factor to idiopathic hepatic lipidosis in cats, however, their inability to convert dietary C18 essential fatty acids into long chain fatty acids creates a need for dietary consumption of 20 carbon long chain fatty acids. Such a dietary requirement leaves cats extremely vulnerable to weight disorders and weight-associated diseases such as diabetes (Appleton et al., 2000). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Weight-loss clothing made from fabrics mixed with neoprene and bio-ceramics Inventor(s): Kim, Wu-Sung; (Pusan-City, KR) Correspondence: BURNS DOANE SWECKER & MATHIS L L P; POST OFFICE BOX 1404; ALEXANDRIA; VA; 22313-1404; US Patent Application Number: 20030106129 Date filed: December 6, 2001 Abstract: The present invention is a Weight-Loss Clothing made from Fabrics mixed with Neoprene and Bio-Ceramics which is designed to reduce the weight of users. In order to achieve the objective of the present invention, the present invention comprises an outer layer made from spandex, a medium layer made from anti-bacterial neoprene and bio-ceramics and an inner layer made from polyester, or cotton, or nylon. Unlike other sportswear or exercising clothing of the same kind available on the market, the present invention provides an excellent weight-loss effect and a good feeling and protects the user's skin from allergy and effectively discharges the sweat of the user out of the present invention. Excerpt(s): The present invention relates to a Weight-Loss Clothing made from Fabrics mixed with Neoprene and Bio-Ceramics which is designed to reduce the weight of users. The neoprene used as one of materials to make the present invention is processed with an anti-bacterial treatment to provide sanitation to the user, in addition to an excellent weight-loss effect. More specifically, the present invention reduces the fat and waste materials contained in the human body, providing a weight-loss effect without giving any harmful effects to the people who wear it. Over the years, the number of people having problems with their obesity has been on the rise continuously due mainly to their eating of high-calorie food and lack of exercise, consequently causing a variety of diseases. A lot of weight-loss technologies and methods are introduced on the market, and one of the most effective and popular methods of losing weight is sweating off either through exercise or other available methods. Since a lot of exercise is required for one to sweat off, a variety of exercise clothing or sportswear that help the users to sweat off with as the least amount of exercise as possible, preventing the air and moisture from coming out of the body of the users, have been introduced on the market. However, such kinds of sportswear or exercising clothing are made from either vinyl or airtightened synthetic materials that their touch is not good and they create allergy to the skin of the users when they wear them during the exercise, especially when they sweat a lot within a short period of time or when they wear them for a long time. Another disadvantage of the conventional sportswear or exercising clothing is that they are not tightly fitted to the body of the users so that the amount of sweat is not high enough to effectively lose weight since the heat and moisture from the bodies of the users are easily discharged through the loosened portion of the sportswear or exercising clothing. Also, those sportswear or exercising clothing available on the market cover the whole part of the body of the user as an outwear to achieve a high weight-loss effect so that they cannot be made or worn as a bra or one-pieced suit such as women's swimming suit as an innerwear. Therefore, users of such sportswear or exercising clothing cannot wear them during their normal activities or at their work. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Keeping Current In order to stay informed about patents and patent applications dealing with weight loss, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “weight loss” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on weight loss. You can also use this procedure to view pending patent applications concerning weight loss. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 7. BOOKS ON WEIGHT LOSS Overview This chapter provides bibliographic book references relating to weight loss. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on weight loss include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “weight loss” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on weight loss: •

The Resolution Diet: Keeping the Promise of Permanent Weight Loss Source: Garden City Park, NY: Avery Publishing Group, 209 p., 1999. Contact: Avery Publishing Group, 120 Old Broadway, Garden City Park, NY 11040. (516) 741-2155, (800) 548-5757. FAX (516) 742-1892. Summary: Heber has developed a weight loss plan consisting of seven stages: getting motivated; identifying and eliminating foods that trigger bingeing; using portion control and meal replacements safely; re-educating the palate to enjoy lower-fat foods; meal planning; making exercise a habit; and maintaining the habits learned. Each step is examined in detail in a chapter, including a quiz to determine the reader's status in relation to the subject of the chapter. Appendixes list resources, the formula for determining body-mass index, and a two-week meal plan.

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The Commonsense Guide to Weight Loss For People with Diabetes Source: Alexandria, VA: American Diabetes Association, 290 p., 1998. Contact: American Diabetes Association, 1660 Duke St., Alexandria, VA 22314. Website www.diabetes.org. (703) 299-2046. Summary: The authors describe how diabetics can maintain a healthy weight while keeping their blood sugar at acceptable levels. They begin with the concept of healthy weight and discuss how to determine a healthy weight. Other chapters discuss measures of progress (such as glucose levels, quality of life, blood pressure, and cholesterol levels), how to set up a diet plan, how to coordinate a weight-loss plan with diabetes care, and how to implement lifestyle changes to make weight control permanent.

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Commonsense Guide to Weight Loss for People with Diabetes Source: Alexandria, VA: American Diabetes Association. 1998. 288 p. Contact: Available from American Diabetes Association, Inc. Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $19.95 plus shipping and handling. ISBN: 0945448856. Order number 481601. Summary: This book dispels myths about dieting and shows readers how to lose weight and keep it off by using commonsense techniques from weight loss experts. Readers learn the crucial elements of weight loss for people who have diabetes, including choosing the right target weight; measuring progress by tracking health, not weight; developing a healthy, low-calorie diet while enjoying tasty, filling meals; coordinating a weight loss program with proper diabetes care; improving a weight loss program with modern medicine; maintaining an active lifestyle; and making permanent lifestyle changes to ensure long-term weight loss. Chapters address issues relevant to each of these topics. The book concludes with information on resource materials and an index. 3 figures. 9 tables.

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Diabetes Weight Loss System Source: Washington, DC: Diabetes Research and Wellness Foundation. 1999. 267 p. Contact: Available from Diabetes Research and Wellness Foundation. 1206 Potomac Street, N.W. Washington, DC 20007-3211. (202) 454-1606. Fax (202) 342-2039. E-mail: agretschel@ diabeteswellness.net. Website: www.diabeteswellness.net. ISBN: 967046505. Summary: This book helps readers with diabetes use a system of behavior modification to achieve and maintain their optimal body weight. The authors describe a model of five stages for behavior change: precontemplation, contemplation, preparation, action, and maintenance. The success of a behavior change depends on how well the person prepares for the tasks of each stage. The book includes 20 chapters: an overview of behavior change, case reports of two people in the precontemplative stage, preparing for behavior change, exercise, understanding the healthy diet, assessment of one's current lifestyle and behavior patterns, changing behavior patterns, stress and eating, understanding and using food labels, beginning to increase daily activity, getting ready for aerobic exercise, the Weightloss Readiness Test, creating a personal weight loss plan, implementing the personal exercise plan, implementing the personal diet plan, relapse prevention, and lifetime weight maintenance. Appendices offer a body mass index (BMI) chart, insulin action charts, food group lists, sample menus, blank forms, and a

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resource lists. The workbook features many blank spaces for readers to individualize the information in each chapter. Line drawings and charts illustrate the book. •

Weight Loss and Eating Behaviour in Alzheimer's Patients Source: Broadway, NY: Springer Publishing Company. 1998. 104 p. Contact: Available from Springer Publishing Company. 536 Broadway, NY 10012-3955. (212) 431-4370; FAX: (212) 941-7842. ISBN: 2-909342-62-X. Summary: This book highlights recent studies on weight loss and eating behaviors in Alzheimer's disease (AD). It includes papers on the factors associated with weight loss in AD, the disease as a risk factor for weight loss in community-dwelling older adults, the temporal relationship of weight loss and dementia in AD, longitudinal weight changes and survival in long-term care residents with dementia, the natural history of weight loss in people with AD and the effects of the disease on mortality, and the association between low body mass index and mesial temporal cortex atrophy in AD. Other topics include energy expenditure in AD, a taxonomy of abnormal feeding behaviors in dementia, an eating behavior scale for functional assessment in AD, tube feeding, protecting the nutritional status of AD patients, weight change in informal caregivers, a training program for dementia caregivers, and a nutrition education and health promotion program for AD patients.

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Losing Weight Safely Source: Rockville, MD: FDA, 8p., 1996. Contact: Food and Drug Administration, Office of Consumer Affairs, 5600 Fishers Lane, HFE-50, Rockville, MD 20857. Summary: This consumer brochure explains why it is important to lose weight and offers suggestions to make it easier. Readers are told to check with their doctors before beginning a weight-loss program, to exercise, to eat a variety of foods, and to reduce their intake of fat and sugar. Guidelines for avoiding fad diets and ineffective treatments are also offered.

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Complete Weight Loss Workbook: Proven Techniques for Controlling WeightRelated Health Problems Source: Alexandria, VA: American Diabetes Association. 1997. 262 p. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $17.95 for members; $19.95 for nonmembers; plus shipping and handling. ISBN: 0945448783. Summary: This workbook provides people who have diabetes with information on losing weight. The workbook helps readers tailor their weight reduction plan to their own lifestyle and health needs by using the worksheets provided in most chapters. Section one focuses on lifestyle change. Chapters help readers learn how to use the workbook; discuss the stages of change, including thinking about change, getting ready for change, taking action to change, and maintaining the change; and help readers consider weight loss and its pros and cons. Section two deals with food and meals. Topics include identifying the ABCs of eating, learning the best rate of weight loss, using a food diary to keep track of food consumed, planning and monitoring meals using calorie or fat counting, reducing fat and caloric intake, reading food labels, and

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eating out. In addition, this section presents shopping strategies and food storage tips. Section three focuses on fitness and health. Chapters discuss the health benefits of physical activity, the basics of engaging in physical fitness, exercise planning, the selection of a physical activity, and the benefits and performance of aerobic exercise. Section four deals with emotions about and obstacles to losing weight. Topics include setting realistic goals, changing one's lifestyle to include eating well and engaging in physical activity, coping with situations that trigger overeating or that keep a person from exercising, dealing with negative thoughts, coping with cravings, and handling emotional eating. Appendices present food diaries; sample 7 day plans for 1200-, 1500-, and 1800-calorie meals; a recipe collection; and a resource list. 4 appendices.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “weight loss” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “weight loss” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “weight loss” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

101 Weight Loss Tips for People with Diabetes by Anne Daly, et al; ISBN: 1580401325; http://www.amazon.com/exec/obidos/ASIN/1580401325/icongroupinterna

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40-30-30 Fat Burning Nutrition: The Dietary Hormonal Connection to Permanent Weight Loss and Better Health by Joyce Daoust (Introduction), Gene Daoust (Introduction); ISBN: 1569120862; http://www.amazon.com/exec/obidos/ASIN/1569120862/icongroupinterna

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Apple Cider Vinegar for Weight Loss and Good Health by Cynthia Holzapfel, Cynthia Nofziger (2002); ISBN: 1570671273; http://www.amazon.com/exec/obidos/ASIN/1570671273/icongroupinterna

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Atkins for Life: The Complete Controlled Carb Program for Permanent Weight Loss and Good Health by Robert C. Atkins (Author) (2003); ISBN: 0312315228; http://www.amazon.com/exec/obidos/ASIN/0312315228/icongroupinterna

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Balance Points for Complex Times: A Simple System for Life Balance and Weight Loss by John Panepinto (2003); ISBN: 1591133866; http://www.amazon.com/exec/obidos/ASIN/1591133866/icongroupinterna

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BANISH YOUR BELLY, BUTT AND THIGHS (FOREVER!) The Real Woman's Guide to Permanent Weight Loss by Prevention Health (Editor), et al; ISBN: 1579540376; http://www.amazon.com/exec/obidos/ASIN/1579540376/icongroupinterna

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Before and After: Living and Eating Well After Weight Loss Surgery by Susan Nuziato Leach (2004); ISBN: 0060567228; http://www.amazon.com/exec/obidos/ASIN/0060567228/icongroupinterna

•

Beyond Pritikin: A Total Nutrition Program for Rapid Weight Loss, Longevity, and Good Health by Ann Louise Gittleman, J. Maxwell Desgrey (Contributor); ISBN: 0553574000; http://www.amazon.com/exec/obidos/ASIN/0553574000/icongroupinterna

Books

271

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Body Confident : A Guided Journal for Losing Weight and Feeling Great by Victoria Moran; ISBN: 1582971005; http://www.amazon.com/exec/obidos/ASIN/1582971005/icongroupinterna

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Choose to Lose : A Food Lover's Guide to Permanent Weight Loss by Nancy Goor (Author), Ronald S. Goor (Author) (1999); ISBN: 0395970970; http://www.amazon.com/exec/obidos/ASIN/0395970970/icongroupinterna

•

Choosing Natural Foods by Looking Through History: Traditional Diets from around the World that have Maintained Health, Weight Loss, and Nutrition.for Centuries! by Mel Moench (2003); ISBN: 0967371198; http://www.amazon.com/exec/obidos/ASIN/0967371198/icongroupinterna

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Chubby No More -The Comfort Connection: A Guidebook for Adding Emotional Power to All Weight Loss Methods by Pamela Aye Simon M. S. R. D. L. D. (2003); ISBN: 1410747417; http://www.amazon.com/exec/obidos/ASIN/1410747417/icongroupinterna

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Conquer Your Food Addiction : The Ehrlich 8-Step Program for Permanent Weight Loss by Caryl Ehrlich; ISBN: 0743229746; http://www.amazon.com/exec/obidos/ASIN/0743229746/icongroupinterna

•

Cooking Thin with Chef Kathleen: 200 Easy Recipes for Healthy Weight Loss by Kathleen Daelemans (Author); ISBN: 061822632X; http://www.amazon.com/exec/obidos/ASIN/061822632X/icongroupinterna

•

Daily Word for Weight Loss: Spiritual Guidance to Give You Courage on Your Journey by Colleen Zuck, Elaine Meyer (2002); ISBN: 1579544363; http://www.amazon.com/exec/obidos/ASIN/1579544363/icongroupinterna

•

De-Stress, Weigh Less : A Six-Step No-Diet Plan For Relaxing Your Way To Permanent Weight Loss by Paul J. Rosch (Author), Carolyn Chambers Clark (Author) (2001); ISBN: 0312977247; http://www.amazon.com/exec/obidos/ASIN/0312977247/icongroupinterna

•

Doctor Nagler's Hypnosis for Weight Loss Tapes (Deluxe Box Set) by Bill Nagler; ISBN: 0971502374; http://www.amazon.com/exec/obidos/ASIN/0971502374/icongroupinterna

•

Dr Atkins for Life: The Controlled Diet for Permanent Weight Loss and Good Health by Robert C. Atkins; ISBN: 1405021101; http://www.amazon.com/exec/obidos/ASIN/1405021101/icongroupinterna

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Dr. Braly's Food Allergy and Nutrition Revolution: For Permanent Weight Loss and a Longer, Healthier Life by James Braly, Laura Torbet (1992); ISBN: 0879835907; http://www.amazon.com/exec/obidos/ASIN/0879835907/icongroupinterna

•

Dr. Shapiro's Picture Perfect Weight Loss 30 Day Plan by Howard M. Shapiro (2002); ISBN: 1579544177; http://www.amazon.com/exec/obidos/ASIN/1579544177/icongroupinterna

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Dr. Shapiro's Picture Perfect Weight Loss Cookbook: More Than 150 Delicious Recipes for Permanent Weight Loss by Howard M., Md. Shapiro (2003); ISBN: 1579544371; http://www.amazon.com/exec/obidos/ASIN/1579544371/icongroupinterna

•

Dr. Shapiro's Picture Perfect Weight Loss Shopper's Guide : Supermarket Choices for Permanent Weight Loss by Howard M. Shapiro (2001); ISBN: 1579544169; http://www.amazon.com/exec/obidos/ASIN/1579544169/icongroupinterna

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Dr. Shapiro's Picture Perfect Weight Loss: The Visual Program for Permanent Weight by Howard M. Shapiro (2003); ISBN: 0446691313; http://www.amazon.com/exec/obidos/ASIN/0446691313/icongroupinterna

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Eat More, Weigh Less: Dr. Dean Ornish's Life Choice Program for Losing Weight Safely While Eating Abundantly by Dean Ornish (Author) (2000); ISBN: 0060959576; http://www.amazon.com/exec/obidos/ASIN/0060959576/icongroupinterna

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Eat to Live: The Revolutionary Formula for Fast and Sustained Weight Loss by Joel Fuhrman, Mehmet C. Oz (Foreword) (2003); ISBN: 0316829455; http://www.amazon.com/exec/obidos/ASIN/0316829455/icongroupinterna

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Eat Well, Lose Weight While Breastfeeding: Complete Nutrition Book for Nursing Mothers, Including a Healthy Guide to Weight Loss Your Doctor Promise by Eileen Behan (1992); ISBN: 0679733558; http://www.amazon.com/exec/obidos/ASIN/0679733558/icongroupinterna

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Energy Breakthrough : Jump-start Your Weight Loss and Feel Great by Sarah Duchess of York, Weight Watchers; ISBN: 0743226208; http://www.amazon.com/exec/obidos/ASIN/0743226208/icongroupinterna

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Fat Free, Flavor Full: Dr. Gabe Mirkin's Guide to Losing Weight and Living by Diana Gabe M.D./Rich Mirkin (Author) (1996); ISBN: 0316574732; http://www.amazon.com/exec/obidos/ASIN/0316574732/icongroupinterna

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First Place Member Kit: The Bible's Way to Weight Loss by Carole Lewis, Gospel Light Publications; ISBN: 0830728694; http://www.amazon.com/exec/obidos/ASIN/0830728694/icongroupinterna

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First Place: The Original Spiritually Based Weight Loss Plan for Whole Person Fitness by Carole B. Lewis, et al; ISBN: 0805401792; http://www.amazon.com/exec/obidos/ASIN/0805401792/icongroupinterna

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Food Combining Bible: Your Complete Guide to Using the Hay Diet for Digestive Health and a Balanced Approach to Weight Loss by Jan Dries, Inge Dries (2002); ISBN: 0007131526; http://www.amazon.com/exec/obidos/ASIN/0007131526/icongroupinterna

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Gary Null's Ultimate Lifetime Diet: A Revolutionary All-Natural Program for Losing Weight and Building a Healthy Body by Gary, Phd Null (2001); ISBN: 0767904745; http://www.amazon.com/exec/obidos/ASIN/0767904745/icongroupinterna

•

G-Index Diet:Missing Link That Makes Permanent Weight Loss Possible by Will Richard/Proctor Podell (Author); ISBN: 0446365769; http://www.amazon.com/exec/obidos/ASIN/0446365769/icongroupinterna

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Good Carbs, Bad Carbs: An Indispensable Guide to Eating the Right Carbs for Losing Weight and Optimum Health by Johanna Burani, Linda Rao; ISBN: 1569245371; http://www.amazon.com/exec/obidos/ASIN/1569245371/icongroupinterna

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Health Journeys: Meditations to Help/Abridged With Weight Loss by Belleruth Naparstek (Author) (2001); ISBN: 1586211188; http://www.amazon.com/exec/obidos/ASIN/1586211188/icongroupinterna

•

KISS Guide to Weight Loss by Barbara Ravage (2001); ISBN: 0789461390; http://www.amazon.com/exec/obidos/ASIN/0789461390/icongroupinterna

•

Lauri's Low-Carb Cookbook: Rapid Weight Loss with Satisfying Meals! (2nd Edition) by Lauri Ann Randolph; ISBN: 0966796314; http://www.amazon.com/exec/obidos/ASIN/0966796314/icongroupinterna

Books

273

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Lean and Lovin' It : Exceptionally Delicious Recipes for Low-Fat Living and Permanent Weight Loss by Don Mauer (Author) (1996); ISBN: 1881527972; http://www.amazon.com/exec/obidos/ASIN/1881527972/icongroupinterna

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Lean For Life: Phase One - Weight Loss by Cynthia Stamper Graff, Jerry Holderman (Contributor); ISBN: 1580000886; http://www.amazon.com/exec/obidos/ASIN/1580000886/icongroupinterna

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Lifeforce: A Dynamic Plan for Health, Vitality, and Weight Loss by Jeffrey S. McCombs (2002); ISBN: 1885003978; http://www.amazon.com/exec/obidos/ASIN/1885003978/icongroupinterna

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Losing It-Naturally : A Complete Holistic Weight Loss Program by Loretta Washburn (1999); ISBN: 1571741224; http://www.amazon.com/exec/obidos/ASIN/1571741224/icongroupinterna

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Losing Weight Feeling Great With Self Hypnosis by Catherine Elizabeth (2003); ISBN: 1403365415; http://www.amazon.com/exec/obidos/ASIN/1403365415/icongroupinterna

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Love Yourself Thin: The Revolutionary Spiritual Approach to Weight Loss by Victoria Moran, Sonnet Pierce; ISBN: 0875964613; http://www.amazon.com/exec/obidos/ASIN/0875964613/icongroupinterna

•

Low-Fat Living: Turn Off the Fat-Makers Turn on the Fat-Burners for Longevity Energy, Weight Loss , Freedom from Disease by Leslie L. Cooper (Contributor), Robert K. Cooper (1998); ISBN: 157954021X; http://www.amazon.com/exec/obidos/ASIN/157954021X/icongroupinterna

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Metabolize: The Personalized Program for Weight Loss by Kenneth Baum, Richard Trubo (Contributor) (2000); ISBN: 0399526382; http://www.amazon.com/exec/obidos/ASIN/0399526382/icongroupinterna

•

Mr. Food Yes You Can: Weight Loss Plan: How I Lost 35 Pounds and You Can Too! by Art Ginsburg, et al (2001); ISBN: 0848724844; http://www.amazon.com/exec/obidos/ASIN/0848724844/icongroupinterna

•

Phat Finish: Weight Loss Surgery by Melissa Anne Hathaway (2003); ISBN: 1579215890; http://www.amazon.com/exec/obidos/ASIN/1579215890/icongroupinterna

•

Plump Pups and Fat Cats: A Seven-Point Weight Loss Program for Your Overweight Pet by Steve Duno (1999); ISBN: 0312244363; http://www.amazon.com/exec/obidos/ASIN/0312244363/icongroupinterna

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Prism Weight Loss Program by Karen Kingsbury (Author) (1999); ISBN: 1576735788; http://www.amazon.com/exec/obidos/ASIN/1576735788/icongroupinterna

•

Slim by Suggestion: 10 Easy Steps to Weight Loss Without Willpower! by Roz Collier, Georgia Foster (2002); ISBN: 0007126662; http://www.amazon.com/exec/obidos/ASIN/0007126662/icongroupinterna

•

Slim Down Sister: The African-American Woman's Guide to Healthy, Permanent Weight Loss by Roniece Weaver, et al (2001); ISBN: 0452280605; http://www.amazon.com/exec/obidos/ASIN/0452280605/icongroupinterna

•

Slim Naturally: Advanced Weight Loss System (Brain Sync Series) by Kelly Howell; ISBN: 1881451100; http://www.amazon.com/exec/obidos/ASIN/1881451100/icongroupinterna

274 Weight Loss

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Solved: The Riddle of Weight Loss by Stephen, M.D. Langer, James F. Scheer (Editor) (1989); ISBN: 0892812966; http://www.amazon.com/exec/obidos/ASIN/0892812966/icongroupinterna

•

Souper Weight Loss Secrets by Lillie Ross; ISBN: 0971988579; http://www.amazon.com/exec/obidos/ASIN/0971988579/icongroupinterna

•

Spiritual Secrets to Weight Loss: Finally, a Permanent Solution by Kara, MD Davis, Kara E. Davis (2002); ISBN: 088419888X; http://www.amazon.com/exec/obidos/ASIN/088419888X/icongroupinterna

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TCM: A Natural Guide to Weight Loss That Lasts by Nan Lu (Author), Ellen Schaplowsky (Author) (2000); ISBN: 0380809052; http://www.amazon.com/exec/obidos/ASIN/0380809052/icongroupinterna

•

The 24-Hour Turnaround : The Formula for Permanent Weight Loss, Anti-Aging, and Optimal Health--Starting Today by Jay Williams (Author) (2003); ISBN: 0060989033; http://www.amazon.com/exec/obidos/ASIN/0060989033/icongroupinterna

•

The 24-Hour Turnaround: The Formula for Permanent Weight Loss, Antiaging, and Optimal Health--Starting Today by Jay Williams, Debra Fulghum Bruce (2002); ISBN: 0060394315; http://www.amazon.com/exec/obidos/ASIN/0060394315/icongroupinterna

•

The 9 Truths About Weight Loss: The No- Tricks, No-Nonsense Plan for Lifelong Weight Control by Daniel S., Ph.D. Kirschenbaum (2001); ISBN: 0805063943; http://www.amazon.com/exec/obidos/ASIN/0805063943/icongroupinterna

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The Bible Cure for Weight Loss and Muscle Gain (Bible Cure Ser) by Don Colbert (2000); ISBN: 0884196844; http://www.amazon.com/exec/obidos/ASIN/0884196844/icongroupinterna

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The Body Code: A Personalized Wellness and Weight Loss Plan Developed at the World Famous Green Valley Spa by Jay Cooper, Kathryn Lance (Contributor) (1999); ISBN: 0671026194; http://www.amazon.com/exec/obidos/ASIN/0671026194/icongroupinterna

•

The Complete Idiot's Guide to Weight Loss by Lucy Beale, et al; ISBN: 0028643852; http://www.amazon.com/exec/obidos/ASIN/0028643852/icongroupinterna

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The Complete Weight Loss Workbook by Judy Wylie-Rosett (Editor), et al; ISBN: 0945448783; http://www.amazon.com/exec/obidos/ASIN/0945448783/icongroupinterna

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The Doctor's Guide to Weight Loss Surgery: How to Make the Decision That Could Save Your Life by Erica Manfred, et al (2003); ISBN: 0553382462; http://www.amazon.com/exec/obidos/ASIN/0553382462/icongroupinterna

•

The Essential Atkins for Life Kit : Tools, Tips, and Techniques for Maintaining a Low Carb Lifestyle, Permanent Weight Loss, and Optimal Health by Robert C. Atkins (Author) (2003); ISBN: 0312321600; http://www.amazon.com/exec/obidos/ASIN/0312321600/icongroupinterna

•

The Fat Fallacy: The French Diet Secrets to Permanent Weight Loss by Will Clower (2003); ISBN: 1400049199; http://www.amazon.com/exec/obidos/ASIN/1400049199/icongroupinterna

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The Formula: A Personalized 40-30-30 Weight Loss Program by Gene Daoust, Joyce Daoust; ISBN: 0345443063; http://www.amazon.com/exec/obidos/ASIN/0345443063/icongroupinterna

Books

275

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The G.I. Diet: The Easy Healthy Way to Permanent Weight Loss by Rick Gallop; ISBN: 0761131787; http://www.amazon.com/exec/obidos/ASIN/0761131787/icongroupinterna

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The Glucose Revolution Pocket Guide to Losing Weight by Thomas M. S. Wolever, et al; ISBN: 1569246777; http://www.amazon.com/exec/obidos/ASIN/1569246777/icongroupinterna

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The Joy of Weight Loss by Norris J. Chumley; ISBN: 1930051190; http://www.amazon.com/exec/obidos/ASIN/1930051190/icongroupinterna

•

The Lite Lifestyle: 150 Ultra Low Calorie Recipes for Rapid Weight Loss! by Laura Creavalle; ISBN: 0966916883; http://www.amazon.com/exec/obidos/ASIN/0966916883/icongroupinterna

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The Lord's Table: A Biblical Approach to Weight Loss by Mike Cleveland (2003); ISBN: 1885904355; http://www.amazon.com/exec/obidos/ASIN/1885904355/icongroupinterna

•

The McDougall Program for Maximum Weight Loss by John A., M.D. McDougall, Mary McDougall (Contributor) (1995); ISBN: 0452273803; http://www.amazon.com/exec/obidos/ASIN/0452273803/icongroupinterna

•

The Miracle Diet Cookbook: Easy Permanent Weight Loss Cookbook: Fat Free, Cholesterol Free, High Fiber by Earl F. Updike, Ethel C. Updike (1996); ISBN: 1887437010; http://www.amazon.com/exec/obidos/ASIN/1887437010/icongroupinterna

•

The New Glucose Revolution Pocket Guide to Losing Weight by Jennie Brand-Miller (Editor), et al; ISBN: 1569244987; http://www.amazon.com/exec/obidos/ASIN/1569244987/icongroupinterna

•

The Patient's Guide to Weight Loss Surgery: Everything You Need To Know About Gastric Bypass and Bariatric Surgery by April Hochstrasser, S. Ross Fox (2004); ISBN: 1578261651; http://www.amazon.com/exec/obidos/ASIN/1578261651/icongroupinterna

•

The Prayer Diet: The Unique Physical, Mental, and Spiritual Approach to Healthy Weight Loss by Matthew Anderson (2002); ISBN: 0806522771; http://www.amazon.com/exec/obidos/ASIN/0806522771/icongroupinterna

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The Pritikin Weight Loss Breakthrough: Five Easy Steps to Outsmart Your Fat Instinct by Robert Pritikin; ISBN: 0451195728; http://www.amazon.com/exec/obidos/ASIN/0451195728/icongroupinterna

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The Schwarzbein Principle: The Truth About Losing Weight, Being Healthy, and Feeling Younger by Diana Schwarzbein, Nancy Deville (1999); ISBN: 1558746803; http://www.amazon.com/exec/obidos/ASIN/1558746803/icongroupinterna

•

The Solution: For Safe, Healthy, and Permanent Weight Loss by Laurel Mellin (Author) (1998); ISBN: 0060987243; http://www.amazon.com/exec/obidos/ASIN/0060987243/icongroupinterna

•

The South Beach Diet: The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss by Arthur Agatston (2003); ISBN: 1579546463; http://www.amazon.com/exec/obidos/ASIN/1579546463/icongroupinterna

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The spiritual path to weight loss : praising God by living a healthy life by Gregory L. Jantz; ISBN: 078532786X; http://www.amazon.com/exec/obidos/ASIN/078532786X/icongroupinterna

276 Weight Loss

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The Swimming Dragon: A Chinese Way to Fitness, Beautiful Skin, Weight Loss & High Energy by Tzu Shih Kuo, et al; ISBN: 0882680633; http://www.amazon.com/exec/obidos/ASIN/0882680633/icongroupinterna

•

The Ten Hidden Barriers to Weight Loss and Exercise: Discover Why You've Failed Before and How to Succeed Now by Lynette A., Ph.D. Menefee, Daniel R., Ph.D. Somberg (2003); ISBN: 1572243244; http://www.amazon.com/exec/obidos/ASIN/1572243244/icongroupinterna

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The Ultimate Weight Solution: The 7 Keys to Weight Loss Freedom by Phil McGraw; ISBN: 0743236742; http://www.amazon.com/exec/obidos/ASIN/0743236742/icongroupinterna

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The Yoga Minibook for Weight Loss: A Specialized Program for a Thinner, Leaner You by Elaine Gavalas, Nelle Davis (Illustrator) (2003); ISBN: 0743226984; http://www.amazon.com/exec/obidos/ASIN/0743226984/icongroupinterna

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The Zone : Revolutionary Life Plan to Put Your Body in Total Balance for Permanent Weight Loss by Barry Sears (Author) (1995); ISBN: 0060391502; http://www.amazon.com/exec/obidos/ASIN/0060391502/icongroupinterna

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Today Is the First Day: Daily Encouragement on the Journey to Weight Loss and a Balanced Life by Carole Lewis (Editor), Beth Moore (2002); ISBN: 0830730656; http://www.amazon.com/exec/obidos/ASIN/0830730656/icongroupinterna

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Turn Off the Fat Genes: The Revolutionary Guide to Losing Weight by Neal, MD Barnard, Neal D. Barnard; ISBN: 0609809040; http://www.amazon.com/exec/obidos/ASIN/0609809040/icongroupinterna

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Turn Off the Hunger Switch Naturally: The Revolutionary New Program That Resets Your Brain Chemistry for Real Weight Loss Without Cravings or Hunger by E. A. Tremblay (Contributor), et al (2003); ISBN: 1583331549; http://www.amazon.com/exec/obidos/ASIN/1583331549/icongroupinterna

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Weight Loss by Metacom Inc, Dr. David Illig; ISBN: 0886764491; http://www.amazon.com/exec/obidos/ASIN/0886764491/icongroupinterna

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Weight Loss by Brain Wave Subliminal Series; ISBN: 1881451356; http://www.amazon.com/exec/obidos/ASIN/1881451356/icongroupinterna

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Weight Loss & Self-Improvement by David Illig (2002); ISBN: 0865800650; http://www.amazon.com/exec/obidos/ASIN/0865800650/icongroupinterna

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Weight Loss : An Alternative Medicine Definitive Guide by Burton Goldberg, Editors of Alternative Medicine; ISBN: 188729919X; http://www.amazon.com/exec/obidos/ASIN/188729919X/icongroupinterna

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Weight Loss [ABRIDGED] by Barrie Konicov; ISBN: 087082953X; http://www.amazon.com/exec/obidos/ASIN/087082953X/icongroupinterna

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Weight Loss for Health Gain by Joe Fitzgibbon (2003); ISBN: 0717135683; http://www.amazon.com/exec/obidos/ASIN/0717135683/icongroupinterna

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Weight Loss for the Mind [UNABRIDGED] by Stuart Wilde; ISBN: 156170413X; http://www.amazon.com/exec/obidos/ASIN/156170413X/icongroupinterna

•

Weight Loss Kit for Dummies by Carol Ann Rinzler (Author) (2001); ISBN: 0764553348; http://www.amazon.com/exec/obidos/ASIN/0764553348/icongroupinterna

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Weight Loss Surgery (Audio Book) by Michelle Boasten; ISBN: 193103317X; http://www.amazon.com/exec/obidos/ASIN/193103317X/icongroupinterna

Books

277

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Weight Loss Surgery: Finding the Thin Person Hiding Inside You, Third Edition by Barbara Thompson; ISBN: 1932205306; http://www.amazon.com/exec/obidos/ASIN/1932205306/icongroupinterna

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Weight Loss Through Persistence: Making Science Work for You by Daniel S., Ph.D. Kirschenbaum; ISBN: 1879237644; http://www.amazon.com/exec/obidos/ASIN/1879237644/icongroupinterna

•

Weight Loss: Brain Wave Subliminal [ABRIDGED] by Kelly Howell (2001); ISBN: 1881451682; http://www.amazon.com/exec/obidos/ASIN/1881451682/icongroupinterna

•

Weight Loss: How to Keep Your Commitment by Jonni Good; ISBN: 097410650X; http://www.amazon.com/exec/obidos/ASIN/097410650X/icongroupinterna

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Win the Fat War : 145 Real-Life Secrets to 100% Weight Loss Success by Anne Alexander (2000); ISBN: 1579541135; http://www.amazon.com/exec/obidos/ASIN/1579541135/icongroupinterna

•

Yoga Conditioning for Weight Loss : Natural Methods to Help Achieve and Maintain Your Ideal Weight by Gaiam (Author), Suzanne Deason (Author) (1903); ISBN: 0875969127; http://www.amazon.com/exec/obidos/ASIN/0875969127/icongroupinterna

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Your Body Revival: Weight Loss Straight Talk by Dave Draper (2002); ISBN: 1931046352; http://www.amazon.com/exec/obidos/ASIN/1931046352/icongroupinterna

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Your Body, Your Diet: A Complete Program to Losing Weight, Boosting Energy, and Being Your Best Self by Elizabeth, Ph.D. Dane, Ann Reinking (Introduction) (2001); ISBN: 034543322X; http://www.amazon.com/exec/obidos/ASIN/034543322X/icongroupinterna

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Your Fat Is Not Your Fault: Overcome Your Body's Resistance to Permanent Weight Loss by Margaret West (Contributor), Carol N. Simontacchi; ISBN: 0874778972; http://www.amazon.com/exec/obidos/ASIN/0874778972/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “weight loss” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11

11

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

278 Weight Loss

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Ephedra and ephedrine for weight loss and athletic performance enhancement: clinical efficacy and side effects Author: Shekelle, Paul G.; Year: 1988; Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Agency for Healthcare Research and Quality, [2002]; ISBN: 1587631350 http://www.amazon.com/exec/obidos/ASIN/1587631350/icongroupinterna

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Health risks of weight loss Author: Berg, Francie M.; Year: 1996; Hettinger, ND: Healthy; ISBN: 0918532442 http://www.amazon.com/exec/obidos/ASIN/0918532442/icongroupinterna

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Methods for voluntary weight loss and control: National Institutes of Health Technology Assessment Conference statement: March 30-April 1, 1992.; Year: 1990; Bethesda, MD (Federal Building, Room 618, Bethesda, 20892): U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, Office of Medical Applications of Research, [1992?]

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The health risks of weight loss Author: Berg, Francie M.; Year: 1994; Hettinger, ND: Healthy

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Weight loss quackery and fads Author: Berg, Francie M.; Year: 1997; Hettinger, ND: Healthy

Chapters on Weight Loss In order to find chapters that specifically relate to weight loss, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and weight loss using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “weight loss” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on weight loss: •

Approach to the Patient with Unintentional Weight Loss and Eating Disorders Source: in Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 739-751. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-6423. Fax: (301) 223-2400. Website: www.lww.com. PRICE: $289.00. ISBN: 781728614. Summary: Body weight is determined by the interplay of caloric intake, activity level, and metabolic rate. Significant alterations involving any of these factors may result in weight loss. This chapter on the approach to patients with unintentional weight loss and eating disorders is from a lengthy, two-volume textbook that integrates the various demands of science, technology, expanding information, good judgment, and common sense into the diagnosis and management of gastrointestinal patients. The first part of the chapter explores unintentional weight loss caused by evolving disease states; the second part focuses on intentional weight loss resulting from eating disorders. Eating disorders present initially as unexplained weight loss because these patients tend to hide their eating behaviors. A careful and thorough diet history will allow one to begin to separate these patients. A thoughtful and deliberate investigative approach to testing is required for the former patients. Simple screening laboratory tests and referral to an eating disorder center are required for the latter. 9 tables. 68 references.

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Weight Loss Source: in Edmundowicz, S.A., ed. 20 Common Problems in Gastroenterology. New York, NY: McGraw-Hill, Inc. 2002. p. 49-58. Contact: Available from McGraw-Hill, Inc. 1221 Avenue of the Americas, New York, NY 10020. (612) 832-7869. Website: www.bookstore.mcgraw-hill.com. PRICE: $45.00;plus shipping and handling. ISBN: 0070220557. Summary: Patients' weight loss is a common complaint that often challenges the primary care physician. Fluctuations in weight over a period of time can often be attributed to diet, exercise, or intrinsic body rhythms; yet involuntary weight loss is of significant concern. This chapter on weight loss is from a book that focuses on the most common gastroenterological problems encountered in a primary practice setting. The chapter is organized to support rapid access to the information necessary to evaluate and treat most patients with this problems. Topics include the incidence of weight loss; principal diagnoses, including decreased food intake, increased metabolism, increased loss of energy, medications, and psychological causes; typical presentation; key points in the patient history, including food intake, physical activity and review of symptoms; the physical examination; ancillary tests, including lab studies for malabsorption and testing for occult (hidden) malignancy; treatment strategies, including the documentation of nutritional status, increase oral intake, the use of enteral supplementation, and the use of hyperalimentation (including total parenteral nutrition or TPN); common clinical errors; and controversies. The chapter includes a chapter outline for quick reference, the text itself, a diagnostic and treatment algorithm, and selected references. 1 figure. 4 tables. 22 references.

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Improving Weight Loss and Maintenance in Patients With Diabetes Source: in Anderson, B.J. and Rubin, R.R., eds. Practical Psychology for Diabetes Clinicians: How to Deal with the Key Behavioral Issues Faced by Patients and Health Care Teams. Alexandria, VA: American Diabetes Association. 1996. p. 113-119. Contact: Available from American Diabetes Association. Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (404) 442-9742. PRICE: $19.95 (members); $24.95 (nonmembers). ISBN: 0945448732. Summary: This chapter, from a guidebook on behavioral issues for diabetes clinicians, provides a framework for improving weight loss and maintenance in patients with diabetes. Topics include setting reasonable goals; the equal or greater importance of exercise as compared with diet; the use of a low fat/low calorie diet with self monitoring; the use of very low calorie diets; the importance of regular patient-health care provider contact; and implementing behavior modification programs. The author stresses that a key component of the strategies outlined is to start slowly and allow the patient to experience initial success. 1 table. 9 references.

Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to weight loss have been published that consolidate information across

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various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:12 •

Directory of Plain Language Health Information Source: Ottawa, Ontario: Canadian Public Health Association. 1999. 104 p. Contact: Available from Canadian Public Health Association. 400-1565 Carling Avenue, Ottawa, Ontario, K1Z 8R1. (613) 725-3769. Fax (613) 725-9826. E-mail: [email protected]. PRICE: $19.95 plus shipping and handling. Also available at www.pls.cpha.ca for free. ISBN: 189432403X. Summary: Patient education materials are often written at a level that is higher than the reading level of the people who need the materials. This directory lists 'plain language' patient education materials. An extensive introductory chapter in the directory describes how patient education materials are evaluated and offers specific information about the best strategies to create plain language materials. Each piece of health information in the directory is rated according to its design assessment, in order to help readers make informed decisions about choosing materials. Part I is a list of health subjects presented in alphabetical order, in the style of a typical index. The page number after a listing notes where to find that piece of health information in Part II. Part II is a list of organizations and their contact information. Below the contact information is a list of the plain language health titles produced by the organization. Each title is grouped under a grade level heading, is numbered, and has a design rating. Part III is an alphabetical list of all the organizations in Part II. Materials related to digestive system diseases include allergies, constipation and soiling in children, cholesterol, hepatitis, constipation, diabetes and diet therapy, exercise for weight control, food choices, nutrition, heart health, immunization, low fat cooking, nausea, vomiting, diarrhea, smoking, and weight loss. Appendices to the directory include a guide to the S.M.O.G. readability formula, clear design tips, and plain language tips. The Directory is also available at www.pls.cpha.ca on the Internet.

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You will need to limit your search to “Directory” and “weight loss” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “weight loss” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.

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CHAPTER 8. MULTIMEDIA ON WEIGHT LOSS Overview In this chapter, we show you how to keep current on multimedia sources of information on weight loss. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on weight loss is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “weight loss” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “weight loss” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on weight loss: •

Living Without Dieting Source: Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 1992, 60 minutes. Contact: WIN, 1 WIN WAY, Bethesda, MD 20892-3665. Summary: Dr. Foreyt opens his lecture with the case of Linda, who has maintained a weight loss of 100 pounds for more than 8 years, and who works at maintaining her weight every minute of every day. Is Linda, he asks, a success or a failure? Dr. Foreyt's next question " It is OK to be fat?," leads into a discussion of the emotional problems and discrimination that people may face because of their weight. The question also leads into a survey of the changes in perceptions of ideal body weight from the Neolithic period through Reubens, Renoir, and Marilyn Monroe to Twiggy and "Playboy" centerfolds. Dr. Foreyt emphasizes that the current belief that it is better to be lean and fit (to be more like Twiggy) often leads to unnecessary dieting as well as to unrealistic expectations. Dr. Foreyt discusses the absence of data on results of treatment except

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from university-based programs. These data indicate that behavioral self-management, very-low-calorie diets, pharmacotherapy, and surgery are all effective, with two-thirds maintaining their new weight at 1 year. However, for nearly all subjects, weight has been regained within 3 to 5 years. Dr. Foreyt discusses the reasons for this regained weight. He explains that the traditional weight loss diets will not achieve success. He points to fat as the culprit and discusses fat reduction versus calorie reduction (the relation of body fat to dietary fat, the need to avoid deprivation and to reduce fat intake). He then discusses the importance of normalized eating (three meals a day with low-fat snacks between), very gradual changes (losing 1 pound a week), realistic weight goals (possible, reasonable), and support from family and friends. He concludes the lecture with a strong statement on the need for healthy eating and no dieting, with a return to the question of Linda's success or failure. •

Physical Activity, Diet Composition, and Obesity Source: Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 1992, 60 minutes. Contact: WIN, 1 WIN WAY, Bethesda, MD 20892-3665. Summary: Dr. Hill's research involves manipulating diet composition and physical activity and observing the effect on body composition and body weight. In this lecture, Dr. Hill discusses recent research results and their implications for the prevention and treatment of obesity. Dr. Hill describes his laboratory's "whole room calorimeter," which provides a controlled environment for the accurate measure of energy intake and expenditure in human subjects. A limitation of the calorimeter is that most study subjects do not attain their usual levels of energy expenditure while confined to the room. Subjects nonetheless show wide variation in energy expenditure, from a low of 200 kcal/day to a high of 1,000kcal/day. This suggests, according to Dr. Hill, that differences in the amount of energy expended in exercise are very important in body weight regulation. More research is needed to identify why some people engage in more physical activity that others and whether some people are more efficient exercisers than others. Dr. Hill goes on to discuss studies on the effect of exercise on body composition. He notes that in short-term studies (less than 20 weeks), the effect of exercise as a treatment for obesity is modest. However, in studies where the subjects were followed up a year later, exercise was the best predictor of successful weight loss. Also discussed is a recent diet composition study conducted in Dr. Hill's laboratory. Investigators manipulated subjects' intake of fats and carbohydrates to observe the effect on body composition and energy expenditure. More than 80 percent of the excess fat consumed was stored as adipose (fat) tissue, and less than 5 percent was burned through increased energy expenditure. Excess carbohydrate was directed more into energy expenditure and less into storage; however, over time, the amount of excess carbohydrate stored as adipose tissue increased. There were striking differences between individuals' responses to this dietary manipulation. Dr. Hill concludes that, calorie for calorie, while dietary fat is more likely to lead to obesity than carbohydrate, some people remain susceptible to obesity even on a high-carbohydrate diet. "The idea that all obesity is due to a high-fat diet is probably naive," he says. He further concludes that a low-fat diet and increased physical activity may be an effective strategy for preventing or treating obesity in some subjects, and that more research is needed to identify subjects who will respond to this regimen.

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Physical Activity, Metabolism, and Weight Control Source: Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 1992, 60 minutes. Contact: WIN, 1 WIN WAY, Bethesda, MD 20892-3665. Summary: Dr. Stern's lecture begins with the statement that obesity is a very complex disorder. Eating too much or being inactive are oversimplified reasons for obesity, which has very firm biological bases. Scientists, says Dr. Stern, fundamentally do not understand why some individuals become obese and others do not. The vast majority of people who lose weight regain it within 5 years. This finding suggests that there are strong biological foundations for obesity. Dr. Stern discusses several animal and human studies showing how diet, exercise, and genes affect obesity and perhaps explain why maintaining weight loss is so difficult. Dr. Stern believes increasing physical activity is a key to maintaining weight loss, but it is unclear whether the effect is metabolic or psychological. Obese people are not necessarily less active, she notes, but most are. In her own studies of Zucker (genetically obese) rats, she found that obese rats remained obese even when they consumed fewer calories than normal-weight rats and were as physically active as normal-weight rats. She cites studies showing that sudden changes (whether increases or decreases) in physical activity affect metabolic rates in both humans and rats. When physical activity stops suddenly, one's metabolic rate drops, which would lead to weight gain if food intake remained constant. Dr. Stern discusses studies showing evidence of a strong genetic component to obesity in both humans and rats. In order to translate these findings from the laboratory to a clinical setting, Dr. Stern suggests that any weight loss program should include a low-fat diet, an individualized weight loss program, regular exercise, problem-solving skills, and a social support network. A question- and-answer period follows the lecture.

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Gender, Genetics, and Obesity Source: Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 1992, 60 minutes. Contact: WIN, 1 WIN WAY, Bethesda, MD 20892-3665. Summary: In this lecture, Dr. Greenwood discusses current understanding of the impact of gender and genetics on obesity and describes animal and human studies that offer clues about why it is so difficult to treat obesity. Data strongly suggest that increased incidence and prevalence of obesity in the United States is not caused solely by increased caloric intake. Dr. Greenwood describes the different patterns of obesity that tend to occur in men and in women and evidence from various studies suggesting that fat distribution may be the factor contributing most to the health risk of obesity. The lecture goes on to discuss animal models that suggest the vulnerability to obesity may be the result of aberrant nutrition partitioning, whereby a higher than normal proportion of nutrients are deposited in fatty tissue, leaving other tissues (notably skeletal muscle) relatively deprived. Dr. Greenwood and her colleagues propose that overeating is an adaptive response to this process, which they believe may be regulated by lipoprotein lipase, an enzyme manufactured by fat cells. Dr. Greenwood also examines research on weight cycling, a phenomenon in which an individual loses weight, gains it back, loses it again, and so on. Evidence gleaned from studies in both rats and humans suggests that weight cycling may be an independent risk factor for increased morbidity and mortality, and may also be associated with the decreased effectiveness of weight loss methods. However, Dr. Greenwood notes that no long-term studies have been conducted on the effects of weight cycling, and that this is an

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important area for future research. The lecture concludes with the observation that weight loss advice should address the need for physical fitness and permanent lifestyle change and diet composition over caloric restriction. •

Human Studies on Obesity Source: Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, 1992, 60 minutes. Contact: WIN, 1 WIN WAY, Bethesda, MD 20892-3665. Summary: In this lecture, Dr. Hirsch describes how his interest in obesity research developed from studies on the composition of human adipose (fat) tissue, which he conducted early in his career. He began offering weight loss treatment to his obese patients in return for their participation in these studies. Dr. Hirsch believed obesity was caused by overeating and inactivity, and could be successfully treated by diet and counseling. He found, however, that many patients felt worse, both physically and emotionally, after weight loss and quickly regained all the lost weight. Studies of growth-stunted and genetically obese rats led him to theorize that genetic predisposition played a crucial role in the development of obesity. Since then, his work has focused on developing a better understanding of the genetics and biology of obesity. Dr. Hirsch briefly describes the work of Max Kleiber, who found a direct relationship between an animal's body size and its caloric intake. This relationship is generally referred to as "Kleiber's line." Dr. Hirsch discusses human studies that suggest some people are genetically predisposed to store more than the usual amount of body fat. When these individuals lose weight, their bodies are "out of balance" relative to Kleiber's line; balance is restored when they return to the obese state. This theory may explain why many obese people feel unwell when they lose weight and quickly return to their previous weight. However, Dr. Hirsch notes that genetic factors alone do not cause obesity; a complex interplay of genetics, psychosocial factors, and food availability is likely to be involved. Dr. Hirsch outlines current work in his laboratory aimed at understanding genetic mechanisms in rodent obesity and discusses questions that future research needs to address on human obesity. He observes that answers to these questions may be important in the study of other behavioral disorders that, like obesity, have biologic roots, but depend on developmental and psychosocial events for their full display. The lecture includes a question-and-answer session and a tribute to the late W. Henry Sebrell, a former director of the NIDDK and the National Institutes of Health, who died in September 1992.

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In the Practice of Medicine, Which Lipids Should Be Measured and When? Source: Atlanta, GA: Emory University Office of Medical Television. 1996. (videocassette). Contact: Available from Robert W. Woodruff Health Sciences Center, Emory University. Office of Medical Television, 1364 Clifton Road, Box M-16, Atlanta, GA 30322. (404) 7279797. Fax (404) 727-9798. PRICE: $75.00. Also available for rental; contact producer for current fee. Item number 96-4. Summary: In this videotape program, Dr. Virgil Brown reviews the most recent recommendations for the diagnosis and management of dyslipidemias. These include placing more emphasis on low levels of LDL and its impact on drug choice, and the importance of weight loss and physical activity as components of dietary therapy. After discussing risk factors for coronary artery disease (CAD), he stratifies therapeutic targets for LDL cholesterol lowering according to the presence of established CAD (secondary

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prophylaxis) and risk factors. Dr. Brown then discusses the steps to be taken in the evaluation of dyslipidemic patients, including the exclusion of secondary causes. The insulin resistance syndrome and familial dyslipidemic hypertension are also discussed. He concludes by commenting on when family members of a dyslipidemic patient should be evaluated. (AA-M). •

Best of Living With Diabetes Television Video Series, Volume 1 Source: Vista, CA: CNBC. Lifetime. 1995. Contact: Available from Living with Diabetes. P.O. Box 2514, Vista, CA 92085-2514. (800) 433-2469. PRICE: $19.95 (as of 1995). Summary: In this videotape program, television medical correspondent Pat Gallagher narrates a compilation of the best of 100 episodes of the newsmagazine television show called Living With Diabetes. Produced by CNBC and Lifetime, the program explains the difference between insulin-dependent and noninsulin-dependent diabetes, and covers weight loss, exercise, cholesterol, high blood pressure, neuropathy, foot care, eye disease, kidney disease, and proper disposal of syringes. In addition, Terri Miller, a nurse and diabetes educator who has diabetes, shares practical tips on living with diabetes. (AA-M).

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Obesity Source: Los Angeles, CA: National Health Video, Inc. 1999. (videocassette). Contact: Available from National Health Video, Inc. 12021 Wilshire Boulevard, Suite 550, Los Angeles, CA 90025. (800) 543-6803. Fax (310) 477-8198. E-mail: [email protected]. PRICE: $89.00 plus shipping and handling. Summary: Obesity is a word that means one thing to the public and another to the health professional. To most people, to be obese is to be very overweight. To health professionals, however, a person can be considered obese even if the degree of overweight is not very great. This health education videotape program focuses on obesity, the impact of obesity on health, and strategies to fight obesity. The program describes methods to measure obesity, including percentage of body fat, and the Body Mass Index (BMI). A worksheet to figure one's own BMI is included in the teacher's guide. The program emphasizes that the causes of obesity are probably some combination of heredity and environment (including food and exercise habits), and notes that physical activity is a key factor in weight management. The program also describes the surgical techniques that can be used to treat obesity; these procedures are often effective but carry their own risks. Procedures covered include the stomach restriction or pouch procedure and the Roux en Y gastric bypass, in which the small intestine is surgically bypassed. The program also discusses miracle diets and diet pills, health problems associated with obesity, childhood obesity and its causes, and how to evaluate a commercial weight loss program. The teacher's guide includes a transcript of the video narration, a worksheet to determine BMI, a list of learning activities and teaching objectives, and a quiz for pre and posttesting. The video features many different people of different ethnic groups, ages, and body sizes; a variety of interactions with health care providers are also depicted. Simple graphics are used to explore some of the scientific concepts covered.

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Strategies for the Prevention and Treatment of Macrovascular Complications of Type 2 Diabetes Source: Kansas City, MO: American Academy of Family Physicians. 1998. (videocassette). Contact: Available from American Academy of Family Physicians. 8880 Ward Parkway, Kansas City, MO 64114-2797. (800) 274-2237. PRICE: $17.95 for members; $25.00 for nonmembers, plus shipping and handling. Summary: The macrovascular (large blood vessel) complications of diabetes account for the majority of the morbidity (related illness) and mortality (death) associated with the disease. In particular, people with type 2 diabetes are at increased risk for cardiovascular disease, since they exhibit many independent risk factors for heart disease, including obesity, hypertension (high blood pressure), and dyslipidemia (disordered levels of fats in the blood). This continuing education program features a videocassette and study guide that discuss why people with diabetes are at increased risk for macrovascular complications and how to reduce the patient's risk of cardiovascular disease. Topics include hyperglycemia (high blood glucose levels) and cardiovascular disease, insulin resistance and cardiovascular disease, the benefits of improved glycemic control, recommended target glycemic goals, nonpharmacologic therapies for diabetes (diet, exercise, patient education), pharmacologic (drug) therapies for diabetes (insulin secretagogues, insulin sensitizers, alpha-glucosidase inhibitors, and insulin), determining the optimal drug treatment regimen for individual patients, and treating cardiovascular risk factors. The program recommends that patients should be seen quarterly or more often, depending upon the severity of their disease, and target goals for HbA1c (glycosylated hemoglobin, a measurement of blood glucose levels over time) and fasting blood glucose should be established at the initial visit and discussed directly with the patient. Patients should be reminded at every office visit that weight loss and regular exercise are the most important aspects of controlling their diabetes and reducing the risk of macrovascular disease. A sample patient education hand out is included in the study guide. Through this program, users can qualify for one credit hour of Continuing Medical Education (CME) in category 1; the appropriate posttest is provided. 5 figures. 14 tables. 15 references.

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Dementia: The Power of Nutrition in Caregiving Source: Bozeman, MT: Montana Department of Public Health and Human Services, 1998. Contact: Montana Aging Services, Division of Senior and Long Term Care. PO Box 4210, Helena, MT 59604. (406) 444-4077; FAX: (406) 444-7743. PRICE: $40.00. Summary: This kit contains a 12-minute video and a series of handouts and transparencies intended for speakers addressing caregivers on the subject of Alzheimer's disease (AD) and nutrition. The video consists of interviews with nutritionists and AD care staff and footage of actual AD patients. The first section describes the role of nutrition in maintaining the health of AD patients; weight loss, caloric intake, and hydration are discussed. The second section focuses on making dining a pleasurable experience, in which aromas and presentation stimulate the appetite, and individual preferences are considered. The final section focuses on the needs of severely impaired patients who require special diets or feeding devices. The handouts and transparencies reinforce the points made in the video and provide information on caregiver resources. Presentation evaluation forms are also included in the kit.

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Helping Hand Video Guide Source: Thousand Oaks, CA: Amgen. 1997. (videocassette). Contact: Available from COMPASS Program, Amgen, Inc. 1 Amgen Center Drive, Professional Services, Mailstop 36-2-A, Thousand Oaks, CA 91362. (888) 508-8088. Website: www.infergen.com. PRICE: Single copy free. Summary: This patient education videotape describes hepatitis C viral infections and the use of Infergen (interferon alfacon 1) therapy to help treat this disease. The first section of the program explains hepatitis C, its risk factors, symptoms, transmission, and complications. The program features scenes of a patient receiving her diagnosis, and narration by a physician, Dr. Melissa Palmer. The program emphasizes the importance of treating hepatitis C, as it can cause long term complications if left untreated. In the second section, the focus is on Infergen: how the drug works, how to inject Infergen, and potential side effects and how to manage them. The video explains in clear terms, with graphics, the differences between bacteria and viruses and why viruses can be so difficult to eradicate from the body's cells. The video includes a section on the process of injecting Infergen, supplies, recordkeeping, places to inject, preparation of the syringe, storage of the drug, and the use of containers for sharps. Potential side effects and strategies to manage each of them are outlined. The side effects can include flulike symptoms, upset stomach, fatigue, loss of appetite, weight loss, depression, and a local reaction at the injection site. The program concludes by describing the COMPASS program of patient education and support provided by the Amgen company. COMPASS includes patient supplies, a patient support and information telephone line, and assistance with financial concerns, including insurance and reimbursement.

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Heartburn Sufferers: Stop Taking Chances Source: Arlington, VA: American College of Gastroenterology. 199x. (videorecording). Contact: Available from American College of Gastroenterology. 4900 B South 31st Street, Arlington, VA 22206. (800) 478-2876. PRICE: Single copy free. Summary: This patient education videotape explains the basics of heartburn and gastroesophageal reflux disease (GERD). Gastroesophageal reflux is a physical condition in which acid from the stomach flows backward up into the esophagus. Frequent problems with reflux (two or more times per week), food sticking, or blood or weight loss, may indicate the more severe problem of GERD. The program discusses causes of heartburn and GERD, treatments for infrequent heartburn, and complications of GERD. Discussion of treatment options for GERD covers lifestyle modification, medications often prescribed (H2 receptor antagonists, proton pump inhibitors, and promotility agents), and surgery. Other topics include the effectiveness of different therapies for GERD, the role of gastroenterologists, diagnostic tests (upper GI series, endoscopy, esophageal manometry or esophageal pH), and the link between duration of heartburn and severity of esophageal disease. The program emphasizes that heartburn is a common but not trivial problem, and encourages readers to consult their health care providers for ongoing problems with heartburn. The program features Dr. Joel Richter from The Cleveland Clinic.

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Fat Chance Source: Oley, PA: Bullfrog Films; 72 minutes, 20 seconds; 1994. Contact: Bullfrog Films, Box 149, Oley, PA 19547 (610) 779-8226.

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Summary: This video chronicles a year in the life of Rick Zakowich, an obese man who sets out to lose weight and becomes an advocate for size acceptance in the process. As the video opens Rick is undertaking one in a lifelong series of weight loss programs. He visits his physician and exercise trainer, but cannot seem to become motivated. He discusses his personal anguish and self-hatred, explaining how obesity has overshadowed every aspect of his life since childhood. With the help of another obese man, Rick becomes part of a national size acceptance organization, initiates a support group for obese men, and becomes comfortable with his body size. •

Diabetes and Food: The Challenge of Choices Source: Santa Monica, CA: Oracle Film and Video. 1990. Contact: Available from Oracle Film and Video. 1820 14th Street, Suite 202, Santa Monica, CA 90404. (800) 262-4550 or (310) 450-6637. PRICE: $229 (as of 1995); rentals available. Summary: This video depicts the real-life struggles of people managing diabetes and also presents down-to-earth solutions that can help preserve the pleasures of eating. Included with the film is a booklet that includes the new Exchange List System and offers information on alcohol use, restaurant dining, and quick and healthy food choices. People with diabetes of different ages and background discuss the challenges and benefits of weight loss, lifestyle changes, and how these factors affect relationships with family and friends. (AA-M).

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Diabetes and Weight Control: Change for a Lifetime Source: Timonium, MD: Milner-Fenwick, Inc. 200x. (videocassette). Contact: Available from Milner-Fenwick, Inc. 2125 Greenspring Drive, Timonium, MD 21093-3100. (800) 432-8433. Fax (410) 252-6316. Website: www.milner-fenwick.com. PRICE: First 15 days free of charge to healthcare professionals; plus shipping and handling. Order number: DB-35. Summary: This video examines the relationship between excess weight, lack of activity, and the development of the insulin resistance characteristic of type 2 diabetes. Weight loss can reduce the risk of diabetic complications and heart disease, and reduce or eliminate the need for medication. Topics related to the issue of long-term weight control include limiting fat and total calories, controlling portion size, eating a variety of foods, spreading food intake throughout the day, and exercising. Patient interviews are used to explore the psychosocial issues associated with weight control. The video also includes weight loss tips and learning tools such as a food diary.

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AIDS: Profile of an Epidemic, Update Contact: Indiana University, Audio - Visual Center, Bloomington, IN, 47405, (812) 3358087. Summary: This video presents all known aspects of AIDS, bringing together both noted personalities (such as Ed Asner who introduces the topic) and experts from related fields--physicians, biochemists immunologists--to discuss cause, transmission, and signs and symptoms. Since the disease was first described in 1981, 60,000 people have contracted it. Of this number, 72 percent are homosexual or bisexual men. Infection in the remaining cases has been through contaminated transfused blood or contaminated needles used by intravenous drug addicts. Several AIDS patients and their physicians are interviewed and describe physical symptoms and emotional responses to the

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disease. Symptoms include unexplained fever for longer than a week, weight loss, swollen glands, night sweats, mood changes, shortness of breath, and diarrhea. The cause is a human retrovirus. Now, meticulous screening of blood products has virtually eliminated that as a source of infection. Extensive research is also under way to develop vaccines to prevent AIDS and new drugs to combat the disease once it has been identified in individuals. Most AIDS patients receive emotional support and counseling from physicians, psychologists, and nurses. The content included in this video adds immeasurably to our knowledge about AIDS. Audience: general public, health care professionals and students, and all those who care for AIDS patients. (Producer's abstract). •

Diabetes: From Detection to Treatment Source: Calhoun, KY: NIMCO. 1994. (videocassette). Contact: Available from NIMCO. P.O. Box 9, 117 Highway 815, Calhoun, KY 423270009. (800) 962-6662 or (502) 273-5050. Fax (502) 273-5844. PRICE: $89.95. Order number: NIM-SM-CD1-V. Summary: This video takes the viewer through the medical detection of diabetes. The model it presents of the cause of diabetes hypothesizes that an environmental trigger in a genetically susceptible person causes inflammation that eventually destroys the cells of the pancreas and leads to a reduction in insulin. The video highlights diabetes symptoms, including polyuria, polydipsia, polyphagia, weight loss, and blurred vision. It explains why people with diabetes consume so much fluid and why they have increased urination. Among the other topics covered are diabetes education, medications and their side effects, diabetic retinopathy, cardiovascular disease, atherosclerosis, foot problems and neuropathy, and renal failure. The video includes numerous comments from physicians and patients.

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Behavioral Approaches to the Treatment of Obesity and Type II Diabetes Source: Bethesda, MD: Weight-Control Information Network. 1993. (videorecording). Contact: Available from Weight-Control Information Network. 1 WIN Way, Bethesda, MD 20892-3665. (800) 946-8098 or (301) 984-7378. Fax (301) 984-7196. E-mail: [email protected]. PRICE: $5.00. Summary: This video, from a lecture series on clinical obesity, addresses behavioral approaches to the treatment of obesity and type 2 diabetes. The speaker, Rena R. Wing from the University of Pittsburgh, examines changes in behavioral approaches to obesity between the 1980s and the 1990s. In the 1980s, researchers considered antecedents and consequences of obesity and believed that a change in environment would lead to a change in behavior. In the 1990s, issues of food provision are being emphasized. Researchers are also stressing the importance of followup visits, since people enrolled in twenty week programs, for example, often gained weight after therapy ended. Studies have also shown that restricting both fat and caloric intake, as opposed to focusing on just one, has been effective in the treatment of type 2 diabetes. In addition, the combination of diet and exercise appears to be effective for long-term weight loss. People who are asked to diet and exercise, as opposed to just exercise, seem to be more successful. The speaker concludes that obesity should continue to be considered a chronic disease and treated with structured exercise programs and lowfat diets. The speaker entertains numerous questions at the end of her lecture. (AA-M).

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Nutrition Strategies in HIV Management Teleconference Contact: TKN - TV, 2000 5th Ave R-101, River Grove, IL, 60171. Summary: This videorecording documents a teleconference on the subject of nutrition and Human immunodeficiency virus (HIV) infection. Hosted by Novella Dudley, it features a panel of four experts from various areas of the field who discuss aspects of HIV and nutrition; they then field questions from both the studio audience and over the telephone. Short video segments introduce each new topic. The panel includes Dr. Donald Kotler, of St. Luke's - Roosevelt Hospital; Joyce Fitzpatrick, a nursing consultant; Frank San Miguel, coordinator of HIV services for travelers and immigrants in Chicago; and Annette Smerko of Caremark. The teleconference opens by considering nutrition as part of the psychosocial needs of a Person with AIDS (PWA). The symptoms of malnutrition are discussed, such as weight loss, anorexia, diarrhea, fever, and painful chewing or swallowing. It addresses financial issues of the cost of medication being so great that some patients cannot afford food. It looks at the different nutritional needs of PWA's, who must avoid weight loss by eating extra calories. The panel addresses the philosophy behind providing nutritional care for someone who is dying, and looks at the effect of alcohol use on nutrition. Case studies are examined; they say that the lack of ability to eat may be due to neurologic disease, drugs, or local pathology. PWA's are encouraged to consult with a dietitian, a physican, and a social worker. The connection between depression and malnutrition is established. The panel looks at specific opportunistic infections that may affect the appetite, such as hepatitis, thrush, and candida. A demonstration is given on safe handling of food to prevent salmonella and other foodborne diseases. The videorecording examines the devastating effects of weight loss on a patient, and looks at the barriers to motivating a patient to eat. It studies ethical concerns in treatment and legal issues involved in refusal to treat. The concluding segment studies the diagnosis and management of gastrointestinal disorders. It touches on steroid use and the use of nutritional supplements. At the end of the videorecording, viewers are urged to complete an evaluation.

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Body Trust: Undieting Your Way to Health and Happiness Source: Billings, MT: Body Trust, 60 minutes, 1993. Contact: Body Trust, 2110 Overland Avenue, Suite 120, Billings, MT 59102. (406) 6569417, (800) 321-9499, FAX (406) 656-0124. Summary: This videorecording is based on the BODY TRUST concept; one that encourages self-esteem, self-love and discourages the preoccupation with dieting and weight loss. The BODY TRUST program teaches viewers to eat less and make healthy food choices without feeling deprived; to enjoy physical activity instead of grueling workout routines; and to appreciate and accept oneself regardless of body size and body weight.

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Now That You Know: Living Healthy With HIV; Part 4 - Understanding Treatment Contact: Kaiser Permanente, National Video Communications, 825 Colorado Blvd Ste 301, Los Angeles, CA, 90041, (323) 259-4776, http://www.kaiserpermanente.org/locations/index.html. Summary: This videorecording tells persons with Human immunodeficiency virus (HIV) infection about symptoms, opportunistic infections, and available treatment. Narrators Bob Goen and Susan Campos introduce the material by saying that infected persons need to take control of their own health, become educated, and become

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informed. The main portion of the videorecording opens with a segment on azidothymidine (AZT). It discusses early intervention and when it is appropriate to begin treatment. A model demonstrates how antiviral treatment, such as AZT intervention, slows the rate of growth. Viewers are warned that being on antiviral therapy does not prevent them from being infectious. Possible side effects of the medication are discussed. After turning to general background information on opportunistic infections, that videorecording takes a detailed look at some of the most common. It classifies symptoms into infections that do not lead to an AIDS diagnosis, such as candida, shingles, and weight loss; nonspecific symptoms, such as fatigue, fever, and night sweats; and opportunistic infections that lead to an AIDS diagnosis. Of those, it takes the most detailed looks at Pneumocystis carinii pneumonia (PCP), cytomegalovirus retinitis (CMV) infection, toxoplasmosis, and mycobacterium avium intracellulare (MAI). Holistic therapies are considered briefly at the conclusion of the videorecording. •

Nutrition and HIV Contact: Pyramid Media, PO Box 1048, Santa Monica, CA, 90406-1048, (310) 828-7577, http://www.pyramidmedia.com. Summary: This videorecording, divided into four sections, talks about the importance of nutrition to persons with HIV infection. Hosted by Dr. Larry Waites and Laurie Miello, a registered dietitian, it emphasizes the point that studies have shown a connection between nutrition and the progression of the illness. The first section looks at nutrition, weight loss, and the function of the immune system. The videorecording says that persons with AIDS (PWAs) have increased metabolic function and increased nutritional needs. The second section examines ways to change eating habits to overcome such symptoms as diarrhea, nausea, and appetite loss. It suggests foods to eat and foods to avoid. Next, the third section explains methods of defensive eating. It looks at ways to prepare foods safely. Finally, the videorecording mentions the concept of Total Parenteral Nutrition (TPN), which is receiving all the carbohydrates, fats, proteins, vitamins, and minerals necessary through intravenous feeding.

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Obesity and Type II Diabetes Source: Los Angeles, CA: National Health Video, Inc. 2000. (videocassette). Contact: Available from National Health Video, Inc. 12021 Wilshire Boulevard, Suite 550, Los Angeles, CA 90025. (800) 543-6803. Fax (310) 477-8198. E-mail: [email protected]. PRICE: $89.00 plus shipping and handling. Summary: This videotape discusses the relationship between type 2 diabetes and obesity. Obesity presents special problems for people who have diabetes because excess body fat decreases the body's ability to use insulin, strains the pancreas, and makes the body less able to use the insulin it produces. Although the causes of obesity are not well understood, factors such as age, heredity, and gender have been associated with weight gain. A weight loss of just 10 to 20 pounds can improve blood glucose levels, blood pressure, and cholesterol. Methods of losing weight include eating a variety of foods in moderation, incorporating moderate activity into a daily schedule, undergoing stomach restrictive and intestinal bypass procedures (recommended only for people who are severely obese), using diet medications, and enrolling in a weight loss program. Other topics include the role of obesity in diseases other than diabetes and the growing problem of childhood obesity. The videotape is accompanied by a teaching resource guide and a transcript of the tape.

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New Lean Life Foods Source: Shingle Springs, CA: NutriVisuals. 1995. (videocassette). Contact: Available from NutriVisuals. P.O. Box 1367, Shingle Springs, CA 95682. (916) 677-1969. Fax (916) 677-2347. PRICE: $99.50 plus shipping and handling. Summary: This videotape introduces the newly revised Lean Life Foods program of weight loss and healthy eating. The program shows viewers how to reduce their caloric intake by cutting down on fat. The program introduces the concepts of fat and calorie counting, depicts common meals both before and after modifications for fat reduction, and provides viewers with tips about food preparation. The video comes with seven pages of recipes for traditional foods, including fried chicken, cole slaw, salad dressings, gravies, spaghetti sauce, waffles, and yogurt. Each recipe notes the calories, fiber, sodium, and fats for a serving.

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Living with Diabetes Source: Andover, MA: Xenejenex, Inc. 1990. Contact: Available from Xenejenex, Inc. 300 Brickstone Square, Andover, MA 01810. (800) 228-2495 or (508) 475-3000. PRICE: $24.95 plus $3 shipping and handling. Summary: This videotape presents a positive approach to healthy living with diabetes mellitus. The videotape presents the best techniques for self-monitoring and suggests ways to avoid common complications. Experts from the Joslin Clinic of Boston discuss alternatives to insulin therapy and how to achieve healthy weight loss. The film also gives recipes to fit this healthier lifestyle.

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Diabetes and Food: The Challenges of Choices Source: Los Angeles, CA: National Health Video. 1992. Contact: Available from National Health Video. 12021 Wilshire Boulevard, Los Angeles, CA 90025. PRICE: $79.95 plus $3 shipping and handling. Summary: This videotape program presents practical solutions that can help to preserve the pleasures of eating for people following a diabetic diet. The tape includes practical tips on exercise, weight loss, special occasions, and family meal planning. (AA-M).

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Ulcerative Colitis: The Disease and Enema Therapy Source: Marietta, GA: Solvay Pharmaceuticals, Inc. 1996. (videocassette). Contact: Available from Solvay Pharmaceuticals, Inc. 901 Sawyer Road, Marietta, GA 30062. (800) 354-0026. PRICE: Single copy free. Summary: This videotape program provides information and reassurance for people recently diagnosed with ulcerative colitis (UC). The program notes that UC can have a great impact on a person's life, but that following the prescribed treatment can help relieve symptoms and return a sense of normalcy. The narrator reviews the possible causes of UC, including genetic, infectious, and autoimmune theories, noting that UC is not contagious or caused by stress or food sensitivity. UC is most often found in the developing world, and people are usually diagnosed in their teens or twenties. The program then features brief interviews with six women who describe how they felt when they first received the diagnosis. Reactions ranged from fear and anxiety to relief that they finally had a name for their symptoms. The narrator then lists the common symptoms of UC: diarrhea, rectal bleeding, bloody stool, loss of appetite, anemia,

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abdominal pain, weight loss, fever, and gas (flatulence). Less common symptoms can include joint pain, skin lesions, and eye inflammation. The program then features a man and two women talking about symptoms, particularly urgency and frequency, and the impact of these symptoms on their lifestyles. The narrator notes that there are rectal agents, oral medications, antibiotics, and combination therapies, but that the video will focus on enema therapy. The program then interviews three patients who use Rowasa (mesalamine in a rectal suspension enema form). The patients talk about enema therapy and the improved quality of life they have found using this form of the drug. The program then uses line drawings to demonstrate how to give oneself an enema. The medication should be given when the patient can stay prone for 30 minutes or, preferably, overnight. The program concludes by encouraging viewers to ask their health care provider to answer any questions they may have. The address and tollfree telephone number (800-343-3637) of the Crohn's and Colitis Foundation of America are also provided. •

New Definition of Diabetes Source: Los Angeles, CA: National Health Video, Inc. 1998. (videocassette). Contact: Available from National Health Video, Inc. 12021 Wilshire Blvd., Suite 550, Los Angeles, CA 90025. (800) 543-6803. Fax (310) 477-8198. E-mail: [email protected]. PRICE: $89.00 plus shipping and handling. Order number 283. Summary: This videotape provides people who have diabetes with information on the new definition of the disease. The videotape begins by explaining the revised fasting plasma glucose (FPG) criteria and their diagnostic implications and discussing the impaired fasting glucose (IFG) category. Diabetes is diagnosed as a FPG level of 126 or above. The criteria for diagnosis were lowered to allow for earlier identification of diabetes so that complications can be prevented. IFG is defined as a blood glucose level of 110 to 125. People with such a value do not yet have diabetes, but they are at risk of developing it. The video continues by identifying factors that indicate the need for diabetes testing, including excessive thirst, frequent urination, weight loss, a family member who has diabetes, age over 45, and obesity. This is followed by an explanation of type 1 and type 2 diabetes. In addition, the videotape presents the food guide pyramid tailored for persons who have diabetes and provides suggestions on food preparation and exercise.

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Living with Diabetes: Making the Diagnosis Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1999. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 071899A. Summary: This videotape, part of a series on living with diabetes, focuses on the diagnosis of diabetes. A moderator discusses the new criteria for the diagnosis and classification of diabetes, the rise in the incidence of diabetes, the symptoms of diabetes, and the prevention of diabetes with an endocrinologist. The videotape begins with a discussion of what diabetes is, how insulin works, the types of diabetes, and risk factors for diabetes. Type 1 diabetes, which was formerly known as insulin dependent diabetes, usually develops quickly, whereas type 2 diabetes, which was formerly known as noninsulin dependent diabetes, usually has a gradual onset. The symptoms of diabetes,

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which are generally the same regardless of the type, are related to high blood sugar. They include excessive urination and thirst, fatigue, hunger, weight loss, and blurred vision. Risk factors for type 1 diabetes include a genetic predisposition for developing the disease. Risk factors for type 2 diabetes include being overweight, sedentary, and over 45 years old; having a history of stillbirth or gestational diabetes; having high blood pressure and high cholesterol; being African American, Hispanic, or Native American; and having previously been identified with impaired glucose tolerance. The acute complications of diabetes include ketoacidosis, nonketotic hyperosmolar syndrome, and hypoglycemia. The chronic complications are divided into microvascular and macrovascular complications. Microvascular complications include retinopathy, neuropathy, and nephropathy. Macrovascular complications include heart attack, stroke, and peripheral vascular disease. Early diagnosis is important in preventing complications. Diagnosis is based on blood sugar levels obtained from a blood glucose test, a fasting plasma glucose test, or an oral glucose tolerance test. The risk of developing type 2 diabetes may be reduced by eating properly, maintaining an ideal weight, and exercising. The videotape includes a self test that viewers can take to assess their risk of developing type 2 diabetes.

Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “weight loss” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on weight loss: •

New Nutritional Guidelines for a New Day in Diabetes Care: Most Commonly Asked Diet Questions Source: Van Nuys, CA: Prana Publications. 1995. (audiocassette). Contact: Available from Prana Publications. 5623 Matilija Avenue, Van Nuys, CA 91401. (800) 735-7726 or (818) 780-1308. Fax (818) 786-7359. E-Mail [email protected]. PRICE: $11.95 plus $3.25 shipping and handling (as of 1995). Order Number A12. Summary: In this audiocassette program for people with diabetes, Betty Brackenridge, former president of the American Association of Diabetes Educators, explains the American Diabetes Association's 1994 nutritional guidelines. Topics include changes in the guidelines; new guidelines regarding sugar; weight loss and determining appropriate weight levels; and other common concerns. (AA-M).

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Effective Drug Therapy for Diabetes Mellitus Source: Alexandria, VA: American Diabetes Association. 1998. (audiocassette). Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $17.95 for members; $22.95 for nonmembers; plus shipping and handling. ISBN: 1580400213. Summary: These audiocassettes provide information on effective drug therapy for diabetes mellitus. They feature articles first published in 'Clinical Diabetes.' An article on

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the use of metformin to treat diabetes provides an overview of this agent. Another article describes the use of acarbose to inhibit alpha-glucosidase. This agent decreases postprandial hyperglycemia by delaying carbohydrate digestion and absorption. A third article focuses on the use of lispro insulin, a rapid acting synthetic analog, to treat diabetes. Topics include the molecular structure of lispro insulin, immunologic concerns, and clinical applications and concerns. Another article deals with the use of troglitazone, a thiazolidinedione that improves insulin resistance without stimulating insulin secretion, to treat diabetes and the insulin resistance syndrome. Topics include the pathophysiology of impaired glucose tolerance and type 2 diabetes, the pathophysiological basis of pharmacological therapy, clinical studies, the effects of troglitazone on body weight and lipids, and the safety and adverse effects of the agent. An article on the use of combination oral agent and insulin therapy in patients who have type 2 diabetes includes discussions of the rationale for the use of combination therapy and the mechanism of action, efficacy, and side effects of various oral agents combined with insulin. The final article focuses on converting patients who have type 2 diabetes from insulin-requiring to noninsulin-requiring. Topics include the disadvantages of insulin utilization in people who have type 2 diabetes, once daily insulin and combination oral therapy, improved glycemic control on oral therapy, weight loss on combination oral therapy, oral monotherapy, and other potential drug combinations.

Bibliography: Multimedia on Weight Loss The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in weight loss (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on weight loss: •

Involuntary weight loss, wound healing, and optimal nutritional intervention. III, Wound healing module [electronic resource] Source: [sponsored by Synermed Communications and The Dannemiller Memorial Educational Foundation]; Year: 2001; Format: Electronic resource; Califon, N.J.: SynerMed Communications, 2001

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Weight loss drugs Source: weight loss : Weintraub interviewed--footage not used; Year: 1996; Format: Videorecording; [New York?: ABC, 1996?]

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CHAPTER 9. PERIODICALS AND NEWS ON WEIGHT LOSS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover weight loss.

News Services and Press Releases One of the simplest ways of tracking press releases on weight loss is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “weight loss” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to weight loss. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “weight loss” (or synonyms). The following was recently listed in this archive for weight loss: •

Weight loss boosts mood in the severely obese Source: Reuters Health eLine Date: September 29, 2003

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Depression associated with severe obesity improves with weight loss Source: Reuters Medical News Date: September 29, 2003

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Weight loss compound shows promise in phase IIb study Source: Reuters Medical News Date: September 19, 2003

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Herbal weight loss aids tied to liver injury Source: Reuters Health eLine Date: September 15, 2003

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Fish-oil fats may stop cancer weight loss Source: Reuters Health eLine Date: September 12, 2003

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Exercise plus weight loss reduces blood pressure in syndrome X patients Source: Reuters Medical News Date: September 10, 2003

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Weight loss reduces left ventricular mass in untreated hypertensives Source: Reuters Industry Breifing Date: August 27, 2003

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Weight loss tied to decrease in inflammatory proteins, improved insulin resistance Source: Reuters Medical News Date: June 24, 2003

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Postprandial surge in gut hormone aids weight loss after gastric bypass Source: Reuters Medical News Date: June 23, 2003

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Low-dose GH with diet and exercise may boost weight loss in obese adults Source: Reuters Industry Breifing Date: June 23, 2003

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Weight loss surgery effective but can involve complications: case series Source: Reuters Medical News Date: May 26, 2003

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Low-carb diet may be no better than low-fat diet for weight loss Source: Reuters Medical News Date: May 22, 2003

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Very low carbohydrate diet safe and effective for short-term weight loss Source: Reuters Medical News Date: April 28, 2003

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Regeneron says weight loss drug effective in phase II trial of diabetics Source: Reuters Industry Breifing Date: April 14, 2003

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Experimental drug produces modest weight loss in diabetics in early trial Source: Reuters Medical News Date: April 14, 2003

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Vascular inflammation, insulin resistance improve after weight loss Source: Reuters Medical News Date: April 09, 2003

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Antiepileptic and neurotrophic factor promote weight loss in obese adults Source: Reuters Industry Breifing Date: April 08, 2003

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Long-term pharmacotherapy for obesity brings small overall weight loss Source: Reuters Medical News Date: April 04, 2003

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Popular weight loss supplement may damage DNA Source: Reuters Health eLine Date: March 17, 2003

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Weight loss reduces proteinuria in overweight patients with chronic nephropathy Source: Reuters Medical News Date: March 07, 2003

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Attempted weight loss associated with reduced mortality Source: Reuters Medical News Date: March 04, 2003

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Losing weight-or even just trying-boosts survival Source: Reuters Health eLine Date: March 03, 2003

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Weight loss surgery changes food preferences Source: Reuters Health eLine Date: January 22, 2003

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Interference with fat metabolism in the brain causes weight loss in rats Source: Reuters Medical News Date: December 12, 2002

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Weight cycling and weight loss do not increase death risk in middle-aged men Source: Reuters Medical News Date: December 09, 2002

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Thyroid hormone levels elevated in obese children, fall with weight loss Source: Reuters Medical News Date: November 29, 2002

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name.

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Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “weight loss” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “weight loss” (or synonyms). If you know the name of a company that is relevant to weight loss, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “weight loss” (or synonyms).

Newsletters on Weight Loss Find newsletters on weight loss using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “weight loss.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “weight loss” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •

Medical Update on Obesity Source: Minneapolis, MN: Sandoz Nutrition, Issue XVII, 4p, Spring 1996. Contact: Sandoz Nutrition, 5320 West 23rd Street, Minneapolis, MN 55416. Summary: This newsletter updates medical professionals about obesity research and treatment. This issue considers the benefits of physical activity following weight loss, and the relationship between weight loss and increased metabolic efficiency.

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Perinatal nutrition update Source: Berkeley, CA: Maternal, Child, and Adolescent Nutrition Leadership Program, University of California at Berkeley. 1994-. semi-annual. Contact: Available from University of California at Berkeley, Maternal, Child, and Adolescent Nutrition Leadership Program, School of Public Health, 426 Earl Warren Hall, Berkeley, CA 94720. Telephone: (415) 642-2523 / fax: (510) 643-6981 / e-mail: [email protected]. Summary: This semiannual newsletter provides abstracts of current research and studies on prenatal nutrition, lactation, and maternal health that have been published in peer-reviewed journals. The newsletter provides a snapshot of new directions in perinatal nutrition instead of a comprehensive review of the literature. Highlights of the first issue include the following topics: maternal diet and childhood brain cancer, whether caffeine is a risk in pregnancy, postpartum weight loss, and lactation and breast cancer. [Funded by the Maternal and Child Health Bureau].

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “weight loss” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on weight loss: •

A New Treatment for Incontinence: Weight Loss Source: Tufts University Health and Diet Letter. 20(10):1. December 2002. Contact: P.O. Box 420235, Palm Coast, FL 32142-0235. 1-800-274-7581. www.healthletter.tufts.edu. Summary: A study of 40 overweight women by researchers at the University of California in San Francisco found that weight loss helped in the treatment of urinary incontinence. Half of the women consumed a low-calorie diet while the other half did not change their eating habits. After 3 months, those in the diet group lost an average of 32 pounds and reduced their incontinence episodes from 25 per week to 12. The control group then followed the diet and experienced similar results. According to lead researcher Leslee Subak, M.D., weight loss seems to be a plausible approach since 70 percent of women with incontinence are obese. One reason why weight loss may help the problem is that lower body weight, particularly less abdominal fat, puts less pressure on the bladder.

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Fatty Acid Synthase Inhibitor Leads to Dramatic Weight Loss in Mice Source: WIN Notes. p. 1, 3. Spring 2001. Contact: Weight-control Information Network. 1-877-WIN-4627. Summary: A study originally published in the June 30, 2000, issue of Science by Johns Hopkins University researchers found that a synthetic enzyme inhibitor causes mice to

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consume up to 90 percent less food, leading to extraordinary weight loss. Francis P. Kuhajda, M.D., who led the research team, believes that the discovery may represent a new therapeutic approach to controlling appetite and body weight. The researchers synthesized a fatty acid synthase (FAS) inhibitor, known as C75, to prevent the body from producing its own fatty acids during energy surplus, which then channels excess fuels into energy storage. When mice receive C75, they can lose 25 percent of their body mass in a couple of days without any perceptible side effects. The researchers conclude that FAS may be an important therapeutic agent for treating obesity. •

Exercise Without Weight Loss Can Reduce Cardiovascular Risk Source: WIN Notes. p.2. Spring 2001. Contact: Weight-control Information Network. 1-877-WIN-4627. Summary: According to a pilot study published in the February 2000 issue of Clinical Exercise Physiology, moderate exercise can significantly lower the risk of heart disease in overweight and mildly obese adults, even if the physical activity does not lead to weight loss. The study, conducted at the Duke University Medical Center in North Carolina, consisted of a 3-month controlled exercise program that monitored participants' weights and diets to prevent weight loss or gain. Three women and four men aged 40 to 55 with body mass indexes (BMI) of 25 to 35 participated in the study. The participants reduced LDL or bad cholesterol, increased HDL or good cholesterol, and decreased body fat. Duke cardiologist William Kraus, M.D, notes that 'this pilot study was a first attempt to isolate the effects of exercise from weight loss in a controlled fashion.' The research team designed the trial so that they could 'attribute all the beneficial effects to exercise alone'.

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Exploding the Myth: Weight Loss Makes You Healthier Source: Healthy Weight Journal. 13(1):4-6. January/February, 1999. Contact: Healthy Living Institute, 402 S. 14th St., Hettinger, ND 58639. (701) 567-2645. Summary: Ernsberger says that since weight loss is so difficult and the effects transitory, obese individuals should instead strive for a healthier lifestyle. By reducing the intake of saturated fats, exercising more, and consuming more fruits and vegetables, individuals may not lose as much weight, according to Ernsberger. However, he says, they will have lower cholesterol and blood sugar levels, as well as lower blood pressure. According to Ernsberger, since this is so, physicians should focus on a lower-fat diet, exercise and medication as treatments for high blood pressure, diabetes and high cholesterol. He says improvements in these conditions brought about by weight loss are temporary, and that weight loss attempts can actually be harmful by preventing the patient from pursuing other treatments.

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Weight Loss Winner-Healthy Fats Source: Running and Fitnews. p. 1. November/December 2002. Contact: The American Running Association. 4405 East West Hwy. Number 405. Bethesda, MD 20814. 1-800-776-2732. www.americanrunning.org. Summary: In a study initially published in the 'International Journal of Obesity and Related Metabolic Disorders,' researchers compared a low-fat diet to a moderate-fat Mediterranean diet including fats such as nuts and olive oil. The two diets contained the same number of daily calories. After 18 months, those following the moderate-fat diet

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averaged a 9-pound loss of body weight and reduced body mass index (BMI) by 1.6 and waist circumference by 2.76 inches. By contrast, those following the low-fat diet gained 6.38 pounds and increased BMI by 1.4 and waist circumference by about 1 inch. The authors concluded that a moderate-fat diet was more satisfying, allowing participants to follow the program with greater success. The healthy fats in this diet also have the extra benefit of contributing to heart-healthy lipid profiles. •

Little Weight Loss From Moderate Exercise Leads to Big Health Gains Source: Tuft's University Health and Nutrition Letter. 21(3):2. May 2003. Contact: P.O. Box 420235, Palm Coast, FL 32142-0235. 800/274-7581. www.healthletter.tufts.edu. Summary: Losing a small amount of weight, even if unnoticeable from a cosmetic point of view, can confer significant health benefits. Researchers looked at modest weight loss that results from regular physical activity. When one exercises, much of the weight loss does not come from fat under the skin that can be pinched. It comes from hidden or intra-abdominal fat. This fat surrounds the internal organs and increases the risk for chronic diseases more than under-the-skin or subcutaneous fat does. A group of Seattle women participated in an exercise program and after a year lost only about 3 pounds. However, the most active women lost 7 percent of their intra-abdominal fat. This is an amount significant enough to improve one's health.

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A Medication Side Effect That may be Overlooked: Unwanted Weight Loss Source: Tufts University Health and Diet Letter. 20(3): 8. May 2002. Contact: P.O. Box 420235, Palm Coast, FL 32142-0235. 800/274-7581. www.healthletter.tufts.edu. Summary: This article discusses involuntary weight loss as a side effect of medication use. Unplanned weight loss can depress the immune system, diminish valuable muscle tissue, and complicate recovery from illness or surgery, particularly for older adults. To correct the problem, physicians may be able to discontinue or substitute medications with those that do not cause weight loss. Health care practitioners can also recommend weight-gain strategies to counteract the effects of drugs. Making an appointment with a physician is recommended if one has an unintentional weight loss of 5 to 10 percent of body weight in 1 year or less, or has lost 5 pounds in 3 months. Drugs that affect appetite loss, taste change, swallowing, and/or nausea/vomiting are listed.

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What is Reasonable Weight Loss? Source: Weight Control Digest. 7(4):633,640-641,644; July/Aug 1997. Contact: Weight Control Digest, 1555 W. Mockingbird Lane, Suite 203, Dallas, TX 75235. (800) 736-7323. Summary: This article examines the issue of weight loss goals, specifically setting a reasonable goal. In the past, health professionals used height and weight charts to establish goals for their patients. More recently, 10 percent of the body weight has been suggested as an ideal goal. However, according to the author, many patients have unrealistic weight loss goals and therefore cannot hope to achieve them. Foster recommends helping the patient articulate beliefs about weight loss and then analyzing them and explaining errors.

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•

The Skinny on Weight Loss Source: Consumer Reports on Health. 10(2):1,3-4. February, 1998. Contact: Consumer Reports, Consumers Union of the US, 101 Truman Ave, Yonkers NY 10703-1057. Summary: This article explains why some myths about obesity and weight loss are not true. These include clothing size as an indication of overweight; weight loss really requires only some willpower; a low-fat diet by itself will help in weight loss; and that protein will help in weight loss. As each myth is explained, tips for losing weight safely are offered.

•

Chronic Dieting: Does it Make Weight Loss More Difficult? Source: The Weight Control Digest. 4(6)377, 380-3; November/December 1994. Contact: Weight Control Digest, 1555 W. Mockingbird Lane, Suite 203, Dallas, TX 75235. (800) 736-7323. Summary: This newsletter article examines the physical and psychological aspects of weight cycling caused by chronic dieting. Chronic dieting is defined as repeated efforts to eat less in order to lose weight. The link between chronic dieting and behavioral changes is addressed. Some researchers suggest that chronic dieting could make it more difficult to concentrate on mental tasks. Past research has also shown that overweight individuals have stronger emotional responses than normal-weight people. The question is posed as to where this could be due to the fact that overweight people diet more frequently. Appetite disturbances, food consumption patterns, and implications for treatment are also considered.

Academic Periodicals covering Weight Loss Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to weight loss. In addition to these sources, you can search for articles covering weight loss that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for weight loss. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with weight loss. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to weight loss: Amphetamines •

Systemic - U.S. Brands: Adderall; Desoxyn; Desoxyn Gradumet; Dexedrine; Dexedrine Spansule; DextroStat http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202031.html

Appetite Suppressants, Sympathomimetic •

Systemic - U.S. Brands: Adipex-P; Adipost; Bontril PDM; Bontril Slow-Release; Didrex; Fastin; Ionamin; Mazanor; Melfiat; Obenix; Obezine; Phendiet; Phendiet105; Phentercot; Phentride; Plegine; Prelu-2; Pro-Fast; PT 105; Sanorex; Tenuate; Tenuate Dospan; Tepanil Ten-Tab; Teram http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202069.html

Growth Hormone •

Systemic - U.S. Brands: Genotropin; Genotropin Miniquick; Humatrope; Norditropin; Nutropin; Nutropin AQ; Protropin; Saizen; Serostim http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202269.html

Orlistat •

Oral--Local - U.S. Brands: Xenical http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500006.html

Rifabutin •

Systemic - U.S. Brands: Mycobutin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202683.html

Sibutramine •

Systemic - U.S. Brands: Meridia http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203725.html

Ursodiol •

Systemic - U.S. Brands: Actigall http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202587.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

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PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.

Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to weight loss by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “weight loss” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for weight loss: •

Somatropin for injection (trade name: Saizen) http://www.rarediseases.org/nord/search/nodd_full?code=104

•

Testosterone (trade name: Androgel) http://www.rarediseases.org/nord/search/nodd_full?code=349

•

Megestrol acetate (trade name: Megace) http://www.rarediseases.org/nord/search/nodd_full?code=208

•

Dihydrotestosterone (trade name: Androgel-DHT) http://www.rarediseases.org/nord/search/nodd_full?code=218

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•

Dronabinol (trade name: Marinol) http://www.rarediseases.org/nord/search/nodd_full?code=294

•

Sermorelin acetate (trade name: Geref) http://www.rarediseases.org/nord/search/nodd_full?code=45

•

Somatropin for injection (trade name: Serostim) http://www.rarediseases.org/nord/search/nodd_full?code=813

•

Testosterone (trade name: TheraDerm Testosterone Transdermal System) http://www.rarediseases.org/nord/search/nodd_full?code=850

If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute13: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

13

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.14 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:15 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

14

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 15 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “weight loss” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “weight loss” (or synonyms) into the “For these words:” box. The following is a sample result: •

Methods for voluntary weight loss and control: National Institutes of Health Technology Assessment Conference statement Source: Bethesda, MD: Office of Medical Applications of Research, U.S. Department of Health and Human Services. 1992. 29 pp. Contact: Available from Office of Medical Applications of Research, National Institutes of Health, Building One, Room 344, 9000 Rockville Pike, Bethesda, MD 20892. Telephone: (301) 496-5787 / fax: (301) 496- 0017 / Web site: http://www.nih.gov. Available at no charge. Summary: The National Institutes of Health Conference on Voluntary Weight Loss and Control was held in Bethesda, Maryland, on March 30-April 1, 1992. This report was prepared as a Technology Assessment Conference Statement after the conference by an independent, non-advocate, non-Federal panel of experts. It addresses five questions: 1) How often and in what ways do Americans try to lose weight? 2) How successful are various methods for weight loss and control? What are the attributes of and barriers to successful weight loss methods/approaches? 3) What are the short- and long-term benefits and adverse effects of weight loss? 4) What are the fundamental principles that should be used to select a personal weight loss and control strategy? 5) What should be the future directions for research on weight loss and control? Names of the members of the Technology Assessment Panel, conference speakers, planning committee, liaison committee, and conference sponsors appear at the back of the report.

•

Methods for Voluntary Weight Loss and Control: An NIH Technology Assessment Conference Source: Bethesda, MD: National Institutes of Health. 1992. 168 p. Contact: Available from Office of Medical Applications Research. Federal Building, Room 116, 7550 Wisconsin Avenue, Bethesda, MD 20892. (301) 496-1148. Summary: This document presents proceedings from the NIH Technology Assessment Conference on methods for voluntary weight loss and control, held in March 1992. The conference was convened to ascertain the practices being employed to achieve weight

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loss and control, to evaluate the evidence for the success of various methods for weight loss and control, and to assess the beneficial and adverse effects of weight loss, in order to provide the best possible advice to the public on methods for voluntary weight loss and control. Abstracts of 21 papers are included, encompassing topics such as cultural and psychosocial determinants of weight concerns, epidemiology of body weight and weight change in the U.S., obesity in minority populations, characteristics of weight loss regimens, weight control practices, standards for success, calorie restriction, behavior modification, exercise, drug treatment, community-based approaches, and short-and long-term benefits and adverse effects of weight loss. Most abstracts include tables and references. •

Ephedra and Ephedrine for Weight Loss and Athletic Performance Enhancement: Clinical Efficacy and Side Effects Source: Rockville, MD: Food and Drug Administration. 2003. 6 p. Contact: Available from Agency for Healthcare Research and Quality. U.S. Department of Health and Human Services, 2101 East Jefferson Street, Rockville, MD 20852. (301) 594-1364. PRICE: Free. AHRQ Publication No. 03-E022. Summary: This Evidence Report/Technology Assessment, funded by the National Institutes of Health Office of Dietary Supplements, the National Center for Complementary and Alternative Medicine, and the Agency for Healthcare Research and Quality, addresses research questions regarding the efficacy of herbal ephedra and ephedrine for weight loss and athletic performance through a comprehensive literature review and synthesis of evidence. The report assesses the safety of these products through a review of clinical trials, as well as meta-analyses where appropriate. In addition, the ephedra- and ephedrine-related adverse events reports on file with the Food and Drug Administration, published case reports, and reports to a manufacturer of ephedra-containing products are reviewed. The report is divided into four major sections: reporting the evidence, methodology, findings, and future research.

•

Commercial Weight Loss Products and Programs: What Consumers Stand to Gain and Lose Source: Washington, DC: U.S. Federal Trade Commission, 34p., 1997. Contact: This report is available on the World Wide Web at http://www.ftc.gov/os/9803/weightlo/rpt.htm. Summary: This is the report of the presiding panel of a conference titled `A Public Conference on the Information Consumers Need to Evaluate Weight Loss Products and Programs.' The panel members represented the Federal Trade Commission, the National Institutes of Health (NIH), and the private sector. The panelists reviewed consumer issues of cost, duration, and safety; examined some of the reasons consumers attempt to lose weight; and analyzed a few of the products and services available in the area of weight loss. In addition, they discussed the state of scientific knowledge about weight loss, and debated the role of government in the weight-loss industry, including the drug- regulating role of the Food and Drug Administration, research done at NIH, and statistical record-keeping on the part of the Centers for Disease Control and Prevention. The panel agreed that further research was needed into consumer behavior in this area, and on the efficacy of the various weight-loss methods. The panel further decided on a plan of action consisting of voluntary disclosure on the part of vendors and service providers, consumer education by all, and continued research by government and academic institutions.

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•

Unintentional Weight Loss in Alzheimer's Disease: An Exploratory Study. Final Report Source: Bronx, NY: Albert Einstein College of Medicine of Yeshiva University. 1986. 40 p. Contact: Available from Albert Einstein College of Medicine of Yeshiva University. Long-Term Care Gerontology Center, 1300 Morris Park Avenue, Bronx, NY 10461. Summary: This study examined possible correlates of unintentional weight loss in individuals with Alzheimer's disease who lived at home with family caregivers. Fortynine patients were followed for a least six weeks using a variety of measurements. A weight loss of at least five pounds was observed in one-third of the sample. Patients who lost weight did not differ significantly from those who did not in age, sex, level of cognitive impairment, food intake, or behavior. Although no single etiology explained the unintentional weight loss, the study did result in the development of useful tools for identifying specific eating problems. The appendixes contain a preliminary progress report and copies of the instruments used.

The NLM Gateway16 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.17 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “weight loss” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 25206 229 533 705 13 26686

HSTAT18 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.19 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as 16

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

17

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 18 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 19

The HSTAT URL is http://hstat.nlm.nih.gov/.

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AHRQ’s Put Prevention Into Practice.20 Simply search by “weight loss” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists21 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.22 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.23 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

20

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 21 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 22

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 23 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on weight loss can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to weight loss. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to weight loss. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “weight loss”:

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•

Other guides Diabetes http://www.nlm.nih.gov/medlineplus/diabetes.html Eating Disorders http://www.nlm.nih.gov/medlineplus/eatingdisorders.html Weight Loss Surgery http://www.nlm.nih.gov/medlineplus/weightlosssurgery.html

Within the health topic page dedicated to weight loss, the following was listed: •

General/Overview Healthy Weight Source: Harvard School of Public Health http://www.hsph.harvard.edu/nutritionsource/weight.html Losing Weight Safely http://www.fda.gov/opacom/lowlit/weightls.html Weight Control: The Power of Healthy Choices Source: American Academy of Family Physicians http://familydoctor.org/healthfacts/197/

•

Treatment Questions and Answers About Safety of Phenylpropanolamine Source: Center for Drug Evaluation and Research http://www.fda.gov/cder/drug/infopage/ppa/qa.htm

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Nutrition American Heart Association Weighs In On Fat Substitutes Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=3002947 Carbohydrates: Going with the (Whole) Grain Source: Harvard School of Public Health http://www.hsph.harvard.edu/nutritionsource/carbohydrates.html Diet: Keeping a Food Diary Source: American Academy of Family Physicians http://familydoctor.org/handouts/299.html Eating Healthy Starts with Healthy Food Shopping Source: National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/shop.htm How Can I Cook Healthfully? http://www.americanheart.org/downloadable/heart/1041806752976CookHealthfu lly.pdf Popular Diets: The Good, the Fad and the Iffy Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00654

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South Beach Diet Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00653 Using Energy Dense Foods to Lose Weight Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=NU00195 Weight-loss and Nutrition Myths: How Much Do You Really Know? Source: National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/health/nutrit/pubs/myths/index.htm •

Specific Conditions/Aspects Adding Pounds When You're Underweight Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=NU00237 Alternatives to Fad Diets Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=510 American Heart Association Guidelines for Selecting a Weight Loss & Maintenance Program Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=2884 Aspartame Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/disorders/aspartame.htm Caffeine: Does It Help You Lose Weight? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00369 Dermatologists Shed Light on Treatments for Cellulite Source: American Academy of Dermatology http://www.aad.org/PressReleases/shedlight.html Do You Know the Health Risks of Being Overweight? Source: Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/pubs/health.htm Fad Diets: What You May Be Missing Source: American Dietetic Association http://webdietitians.org/Public/NutritionInformation/92_nfs0200b.cfm Physical Activity and Weight Control Source: Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/pubs/physact.htm Slow Metabolism: Is There Any Such Thing? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00618 Tipping the Scales? Weight-Loss Ads Found Heavy on Deception Source: Federal Trade Commission http://www.ftc.gov/bcp/conline/features/wgtloss.htm

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Weight Cycling Source: Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/pubs/wcycling.htm Yoga as a Weight-loss Method? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00568 You Can Control Your Weight as You Quit Smoking Source: Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/pubs/quitsmok/index.htm •

Children Helping Your Overweight Child Source: Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/pubs/helpchld.htm Is Dieting OK for Kids? Source: Nemours Foundation http://kidshealth.org/kid/stay_healthy/food/diet.html What About a Formal Weight-Loss Program for Children? Source: American Academy of Pediatrics http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZB92U8W7C &sub_cat=382 Your Child's Weight Source: Nemours Foundation http://kidshealth.org/parent/nutrition_fit/nutrition/childs_weight.html

•

From the National Institutes of Health Aim for a Healthy Weight: Key Recommendations Source: National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/recommen.htm Choosing a Safe and Successful Weight-Loss Program Source: Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/pubs/choose.htm Embrace Your Health! Lose Weight if You are Overweight Source: National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/health/public/heart/other/chdblack/embrace1.htm Weight Loss for Life Source: Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/pubs/wtloss/wtloss.htm

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Journals/Newsletters WIN Notes Source: Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/winnotes/wnotes.htm

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Latest News Commercial Use of Tagatose Sweetener Source: 09/25/2003, American Diabetes Association http://ada.yellowbrix.com/pages/ada/Story.nsp?story_id=42026321&ID=ada NHLBI Study Finds Moderate Physical Activity Promotes Weight Loss as well as Intense Exercise Source: 09/09/2003, National Cancer Institute, National Heart, Lung, and Blood Institute http://www.nih.gov/news/pr/sep2003/nhlbi-09.htm

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Lists of Print Publications Weight Control and Obesity Source: Food and Nutrition Information Center http://www.nal.usda.gov/fnic/pubs/bibs/topics/weight/consumer.html Weight Management: Nutrition and Cookbook Reviews Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=NU00184

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Men Fit and Fabulous As You Mature Source: Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/fitfabmature/fitandfab.html Weight Gain As You Age Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01076

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Organizations American Dietetic Association http://webdietitians.org/Public/index.cfm American Obesity Association http://www.obesity.org/ National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/ Weight-control Information Network Source: National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/health/nutrit/win.htm

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Research Drug Targets Brain Circuits That Drive Appetite and Body Weight Source: National Institute of Mental Health http://www.nih.gov/news/pr/jul2002/nimh-25.htm HHS Acts to Reduce Potential Risks of Dietary Supplements Containing Ephedra Source: Food and Drug Administration http://www.fda.gov/bbs/topics/NEWS/2003/NEW00875.html

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Journal of the American Medical Association Study: Efficacy and Safety of LowCarbohydrate Diets Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=3010801 NCCAM Consumer Advisory on Ephedra Source: National Center for Complementary and Alternative Medicine http://nccam.nih.gov/health/alerts/ephedra/consumeradvisory.htm NHLBI Study Finds Moderate Physical Activity Promotes Weight Loss as well as Intense Exercise Source: National Cancer Institute, National Heart, Lung, and Blood Institute http://www.nih.gov/news/pr/sep2003/nhlbi-09.htm NHLBI Study Tests Novel Ways to Help Americans Keep Weight Off Source: National Heart, Lung, and Blood Institute http://www.nih.gov/news/pr/jul2003/nhlbi-14.htm Relationship between Intentional Weight Loss and Mortality Source: American College of Physicians http://www.annals.org/cgi/content/full/138/5/I-56 •

Statistics New CDC Report Analyzes Patterns of Body Weight in US Adults Source: National Center for Health Statistics http://www.cdc.gov/nchs/releases/02facts/adultwght.htm

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Teenagers Are Detox Diets Safe? Source: Nemours Foundation http://kidshealth.org/teen/food_fitness/dieting/detox_diets.html Deal with Diets Source: Nemours Foundation http://kidshealth.org/teen/food_fitness/dieting/dieting.html How Can I Lose Weight Safely? Source: Nemours Foundation http://kidshealth.org/teen/food_fitness/dieting/lose_weight_safely.html

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Women Fit and Fabulous As You Mature Source: Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/fitfabmature/fitandfab.html Weight Gain As You Age Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01076

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system

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(mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on weight loss. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Weight Expectations: Weight Loss and You Source: Chicago, IL: American Dietetic Association. 1992. 4 p. Contact: Available from American Dietetic Association. 216 West Jackson Boulevard, Suite 800, Chicago IL 60606. (800) 366-1655. PRICE: Free. Summary: A brochure provides information and tips concerning what should be done to lose weight, how to assess fad diets, eating disorders, and food preparation/consumption suggestions. A table provides information on daily servings and food exchanges for different food groups. This brochure is also available in Spanish.

•

Losing weight and keeping it off Source: National Pork Producers Council. Contact: National Pork Producers Council, Nutrition Communications, P.O. Box 10383, Des Moines, IA 50306. (515) 223-2619. Summary: Each year, more than half of all Americans try to lose weight or maintain a recent weight loss. Many soon realize there's no magic diet or pill for a healthy body. This fact sheet states that the key to maintaining a healthy weight is a combination of realistic goal-setting, healthful eating and regular physical activity.

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Setting goals for weight loss Source: Partnership for Healthy Weight Management. Contact: Federal Trade Commission, Consumer and Business Education Office, 600 Pennsylvania Avenue, NW, Washington, DC 20580. Summary: Successful weight loss and healthy weight management depend on sensible goals and expectations. Losing even 5 to 10 percent of your weight is the kind of goal that can help improve your health. This brochure discusses how to set sensible goals for yourself so that you'll be more likely to meet them and have a better chance of keeping the weight off.

•

Weight Loss: Finding a Weight Loss Program That Works for You Source: International Food Information Council. 12 pp. Undated.

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Contact: International Food Information Council Foundation, 1100 Connecticut Avenue, NW, Suite 430, Washington, DC 20036. 202-296-6540. www.ificinfo.health.org. Summary: This booklet describes information weight loss programs provide and helps consumers ask the right questions to choose a safe and effective weight loss method. The second part of the booklet helps consumers determine whether their current weight puts them at risk for health problems. Tables describe how to find body mass index (BMI) and BMI risk categories. The booklet also includes a personal health profile evaluation checklist and a checklist for evaluating weight loss products and services. It provides information on finding additional resources on healthy weight management. •

Weight Loss for Life Source: Bethesda, MD: Weight-Control Information Network. 1998. 20 p. Contact: Available from Weight-Control Information Network. 1 WIN Way, Bethesda, MD 20892-3665. (800) 946-8098 or (301) 984-7378. Fax (301) 984-7196. E-mail: [email protected]. PRICE: Full-text available online at no charge; single copy free. Summary: This booklet provides information about long term weight loss. Health experts agree that adults who are overweight and have weight-related medical problems, such as type 2 diabetes, can benefit from weight loss. Topics include how weight loss occurs, diet, physicalactivity, and behavior change. Do-it-yourself programs, non-clinical programs, and clinical programs are three types of weight-loss programs described in the brochure. Types of diets discussed include fixed-menu diets, exchangetype diets, prepackaged-meal diets, formula diets, questionable diets, and flexible diets. The brochure notes that the ideal diet takes personal preferences into account and includes a wide variety of foods with sufficient calories and nutrients for good health. A diet plan should teach people how to select and prepare healthy food, as well as how to maintain their new weight. Researchers believe that people who include physical activity in their weight-loss programs are more likely to maintain weight loss over time. The booklet includes a weight-for-height chart and a sidebar that lists vigorous activities and moderate-intensity activities. The booklet concludes with a list of twelve publications to consult for further information. 2 figures.

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Weight Loss: A Winning Battle Source: Boston, MA: Joslin Diabetes Center. 1999. 30 p. Contact: Available from Joslin Diabetes Center. One Joslin Place, Boston, MA 02215. (800) 344-4501 or (508) 583-3240. Fax (617) 732-2562. Website: www.joslin.harvard.edu. PRICE: $34.00 for package of 10; plus shipping and handling. Order number JDC170. Summary: This booklet provides people who have diabetes with information on losing weight and maintaining weight loss. The booklet begins by explaining the importance of weight loss for many people who have diabetes, particularly those who have type 2 diabetes. This followed by a discussion of the importance of taking control and being a positive thinker. The booklet explains why fad diets do not work over a long time period and offers tips for weight management success. The booklet then presents ways to reduce dietary fat and cholesterol and ways to increase fiber in meals. Other topics include eating high-fiber, low calorie snacks; consuming alcoholic beverages; and weighing and measuring food. The booklet offers healthful hints for managing an eating plan, including putting up reminders, analyzing the chain of events that leads to overeating, breaking habits associated with overeating, finding activities to deal with emotions, asking for support of family and friends, planning obstacles to unhealthful

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eating, planning aids to healthful eating, and keeping a food record. In addition, the booklet discusses the importance of exercise in diabetes management and offers suggestions for beginning an exercise program. The booklet concludes with a checklist for helping readers achieve weight loss success. 4 tables. •

How Much Food is Enough: Food Myths and Keys to Weight Loss Source: Alexandria, VA: American Diabetes Association. 2003. 3 p. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. E-mail: [email protected]. Fax: (770) 4429742. Website: www.diabetes.org. PRICE: Full-text available online at no charge; contact organization for print copies. Summary: This brochure helps people recently diagnosed with diabetes to understand the connections between caloric intake and body weight. The brochure stresses that when one limits the number of calories consumed in each day, portion control can help readers include their favorite foods in their meal plan. By monitoring the serving sides of the foods they enjoy, and by combining it with regular exercise, patients can enjoy a wide variety of meals, including favorite foods and ethnic dishes, and still lose weight. For those who have diabetes and are overweight, shedding those extra pounds by trimming serving sizes and calories can help lower the blood glucose levels. The brochure helps readers understand the truth behind some food myths, know how to evaluate their current diet and food habits, accurately estimate food portion sizes, and determine how much weight to lose. Readers are advised to work closely with their health care providers and to contact the American Diabetes Association (www.diabetes.org) for more information. 1 table.

•

Eating for Health: With Poor Appetite and Weight Loss Contact: Health Education Board for Scotland, Woodburn House, Canaan Ln, Edinburgh. Summary: This brochure outlines specific foods that may help to counter poor appetite and wasting syndrome associated with Acquired immunodeficiency syndrome (AIDS), caused by Human immunodeficiency virus (HIV). The brochure suggests foods which may be more palatable to Persons with AIDS (PWA's), as well as those that provide necessary calories and energy. The brochure recommends foods to eat when PWA's are feeling nauseous or experiencing diarrhea, poor appetite, or sore mouths. Recipes are included.

•

Weight Control: Losing Weight and Keeping It Off Source: Kansas City, MO: American Academy of Family Physicians. 2001. 4 p. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. PRICE: $12.50 for 50 copies for members, $18.75 for 50 copies for nonmembers. Order number: 1522. Summary: This brochure, which is presented in question and answer format, provides information about weight control. The brochure notes that a regular exercise program, a regular eating pattern, and support may help a person lose weight. Topics include ideal weight, eating and emotions, the role of exercise, types of exercise, making exercise a habit, changing eating habits, the drawbacks of skipping meals and eating foods high in fat, social pressure, and diet drugs. Sidebars address causes of being overweight, tips on

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losing weight, and foods high in fat. According to the brochure, heredity, social pressure, a low metabolism, and problems with hormone levels are several causes of being overweight. The brochure concludes that appetite suppressants are ineffective at keeping weight off. (AA-M). •

A Better Chance for Weight Loss Source: Glendale, WI: Largely Positive, Inc., 1p., N.D. Contact: Largely Positive, Inc., P.O. Box 17223, Glendale, WI 53217. Summary: This fact sheet contains some advice for people who are about to embark on a weight loss program. The suggestions come from a review of the research which indicates that people could lose more weight if they go about weight reduction properly. Some suggestions include developing a personal plan, losing weight slowly, exercising, cutting fat, and being realistic.

•

Weight Loss and Sports Performance Source: Omaha, NE: International Center for Sports Nutrition, 2p., N.D. Contact: International Center for Sports Nutrition, 502 South 44th Street, Suite 3012, Omaha, NE 68105. (402) 559-5505. Summary: This fact sheet highlights connection between proper weight and sports performance. The reader is advised to avoid rapid and/or excessive weight loss. The negative consequences associated with unhealthy weight loss are outlined. Athletes are also cautioned to lose their weight prior to the competitive season and maintain that weight. Guidelines for achieving ideal competitive weight are provided.

•

Weight Loss: Diets Don't Work, Lifestyle Changes Do Source: Alexandria, VA: American Diabetes Association. 1997. 4 p. Contact: Available from American Diabetes Association, Inc. Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. PRICE: $9.95 (members), $11.95 (nonmembers) for 50 copies; single copy free. Order number CDBD07. Summary: This fact sheet, which is one in a series of 42 fact sheets about daily living and coping with diabetes, covers weight loss as one of the best treatments for noninsulindependent diabetes mellitus (NIDDM, or Type II). NIDDM is rare in societies in which obesity is rare. In the United States, 80 percent of people with NIDDM are overweight when they get diabetes. The fact sheet covers the connection between diabetes and obesity, the causes of diabetes, the disadvantages of being overweight, the benefits of weight loss as a treatment for diabetes, a weight loss plan, eating less, and exercising more. The fact sheet points out that keeping weight off by changing habits is more important than losing it in the first place, as people who repeatedly lose and gain back weight may have more health problems than people who remain overweight. (AA-M).

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Weight Loss and Wasting Syndrome Contact: National AIDS Treatment Information Project, Beth Israel Deaconess Medical Center, Beth Israel Hospital, 330 Brookline Ave Libby Bldg 317, Boston, MA, 02215, (617) 667-5520, http://www.natip.org.

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Summary: This fact sheet, written for individuals with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), provides information about weight loss and wasting syndrome. Symptoms of wasting system include unexplained involuntary weight loss, fever, and/or diarrhea. The fact sheet describes the chemical functions that take place in the body to convert food to lean body mass and fat and the process by which the body begins to lose weight and break down lean body mass. Reasons for this latter process in HIV-positive people are not fully understood by doctors. Some of the factors that may contribute to weight loss and wasting syndrome include the development of a new illness, medication side effects, weakness that prohibits individuals from feeding themselves, depression, nausea/vomiting, mouth pain, difficulty swallowing, and long-term diarrhea. Some of the ways by which weight loss can be managed medically are identified. These methods include treatments with antiretrovirals, megestrol acetate (Megace), dronabinol (Marinol), testosterone, growth hormones, thalidomide, and hyperalimentation. The benefits and possible side effects of these drugs are discusses. A table identifies the factors contributing to weight loss in HIV, their causes, and the ways by which they are managed. •

Smoking and Weight Loss. Eight Things you Should Know Source: Journeyworks Publishing. Title number 5217. Contact: P.O. Box 8466. Santa Cruz, CA 95061. (800) 775-1998. Summary: This pamphlet, written primarily for adolescents and young adults, discusses the disadvantages of using smoking as a means to lose weight. The eight topics explained include that cigarettes are not a good method to lose weight; stay away from cigarettes to feel more attractive; and to keep fit, stay active and eat healthfully. The pamphlet also discusses how smoking makes it more difficult to breathe so that it is harder to stay fit and gives suggestions on what to tell someone if he or she insinuates that a person can lose weight by starting to smoke. It reviews how smoking is not worth the risks and people who do smoke can quit without gaining weight. The last topic discussed is that accepting one's body will help one feel better about oneself. Healthfinder™

Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Aim for A Healthy Weight!: Information for Patients and the Public Summary: These guidelines from the National Heart, Lung, and Blood Institute present a new approach for the assessment of overweight and obesity and establish principles of safe and effective weight loss. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4330

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•

Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults Summary: A guideline for physicians that presents a new approach for the assessment of overweight and obesity and establish principles of safe and effective weight loss. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2814

•

Dieting and Gallstones Summary: This online document gives consumers basic information on gallstones and the effect of weight loss on this condition. Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1448

•

Fad Diets - The American Heart Association Summary: The information on this site is designed to inform the public about misleading weight loss claims and also to set the record straight about the American Heart Association's eating plan for healthy Source: American Heart Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2549

•

Information about Losing Weight and Maintaining a Healthy Weight Summary: This web site provides links to information about obesity and weight loss provided by CFSAN, other Federal government agencies and non-government agencies. Source: Center for Food Safety and Applied Nutrition http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3632

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Paunch Lines: Weight Loss Claims Are No Joke For Dieters Summary: This online consumer advisory cautions against advertisements for products promising quick, easy ways to lose weight. Source: Federal Trade Commission http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2111

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Setting Goals for Weight Loss Summary: The information on this page is designed to help you take the necessary steps for setting reachable goals and achieving success from your weight loss program. Source: General Government Agency http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4563

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Voluntary Guidelines for Providers of Weight Loss Products or Services Summary: A consensus of voluntary consumer disclosure practices reached by a panel of weight management companies, weight loss professionals, and consumer protection groups. Source: Federal Communications Commission http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4510

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Weight Loss and Control Summary: The Weight-Control Information Network (WIN) is a national source of information on weight control, obesity, and weight-related nutritional disorders for health professionals and the public. Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=707

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Weight Loss: Finding a Weight Loss Program That Works For You Summary: Fill in the personal health profile, follow the checklist to compare different weight loss programs, and use the Body Mass Index (BMI) Calculator to determine your BMI and set your weight goal. Source: Federal Citizen Information Center, U.S. General Services Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5976 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to weight loss. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources

A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/specific.htm

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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

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Med Help International: http://www.medhelp.org/HealthTopics/A.html

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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

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WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to weight loss. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with weight loss. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about weight loss. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “weight loss” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “weight loss”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format

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option “Organization Resource Sheet.” Type “weight loss” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “weight loss” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.24

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

24

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)25: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

25

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

337

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on weight loss: •

Basic Guidelines for Weight Loss Weight loss - unintentional Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm Weight loss and age Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001962.htm

•

Signs & Symptoms for Weight Loss Anorexic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003121.htm Anxiety Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Constipation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003125.htm

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Depression Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Diarrhea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003126.htm Edema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Fainting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003092.htm Hair loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003246.htm Hunger Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003134.htm Increased thirst Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003085.htm Loss of appetite Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003121.htm Mouth sores Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003059.htm Muscle wasting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003188.htm Palpitations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Sensitivity to cold Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003095.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Sweating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003218.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm •

Background Topics for Weight Loss Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm

Online Glossaries 343

Drug abuse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm Endocrine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002351.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Intentional weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001940.htm Malignancy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002253.htm Metabolism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002257.htm Physical activity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Smoking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002032.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

345

WEIGHT LOSS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 5-Hydroxytryptophan: Precursor of serotonin used as antiepileptic and antidepressant. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal fat: Fat (adipose tissue) that is centrally distributed between the thorax and pelvis and that induces greater health risk. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetone: A colorless liquid used as a solvent and an antiseptic. It is one of the ketone bodies produced during ketoacidosis. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Actin: Essential component of the cell skeleton. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acylation: The addition of an organic acid radical into a molecule. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adduct: Complex formed when a carcinogen combines with DNA or a protein. [NIH]

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Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenosine Triphosphate: Adenosine 5'-(tetrahydrogen triphosphate). An adenine nucleotide containing three phosphate groups esterified to the sugar moiety. In addition to its crucial roles in metabolism adenosine triphosphate is a neurotransmitter. [NIH] Adenylate Cyclase: An enzyme of the lyase class that catalyzes the formation of cyclic AMP and pyrophosphate from ATP. EC 4.6.1.1. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adult-Onset Diabetes: Former term for noninsulin-dependent or type II diabetes. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Aerobic Metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, oxidative metabolism, or cell respiration. [NIH] Aerobic Respiration: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as oxidative metabolism, cell respiration, or aerobic metabolism. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the

Dictionary 347

complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Age-Adjusted: Summary measures of rates of morbidity or mortality in a population using statistical procedures to remove the effect of age differences in populations that are being compared. Age is probably the most important and the most common variable in determining the risk of morbidity and mortality. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allograft: An organ or tissue transplant between two humans. [NIH] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alpha Cell: A type of cell in the pancreas (in areas called the islets of Langerhans). Alpha cells make and release a hormone called glucagon, which raises the level of glucose (sugar) in the blood. [NIH]

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Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Amylase: An enzyme that helps the body digest starches. [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaerobic Threshold: The oxygen consumption level above which aerobic energy production is supplemented by anaerobic mechanisms during exercise, resulting in a sustained increase in lactate concentration and metabolic acidosis. The anaerobic threshold is affected by factors that modify oxygen delivery to the tissues; it is low in patients with heart disease. Methods of measurement include direct measure of lactate concentration, direct measurement of bicarbonate concentration, and gas exchange measurements. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU]

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Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgenic: Producing masculine characteristics. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Anginal: Pertaining to or characteristic of angina. [EU] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called endarterectomy. [NIH] Angiotensin-Converting Enzyme Inhibitors: A class of drugs whose main indications are the treatment of hypertension and heart failure. They exert their hemodynamic effect mainly by inhibiting the renin-angiotensin system. They also modulate sympathetic nervous system activity and increase prostaglandin synthesis. They cause mainly vasodilation and mild natriuresis without affecting heart rate and contractility. [NIH] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [NIH] Anhydrous: Deprived or destitute of water. [EU] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anionic: Pertaining to or containing an anion. [EU] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or

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positive pole during electrolysis. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Anode: Electrode held at a positive potential with respect to a cathode. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

Anovulation: Suspension or cessation of ovulation in animals and humans. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anthropometric measurements: Measurements of human body height, weight, and size of component parts, including skinfold measurement. Used to study and compare the relative proportions under normal and abnormal conditions. [NIH] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antidepressive Agents: Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several monoamine oxidase inhibitors are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents also appear to act through brain catecholamine systems. A third group (antidepressive agents, secondgeneration) is a diverse group of drugs including some that act specifically on serotonergic systems. [NIH] Antidote: A remedy for counteracting a poison. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antiepileptic: An agent that combats epilepsy. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with

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specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antineoplastic Agents: Substances that inhibit or prevent the proliferation of neoplasms. [NIH]

Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipruritic: Relieving or preventing itching. [EU] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antithrombotic: Preventing or interfering with the formation of thrombi; an agent that so acts. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Antrectomy: An operation to remove the upper portion of the stomach, called the antrum. This operation helps reduce the amount of stomach acid. It is used when a person has complications from ulcers. [NIH] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH]

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Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. [NIH] Aphakia: Absence of crystalline lens totally or partially from field of vision, from any cause except after cataract extraction. Aphakia is mainly congenital or as result of lens dislocation and subluxation. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Apnoea: Cessation of breathing. [EU] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Appetite Regulation: Physiologic mechanisms which regulate or control the appetite and food intake. [NIH] Aqueous: Having to do with water. [NIH] Arachidonate 15-Lipoxygenase: An enzyme that catalyzes the oxidation of arachidonic acid to yield 15-hydroperoxyarachidonate (15-HPETE) which is rapidly converted to 15-hydroxy5,8,11,13-eicosatetraenoate (15-HETE). The 15-hydroperoxides are preferentially formed in neutrophils and lymphocytes. EC 1.13.11.33. [NIH] Arachidonate Lipoxygenases: Enzymes catalyzing the oxidation of arachidonic acid to hydroperoxyarachidonates (HPETES). These products are then rapidly converted by a peroxidase to hydroxyeicosatetraenoic acids (HETES). The positional specificity of the enzyme reaction varies from tissue to tissue. The final lipoxygenase pathway leads to the leukotrienes. EC 1.13.11.- . [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arcuate Nucleus: A nucleus located in the middle hypothalamus in the most ventral part of the third ventricle near the entrance of the infundibular recess. Its small cells are in close contact with the ependyma. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles). Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the

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arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteriovenous Fistula: An abnormal communication between an artery and a vein. [NIH] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Articular: Of or pertaining to a joint. [EU] Aspartame: Flavoring agent sweeter than sugar, metabolized as phenylalanine and aspartic acid. [NIH] Aspartic: The naturally occurring substance is L-aspartic acid. One of the acidic-amino-acids is obtained by the hydrolysis of proteins. [NIH] Aspartic Acid: One of the non-essential amino acids commonly occurring in the L-form. It is found in animals and plants, especially in sugar cane and sugar beets. It may be a neurotransmitter. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astringent: Causing contraction, usually locally after topical application. [EU] Asynchronous: Pacing mode where only one timing interval exists, that between the stimuli. While the duration of this interval may be varied, it is not modified by any sensed event once set. As no sensing occurs, the upper and lower rate intervals are the same as the pacema. [NIH] Atopic: Pertaining to an atopen or to atopy; allergic. [EU] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied

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pharmacologic activities. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Avian: A plasmodial infection in birds. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Barbiturate: A drug with sedative and hypnotic effects. Barbiturates have been used as sedatives and anesthetics, and they have been used to treat the convulsions associated with epilepsy. [NIH] Baroreflex: A negative feedback system which buffers short-term changes in blood pressure. Increased pressure stretches blood vessels which activates pressoreceptors (baroreceptors) in the vessel walls. The net response of the central nervous system is a reduction of central sympathetic outflow. This reduces blood pressure both by decreasing peripheral vascular resistance and by lowering cardiac output. Because the baroreceptors are tonically active, the baroreflex can compensate rapidly for both increases and decreases in blood pressure. [NIH]

Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH]

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Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Beta-Thromboglobulin: A platelet-specific protein which is released when platelets aggregate. Elevated plasma levels have been reported after deep venous thrombosis, preeclampsia, myocardial infarction with mural thrombosis, and myeloproliferative disorders. Measurement of beta-thromboglobulin in biological fluids by radioimmunoassay is used for the diagnosis and assessment of progress of thromboembolic disorders. [NIH] Bezoar: A ball of food, mucus, vegetable fiber, hair, or other material that cannot be digested in the stomach. Bezoars can cause blockage, ulcers, and bleeding. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliopancreatic Diversion: A surgical procedure which diverts pancreatobiliary secretions via the duodenum and the jejunum into the colon, the remaining small intestine being anastomosed to the stomach after antrectomy. The procedure produces less diarrhea than does jejunoileal bypass. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biopterin: A natural product that has been considered as a growth factor for some insects. [NIH]

Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biphasic: Having two phases; having both a sporophytic and a gametophytic phase in the life cycle. [EU]

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Bladder: The organ that stores urine. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Image: Individuals' personal concept of their bodies as objects in and bound by space, independently and apart from all other objects. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Body Weight Changes: A clinical manifestation consisting of alterations in an individual's weight from his or her norm. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Boron: A trace element with the atomic symbol B, atomic number 5, and atomic weight 10.81. Boron-10, an isotope of boron, is used as a neutron absorber in boron neutron capture therapy. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut

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walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Broadband: A wide frequency range. Sound whose energy is distributed over a broad range of frequency (generally, more than one octave). [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Buffers: A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. [NIH]

Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Cachexia: General ill health, malnutrition, and weight loss, usually associated with chronic disease. [NIH] Cadmium: An element with atomic symbol Cd, atomic number 48, and atomic weight 114. It is a metal and ingestion will lead to cadmium poisoning. [NIH] Cadmium Poisoning: Poisoning occurring after exposure to cadmium compounds or fumes. It may cause gastrointestinal syndromes, anemia, or pneumonitis. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal

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functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH] Calorimeter: Measures the amounts of heat absorbed or given off by a solid, a liquid, or a gas. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiopathy: Any disorder or disease of the heart. In addition to heart disease of inflammatory origin, there are arteriosclerotic cardiopathy, due to arteriosclerosis; fatty cardiopathy, due to growth of fatty tissue; hypertensive cardiopathy, due to high blood pressure; nephropathic cardiopathy, due to kidney disease, thyrotoxic cardiopathy, due to thyroid intoxication; toxic cardiopathy, due to the effect of some toxin; and valvular cardiopathy, due to faulty valve action. [EU] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiotonic: 1. Having a tonic effect on the heart. 2. An agent that has a tonic effect on the heart. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high

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blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group. [NIH] Caspase: Enzyme released by the cell at a crucial stage in apoptosis in order to shred all cellular proteins. [NIH] Catabolism: Any destructive metabolic process by which organisms convert substances into excreted compounds. [EU] Cataract: An opacity, partial or complete, of one or both eyes, on or in the lens or capsule, especially an opacity impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). [EU] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH]

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Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell Fusion: Fusion of somatic cells in vitro or in vivo, which results in somatic cell hybridization. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Cheilitis: Inflammation of the lips. It is of various etiologies and degrees of pathology. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH]

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Chemotaxis: The movement of cells or organisms toward or away from a substance in response to its concentration gradient. [NIH] Chemotherapeutic agent: A drug used to treat cancer. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chloroform: A commonly used laboratory solvent. It was previously used as an anesthetic, but was banned from use in the U.S. due to its suspected carcinogenecity. [NIH] Chloroprene: Toxic, possibly carcinogenic, monomer of neoprene, a synthetic rubber; causes damage to skin, lungs, CNS, kidneys, liver, blood cells and fetuses. Synonym: 2chlorobutadiene. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] Ciliary Neurotrophic Factor: A neurotrophic factor that promotes the survival of various neuronal cell types and may play an important role in the injury response in the nervous

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system. [NIH] Cimetidine: A histamine congener, it competitively inhibits histamine binding to H2 receptors. Cimetidine has a range of pharmacological actions. It inhibits gastric acid secretion, as well as pepsin and gastrin output. It also blocks the activity of cytochrome P450. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Citric Acid: A key intermediate in metabolism. It is an acid compound found in citrus fruits. The salts of citric acid (citrates) can be used as anticoagulants due to their calcium chelating ability. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clozapine: A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coal: A natural fuel formed by partial decomposition of vegetable matter under certain environmental conditions. [NIH] Coccidiosis: Protozoan infection found in animals and man. It is caused by several different genera of Coccidia. [NIH] Cod Liver Oil: Oil obtained from fresh livers of the cod family, Gadidae. It is a source of

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vitamins A and D. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Community Health Nursing: General and comprehensive nursing practice directed to individuals, families, or groups as it relates to and contributes to the health of a population. This is not an official program of a Public Health Department. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials

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including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Cones: One type of specialized light-sensitive cells (photoreceptors) in the retina that provide sharp central vision and color vision. [NIH] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH]

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Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]

Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]

Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD

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results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Corticotropin-Releasing Hormone: A neuropeptide released by the hypothalamus that stimulates the release of corticotropin by the anterior pituitary gland. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]

Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Criterion: A standard by which something may be judged. [EU] Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with longitudinal studies which are followed over a period of time. [NIH] Crystallization: The formation of crystals; conversion to a crystalline form. [EU] Culture Media: Any liquid or solid preparation made specifically for the growth, storage, or transport of microorganisms or other types of cells. The variety of media that exist allow for the culturing of specific microorganisms and cell types, such as differential media, selective media, test media, and defined media. Solid media consist of liquid media that have been solidified with an agent such as agar or gelatin. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Curcumin: A dye obtained from tumeric, the powdered root of Curcuma longa Linn. It is used in the preparation of curcuma paper and the detection of boron. Curcumin appears to possess a spectrum of pharmacological properties, due primarily to its inhibitory effects on metabolic enzymes. [NIH]

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Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyproheptadine: A serotonin antagonist and a histamine H1 blocker used as antipruritic, appetite stimulant, antiallergic, and for the post-gastrectomy dumping syndrome, etc. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytomegalovirus Infections: Infection with Cytomegalovirus, characterized by enlarged cells bearing intranuclear inclusions. Infection may be in almost any organ, but the salivary glands are the most common site in children, as are the lungs in adults. [NIH] Cytomegalovirus Retinitis: Infection of the retina by cytomegalovirus characterized by retinal necrosis, hemorrhage, vessel sheathing, and retinal edema. Cytomegalovirus retinitis is a major opportunistic infection in AIDS patients and can cause blindness. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decision Theory: A theoretical technique utilizing a group of related constructs to describe or prescribe how individuals or groups of people choose a course of action when faced with several alternatives and a variable amount of knowledge about the determinants of the outcomes of those alternatives. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH]

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Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dermatitis: Any inflammation of the skin. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] DHEA: Dehydroepiandrosterone. A substance that is being studied as a cancer prevention drug. It belongs to the family of drugs called steroids. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Retinopathy: Retinopathy associated with diabetes mellitus, which may be of the background type, progressively characterized by microaneurysms, interretinal punctuate macular edema, or of the proliferative type, characterized by neovascularization of the retina and optic disk, which may project into the vitreous, proliferation of fibrous tissue, vitreous hemorrhage, and retinal detachment. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other

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holds the patient's blood. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diastolic: Of or pertaining to the diastole. [EU] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]

Dietary Fiber: The remnants of plant cell walls that are resistant to digestion by the alimentary enzymes of man. It comprises various polysaccharides and lignins. [NIH] Diethylstilbestrol: DES. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Differential Thermal Analysis: Technique by which phase transitions of chemical reactions can be followed by observation of the heat absorbed or liberated. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilated cardiomyopathy: Heart muscle disease that leads to enlargement of the heart's chambers, robbing the heart of its pumping ability. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important

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determinant of therapy and prognosis. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuresis: Increased excretion of urine. [EU] Docetaxel: An anticancer drug that belongs to the family of drugs called mitotic inhibitors. [NIH]

Domesticated: Species in which the evolutionary process has been influenced by humans to meet their needs. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Dronabinol: A synthetic pill form of delta-9-tetrahydrocannabinol (THC), an active ingredient in marijuana that is used to treat nausea and vomiting associated with cancer chemotherapy. [NIH] Drug Combinations: Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. It is differentiated from combination drug therapy in which two or more drugs are administered separately for a combined effect. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Dumping Syndrome: Gastrointestinal nonfunctioning pylorus. [NIH]

symptoms

resulting

from

an

absent

or

Duodenum: The first part of the small intestine. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dyslipidemia: Disorders in the lipoprotein metabolism; classified as hypercholesterolemia, hypertriglyceridemia, combined hyperlipidemia, and low levels of high-density lipoprotein (HDL) cholesterol. All of the dyslipidemias can be primary or secondary. Both elevated

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levels of low-density lipoprotein (LDL) cholesterol and low levels of HDL cholesterol predispose to premature atherosclerosis. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dysphoria: Disquiet; restlessness; malaise. [EU] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Ego: The conscious portion of the personality structure which serves to mediate between the demands of the primitive instinctual drives, (the id), of internalized parental and social prohibitions or the conscience, (the superego), and of reality. [NIH] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elasticity: Resistance and recovery from distortion of shape. [NIH] Electric shock: A dangerous patho-physiological effect resulting from an electric current passing through the body of a human or animal. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU]

Emetic: An agent that causes vomiting. [EU] Emollient: Softening or soothing; called also malactic. [EU] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory

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laboratory test results. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Enanthate: An oily injectable contraceptive given every 8 weeks. [NIH] Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called atherectomy. [NIH] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endocytosis: Cellular uptake of extracellular materials within membrane-limited vacuoles or microvesicles. Endosomes play a central role in endocytosis. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometrium: The layer of tissue that lines the uterus. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH]

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Endotoxemia: A condition characterized by the presence of endotoxins in the blood. If endotoxemia is the result of gram-negative rod-shaped bacteria, shock may occur. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Energetic: Exhibiting energy : strenuous; operating with force, vigour, or effect. [EU] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Energy deficit: A state in which total energy intake is less than total energy need. [NIH] Energy Intake: Total number of calories taken in daily whether ingested or by parenteral routes. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Ependyma: A thin membrane that lines the ventricles of the brain and the central canal of the spinal cord. [NIH] Ephedrine: An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epigastric: Having to do with the upper middle area of the abdomen. [NIH]

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Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythrocyte Indices: Quantification of size and cell hemoglobin content or concentration of the erythrocyte, usually derived from erythrocyte count, blood hemoglobin concentration, and hematocrit. Includes the mean cell volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC). Use also for cell diameter and thickness. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Manometry: A test to measure muscle tone inthe esophagus. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estriol: (16 alpha,17 beta)-Estra-1,3,5(10)-triene-3,16,17-triol. A metabolite of estradiol and usually the predominant estrogenic metabolite in urine. During pregnancy, large amounts of estriol are produced by the placenta. It has also been obtained from plant sources. The 16 beta-isomer has also been isolated from the urine of pregnant women. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrone: 3-Hydroxyestra-1,3,5(10)-trien-17-one. A metabolite of estradiol but possessing less biological activity. It is found in the urine of pregnant women and mares, in the human placenta, and in the urine of bulls and stallions. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), estrone may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Ethinyl Estradiol: A semisynthetic estrogen with high oral estrogenic potency. It is often used as the estrogenic component in oral contraceptives. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excipients: Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form; a binder, matrix, base or diluent in pills, tablets, creams, salves, etc. [NIH]

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Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excrete: To get rid of waste from the body. [NIH] Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [NIH] Exercise Tolerance: The exercise capacity of an individual as measured by endurance (maximal exercise duration and/or maximal attained work load) during an exercise test. [NIH]

Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expert Systems: Computer programs based on knowledge developed from consultation with experts on a problem, and the processing and/or formalizing of this knowledge using these programs in such a manner that the problems may be solved. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extreme obesity: A body mass index [NIH] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Faecal: Pertaining to or of the nature of feces. [EU] Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fat Substitutes: Compounds used in food or in food preparation to replace dietary fats. They may be carbohydrate-, protein-, or fat-based. Fat substitutes are usually lower in calories but provide the same texture as fats. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli.

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[NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fatty Liver: The buildup of fat in liver cells. The most common cause is alcoholism. Other causes include obesity, diabetes, and pregnancy. Also called steatosis. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Feeding Behavior: Behavioral responses or sequences associated with eating including modes of feeding, rhythmic patterns of eating, and time intervals. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fenfluramine: A centrally active drug that apparently both blocks serotonin uptake and provokes transport-mediated serotonin release. [NIH] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH] Fibrinolytic: Pertaining to, characterized by, or causing the dissolution of fibrin by enzymatic action [EU] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filler: An inactive substance used to make a product bigger or easier to handle. For example, fillers are often used to make pills or capsules because the amount of active drug is too small to be handled conveniently. [NIH] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH]

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Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Food Deprivation: The withholding of food in a structured experimental situation. [NIH] Food Exchange: See: Exchange lists. [NIH] Food Habits: Acquired or learned food preferences. [NIH] Food Preferences: The selection of one food over another. [NIH] Foot Care: Taking special steps to avoid foot problems such as sores, cuts, bunions, and calluses. Good care includes daily examination of the feet, toes, and toenails and choosing shoes and socks or stockings that fit well. People with diabetes have to take special care of their feet because nerve damage and reduced blood flow sometimes mean they will have less feeling in their feet than normal. They may not notice cuts and other problems as soon as they should. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Forskolin: Potent activator of the adenylate cyclase system and the biosynthesis of cyclic AMP. From the plant Coleus forskohlii. Has antihypertensive, positive ionotropic, platelet aggregation inhibitory, and smooth muscle relaxant activities; also lowers intraocular pressure and promotes release of hormones from the pituitary gland. [NIH] Frail Elderly: Older adults or aged individuals who are lacking in general strength and are unusually susceptible to disease or to other infirmity. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Fructose: A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gait: Manner or style of walking. [NIH]

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Gallate: Antioxidant present in tea. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganciclovir: Acyclovir analog that is a potent inhibitor of the Herpesvirus family including cytomegalovirus. Ganciclovir is used to treat complications from AIDS-associated cytomegalovirus infections. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gasoline: Volative flammable fuel (liquid hydrocarbons) derived from crude petroleum by processes such as distillation reforming, polymerization, etc. [NIH] Gastrectomy: An operation to remove all or part of the stomach. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Balloon: An inflatable device implanted in the stomach as an adjunct to therapy of morbid obesity. Specific types include the silicone Garren-Edwards Gastric Bubble (GEGB), approved by the FDA in 1985, and the Ballobes Balloon. [NIH] Gastric banding: Surgery to limit the amount of food the stomach can hold by closing part of it off. A band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. The small outlet delays the emptying of food from the pouch and causes a feeling of fullness. [NIH]

Gastric Bypass: Surgical procedure in which the stomach is transected high on the body. The resulting proximal remnant is joined to a loop of the jejunum in an end-to-side anastomosis. This procedure is used frequently in the treatment of morbid obesity. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids,

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pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastroplasty: Surgical treatment of the stomach or lower esophagus used to decrease the size of the stomach. The procedure is used mainly in the treatment of morbid obesity and to correct defects in the lower esophagus or the stomach. Different procedures employed include vertical (mesh) banded gastroplasty, silicone elastomer ring vertical gastroplasty and horizontal banded gastroplasty. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Generator: Any system incorporating a fixed parent radionuclide from which is produced a daughter radionuclide which is to be removed by elution or by any other method and used in a radiopharmaceutical. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Ginger: Deciduous plant rich in volatile oil (oils, volatile). It is used as a flavoring agent and has many other uses both internally and topically. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH]

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Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glossitis: Inflammation of the tongue. [NIH] Glucagonoma: Glucagon-secreting tumor of the pancreatic alpha cells characterized by a distinctive rash, weight loss, stomatitis, glossitis, diabetes, hypoaminoacidemia, and normochromic normocytic anemia. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycerophospholipids: Derivatives of phosphatidic acid in which the hydrophobic regions are composed of two fatty acids and a polar alcohol is joined to the C-3 position of glycerol through a phosphodiester bond. They are named according to their polar head groups, such as phosphatidylcholine and phosphatidylethanolamine. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosidic: Formed by elimination of water between the anomeric hydroxyl of one sugar and a hydroxyl of another sugar molecule. [NIH] Glycosylation: The chemical or biochemical addition of carbohydrate or glycosyl groups to other chemicals, especially peptides or proteins. Glycosyl transferases are used in this biochemical reaction. [NIH] Glycosyltransferases: Enzymes that catalyze the transfer of glycosyl groups to an acceptor. Most often another carbohydrate molecule acts as an acceptor, but inorganic phosphate can also act as an acceptor, such as in the case of phosphorylases. Some of the enzymes in this group also catalyze hydrolysis, which can be regarded as transfer of a glycosyl group from the donor to water. Subclasses include the hexosyltransferases, pentosyltransferases, sialyltransferases, and those transferring other glycosyl groups. EC 2.4. [NIH]

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Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonads: The gamete-producing glands, ovary or testis. [NIH] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Government Agencies: Administrative units of government responsible for policy making and management of governmental activities in the U.S. and abroad. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-Negative Bacteria: Bacteria which lose crystal violet stain but are stained pink when treated by Gram's method. [NIH] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Granulocyte: A type of white blood cell that fights bacterial infection. Neutrophils, eosinophils, and basophils are granulocytes. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Gynecologic cancer: Cancer of the female reproductive tract, including the cervix, endometrium, fallopian tubes, ovaries, uterus, and vagina. [NIH] Habitat: An area considered in terms of its environment, particularly as this determines the type and quality of the vegetation the area can carry. [NIH] Haematemesis: The vomiting of blood. [EU] Haemoptysis: The expectoration of blood or of blood-stained sputum. [EU] Hallucinogens: Drugs capable of inducing illusions, hallucinations, delusions, paranoid ideations, and other alterations of mood and thinking. Despite the name, the feature that distinguishes these agents from other classes of drugs is their capacity to induce states of altered perception, thought, and feeling that are not experienced otherwise. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when

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coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural. [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For example, anemia shows a low hematocrit, polycythemia, high values. [NIH] Hematuria: Presence of blood in the urine. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to

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hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocyte: A liver cell. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Heterozygotes: Having unlike alleles at one or more corresponding loci on homologous chromosomes. [NIH] Hexosyltransferases: Enzymes that catalyze the transfer of hexose groups. EC 2.4.1.-. [NIH] Hirsutism: Excess hair in females and children with an adult male pattern of distribution. The concept does not include hypertrichosis, which is localized or generalized excess hair. [NIH]

Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also

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called endocrine therapy. [NIH] Hospital Mortality: A vital statistic measuring or recording the rate of death from any cause in hospitalized populations. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Human Engineering: The science of designing, building or equipping mechanical devices or artificial environments to the anthropometric, physiological, or psychological requirements of the people who will use them. [NIH] Human growth hormone: A protein hormone, secreted by the anterior lobe of the pituitary, which promotes growth of the whole body by stimulating protein synthesis. The human gene has already been cloned and successfully expressed in bacteria. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Hydration: Combining with water. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperemesis: Excessive vomiting. [EU] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrichosis: Localized or generalized excess hair. The concept does not include hirsutism, which is excess hair in females and children with an adult male pattern of distribution. [NIH]

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Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypertrophic cardiomyopathy: Heart muscle disease that leads to thickening of the heart walls, interfering with the heart's ability to fill with and pump blood. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglossal Nerve: The 12th cranial nerve. The hypoglossal nerve originates in the hypoglossal nucleus of the medulla and supplies motor innervation to all of the muscles of the tongue except the palatoglossus (which is supplied by the vagus). This nerve also contains proprioceptive afferents from the tongue muscles. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Hypoglycemic: An orally active drug that produces a fall in blood glucose concentration. [NIH]

Hypogonadism: Condition resulting from or characterized by abnormally decreased functional activity of the gonads, with retardation of growth and sexual development. [NIH] Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other conditions. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypoventilation: A reduction in the amount of air entering the pulmonary alveoli. [NIH] Hysterectomy: Excision of the uterus. [NIH] Ibogaine: One of several indole alkaloids extracted from Tabernanthe iboga, Baill. It has a complex pharmacological profile and interacts with multiple systems of neurotransmission. Ibogaine has psychoactive properties and appears to modulate tolerance to opiates. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileitis: Inflammation of the ileum. [EU] Ileum: The lower end of the small intestine. [NIH] Illusions: The misinterpretation of a real external, sensory experience. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH]

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Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunogenic: Producing immunity; evoking an immune response. [EU] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU]

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Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infection Control: Programs of disease surveillance, generally within health care facilities, designed to investigate, prevent, and control the spread of infections and their causative microorganisms. [NIH] Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [NIH] Ingestion: Taking into the body by mouth [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inoperable: Not suitable to be operated upon. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH]

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Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [NIH] Interleukin-8: A cytokine that activates neutrophils and attracts neutrophils and Tlymphocytes. It is released by several cell types including monocytes, macrophages, Tlymphocytes, fibroblasts, endothelial cells, and keratinocytes by an inflammatory stimulus. IL-8 is a member of the beta-thromboglobulin superfamily and structurally related to platelet factor 4. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervention Studies: Epidemiologic investigations designed to test a hypothesized causeeffect relation by modifying the supposed causal factor(s) in the study population. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intraocular: Within the eye. [EU] Intraocular pressure: Pressure of the fluid inside the eye; normal IOP varies among individuals. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intrinsic Factor: A glycoprotein secreted by the cells of the gastric glands that is required for the absorption of vitamin B 12. Deficiency of intrinsic factor results in pernicious anemia. [NIH]

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Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Invertebrates: Animals that have no spinal column. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Involution: 1. A rolling or turning inward. 2. One of the movements involved in the gastrulation of many animals. 3. A retrograde change of the entire body or in a particular organ, as the retrograde changes in the female genital organs that result in normal size after delivery. 4. The progressive degeneration occurring naturally with advancing age, resulting in shrivelling of organs or tissues. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isopropyl: A gene mutation inducer. [NIH] Jejunoileal Bypass: A surgical procedure consisting of the anastomosis of the proximal part of the jejunum to the distal portion of the ileum, so as to bypass the nutrient-absorptive segment of the small intestine, to treat morbid obesity. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratinocytes: Epidermal cells which synthesize keratin and undergo characteristic changes as they move upward from the basal layers of the epidermis to the cornified (horny) layer of the skin. Successive stages of differentiation of the keratinocytes forming the epidermal layers are basal cell, spinous or prickle cell, and the granular cell. [NIH] Keto: It consists of 8 carbon atoms and within the endotoxins, it connects poysaccharide and lipid A. [NIH] Ketoacidosis: Acidosis accompanied by the accumulation of ketone bodies (ketosis) in the body tissues and fluids, as in diabetic acidosis. [EU] Ketone Bodies: Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. [NIH] Ketosis: A condition of having ketone bodies build up in body tissues and fluids. The signs of ketosis are nausea, vomiting, and stomach pain. Ketosis can lead to ketoacidosis. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels

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under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lactation: The period of the secretion of milk. [EU] Lactulose: A mild laxative. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lethal: Deadly, fatal. [EU] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

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Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. It is produced by glands on the tongue and by the pancreas and initiates the digestion of dietary fats. (From Dorland, 27th ed) EC 3.1.1.3. [NIH] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipid Mobilization: The breakdown of stored triglyceride in adipose tissue with the release of free fatty acids and glycerol. Depot fat hydrolysis is catalyzed by a lipase in response to pituitary lipid mobilization factors (LMF), various hormones, serotonin, or hepatotoxins such as carbon tetrachloride. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipodystrophy: A collection of rare conditions resulting from defective fat metabolism and characterized by atrophy of the subcutaneous fat. They include total, congenital or acquired, partial, abdominal infantile, and localized lipodystrophy. [NIH] Lipolysis: The hydrolysis of lipids. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lipoprotein Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. The enzyme hydrolyzes triacylglycerols in chylomicrons, very-low-density lipoproteins, low-density lipoproteins, and diacylglycerols. It occurs on capillary endothelial surfaces, especially in mammary, muscle, and adipose tissue. Genetic deficiency of the enzyme causes familial hyperlipoproteinemia Type I. (Dorland, 27th ed) EC 3.1.1.34. [NIH] Liposome: A spherical particle in an aqueous medium, formed by a lipid bilayer enclosing an aqueous compartment. [EU] Lipoxygenase: An enzyme of the oxidoreductase class that catalyzes reactions between linoleate and other fatty acids and oxygen to form hydroperoxy-fatty acid derivatives. Related enzymes in this class include the arachidonate lipoxygenases, arachidonate 5lipoxygenase, arachidonate 12-lipoxygenase, and arachidonate 15-lipoxygenase. EC 1.13.11.12. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood

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and aids in digestion by secreting bile. [NIH] Liver metastases: Cancer that has spread from the original (primary) tumor to the liver. [NIH]

Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Low-calorie diet: Caloric restriction of about 800 to 1,500 calories (approximately 12 to 15 kcal/kg of body weight) per day. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lower-fat diet: An eating plan in which 30 percent or less of the day's total calories are from fat. [NIH] Lubricants: Oily or slippery substances. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along

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lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malaise: A vague feeling of bodily discomfort. [EU] Malformation: A morphologic developmental process. [EU]

defect

resulting

from

an

intrinsically

abnormal

Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mammography: Radiographic examination of the breast. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Maximum Tolerated Dose: The highest dose level eliciting signs of toxicity without having major effects on survival relative to the test in which it is used. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Mechanoreceptors: Cells specialized to transduce mechanical stimuli and relay that information centrally in the nervous system. Mechanoreceptors include hair cells, which

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mediate hearing and balance, and the various somatosensory receptors, often with nonneural accessory structures. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Median survival time: The point in time from either diagnosis or treatment at which half of the patients with a given disease are found to be, or expected to be, still alive. In a clinical trial, median survival time is one way to measure how effective a treatment is. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megestrol Acetate: A drug that belongs to the group of hormones called progestins, used as hormone therapy to block estrogen and to suppress the effects of estrogen and androgens. [NIH]

Melanin: The substance that gives the skin its color. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Lipids: Lipids, predominantly phospholipids, cholesterol and small amounts of glycolipids found in membranes including cellular and intracellular membranes. These lipids may be arranged in bilayers in the membranes with integral proteins between the layers and peripheral proteins attached to the outside. Membrane lipids are required for active transport, several enzymatic activities and membrane formation. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH]

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Mental Health: The state wherein the person is well adjusted. [NIH] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metabolization: The chemical process by which matter is broken down into simpler substances, said especially of food processed by the human body. [EU] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methyltransferase: A drug-metabolizing enzyme. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microscopy, Confocal: A light microscopic technique in which only a small spot is illuminated and observed at a time. An image is constructed through point-by-point scanning of the field in this manner. Light sources may be conventional or laser, and fluorescence or transmitted observations are possible. [NIH] Midaxillary line: An imaginary vertical line that passes midway between the anterior and posterior axillary (armpit) folds. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Millimeter: A measure of length. A millimeter is approximately 26-times smaller than an inch. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in

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renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Minority Groups: A subgroup having special characteristics within a larger group, often bound together by special ties which distinguish it from the larger group. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Modulator: A specific inductor that brings out characteristics peculiar to a definite region. [EU]

Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Monounsaturated fat: An unsaturated fat that is found primarily in plant foods, including olive and canola oils. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motivations: The most compelling inner determinants of human behavior; also called drives, urges, impulses, needs, wants, tensions, and willful cravings. [NIH]

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Mountaineering: A sport involving mountain climbing techniques. [NIH] Mucocutaneous: Pertaining to or affecting the mucous membrane and the skin. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucositis: A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Myalgia: Pain in a muscle or muscles. [EU] Mycobacterium: A genus of gram-positive, aerobic bacteria. Most species are free-living in soil and water, but the major habitat for some is the diseased tissue of warm-blooded hosts. [NIH]

Mycobacterium avium: A bacterium causing tuberculosis in domestic fowl and other birds. In pigs, it may cause localized and sometimes disseminated disease. The organism occurs occasionally in sheep and cattle. It should be distinguished from the M. avium complex, which infects primarily humans. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myeloma: Cancer that arises in plasma cells, a type of white blood cell. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle

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fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Myristate: Pharmacological activator of protein kinase C. [NIH] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Natriuresis: The excretion of abnormal amounts of sodium in the urine. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needs Assessment: Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Neoprene: An oil-resistant synthetic rubber made by the polymerization of chloroprene. [NIH]

Neopterin: A pteridine derivative present in body fluids; elevated levels result from immune system activation, malignant disease, allograft rejection, and viral infections. (From Stedman, 26th ed) Neopterin also serves as a precursor in the biosynthesis of biopterin. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with

Dictionary 399

atrophy of the affected central or peripheral nervous system structures. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Non-small cell lung cancer: A group of lung cancers that includes squamous cell carcinoma,

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adenocarcinoma, and large cell carcinoma. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Normotensive: 1. Characterized by normal tone, tension, or pressure, as by normal blood pressure. 2. A person with normal blood pressure. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Obsession: A recurrent, persistent thought, image, or impulse that is unwanted and distressing (ego-dystonic) and comes involuntarily to mind despite attempts to ignore or suppress it. Common obsessions involve thoughts of violence, contamination, and selfdoubt. [EU] Occult: Obscure; concealed from observation, difficult to understand. [EU] Octopamine: An alpha-adrenergic sympathomimetic amine, biosynthesized from tyramine in the CNS and platelets and also in invertebrate nervous systems. It is used to treat hypotension and as a cardiotonic. The natural D(-) form is more potent than the L(+) form in producing cardiovascular adrenergic responses. It is also a neurotransmitter in some invertebrates. [NIH] Oligomenorrhea: Abnormally infrequent menstruation. [NIH] Oligosaccharides: Carbohydrates consisting of between two and ten monosaccharides connected by either an alpha- or beta-glycosidic link. They are found throughout nature in both the free and bound form. [NIH]

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Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Omega-3 fatty acid: A type of fat obtained in the diet and involved in immunity. [NIH] Omeprazole: A highly effective inhibitor of gastric acid secretion used in the therapy of gastric ulcers and Zollinger-Ellison syndrome. The drug inhibits the H(+)-K(+)-ATPase (H(+)-K(+)-exchanging ATPase) in a pH-dependent manner. This ATPase is considered the proton pump in the secretory membrane of the parietal cell. [NIH] On-line: A sexually-reproducing population derived from a common parentage. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic Disk: The portion of the optic nerve seen in the fundus with the ophthalmoscope. It is formed by the meeting of all the retinal ganglion cell axons as they enter the optic nerve. [NIH]

Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orlistat: A lipase inhibitor used for weight loss. Lipase is an enzyme found in the bowel that assists in lipid absorption by the body. Orlistat blocks this enzyme, reducing the amount of fat the body absorbs by about 30 percent. It is known colloquially as a "fat blocker." Because more oily fat is left in the bowel to be excreted, Orlistat can cause an oily anal leakage and fecal incontinence. Orlistat may not be suitable for people with bowel conditions such as irritable bowel syndrome or Crohn's disease. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteolysis: Dissolution of bone that particularly involves the removal or loss of calcium. [NIH]

Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25

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to 29.9 kg/m2. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxandrolone: A synthetic hormone with anabolic and androgenic properties. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, cell respiration, or aerobic metabolism. [NIH] Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Pacemaker: An object or substance that influences the rate at which a certain phenomenon occurs; often used alone to indicate the natural cardiac pacemaker or an artificial cardiac pacemaker. In biochemistry, a substance whose rate of reaction sets the pace for a series of interrelated reactions. [EU] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsies: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancytopenia: Deficiency of all three cell elements of the blood, erythrocytes, leukocytes and platelets. [NIH] Papilloma: A benign epithelial neoplasm which may arise from the skin, mucous membranes or glandular ducts. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU]

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Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Parturition: The act or process of given birth to a child. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Pentagastrin: A synthetic polypeptide that has effects like gastrin when given parenterally. It stimulates the secretion of gastric acid, pepsin, and intrinsic factor, and has been used as a diagnostic aid. [NIH] Pentosyltransferases: Enzymes of the transferase class that catalyze the transfer of a pentose group from one compound to another. (Dorland, 28th ed) EC 2.4.2. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or

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multiple sets of these or other symbols such as geometric figures. [NIH] Performance status: A measure of how well a patient is able to perform ordinary tasks and carry out daily activities. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peroneal Nerve: The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot. [NIH] Petrolatum: A colloidal system of semisolid hydrocarbons obtained from petroleum. It is used as an ointment base, topical protectant, and lubricant. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenolphthalein: An acid-base indicator which is colorless in acid solution, but turns pink to red as the solution becomes alkaline. It is used medicinally as a cathartic. [NIH]

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Phentermine: A central nervous system stimulant and sympathomimetic with actions and uses similar to those of dextroamphetamine. It has been used most frequently in the treatment of obesity. [NIH] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phenylephrine: An alpha-adrenergic agonist used as a mydriatic, nasal decongestant, and cardiotonic agent. [NIH] Phenylpropanolamine: A sympathomimetic that acts mainly by causing release of norepinephrine but also has direct agonist activity at some adrenergic receptors. It is most commonly used as a nasal vasoconstrictor and an appetite depressant. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]

Pilot study: The initial study examining a new method or treatment. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth

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day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH]

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Polycystic Ovary Syndrome: Clinical symptom complex characterized by oligomenorrhea or amenorrhea, anovulation, and regularly associated with bilateral polycystic ovaries. [NIH] Polydipsia: Chronic excessive thirst, as in diabetes mellitus or diabetes insipidus. [EU] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses. [NIH]

Polyethylene Glycols: Alpha-Hydro-omega-hydroxypoly(oxy-1,2-ethanediyls). Additional polymers of ethylene oxide and water and their ethers. They vary in consistency from liquid to solid, depending on the molecular weight, indicated by a number following the name. Used as surfactants in industry, including foods, cosmetics and pharmaceutics; in biomedicine, as dispersing agents, solvents, ointment and suppository bases, vehicles, tablet excipients. Some specific groups are lauromagrogols, nonoxynols, octoxynols and poloxamers. [NIH] Polyglycolic Acid: Poly(oxy(1-oxo-1,2-ethanediyl)). A biocompatible polymer used as a surgical suture material. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polyphagia: Great hunger; a sign of diabetes. People with this great hunger often lose weight. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Polyuria: Urination of a large volume of urine with an increase in urinary frequency, commonly seen in diabetes. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH]

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Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Precipitation: The act or process of precipitating. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Pregnancy Complications: The co-occurrence of pregnancy and a disease. The disease may precede or follow conception and it may or may not have a deleterious effect on the pregnant woman or fetus. [NIH] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Preoperative: Preceding an operation. [EU] Pressoreceptors: Receptors in the vascular system, particularly the aorta and carotid sinus, which are sensitive to stretch of the vessel walls. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [NIH] Private Sector: That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Program Development: The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).

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[NIH]

Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Pro-Opiomelanocortin: A precursor protein, MW 30,000, synthesized mainly in the anterior pituitary gland but also found in the hypothalamus, brain, and several peripheral tissues. It incorporates the amino acid sequences of ACTH and beta-lipotropin. These two hormones, in turn, contain the biologically active peptides MSH, corticotropin-like intermediate lobe peptide, alpha-lipotropin, endorphins, and methionine enkephalin. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Propylene Glycol: A clear, colorless, viscous organic solvent and diluent used in pharmaceutical preparations. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH]

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Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prosthesis: An artificial replacement of a part of the body. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH] Proton Pump Inhibitors: Medicines that stop the stomach's acid pump. Examples are omeprazole (oh-MEH-prah-zol) (Prilosec) and lansoprazole (lan-SOH-prah-zol) (Prevacid). [NIH]

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU]

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Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Psychotropic Drugs: A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents). [NIH] Psyllium: Dried, ripe seeds of Plantago psyllium, P. indica, and P. ovata (Plantaginaceae). Plantain seeds swell in water and are used as demulcents and bulk laxatives. [NIH] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Puerperium: Period from delivery of the placenta until return of the reproductive organs to their normal nonpregnant morphologic state. In humans, the puerperium generally lasts for six to eight weeks. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Alveoli: Small polyhedral outpouchings along the walls of the alveolar sacs, alveolar ducts and terminal bronchioles through the walls of which gas exchange between alveolar air and pulmonary capillary blood takes place. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary Fibrosis: Chronic inflammation and progressive fibrosis of the pulmonary alveolar walls, with steadily progressive dyspnea, resulting finally in death from oxygen lack or right heart failure. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Purgative: 1. Cathartic (def. 1); causing evacuation of the bowels. 2. A cathartic, particularly one that stimulates peristaltic action. [EU] Pylorus: The opening in a vertebrate from the stomach into the intestine. [EU] Quackery: The fraudulent misrepresentation of the diagnosis and treatment of disease. [NIH]

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Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that

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the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Reassurance: A procedure in psychotherapy that seeks to give the client confidence in a favorable outcome. It makes use of suggestion, of the prestige of the therapist. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Reconstitution: 1. A type of regeneration in which a new organ forms by the rearrangement of tissues rather than from new formation at an injured surface. 2. The restoration to original form of a substance previously altered for preservation and storage, as the restoration to a liquid state of blood serum or plasma that has been dried and stored. [EU] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refractory: Not readily yielding to treatment. [EU] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Renal Veins: Short thick veins which return blood from the kidneys to the vena cava. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH]

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Renin-Angiotensin System: A system consisting of renin, angiotensin-converting enzyme, and angiotensin II. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming angiotensin I. The converting enzyme contained in the lung acts on angiotensin I in the plasma converting it to angiotensin II, the most powerful directly pressor substance known. It causes contraction of the arteriolar smooth muscle and has other indirect actions mediated through the adrenal cortex. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory distress syndrome: A lung disease that occurs primarily in premature infants; the newborn must struggle for each breath and blueing of its skin reflects the baby's inability to get enough oxygen. [NIH] Respiratory Mechanics: The physical or mechanical action of the lungs, diaphragm, ribs, and chest wall during respiration. It includes airflow, lung volume, neural and reflex controls, mechanoreceptors, breathing patterns, etc. [NIH] Resting metabolic rate: RMR accounts for 65 to 75 percent of daily energy expenditure and represents the minimum energy needed to maintain all physiological cell functions in the resting state. The principal determinant of RMR is lean body mass (LBM). Obese subjects have a higher RMR in absolute terms than lean individuals, an equivalent RMR when corrected for LBM and per unit surface area, and a lower RMR when expressed per kilogram of body weight. Obese persons require more energy for any given activity because of a larger mass, but they tend to be more sedentary than lean subjects. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Detachment: Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). [NIH] Retinitis: Inflammation of the retina. It is rarely limited to the retina, but is commonly associated with diseases of the choroid (chorioretinitis) and of the optic nerve

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(neuroretinitis). The disease may be confined to one eye, but since it is generally dependent on a constitutional factor, it is almost always bilateral. It may be acute in course, but as a rule it lasts many weeks or even several months. [NIH] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Retrovirus: A member of a group of RNA viruses, the RNA of which is copied during viral replication into DNA by reverse transcriptase. The viral DNA is then able to be integrated into the host chromosomal DNA. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Rhodopsin: A photoreceptor protein found in retinal rods. It is a complex formed by the binding of retinal, the oxidized form of retinol, to the protein opsin and undergoes a series of complex reactions in response to visible light resulting in the transmission of nerve impulses to the brain. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Rickettsiae: One of a group of obligate intracellular parasitic microorganisms, once regarded as intermediate in their properties between bacteria and viruses but now classified as bacteria in the order Rickettsiales, which includes 17 genera and 3 families: Rickettsiace. [NIH]

Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Salicylic: A tuberculosis drug. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the

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mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Salivation: 1. The secretion of saliva. 2. Ptyalism (= excessive flow of saliva). [EU] Salmonella: A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria that utilizes citrate as a sole carbon source. It is pathogenic for humans, causing enteric fevers, gastroenteritis, and bacteremia. Food poisoning is the most common clinical manifestation. Organisms within this genus are separated on the basis of antigenic characteristics, sugar fermentation patterns, and bacteriophage susceptibility. [NIH] Sanitation: The development and establishment of environmental conditions favorable to the health of the public. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Satiation: Full gratification of a need or desire followed by a state of relative insensitivity to that particular need or desire. [NIH] Saturated fat: A type of fat found in greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products, lard, and in some vegetable oils, including coconut, palm kernel, and palm oils. Saturated fat raises blood cholesterol more than anything else eaten. On a Step I Diet, no more than 8 to 10 percent of total calories should come from saturated fat, and in the Step II Diet, less than 7 percent of the day's total calories should come from saturated fat. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Scatter: The extent to which relative success and failure are divergently manifested in qualitatively different tests. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and

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supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sedentary: 1. Sitting habitually; of inactive habits. 2. Pertaining to a sitting posture. [EU] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Self-Help Groups: Organizations which provide an environment encouraging social interactions through group activities or individual relationships especially for the purpose of rehabilitating or supporting patients, individuals with common health problems, or the elderly. They include therapeutic social clubs. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequential treatment: One treatment after the other. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH]

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Shedding: Release of infectious particles (e. g., bacteria, viruses) into the environment, for example by sneezing, by fecal excretion, or from an open lesion. [NIH] Shivering: Involuntary contraction or twitching of the muscles. It is a physiologic method of heat production in man and other mammals. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Sialyltransferases: A group of enzymes with the general formula CMP-Nacetylneuraminate:acceptor N-acetylneuraminyl transferase. They catalyze the transfer of Nacetylneuraminic acid from CMP-N-acetylneuraminic acid to an acceptor, which is usually the terminal sugar residue of an oligosaccharide, a glycoprotein, or a glycolipid. EC 2.4.99.-. [NIH]

Sibutramine: A drug used for the management of obesity that helps reduce food intake and is indicated for weight loss and maintenance of weight loss when used in conjunction with a reduced-calorie diet. It works to suppress the appetite primarily by inhibiting the reuptake of the neurotransmitters norepinephrine and serotonin. Side effects include dry mouth, headache, constipation, insomnia, and a slight increase in average blood pressure. In some patients it causes a higher blood pressure increase. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Silicic: A mixture of gelatinous substances obtained by treating silicates with acids. [NIH] Silicon: A trace element that constitutes about 27.6% of the earth's crust in the form of silicon dioxide. It does not occur free in nature. Silicon has the atomic symbol Si, atomic number 14, and atomic weight 28.09. [NIH] Silicon Dioxide: Silica. Transparent, tasteless crystals found in nature as agate, amethyst, chalcedony, cristobalite, flint, sand, quartz, and tridymite. The compound is insoluble in water or acids except hydrofluoric acid. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH]

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Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Small cell lung cancer: A type of lung cancer in which the cells appear small and round when viewed under the microscope. Also called oat cell lung cancer. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smoking Cessation: Discontinuation of the habit of smoking, the inhaling and exhaling of tobacco smoke. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social pressure: A strategy used in behavior therapy in which individuals are told that they possess the basic self-control ability to lose weight, but that coming to group meetings will strengthen their abilities. The group is asked to listen and give advice, similar to the way many self-help groups, based on social support, operate. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall

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in contrast to the viscera. [EU] Somatic cells: All the body cells except the reproductive (germ) cells. [NIH] Soybean Oil: Oil from soybean or soybean plant. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sports Medicine: The field of medicine concerned with physical fitness and the diagnosis and treatment of injuries sustained in sports activities. [NIH] Sputum: The material expelled from the respiratory passages by coughing or clearing the throat. [NIH] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Stabilization: The creation of a stable state. [EU] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Standard therapy: A currently accepted and widely used treatment for a certain type of cancer, based on the results of past research. [NIH]

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Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Steatosis: Fatty degeneration. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Steroid therapy: Treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation. [NIH] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]

Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Styptic: Astringent. [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Sublingual: Located beneath the tongue. [EU] Subspecies: A category intermediate in rank between species and variety, based on a

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smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppository: A medicated mass adapted for introduction into the rectal, vaginal, or urethral orifice of the body, suppository bases are solid at room temperature but melt or dissolve at body temperature. Commonly used bases are cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, polyethylene glycols of various molecular weights, and fatty acid esters of polyethylene glycol. [EU] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic

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discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Syncope: A temporary suspension of consciousness due to generalized cerebral schemia, a faint or swoon. [EU] Synephrine: Sympathetic alpha-adrenergic agonist with actions like phenylephrine. It is used as a vasoconstrictor in circulatory failure, asthma, nasal congestion, and glaucoma. [NIH]

Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetrahydrocannabinol: A psychoactive compound extracted from the resin of Cannabis sativa (marihuana, hashish). The isomer delta-9-tetrahydrocannabinol (THC) is considered the most active form, producing characteristic mood and perceptual changes associated with this compound. Dronabinol is a synthetic form of delta-9-THC. [NIH] Thalidomide: A pharmaceutical agent originally introduced as a non-barbiturate hypnotic, but withdrawn from the market because of its known tetratogenic effects. It has been reintroduced and used for a number of immunological and inflammatory disorders. Thalidomide displays immunosuppresive and anti-angiogenic activity. It inhibits release of tumor necrosis factor alpha from monocytes, and modulates other cytokine action. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thermogenesis: The generation of heat in order to maintain body temperature. The

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uncoupled oxidation of fatty acids contained within brown adipose tissue and shivering are examples of thermogenesis in mammals. [NIH] Thermoregulation: Heat regulation. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thromboses: The formation or presence of a blood clot within a blood vessel during life. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thrush: A disease due to infection with species of fungi of the genus Candida. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Ticlopidine: Ticlopidine is an effective inhibitor of platelet aggregation. The drug has been found to significantly reduce infarction size in acute myocardial infarcts and is an effective antithrombotic agent in arteriovenous fistulas, aorto-coronary bypass grafts, ischemic heart disease, venous thrombosis, and arteriosclerosis. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Plasminogen Activator: A proteolytic enzyme in the serine protease family found in many tissues which converts plasminogen to plasmin. It has fibrin-binding activity and is immunologically different from urinary plasminogen activator. The primary sequence, composed of 527 amino acids, is identical in both the naturally occurring and synthetic proteases. EC 3.4.21.68. [NIH]

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Tolazamide: A sulphonylurea hypoglycemic agent with actions and uses similar to those of chlorpropamide. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]

Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH] Tranquilizing Agents: A traditional grouping of drugs said to have a soothing or calming effect on mood, thought, or behavior. Included here are the anti-anxiety agents (minor tranquilizers), antimanic agents, and the antipsychotic agents (major tranquilizers). These drugs act by different mechanisms and are used for different therapeutic purposes. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcutaneous: Transdermal. [EU] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to

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the skin in ointment or patch form. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transferases: Transferases are enzymes transferring a group, for example, the methyl group or a glycosyl group, from one compound (generally regarded as donor) to another compound (generally regarded as acceptor). The classification is based on the scheme "donor:acceptor group transferase". (Enzyme Nomenclature, 1992) EC 2. [NIH] Transitional cell carcinoma: A type of cancer that develops in the lining of the bladder, ureter, or renal pelvis. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Triad: Trivalent. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Troglitazone: A drug used in diabetes treatment that is being studied for its effect on reducing the risk of cancer cell growth in fat tissue. [NIH] Tubal ligation: An operation to tie the fallopian tubes closed. This procedure prevents pregnancy by blocking the passage of eggs from the ovaries to the uterus. [NIH]

Dictionary 427

Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tungsten: A metallic element with the atomic symbol W, atomic number 74, and atomic weight 183.85. It is used in many manufacturing applications, including increasing the hardness, toughness, and tensile strength of steel; manufacture of filaments for incandescent light bulbs; and in contact points for automotive and electrical apparatus. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Tyramine: An indirect sympathomimetic. Tyramine does not directly activate adrenergic receptors, but it can serve as a substrate for adrenergic uptake systems and monoamine oxidase so it prolongs the actions of adrenergic transmitters. It also provokes transmitter release from adrenergic terminals. Tyramine may be a neurotransmitter in some invertebrate nervous systems. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Ultraviolet radiation: Invisible rays that are part of the energy that comes from the sun. UV radiation can damage the skin and cause melanoma and other types of skin cancer. UV radiation that reaches the earth's surface is made up of two types of rays, called UVA and UVB rays. UVB rays are more likely than UVA rays to cause sunburn, but UVA rays pass deeper into the skin. Scientists have long thought that UVB radiation can cause melanoma and other types of skin cancer. They now think that UVA radiation also may add to skin damage that can lead to skin cancer and cause premature aging. For this reason, skin specialists recommend that people use sunscreens that reflect, absorb, or scatter both kinds of UV radiation. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Uric: A kidney stone that may result from a diet high in animal protein. When the body

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breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Plasminogen Activator: A proteolytic enzyme that converts plasminogen to plasmin where the preferential cleavage is between arginine and valine. It was isolated originally from human urine, but is found in most tissues of most vertebrates. EC 3.4.21.73. [NIH]

Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vagotomy: The interruption or removal of any part of the vagus (10th cranial) nerve. Vagotomy may be performed for research or for therapeutic purposes. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Vanadium: Vanadium. A metallic element with the atomic symbol V, atomic number 23, and atomic weight 50.94. It is used in the manufacture of vanadium steel. Prolonged exposure can lead to chronic intoxication caused by absorption usually via the lungs. [NIH] Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Varicose vein: An abnormal swelling and tortuosity especially of the superficial veins of the legs. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Vena: A vessel conducting blood from the capillary bed to the heart. [NIH]

Dictionary 429

Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Vertical banded gastroplasty: A surgical treatment for extreme obesity; an operation on the stomach that involves constructing a small pouch in the stomach that empties through a narrow opening into the distal stomach and duodenum. [NIH] Very low-calorie diet: Very low-calorie diet. The VLCD of 800 (approximately 6-10 kcal/kg body weight) or fewer calories per day is conducted under physician supervision and monitoring and is restricted to severely obese persons. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Load: The quantity of measurable virus in the blood. Change in viral load, measured in plasma, is used as a surrogate marker in HIV disease progression. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Visceral fat: One of the three compartments of abdominal fat. Retroperitoneal and subcutaneous are the other two compartments. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitreous: Glasslike or hyaline; often used alone to designate the vitreous body of the eye (corpus vitreum). [EU] Vitreous Hemorrhage: Hemorrhage into the vitreous body. [NIH] Vitreous Humor: The transparent, colorless mass of gel that lies behind the lens and in front of the retina and fills the center of the eyeball. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH]

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Vivo: Outside of or removed from the body of a living organism. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Waist circumference: To define the level at which the waist circumference is measured, a bony landmark is first located and marked. The subject stands, and the technician, positioned to the right of the subject, palpates the upper hip bone to locate the right ileum. Just above the uppermost lateral border of the right ileum, a horizontal mark is drawn and then crossed with a vertical mark on the midaxillary line. The measuring tape is then placed around the trunk, at the level of the mark on the right side, making sure that it is on a level horizontal plane on all sides. The tape is then tightened slightly without compressing the skin and underlying subcutaneous tissues. The measure is recorded in centimeters to the nearest millimeter. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Wettability: The quality or state of being wettable or the degree to which something can be wet. This is also the ability of any solid surface to be wetted when in contact with a liquid whose surface tension is reduced so that the liquid spreads over the surface of the solid. [NIH]

White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yohimbine: A plant alkaloid with alpha-2-adrenergic blocking activity. Yohimbine has been used as a mydriatic and in the treatment of impotence. It is also alleged to be an aphrodisiac. [NIH]

Zinc Acetate: A salt produced by the reaction of zinc oxide with acetic acid and used as an astringent, styptic, and emetic. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

431

INDEX 5 5-Hydroxytryptophan, 176, 208, 256, 345 A Abdomen, 345, 356, 361, 373, 388, 391, 403, 404, 420, 421, 424, 428 Abdominal fat, 26, 51, 58, 93, 301, 303, 345, 429 Abdominal Pain, 293, 345, 378, 427 Aberrant, 283, 345 Acceptor, 259, 345, 380, 391, 402, 418, 426 Acetone, 222, 345, 389 Acetylcholine, 258, 345, 361, 399 Acidosis, 345, 348, 389 Acne, 220, 345 Acrylonitrile, 345, 415 Actin, 345, 398 Activities of Daily Living, 5, 6, 345 Acylation, 125, 345 Adaptability, 345, 360 Adaptation, 77, 345, 406 Adduct, 205, 237, 345 Adenine, 346 Adenocarcinoma, 118, 346, 400 Adenosine, 252, 346, 357, 405 Adenosine Triphosphate, 252, 346, 405 Adenylate Cyclase, 346, 377 Adipocytes, 14, 18, 26, 54, 211, 346, 390 Adjustment, 46, 345, 346 Adolescence, 48, 346 Adrenal Cortex, 346, 347, 366, 374, 408, 414 Adrenal Medulla, 346, 359, 374, 400 Adrenergic, 23, 92, 207, 211, 346, 350, 351, 370, 373, 374, 400, 405, 422, 423, 427, 430 Adult-Onset Diabetes, 202, 203, 346 Adverse Effect, 23, 165, 218, 229, 238, 295, 314, 315, 346, 362, 418 Aerobic, 12, 18, 24, 53, 86, 104, 164, 185, 241, 268, 270, 346, 348, 375, 397, 402 Aerobic Exercise, 12, 18, 53, 86, 104, 185, 241, 268, 270, 346 Aerobic Metabolism, 346, 402 Aerobic Respiration, 346, 402 Afferent, 346, 390 Affinity, 227, 346, 347, 362, 419 Agar, 347, 366, 406 Age of Onset, 161, 347, 427 Age-Adjusted, 5, 347

Agonist, 24, 202, 220, 258, 347, 370, 373, 398, 399, 405, 423 Airway, 42, 118, 347, 419 Aldosterone, 45, 347 Alertness, 347, 357 Algorithms, 347, 355 Alimentary, 121, 347, 369, 402, 403 Alkaline, 226, 345, 347, 348, 357, 404 Alkaloid, 347, 358, 399, 430 Alleles, 347, 383 Allergen, 157, 347 Allograft, 347, 398 Allylamine, 347, 348 Alpha Cell, 347, 380 Alpha Particles, 348, 412 Alternative medicine, 300, 348 Ameliorating, 246, 348 Amenorrhea, 118, 168, 348, 350, 407 Amine, 205, 237, 244, 348, 383, 400 Amino Acid Sequence, 348, 350, 409 Ammonia, 348, 422, 427 Amputation, 39, 144, 348 Amylase, 238, 348 Anabolic, 79, 132, 195, 348, 402 Anaerobic, 217, 348, 416 Anaerobic Threshold, 217, 348 Anaesthesia, 348, 386 Anal, 348, 373, 392, 401 Analgesic, 222, 348 Analog, 295, 349, 378 Anaphylatoxins, 349, 364 Anastomosis, 260, 349, 378, 389 Anatomical, 349, 353, 361, 369, 386, 417 Androgenic, 349, 402 Androgens, 346, 349, 366, 394 Anemia, 82, 120, 292, 349, 357, 377, 380, 382, 388 Anesthesia, 347, 349, 350, 372 Aneurysm, 349, 428 Angina, 17, 43, 91, 349 Angina Pectoris, 91, 349 Anginal, 91, 349 Angioplasty, 17, 220, 349 Angiotensin-Converting Enzyme Inhibitors, 135, 349 Angiotensinogen, 69, 349, 413, 414 Anhydrous, 223, 254, 349 Animal model, 8, 28, 47, 283, 349

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Anionic, 203, 244, 349 Anions, 349, 389, 417 Ankle, 350, 428 Anode, 205, 237, 349, 350 Anorexia Nervosa, 75, 76, 100, 101, 119, 169, 350 Anovulation, 48, 350, 407 Antagonism, 350, 357, 362 Anthropometric measurements, 77, 350 Anti-Anxiety Agents, 350, 411, 425 Antibiotic, 350, 357, 420 Antibodies, 65, 350, 382, 384, 385, 393, 406 Antibody, 347, 350, 351, 363, 382, 383, 386, 387, 394, 396, 412, 420 Anticoagulant, 350, 410 Antidepressant, 61, 345, 350, 376 Antidepressive Agents, 350, 411 Antidote, 11, 350 Antiemetic, 222, 223, 235, 350, 351 Antiepileptic, 298, 345, 350 Antigen, 347, 350, 351, 363, 383, 384, 385, 386, 387, 394, 412 Antigen-Antibody Complex, 351, 363 Antihypertensive, 40, 351, 377 Anti-inflammatory, 251, 351, 353, 366, 368, 380, 386 Anti-Inflammatory Agents, 351, 353, 366 Antimicrobial, 351, 368 Antineoplastic, 28, 351, 366 Antineoplastic Agents, 28, 351 Antioxidant, 88, 163, 351, 378, 402 Antipruritic, 351, 367 Antipsychotic, 351, 362, 399, 425 Antiseptic, 345, 351 Antithrombotic, 351, 424 Antiviral, 195, 291, 351, 388 Antrectomy, 351, 355 Anuria, 351, 390 Anus, 348, 351, 356, 363, 373, 376, 413 Anxiety, 292, 341, 350, 352 Aorta, 352, 408, 429 Aortic Valve, 101, 352 Aphakia, 352, 414 Apnea, 42, 173, 352 Apnoea, 118, 142, 352 Apolipoproteins, 19, 352, 391 Apoptosis, 37, 136, 221, 237, 238, 352, 359 Appetite Regulation, 218, 352 Aqueous, 205, 223, 237, 262, 352, 354, 367, 372, 390, 391 Arachidonate 15-Lipoxygenase, 352, 391 Arachidonate Lipoxygenases, 352, 391

Arachidonic Acid, 352, 409 Arcuate Nucleus, 34, 352 Arginine, 144, 219, 252, 349, 352, 399, 428 Arterial, 12, 142, 347, 352, 353, 361, 365, 384, 410, 423 Arteries, 206, 352, 353, 356, 365, 392, 395, 397, 411 Arterioles, 352, 353, 356, 358, 397, 428 Arteriolosclerosis, 352, 353 Arteriosclerosis, 206, 353, 358, 385, 397, 424 Arteriovenous, 57, 353, 424 Arteriovenous Fistula, 353, 424 Arteritis, 128, 353 Artery, 33, 55, 75, 230, 248, 284, 349, 352, 353, 366, 371, 372, 393, 411 Articular, 353, 401 Aspartame, 321, 353 Aspartic, 353 Aspartic Acid, 353 Aspirin, 219, 353 Assay, 28, 47, 258, 353, 412 Astringent, 353, 421, 430 Asynchronous, 60, 353 Atopic, 220, 353 Atrial, 353, 365, 426 Atrioventricular, 353, 365 Atrium, 353, 365, 426, 429 Atrophy, 57, 220, 269, 353, 391, 399 Atypical, 353, 362 Auditory, 353, 393, 428 Autacoids, 353, 386 Autoimmune disease, 354, 397 Autonomic, 71, 102, 147, 345, 351, 354, 400, 404, 419, 422 Autonomic Nervous System, 102, 354, 404, 419, 422 Avian, 231, 255, 354 B Back Pain, 113, 354 Bacteremia, 238, 354, 416 Bacterial Physiology, 345, 354 Bacteriophage, 354, 406, 416, 426 Bacterium, 354, 397 Barbiturate, 354, 423 Baroreflex, 12, 27, 354 Base, 190, 197, 221, 242, 346, 354, 368, 374, 389, 390, 404, 423 Basophils, 354, 381, 390 Behavior Therapy, 11, 25, 52, 247, 354, 419 Benign, 353, 355, 382, 398, 402, 412, 430 Benzene, 232, 355

Index 433

Beta-Thromboglobulin, 355, 388 Bezoar, 247, 355 Bilateral, 73, 95, 119, 229, 355, 407, 415 Bile, 98, 126, 355, 378, 392, 421 Bile Acids, 355, 378, 421 Bile Acids and Salts, 355 Bile duct, 355, 378 Biliary, 123, 355, 358 Biliopancreatic Diversion, 9, 68, 122, 355 Bilirubin, 355, 378 Biochemical, 99, 219, 347, 355, 380, 390, 401, 417 Biological response modifier, 355, 388 Biopsy, 10, 26, 57, 355 Biopterin, 355, 398 Biotechnology, 64, 65, 277, 300, 313, 355 Biphasic, 223, 355 Bladder, 220, 263, 301, 356, 364, 377, 386, 397, 410, 413, 426, 427, 428 Blood Cell Count, 238, 356, 382 Blood Coagulation, 356, 358, 424 Blood Glucose, 203, 222, 286, 291, 293, 294, 327, 356, 383, 385, 387 Body Fluids, 356, 357, 398, 419 Body Image, 41, 44, 81, 184, 186, 356 Body Weight Changes, 24, 356 Bone Density, 58, 356 Bone Marrow, 140, 169, 238, 355, 356, 379, 386, 393, 396, 419 Bone scan, 356, 416 Boron, 356, 366 Bowel, 171, 348, 356, 369, 373, 388, 390, 401, 404, 421, 427 Bowel Movement, 356, 369, 421 Brachytherapy, 356, 388, 412 Bradykinin, 356, 399 Branch, 229, 339, 357, 393, 403, 411, 420, 422, 423, 424 Breakdown, 57, 211, 230, 253, 357, 369, 378, 391, 401 Broadband, 60, 357 Broad-spectrum, 48, 357 Bronchitis, 357, 361 Buccal, 357, 421 Buffers, 354, 357 Bulimia, 22, 61, 357 Burns, 229, 230, 357 Burns, Electric, 357 Bypass, 10, 37, 184, 247, 291, 357, 389, 424 C Cachexia, 79, 121, 189, 190, 191, 196, 250, 357

Cadmium, 249, 357 Cadmium Poisoning, 357 Caffeine, 160, 164, 167, 176, 213, 219, 233, 253, 301, 321, 357 Calcification, 353, 357 Calcium, 161, 208, 226, 239, 244, 357, 362, 363, 384, 401, 418 Calculi, 358, 381 Calorimeter, 282, 358 Capillary, 356, 358, 391, 411, 428, 429 Capsaicin, 162, 358 Capsules, 223, 234, 358, 376, 379 Carbon Dioxide, 217, 218, 358, 405, 414, 429 Carcinogen, 345, 358, 374 Carcinogenic, 355, 358, 361, 387, 409, 421 Carcinoma, 220, 358, 400, 420 Cardiac, 12, 17, 27, 38, 77, 99, 106, 147, 194, 211, 212, 218, 347, 354, 357, 358, 365, 371, 372, 374, 378, 397, 402, 421 Cardiac Output, 218, 354, 358 Cardiomyopathy, 358 Cardiopathy, 67, 358 Cardiopulmonary, 62, 77, 217, 358 Cardiorespiratory, 21, 56, 346, 358 Cardiotonic, 358, 400, 405 Cardiovascular System, 229, 359 Carnitine, 156, 164, 166, 359 Carotene, 156, 176, 180, 359, 414 Carrier Proteins, 359, 412 Case report, 104, 140, 160, 268, 315, 359, 362 Case series, 298, 359, 362 Case-Control Studies, 30, 359, 373 Caspase, 37, 237, 359 Catabolism, 8, 57, 359 Cataract, 352, 359, 414 Catecholamine, 202, 210, 225, 350, 359, 370, 404 Catheterization, 349, 359 Cathode, 205, 237, 350, 359 Cations, 359, 389 Causal, 359, 373, 388 Cause of Death, 48, 49, 246, 359 Cell Death, 37, 352, 360 Cell Differentiation, 360, 418 Cell Division, 354, 360, 396, 406 Cell Fusion, 47, 360 Cell membrane, 203, 359, 360, 368, 405 Cell proliferation, 37, 220, 353, 360, 418 Cell Respiration, 346, 360, 402, 414 Cell Size, 26, 360

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Cell Survival, 237, 238, 360 Cellobiose, 360 Cellulose, 253, 360, 406 Cerebral, 360, 374, 423, 424 Cerebrovascular, 12, 358, 360 Cerebrum, 360 Cervical, 220, 360 Cervix, 220, 360, 381 Character, 349, 360, 367 Cheilitis, 82, 360 Chemotactic Factors, 360, 364 Chemotaxis, 250, 361 Chemotherapeutic agent, 87, 144, 238, 361 Chemotherapy, 18, 80, 140, 196, 197, 198, 235, 237, 238, 361, 370 Chest wall, 361, 414 Chin, 104, 135, 361, 394 Chloroform, 202, 361 Chloroprene, 361, 398 Cholecystectomy, 256, 361 Cholesterol, 31, 47, 82, 98, 126, 161, 170, 206, 211, 225, 233, 245, 262, 268, 275, 280, 284, 285, 291, 294, 302, 326, 355, 361, 365, 370, 378, 384, 391, 392, 394, 416, 421 Cholesterol Esters, 361, 391 Cholinergic, 351, 361, 399 Chromatin, 352, 361, 373, 399 Chromium, 29, 156, 167, 213, 229, 253, 256, 259, 361 Chromosomal, 361, 415 Chromosome, 361, 381, 391 Chronic Disease, 13, 16, 35, 60, 222, 246, 256, 289, 303, 357, 361 Chronic Obstructive Pulmonary Disease, 136, 141, 148, 361 Chronic renal, 361, 406 Chylomicrons, 361, 391 Ciliary, 129, 361 Ciliary Neurotrophic Factor, 129, 361 Cimetidine, 80, 362 Cirrhosis, 29, 169, 171, 362 CIS, 252, 362, 414 Citric Acid, 226, 362 Citrus, 219, 229, 362 Clamp, 18, 26, 31, 362 Clear cell carcinoma, 362, 369 Clinical Medicine, 362, 408 Clinical study, 44, 55, 190, 362, 365 Cloning, 355, 362 Clozapine, 79, 125, 362 Coagulation, 31, 91, 356, 362, 383, 424

Coal, 355, 362 Coccidiosis, 231, 255, 362 Cod Liver Oil, 362, 372 Cofactor, 363, 410, 424 Cohort Studies, 363, 373 Colitis, 174, 221, 292, 293, 363 Collagen, 80, 348, 363, 376, 379, 406 Collapse, 42, 217, 357, 363, 419 Colon, 74, 113, 220, 256, 355, 363, 390, 427 Colorectal, 81, 169, 363 Combination Therapy, 295, 363 Community Health Nursing, 55, 363 Comorbidity, 22, 186, 363 Complement, 49, 50, 65, 349, 363, 364 Complementary and alternative medicine, 159, 160, 180, 364 Complementary medicine, 160, 364 Complete remission, 364, 413 Compliance, 12, 40, 46, 48, 212, 364 Computational Biology, 313, 364 Computed tomography, 356, 364, 416 Conception, 364, 376, 408, 421 Concomitant, 57, 138, 195, 364 Cones, 364, 414 Confounding, 35, 364 Congestion, 351, 364, 423 Congestive heart failure, 21, 89, 364 Conjugated, 166, 218, 238, 355, 364, 367 Conjunctiva, 364, 387 Connective Tissue, 356, 363, 364, 368, 376, 378, 379, 392, 415, 416 Consciousness, 183, 348, 350, 365, 368, 370, 411, 423 Constipation, 259, 280, 341, 351, 365, 418 Constriction, 258, 365, 389 Consultation, 365, 375 Consumption, 8, 76, 224, 235, 241, 263, 304, 325, 365, 378, 400, 402 Contamination, 365, 400 Continuum, 218, 365 Contractility, 349, 365 Contraindications, ii, 365 Control group, 4, 20, 27, 37, 38, 49, 50, 52, 57, 199, 301, 365, 412 Controlled clinical trial, 15, 16, 59, 66, 81, 160, 365 Controlled study, 3, 63, 133, 135, 365 Coordination, 22, 23, 365, 397 Cor, 52, 85, 365, 366, 409 Coronary, 33, 54, 55, 75, 124, 212, 225, 230, 248, 256, 284, 349, 358, 365, 366, 395, 397, 424

Index 435

Coronary Circulation, 349, 365 Coronary heart disease, 54, 124, 212, 225, 256, 358, 365 Coronary Thrombosis, 366, 395, 397 Cortex, 269, 366, 374 Corticosteroid, 95, 366, 421 Corticotropin-Releasing Hormone, 85, 366 Cortisol, 58, 85, 366 Cortisone, 366, 368 Cost Savings, 116, 366 Cranial, 229, 366, 382, 385, 398, 404, 428 Creatine, 18, 156, 251, 252, 366 Creatinine, 366, 390 Criterion, 114, 366 Cross-Sectional Studies, 20, 366, 373 Crystallization, 243, 366 Culture Media, 14, 347, 366 Curative, 366, 423 Curcumin, 219, 366 Cyclic, 228, 243, 260, 261, 346, 357, 367, 377, 381, 399, 409 Cyproheptadine, 190, 367 Cytochrome, 362, 367 Cytokine, 65, 130, 231, 234, 251, 255, 367, 388, 423 Cytomegalovirus, 291, 367, 378 Cytomegalovirus Infections, 367, 378 Cytomegalovirus Retinitis, 291, 367 Cytoplasm, 352, 354, 360, 367, 373, 396, 399 Cytotoxic, 10, 238, 358, 367, 412, 418 D Dairy Products, 12, 367, 416 Data Collection, 367, 377 Deamination, 367, 427 Decision Theory, 11, 367 Degenerative, 207, 367, 383, 401, 414, 415 Dehydration, 40, 183, 243, 367 Deletion, 352, 367 Delivery of Health Care, 368, 382 Dementia, 4, 5, 6, 79, 127, 222, 269, 286, 351, 368 Density, 7, 18, 76, 161, 228, 356, 368, 370, 391, 401, 407 Depolarization, 368, 418 Depressive Disorder, 26, 368 Deprivation, 282, 368 Dermatitis, 82, 220, 368, 371 Dermis, 368, 422, 425 Detergents, 244, 368 Dexamethasone, 105, 119, 368 Dextroamphetamine, 368, 405

DHEA, 177, 368 Diabetes Insipidus, 368, 407 Diabetic Retinopathy, 289, 368, 405 Diagnostic procedure, 201, 300, 368 Dialyzer, 368, 382 Diaphragm, 229, 369, 414 Diarrhoea, 66, 122, 129, 369, 378 Diastolic, 369, 384 Dietary Fats, 369, 375, 391 Dietary Fiber, 50, 369 Diethylstilbestrol, 252, 369 Dietitian, 290, 291, 369 Differential Thermal Analysis, 261, 369 Digestion, 295, 347, 355, 356, 369, 388, 391, 392, 403, 421, 428 Digestive system, 200, 280, 369, 397 Digestive tract, 369, 419, 420 Dilatation, 349, 369, 408, 428 Dilatation, Pathologic, 369, 428 Dilated cardiomyopathy, 89, 369 Dilation, 356, 369, 428 Dilution, 58, 369 Diploid, 369, 406 Direct, iii, 18, 215, 258, 284, 305, 348, 362, 369, 370, 405, 413, 423 Discrete, 61, 122, 369 Discrimination, 281, 369 Disease Progression, 37, 42, 146, 369, 429 Dissociation, 346, 370 Distal, 370, 371, 379, 389, 410, 429 Diuresis, 357, 370 Docetaxel, 196, 370 Domesticated, 263, 370 Dopamine, 351, 362, 368, 370, 399, 405 Dose-dependent, 35, 370 Double-blind, 3, 76, 92, 135, 160, 163, 235, 370 Dronabinol, 3, 308, 329, 370, 423 Drug Combinations, 295, 370 Drug Interactions, 306, 307, 370 Dumping Syndrome, 367, 370 Duodenum, 247, 355, 370, 378, 389, 402, 421, 429 Dyes, 216, 354, 370, 399 Dyslipidemia, 12, 28, 49, 256, 258, 286, 370 Dysphagia, 97, 101, 170, 371 Dysphoria, 100, 371 Dysphoric, 368, 371 Dyspnea, 371, 411 Dystrophy, 124, 371

436 Weight Loss

E Eating Disorders, 62, 100, 101, 114, 137, 161, 170, 229, 278, 320, 325, 371 Eczema, 220, 371 Edema, 342, 367, 368, 371 Effector, 345, 363, 371 Ego, 371, 400 Elastic, 247, 371, 422 Elasticity, 353, 371 Electric shock, 258, 371 Electrocoagulation, 362, 371 Electrode, 205, 215, 229, 237, 350, 359, 371 Electrolyte, 347, 366, 371, 390, 395, 407, 419 Embolus, 371, 387 Embryo, 360, 371, 386 Emesis, 259, 371 Emetic, 222, 371, 430 Emollient, 371, 380 Emphysema, 361, 371 Empirical, 57, 371 Emulsion, 126, 203, 205, 237, 372 Enanthate, 195, 372 Endarterectomy, 349, 372 Endocarditis, 101, 372 Endocardium, 372 Endocytosis, 47, 372 Endogenous, 34, 370, 371, 372 Endometrial, 256, 372 Endometrium, 372, 381, 394 Endorphins, 372, 399, 409 Endoscopy, 65, 287, 372 Endothelial cell, 372, 388, 424 Endothelium, 43, 372, 399, 406 Endothelium, Lymphatic, 372 Endothelium, Vascular, 372 Endothelium-derived, 43, 372, 399 Endotoxemia, 234, 373 Endotoxic, 373, 391 Endotoxin, 234, 373, 427 End-stage renal, 361, 373, 406 Enema, 292, 293, 373 Energetic, 208, 373 Energy balance, 6, 31, 34, 35, 53, 122, 213, 373, 390 Energy deficit, 24, 373 Energy Intake, 6, 9, 14, 19, 20, 53, 75, 93, 213, 224, 282, 373 Enkephalin, 373, 409 Environmental Health, 312, 314, 373 Enzymatic, 348, 358, 359, 364, 373, 376, 383, 394, 414

Enzyme Inhibitors, 127, 373 Eosinophilia, 68, 373 Eosinophils, 373, 381, 390 Ependyma, 352, 373, 424 Ephedrine, 23, 152, 154, 159, 163, 167, 177, 202, 213, 219, 229, 233, 278, 315, 373 Epidemic, 30, 36, 41, 43, 49, 50, 55, 230, 248, 288, 373, 420 Epidemiologic Studies, 19, 373 Epidemiological, 10, 373 Epidermal, 373, 389, 430 Epigastric, 373, 402 Epinephrine, 177, 346, 370, 374, 399, 400, 427 Epithelial, 47, 231, 238, 346, 374, 402 Epithelial Cells, 47, 231, 374 Epithelium, 47, 372, 374, 378, 414 Erythrocyte Indices, 356, 374 Erythrocytes, 349, 356, 374, 402 Esophageal, 65, 121, 230, 263, 287, 374 Esophageal Manometry, 287, 374 Esophagus, 220, 287, 369, 374, 379, 382, 392, 404, 413, 421 Estradiol, 252, 374 Estriol, 252, 374 Estrogen, 252, 253, 374, 394, 409 Estrone, 252, 374 Ether, 252, 374 Ethinyl Estradiol, 252, 374 Ethnic Groups, 285, 374 Eukaryotic Cells, 374, 386, 401 Evacuation, 365, 374, 378, 390, 411 Evoke, 374, 421 Excipients, 224, 253, 374, 407 Excitation, 215, 375, 399 Excrete, 351, 375, 389 Exercise Test, 39, 375 Exercise Tolerance, 207, 375 Exhaustion, 33, 350, 375 Exocrine, 375, 402 Exogenous, 55, 371, 372, 375, 427 Expert Systems, 262, 375 Expiration, 375, 414 Extensor, 375, 410 External-beam radiation, 375, 412 Extracellular, 215, 259, 364, 372, 375, 376, 419 Extracellular Matrix, 364, 375, 376 Extraction, 24, 246, 352, 375, 414 Extreme obesity, 74, 375, 429 Extremity, 375, 417

Index 437

F Faecal, 369, 375 Fallopian tube, 375, 381, 426 Family Planning, 313, 375 Fat Substitutes, 206, 320, 375 Fatigue, 29, 65, 189, 196, 287, 291, 294, 375, 382 Fatty acids, 45, 104, 116, 194, 207, 210, 226, 253, 263, 302, 376, 380, 391, 409, 424 Fatty Liver, 9, 10, 28, 82, 376 Feces, 365, 375, 376, 421 Feeding Behavior, 269, 376 Femoral, 136, 376 Femur, 376 Fenfluramine, 114, 376 Fermentation, 376, 416 Fetus, 376, 405, 408, 421, 428 Fibrin, 356, 376, 406, 424 Fibrinogen, 376, 406, 424 Fibrinolysis, 91, 376 Fibrinolytic, 31, 376 Fibroblasts, 231, 376, 388 Fibrosis, 29, 169, 347, 376, 411, 417 Filler, 225, 376 Flatulence, 259, 293, 376 Flatus, 376, 378 Fluorescence, 376, 395 Fluoxetine, 62, 96, 102, 376 Focus Groups, 8, 13, 60, 377 Folate, 120, 163, 377 Fold, 260, 377, 395 Folic Acid, 377 Food Deprivation, 7, 223, 377 Food Exchange, 325, 377 Food Habits, 327, 377 Food Preferences, 299, 377 Foot Care, 285, 377 Forearm, 356, 377 Forskolin, 253, 377 Frail Elderly, 123, 377 Free Radicals, 351, 370, 377 Friction, 203, 377 Fructose, 225, 377 Fundus, 209, 377, 401 Fungi, 377, 395, 424 G Gait, 8, 377 Gallate, 233, 378 Gallbladder, 97, 98, 212, 256, 345, 355, 361, 369, 377, 378 Gallstones, 97, 98, 170, 248, 256, 330, 355, 378

Gamma Rays, 378, 412 Ganciclovir, 122, 378 Ganglia, 345, 351, 378, 385, 398, 404, 422 Gas, 216, 249, 293, 348, 358, 376, 378, 384, 399, 411, 428, 429 Gasoline, 355, 378 Gastrectomy, 9, 367, 378 Gastric Balloon, 98, 260, 378 Gastric banding, 117, 128, 135, 144, 248, 378 Gastric Bypass, 9, 10, 37, 58, 74, 83, 93, 99, 103, 111, 125, 126, 135, 248, 275, 285, 298, 378 Gastric Emptying, 167, 378 Gastric Juices, 378, 403 Gastric Mucosa, 378, 403 Gastrin, 362, 378, 383, 403 Gastroenteritis, 378, 416 Gastroesophageal Reflux, 170, 262, 263, 287, 378 Gastrointestinal tract, 245, 376, 379, 417, 421 Gastroplasty, 66, 74, 94, 98, 247, 248, 379 Gelatin, 253, 366, 379, 380, 422 Gels, 215, 379 Gene Expression, 9, 52, 59, 109, 141, 379 Gene Therapy, 34, 379 Generator, 209, 379 Genetics, 191, 283, 284, 379 Genital, 221, 362, 379, 389 Genotype, 35, 69, 70, 379 Germ Cells, 379, 401, 423 Gestation, 379, 404, 406 Gestational, 129, 294, 379 Ginger, 212, 219, 379 Gland, 346, 366, 379, 392, 402, 405, 410, 417, 421, 422, 424 Glomerular, 380, 390, 413 Glossitis, 82, 380 Glucagonoma, 82, 380 Glucocorticoid, 9, 220, 368, 380 Glucose Intolerance, 368, 380 Glucose tolerance, 18, 35, 76, 90, 294, 295, 380 Glucose Tolerance Test, 18, 35, 294, 380 Glycerol, 99, 207, 380, 391, 405 Glycerophospholipids, 380, 405 Glycine, 252, 348, 355, 380, 399, 417 Glycoprotein, 259, 376, 380, 388, 418, 424, 427 Glycosidic, 360, 380, 400 Glycosylation, 259, 380

438 Weight Loss

Glycosyltransferases, 259, 380 Goats, 367, 381 Gonadal, 381, 421 Gonads, 381, 385 Gout, 72, 170, 381 Governing Board, 381, 408 Government Agencies, 330, 381, 408 Grade, 256, 280, 381 Graft, 203, 381, 384 Grafting, 381, 386 Gram-negative, 251, 373, 381, 416 Gram-Negative Bacteria, 251, 373, 381 Gram-positive, 381, 397 Granulocyte, 238, 381 Guanylate Cyclase, 381, 399 Gynecologic cancer, 28, 381 H Habitat, 381, 397 Haematemesis, 371, 381 Haemoptysis, 68, 381 Hallucinogens, 381, 411 Haploid, 381, 406 Haptens, 347, 381, 412 Headache, 357, 382, 387, 418 Health Behavior, 47, 120, 382 Health Care Costs, 26, 230, 382 Health Education, 32, 138, 186, 285, 327, 382 Health Expenditures, 382 Health Promotion, 30, 184, 210, 269, 382 Health Status, 60, 382 Health Surveys, 60, 382 Heart attack, 40, 206, 212, 294, 358, 382 Heart failure, 57, 127, 349, 373, 382, 411 Heartburn, 287, 382 Hematocrit, 356, 374, 382 Hematuria, 68, 382 Hemodialysis, 149, 368, 382, 390 Hemodynamics, 12, 382 Hemoglobin, 19, 56, 183, 286, 349, 356, 374, 382, 383, 390 Hemoglobinopathies, 379, 383 Hemorrhage, 367, 371, 382, 383, 421, 429 Hemostasis, 31, 383, 417 Hepatic, 9, 10, 29, 69, 101, 162, 164, 263, 380, 383 Hepatitis, 280, 287, 290, 383 Hepatocyte, 9, 383 Heredity, 285, 291, 328, 379, 383 Heterogeneity, 347, 383 Heterozygotes, 35, 383 Hexosyltransferases, 380, 383

Hirsutism, 48, 383, 384 Histamine, 349, 351, 362, 367, 383 Histology, 9, 10, 383 Homeostasis, 10, 14, 29, 34, 86, 105, 140, 383, 419 Homogeneous, 35, 352, 365, 383 Homologous, 347, 379, 383, 423 Hormonal, 6, 56, 99, 183, 196, 224, 253, 270, 353, 366, 383 Hormone Replacement Therapy, 31, 72, 383 Hormone therapy, 383, 394 Hospital Mortality, 39, 384 Host, 8, 46, 234, 354, 384, 386, 415, 429 Human Engineering, 60, 384 Human growth hormone, 6, 384 Hybrid, 52, 384 Hybridization, 35, 360, 384 Hybridomas, 384, 388 Hydration, 245, 286, 384 Hydrogen, 345, 348, 354, 357, 358, 384, 391, 396, 399, 400, 402, 404, 410 Hydrolysis, 353, 360, 380, 384, 391, 405, 410 Hydrophilic, 368, 384 Hydrophobic, 210, 226, 368, 380, 384, 391 Hydroxyproline, 348, 363, 384 Hypercalcemia, 65, 384 Hypercholesterolemia, 171, 370, 384 Hyperemesis, 114, 384 Hyperglycemia, 259, 286, 295, 384 Hyperlipidemia, 29, 259, 370, 384 Hypersensitivity, 347, 384, 415 Hypertrichosis, 383, 384 Hypertriglyceridemia, 370, 385 Hypertrophic cardiomyopathy, 104, 385 Hypertrophy, 26, 130, 365, 385, 426 Hyperuricemia, 381, 385 Hypnotic, 102, 354, 385, 423 Hypoglossal Nerve, 42, 385 Hypoglycemia, 65, 202, 294, 385 Hypoglycemic, 39, 385, 425 Hypogonadism, 195, 385 Hypokinesia, 385, 403 Hypotension, 66, 351, 385, 400 Hypothalamic, 34, 52, 152, 154, 385 Hypothalamus, 352, 354, 366, 373, 385, 405, 409, 424 Hypoventilation, 42, 108, 385 Hysterectomy, 253, 385 I Ibogaine, 210, 385

Index 439

Id, 155, 168, 320, 321, 322, 323, 324, 331, 338, 340, 371, 385 Idiopathic, 89, 263, 385 Ileitis, 221, 385 Ileum, 385, 389, 430 Illusions, 100, 381, 385, 416 Immune function, 203, 231, 385 Immune response, 231, 255, 350, 354, 366, 381, 385, 386, 422, 429 Immune Sera, 385, 386 Immune system, 203, 221, 250, 291, 303, 385, 386, 393, 397, 398, 428, 430 Immunity, 386, 401, 426 Immunization, 280, 386, 408 Immunodeficiency, 109, 130, 147, 290, 327, 329, 386 Immunodeficiency syndrome, 327, 386 Immunogenic, 386, 391, 412 Immunologic, 6, 42, 145, 295, 360, 386, 412 Immunology, 46, 251, 347, 386 Immunosuppressive, 380, 386 Impairment, 22, 26, 27, 34, 316, 386, 394 Implant radiation, 386, 388, 412 Implantation, 260, 364, 386 Impotence, 210, 386, 430 In situ, 34, 52, 386 In Situ Hybridization, 34, 52, 386 In vitro, 28, 105, 203, 360, 379, 386 In vivo, 8, 24, 47, 215, 251, 360, 379, 386 Incision, 386, 389 Incompetence, 379, 386 Incontinence, 87, 215, 301, 373, 386, 401 Indicative, 270, 386, 403, 428 Indomethacin, 251, 386 Induction, 11, 20, 221, 250, 349, 351, 386, 409 Infarction, 15, 16, 60, 193, 387, 424 Infection Control, 250, 387 Infertility, 230, 387 Infiltration, 26, 387 Influenza, 46, 387 Ingestion, 213, 235, 236, 257, 258, 357, 380, 387, 406 Initiation, 203, 387 Inlay, 387, 414 Innervation, 385, 387, 404, 417, 424 Inoperable, 66, 140, 387 Inorganic, 252, 380, 387, 397 Insight, 6, 30, 387 Insomnia, 387, 418 Insulator, 387, 397

Insulin-dependent diabetes mellitus, 9, 96, 387 Insulin-like, 63, 115, 387 Interferon, 65, 231, 251, 255, 287, 388 Interferon-alpha, 388 Interleukin-1, 37, 388 Interleukin-2, 388 Interleukin-6, 56, 65, 70, 87, 388 Interleukin-8, 70, 122, 388 Intermittent, 80, 150, 171, 388, 392 Internal radiation, 388, 412 Interstitial, 356, 388, 413 Intervention Studies, 39, 388 Intestinal, 171, 184, 219, 238, 291, 359, 380, 388, 393 Intestine, 209, 355, 356, 388, 390, 411 Intoxication, 358, 388, 428, 430 Intracellular, 26, 357, 387, 388, 394, 399, 407, 409, 415, 418 Intramuscular, 388, 402 Intraocular, 377, 388 Intraocular pressure, 377, 388 Intravenous, 252, 288, 291, 388, 402 Intrinsic, 279, 347, 388, 403 Intrinsic Factor, 388, 403 Invasive, 9, 215, 247, 248, 386, 389, 393 Invertebrates, 389, 400 Involution, 123, 389 Ions, 244, 354, 357, 370, 371, 384, 389, 396 Ischemia, 37, 353, 389 Isopropyl, 222, 389 J Jejunoileal Bypass, 355, 389 Jejunum, 355, 378, 389 Joint, 149, 293, 353, 389, 401, 422 K Kb, 312, 389 Keratinocytes, 388, 389 Keto, 176, 389 Ketoacidosis, 294, 345, 389 Ketone Bodies, 29, 345, 389 Ketosis, 389 Kidney Failure, 68, 373, 389, 390 Kidney Failure, Acute, 390 Kidney Failure, Chronic, 390 Kinetic, 242, 390 L Labile, 363, 390 Lactation, 133, 301, 390, 409 Lactulose, 143, 390 Large Intestine, 369, 388, 390, 413, 419 Larynx, 220, 390, 425, 428

440 Weight Loss

Latent, 390, 408 Laxative, 219, 347, 390 Lectin, 202, 390, 394 Lens, 257, 352, 359, 390, 414, 429 Leptin, 8, 14, 34, 42, 45, 52, 58, 59, 63, 76, 78, 79, 81, 99, 105, 106, 109, 110, 113, 124, 125, 126, 131, 133, 134, 139, 148, 152, 153, 154, 190, 233, 390 Lethal, 110, 234, 390 Leucine, 57, 140, 390, 403 Leukemia, 169, 171, 194, 220, 379, 390 Leukocytes, 231, 354, 356, 360, 373, 386, 388, 390, 396, 399, 402, 427 Library Services, 338, 390 Life cycle, 355, 377, 391 Ligament, 375, 391, 410 Ligation, 391 Linkage, 259, 360, 391 Lip, 193, 391 Lipase, 93, 101, 207, 391, 401 Lipid A, 33, 35, 391, 401 Lipid Mobilization, 239, 391 Lipid Peroxidation, 391, 402 Lipodystrophy, 26, 391 Lipolysis, 18, 105, 202, 224, 238, 253, 391 Lipopolysaccharide, 35, 234, 251, 381, 391 Lipoprotein, 35, 72, 91, 104, 111, 162, 191, 283, 370, 381, 391, 392 Lipoprotein Lipase, 35, 191, 283, 391 Liposome, 252, 391 Lipoxygenase, 251, 352, 391 Liver metastases, 81, 392 Liver scan, 392, 416 Liver Transplantation, 9, 392 Lobe, 384, 392, 409 Localized, 47, 383, 384, 387, 391, 392, 397, 406, 427 Locomotion, 392, 406 Longitudinal Studies, 366, 392 Longitudinal study, 25, 392 Long-Term Care, 47, 142, 269, 316, 392 Loop, 378, 392 Low-calorie diet, 112, 113, 144, 150, 208, 268, 282, 301, 392, 429 Low-density lipoprotein, 89, 371, 391, 392 Lower Esophageal Sphincter, 379, 392 Lower-fat diet, 302, 392 Lubricants, 242, 392 Lumbar, 354, 392, 416, 424 Lumen, 247, 372, 392 Lutein Cells, 392, 409 Lymph, 360, 372, 392, 393

Lymph node, 360, 392, 393 Lymphatic, 172, 220, 372, 387, 392, 393, 406, 419, 420, 424 Lymphatic system, 220, 392, 393, 419, 420, 424 Lymphocyte, 351, 393, 394 Lymphoid, 190, 350, 393 Lymphoma, 124, 172, 189, 190, 194, 393 Lysine, 208, 219, 393 M Macrophage, 234, 238, 388, 393 Magnetic Resonance Imaging, 38, 58, 77, 393, 416 Malabsorption, 41, 172, 279, 393 Malaise, 114, 371, 393 Malformation, 97, 393 Malignancy, 95, 279, 343, 393 Malignant, 108, 220, 346, 351, 353, 393, 398, 412, 416 Malnutrition, 4, 40, 42, 128, 263, 290, 353, 357, 393 Mammary, 391, 393 Mammography, 47, 393 Maxillary, 257, 393 Maximum Tolerated Dose, 28, 393 Meat, 12, 195, 209, 369, 393, 416 Meatus, 393, 428 Mechanoreceptors, 393, 414 Medial, 218, 353, 394, 424 Median survival time, 28, 394 Mediate, 47, 52, 54, 370, 371, 394 Mediator, 37, 64, 388, 394, 417 Medical Records, 211, 394, 415 MEDLINE, 313, 394 Megestrol Acetate, 87, 195, 329, 394 Melanin, 35, 394, 405, 427 Melanoma, 394, 427 Membrane Lipids, 394, 405 Membrane Proteins, 394, 410 Memory, 350, 368, 394 Meninges, 360, 394 Menopause, 35, 253, 394, 407, 408 Menstrual Cycle, 118, 394, 408 Menstruation, 348, 394, 400 Mental Disorders, 200, 385, 394, 408, 411 Mental Health, iv, 6, 200, 312, 317, 323, 395, 408, 411 Mesenteric, 54, 395 Mesentery, 395, 404 Meta-Analysis, 24, 163, 395 Metabolic disorder, 368, 381, 395 Metabolite, 374, 395

Index 441

Metabolization, 217, 395 Methionine, 252, 395, 409, 422 Methyltransferase, 125, 252, 395 Microbe, 395, 425 Microbiology, 46, 345, 353, 395 Microorganism, 363, 395, 403, 429 Micro-organism, 395, 405 Microscopy, 47, 395 Microscopy, Confocal, 47, 395 Midaxillary line, 395, 430 Milliliter, 356, 395 Millimeter, 395, 430 Mineralization, 88, 395 Mineralocorticoids, 346, 366, 395 Minority Groups, 15, 16, 59, 396 Mitosis, 352, 396 Mitotic, 370, 396 Mobility, 32, 234, 396 Mobilization, 211, 224, 391, 396 Modeling, 38, 40, 48, 396 Modulator, 231, 255, 396 Molecular Structure, 295, 396 Monitor, 80, 217, 241, 366, 396, 400 Monoclonal, 384, 396, 412 Monocytes, 231, 388, 390, 396, 423 Mononuclear, 250, 396, 427 Monotherapy, 295, 396 Monounsaturated fat, 162, 252, 396 Morphology, 46, 359, 396 Motility, 97, 386, 396, 417 Motion Sickness, 396, 398 Motivations, 64, 117, 193, 396 Mountaineering, 124, 397 Mucocutaneous, 220, 397 Mucosa, 378, 397, 409, 421 Mucositis, 238, 397 Mucus, 355, 397, 427 Multiple sclerosis, 222, 397 Muscle Fibers, 397, 398 Muscular Dystrophies, 371, 397 Musculature, 18, 385, 397 Myalgia, 387, 397 Mycobacterium, 291, 397 Mycobacterium avium, 291, 397 Mydriatic, 369, 397, 405, 430 Myelin, 397 Myeloma, 194, 220, 397 Myocardial infarction, 15, 16, 30, 43, 60, 355, 366, 395, 397 Myocardial Ischemia, 349, 397 Myocardium, 349, 395, 397 Myopia, 397, 414

Myosin, 57, 397 Myristate, 222, 398 N Naive, 282, 398 Naloxone, 122, 398 Narcolepsy, 368, 373, 398 Nasal Mucosa, 387, 398 Natriuresis, 349, 398 Nausea, 3, 222, 235, 258, 280, 291, 303, 329, 350, 351, 370, 378, 389, 398, 427 NCI, 1, 28, 189, 190, 192, 193, 194, 196, 197, 199, 311, 362, 398 Needs Assessment, 114, 398 Neonatal, 133, 398 Neoplasia, 398 Neoplasm, 108, 398, 402, 416, 427 Neoplastic, 238, 384, 393, 398 Neoprene, 264, 361, 398 Neopterin, 6, 398 Nephropathy, 39, 294, 299, 389, 398 Nervous System, 52, 71, 211, 345, 346, 354, 355, 357, 360, 362, 368, 373, 378, 382, 393, 394, 397, 398, 399, 400, 404, 405, 417, 422, 423, 427 Neural, 27, 37, 346, 394, 398, 414 Neuralgia, 99, 398 Neurodegenerative Diseases, 221, 398 Neuroleptic, 351, 362, 399 Neurologic, 290, 350, 399 Neuromuscular, 42, 185, 345, 399 Neuromuscular Junction, 345, 399 Neuronal, 52, 258, 361, 399 Neurons, 378, 399, 422, 423 Neuropathy, 67, 101, 285, 289, 294, 399 Neuropeptide, 52, 366, 399 Neurotransmitter, 345, 346, 348, 353, 357, 370, 380, 383, 399, 400, 418, 422, 423, 427 Neutrons, 348, 399, 412 Neutrophils, 352, 381, 388, 390, 399 Nicotine, 258, 399 Nitric Oxide, 43, 45, 399 Nitrogen, 230, 249, 347, 348, 349, 390, 399 Non-small cell lung cancer, 66, 120, 140, 196, 399 Nonverbal Communication, 400, 411 Norepinephrine, 346, 370, 373, 399, 400, 405, 418 Normotensive, 44, 45, 400 Nuclear, 204, 374, 378, 400 Nuclei, 52, 348, 379, 393, 396, 399, 400, 410 Nucleic acid, 384, 386, 399, 400 Nucleic Acid Hybridization, 384, 400

442 Weight Loss

Nucleus, 252, 352, 354, 361, 367, 373, 374, 378, 385, 396, 399, 400, 410, 419 Nutritional Status, 6, 41, 269, 279, 400 O Observational study, 29, 112, 127, 400 Obsession, 250, 400 Occult, 279, 400 Octopamine, 202, 400 Oligomenorrhea, 400, 407 Oligosaccharides, 259, 400 Oliguria, 390, 401 Omega-3 fatty acid, 192, 194, 401 Omeprazole, 401, 410 On-line, 25, 62, 341, 401 Opacity, 359, 368, 401 Opiate, 373, 398, 401 Opportunistic Infections, 290, 401 Opsin, 401, 414, 415 Optic Disk, 368, 401 Oral Health, 401 Oral Hygiene, 257, 401 Organelles, 367, 396, 401 Orlistat, 96, 109, 123, 124, 126, 138, 179, 306, 401 Osteoarthritis, 32, 120, 153, 154, 172, 191, 212, 240, 256, 401 Osteolysis, 69, 401 Osteoporosis, 133, 245, 401 Outpatient, 97, 401 Ovaries, 381, 401, 407, 417, 426 Ovary, 233, 374, 381, 401, 402 Ovulation, 48, 350, 402 Ovum, 379, 391, 402, 408, 409, 430 Oxandrolone, 79, 132, 197, 198, 230, 402 Oxidation, 34, 35, 65, 73, 78, 105, 110, 162, 233, 345, 351, 352, 367, 391, 402, 424 Oxidative metabolism, 38, 346, 402 Oxidative Stress, 10, 43, 45, 402 Oxygen Consumption, 230, 348, 375, 402, 414 Oxygenation, 141, 142, 402 P Pacemaker, 209, 402 Palate, 267, 402, 421 Palliative, 140, 402, 423 Palsies, 101, 402 Palsy, 108, 402 Pancreas, 26, 106, 289, 291, 345, 347, 369, 387, 391, 402 Pancreatic, 82, 359, 379, 380, 402 Pancreatic Juice, 379, 402 Pancytopenia, 95, 402

Papilloma, 221, 402 Parenteral, 67, 279, 291, 373, 402, 403 Parenteral Nutrition, 279, 291, 403 Parkinsonism, 108, 351, 403 Paroxysmal, 349, 403 Partial remission, 403, 413 Parturition, 403, 409 Patch, 223, 403, 426 Pathogen, 250, 403 Pathogenesis, 5, 37, 47, 403 Pathologic, 34, 124, 345, 352, 355, 365, 384, 403, 410 Pathologic Processes, 352, 403 Pathophysiology, 14, 21, 29, 43, 45, 48, 295, 403 Patient Compliance, 208, 222, 403 Patient Education, 60, 71, 103, 280, 286, 287, 325, 336, 338, 343, 403 Pelvic, 87, 403, 410 Pelvis, 345, 392, 401, 403, 427, 428 Pentagastrin, 263, 403 Pentosyltransferases, 380, 403 Pepsin, 362, 403 Pepsin A, 362, 403 Peptic, 125, 172, 403 Peptic Ulcer, 125, 172, 403 Peptide, 34, 55, 348, 390, 403, 409, 410 Perception, 7, 75, 381, 403, 416 Performance status, 140, 404 Perinatal, 301, 404 Peripheral Nervous System, 399, 402, 404, 422 Peripheral Vascular Disease, 172, 294, 404 Peritoneal, 28, 404 Peritoneum, 395, 404 Peroneal Nerve, 108, 404, 417 Petrolatum, 372, 404 PH, 66, 72, 89, 103, 356, 404 Phagocytosis, 47, 404 Pharmaceutical Preparations, 226, 360, 379, 404, 409 Pharmacologic, 12, 36, 45, 61, 208, 286, 349, 354, 404, 425 Pharmacotherapy, 72, 82, 102, 106, 124, 128, 132, 141, 248, 282, 299, 404 Pharynx, 379, 387, 404, 428 Phenolphthalein, 372, 404 Phentermine, 114, 179, 208, 405 Phenyl, 244, 405 Phenylalanine, 353, 403, 405, 427 Phenylephrine, 405, 423

Index 443

Phenylpropanolamine, 125, 179, 213, 320, 405 Phospholipases, 405, 418 Phospholipids, 252, 375, 391, 394, 405 Phosphorus, 357, 405 Phosphorylation, 82, 149, 405 Photocoagulation, 362, 405 Physical Examination, 279, 405 Physical Fitness, 270, 284, 405, 420 Physical Therapy, 228, 405 Physiologic, 10, 14, 29, 34, 218, 221, 347, 352, 385, 394, 405, 409, 413, 418, 426 Pigmentation, 220, 405 Pigments, 216, 359, 405, 414 Pilot study, 13, 17, 60, 63, 72, 96, 127, 302, 405 Pituitary Gland, 366, 377, 405, 409 Placenta, 374, 405, 408, 411 Plants, 210, 347, 353, 358, 362, 380, 390, 396, 400, 405, 406, 407, 416, 425, 426 Plaque, 349, 406 Plasma, 28, 36, 58, 59, 63, 70, 75, 76, 93, 99, 105, 116, 125, 126, 136, 144, 147, 162, 293, 294, 350, 355, 360, 361, 372, 376, 379, 380, 383, 389, 396, 397, 406, 413, 414, 417, 429 Plasma cells, 350, 397, 406 Plasmin, 406, 424, 428 Plasminogen, 136, 406, 424, 428 Plasminogen Activators, 406 Plasticity, 149, 406 Platelet Activation, 406, 418 Platelet Aggregation, 349, 377, 399, 406, 424 Platelets, 355, 399, 400, 402, 406, 417, 424 Pleated, 205, 236, 406 Plexus, 406, 417 Pneumonia, 291, 365, 406 Poisoning, 357, 378, 388, 398, 406, 416 Policy Making, 381, 406 Polycystic, 48, 121, 132, 406, 407 Polycystic Ovary Syndrome, 121, 132, 407 Polydipsia, 289, 407 Polyethylene, 222, 260, 261, 407, 422 Polyethylene Glycols, 407, 422 Polyglycolic Acid, 243, 407 Polymers, 226, 227, 232, 260, 261, 407, 410, 421 Polymorphism, 35, 45, 70, 407 Polyphagia, 289, 407 Polysaccharide, 351, 360, 407 Polyunsaturated fat, 166, 407

Polyuria, 289, 407 Posterior, 348, 354, 395, 402, 407 Postmenopausal, 18, 30, 31, 35, 67, 92, 110, 119, 131, 133, 134, 401, 407 Postnatal, 81, 407 Postoperative, 44, 46, 58, 407 Postprandial, 57, 89, 122, 226, 295, 298, 407 Postsynaptic, 407, 418, 423 Potassium, 113, 226, 232, 233, 347, 396, 407 Potentiates, 388, 407 Potentiation, 407, 418 Practicability, 408, 426 Practice Guidelines, 32, 316, 408 Precancerous, 220, 408 Precipitation, 244, 408 Precursor, 224, 249, 345, 349, 352, 370, 371, 372, 373, 398, 400, 405, 406, 408, 409, 427 Predisposition, 30, 36, 50, 284, 294, 408 Pregnancy Complications, 240, 408 Premalignant, 220, 408 Premenopausal, 58, 92, 118, 161, 164, 181, 408 Prenatal, 301, 371, 408 Preoperative, 44, 46, 94, 112, 143, 408 Pressoreceptors, 354, 408 Primary Prevention, 50, 408 Private Sector, 315, 408 Probe, 42, 57, 408 Progesterone, 408, 409, 421 Program Development, 117, 408 Progression, 5, 29, 32, 37, 291, 349, 409 Progressive, 39, 41, 42, 51, 58, 150, 353, 360, 361, 362, 368, 381, 389, 390, 397, 398, 401, 406, 409, 411, 413, 427 Prolactin, 87, 409 Promoter, 242, 258, 409 Prone, 293, 409 Pro-Opiomelanocortin, 34, 372, 409 Prophylaxis, 285, 409 Proportional, 20, 26, 57, 72, 409 Propylene Glycol, 222, 409 Prospective study, 10, 16, 66, 115, 127, 153, 155, 392, 409 Prostaglandin, 251, 349, 409 Prostaglandins A, 386, 409 Prostate, 47, 173, 220, 233, 256, 410 Prosthesis, 260, 410 Protease, 363, 410, 424 Protein C, 240, 348, 352, 354, 391, 410, 427 Protein S, 58, 195, 230, 239, 277, 355, 384, 410 Proteinuria, 299, 410

444 Weight Loss

Proteolytic, 65, 237, 363, 376, 406, 410, 424, 428 Protocol, 9, 20, 61, 190, 197, 410 Proton Pump, 287, 401, 410 Proton Pump Inhibitors, 287, 410 Protons, 348, 384, 410, 412 Protozoa, 395, 410 Proximal, 251, 260, 370, 378, 389, 410 Pruritic, 371, 410 Pruritus, 124, 410 Psoriasis, 220, 410 Psychiatric, 22, 62, 63, 394, 410 Psychiatry, 5, 11, 12, 22, 32, 43, 46, 50, 52, 56, 57, 61, 63, 76, 79, 96, 117, 125, 141, 410, 411 Psychic, 394, 411 Psychoactive, 385, 411, 423, 430 Psychopathology, 22, 61, 411 Psychotherapy, 22, 23, 61, 411, 413 Psychotropic, 117, 411 Psychotropic Drugs, 117, 411 Psyllium, 179, 411 Puberty, 48, 411 Public Policy, 313, 411 Puerperium, 94, 411 Pulmonary, 42, 119, 148, 162, 221, 248, 356, 365, 375, 385, 390, 411, 422, 429 Pulmonary Alveoli, 385, 411 Pulmonary Artery, 356, 411, 429 Pulmonary Edema, 390, 411 Pulmonary Fibrosis, 221, 411 Pulmonary hypertension, 248, 365, 411 Pulse, 73, 221, 229, 396, 411 Purgative, 390, 411 Pylorus, 247, 370, 411 Q Quackery, 278, 411 Quaternary, 244, 412 R Race, 18, 24, 26, 29, 58, 125, 161, 412 Radiation, 126, 128, 153, 154, 173, 189, 193, 261, 349, 375, 376, 377, 378, 388, 412, 416, 427, 430 Radiation therapy, 126, 193, 375, 388, 412 Radioactive, 356, 384, 386, 388, 392, 400, 412, 416 Radioimmunoassay, 14, 52, 355, 412 Radioisotope, 412, 425 Radiolabeled, 47, 412 Radiopharmaceutical, 379, 412 Radiotherapy, 356, 412 Random Allocation, 412

Randomization, 7, 15, 16, 44, 60, 412 Randomized clinical trial, 46, 412 Reassurance, 292, 413 Recombinant, 6, 124, 129, 139, 231, 255, 413 Recombination, 379, 413 Reconstitution, 245, 413 Rectal, 292, 413, 422 Rectum, 351, 356, 363, 369, 376, 378, 386, 390, 410, 413 Recurrence, 63, 75, 413 Refer, 1, 262, 357, 363, 372, 377, 392, 398, 399, 413, 425 Reflex, 42, 118, 413, 414 Reflux, 98, 230, 287, 378, 413 Refractory, 18, 371, 413 Regeneration, 413 Regimen, 17, 18, 40, 52, 184, 210, 217, 218, 228, 237, 282, 286, 371, 403, 404, 413 Regurgitation, 379, 382, 413 Relapse, 63, 187, 268, 413 Relaxant, 245, 377, 413 Remission, 71, 413 Renal failure, 263, 289, 413 Renal pelvis, 413, 426 Renal Veins, 252, 413 Renin, 45, 349, 413, 414 Renin-Angiotensin System, 349, 414 Resolving, 24, 414 Respiration, 95, 118, 163, 208, 352, 358, 396, 414 Respiratory distress syndrome, 233, 234, 414 Respiratory Mechanics, 142, 414 Resting metabolic rate, 35, 53, 70, 106, 166, 414 Restoration, 27, 42, 221, 238, 405, 413, 414, 430 Retina, 364, 367, 368, 390, 397, 414, 415, 429 Retinal, 220, 367, 368, 401, 414, 415 Retinal Detachment, 220, 368, 414 Retinitis, 367, 414, 415 Retinoid, 220, 415 Retinol, 414, 415 Retinopathy, 39, 294, 368, 415 Retrograde, 389, 415 Retrospective, 4, 415 Retrospective study, 4, 415 Retroviral vector, 379, 415 Retrovirus, 289, 415 Rheumatism, 109, 415

Index 445

Rheumatoid, 109, 173, 415 Rheumatoid arthritis, 109, 415 Rhinitis, 373, 415 Rhodopsin, 401, 414, 415 Ribose, 346, 415 Rickettsiae, 415 Rigidity, 403, 406, 415 Rod, 354, 362, 373, 415, 416 Rubber, 203, 345, 361, 398, 415 S Salicylic, 261, 415 Saliva, 415, 416 Salivary, 367, 369, 415, 416 Salivary glands, 367, 369, 415, 416 Salivation, 210, 416 Salmonella, 209, 290, 378, 416 Sanitation, 264, 416 Saponins, 416, 421 Sarcoma, 220, 416 Satiation, 207, 229, 260, 416 Saturated fat, 19, 302, 416 Scans, 18, 35, 416 Scatter, 214, 416, 427 Schizoid, 416, 430 Schizophrenia, 125, 141, 416, 430 Schizotypal Personality Disorder, 416, 430 Sciatic Nerve, 73, 404, 416, 424 Sclerosis, 37, 352, 353, 397, 417 Screening, 13, 28, 44, 47, 239, 278, 289, 362, 417 Sedentary, 27, 30, 53, 58, 86, 88, 93, 191, 206, 294, 414, 417 Self Care, 345, 417 Self-Help Groups, 417, 419 Semen, 410, 417 Semisynthetic, 374, 417 Senile, 4, 401, 417 Sensor, 221, 417 Sepsis, 233, 234, 251, 417 Septic, 233, 234, 417 Sequential treatment, 62, 417 Serine, 417, 424 Serotonin, 179, 345, 351, 362, 367, 376, 391, 399, 404, 417, 418 Serous, 372, 417 Serum Albumin, 412, 417 Sex Characteristics, 346, 349, 411, 417, 423 Shedding, 184, 327, 418 Shivering, 418, 424 Shock, 233, 234, 373, 418, 426 Sialyltransferases, 380, 418

Sibutramine, 11, 86, 92, 109, 112, 113, 115, 116, 135, 180, 306, 418 Signal Transduction, 110, 418 Signs and Symptoms, 288, 413, 418 Silicic, 248, 418 Silicon, 232, 418 Silicon Dioxide, 418 Skeletal, 18, 33, 38, 57, 58, 105, 136, 141, 183, 252, 283, 349, 362, 397, 418 Skeleton, 345, 376, 389, 409, 418, 419 Skull, 419, 423 Sleep apnea, 42, 57, 118, 121, 212, 230, 240, 248, 256, 419 Small cell lung cancer, 419 Small intestine, 285, 355, 361, 370, 383, 385, 388, 389, 419 Smoking Cessation, 94, 120, 419 Smooth muscle, 347, 349, 353, 357, 377, 383, 414, 419, 422 Sneezing, 418, 419 Social Environment, 17, 412, 419 Social pressure, 327, 419 Social Support, 25, 52, 54, 72, 186, 283, 419 Social Work, 290, 419 Sodium, 44, 45, 58, 69, 136, 165, 226, 253, 292, 347, 381, 396, 398, 419, 422 Soft tissue, 69, 356, 418, 419 Solid tumor, 189, 190, 197, 198, 419 Solitary Nucleus, 354, 419 Solvent, 24, 204, 224, 254, 345, 355, 361, 380, 409, 419 Somatic, 346, 360, 396, 404, 419, 420, 428 Somatic cells, 360, 396, 420 Soybean Oil, 407, 420 Specialist, 332, 369, 420 Specificity, 347, 352, 420 Spectrum, 366, 420 Sphincter, 390, 420 Spinal cord, 360, 361, 373, 394, 398, 399, 404, 413, 416, 420, 422 Spleen, 114, 367, 393, 420 Sporadic, 398, 420 Sports Medicine, 68, 91, 107, 165, 167, 228, 336, 420 Sputum, 381, 420 Squamous, 399, 420 Squamous cell carcinoma, 399, 420 Stabilization, 3, 88, 223, 254, 420 Stabilizer, 243, 420 Staging, 416, 420 Standard therapy, 63, 420 Statistically significant, 6, 421

446 Weight Loss

Steatosis, 376, 421 Steel, 217, 362, 421, 427, 428 Stent, 247, 421 Sterility, 118, 387, 421 Steroid, 114, 220, 252, 290, 355, 366, 416, 421 Steroid therapy, 114, 421 Stillbirth, 294, 421 Stimulant, 245, 357, 367, 368, 383, 405, 421 Stimulus, 11, 35, 365, 371, 375, 387, 388, 413, 421, 424 Stomatitis, 82, 380, 421 Stool, 292, 363, 386, 390, 421 Stress, 17, 43, 45, 97, 107, 152, 154, 183, 245, 268, 271, 292, 342, 354, 359, 366, 378, 398, 402, 408, 415, 421 Stroke, 15, 16, 43, 45, 60, 111, 173, 200, 212, 218, 221, 230, 246, 294, 312, 321, 358, 421 Styptic, 421, 430 Styrene, 415, 421 Subacute, 387, 421 Subclinical, 12, 387, 421 Subcutaneous, 26, 54, 74, 77, 105, 136, 303, 346, 371, 391, 402, 421, 429, 430 Sublingual, 234, 421 Subspecies, 420, 421 Substance P, 395, 413, 417, 422 Substrate, 13, 78, 162, 217, 373, 422, 427 Sulfur, 395, 422 Sunburn, 422, 427 Supplementation, 44, 58, 161, 163, 164, 166, 208, 279, 422 Support group, 222, 288, 422 Suppository, 234, 407, 422 Suppression, 10, 18, 119, 137, 164, 207, 208, 211, 226, 232, 250, 366, 422 Surfactant, 203, 244, 245, 422 Survival Rate, 28, 422 Sweat, 95, 264, 368, 422 Sweat Glands, 368, 422 Sympathetic Nervous System, 53, 349, 354, 422 Sympathomimetic, 213, 306, 368, 370, 374, 400, 405, 422, 427 Symphysis, 361, 410, 422 Symptomatic, 32, 234, 350, 422 Symptomatology, 76, 422 Synapse, 346, 399, 423, 426 Synaptic, 399, 418, 423 Synaptic Transmission, 399, 423 Syncope, 99, 423 Synephrine, 219, 423

Synergistic, 37, 409, 423 Systolic, 94, 109, 384, 423 T Tachycardia, 354, 423 Tachypnea, 354, 423 Temporal, 269, 393, 423 Testis, 374, 381, 423 Testosterone, 48, 130, 195, 196, 307, 308, 329, 423 Tetrahydrocannabinol, 222, 223, 234, 235, 370, 423 Thalidomide, 121, 194, 195, 329, 423 Therapeutics, 54, 66, 121, 148, 245, 307, 423 Thermal, 203, 204, 225, 230, 232, 243, 245, 370, 399, 423 Thermogenesis, 202, 213, 226, 233, 423 Thermoregulation, 182, 208, 424 Thigh, 18, 376, 424 Third Ventricle, 352, 385, 424 Thoracic, 95, 118, 152, 153, 163, 354, 369, 424, 430 Thorax, 118, 345, 392, 424, 428 Threshold, 218, 258, 348, 384, 424 Thrombin, 376, 406, 410, 424 Thrombolytic, 406, 424 Thrombomodulin, 410, 424 Thromboses, 142, 424 Thrombosis, 355, 410, 421, 424 Thrombus, 366, 387, 397, 406, 424, 429 Thrush, 141, 290, 424 Thymus, 386, 393, 424 Thyroid, 6, 138, 140, 141, 174, 180, 253, 299, 358, 424, 427 Tibial Nerve, 417, 424 Ticlopidine, 82, 424 Tissue Plasminogen Activator, 220, 424 Tolazamide, 68, 425 Tolerance, 244, 345, 380, 385, 425 Tomography, 364, 416, 425 Tone, 43, 147, 374, 400, 401, 425 Tonus, 425 Tooth Preparation, 345, 425 Topical, 220, 222, 353, 404, 425 Torsion, 387, 425 Toxic, iv, 29, 75, 355, 358, 361, 386, 399, 421, 425 Toxicity, 18, 28, 167, 220, 238, 253, 370, 393, 425 Toxicology, 70, 165, 314, 425 Toxin, 358, 373, 425 Toxoplasmosis, 291, 425

Index 447

Trace element, 356, 361, 418, 425 Tracer, 57, 425 Trachea, 390, 404, 424, 425 Traction, 362, 425 Tranquilizing Agents, 411, 425 Transcriptase, 415, 425 Transcutaneous, 222, 425 Transdermal, 222, 223, 234, 308, 425 Transduction, 418, 426 Transfection, 355, 379, 426 Transfer Factor, 386, 426 Transferases, 380, 426 Transitional cell carcinoma, 263, 426 Translation, 348, 426 Transmitter, 345, 370, 394, 400, 426, 427 Transplantation, 72, 361, 386, 390, 426 Trauma, 37, 382, 426 Treatment Outcome, 73, 426 Trees, 415, 426 Tremor, 403, 426 Triad, 140, 426 Tricuspid Atresia, 365, 426 Triglyceride, 9, 26, 33, 63, 90, 162, 207, 233, 385, 391, 426 Troglitazone, 295, 426 Tubal ligation, 253, 426 Tumor Necrosis Factor, 8, 70, 122, 423, 427 Tumour, 81, 134, 144, 238, 427 Tungsten, 226, 359, 427 Tyramine, 400, 427 Tyrosine, 152, 154, 180, 208, 370, 427 U Ulcer, 403, 427, 428 Ulcerative colitis, 292, 427 Ultraviolet radiation, 260, 261, 422, 427 Unconscious, 385, 427 Urea, 139, 390, 422, 427 Uremia, 390, 413, 427 Ureter, 413, 426, 427 Urethra, 410, 427, 428 Uric, 381, 385, 427 Urinary, 121, 143, 230, 301, 358, 373, 386, 401, 407, 424, 427, 428 Urinary Plasminogen Activator, 424, 428 Urinary tract, 121, 428 Urine, 221, 351, 356, 366, 368, 370, 374, 382, 386, 389, 390, 398, 401, 407, 410, 413, 427, 428 Uterus, 220, 233, 360, 372, 377, 381, 385, 394, 401, 408, 426, 428 V Vaccine, 410, 428

Vacuoles, 372, 401, 428 Vagina, 360, 369, 381, 394, 428 Vaginal, 422, 428 Vagotomy, 98, 428 Vagus Nerve, 229, 419, 428 Vanadium, 215, 253, 259, 428 Varicose, 174, 213, 428 Varicose vein, 213, 428 Vascular Resistance, 354, 428 Vasodilation, 43, 349, 428 Vasodilators, 399, 428 Vasomotor, 43, 428 VE, 70, 122, 191, 276, 428 Vein, 349, 353, 388, 400, 428, 429 Vena, 413, 428 Venous, 57, 230, 353, 355, 356, 410, 424, 426, 429 Venous blood, 356, 429 Venous Thrombosis, 355, 424, 429 Ventral, 352, 385, 429 Ventricle, 352, 353, 365, 411, 423, 424, 426, 429 Ventricular, 12, 94, 109, 130, 298, 365, 426, 429 Venules, 356, 358, 372, 429 Vertebral, 97, 429 Vertical banded gastroplasty, 89, 104, 112, 144, 153, 155, 429 Very low-calorie diet, 143, 429 Veterinary Medicine, 313, 429 Viral, 47, 231, 250, 287, 387, 398, 415, 426, 429, 430 Viral Load, 47, 429 Virulence, 425, 429 Virus, 46, 109, 130, 147, 221, 290, 327, 329, 354, 388, 406, 415, 426, 429 Visceral, 18, 19, 27, 31, 35, 54, 95, 106, 110, 130, 131, 145, 174, 354, 404, 428, 429 Visceral Afferents, 354, 428, 429 Visceral fat, 18, 19, 27, 31, 35, 106, 130, 131, 145, 429 Viscosity, 242, 245, 248, 260, 429 Vitreous, 368, 390, 414, 429 Vitreous Hemorrhage, 368, 429 Vitreous Humor, 414, 429 Vitro, 202, 429 Vivo, 9, 430 Volition, 389, 430 W Waist circumference, 303, 430 Warts, 221, 430 Wettability, 248, 430

448 Weight Loss

White blood cell, 238, 350, 381, 390, 393, 397, 406, 430 Windpipe, 404, 424, 430 Withdrawal, 209, 430 Womb, 428, 430 Wound Healing, 58, 128, 221, 251, 295, 430 X Xenograft, 349, 430

X-ray, 52, 74, 356, 359, 364, 376, 378, 400, 412, 416, 420, 430 Y Yohimbine, 202, 210, 430 Z Zinc Acetate, 249, 430 Zymogen, 410, 430

Index 449

450 Weight Loss

Index 451

452 Weight Loss