The influence of parity order and body condition and serum hormones on weaning-to-estrus interval of sows.

This study was performed to investigate the weaning-to-estrus interval (WEI) in primiparous and multiparous sows in relation to their weight and back-fat thickness changes and serum hormone imbalance (insulin, growth hormone, and cortisol) at the end of gestation and during lactation. Ten primiparous and ten multiparous Camborough sows, fourth to seventh parity, were used in this experiment. During gestation, daily food intake was 2.4 kg (sow commercial diet: 2.96 Mcal/kg, 16% crude protein) and during lactation all sows were fed on a wet commercial diet (3.34 Mcal/kg, 17% crude protein) ad libitum, three times per day. Blood samples were collected and back-fat thickness at the P(2) site were recorded at 6 days before and 2, 7, 14, 21 and 25 days after farrowing. Body weight was recorded on the same dates, except the date before farrowing. The WEI was also recorded. The average daily feed intake was different (P<0.05) between primiparous and multiparous sows during lactation (5.23 versus 5.72kg per day, respectively). There was a difference (P<0.05) between primiparous and multiparous sows in total percentage of back-fat thickness loss from the end of gestation until weaning (-20.18 and -9.03%, respectively). The total percentage of weight loss during lactation was slightly greater (P>0.05) in multiparous than primiparous sows. Weaning-to-estrus interval was greater (P<0.05) in the primiparous group when compared with the multiparous group (5.55 and 4.22 days, respectively). No differences were found in insulin, growth hormone (GH), and cortisol concentrations between parity groups, except on the 21st day of lactation, when GH was greater in primiparous sows. There was no correlation between percentage of total weight loss and WEI, or percentage of back-fat thickness loss (total or by periods) and WEI. There were positive correlations between GH serum concentration on the 14th and 21st days and the percentage of weight loss in the third week of lactation (r=0.46, P<0.04 and r=0.52, P<0.02, respectively), and between GH concentration on the 21st and on weaning days and WEI (r=0.54, P<0.02 and r=0.42, P<0.06, respectively). Our results indicate that the hormone change (imbalance) during lactation, mainly GH, seems to be a better parameter to explain the difference in WEI between primiparous and multiparous sows than change in body condition.

APOE-epsilon4 is associated with weight loss in women with AD: a population-based study.

OBJECTIVE: To investigate whether the APOE-epsilon4 allele is associated with weight loss in patients with AD or in nondemented elderly subjects. BACKGROUND: weight loss has been considered a typical feature of AD. APOE-epsilon4 is a risk factor for AD and was recently proposed to be associated with weight loss in elderly women. It is not known whether APOE-epsilon4 is associated with weight loss in patients with AD or in the general population. METHODS: Weight and BMI measurements at an average interval of 3.5 years and APOE phenotype determination were performed in an elderly population (n = 980), including 46 patients with AD and 911 control subjects at the end of the follow-up. RESULTS: On average, patients with AD with the epsilon4 allele lost 1.9 +/- 4.0 kg (BMI 0.8 +/- 1.8 kg/m2) whereas epsilon4 noncarriers gained 1.2 +/- 3.8 kg (BMI 0.4 +/- 1.5 kg/m2) (both p < 0.05), after controlling for diabetes and exercise. However, when men and women were analyzed separately, weight loss was observed only in those women with AD with the epsilon4 allele. Clinically significant weight loss, defined as loss of > or = 5% of body weight, occurred more frequently in both patients with AD (30% versus 6%; p < 0.05) and control subjects (28% versus 18%; p < 0.001) carrying the epsilon4 allele. CONCLUSIONS: The APOE-epsilon4 allele may contribute to the unexplained weight loss in AD, especially in women.

Short term energy restriction (using meal replacements) improves reproductive parameters in polycystic ovary syndrome.

Background- Polycystic ovary syndrome (PCOS) is a common endocrine condition affecting women of reproductive age. weight loss improves the reproductive and metabolic dysfunction associated with PCOS. However, it is unclear what extent of adiposity reduction is required to restore reproductive function. Objective- To assess the relative effects of energy restriction and weight loss on changes in reproductive parameters and to assess the effectiveness of meal replacements as a weight loss strategy in overweight women with PCOS. Design- Overweight women with PCOS (n = 34; age = 32.6+/- 5.1 years; weight = 96.0+/-19.5 kg; mean+/-SD) followed a weight loss intervention (two meal replacements, low fat snacks and evening meal daily) for 8 weeks. Fasting weight, waist circumference, body composition (assessed by bioelectrical impedance analysis), blood pressure (BP) and venous testosterone, sex hormone binding globulin (SHBG) and free androgen index (FAI) were assessed fortnightly. Outcomes- The intervention resulted in a reduction in weight (5.6+/-2.4 kg, 6%), waist circumference (6.1+/-2.5 cm), body fat (4.1+/-2.2 kg) and systolic BP (8.4+/-11.1 mmHg) (p< 0.001). There was no change in SHBG but a significant reduction in testosterone (0.3+/-0.7 nmol/L, p = 0.05) and FAI (3.1+/-4.6nmol/L, 16.8%)(p = 0.001). This change in FAI occurred from week 0 - 2 (2.4+/-4.2 nmol/L, p=0.002) and corresponded with a weight loss of 2.4+/-1.0 kg(2.5%) with no further changes in FAI occurring from week 2 - 8. The change in FAI from week 0 - 2 or week 0 - 8 did not correlate with the change in weight, waist circumference or fat mass. Conclusions- Reproductive parameters improved after only 2 weeks of weight loss. Therefore, these data suggest that reproductive function can be restored with either a small degree of weight loss or by acute energy restriction. The implication is that only short term energy restriction may be required to improve reproductive function. This requires further investigation.

Carbon dioxide and ethylene interactions in tulip bulbs.

The effect of CO2 on ethylene-induced gummosis (secretion of polysaccharides), weight loss and respiration in tulip bulbs (Tulipa gesneriana L.) was investigated. A pretreatment with 1-MCP prevented these ethylene-induced effects, indicating that ethylene action must have been directed via the ethylene receptor. Treatment with 0.3 Pa ethylene for 2 days caused gummosis on 50% of the total number of bulbs of cultivar Apeldoorn, known to be sensitive for gummosis. Addition of CO2 (10 kPa) reduced the ethylene-induced gummosis to 18%. In a second experiment the influence of ethylene and CO2 on respiration and FW loss of bulbs of the cultivar Leen van der Mark was studied. A range of ethylene partial pressures (0.003-0.3 Pa) was applied continuously for 29 days. Ethylene caused a transient peak in O2 consumption rate during the first days after the start of application. The relation between O2 consumption rate and ethylene partial pressure could be described by Michaelis-Menten kinetics. Respiratory peaks were reduced by CO2. This inhibition by CO2 could not totally be due to competition with ethylene at the receptor binding-site, as was indicated by the use of an O2 consumption model. Pre-treatment of bulbs with 1-MCP and subsequent exposure to CO2 showed that CO2 could influence respiration irrespective of any interaction with ethylene. Ethylene and CO2 both stimulated weight loss. The effect of combined treatments of ethylene and CO2 on weight loss was at least as strong as the sum of the separate effects, which implies that competition between ethylene and CO2 at the receptor binding-site was unlikely.

Effects of identical weight loss on body composition and features of insulin resistance in obese women with high and low liver fat content.

Our objective was to determine how 8% weight loss influences subcutaneous, intra-abdominal, and liver fat (LFAT), as well as features of insulin resistance, in obese women with high versus low LFAT. A total of 23 women with previous gestational diabetes were divided into groups of high (9.4 +/- 1.4%) and low (3.3 +/- 0.4%) LFAT based on their median LFAT (5%) measured with proton spectroscopy. Both groups were similar with respect to age, BMI, and intra-abdominal and subcutaneous fat. Before weight loss, women with high LFAT had higher fasting serum insulin and triglyceride concentrations than women with low LFAT. At baseline, LFAT correlated with the percent of fat (r = 0.44, P < 0.05) and saturated fat (r = 0.45, P < 0.05) of total caloric intake but not intra-abdominal or subcutaneous fat or fasting serum free fatty acids. weight loss was similar between the groups (high LFAT -7.4 +/- 0.2 vs. low LFAT -7.7 +/- 0.3 kg). LFAT decreased from 9.4 +/- 1.4 to 4.8 +/- 0.7% (P < 0.001) in women with high LFAT and from 3.3 +/- 0.4 to 2.0 +/- 0.2% (P < 0.001) in women with low LFAT. The absolute decrease in LFAT was significantly higher in women with high than low LFAT (-4.6 +/- 1.0 vs. -1.3 +/- 0.3%, P < 0.005). The decrease in LFAT was closely correlated with baseline LFAT (r = -0.85, P < 0.001) but not with changes in the volumes of intra-abdominal or subcutaneous fat depots, which decreased similarly in both groups. LFAT appears to be related to the amount of fat in the diet rather than the size of endogenous fat depots in obese women. Women with initially high LFAT lost more LFAT by similar weight loss than those with low LFAT, although both groups lost similar amounts of subcutaneous and intra-abdominal fat. These data suggest that LFAT is regulated by factors other than intra-abdominal and subcutaneous fat. Therefore, LFAT does not appear to simply reflect the size of endogenous fat stores.

Snoring and Sleep Apnea in Obese Adolescents: Effect of Long-term weight loss-Rehabilitation.

Objective: To test the effect of a long-term weight loss rehabilitation program in extremely obese adolescents on breathing parameters during sleep. Methods: Thirty-eight extremely obese [mean body mass index (BMI) 45.3 +/- 7.9kg/m(2)] adolescents participated during a three- to nine-month period in an inpatient weight loss rehabilitation in a specialized long-term rehabilitation center. Breathing parameters were registered via a seven-channel portable screening device. Body weight and arterial blood pressure were measured before and after the long-term treatment. Results: Mean BMI decreased from 45.3 to 35.8 (p < 0.001), mean diastolic blood pressure decreased from 89 mmHg to 81 mmHg (p = 0,002). Nine patients had a RDI of >/=5 and 30 patients a RDI of <5; the mean RDI decreased from 4.08 to 3.27 (n.s.). Within the group, the RDI was >/=5 and the mean RDI decreased from 10.3/h to 5.2/h (p = 0.02). The mean SaO2 increased from 93.65 to 95.35% (p = 0.003), lowest SaO2 increased from 72.14 to 73.19% (n.s.) and snoring frequency decreased from 37.56% of total sleep time (TST) to 32.86% of TST (n.s.). Conclusion: A long-term inpatient weight loss program has a positive effect on breathing parameters during sleep in extremely obese adolescents. However, the effect on apneic events and snoring is relatively minor compared to the effect on arterial oxygen saturation. The role of obesity in the origin of respiratory events and snoring in adolescents might be overestimated.

Abdominal tuberculosis. On-going challenge to gastroenterologists.

OBJECTIVE: The aim of this study is to record the observations and experience on the diagnosis and management of abdominal tuberculosis (TB) and to highlight the difficulties in the diagnosis and management of this condition. METHODS: Two hundred consecutive patients attending the Gastroenterology Department of the King Khalid National Guard Hospital, Jeddah, Kingdom of Saudi Arabia between May 1991 and May 2001, suspected with abdominal TB were investigated. A detailed clinical history and physical examination were obtained. Data of 75 confirmed cases of abdominal TB were analyzed. RESULTS: The most common presenting symptoms were anorexia (84%), abdominal pain (84%) and weight loss (72%). Abdominal tenderness was the most common clinical finding, followed by ascites and abdominal mass (42%). The chest radiograph suggestive of pulmonary TB was diagnosed in 24 patients (32%). Computed tomographic (CT) scanning revealed abnormalities in all 51 patients who underwent the procedure, while positive findings were observed by abdominal ultrasound in 66% of the tested patients. Histopathological examination of patients showed tuberculous granuloma, while acid fast bacilli were seen in 34%. Mycobacterium tuberculosis was identified by microbiological methods in 60% of patients. The most common presenting symptoms were anorexia (84%), abdominal pain (84%) and weight loss (72%). Abdominal tenderness was the most common clinical finding, followed by ascites and abdominal mass (42%). The chest radiograph suggestive of pulmonary TB was diagnosed in 24 patients (32%). Computed tomographic (CT) scanning revealed abnormalities in all 51 patients who underwent the procedure, while positive findings were observed by abdominal ultrasound in 66% of the tested patients. Histopathological examination of patients showed tuberculous granuloma, while acid fast bacilli were seen in 34%. Mycobacterium tuberculosis was identified by microbiological methods in 60% of patients. CONCLUSION: A high index of clinical suspicion is required to make an early diagnosis of abdominal TB. Suspicion should be aroused, particularly in patients having a combination of anorexia, abdominal pain, weight loss and ascites. Diagnosis requires the utilization of a combination of various diagnostic procedures especially abdominal ultrasound, CT scan and endoscopy, which provides a high diagnostic yield in this disease. A normal chest radiograph does not exclude the presence of abdominal TB. A timely use of laparoscopy are often required to prevent surgical intervention.

The effect of participation in a weight loss programme on short-term health resource utilization.

Obese people consume significantly greater amounts of health resources. This study set out to determine if health resource utilization by obese people decreases after losing weight in a comprehensive medically supervised weight management programme. Four hundred and fifty-six patients enrolled in a single-centred, multifaceted weight loss programme in a universal health care system were studied. Patient information was anonymously linked with administrative databases to measure health resource utilization for 1 year before and after the programme. Mean body mass index (BMI) decreased by more than 15%. The mean annual physician visits (pre = 9.6, post = 9.4) did not change significantly after the programme. However, patients saw a significantly fewer number of different physicians per year following the programme (pre = 4.5, post = 3.9; P < 0.001). Mean annual number of emergency visits (pre = 0.2; post = 0.2) and hospital admissions (pre = 0.05; post = 0.08) did not change. Neither baseline BMI, nor its change during the programme, influenced changes in health resource utilization. Our study suggests that weight loss in a supervised weight management programme does not necessarily decrease short-term health resource utilization. Further study is required to determine if patients who maintain their weight loss experience a decrease in health utilization.