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Di- saster plans are developed and revised to guide disaster response and increase available Fig buy motrin 600mg free shipping. Planning activities include developing hazard analyses motrin 600mg generic, writing mutual aid op- erational plans cheap motrin 400mg otc, training response personnel and improving public information and com- munications systems. Actions taken during the build-up of a crisis situation are designed to increase an organisation’s ability to respond effectively. Increased readiness actions include brie¿ng government of- ¿cials, reviewing plans, preparing information for release to the public, updating resource lists and testing warning and communications systems. The incidents’ resource requirements continually change to meet the needs of the incident. Recovery is both short-term activity, intended to return vital life-support systems to operation, and long-term activity, designed to return infrastructure systems to predisaster conditions. Speci¿c hazard mitigation plans are prepared following a federally declared disaster. They reÀect the current risk analysis and mitigation priorities speci¿c to the de- clared disaster. Written plans may vary widely in scope, detail, structure, purpose and elaborateness. In every case, the disaster plan is the product of the planning process, thereby becoming the principal connection between the disaster planning activity and the disaster response. The focus is upon writing down a description and analysis of needs that arise and actions that can be undertaken and resources that should be assembled to support the actions. Put another way, the planning process anticipates demands and devises strategies and tactics, linked with resources, for meeting them. Thus, plans address all aspects of the response, including personnel, equipment, contingency is- sues, policy issues and interorganisational and intergovernmental relations. Once a plan is created, its implementation revolves around the logistics and protocol needed to execute the speci¿ed series of tasks. These include both training and education of personnel regarding the threats, the response processes and procedures and the use of the equipment called for under the plan. Training is the activity that translates information de¿ned as needed by the plan into a coherent programme that can be imparted to responders. Then, simulations represent the constructed opportunities to test the protocols and equipment speci¿ed under a plan and taught in the training phase. Moreover they provide the “experience” needed to reduce errors and that cannot be gained in a real situation due to ethical and practical aspects, as the disaster involves a multitude of victims. The main feature of a simulation is that it is used to reproduce reality in a simpli¿ed way, so that learners can better understand why things happen and how. Participatory simulations are learning games in which players play an active role in the simulation of a system or process. Ingrassia ated by a set of underlying rules that enable enquiry and experimentation [23]. Learners actively participate, analyse information, make decisions and see the outcome of their actions. Advantages in training over real operational systems include: elimination of catastrophic consequences of error; reduction of physical danger; cost containment; elimination of nonsalient attributes; “replay” possibilities; com- pression or expansion of time; and iterative manipulation of variables for evolving design and data collection [25]. The use of simulations in medical education, in general, and in disaster medicine educa- tion, in particular, is well documented [26–30]. When considering simulations, we distin- guish two different kinds: virtual and live. In the former, real people use simulated equip- ment in a simulated world (or virtual environment); in the latter, real people use simulated (or dummy) equipment in the real world. Interactive simulation systems ¿t the requirement of allowing social in- teraction, which is the key element in those scenarios where users are expected to cooper- ate in order to solve a particular problem, such as in response to disasters. Live simulations are major enterprises that demand many resources, a full staff of evaluators and control- lers, a complement of actors (victims and other event-impacted personnel) and realistic simulations of the physical damage and other consequences of the event. Participants at all levels must literally execute their tasks under the disaster plan on the operational ¿eld in real time. Unfortunately, there is no strong evidence to support ¿rm conclusions about the effec- tiveness of speci¿c training methods. The authors conclude that different types of training exercises may have differ- ent roles to play in educating hospital staff in disaster response. Gradually, this attitude changed to an empha- sis on preparedness measures, such as stockpiling of relief goods, preparedness plans and a growing role of education and training. Disasters might no longer be considered as extreme events created entirely by natural forces but as unresolved problems of development. This disaster preparedness and planning approach is the only key to improving the ef¿ciency of relief and response actions and reducing the impact of such inevitable events. Kennedy K, Aghbabian R, Gans L et al (1996) Triage: techniques and applications in decision making. In: Metz B, Davidson O, Swart R, Pan J (eds) Climate change 2001: impacts, adaptation and vulnerability. World Health Organization (1991) Psychosocial consequences of disasters – pre- vention and management. Similarities to the 1988 earth- quake in Armenia: time to teach the public life-supporting ¿rst aid? Colella V (2000) Participatory simulations: Building collaborative understand- ing through immersive dynamic modelling. Kopf S, Scheele N et al (2005) Improving activity and motivation of students with innovative teaching and learning technologies. Ragazzoni L et al (2010) The effectiveness of train- ing with an emergency department simulator on medical student performance in a simulated disaster. Chemical releases arising from techno- logical incidents, natural disasters, and conÀict and terrorism are common [1]. The In- ternational Federation of Red Cross and Red Crescent Societies has estimated that be- tween 1998 and 2007, there were nearly 3,200 technological disasters with approximately 100,000 people killed and nearly 2 million people affected. Unfortunately, the threat of ma- jor events involving chemicals is predicted to increase worldwide for three main reasons. First, the chemical industry is rapidly growing, and the number of chemicals available in the market is increasing [2]. Second, chemical incidents may have an impact beyond their original location, in some cases crossing national borders. Third, there is concern regard- ing the deliberate use of chemicals for terrorist purposes [3]. Thus, emergency involving exposure to chemicals could represent one of the most common di- sasters that occur in the community setting. To minimise these negative impacts, and be- cause chemical incidents often involve acute releases and health risks with a very dynamic time course (as a result of changing conditions, e. It might be taken into consideration that a single patient exposed to a hazardous material may overwhelm even a modern, high-volume facility [4]. Preparation begins with a thorough understanding of the threat and with the develop- ment of simple and ef¿cient countermeasures. When a chemical incident occurs, rapid and effective response is dependent on detailed prevention planning, appropriate medical treatment and subsequent postevent analysis to improve the quality of future response operations. Therefore, the term chemical incident might refer to events caused by humans, such as the explosion of a factory that stores or uses chemicals, contamination of food or water supply with a chemical, an oil spill, a leak in a storage unit during transportation or an outbreak of disease that is (likely to be) associated with chemical exposure. There is increasing awareness that natural disas- ters can trigger technological disasters and that these conjoint events may pose tremendous threats to regions, particularly those unprepared for such events. In fact, natural causes, such as volcanoes, earthquakes and forest ¿res, can cause chemical incidents. Natural disasters may disrupt chemical containment systems and cause secondary anthropogenic chemical incidents (e. The term natech disasters (natural- disaster-triggered technological disasters) refer to this type of incident [6]. Chemical disasters caused by humans are the result of signi¿cant human action, either intentional or unintentional. Incidents in- volving the use of commercial or industrial chemicals have the potential to cause a major public health disaster comparable to that of known agents used for deliberate releases, such as vesicants or nerve gases. Chemical terrorism may actually occur as an intentional toxic chemical spill or release involving industrial and/or commercial products.

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Erythromycin or tetracyclines buy 400 mg motrin mastercard, may occur from embolism due to agglutinating borre- dehydro- or streptomycin (never in Psittaciformes) or lias 600mg motrin with amex. A strain-specific immunity develops in survi- furane derivatives (not in waterfowl) can be tried motrin 400mg without prescription. Incubation periods are four to eight days de- Diseases frequently recur despite therapy. Dogs can be a reservoir for hu- Clinical Disease and Pathology man infections, but it is not known if they can trans- Acute cases are characterized by a high fever (bacte- mit the organisms to birds. Dogs should not be al- ria generally cause a low body temperature), ano- lowed direct access to birds. Spon- The genus Vibrio comprises numerous species that taneous recovery may occur around the sixth day are not easy to differentiate. In these birds the larly waterfowl (vibrio is generally found in aquatic spleen may be small or normal in size. Histology displays disease in humans, an analysis of avian strains in the multiple necrotic foci without inflammatory reac- vicinity of human cases might be advisable. Spirochaetaceae Diagnosis Blood smears stained with Giemsa or examined by Borrelia (Bor. A granular form of the organism tion, fluorescence techniques, immunodiffusion) can may occur in ticks and the blood of the birds that be demonstrated from the 4th to the 30th day post- have recovered from a disease. Chickens are the only defined host and lose cies appears to be host-specific and is found in rats or weight in response to a malabsorption syndrome. The incubation period is sianiformes, Anatiformes, Psittaciformes, Columbi- one to seven weeks dependent on the infective dose. There is variance in spe- Culture is possible on spectinomycin blood agar in an cies susceptibility. Fluorescent antibodies de- pathomorphologic changes are similar to those de- signed for T. Such condi- Spirochaetaceae Undifferentiated: A non-classified tions may occur in large bodies of water, and in these spirochete from choanal and tracheal mucus of a situations Pasteurella spp. Two other cockatiels have in tropical climates peak with seasonal highs in am- been found to harbor similar organisms in the respi- bient temperature and humidity. Histopathology showed a mild in- flammatory reaction in the nasal sinus, but not in the P. In the lower parts of the respiratory tract, species is divided into strains based on 16 serologi- the organisms could not be demonstrated using ar- cally distinct endotoxins and 4 capsular polysaccha- gentation. Interference with the ciliary activity of the are most commonly isolated from birds. If the organism ing in tissue smears or from first culture passages is able to colonize the respiratory mucosa, it can when fixed in methanol and stained with methylene induce conjunctivitis and respiratory signs including blue. Aspergillosis is one of the The latter is usually considered a secondary patho- triggering factors that allows this secondary patho- gen. Postmortem findings waterfowl, pigeons and Psittaciformes have not been associated with P. Diseases by less virulent strains usually occur in stressed or immunocom- promised hosts. Clinical Disease and Pathology Acute forms are characterized by cyanosis, dyspnea and diarrhea followed by death. Birds that survive acute disease often develop respiratory rales, sinusitis, conjunctivitis or swelling of the sinus in- fraorbitalis. Postmortem findings with acute disease may be ab- sent or limited to petechiae or ecchymoses of the parenchymal organs. Catarrhal to fibri- ately after the injury occurs, and become rapidly depressed and die 12 to 24 hours later. Any carnivore-related injury in a bird is a nous rhinitis, necrotic pneumonia, sinusitis, ble- critical emergency. Following bacteremia, Pasteurella may colonize numerous tissues, resulting in arthri- fibrinous inflammation of the upper respiratory tis, osteomyelitis, otitis media and granulomatous tract, pneumonia and air sacculitis. Some strains will colonize the air Transmission cells of the cranial bones causing fibrinous exudate. Pasteurella infections in birds principally occur in In waterfowl, a diphtheroid enteritis may be ob- the respiratory tract. Transmission can occur through direct contact Diagnosis with contaminated aerosols or through mechanical The isolation of the causative agent is necessary. Septicemic birds rarely survive, even when treated multocida, and any bird that has been mouthed by a intensively. Parenteral administration of broad-spec- cat should be treated with antibiotics immediately trum, long-acting sulfonamides can be tried. Treating birds with Pathogenesis chronic forms is very difficult because of the irre- Virulent strains of P. Less virulent strains result in bac- teriemia and colonization of the lungs, liver, kidneys, Control spleen and heart. Weakly virulent strains generally Preventing rodents and free-ranging birds from en- cause a chronic respiratory disease. Failures liver necrosis, salpingitis, peritonitis, endocarditis associated with the vaccine occur because of the nu- valvularis and fibrinous arthritis are typical lesions. The production of vaccines from strains that persist in an aviary may provide successful long- Diagnosis and Treatment term control. The taxonomic reclassification of the Pas- Tetracyclines and chloramphenicol are indicated for teurellaceae is intertwined with the genus Actino- initial therapy. Because of these classification revisions, difficult to interpret because of oversized inhibition even the actinobacilli that are pathogenic in birds zones. The situation has been compli- during the first week of life or lesions become too cated in recent years because many new strains have extensive to be reversed. However, this classification is not The haemophilus strains that infect companion birds valid. They probably serve as secondary in- Some strains are considered to be primary patho- vaders that sustain upper and sometimes lower res- gens, but the majority of this genus is comprised of piratory tract disease. There are no simple labora- tory tests for differentiation between primary and Pathogenesis secondary invaders. Incubation pe- duce a number of cellular toxins, including neu- riods in the avian host are not known. Birds do not appear to develop an immune response following Clinical Disease and Pathology infection, and relapses are common. Spe- Clinical Disease and Pathology cies-specific strains that infect geese morphologically Haemophilus infections generally cause a rhinitis resemble P. This organism has been ref- that results in a serous-to-mucoid or even fibrinous erenced as a cause of chronic disease in the gosling,26 exudate. Mortality rates in this age group can Blue Crane Pneumonia (together with staphylococci) reach 75% of exposed young. Acute disease develops and necrosis of liver tissue in older birds and is characterized by sinusitis, con- Pigeon Rhinitis junctivitis, coughing and diarrhea, followed in two African Grey Parrot Pneumonia, air sacculitis days by tremors, ataxia and convulsions. Survivors Plum-headed Parakeet Sinusitis, swelling of the liver together are stunted and fail to grow. Cytophaga-induced spondylitis with compression Muscovy Duck Rhinitis, sinusitis of the spinal cord was reported in turkeys. There was exudate forma- the beak cavity tion within the ventricles as well as proliferation of Siamese Fireback Necrosis of the lung tissue. Isolation and identification of the causa- tive agent is necessary in all other cases. Tularemia New Duck Disease (Duck Septicemia) Tularemia is caused by Francisella tularensis, a mo- The etiologic agent of duck septicemia has been sus- tile, short rod, 0. Isolates are pected to be Pfeifferella, Pasteurella or Moraxella reported occasionally, mainly from birds that inhabit anatipestifer. The causative organism has recently the northern and subarctic regions of the northern been placed in the genus Cytophaga, which is a hemisphere, such as the Common Pheasant, Wax- semiaerobic, nonmotile rod.

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Internationally acknowledged research areas are Biophysics buy motrin 600mg cheap, Biochemistry cheap motrin 400mg amex, Cell Biology purchase motrin 400mg overnight delivery, Immunology, Experimental and Clinical Oncology, Hematology, Neurobiology, Molecular Biology, Neurology, and Physiology. New Facilities at the University of Debrecen The development of the Medical School of the University of Debrecen has been accelerated in recent years, with the following important results: -New units have been developed to increase the quality of the medical care (Center for Nephrology, a newly constructed building serving the Cardiology and Heart Surgery Departments, a Kidney Transplantation Unit, a new building for the 3rd Department of Internal Medicine). Students can use up to 30 terminals at the same time in the Education Center, in the Center for Educational Development, and in a number of other departments. The access will be available free of charge for all students of the University of Debrecen. The primary goal of the program is to reduce the mortality of these severe disorders. This high-tech equipment not only allows easier, earlier, and more precise diagnosis of various tumorous diseases, but it also helps in the early recognition of several neurological and cardiovascular disorders. Markusovszky Kollégium Phone +36-52-411-717/55376 Fax +36-52-255-028 Internet www. Tünde Fekete English Program Officer Tamás Bagi (3rd-4th year Medicine, 1-5th year Pharmacy) Ms. Allergology Full Professor, Head of Division of Human Surgery and István Juhász M. Haematology and Oncology Associate Professor, Head of Division of General Gábor Mogyorósy M. Health Psychology Associate Professor, Head of Division of Humanities Attila Bánfalvi M. The requirements in these premedical science subjects are rigorous, thus it is recommended that students who need a period of preparation prior to beginning the General Medicine, Dentistry or Pharmacy Program join the Basic Medicine Course. Students successfully completing the course are directly admitted to their chosen program. Students are encouraged to ask questions related to the topic of the lectures discussed, and participate in solving problems related to the topic of the seminar. Some professors will ask for students to volunteer information, but some professors call on students randomly. It is, thus, a good idea to come to class prepared so as not to be embarrassed in front of the class. The usage of electronic devices, textbooks and any form of interaction between students during the tests are strictly forbidden. Violation of these above mentioned regulations results in an immediate and unconditional dismissal from the program. Attending lectures is strongly recommended, attendance of seminars is compulsory and recorded. Self Control Tests, End of Semester Exams, and Final Exams will be assessed as follows. Year, Semester: Basic Medicine Course, 1 semesterst Number of teaching hours: Lecture: 60 Seminar: 30 st 1 week: Lecture: The chemistry of life 1. Fungi: recyclers, pathogens, parasites 2 Differential gene expression in development 1. Year, Semester: Basic Medicine Course, 2nd semester Number of teaching hours: Lecture: 45 Seminar: 60 st 1 week: Lecture: Tissues, Organs and Organ Systems 1. Year, Semester: Basic Medicine Course 1 , semesterst Number of teaching hours: Lecture: 60 Seminar: 30 st 1 week: Lecture: 1-2. The content of each Self Control Test is indicative and subject to change with prior notice. Year, Semester: Basic Medicine Course, 2nd semester Number of teaching hours: Lecture: 60 Seminar: 30 1st week: Lecture: 1-2. The camera, the simple magnifier, the compound microscope, the telescope and the eye. Year, Semester: Basic Medicine Course, 1 semesterst Number of teaching hours: Lecture: 60 Seminar: 30 1st week: Lecture: Introduction to general chemistry. Year, Semester: Basic Medicine Course, 2nd, semester Number of teaching hours: Lecture: 60 Seminar: 30 st 1 week: Lecture: The halogens. Discussion of inorganic chemistry th 4 week: Lecture: Covalent bonding in organic compounds. Academic advisor: László Répás, Department of Foreign Languages Recommended books: Marschalkó, Gabriella: Hungarolingua Basic Level 1. The requirements of these condensed premedical science subjects are very rigorous, thus preparation prior to the beginning the General Medicine, Dentistry or Pharmacy Program is recommended. Students successfully completing the course are directly admitted to their chosen program. Students are encouraged to ask questions related to the topic of the lectures discussed, and participate in solving problems related to the topic of the seminar. Some professors will ask for students to volunteer information, but some professors call on students randomly. It is, thus, a good idea to come to class prepared so as not to be embarrassed in front of the class. The usage of electronic devices, textbooks and any form of interaction between students during the tests are strictly forbidden. Violation of these above mentioned regulations results in an immediate and unconditional dismissal from the program. Attending lectures is strongly recommended, attendance of seminars is compulsory and recorded. Self Control Tests, End of Semester Exams, and Final Exams will be assessed as follows. The camera, the simple magnifier, the compound microscope, the telescope and the eye. Carboxylic acid derivatives: esters, fats, lactones, amides, lactams, thiol esters anhydrides, acyl chlorides. A credit is a relative index of cumulative work invested in a compulsory, a required elective or a freely chosen subject listed in the curriculum. The credit value of a course is based upon the number of lectures, seminars and practical classes of the given subject that should be attended or participated in (so called "contact hours"), and upon the amount of work required for studying and preparing for the examination(s). Together with the credit(s) assigned to a particular subject (quantitative index), students are given grades (qualitative index) on passing an exam/course/class. It provides a wider range of choice, enables the students to make progress at an individual pace, and it also offers students a chance to study the compulsory or required subjects at a different university, even abroad. Owing to the flexible credit accumulation system, the term "repetition of a year" does not make sense any longer. It should be noted, however, that students do not enjoy perfect freedom in the credit system either, as the system does not allow students to randomly include subjects in their curriculum or mix modules. Since knowledge is based on previous studies, it is imperative that the departments clearly and thoroughly lay down the requirements to be met before students start studying a subject. Students can be given their degree if, having met other criteria as well, they have collected 360 credits during their studies. According to the credit regulations, students should obtain an average of 30 credits in each semester. The criterion of obtaining 1 credit is to spend 30 hours (including both contact and non-contact hours) studying the given subject. Students accumulate the required amount of credits by passing exams on compulsory, required elective and freely chosen subjects. Completion of every single compulsory credit course is one of the essential prerequisites of getting a degree. Courses belonging to the required elective courses are closely related to the basic subjects, but the information provided here is more detailed, and includes material not dealt with in the frame of the compulsory courses. Students do not need to take all required elective courses, but they should select some of them wisely to accumulate the predetermined amount of credits from this pool. Finally, a certain amount of credits should be obtained by selecting from the freely chosen courses, which are usually not related to the basic (and thus mandatory) subjects, but they offer a different type of knowledge. According to the qualification requirements, professional (compulsory and required elective) courses fall into three modules. The basic module provides the theoretical basis of medicine, and ensures that the necessary practical skills are developed. The preclinical module lays down the foundations of clinical knowledge, while in the clinical module the students are taught clinical medicine, and they attend practical classes to ensure proper command of the medical procedures. The credits accumulated in the different modules for compulsory and required courses should show the following distribution: basic module:92-124, preclinical module:44-64, and clinical module:138-186 credits. There are 15 compulsory final examinations in the curriculum; therefore one final exam is worth at least 10 credits.

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Higher serum vitamin D concentrations are associated with longer leukocyte telomere length in women buy motrin 600mg with mastercard. Effect of dehydroepiandrosterone on muscle strength and physical function in older adults: a systematic review cheap 600 mg motrin otc. Sleep health purchase 400mg motrin amex, lifestyle and mental health in the Japanese elderly: ensuring sleep to promote a healthy brain and mind. C-reactive protein and high-sensitivity C-reactive protein: an update for clinicians. C-reactive protein and the 10-year incidence of coronary heart disease in older men and women: the Cardiovascular Health Study. Primer: the practical use of biological markers of rheumatic and systemic inflammatory diseases. The accumulative effects of modifiable risk factors on inflammation and haemostasis. Relation between a diet with a high glycemic load and plasma concentrations of high- sensitivity C-reactive protein in middle-aged women. Serum C-reactive protein concentrations are inversely associated with dietary flavonoid intake in U. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exercise training and plasma C-reactive protein and interleukin-6 in elderly people. No reduction in C-reactive protein following a 12-month randomized controlled trial of exercise in men and women. Variations in C-reactive protein, plasma free radicals and fibrinogen values in patients with osteoarthritis treated with Pycnogenol. Effects of grape seed extract in type 2 diabetic subjects at high cardiovascular risk: a double blind randomized placebo controlled trial examining metabolic markers, vascular tone, inflammation, oxidative stress and insulin sensitivity. Anti-inflammatory properties of curcumin, a major constituent of Curcuma longa: a review of preclinical and clinical research. Comparison of systemic availability of curcumin with that of curcumin formulated with phosphatidylcholine. Efficacy and safety of Meriva, a curcumin-phosphatidylcholine complex, during extended administration in osteoarthritis patients. Blunted cortisol response to awakening in mild to moderate depression: regulatory influences of sleep patterns and social contacts. Sleep disturbances are correlated with decreased morning awakening salivary cortisol. Insulin resistance after oral glucose tolerance testing in patients with major depression. Food allergy: its manifestations and control and the elimination diets: a compendium. A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. A standardized Withania somnifera extract significantly reduces stress-related parameters in chronically stressed humans: a double-blind, randomized, placebo-controlled study. The effectiveness and practicality of occupational stress management interventions: a survey of subject matter expert opinions. Evaluation of a wellness-based mindfulness stress reduction intervention: a controlled trial. Annual medical spending attributable to obesity: payer- and service-specific estimates. Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. Update on adipocyte hormones: regulation of energy balance and carbohydrate/lipid metabolism. Evidence that insulin resistance is responsible for the decreased thermic effect of glucose in human obesity. Effect of weight reduction on resting energy expenditure, substrate utilization, and the thermic effect of food in moderately obese women. Children at familial risk for obesity: an examination of dietary intake, physical activity, and weight status. Exercise training prevents regain of visceral fat for 1 year following weight loss. Diets with high or low protein content and glycemic index for weight-loss maintenance. Water consumption increases weight loss during a hypocaloric diet intervention in middle-aged and older adults. Effects of an ad libitum low-fat, high-carbohydrate diet on body weight, body composition, and fat distribution in older men and women. The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia. Mild overweight treated with energy restriction and a dietary fiber supplement: a 6- month randomized, double-blind, placebo-controlled trial. An analytical ultracentrifuge study on ternary mixtures of konjac glucomannan supplemented with sodium alginate and xanthan gum. Studies on macromolecular interactions in ternary mixtures of konjac glucomannan, xanthan gum and sodium alginate. Beneficial effects of viscous dietary fiber from konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial. The effect of a novel viscous polysaccharide along with lifestyle changes on short-term weight loss and associated risk factors in overweight and obese adults: an observational retrospective clinical program analysis. Meal replacements are as effective as structured weight-loss diets for treating obesity in adults with features of metabolic syndrome. Value of structured meals for weight management: risk factors and long-term weight maintenance. A novel soy-based meal replacement formula for weight loss among obese individuals: a randomized controlled clinical trial. A controlled trial of protein enrichment of meal replacements for weight reduction with retention of lean body mass. Efficacy of a meal replacement diet plan compared to a food-based diet plan after a period of weight loss and weight maintenance: a randomized controlled trial. Effects of supplemental chromium on patients with symptoms of reactive hypoglycemia. Hypothesis: sensitization of insulin-dependent hypothalamic glucoreceptors may account for the fat-reducing effects of chromium picolinate. Effects of resistive training and chromium picolinate on body composition and skeletal muscle size in older women. International Journal of Sport Nutrition and Exercise Metabolism 2002; 12: 125–135. Effect of chromium supplementation and exercise on body composition, resting metabolic rate and selected biochemical parameters in moderately obese women following an exercise program. The effects of oral 5-hydroxytryptophan administration on feeding behavior in obese adult female subjects. Effects of 5-hydroxytryptophan on eating behavior and adherence to dietary prescriptions in obese adult subjects. Eating behavior and adherence to dietary prescriptions in obese adult subjects treated with 5-hydroxytryptophan. Efficacy of a novel calcium/potassium salt of (-)-hydroxycitric acid in weight control. Enhanced thermogenesis and diminished deposition of fat in response to overfeeding with diet containing medium chain triglyceride. Greater rise in fat oxidation with medium-chain triglyceride consumption relative to long-chain triglyceride is associated with lower initial body weight and greater loss of subcutaneous adipose tissue. International Journal of Obesity and Related Metabolic Disorders 2003; 27: 1565–1571. Medium-chain triglycerides increase energy expenditure and decrease adiposity in overweight men. Differential rates of conversion of testosterone to dihydrotestosterone in acne and normal human skin—a possible pathogenic factor in acne.

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