A Multidisciplinary Approach to Treating Obesity in a Community Health Centre

Objectives

The aim of the study is to assess the weight loss programme with regards to the long-term effectiveness of weight reduction and weight maintenance, using completion rate and BMI, blood sugar, cholesterol and blood pressure levels as outcomes. The aim of the study also includes identifying the factors associated with adherence to the programme.

Methods

The programme was developed by a multidisciplinary team. It included 6 months of introduction and another 18 months of maintenance. The data for 397 participants was collected after 24 months.

Results

346 participants have completed the introduction and 123 have completed the programme. In the introduction, the average weight loss was 12% of the initial weight. The participants, who completed the full programme, lost 9.4% of their initial weight. The participants also significantly (p<0.05) reduced their blood sugar and cholesterol levels, as well as their blood pressure. The factors associated with adherence to the programme are: age over 50, lower educational levels, lower initial weight and higher weight loss in the introduction.

Conclusions

The multi-disciplinary approach to obesity treatment was effective for a selected group of people. The proportion of dropouts was relatively high, but still low compared to similar programmes. Group treatment and mutual support are of a great importance in bringing about and maintaining the changes.     

Synthesis and Biodistribution of [11C]Adenosine 5′-Monophosphate ([11C]AMP)

Purpose Imaging purine receptors and adenylate biodistribution in vivo may be of clinical importance not only for the investigation of normal adenylate metabolism but also in pathological conditions where adenylate uptake and/or release from certain tissues and organs may be altered, such as some types of cancer. In order to develop a tracer for positron emission tomography (PET) that would not be subject to loss of its radioisotope, adenosine 5-monophosphate (AMP) was intrinsically labeled at the C-8 position with carbon-11.Procedures [¹¹C]AMP was synthesized by reacting 5-amino-1--d-ribofuranosylimidazole-4-carboxamidine-5-phosphate with [¹¹C]formaldehyde. The metabolism of [¹¹C]AMP in human blood was determined in vitro both in the presence and absence of dipyridamole. The ex vivo biodistribution of [¹¹C]AMP and its in vivo dosimetry were determined in normal mice. The effect of dipyridamole on the distribution of [¹¹C]AMP in mice was also determined.Results [¹¹C]AMP was reliably synthesized in 34 minutes (n = 7) with an average radiochemical yield of 2.4% and an average specific activity of 90.10 GBq/mol (2435 mCi/mol) at end of synthesis. In normal mice, the highest uptake of [¹¹C]AMP was in the lungs, blood, and heart. The ex vivo mouse experiments showed that the uptake of ¹¹C radiotracer in the lungs at 60 minutes postinjection was significantly lower for dipyridamole-treated animals than controls. Dosimetry showed that the critical organs for radiation dose burden are kidneys and bladder.Conclusions Treatment with dipyridamole blocked the red blood cell uptake of extracellular adenosine and therefore its subsequent intracellular conversion to ATP. The biodistribution studies indicate that the tracer has substantial accumulation in the kidneys, lungs, heart, and blood. [¹¹C]AMP is promising as a PET-imaging agent to trace adenylate biology in vivo.     

Socio-Economic Characteristics in Notified Erythema Migrans Patients

Background

Lyme borreliosis disease results from infection by members of the Borrelia burgdorferi sensu lato complex. The most common clinical presentation of Lyme borreliosis is erythema migrans (EM). To gain knowledge of the epidemiological parameters and the risk factors of EM in Slovenia, a survey has been carried out in 2010.

Methods

A short anonymous and self-administrated questionnaire was sent to 4917 notified EM patients in 2010, aiming to collect epidemiological data and assess socio-economic determinants in patients with EM.

Results

Three thousand and five (61%) patients with EM returned completed questionnaires. One thousand and nine hundred twenty-nine (74%) patients noted the tick where the EM developed. The tick bite was most often located on the legs in adults and in the head/neck area in children. The time that elapsed before the tick has been removed increased significantly with age. The attached tick was most frequently overlooked in preschool children. Nearly 70% of patients believed that they contracted the infection with borrelia near home. Infection away from their permanent residence was more often the case in those with a higher level of education and in 15–49 age groups. Compared to the Slovenian general population over 14 years of age, those with a higher level of education, the unemployed and farmers were overrepresented among the EM patients.

Conclusions

The risk of Lyme borreliosis is widespread in Slovenia, with some areas more affected then others. Determinants of exposure to infected ticks are different, and depend on the socio-economic status and demographic characteristics.