Why some of us get fat and what we can do about it

There is a widespread obesity epidemic in the developed world which is having an adverse impact on the health of affected individuals. Many of the afflicted have a genetic predisposition to become obese. These individuals become obese when they over consume highly palatable, calorically dense foods which are readily available at low cost. Once obesity occurs, fewer than 10% of affected individuals can sustain significant weight loss permanently. The hypothesis of this review is that some obesity-prone individuals have an inborn reduction in their ability to sense and respond to inhibitory signals from adipose stores and other organs which should limit their intake of energy when it exceeds their metabolic needs. Furthermore, the physiological processes which drive all of us to seek and ingest food and limit energy expenditure during periods of negative energy balance provide an irresistible drive to regain lost adipose stores in weight-reduced obese individuals. For this reason, prevention of obesity and the identification factors which promote the development of neural pathways which enhance the negative feedback signals from the periphery should be a major focus of ongoing research in this field.     

What is so special about thinking; after all,we all do it!

Understanding the adaptive immune system can be simplified by treating it as three linked modules, the generation of the recognitive repertoire, the sorting of the repertoire by purging anti-self, and the coupling of the repertoire to appropriate effector mechanisms. Each of these modules has a unique database and a logic that is determined by evolutionary considerations founded on value versus harm. Selection cannot operate to perfection, only to adequacy, meaning not limiting to the procreation of the species. Consequently, this system has limits in that it fails, by human standards, to adequately protect against a variety of pathogens and, even when protecting successfully against others, all too often initiates autoimmunity and innocent bystander pathology. What evolution trivializes defines the subject called clinical immunology. If we wish to deal with the pathology that evolution views to be of an acceptable frequency, then we had best first understand what it did give us as a sufficiently functional system, namely the decision pathways of the three modules and in what ways their protective outputs are limited.     

Difficult intubation--when can we predict it?

Anaesthetists at times encounter difficult intubation in an apparently normal individual in spite of using the best possible positioning and most profound relaxation. This study was carried out to find out the most simple and easy measurement that may predict a difficult intubation. The study was conducted in three groups of patients of twenty each. The first group consisted of patients in whom intubation was easy. Second group consisted of anticipated difficult intubation. Cases in whom very difficult intubation was encountered were analyzed retrospectively and were included in third group. An attempt has been made to predict difficult intubation with the roentgenographic study of lateral view of mandible along with the measurement of distance from chin to thyroid cartilage. Of all the parameters, ratio of effective mandibular length to posterior mandibular depth and distance from chin to thyroid cartilage were found to be important to predict difficult intubation.     

Cognitive-behavioral treatment for rapists: can we do better?

A review of treatment studies with rapists suggests that the currently used cognitive-behavioral treatment strategies remain limited in their success. The current article proposes that some reasons for the limited success may be that current treatment approaches do not adequately address the heterogeneity of the population, emphasize changing patterns of physiological arousal and cognitive distortions rather than psychological acceptance, and neglect to address differences in the function of sexually aggressive behavior among individuals. With the hope of decreasing rates of victimization and preventing recidivism by rapists, this article offers several treatment suggestions that should be tested empirically to determine if treatment efficacy can be increased with this population.     

B-G: we know what it is, but what does it do?

B-G molecules are polymorphic cell surface proteins that are encoded by the chicken MHC. Here, Jim Kaufman and Jan Salomonsen briefly summarize developments in the molecular genetics, the structure and the tissue distribution of B-G molecules, and discuss possible functions of this intriguing multigene family.     

Umbilical cord blood transplantation: where do we stand?

Although allogeneic stem cell transplantation can cure patients with hematologic malignancies, limiting factors such as lack of suitable donors and GVHD toxicity have led to the exploration of umbilical cord blood (UCB) as an alternative source of hematopoietic stem cells. This overview examines the advantages and disadvantages of UCB as a donor source and reviews data from preclinical and clinical studies. Ethical issues regarding UCB transplantation are also addressed.     

Why are empirically supported treatments for bulimia nervosa underutilized and what can we do about it?

Empirically supported therapies for bulimia nervosa, as well as for other disorders, are rarely utilized. Underutilization is frequently attributed to doubts among psychotherapists about the value of randomized controlled trials and professional resistance to the perceived constraints of manualized therapy. However, controversies about the usefulness of empirically supported therapies have been shaped by lack of access to adequate training and inexperience in delivering these treatments. A proposal for expanding training opportunities is presented along with discussion about how more intensive training for the practicing therapist would affect current controversies regarding the value and relevance of empirically supported therapies for bulimia nervosa and other disorders.     

Prediction of ovarian hyperstimulation syndrome: why predict if we can prevent!

Dear Sir, Ovarian hyperstimulation syndrome (OHSS) continues to be a seriousand potentially life-threatening complication of ovarian stimulation.A World Health Organization report states that the world-wideincidence of severe OHSS is 0.2–1% of all assisted reproductioncycles, with a     

Public health and Hurricane Katrina: lessons learned and what we can do now

Keith C. Ferdinand, MD, FACC, presently resides in Atlanta, GA, displaced from his native New Orleans by Hurricane Katrina, September 2005. The hurricane destroyed hiss cardiovascular center and severely damaged his home. In Atlanta, he is director of the Association of Black Cardiologists Hurricane Katrina Relief.