A randomised trial of an internet weight control resource: The UK Weight Control Trial [ISRCTN58621669]

Background

Obesity treatment is notoriously unsuccessful and one of the barriers to successful weight loss reported by patients is a lack of social support. The Internet offers a novel and fast approach to the delivery of health information, enabling 24-hour access to help and advice. However, much of the health information available on the Internet is unregulated or not written by qualified health professionals to provide unbiased information. The proposed study aims to compare a web-based weight loss package with traditional dietary treatment of obesity in participants. The project aims to deliver high quality information to the patient and to evaluate the effectiveness of this information, both in terms of weight loss outcomes and cost-effectiveness.

Methods

This study is a randomised controlled trial of a weight loss package against usual care provided within General Practice (GP) surgeries in Leeds, UK. Participants will be recruited via posters placed in participating practices. A target recruitment figure of 220 will enable 180 people to be recruited (allowing for 22% dropout). Participants agreeing to take part in the study will be randomly allocated using minimisation to either the intervention group, receiving access to the Internet site, or the usual care group. The primary outcome of the study will be the ability of the package to promote change in BMI over 6 and 12 months compared with traditional treatment. Secondary outcomes will be the ability of the Internet package to promote change in reported lifestyle behaviours. Data will be collected on participant preferences, adherence to treatment, health care use and time off work. Difference in cost between groups in provision of the intervention and the cost of the primary outcome will also be estimated.

Conclusion

A positive result from this study would enhance the repertoire of treatment approaches available for the management of obesity. A negative result would be used to inform the research agenda and contribute to redefining future strategies for tackling obesity.

     

Ultrastructural and biochemical alterations effected by viridin B, a bacterocin of alpha-hemolytic streptococci.

Viridin B, a bacteriocin produced by Streptococcus mitis strain 42885, was shown previously to exert a bactericidal effect against a Neisseria sicca strain but only a bacteriostatic effect against a coagulase-negative staphylococcus. In the present report, this dual effect was defined further. Viridin B caused the appearance of mesosomes in both indicator strains early in the course of exposure. Whereas mesosomes were the only noticeable alterations in the staphylococcal strain at all times of exposure to bacteriocin, progressive changes occurred in the N. sicca cells involving the nucleoid and cytoplasmic contents and resulting in the appearance of bacterial ghosts. Biochemical studies indicated a rapid and complete cessation of the incorporation of [3H]thymidine in N. sicca and in the staphylococcus. Whereas the incorporation of [3H]leucine and [3H]uridine in N. sicca was completely stopped, such incorporation was only reduced in the staphylococcus.     

Segmental coronary artery disease: detection by rotating slant-hole collimator tomography and planar thallium 201 myocardial scintigraphy

Normal quantitative circumferential profile limits were established for a 30 degrees bilateral rotating slant-hole (RSH) collimator tomographic system. This system's value in detecting segmental coronary artery disease was assessed in a study evaluating 196 patients by thallium 201 myocardial scintigraphy and coronary arteriography. Profile curves were calculated from images of 20 healthy patients and used to identify significant coronary artery disease (greater than or equal to 70% diameter narrowing) in the left anterior descending (LAD), the right, and the left circumflex (LCx) coronary arteries. In a group of 86 patients, an abnormality on the apical or middle plane optimally identified segmental coronary artery disease. When such abnormalities were prospectively evaluated in a test group of 110 patients, the sensitivity and specificity were 79% and 93% for LAD, 90% and 90% for right, and 83% and 83% for LCx coronary artery disease. Compared with qualitative interpretation of the planar and tomographic images, quantitative tomography significantly improved the sensitivity of T1-201 imaging in detecting LAD, right, and LCx coronary artery disease (P less than .001) in patients with or without previous myocardial infarction.     

Barium intravasation: radiographic and CT findings in a nonfatal case

A woman survived venous intravasation of barium complicating an abdominal barium study. Barium deposition in the reticuloendothelial system was evident by an increase in density in the liver, spleen, and bones on plain radiographs and marked elevation of attenuation values of these organs on computed tomographic scans. The literature on barium intravasation is reviewed.