Adult weight management: Translating research and guidelines into practice

Purpose: To provide a practical approach to managing overweight and obese adult patients based on data from research and recommendations from established guidelines.
Data sources: Comprehensive review articles and original research articles identified through Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL).
Conclusions: There is a great deal of research being conducted on new ways to treat obesity; however, despite all this new information, many primary care providers continue to report that they do not address weight or weight control strategies with their patients. Reasons include too little time, not enough training, lack of financial incentive, and failure to believe that patients can be successful.
Implications for practice: Weight management essentially comes down to one key concept: negative energy balance (fewer calories in and/or more calories out). Patients can be taught how to achieve a negative energy balance by using a food/exercise diary to track their daily caloric goal to achieve a 1–2 pound weight loss per week. Nurse practitioners (NPs) can implement safe and effective weight management plans for their patients by teaching them how to self-monitor, eat healthy, and exercise. This method is similar to what NPs commonly use for patients with diabetes mellitus.     

Latent functional duality in an accessory pathway

Accessory atrioventricular pathways classically possess neither decremental conduction nor functional duality. This report details an accessory pathway in which functional longitudinal dissociation, with decremental ventriculoatrial conduction in each component, was observed after, but not before, administration of the antiarrhythmic drug recainam.     

Prostaglandin E and F concentration in the fimbria of the rabbit fallopian tube increases at the time of ovulation

To see if the fimbrial concentrations of Prostaglandin E (PGE) and Prostaglandin F (PGF) change in the process of ovulation, these prostaglandins were measured in the fimbriae of one group of 18 doe rabbits using the specific radioimmunoassay; 13 rabbits were bred so as to induce ovulation and 5 rabbits were not bred. The PGE and PGF in the fimbriae of the 13 bred rabbits were 105.4 +/- 18.5 pg/mg of protein and 186 +/- 26.9 pg/mg protein, respectively. In the 5 control unbred animals, the fimbrial PGE and PGF concentrations were 39.6 +/- 5.9 pg/mg protein and 111 +/- 14.7 pg/mg protein, respectively (p less than 0.05). In an additional group of 8 rabbits (2 before ovulation and 6 after ovulation), it was found that the rise in the PGE and PGF concentration association with ovulation was maximal in fimbriae harvested immediately before ovulation (8 hours-8 hours 30 postcoitally) (p less than 0.001). These findings are consistent with the hypothesis that fimbrial PGE and PGF play a role in the process of ovum retrieval in the rabbit.     

Individualised quality of life after pacing. Does mode matter?

AIMS: To examine the hypothesis that atrial based pacing improves Quality of Life (QoL) after pacing by undertaking a detailed QoL evaluation that includes an individualised assessment as well as disease specific evaluation. METHODS: Prospective study of patients randomised to VVI(R) or atrial based pacing modes using the Schedule for the Evaluation of Individual QoL (SEIQoL), the 36-item Medical Outcomes Study Short-Form General Health Survey (SF36), and a modified version of the Karolinska Cardiovascular Symptomatology Questionnaire (KCSQ). RESULTS: Seventy-three patients completed the two-year follow up of the study. Pacing improved SEIQoL scores, cardiovascular symptoms and the physical role limitation, social limitation and mental health domains of SF36 from baseline to one month. Pacing mode had no effect on QoL the major determinants of which were baseline QoL and a history of coronary artery disease. CONCLUSION: Atrial based pacing does not improve QoL in the two years after pacing when compared with VVI(R) pacing.     

Contact allergy to dental materials in patients with orofacial complaints

Two groups of individuals were patch tested for frequencies of contact allergy to dental materials. The patient group with orofacial and distant symptoms and complaints referred to the Department of Prosthetic Dentistry were compared with an age-sex matched control group of individuals referred to the Department of Dermatology. The results did not show any differences in patch test reactions between the patient and control groups. The study did not prove any obvious associations between the patients' symptoms or objective findings and the patch test results.