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High-protein weight-loss diets: are they safe and do they work? A review of the experimental and epidemiologic data.

Recommendations for increased consumption of protein are among the most common approaches of popular or fad diets. This review summarizes the effects of dietary protein on satiety, energy intake, thermogenesis, and weight loss, as well as its effect on a variety of health outcomes in adults. In short-term studies, dietary protein modulates energy intake via the sensation of satiety and increases total energy expenditure by increasing the thermic effect of feeding. Whereas these effects did not contribute to weight and fat loss in those studies in which energy intake was fixed, one ad libitum study does suggest that a high-protein diet results in a greater decrease in energy intake, and therefore greater weight and fat loss. In terms of safety, there is little long-term information on the health effects of high-protein diets. From the available data, however, it is evident that the consumption of protein greater than two to three times the U.S. Recommended Daily Allowance contributes to urinary calcium loss and may, in the long term, predispose to bone loss. Caution with these diets is recommended in those individuals who may be predisposed to nephrolithiasis or kidney disease, and particularly in those with diabetes mellitus.

Diet, Reducing↗

[Comparison of epidemiological data on pulmonary tuberculosis in Sorocaba, Säo Paulo, Brazil, (1986-1996)].

Pulmonary tuberculosis is a serious public health problem in Brazil. Data were collected relating to the patients' health before diagnosis and also to the time lag between this diagnosis and the beginning of specific treatment over a period of three months. Fifty patients suffering from pulmonary tuberculosis were questioned about: symptomatology before diagnosis, lapse between the occurrence of the first symptoms and the beginning of treatment and relationship with AIDS. There had been no significant change in the time-lag between the time of discovery of new cases and the beginning of treatment, over the last ten years.

AIDS-Related Opportunistic Infections↗

Selection of patients for myocardial perfusion scintigraphy based on fuzzy sets theory applied to clinical-epidemiological data and treadmill test results.

Coronary artery disease (CAD) is a worldwide leading cause of death. The standard method for evaluating critical partial occlusions is coronary arteriography, a catheterization technique which is invasive, time consuming, and costly. There are noninvasive approaches for the early detection of CAD. The basis for the noninvasive diagnosis of CAD has been laid in a sequential analysis of the risk factors, and the results of the treadmill test and myocardial perfusion scintigraphy (MPS). Many investigators have demonstrated that the diagnostic applications of MPS are appropriate for patients who have an intermediate likelihood of disease. Although this information is useful, it is only partially utilized in clinical practice due to the difficulty to properly classify the patients. Since the seminal work of Lotfi Zadeh, fuzzy logic has been applied in numerous areas. In the present study, we proposed and tested a model to select patients for MPS based on fuzzy sets theory. A group of 1053 patients was used to develop the model and another group of 1045 patients was used to test it. Receiver operating characteristic curves were used to compare the performance of the fuzzy model against expert physician opinions, and showed that the performance of the fuzzy model was equal or superior to that of the physicians. Therefore, we conclude that the fuzzy model could be a useful tool to assist the general practitioner in the selection of patients for MPS.

Adult↗

Tolerability of nimesulide. Epidemiological data.

This review describes the tolerability profile of nimesulide as documented in a global assessment of the clinical data available to Helsinn for this drug. Data from 151 trials were considered and the relevant case report forms and study reports were used as source information. The analysis was conducted using between-treatment and within-treatment comparisons. The between-treatment comparison included data derived from placebo-controlled trials, while the within-treatment comparison included nimesulide data only. Of 4945 subjects treated with nimesulide, 349 (7.1%) experienced adverse events and 52 (1.1%) withdrew from treatment. The most frequently reported adverse events were those related to the digestive system, body as a whole, skin and nervous system. The incidence and nature of adverse events observed for nimesulide-treated patients were similar to those of the placebo group. Nimesulide was particularly well tolerated by the liver, lungs, kidneys and blood.

Anti-Inflammatory Agents, Non-Steroidal↗

Sexually acquired HIV infections: an analysis of epidemiological data concerning cases reported in Sweden 1988-90.

536 Swedish residents who during the years 1988-90 were reported as having contracted HIV through sexual contacts were asked about circumstances regarding the transmission. Answers were received in 411 (76.7%) of the cases (285 homosexual men, 68 heterosexual men and 58 heterosexual women). In 282 (69%) of the cases the persons were without symptoms and in 231 (56%) cases the infection was considered to be < 3 years old. Among homosexual men and heterosexual women the infection was usually acquired in Sweden or Europe whilst heterosexual men more often acquired their infection at casual contacts on other continents.

Adult↗

Taiwan National Poison Center: epidemiologic data 1985-1993.

UNLABELLED: The Taiwan National Poison Center has received more than 30,000 telephone calls since its establishment in July 1985. OBJECTIVE: To obtain more information about poisoning exposures in Taiwan, a retrospective analysis was conducted of all telephone calls to the center concerning human poisoning exposures July 1985 through December 1993. METHODS: The following data were tabulated: age, sex, intent of exposure, route of exposure, substances ingested and clinical severity. RESULTS: During the eight years (1985-1993), 23,436 telephone calls concerning human poisoning exposure were recorded. Adults accounted for most cases (75.2%) and exposures involving males (54.2%) were somewhat more prevalent than female poisoning exposures (44.7%). Intentional poisonings (54.6%) were more common than unintentional poisonings (40.1%), with an inverse relationship in pediatric poisoning exposures. After amphetamines, the most frequently ingested poisons were pesticides, benzodiazepines, and cleaning products. Fatalities occurred most frequently following ingestion of pesticides. The mortality rate was 5.7% for all exposures. CONCLUSIONS: Human poisoning is a serious problem in Taiwan. The reduction of suicide attempts is a major objective. Childhood poisonings are underreported and of high mortality.

Adolescent↗

[Use of epidemiological data to predict the occurrence of arteriosclerotic diseases in urban residents].

From 1983 to 1986, 100,352 urban residents were screened for cardiovascular disease. Glucose and protein levels in urine, total cholesterol, triglycerides, high density lipoprotein cholesterol, blood pressure, and aortic pulse wave velocity were measured. Retinal examinations and electrocardiography were also done. A follow-up survey was conducted two years after screening. A total of 34,895 subjects had no disease and 301 had arteriosclerotic diseases. The occurrence of cardio- and cerebrovascular diseases could not have been predicted from any one abnormal result on a screening test, but might have been predicted from multiple abnormal results, with each factor having its own weight and a unique association with other factors. The risk of disease increased multiplicatively higher rather than additively with the number of abnormal test results. We used Hayashi's quantification method III to determine which combination of abnormal test results was associated with a higher risk of arterio sclerotic diseases, and thus developed a comprehensive indicator of disease risk by grouping several abnormal test results that were affected by different factors. This evaluation system can be used to predict the onset of arteriosclerotic diseases to some degree and can contribute to preventive medicine.

Aged↗