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ideal body weight [keywords]
- Variables that discriminate bulimic from nonbulimic adolescent females. [Journal Article]
- J Youth Adolesc 1985 Apr; 14(2):85-98.
The present study identified variables that discriminated bulimic (N=71) from nonbulimic (N=71) adolescent females within a high school setting. A discriminant function analysis identified six variables that significantly differentiated these two groups. These variables included disturbed eating attitudes, negative perceptions of weight and body image, depressive symptomatology, and alcohol use. Post hoct tests indicated that, compared to the nonbulimic girls, the bulimic adolescents were significantly more depressed, viewed themselves as significantly more overweight, used alcohol significantly more frequently, possessed significantly more disturbed eating attitudes, had a significantly greater discrepancy between their current and ideal weight, and felt it was significantly more important to achieve this ideal weight. The implications of these findings for the etiology and early identification of bulimia in adolescence are discussed.
- Rhythmic life of the Arctic charr: Adaptations to life at the edge. [JOURNAL ARTICLE]
- Mar Genomics 2013 Nov 26.
High latitudes are characterized by strong seasonal changes in environmental conditions, including temperature and food availability. To cope with these changes, many high latitude species have developed circannual oscillators that enable them to anticipate and prepare for forthcoming environmental changes and synchronize seasonal events (e.g. reproduction) to environmental fluctuations. The Arctic charr (Salvelinus alpinus) is the world's northernmost freshwater fish species with a distribution largely confined within the Arctic. In the northernmost part of its distribution they have developed an anadromous life-history strategy implying annual, seaward migrations in the summer to utilize the rich feeding opportunity in the sea. Overwintering in freshwater is characterized by anorexia and energy conservation. The seaward migration in early summer is preceded by physiological and behavioral changes (smolting), by which they develop seawater tolerance (hypoosmoregulatory ability) and migratory behavior. When migrating to the sea, Arctic charr have regained a strong appetite and within 4-6weeks in the sea they may have doubled their body weight and increased their body fat stores several-fold, in anticipation of the resources needed for reproduction in the autumn and overwintering. All these processes are regulated independently of environmental changes; captive offspring of anadromous charr kept in freshwater displays seasonal changes in seawater tolerance and strong seasonal changes in food intake and growth even when they are continuously fed in excess and held at a constant water temperature in freshwater. A correct timing of these events is crucial for their survival in the Arctic and the Arctic charr seems to possess timing mechanisms that include endogenous, circannual oscillator(s) entrainable by photoperiod. The entrainment mechanism may be linked to diel melatonin rhythms, which in this species exactly mirror overground photoperiod, even during the winter residence in lakes with thick ice and snow. Little is known, however, about how photoperiod, melatonin and putative endogenous clock(s) interact in the generation of seasonal rhythms in fish, and downstream neuroendocrine mechanisms leading to physiological changes. The anadromous Arctic charr seems ideal as a model for studying such mechanisms.
- Use of Partial Venovenous Cardiopulmonary Bypass in Percutaneous Hepatic Perfusion for Patients with Diffuse, Isolated Liver Metastases: A Case Series. [JOURNAL ARTICLE]
- J Cardiothorac Vasc Anesth 2013 Nov 27.
Diffuse isolated liver metastases are the dominant mode of tumor progression in a number of cancers and present a major treatment challenge for oncologists. An experimental treatment, percutaneous hepatic perfusion (PHP), utilizes partial venovenous cardiopulmonary bypass to allow administration of high-dose chemotherapy directly and solely to the liver with filtration of chemotherapeutic agents from the blood prior to its return to the systemic circulation, thereby minimizing toxic systemic effects. The following case series describes the management of 5 patients with metastatic melanoma undergoing serial PHPs.A single-center experience from a national multi-center random-assignment trial comparing PHP to best alternative care (BAC) in patients with diffuse melanoma liver metastases.A tertiary care hospital.Five patients with metastatic melanoma to the liver.Five patients underwent a total of fifteen PHPs using a venovenous bypass circuit with hemofiltration, receiving hepatic intra-arterial melphalan, 3 mg/kg of ideal body weight, for 30 minutes with a total of 60 minutes of hemofiltration.Five patients tolerated the procedure well with transient hemodynamic and metabolic changes.In patients with diffuse isolated liver metastases, PHP is a safe and well-tolerated procedure that can be performed more than once and is associated with marked anti-tumor activity in some patients.
- Implicit theories of the body among college women: Implications for physical activity. [JOURNAL ARTICLE]
- J Health Psychol 2013 Nov 21.
This study explored the relationship between implicit theories of the body (ITB) and self-reported physical activity. ITB are beliefs about the malleability of the body. Individuals may hold entity ITB (that body appearance is fixed) or incremental ITB (that body appearance can be changed). Female undergraduate students (N = 313) completed an online survey assessing ITB, physical activity, and discrepancy between actual and ideal body weight. Participants endorsing incremental ITB reported more physical activity. A significant ITB by weight discrepancy interaction emerged. Developing interventions targeting implicit theories of the body may be one way to increase physical activity.
- The Effect of "In Favor of Myself": Preventive Program to Enhance Positive Self and Body Image among Adolescents. [Journal Article]
- PLoS One 2013; 8(11):e78223.
Positive self-esteem, emotional well-being, school achievements and family connectedness are considered protective factors against health-compromising behaviors. This study examined the effect of an interactive, community-based, media literacy and dissonance wellness program, In Favor of Myself, on the self-image, body image, eating attitudes and behavior of young adolescents. A preliminary cohort study was conducted among 972 program participants who did not take part in the controlled trial. Over 75% of participants said they would recommend the program to their friends.A controlled trial was conducted to evaluate program acceptability, efficacy and effectiveness among 259 participants (210 in the intervention group and 49 in the control group), aged 12-14 years, who completed questionnaires during at least two assessment times. Program materials were provided, along with leaders' training, in order to ensure quality program delivery and creation of a wide network of committed program leaders.The program significantly reduced drive for thinness and self-worth contingent upon others' approval, the gap between current body figure and ideal figure, and the impact of mood on girls' self-image. Superiority was found among those participating in the intervention group with respect to recognizing media strategies, the influence of media on desire to change, and the influence of appearance on self-confidence and drive for thinness.In Favor of Myself shows promising results for strengthening adolescents' ability to cope with the challenges of their life stage. Suggestions for improving In Favor of Myself are presented.
- Negotiated media effects. Peer feedback modifies effects of media's thin-body ideal on adolescent girls. [JOURNAL ARTICLE]
- Appetite 2013 Nov 18.
The present study introduces a theoretical framework on negotiated media effects. Specifically, we argue that feedback of peers on thin-body ideal media images and individual dispositions guide effects on adolescent girls' psychosocial responses to media exposure. Therefore, we examined the thin-body ideal as portrayed in media and peers' feedback on such thin-ideal images in their combined effects on adolescent girls' body dissatisfaction, objectified body consciousness, and social comparison with media models. Hence, media models and peer comments were systematically combined as incorporated entities in YouTube-formats. Hypotheses were tested in a 3 (media models: extremely thin vs. thin vs. normal weight)×3 (peer comments: 6kg-underweight vs. 3kg-underweight vs. normal-weight)×2 (appearance schematicity: lower vs. higher) between-subjects design (N=216). Results showed that peer comments indicating that a media model was 'only 3kg-underweight' exerted most negative responses, particularly in girls who strongly process appearance relevant information. Peer feedback interacts with media models in guiding perceptions of what is considered an 'ideal' body shape. Results highlight the important role of peers as well as individual predispositions in view of understanding how thin-ideal media images may impact adolescent girls' body image concerns.
- Comparative Pharmacokinetics and Pharmacodynamics of Doripenem and Meropenem in Obese Patients. [JOURNAL ARTICLE]
- Ann Pharmacother 2013 Nov 14.
Antimicrobial pharmacokinetic and pharmacodynamic data are limited in obesity.To evaluate the steady-state pharmacokinetics and pharmacodynamics of doripenem and meropenem in obese patients hospitalized on a general ward.Patients with a body mass index (BMI) ≥40 kg/m(2) or total body weight (TBW) ≥100 pounds over their ideal body weight randomly received doripenem 500 mg (1-hour infusion) or meropenem 1 g (0.5-hour infusion) every 8 hours. Differences in pharmacokinetic parameters were determined by unpaired t test. Monte Carlo simulations were performed for 500 mg and 1 g every 8 hours, infused over 1 and 4 hours for doripenem and 0.5 and 3 hours for meropenem. Probability of target attainment (PTA) was calculated using a pharmacodynamic target of 40% fT > MIC (free drug concentrations above the minimum inhibitory concentration [MIC]), and cumulative fraction of response (CFR) was calculated using MIC data for 8 Gram-negative pathogens.Twenty patients were studied. Volume of distribution at steady state, corrected for TBW, was significantly larger (0.18 ± 0.04 vs 0.13 ± 0.05 L/kg, P = .048) and systemic clearance was significantly faster for doripenem (11.7 ± 4.1 vs 8.1 ± 2.6 L/h, P = .03). PTA was >90% for all regimens at MICs ≤2 µg/mL. CFR was >90% for all regimens against 6 enteric Gram-negative pathogens and for 3 of 4 regimens for each drug against Pseudomonas aeruginosa.Doripenem and meropenem pharmacokinetics differ in obesity. However, currently approved dosing regimens provide adequate pharmacodynamic exposures for susceptible bacteria in obese patients.
- Performance of a Divided-Load Intravenous Vancomycin Dosing Strategy for Critically Ill Patients. [JOURNAL ARTICLE]
- Ann Pharmacother 2013 Oct 25.
Current guidelines recommend vancomycin trough concentrations 15 to 20 µg/mL in complicated infections and all trough concentrations above 10 µg/mL.We assessed the performance of a novel divided-load protocol designed to attain target trough concentrations within 24 hours of initiation and prevent doses given at concentrations above the target range, in critically ill patients.The protocol was evaluated in 79 critically ill patients through retrospective medical record review. Vancomycin serum concentrations were drawn before the third dose after initiation and after any dosing change. Steady-state concentrations were drawn before the fifth or sixth doses. Vancomycin concentrations before the second dose were predicted using a nonparametric expectation maximization algorithm.Sixty-nine of 79 patients received scheduled doses, and 62 (90%) of the scheduled-dose patients attained therapeutic target concentrations 12 to 24 hours after therapy initiation. Eight scheduled-dose patients weighed > 150% of ideal body weight (IBW) and were significantly more likely to exhibit supratherapeutic trough concentrations before the fifth or sixth doses (P = .0004) compared with patients weighing ≤150% of IBW. Ten of 79 patients (8 dialysis dependent and 2 experiencing acute kidney injury) were dosed in response to measured serum drug concentrations drawn according to the divided-load protocol. All the 8 dialysis-dependent patients (100%) attained therapeutic concentrations 12 hours after therapy initiation.The divided-load vancomycin dosing strategy achieved measured trough concentrations 15 to 20 µg/mL for most critically ill patients within 24 hours of initial dosing, without allowing doses given during supratherapeutic concentrations.
- Improvement of orthotopic lung cancer mouse model via thoracotomy and orotracheal intubation enabling in vivo imaging studies. [JOURNAL ARTICLE]
- Lab Anim 2013 Nov 20.
Investigation of molecular mechanisms and the efficiency of novel therapeutics for the treatment and prevention of a disease require accurate and accessible preclinical models. Recent developments in personalized medicine employing molecular medicine concepts have favored mice because their genetic make-up is well known and easy to manipulate. For lung cancer, however, orthotopic models in mice are difficult to create due to their narrow glottis openings which act as obstacles to intubation. In the present study, we develop an orotracheal intubation device which gives a clearer view of the narrow mouse glottis and increases the success rate of intubation. We achieved anesthetization via orotracheal intubation using this novel device and then performed a thoracotomy by making an incision between the fourth and fifth intercostal ribs on the right side of the chest. Lung tumor cells were then inoculated at this site. Tumor formation was monitored through bioluminescence optical and magnetic resonance (MR) imagings, which was confirmed by histological analysis. Temperature drop (<35) and/or loss of body weight (>30% of the initial body weight) observed during any procedure were used as interruption criteria. This method exhibited high tumorigenicity (100%) and a low mortality rate (8%) at specific sites making it ideal for creating orthotopic lung tumor models and making it particularly useful for sequential follow-up studies using in vivo image analysis.
- Pharmacokinetic analysis of anti-hemophilic factor in the obese patient. [JOURNAL ARTICLE]
- Haemophilia 2013 Nov 20.
Standard dosing for individuals with hemophilia A is based on body weight such that 50 IU kg(-1) is defined as a 100% dose, or one attaining 1.00 IU mL(-1) factor VIII (FVIII) clotting activity. No guidelines exist, however, for individuals with hemophilia who are obese, body mass index (BMI) ≥ 30, who may actually be 'over'-treated based on higher in vivo recovery based on higher weight. Alternative treatment guidelines are needed for such patients. To determine FVIII pharmacokinetics we retrospectively collected data during ideal-body-weight dosing from six obese (BMI ≥ 30) hemophilia A patients cared for at the Hemophilia Center of Western PA, for prophylaxis or surgery. The pharmacokinetic data from six subjects undergoing ideal-body-weight dosing with recombinant FVIII indicate peak levels and half-life comparable to standard 50 IU kg(-1) dosing. The mean peak FVIII:C was 1.00 IU dL(-1) and the mean FVIII:C half-life was 10.14 h. IBW-dosing resulted in an average 48.9% reduction in factor use per patient over a 3-month period, for an annualized savings of $133 000 per patient. Ideal-body-weight dosing of recombinant FVIII in obese patients with hemophilia A results in comparable pharmacokinetics, including peak and half-life, with comparable hemostatic efficacy for prophylaxis and surgical treatment, at a significant reduction in factor use and cost. Future studies are needed to confirm these findings in individuals with other congenital bleeding disorders and in children.