North American Journal of Medical Sciences最新文献

{"title":"New Right Bundle Branch Block as a Criterion for Emergent Coronary Angiography","authors":"Jonah M. Pozen, A. Mankad, J. T. Owens, I. Jovin","doi":"10.4103/1947-2714.172849","DOIUrl":"https://doi.org/10.4103/1947-2714.172849","url":null,"abstract":"Context: ST-segment elevations in two or more contiguous leads or new left bundle branch block (LBBB) on electrocardiography (ECG) in a patient with acute onset chest pain are diagnostic criteria for acute myocardial infarction (AMI) and generally warrant urgent coronary angiography and cardiac catheterization. However, the significance of new right bundle branch block (RBBB) without other acute ECG changes is unclear and is currently not considered a criterion. Case Report: We present a patient with chest pain, positive biomarkers of myocardial necrosis and isolated new right bundle block on ECG. He was diagnosed with AMI but did not undergo urgent reperfusion therapy in the absence of ST-segment elevations or new LBBB. However, angiography ultimately demonstrated complete coronary occlusion. Conclusion: The established criteria for emergent catheterization may prove to be more sensitive with the inclusion of the presence of new RBBB on ECG.","PeriodicalId":19703,"journal":{"name":"North American Journal of Medical Sciences","volume":"516 1","pages":"569 - 571"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77125999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Signatures of Oxidative Stress and Their Relationship with Erythrocyte Membrane Surface Roughness Among Workers of Manual Materials Handling (MMH)","authors":"Subrata Ghosh, M. Acharyya, Titlee Majumder, Anandi Bagchi","doi":"10.4103/1947-2714.172846","DOIUrl":"https://doi.org/10.4103/1947-2714.172846","url":null,"abstract":"Background: Brickfield workers in India perform manual materials handling (MMH) and as a result, are at a high risk of developing oxidative stress. This results in an alteration of the various markers of metabolic oxidative stress at the cellular level. Since red blood cell (RBC) is the central point where oxygen, glucose-6-phosphate dehydrogenase (G-6-PD), and glutathione (GSH) are involved, the surface roughness and its alteration and modeling with respect to workers exposed to MMH may be considered as helpful determinants in predicting early damage to the cell and restoring better health to the exposed population, that is, the worker exposed to stress. Hence, nanometric analysis of the surface roughness of the RBC may serve as an early indicator of the stress-related damage in these individuals. Aims: The purpose of the study was to identify early red blood corpuscular surface damage profile in terms of linear modeling correlating various biochemical parameters. Linear modeling has been aimed to be developed in order to demonstrate how individual oxidative stress markers such as malondialdehyde (MDA), G-6-PD, and reduced GSH are related to the RBC surface roughness [root mean square (RMS)]. Materials and Methods: Conventional analysis of these biochemical responses were evaluated in MMH laborers (age varying between 18 years and 21 years) and a comparable control group of the same age group (with sedentary lifestyles). Peak expiratory flow rate (PEFR) and RBC surface analysis by atomic-force microscopy (AFM) and correlated scanning probe microscopy (SPM-analytical software) with corresponding image analysis were performed immediately after completion of standardized exercise (MMH) at the brickfield. Results: A number of correlated significances and regressive linear models were developed among MDA, G-6-PD, GSH, and RBC surface roughness. Conclusion: It appears that these linear models might be instrumental in predicting early oxidative damages related to specific occupational hazards.","PeriodicalId":19703,"journal":{"name":"North American Journal of Medical Sciences","volume":"148 1","pages":"558 - 566"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77910036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cortical Hemiballism: A Case of Hemiballismus Associated with Parietal Lobe Infarct","authors":"P. Shrestha, Janak Adhikari, D. Poudel, R. Pathak, P. Karmacharya","doi":"10.4103/1947-2714.172850","DOIUrl":"https://doi.org/10.4103/1947-2714.172850","url":null,"abstract":"Context: Hemiballismus is characterized by involuntary, irregular, large amplitude, and violent flinging movements of limbs. Stroke (middle and posterior cerebral artery) remains the most common etiology with 2/3 being lacunar. Lesions outside the substantia niagra (STN) can cause hemiballism, and only a minority by STN lesions, unlike the classical belief. Compared to those arising from STN, cortical hemiballismus is usually less severe with a good prognosis. Case Report: A 61-year-old man presented with sudden onset involuntary flinging movements of his right upper extremity accompanied by numbness and tingling. Past medical history was significant for stroke 2 years back with no residual deficits. Vitals signs were blood pressure of 165/84 mm Hg, and heart rate - 82 beats/min. Irregular, arrhythmic, jerky flinging movement, and decreased sensation to light touch in right upper extremity was noted. Magnetic resonance imaging of the brain revealed acute posterior left parietal lobe infarction. He was treated with aspirin and atorvastatin. Thrombolytic therapy was offered but declined. The movements resolved spontaneously over the next 2 days. No further episodes occurred at 3-month follow-up. Conclusion: Lesions affecting various areas outside the STN can cause hemiballism and usually carries a good prognosis with spontaneous resolution. Acute thrombolytic therapy may be considered on an individual basis. Treatment with antipsychotics can be useful for severe and recurring symptoms.","PeriodicalId":19703,"journal":{"name":"North American Journal of Medical Sciences","volume":"1 1","pages":"572 - 574"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89290631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometrial Cancer and The Role of Statins","authors":"Ammar Humayun, Muhammad Shahzeb Khan, Syed Arish Haider, M. H. Arshad, Ekta Golani","doi":"10.4103/1947-2714.172855","DOIUrl":"https://doi.org/10.4103/1947-2714.172855","url":null,"abstract":"Dear Editor, \u0000 \u0000According to the new guidelines published by the American College of Cardiology, it is predicted by experts that statins will become one of the most commonly prescribed drugs in the age group of 40-75 years.[1] Statins have been clearly shown to improve morbidity and mortality in patients with cardiovascular diseases. Recently, the beneficial effect of statins on the prognosis and risk of various cancers including gynecological malignancies has also been highlighted in multiple studies. \u0000 \u0000Endometrial cancer, the most common cancer of the female genital tract, has already caused more than 10,000 mortalities in the United States alone in the year 2015.[2] With advanced-stage endometrial cancer presenting with an extremely poor outcome, it is important that factors that can help to decrease the risk of endometrial cancer should be thoroughly investigated. The role of statins in this regard has been highly debatable in the recent past. In an attempt to collect updated evidence, we conducted an extensive literature search utilizing Medline (PubMed and OvidSP) and Cochrane Library to identify all possible studies that have investigated the impact of statins on the risk and prognosis of endometrial cancer. \u0000 \u0000Thirteen relevant citations were found[3,4,5,6,7,8,9,10,11,12,13,14,15] and are shown in Tables ​Tables11 and ​and2.2. Three studies[5,6,7] showed that statins significantly reduce the risk of developing endometrial cancer while seven studies[8,9,10,11,12,13,14] reported no such relationship. The three studies that documented favorable impact of statins on endometrial cancers were all limited by lack of randomization, single center locations, relatively small sample sizes, and confounders as patients had multiple comorbidities. Only three studies[3,4,12] were found that investigated the effect of statins on endometrial cancer survival, which are shown in Table 2. Nevadunsky et al.[3] reported that statins significantly (HR = 0.63) prolong survival in patients with endometrial cancer while the other two studies[4,12] concluded that statins have no significant effect on mortality. These studies have not mentioned if they have looked at progression-free survival or overall survival versus a cancer specific outcome such as time to recurrence. \u0000 \u0000 \u0000 \u0000Table 1 \u0000 \u0000Summary of the evidence regarding role of statins in the risk of endometrial cancer \u0000 \u0000 \u0000 \u0000 \u0000 \u0000Table 2 \u0000 \u0000Summary of evidence regarding statins and outcome of endometrial cancer \u0000 \u0000 \u0000 \u0000It is vital to consider the duration of statin usage as well. In a recent meta-analysis by Liu et al.,[15] it was shown that when statins were taken for greater than 5 years, the risk of endometrial cancer was reduced by 31%. Moreover, they reported that studies conducted in Asian populations only had a significant relationship when all potential confounders were considered. It is important to note that patients who take statins tend to be elderly, have multiple comorbidities, and medication regime","PeriodicalId":19703,"journal":{"name":"North American Journal of Medical Sciences","volume":"5 1","pages":"577 - 579"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88783017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Signatures of Oxidative Stress in the Red Blood Cells: Editorial Commentary","authors":"E. Nwose","doi":"10.4103/1947-2714.172847","DOIUrl":"https://doi.org/10.4103/1947-2714.172847","url":null,"abstract":"This issue of the journal contains an interesting article—“Metabolic Signatures of Oxidative Stress and their Relationship with Erythrocyte Membrane Surface Roughness among Workers of Manual Material Handling (MMH)”. Oxidative stress has been a longtime research interest that is yet to be assessed by a clinical laboratory for evidence-based practice, because it is perceived to be implicated in virtually every disease or condition. The report surely has backing from the literature. For instance, oxidative stress has known metabolic signatures,[1,2] which is hallmarked by glutathione (GSH), as well as reactive oxygen species.[3] \u0000 \u0000The concept of erythrocyte oxidative stress (EOS) further denotes that the biomarkers vis-a-vis metabolic signatures are detectable in red blood cells. Indeed, cardiovascular complications in diabetes represent a major health problem worldwide, but knowledge of progression and degree of risk in prediabetes is limited. Significant changes in biomarkers of EOS and indicators of related macrovascular events that may underlie the development of diabetic macrovascular complications, have been consistently reported. The biomarkers are speculated to be emerging risk indicators, namely, (1) indices of EOS, including erythrocyte-reduced GSH, malondialdehyde, and associated enzymes; (2) indices of vasculopathy, including plasma D-dimer, homocysteine, and whole blood viscosity; and (3) indices of dyslipidemia, namely, total cholesterol (TC), high-density lipoprotein (HDL), and TC/HDL ratio. Thus, there has been the recognition of a spectrum of metabolic profile[3] that should be narrowed down to a useful panel of tests to improve early identification and intervention.[4] \u0000 \u0000The present article highlights the significant impact of EOS on the surface of the blood cell membranes. While this effect may be known,[5] it is probably yet to be appreciated that apparently healthy individuals may suffer oxidative damage as occupational hazard. The authors have attempted to develop a linear model to demonstrate how individual oxidative stress marker is related to surface roughness of the erythrocyte membrane. It will be interesting to see corroborative reports that will exemplify and validate the speculated model. \u0000 \u0000Further, the authors have, albeit passively, also mentioned a phenomenon that the carriage of oxygen inside the blood and/or body must be assessed by means of biochemical parameters and the nanoscale levels of changes in the surface roughness of the erythrocyte membrane. This may follow the concept of EOS being associated with hypoxia — e.g., oxidative stress can induce hyperviscosity that in turn leads to the sequence of reduced blood flow, less oxygen supply, and tissue hypoxia. The phenomenon may follow the concept of oxidative stress-inducing anemia or exacerbating iron-deficiency anemia as well. It would be interesting to see corroborative reports that will expatiate on this phenomenon.","PeriodicalId":19703,"journal":{"name":"North American Journal of Medical Sciences","volume":"35 1","pages":"567 - 568"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84423678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study of the Inability to Fit Hands Around Neck as a Predictor of Obstructive Sleep Apnea","authors":"P. J. Edmonds, L. Edmonds","doi":"10.4103/1947-2714.172843","DOIUrl":"https://doi.org/10.4103/1947-2714.172843","url":null,"abstract":"Background: Considering the high estimates of undiagnosed and untreated obstructive sleep apnea (OSA), there is a need for simple and accurate diagnostic tests. Neck circumference has long been correlated with OSA, but its usefulness as a diagnostic tool has been limited. Aims: We proposed to evaluate the value of a simple neck grasp test to help identify OSA. We hypothesized that the inability of a patient in a sleep clinic to fit their hands around their neck is predictive of OSA. Materials and Methods: A retrospective review of medical records of patients evaluated in a general sleep clinic was performed. Easy sleep apnea predictor (ESAP) positive was defined as the inability to place the hands around the neck with digits touching in the anterior and posterior. ESAP negative was the ability to place hands around the neck. Positive for OSA in this symptomatic sleep clinic population was defined as an apnea-hypopnea index (AHI) of ≥5. Results: A total of 47 subjects (36% female) had ESAP data available, which were reviewed. The mean age was 51.6 years (SD 14.4, range 29-81 years). The mean body mass index (BMI) was 38.8 (SD 9.9, range 20.4-69.5). Review showed 87.2% (N = 41) tested positive for OSA by AHI of ≥5. The sensitivity and specificity of ESAP were 68.3% and 100%, respectively. The positive predictive power was 100% and the negative predictive power was 31.6%. Conclusion: As we hypothesized, ESAP positive (inability to span neck) was predictive of OSA in a population of sleep clinic patients. An ESAP positive test was 100% predictive of the presence of OSA (AHI of ≥5). ESAP shows promise for ease of clinical use to predict the presence of OSA in a general sleep clinic population.","PeriodicalId":19703,"journal":{"name":"North American Journal of Medical Sciences","volume":"78 1","pages":"553 - 557"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89246135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is There a Clinically Meaningful Change in the Blood Pressure of Osteoarthritis Patients with Comorbid Hypertension During the Course of Balneotherapy?","authors":"E. Hayta, M. Yılmaz, İlker Yayıkçı, Zafer Özer, Ö. Şahin","doi":"10.4103/1947-2714.170616","DOIUrl":"https://doi.org/10.4103/1947-2714.170616","url":null,"abstract":"Background: Balneotherapy (BT) is a treatment modality that uses the physical and chemical effects of water, including thermomineral, acratothermal, and acratopegal waters. It has many effects on cardiovascular system. Aim: The aim of the study is to investigate the effects of 3-week BT on blood pressure of osteoarthritis (OA) patients with no hypertension (HT), and controlled or uncontrolled HT. Materials and Methods: The OA patients (n = 270) were divided into three groups: No HT, controlled HT, and uncontrolled HT. All the groups received BT in the facilities of our university hospital at the same time every day (10:00-11:30 AM) for 10 min per day, 5 days per week, for a total duration of 15 days in a 3-week period. Systolic and diastolic blood pressures and pulse rates were measured before and after BT on daily basis. Results: Overall, (1) the pulse rates of study groups measured after BT were significantly increased compared to before BT; (2) the systolic blood pressures of study groups measured before and after BT were found as comparable; and (3) the diastolic blood pressures of no HT and controlled HT groups measured before and after BT were not statistically significant (P > 0.05); however, in the uncontrolled HT group, the diastolic blood pressure showed a decreasing trend after BT (P < 0.05). Conclusions: In patients with OA, BT can be safely used without resulting in any meaningful changes in systolic and diastolic blood pressures in patients with normal and controlled HT but a decrease in diastolic blood pressure of patients with uncontrolled HT. This may be an advantage in OA patients having HT as comorbid disease.","PeriodicalId":19703,"journal":{"name":"North American Journal of Medical Sciences","volume":"15 1","pages":"517 - 523"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82423747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Need to Emphasize Nephrology Knowledge in Residents-in-Training","authors":"S. Akbar, H. Iqbal, U. Ahmed","doi":"10.4103/1947-2714.170621","DOIUrl":"https://doi.org/10.4103/1947-2714.170621","url":null,"abstract":"Background: Chronic kidney disease is an increasingly prevalent health problem with the potential for poor outcome of end-stage renal disease. Hospitalized critically ill patients are prone to acute renal injury from numerous factors such as poor renal perfusion secondary to ischemia and hypotension, nephrotoxin exposure, and intravenous contrast exposure. Aims: We set to explore resident awareness and knowledge about chronic kidney disease management, timely nephrology referrals, preventing inadvertent acute kidney injury (AKI), and the understanding of basic electrolyte physiology. Materials and Methods: We conducted a cross-sectional study using an online questionnaire survey of internal medicine, Medicine/Pediatrics and Family Medicine residents in the United States to determine the knowledge of residents during their training about nephrology. Results: The survey questionnaire was sent out to 270 residents. Forty-seven (17%) respondents completed the survey. Out of them, 57% of the residents chose to refer a patient with an estimated glomerular filtration rate <30 mL/min/1.73 m 2 to a nephrologist; 66% felt that it was safe to use aspirin in stage IV chronic kidney disease; 82% did not want to use metformin or Lovenox in stage IV chronic kidney disease; 87% answered that they would make the patient resume angiotensin converting enzyme inhibitor or angiotensin II receptor blockers (ARBs) about 48-72 h after contrast exposure. Only 7.5% decided to hold angiotensin converting enzyme inhibitors/ARBs before contrast exposure. Meanwhile, 70% correctly identified the efferent arteriole as the site of action of angiotensin converting enzyme inhibitors/ARBs and 76% identified nitrofurantoin as a contraindication in renal insufficiency. Conclusion: Residency offers a golden opportunity for resident physicians to create a strong foundation of concepts in medicine. There are several basic areas in the field of nephrology that need to be further emphasized during residency training to help improve patient care and potentially decrease the incidence of AKI.","PeriodicalId":19703,"journal":{"name":"North American Journal of Medical Sciences","volume":"57 1","pages":"524 - 528"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81509488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of Oro-Pharyngo-Esophageal Scintigraphy in the Management of Patients with Aspiration into the Tracheo-bronchial Tree and Consequent Dysphagia","authors":"M. Grosso, V. Duce, B. Fattori, L. Bruschini, M. Meniconi, R. Raschillà, Fabiola Cocco, L. Locantore, F. Guidoccio, F. Orsini, K. Massri, D. Volterrani, D. Rubello","doi":"10.4103/1947-2714.170628","DOIUrl":"https://doi.org/10.4103/1947-2714.170628","url":null,"abstract":"Context: Tracheo-bronchial aspiration is the most invalidating condition which can happen to patients affected by dysphagia, especially when caused by central neurologic disorders; the associated pneumonia episodes represent the most frequent cause of death in these patients. Oro-pharyngo-esophageal scintigraphy (OPES) allows both functional imaging and semiquantitative evaluation of the subsequent phases of swallowing. Case Report: We evaluated by means of OPES a woman who had previously undergone high-dose external beam radiation therapy for a nasopharyngeal carcinoma, which determined tissue fibrosis and progressive dysphagia. Conclusion: In this patient with dysphagia, OPES was a simple, inexpensive, noninvasive, and reliable technique that allowed to show the presence of bolus aspiration and quantified tracheobronchial aspirate.","PeriodicalId":19703,"journal":{"name":"North American Journal of Medical Sciences","volume":"44 1","pages":"533 - 536"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77425744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caralluma Fimbriata Supplementation Improves the Appetite Behavior of Children and Adolescents with Prader-Willi Syndrome","authors":"Joanne L Griggs, X. Su, M. Mathai","doi":"10.4103/1947-2714.170611","DOIUrl":"https://doi.org/10.4103/1947-2714.170611","url":null,"abstract":"Background: Prader-Willi syndrome (PWS) results from a deletion of the paternal genes in the region of chromosome 15q11-q13. PWS develops hyperphagia, which when left unmanaged, leads to an excessive ingestion of food. To date there is inadequate pharmacological treatment or supplementation for modification of the PWS hyperphagia and/or the associated behaviors. Therefore, the best practice is familial supervision and restriction of diet and environment. Aim: We aimed to determine if the natural supplement of Caralluma fimbriata extract (CFE) could attenuate hyperphagia or the associated appetite behaviors in children and adolescents with PWS over the 4-week pilot trial period. Materials and Methods: We conducted a placebo-controlled, double-blind, randomized crossover trial over a 10-week period to investigate the effects of CFE on hunger control, in a cohort of children and adolescents with confirmed PWS (n =15, mean age 9.27 ± 3.16 years, body weight 43.98 ± 23.99 kg). Participants from Australia and New Zealand ingested CFE or a placebo of maltodextrin/cabbage leaf over a 4-week period, with a 2-week washout before the crossover to the other treatment. Weekly comparisons in appetite behavior, severity, and drive were recorded by parents, as scaled time-point measures on a hyperphagia questionnaire validated for PWS. Results: CFE administration was found to induce a significant accumulative easing of hyperphagia (P = 0.05), with decreases evident in one-third of the participants. Furthermore due to CFE supplementation, a significant decrease (P ≤ 0.05) was recorded in the category of behavior and a decrease in hyperphagia (n = 8, P = 0.009) was observed at the highest dose 1,000 mg/day (recommended adult dose). There were no reported adverse effects at any dose. Conclusion: We demonstrate that an extract of the Indian cactus succulent Caralluma fimbriata eases hyperphagic appetite behavior within a cohort of children and adolescents (n = 15) with PWS without notable adverse effects. The outcomes of this study will have a potential positive impact on PWS management.","PeriodicalId":19703,"journal":{"name":"North American Journal of Medical Sciences","volume":"48 1","pages":"509 - 516"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77580743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}