Lack of metabolic and behavioral adaptations in rural Gambian men with low body mass index.

Energy expenditure was measured by means of a respiratory chamber in two groups of adult rural Gambian men. The first group (n = 29) had a low body mass index (BMI; in kg/m2) < 18.5), whereas the control group (n = 29) had a higher BMI (> 22). This study shows that the energy expenditure of Gambian men with low BMI is not different from that of Gambian men with normal BMI when the results are normalized for fat-free mass or for weight by analysis of covariance. In Gambian men the nutritional status thus does not seem to affect energy metabolism notably. No differences in respiratory quotient, diet-induced thermogenesis, net work efficiency, spontaneous physical activity, heart rate, or urinary catecholamine excretion were observed between the two groups. It is, however, interesting to note that the basal metabolic rate of Gambian men, regardless of their nutritional status, is approximately 10% (range 4-12% depending on the reference value used) lower than that predicted for individuals living in industrialized countries.

High level of free-living energy expenditure in rural Gambian men: lack of behavioural adaptation between low and normal BMI groups.

OBJECTIVE: To explore if a behavioural adaptation--such as a reduction in total free-living energy expenditure (EE)--occurs in Gambian individuals with low body mass index (BMI < 18.5 kg/m2). DESIGN: Cross-sectional comparative study of young Gambian men living in rural area. METHODS: Total daily free-living EE was assessed from the heart rate method (using individual regression line between heart rate and EE determined in a respiration chamber). SUBJECTS: One group of underweight men (n = 26, BMI = 17.2 +/- 0.2 kg/m2 compared to a control group with normal BMI matched for age and height (n = 28, BMI = 23.3 +/- 0.2 kg/m2). RESULTS: In absolute value, the free-living EE of the low BMI group was significantly lower than that of the control group (10.3 +/- 0.5 vs 12.7 +/- 0.5 MJ/d, P < 0.001). Expressed per kg body weight or kg fat-free mass, the differences between the two groups disappeared. In both groups, the level of free-living EE averaged approximately two times the basal metabolic rate. CONCLUSIONS: Rural Gambian men with low BMI and normal BMI have similar levels of free-living EE when normalized for body weight or fat-free mass. Their level of activity can be judged as moderate to heavy. Within the range of BMIs studied there was no evidence of behavioural adaptation to save energy.

[Lithotripsy of biliary calculi by shock waves. Current possibilities and perspectives]. / La lithotripsie du calcul biliarie par ondes de choc. Possibilités actuelles et perspectives.

The extracorporal shock wave lithotripsy can be recommended for the destruction of cholelithiasis in the gallbaldder and in intra- and extrahepatic ducts. For this treatment a strict selection of patients is necessary. Only bile stones composed mainly of cholesterol can be treated. It is better if the gallbladder contains only one stone. The gallbladder has to be anatomically and functionally intact. With this technic of destruction of cholelithiasis associated with litholytic medication a good result can be obtained and about 60% of patients have no cholethiasis after one year.