Long-term drug treatment of obesity in a private practice setting.

This study evaluated the long-term efficacy and safety of the combination of phentermine and fenfluramine for the treatment of obesity in a private practice setting. A total of 1388 consecutive, qualified patients presenting to a private general internal medicine practice in Charlotte, NC, were enrolled with eligibility criteria including: age 18 years to 60 years, 20% over "desirable" bodyweight or body mass index > 27, no serious medical or psychiatric disease, and no contraindications to drug therapy. Patients were instructed in diet, exercise, and behavior modification techniques and received phentermine (15 mg/day to 30 mg/day) and fenfluramine (20 mg/day to 60 mg/day) continuously for over 3 years. Average duration of treatment was 15.9 months, and average weight loss at the last visit was 11.6 kg, or 11.7% of initial bodyweight. For patients completing 1 year of drug treatment, mean weight loss was 16.5 kg, or 16% of initial weight. Weight loss persisted for 2 years, but partial regain was seen at 3 years. The dropout rates were 18% at 6 months, 39% at 1 year, 68% at 2 years, and 78% at 3 years. At 1 year, blood pressure of hypertensive patients fell from 151/95 mm Hg to 127/78 mm Hg, and serum cholesterol and triglycerides of hyperlipidemic patient fell by 0.750 mmol/L (29 mg/dL) and 0.937 mmol/L (83 mg/dL), respectively. Adverse events were modest. We conclude that, in a private practice setting, long-term treatment of obesity with the combination of phentermine, fenfluramine, and a weight maintenance program is generally safe and effective. More research is needed to determine efficacy and safety for longer than 3 years.

Quantitative cytophotometric and autoradiographic analysis of the cell cycle kinetics during growth and development of the plasmodium in the myxomycete Didymium iridis.

Nuclear changes in basic protein, RNA, and DNA in plasmodia of Didymium iridia at 4, 8, and 12 days during their progression through the growth cycle prior to sporulation were analysed. Relative determinations of basic protein and RNA were made using naphthol yellow-S/azure B in conjunction with absorption microspectrophotometry. DNA was quantified by quantitative cytophotometric measurements of Feulgen-stained nuclei. Autoradiographic techniques provided information on periods of DNA synthesis. A net decrease in protein and RNA to a point of stabilization was shown which correlated with increased age of the organism and decreased nutrient supply in the plasmodia. The 4C DNA content of the 4 day plasmodia indicated rapid growth and high metabolic activity while in the 8 day plasmodia a 2C DNA was observed consistent with the presence of a G1 period of some duration.