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Dr. Charles Lapp, Hunter-Hopkins Center, Charlotte, North Carolina Dr. Susan Levine, internal medicine practice, New York City Dr. Dan Peterson, Sierra Internal Medicine, Incline Village, Nevada Dr. Alan Pocinki, internal medicine practice, Washington, DC.
Some even afford a possible cure for example, in focal atrial fibrillation ; , although many have been studied in relatively small numbers of patients who have failed or cannot tolerate ; medical treatment, for instance, ali orlistat.

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Chairpersons: G. Mancia Milan, Italy ; L.M. Ruilope Madrid, Spain ; Introduction G. Mancia Milan, Italy ; Managing hypertension: a question of STRATHE F. Zannad Dommartin, France ; Further evidence for low-dose combination in patients with LVH B. Dahlf Gteborg, Sweden ; Challenging established hypertension management strategies in diabetic patients C.E. Mogensen Aarhus, Denmark ; Targeting endothelial dysfunction in hypertensive patients C. Thuillez Rouen, France ; What will the ADVANCE trial tell us that we don't already know? N. Poulter London, UK ; Conclusion L.M. Ruilope Madrid, Spain. Indomethacin indocin indomethacin indomethacin images indomethacin drug interactions user comments: be the first to write a comment about indomethacin see also: acute gout , ankylosing spondylitis , bartter syndrome , bursitis , cluster headache , gitelman syndrome , langerhans' cell histiocytosis , osteoarthritis , pain , patent ductus arteriosus , rheumatoid arthritis , tendonitis all services a-z drug list drugs & medications diseases & conditions news & articles pill identifier interactions checker drug side effects drug image search new drug approvals new drug applications fda drug alerts clinical trial results patient care notes medical encyclopedia medical dictionary medical videos - community forums for professionals drug imprint codes medical abbreviations veterinary drugs contact us news feeds advertise here recent searches gamunex mesothelioma effexor orlistat cosopt roxicet mescaline sterile talc evoclin cozaar alli viagra propecia xenical botox levitra topamax lunesta soliris betaseron acyclovir wellbutrin advate ceprotin taxotere recently approved totect acam2000 somatuline depot evithrom zingo selzentry evamist calomist privigen atralin gel more. Thus, asking men about ed as part of the review of symptoms is an effective means of practicing preventive vascular medicine.
Fig. 3. Effect of Orlitsat on cellular activity of fatty acid synthase FAS ; . A, FAS activity in intact PC-3 cells was measured with a membrane-permeable activity probe, fluorophosphonate FP ; -BODIPY. PC-3 cells were first incubated with a range of Orlistat, and the remaining FAS activity was assessed by adding FP-BODIPY to the cells. Cell lysates were separated on SDS-PAGE, and active serine hydrolases were visualized top panel ; as described in "Materials and Methods." The effect of Orlostat on the level of FAS protein was measured using the same cell lysates as in by Western blot bottom panel ; . B, immune precipitation of the complex between FAS and FP-6-carboxytetramethylrhodamine TAMRA ; . Cell lysates were treated with 12 M Oorlistat ; or vehicle control ; before labeling with FP-TAMRA. FAS was immune precipitated with anti-FAS antibody. The top panel indicates the level of the complex between FP-TAMRA and FAS, whereas the bottom panel Western blot ; shows the amount of total FAS expression. C, the effect of Orlostat on cellular fatty acid synthesis was gauged by measuring the incorporation of [14C]acetate into fatty acids as described in "Materials and Methods." D, the ability of Orlistag to block labeling of the recombinant thioesterase domain of FAS was measured by preincubating the thioesterase with a range of Orlistat and subsequently with the activity probe FP-TAMRA. Samples were run on SDG-PAGE, and signal was visualized as described; bars, SD and ovral.

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X read more xenical sometimes known as orlistat, xenical is a lipase inhibitor that is used as an aid to help you lose weight, by preventing the digestion of some of the fat you eat.

Tell a friend printer friendly format orlistat is the ‘ generic' name and parlodel. One cause considered for backache in Helicopter Pilots HP ; is Whole-Body Vibration WBV ; increasing activity in the Back Muscle BM ; , leading to fatigue. However, BM was not observed to be affected by WBV in HPs during 15 min of flight J Biomech 43 10 ; : 1309-1315 ; . This study investigates the effect of WBV on the electromyogram EMG ; of the BM during flights, and compares the helicopter vibration to limits in the guidelines of ISO 2631-1 1997 ; for comfort and health. Flights lasting 2 h in average of 12 HP were monitored in Bell 412 and S-76 helicopters. The fore-and-aft X ; , lateral Y ; and vertical Z ; WBV was measured at the pilot's seat through a triaxial accelerometer. The EMG of the right and left BM was obtained by bipolar surface electrodes placed 3 cm from the 3rd lumbar vertebra. All signals were registered on a digital recorder and digitized to a computer sample rate of 1000 Hz ; . The effect of vibration was investigated in epochs of 1 min length by the coherence function between Smoothed Rectified EMG SREMG ; and the Z vibration, and by the correlation between coherently averaged SREMG and Z in cycles corresponding to the main rotor frequency 1R ; and its 1st harmonic 2R ; . One pilot showed a pattern on SREMG which could be related to vibration at 1R but statistical tests revealed no significant effect p 0.05 ; in the 12 pilots. Compared to ISO 26311, the WBV of both helicopters showed to be "a little" and "fairly" uncomfortable and, concerning health, within the "caution zone" for 8 h of daily exposure. While it is proposed that backache in HP could be attributed to muscle fatigue due to vibration, the present study does not support this hypothesis. The WBV measured indicates that attention should be given concerning the daily exposure dose. ACKNOWLEDGEMENT This study was sponsored by Brazilian Technical Cooperation Program of ICAO and by Brazilian Research Council CNPq.

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14 randomized, double-blind study. Diabetes Care 1998; 21: 12881294. Hanefeld M, Sachse G. The effects of orlistat on body weight and glycemic control in overweight patients with type 2 diabetes: a randomized, placebo-controlled trial. Diab Obes Metab 2002; 4: 415423. Serrano-Rios M, Armero F, Genis M. Orlistat efficacy on weight loss in overweight or obese patients with type 2 diabetes mellitus. Spanish randomized clinical trial. Poster presented at American Diabetes Association annual scientific sessions 2001, Philadelphia. Deerochanawong C. Effect of treatment with orlistat in overweight or obese Thai patients with type 2 diabetes. Poster presented at American Diabetes Association annual scientific sessions 2001, Philadelphia. Bonnici F. Effect of orlistat on glycemic control and body weight in overweight or obese South African patients with type 2 diabetes. Poster presented at American Diabetes Association annual scientific sessions 2001, Philadelphia. Sonnenberg FA, Beck JR. Markov models in medical decision making: a practical guide. Med Decis Making 1993; 13: 322338. Stratton IM, Adler AI, Neil HAW, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR. Association of glycemia with macrovascular and microvascular complications of type 2 diabetes UKPDS 35 ; : prospective observational study. BMJ 2000; 321: 405412. Hakim Z, Wolf A, Garrison L. Estimating the effects of changes in body mass index on health state preferences. Pharmacoeconomics 2002; 20: 393404. Hautpman J, Charles L, Boldrin M, Collins H, Segal KR. Orlistat in the long-term treatment of obesity in primary care settings. Arch Fam Med 2000; 9: 160167. Lamotte M, Annemans L, Lefever A, Nechelput M, Masure J. A health economic model to assess the long-term effects and cost23 effectiveness of orlistat in obese type 2 diabetic patients. Diabetes Care 2002; 25: 303308. Maetzel A, Ruof J, Covington M, Wolf A. Economic evaluation of orlistat in overweight and obese patients with type 2 diabetes mellitus. Pharmacoeconomics 2003; 21: 501512. Rissanen A, Lean M, Rossner S, Segal KR, Sjostrom L. Predictive values of early weight loss in obesity management with orlistat: an evidence-based assessment of prescribing guidelines. Int J Obes Relat Metab Disord 2003; 27: 103109. Albu J, Raja-Kahn N. The management of the obese diabetic patient. Primary Care 2003; 30: 465491. Wing RR, Marcus MD, Epstein LH, Salata R. Type II diabetic subjects lose less weight than their overweight spouses. Diabetes Care 1987; 10: 563566. Mark DB, Hlatky MA, Califf RM, Naylor CD, Lee KL, Armstrong PW, Barbash G, White H, Simoons ML, Nelson CL. Cost effectiveness of thrombolytic therapy with tissue plasminogen activator as compared with streptokinase for acute myocardial infarction. N Engl J Med 1995; 332: 14181424. Hiatt MD. Thrombolytic therapy with streptokinase and tissue plasminogen activator in a patient with suspected acute myocardial infarction: a decision analysis. Cardiology 1999; 91: 243249. Sullivan SD, Lew DP, Devine EB, Hakim Z, Reiber G, Veenstra D. Health state preference assessment in diabetic peripheral neuropathy. Pharmacoeconomics 2002; 20: 10791089. Churchill DN, Torrance GW, Taylor DW, Barnes CC, Ludwin D, Shimizu A, Smith EK. Measurement of quality of life in end-stage renal disease: the time trade-off approach. Clin Invest Med 1987; 10: 1420. Havranek EP, McGovern KM, Weinberger J, Brocato A, Lowes BD, Abraham WT. Patient preferences for heart failure treatment: utilities are valid measures of health-related quality of life in heart failure. J Card Fail 1999; 5: 8591 and periactin.

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Study Orlistat vs. Placebo Bakris 2002 Cocco 2005 Guy-Grand 2004 hypertensive diabetic Sibutramin vs. Placebo Fanghnel 2003 Faria 2002, 2005 McMahon 2002 McMahon 2000 Orlistat vs. Sibutramin Derosa 2005 SBP mmHg -13 vs -11; ns -4, 3 vs -0, 9; ns -9, 8 vs -9, 8; ns -4, 2 vs -0, 7; p 0, 05 -13, 9 vs -16, 5; ns -4, 6 vs -0, 6; ns + 3, 8 vs 0497 + 2, 7 vs DBP mmHg -11 vs -9, 0; p 0, 002 -3, 6 vs -0, 8; ns -7, 5 vs -7, 3; ns -3, 2 vs. -1, 3; ns -11, 4 vs -11, 7; ns + 1, 0 vs -2, 1; ns + 3, 0 vs -0, 1; p 0, 004 + 2, 0 vs -1, 3; p 0, 05 -3 vs 0; ns body weight kg -5, 4 vs. -2, 7; p 0, 001 -5, 6 vs -2, 6; p 0, 001 -5, 8 vs -1, 8; p 0, 0001 -3, 9 vs -1, 3; p 0, 0001 -5, 5 vs -3, 4; sign -6, 8 vs -2, 4; p 0, 001 -4, 5 vs -0, 4; p 0, 05 -4, 4 vs -0, 5; p 0, 05 -8, 4 vs -8, 3; ns and piracetam. P210 P142 Gum Disorders Gingivitis inflammation of the gums. Pyorrhea - slowly progressive disease where in the gums recede and the teeth fall out. Vincent's Angina - an ulceration of the gums which usually extends to the oral mucosa, pharynx, and tonsils. No serious underlying disorder, full recovery Others Gynecomastia Benign enlargement of the male breasts. Present Operated, recovered Hallux Malleus, Valgus, Hammertoe Hallux Malleus angulation of the great toe away from the midline of the body. Valgus - abnormal bony prominence on the great toe. Hammertoe - bending of the end joint of the toe. Present Operated, recovered Hand-Schuller-Christian Disease A form of granulomatous disease with lipid storage caused by faulty metabolism. Occurs mostly in children. Hay Fever See Allergy ; 784 Headache Chronic, intermittent, or recurrent pain in the head and symptom of some abnormal function. Mild, not disabling Moderate, on prescription medication Frequent, severe or disabling Others 390 - Heart Conditions Atrial Septal Defect 0-5 years DCL STD STD DCL HFC ELIM STD DCL STD STD HFC, for instance, . Leading article Clinical trials with orlistat Orlistat, a semisynthetic derivative of lipstatin, is a potent and selective inhibitor of gastric and pancreatic lipases [25] Table I ; . When administered with fat-containing foods, it partially inhibits the hydrolysis of triglycerides, thus reducing the subsequent absorption of monoglycerides and free fatty acids. Orlistat treatment results in a dose-dependent reduction in body weight in obese subjects, at an optimal dosage regimen of 120 mg t.i.d., and is generally well tolerated apart from some intestinal side effects during the first few days or weeks of administration. The efficacy and safety of orlistat have been demonstrated in several large placebo-controlled clinical trials over 2 years in obese non-diabetic subjects [26]. Orlistat has also been investigated in the treatment of obese patients with overt type 2 diabetes [27, 28]. Positive results of treatment with orlistat at a dose of 120 mg t.i.d. have recently been reported in obese patients with diabetes treated with a sulfonylurea [2931], metformin [31, 32] or insulin [33] Table II ; . A large, multicentre, randomized, double-blind, placebo-controlled study determined the effects of orlistat 120 mg t.i.d. in obese type 2 diabetic patients treated with sulfonylurea hypoglycemic agents [29]. After 1 year of treatment, a mean difference of 2.4 kg greater weight loss was observed in the orlistat group vs. the placebo group, which was associated with significant reductions in fasting blood glucose and HbA1c levels. Furthermore, a significant reduction in the dose of oral hypoglycemic agents was seen in the orlistat group. A 1-year, multicentre, randomized, double-blind, placebo-controlled trial demonstrated that orlistat is a useful adjunct treatment for producing weight loss and improving glycemic control in obese patients with type 2 diabetes who are being treated with metformin [32]. Finally, in overweight or obese patients with type 2 diabetes who had suboptimal metabolic control with insulin therapy, 1 year of orlistat treatment, compared with placebo, produced significantly greater decreases in body weight, HbA1c levels, fasting serum glucose concentrations, and the required doses of insulin and other diabetic medications [33]. A post hoc analysis of the results of these three large-scale studies suggests that lowering of HbA1c levels with orlistat in obese type 2 diabetic patients may be partially independent of weight loss as some improvement of blood glucose control was also observed in the absence of weight reduction and piroxicam.

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Management Non-drug treatment Prevention, health education Avoid drugs which aggravate the situation e.g. diuretics Comments Pathogenesis A clinical disease characterised by neurological features, dehydration, extreme hyperglycaemia, hypernatrameia and usually minimal or no ketoacidosis. Referral criteria Failure to respond coma ; Concomitant disease e.g. CVA, CCF etc. Fluid replacement for dehydration and electrolyte disturbances and pletal.

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Weight loss improves metabolic abnormalities and reduces cardiovascular risk in obese hypertensive patients. To evaluate the impact of a sustained weight loss on coronary risk, 181 hypertensive patients with metabolic syndrome underwent to orlisttat therapy, 120 mg, t.i.d., plus diet for 36 weeks. During therapy, Framingham risk scores FRS ; were calculated for determination of coronary heart disease risk in ten years. Body mass index decreased from 35.0 4.2 to 32.6 4.5 kg m2 p 0.0001 ; and waist circumference from 108.1 10.1 to 100.5 11.1 cm p 0.0001 ; , at the end of the study period week 36 ; . Systolic and diastolic blood pressure showed reductions after the two first weeks, which were maintained up to the end of the study. A clear shift to the left in FRS distribution curve occurred at the end of the study, compared to baseline, indicating a reduction in coronary risk. Over all patients at risk, 49.2% moved to a lower risk category. A weight loss 5% occurred in 64.6% of all patients, associated with improvement in glucose metabolism. Among those with abnormal glucose metabolism, 38 out 53 patients 71.7% ; improved their glucose tolerance p 0.0005 ; . In conclusion, long-term orlistat therapy helps to reduce and maintain a lower body weight, decreasing risk of coronary disease and improving glucose metabolism, thus protecting against type 2 diabetes. Arq Bras Endocrinol Metab 2006; 50 2: ; Keywords: Central obesity; Orlistat; Weight reduction; Cardiovascular risk; Framingham risk score and premphase. Orlistat is a lipase inhibitor that reduces the absorption of fat and its associated calories. Under the right circumstances orlistat can help obese adults to lose a modest amount of weight, but can it work in adolescents, who are traditionally far more difficult to treat? A randomised trial of 539 obese adolescents has found that those taking orlistat as part of a package including diet and exercise lost more weight over one year than those on the same diet and exercise programme taking placebo. As with adults, the loss was modest. After a year, 26.5% of teenagers taking orlistat and 15.7% of teenagers taking a placebo had reduced their body mass index kg m2 ; by least 5% P 0.005 ; . Also, the orlistat group had reduced their body mass index by 0.55, whereas the placebo group had increased theirs by 0.31 P 0.001 ; . Gastrointestinal side effects were more common in the orlistat group, but none were serious. Orlistat is now licensed for teenagers in the United States, thanks partly to the results of this industry sponsored trial, but in an accompanying editorial pp 2932-4. Orlistat disclaimer orlistat drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of xenical and propranolol and orlistat.
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On october 29, 2004 roche announced that the fda has approved labeling showing that weight loss with xenical orlistat ; delayed the onset of type 2 diabetes in obese patients with impaired glucose tolerance igt or pre-diabetes. E.N. Simantirakis 1 , S.I. Chrysostomakis 1 , S.E. Schiza 2 , N.C. Klapsinos 1 , P. Kafarakis 1 , M. Melessanakis 1 , N.M. Siafakas 2 , P.E. Vardas 3 . 1 Heraklion University Hospital, Cardiology Dept., Heraklion, Crete, Greece; 2 Heraklion University Hospital, Dept. of Pneumonology, Heraklion, Greece; 3 Heraklion University Hospital, Department of Cardiology, Heraklion, Greece Purpose: The role of atrial overdrive pacing AOP ; in sleep apnoea hypopnoea syndrome OSAHS ; has recently been under investigation. Our aim was to prospectively evaluate the effect of AOP 24 hours after implantation and subsequently after one month of pacing in patients with OSAHS and to compare it with the established continuous positive airway pressure n-CPAP ; treatment. Methods: Sixteen patients 12 men, aged 6011years ; with moderate or severe OSAHS and normal left ventricular systolic function were included in the study. After a baseline diagnostic polysomnographic study a dual chamber pacemaker was implanted in all patients. At 48 hours post implantation, the pts were randomised into two groups. The first group's pacemaker was programmed to AOP with a rate of 15 bpm above the spontaneous mean nocturnal heart rate ; , while the second group's pacemakers were programmed to pace as AAI at 30 bpm. A polysomnographic study was performed the first night after randomisation and the patients under AOP continued to have that therapy while the remainders were put on n-CPAP therapy. One month later the two groups of patients switched therapies. They underwent 2 more full night polysomnographic studies, one month apart during which a number of respiratory and electroengephalographic parameters were recorded. Results: During the first night of AOP and at one month no significant changes were observed in any of the respiratory parameters measured. In contrast, all parameters improved greatly with n-CPAP. Conclusion: Although n-CPAP therapy is highly effective for the treatment of patients with OSAHS, AOP has no effect on a representative group of such patients and proscar.
MP661 CO - TRIMOXAZOLE INDUCED ACUTE INTERSTITIAL NEPHRITIS IN RENAL ALLOGRAFTS: CLINICAL COURSE AND OUTCOME J.P. Garvey, Sanjay Haresh Chotirmall, Anthony Dorman, Joseph Walshe. Nephrology & Transplantation, Beaumont Hosp, Dublin, Ireland MP662 CLINICAL PROFILE AND RISK FACTOR ANALYSIS IN POST RENAL TRANSPLANT TUBERCULOSIS Tarun Kumar Saha, Anil Kumar Baskal Thimme Gowda, Vikrant Reddy, Kiran Fernandez, Kamal Kiran. Nephrology, Kamineni Hosp, Hyderabad, Andra Pradesh, India MP663 CIPROFLOXACIN BUT NOT CEFUROXIM AS INDUCTIVE PROPHYLACTIC AGENTS INCREASES THE RISK FOR EARLY DIARRHEA IN KIDNEY TRANSPLANT RECIPIENTS Ladislava Lyerova, Vera Lanska, Vladimir Teplan, Stefan Vitko, Ondrej Viklicky. Dept Nephrology, Transplant Centre, Inst Clinical and Experimental Medicine, Prague, Czech Republic MP664 CAN A STRUCTURED, MULTIDISCIPLINARY PROGRAMME COMBINING EXERCISE, DIET AND ORLISTAT ACHIEVE SIGNIFICANT WEIGHT LOSS AND IMPROVED FUNCTIONAL ABILITY IN PATIENTS WITH CHRONIC KIDNEY DISEASE? Sharlene Cook, Helen Maclaughlin, Gemma Newell, Marcelle Holesgrove, Deepa Kariyawasam, Magnus Roseke, Ian Macdougall. Renal, Kings College Hosp, London, United Kingdom MP665 ENDOUROLOGICAL INTERVENTIONS USED TO TREAT UROLOGICAL COMPLICATIONS IN 700 KIDNEY RECIPIENTS Mohamadreza Nikoobakht, Mohsen Taherimahmoudi, Abdolrasoul Mehrsai, Amirreza Abedi, Gholamreza Pourmand. Urology, Sina Hosp, Tehran Univ, Tehran, Iran MP666 EVALUATION OF BONE MINERAL DENSITY AND MARKERS OF BONE TURNOVER IN MEN ON HAEMODIALYSIS AND AFTER RENAL TRANSPLANTATION Ilona Kurnatowska, 1 Arkadiusz Zygmunt, 2 Feliks Kacprzyk, 1 Michal Nowicki, 1 Andrzej Lewinski.2 1Dept Nephrology, Hypertension and Kidney Transplantation, 2Dept Endocrinology and Metabolic Diseases, Medical Univ, Ldz, Poland.

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Table 2. Drug regimens for primary and secondary prophylaxis for the most common opportunistic infections. Published in 1991 Vathenen AS, Knox AJ, Wisniewski A, Tattersfield AE. Time course of change in bronchial reactivity with an inhaled corticosteroid in asthma. Rev Respir Dis 1991; 143: 1317-1321. Can morbidity associated with untreated asthma in primary school childen be reduced?: A controlled intervention study. Hill R, Williams J, Britton J, Tattersfield A. British Medical Journal 1991; 303: 1169-1174. Nutrition Center in Scottsdale, Ariz., sees orlistat as the "forerunner in an explosion in similar drugs that will be used in combination with central nervous system-acting drugs like bupropion." Describing orlistat as a whole new class of drug, Robertson adds, "It can be useful on a PRN basis; that is, you take one when you know you will be having a high-fat meal. But it has unpleasant GI side effects. And at three times a day, it's not a cheap drug. Its main place is probably going to be in long-term maintenance." Orlistat costs around $100 per month. "Obviously, we hate to see a 30-yearold on medication, so we try to do everything in our power to avoid it, " says Lisa Nicholson, PhD, RD, a specialist in health behavior research at the University of Southern California School of Medicine. "But at a certain point, drugs can be useful and appropriate. When a person's weight is very high, it's not always a question of weakness of willpower. We don't blame a Type-l diabetic or a schizophrenic for needing medication. It's the same with cholesterol-lowering drugs.
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May 8, 2007 ereleases press release ; , if your doctor feels you need pharmaceutical aid to reduce weight, medications such as xenical orlistat ; or accomplia rimonabant ; are available at fda warns of counterfeit prescription drugs purchased online - may 2, 2007 medscape subscription ; may 2, 2007 the us food and drug administration fda ; is warning consumers and healthcare professionals of the risk for obtaining counterfeit drugs when genaera begins human trials of obesity drug - may 8, 2007 drugresearcher , reductil meridia sibutramine ; and roche' s xenical orlistat ; , a lipase inhibitor that prevents absorption of dietary fat in the gastrointestinal tract and ovral.

Congratulations to our new Council elected at the AGM on 22 June. Thankyou for your service to PACSA. Patrick Pillay Chairperson ; Phumzile Zondi Mabizela Deputy Chairperson ; John Inglis Treasurer ; Zonke Sithole Deputy Treasurer ; Revd Bonginkosi Mkhize Executive ; Revd Mary Moleko Executive ; Revd Thulani Ndlazi Executive ; Revd Lincie Cele Prof Colin Gardner Mowethu Mosery Zama Ngubane Revd Bheki Nowele Zandile Radebe Revd Sipho Sokhela Mduduzi Zwane. Ters in obese patients with type 2 diabetes mellitus. Diabetes Obes Metab. 2000; 2: 175187. Apfelbaum M, Vague P, Ziegler O, Hanotin C, Thomas F, Leutenegger E. Long-term maintenance of weight loss after a very-low-calorie diet: a randomized blinded trial of the efficacy and tolerability of sibutramine. J Med. 1999; 106: 179 Hadvary P, Lengsfeld H, Wolfer H. Inhibition of pancreatic lipase in vitro by the covalent inhibitor tetrahydrolipstatin. Biochem J. 1988; 256: 357361. Zhi J, Melia AT, Guerciolini R, Chung J, Kinberg J, Hauptman JB, Patel IH. Retrospective population-based analysis of the dose-response fecal fat excretion ; relationship of orlistat in normal and obese volunteers. Clin Pharmacol Ther. 1994; 56: 82 Zhi J, Melia AT, Funk C, Viger-Chougnet A, Hopfgartner G, Lausecker B, Wang K, Fulton JS, Gabriel L, Mulligan TE. Metabolic profiles of minimally absorbed orlistat in obese overweight volunteers. J Clin Pharmacol. 1996; 36: 1006 Rossner S, Sjostrom L, Noack R, Meinders AE, Noseda G. Weight loss, weight maintenance, and improved cardiovascular risk factors after 2 years treatment with orlistat for obesity. European Orlistat Obesity Study Group. Obes Res. 2000; 8: 49 Sjostrom L, Rissanen A, Andersen T, Boldrin M, Golay A, Koppeschaar HP, Krempf M. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Lancet. 1998; 352: 167172. Davidson MH, Hauptman J, DiGirolamo M, Foreyt JP, Halsted CH, Heber D, Heimburger DC, Lucas CP, Robbins DC, Chung J, et al. Weight control and risk factor reduction in obese subjects treated for 2 years with orlistat: a randomized controlled trial. JAMA. 1999; 281: 235242. Finer N, James WP, Kopelman PG, Lean ME, Williams G. One-year treatment of obesity: a randomized, double-blind, placebo-controlled, multicentre study of orlistat, a gastrointestinal lipase inhibitor. Int J Obes Relat Metab Disord. 2000; 24: 306 Hauptman J, Lucas C, Boldrin MN, Collins H, Segal KR. Orlistat in the long-term treatment of obesity in primary care settings. Arch Fam Med. 2000; 9: 160 Hill JO, Hauptman J, Anderson JW, Fujioka K, O'Neil PM, Smith DK, Zavoral JH, Aronne LJ. Orlistat, a lipase inhibitor, for weight maintenance after conventional dieting: a 1-y study. J Clin Nutr. 1999; 69: 1108 Hollander PA, Elbein SC, Hirsch IB, Kelley D, McGill J, Taylor T, Weiss SR, Crockett SE, Kaplan RA, Comstock J, et al. Role of orlistat in the treatment of obese patients with type 2 diabetes. A 1-year randomized double-blind study. Diabetes Care. 1998; 21: 1288 Miles JM, Leiter L, Hollander P, Wadden T, Anderson JW, Doyle M, Foreyt J, Aronne L, Klein S. Effect of orlistat in overweight and obese patients with type 2 diabetes treated with metformin. Diabetes Care. 2002; 25: 11231128. Kelley DE, Bray GA, Pi-Sunyer X, Klein S, Hill J, Miles J, Hollander P. Clinical efficacy of orlistat therapy in overweight and obese patients with insulin-treated type 2 diabetes: a 1-year, randomized controlled trial. Diabetes Care. 2002; 25: 10331041. Schnetzler B, Kondo-Oestreicher M, Vala D, Khatchatourian G, Faidutti B. Orlistat decreases the plasma level of cyclosporine and may be responsible for the development of acute rejection episodes. Transplantation. 2000; 70: 1540 Colman E, Fossler M. Reduction in blood cyclosporine concentrations by orlistat. N Engl J Med. 2000; 342: 11411142. Le Beller C, Bezie Y, Chabatte C, Guillemain R, Amrein C, Billaud EM. Co-administration of orlistat and cyclosporine in a heart transplant recipient. Transplantation. 2000; 70: 15411542. Guerciolini R. Mode of action of orlistat. Int J Obes Relat Metab Disord. 1997; 21: S12S23. Mittendorfer B, Ostlund RE Jr, Patterson BW, Klein S. Orlistat inhibits dietary cholesterol absorption. Obes Res. 2001; 9: 599 Hellerstein MK. Carbohydrate-induced hypertriglyceridemia: modifying factors and implications for cardiovascular risk. Curr Opin Lipidol. 2002; 13: 33 Stafford RS, Radley DC. National trends in antiobesity medication use. Arch Intern Med. 2003; 163: 1046 Munro JF, MacCuish AC, Wilson EM, Duncan LJP. Comparison of continuous and intermittent anorectic therapy in obesity. BMJ. 1968; 1: 352354.