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Obesity is a chronic problem affecting an increasing number of people worldwide and is now recognized as a global epidemic. Various factors involved in the complex genetic-environmental interactions that cause obesity will promote long-term positive energy balance. A cluster of environmental factors, including high energy intakes in the diet, low energy expenditure, and disturbed substrate oxidation, favour the increase and unfavourable distribution of fat mass. Obesity is a major risk factor for hypertension, cardiovascular disease development and diabetes mellitus, and represents a growing worldwide health problem. Several epidemiological studies have shown a high prevalence of cardiovascular complications and mortality in obesity and metabolic syndrome, type-2 diabetes or hypertension. For at “risk populations” predisposed to target organ damage, stringent targets for blood pressure control, dyslipidaemia, and glycaemia have been set in clinical guidelines, however clinical trial and real-life evidence suggest that these targets are difficult to achieve and sustain. The first line treatment for obesity, and obesity related conditions is weight loss. Life-style modification including low caloric diet, reducing sedentary behaviour and increasing exercise form the basis of all therapy, with more severe obesity pharmacotherapy or bariatric (weight loss) surgery may be indicated. Maintaining weight loss is often the greatest challenge. We review the effect of weight loss, using life-style modifications or bariatric surgery in obese subjects, on obesity-related hypertension, the metabolic syndrome, and some of the putative neurohormonal changes that drive obesity related disease.

Endothelins (ETs) are 21-amino acid peptides that bind to membrane receptors to initiate pathophysiological effects. Two types of ET receptors, ETA and ETB, have been identified. Various ET receptor antagonists are being developed as therapeutic agents. This report examines the effects of bovine serum albumin (BSA) on the potency of ET receptor antagonists and compares five ET receptor antagonists. Competition studies show that in the absence of BSA, A-127722 and L-749329 inhibited ET-1 binding to ETA receptor with the same IC50 value of 0.09 nM. Addition of increasing concentrations of BSA incrementally decreased the potency of the antagonists: in the presence of 5% BSA, the IC50 values increased to 4.3 and 820 nM, respectively. Similarly, addition of BSA decreased the potency of antagonists in inhibiting ET-1-stimulated phosphatidylinositol hydrolysis. These results suggest that serum albumin has profound effects on the potencies of ET receptor antagonists. FR139317, PD-156707, L-749329, Ro-47-0203 and A-127722 were then selected for direct comparison under identical experimental conditions with 0.2% BSA. The potency of antagonists was assessed by binding studies for the determination of IC50 and Ki values and by ET-1-stimulated phosphatidylinositol hydrolysis and arachidonic acid release for the determination of IC50 and pA2 values. All five antagonists inhibited ET binding and the biological effects exerted by ET in a competitive mode. The Ki values for A-127722, PD-156707, FR139317, Ro-47-0203 and L-749329 for the ETA receptor were 0.07, 0.38, 0.80, 3.67 and 33.6 nM, respectively. A similar hierarchy was revealed by the functional assays. Our results suggest that the rank order of potency of the antagonists is A-127722 > or = PD-156707 > or = FR139317 > Ro-47-0203 > L-749329.

Occupational health is preventive medicine in the working environment. The industrial physician gives attention to the healthfulness of the conditions and materials of the work and performs certain services; the latter embrace physical examinations, referral of patients to their family physicians when non-occupational disease is found, health education and counseling, emergency or palliative treatment for certain nonoccupational conditions, immunization against diseases to which workers are occupationally exposed, and certain nonoccupational preventive health services. There must be free communication and mutual understanding between plant physician and family physician. In situations requiring mediation by a third party the county medical society's grievance committee should hear both sides. The problems and procedures of the industrial physician should be set forth at meetings under the auspices of state medical societies. Such presentations help to foster good relations between plant and family physicians.

THE ARMY Industrial Hygiene Laboratory applied 28,201 test patches to 2,036 volunteer human test subjects during the period March 1948 to April 1949 in the "prophetic" patch testing of various items of military supplies and equipment destined for contact with the skin of personnel of the armed forces. In addition to the standard, cellophane-backed, elastic adhesive patch, known as the Schwartz patch, two other devices, to be described, were tried experimentally for holding the test materials in contact with the skin, in an effort to make the conditions surrounding the testing of an item correspond more closely with conditions surrounding the use of that item. Materials tested included leathers, fabrics and plastics treated with chemicals to render them resistant to mildew, fabrics treated with chemicals to make them resistant to shrinkage, natural and butyl rubbers for gas masks, gauze impregnated with antiseptic solutions and untreated or widely accepted materials to

This study of air pollution in Charleston, South Carolina, was undertaken at the request of the state health department and is intended primarily for the information and guidance of the state and local officials. Such studies have been made of several other cities and similar reports prepared. This report is well written, fully illustrated, and strengthened with easily understood tables, charts, graphs, drawings, photographs, and appendixes. For the enlightenment of interested lay, technical, and professional persons, private as well as public, everywhere, this report gives a clear exposition of the factors that may account for air pollution. It broadly outlines for the assessment and control of air pollution a program which, while tailored to Charleston, could be adapted to other communities. It enjoins a sane and sound approach to air pollution control. Inferentially, it deplores the approach taken by some communities in which the control efforts (many times ineffective) result

This scholarly, clearly and succinctly written book deals authoritatively with the fluorides, particularly the inorganic ones, and with the recognition, assessment, prevention, control, and treatment of their harmful effects on man, animals, and plants. At the same time, it establishes the value of the fluorides, not only to man's economy, but also to his health and effectively refutes the objections raised to the fluoridation of public water supplies for the prevention of dental caries.The book cites 204 references to the literature on its subject. These are arranged for convenience in the alphabetic order of the names of their authors. It contains 34 tables and 11 figures, all carefully selected. The book consists of an introduction and 13 chapters, titled, respectively, "Occurrence of Fluorides," "Skeletal Fluorosis in Man," "Ingestion, Inhalation, Excretion, and Storage," "Fluoride Concentration in Blood and Effects on Enzymes," "Acute Fluoride Poisoning in Man," "The Effects of Organic

This book contains much valuable material and is well indexed, but it consists almost wholly of direct quotations whose lengths do not always correspond with the authority generally accorded their authors. This fact, plus the paucity of references to authoritative statements, could confuse rather than help the reader who seeks guidance in the fundamentals of occupational health.Unfortunately, the reader who has limited acquaintance with the subject of occupational health is likely to get the impression that this is the same as the "health of people who work." Neither the book nor its references make it sufficiently clear that occupational health is essentially a program of preventive medicine in industry, whereas the "health of people who work" includes also medical care for nonoccupational illnesses and injuries. The failure of this author to consider the health of farm and hospital workers, two large categories of people who work, is unfortunate. Some