Species of Hoodia Sweet ex Decne., family Apocynaceae, a southern African succulent plant, have been recognized for their appetite suppressing properties. Products that support appetite and weight control have been developed in Israel from locally cultivated Hoodia spp. To study consumer acceptance, efficacy of, and tolerance for a frozen product based on whole aerial parts of Hoodia parviflora N.E. Br., we initiated and conducted this single-blind, randomized, placebo-controlled consumer trial. Volunteer participants ingested flavored 3 g frozen Hoodia or placebo cubes for 40 days. Subjects were weighed and measured and baseline body-mass index was determined. Adverse events were monitored and eight mild, transient, possible treatment-emergent events were reported. No moderate, severe, or chronic events were reported. On days 1, 10, and 40, subjects self-reported their perceptions of food consumption, hunger development, incidence and control of food cravings, and efficacy of the product. On day 40, the treatment group demonstrated a statistically significant decrease in measured quantitative parameters against the placebo and reported a positive perception of the product.

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A 35-year-old man presented to the hospital in December 1996 with a 10-day history of fever (temperature as high as 40°C [104°F]) and 1-day history of nausea, vomiting, and mild abdominal pain in the right upper quadrant. He denied having headache, rash, diarrhea, or neurologic, respiratory tract, musculoskeletal, or genitourinary tract symptoms. Evaluation by a physician eight days earlier had not revealed the source of the fever. The patient appeared healthy, with no pallor, jaundice, or stigmata of liver insufficiency. Except for the presence of mild tenderness in the right upper quadrant of the abdomen and moderate hypotonia of the anal sphincter, the examination was unremarkable. The stool was negative for occult blood.This young man had an acute change in his usual state of health, characterized by high fever. My first concern is an infectious disease -either limited to the abdomen or a generalized process with intraabdominal involvement. Laboratory tests may help characterize the process and pinpoint its location.The white-cell count was 7600 per cubic millimeter, with 73 percent granulocytes, 24 percent lymphocytes, 2 percent monocytes, and 1 percent eosinophils. Laboratory tests revealed the following values: hemoglobin, 8.1 g per deciliter, with normal red-cell indexes; lactate dehydrogenase, 239 U per liter; aspartate aminotransferase, 50 U per liter; total bilirubin, 3.1 mg per deciliter; conjugated bilirubin, 1.8 mg per deciliter; alkaline phosphatase, 167 U per liter; 5 -nucleotidase, 28 U per liter; total protein, 5.5 g per deciliter; and albumin, 2.7 g per deciliter. Urinalysis was positive for bilirubin and urobilinogen and negative for white cells and bacteria. Two sets of blood cultures were negative, and radiography of the chest was unrevealing.The New England Journal of Medicine Downloaded from nejm.org at NORTHERN KENTUCKY UNIV on August 10, 2015. For personal use only. No other uses without permission.