Obesity is a major health problem facing the developed and developing world. Efforts by individuals, health professionals, educators, and policy makers to combat the escalating trend of growing obesity prevalence have been multifaceted and mixed in outcome. Various dietary supplements have been marketed to reduce obesity. These products have been suggested to accomplish this by decreasing energy intake and energy absorption, and/or increasing metabolic rate. Ephedra, one such supplement, was banned from sale in the US market because of concerns about adverse events. Another substance, Citrus aurantium, which contains several compounds including synephrine alkaloids, has been suggested as a safe alternative. This review examines the evidence for safety and efficacy of C. aurantium and synephrine alkaloids as examined in animal studies, clinical weight loss trials, acute physiologic studies and case reports. Although at least three reviews of C. aurantium have been published, our review expands upon these by: (i) distinguishing and evaluating the efficacy of C. aurantium and related compounds; (ii) including results from previously unreviewed research; (iii) incorporating recent case reports that serve to highlight, in an anecdotal way, potential adverse events related to the use of C. aurantium and related compounds; and (iv) offering recommendations to guide the design of future trials to evaluate the safety and efficacy of C. aurantium. While some evidence is promising, we conclude that larger and more rigorous clinical trials are necessary to draw adequate conclusions regarding the safety and efficacy of C. aurantium and synephrine alkaloids for promoting weight loss.

SynopsisThe aim of this article was to systematically review the existing literature on the use of yoga for persons with arthritis. We included peer-reviewed research from clinical trials (published from 1980-2010) that used yoga as an intervention for arthritis patients and reported quantitative findings. Eleven studies were identified, including four RCTs and four NRCTs. All trials were small and control groups varied. No adverse events were reported and attrition was comparable or better than typical for exercise interventions. Evidence was strongest for reduction in disease symptoms (tender/swollen joints, pain) and disability, as well as improved self-efficacy and mental health. Interventions, research methods and disease diagnoses were heterogeneous. Larger, rigorous RCTs are necessary to more effectively quantify the effects of yoga for arthritic populations Keywords yoga; rheumatoid arthritis; osteoarthritis; physical activity; exercise; mindfulness IntroductionYoga includes a variety of theories and practices that originated in ancient India and have evolved and spread throughout the world. In Sanskrit, yoga means "to yoke" or connect 1 . This typically refers to mind-body integration, but over the thousands of years that yoga has evolved, this focus has also been applied to spatial surroundings, nature, other individuals and spiritual interconnectedness 2 . The physical practice of yoga, referred to as "hatha," was originally intended to prepare for meditation, an important spiritual practice in many cultures. In recent decades, hatha yoga has become popular for physical activity and stress management. Other aspects of yoga, including study of ancient texts, dietary practices, acts of service, and moral living may be mentioned, but are not generally a focus of western classes.© 2010 Elsevier Inc. All rights reserved.Corresponding author for proof and reprints: Steffany Haaz, PhD, Johns Hopkins Arthritis Center, 5200 Eastern Avenue, Mason F. Lord, Center Tower, 4 th Floor, Baltimore, MD 21224, (410) 550-5216, shaaz@jhsph.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.The authors have nothing to disclose. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptAfter attention to posture, deep breathing and/or chanting, yoga practice often begins with a slow movement sequence to increase blood flow and warm muscles. This is followed by poses that include flexion, extension, adduction, abduction and rotation 1;3 . Holding poses builds strength by engaging muscles in isometric contraction 4;5 . Moving joints through their fu...

Banking of cord blood (CB) for unrelated hematopoietic stem cell (HSC) transplantation is well established. However, directed-donor banking of CB for siblings in a current good tissue practices (cGTP) environment has not previously been investigated. Families were eligible for the present study if they were caring for a child with a disorder treatable by HSC transplantation and expecting the birth of a full sibling. We devised standard operating procedures and policies to address eligibility, donor recruitment, donor and recipient evaluation, CB collection, shipping, graft characterization, storage, and release of CB from quarantine. Many of these policies are distinctly different from those established for unrelated-donor CB banks. We enrolled 540 families from 42 states. Collections occurred at several hundred different hospitals. No family was deferred on the basis of health history or infectious disease testing, but departures from standard donor suitability criteria were documented. Disease categories for sibling recipients included malignancy, sickle cell anemia, thalassemia major, nonmalignant hematological conditions, and metabolic errors. Mean CB volume (including anticoagulant) was 103.1 mL; mean nucleated cell count was 8.9 x 10(8). Cell dose exceeded 1.5 x 10(7) nucleated cells per kilogram for 90% of banked units. Seventeen units (3.4%) have been transplanted. Sixteen of the 17 CB allograft recipients had stable engraftment of donor cells. Remote-site collection of sibling donor CB can be accomplished with a high success rate and in a cGTP-guided environment. The cellular products have been used successfully for transplantation; their number and characteristics should be adequate to support the first prospective clinical investigations of sibling CB transplantation.

Objective: To test the effects of a lifestyle physical activity [LPA] program on health status, pain, fatigue, and function in adults with the fibromyalgia syndrome [FMS]. Methods: Forty-eight sedentary adults with FMS were randomized to either LPA or a FMS education control [FME] group. The LPA participants gradually worked toward accumulating 30 minutes of self-selected moderate-intensity LPA, five to seven days per week. Thirty-four participants [71 percent] completed the study.Results: The LPA group increased their physical activity by 70 percent, as assessed by pedometer. Seventy-one percent of participants randomized to LPA reported that their health status was improved, compared with 25 percent of the FME group [P = 0.013]. There were no statistically significant post-intervention differences between the LPA and FME groups in pain, fatigue, FMS impact, or six-minute walk distance.Conclusion: The LPA group increased their physical activity and improved global ratings of FMS-related change. Lifestyle physical activity might be a new way to assist persons with FMS to become more physically active.