title: Meatballs (film)

text: During the first day of competition, Mohawk dominates North Star, often winning by cheating. Crockett fails to clear the high jump bar, Hardware gets pummelled in boxing, and Jackie suffers a broken ankle in field hockey, thanks to the dirty work of two Mohawk girls. The score at the end of Day One is: Mohawk 170, North Star 63. That evening at the North Star Lodge, Tripper rouses the demoralized campers by explaining that victory or defeat is unimportant. In unison, Camp North Star begins to chant, "It just doesn't matter!" Day Two of the Olympiad belongs to newly inspired North Star as they win every event. Wheels outwrestles his opponent, Spaz defeats Rhino in a stacking contest with inspiration from Jackie and a thwarted Mohawk cheating attempt, and, after 12 years of North Star defeats, Fink finally beats "The Stomach" in the Frankfurter/Wiener-eating contest. North Star now trails by only 10 points with one event left, a four-mile cross country run for 20 points. Tripper offers to select a surprised Rudy to compete against Horse, Mohawk's star runner. Rudy's many mornings spent jogging and training with Tripper pay off as he wins the race, giving North Star its first Olympiad victory by a score of 230–220.


title: Meatballs (film)

text: Later that evening, Morty, Tripper, Roxanne, and the CITs sing around a campfire and say their final goodbyes as the camp prepares to close at the end of summer. Rudy has already decided to return to camp next year and Roxanne agrees to live with Tripper. The two ride off on Tripper's motorcycle, leading the buses out of camp and leaving Morty behind, in bed, on a raft in the middle of the lake.


title: Meatballs (film)

text: Harold Ramis said that Reitman did not know for certain whether Murray would be in the film until he showed up for the third day of filming. Eddie Deezen was approached to play Spaz but declined as he was already committed to "1941".


title: Meatballs (film)

text: Filming took place at Camp White Pine, on Hurricane Lake, between Haliburton and West Guilford, Ontario, in August–September 1978.


title: Meatballs (film)

text: Review aggregation website Rotten Tomatoes gives the film a score of 73% based on 37 reviews. The website's critical consensus reads, ""Meatballs" is a summer camp comedy with few surprises, but Bill Murray's riffing adds a spark that sets it apart from numerous subpar entries in a frequently uninspired genre".


title: Meatballs (film)

text: Vincent Canby of "The New York Times" wrote, "With far fewer high spirits than 'Animal House,' and only two characters of any interest, 'Meatballs' reveals itself to be a loud, off-key cry for conformism of a most disappointing sort. It's a sheep in wolf's clothing." Dale Pollock of "Variety" wrote, "Record of tv stars making the transition to feature films is spotty overall, but Bill Murray proves a welcome exception to the rule. The 'Saturday Night Live' regular manages to sock over 'Meatballs' with amazing vitality and elan."


title: Meatballs (film)

text: Gene Siskel of the "Chicago Tribune" gave the film 2.5 stars out of 4 and stated that it "is pleasant as can be, but there's hardly a belly laugh in it. Murray plays a nice guy counselor who befriends a lonely camper. It's all very sweet, but funny? Not particularly." Kevin Thomas of the "Los Angeles Times" called the film "a fast, funny sendup of summer-camp life" that "is not as all-out raunchy as 'Animal House'—but it's hilarious in a similar blissfully uncomplicated and nutty way." Gary Arnold of "The Washington Post" wrote, "'Meatballs' is as tartly, unpretentiously funny as its title ... As the senior boys' counselor, an easygoing role model and spontaneous comic genius, Bill Murray of 'Saturday Night Live' makes a deceptively sensational debut as a film comedy star." Jack Kroll of "Newsweek" remarked that "this film has almost none of the scraggy, raunchy, irreverent anarchy that gave "Animal House" a kind of perverse anti-style. There's nothing at all perverse about "Meatballs"; in fact, it's so cutesy, squeaky-clean that it becomes Andy Hardy with a few extra belches."


title: Meatballs (film)

text: The film was a surprise hit. It opened in 7 theatres in Toronto and grossed $105,635 in its first four days. A week later, it opened on 93 screens in New York, grossing $1.5 million for the week and placing fifth at the US box office. It grossed $17.9 million in its first 17 days of national release. The film was the first Canadian film to gross more than $2.5 million in Canada, surpassing 1970's "Deux femmes en or", to become the highest-grossing film of all-time, with a gross of $4.2 million, winning the Golden Reel Award for the year. It also became the highest-grossing Canadian film in the United States, with a combined gross of $43 million in the United States and Canada. It was also the highest-grossing film in the US without any US investment at the time until surpassed by "Chariots of Fire" in 1982. The film grossed $70 million worldwide.


title: Meatballs (film)

text: The film's score was written by Elmer Bernstein and several musicians also contributed to the soundtrack including Mary MacGregor (performing "Good Friend"), David Naughton (performing "Makin' It", which served as the theme for his title sitcom, which was cancelled before the film's release), and Rick Dees and His Cast of Idiots (performing the title theme "Meatballs"). "Good Friend" and "Makin' It" made the Billboard and Cashbox pop charts (see below).


title: Meatballs (film)

text: "Meatballs" was first released on DVD in 1999 by HBO (although Paramount Pictures was behind the original theatrical release and the first VHS and SelectaVision release in the 1980s, and also continues to hold international video rights.) Sony Pictures Entertainment issued a special-edition DVD (with an anamorphic transfer, a director's commentary, and a "Making of" featurette) on June 5, 2007. The sequels did not receive the same treatment of re-release. However, Lionsgate released the Blu-ray on June 12, 2012 and DVD reissue on February 22, 2022, which retains the commentary from the Sony DVD but not the featurette.


title: Meatballs (film)

text: "Meatballs" was followed by three sequels: "Meatballs Part II" (1984), "" (1986) and "Meatballs 4" (1992), none of which involved either Reitman or Murray. Only "Meatballs III" had any relation to the story or characters of the original, featuring Patrick Dempsey as Rudy Gerner.


title: Todd Haberkorn

text: Todd Haberkorn is an American voice actor and director, who has dubbed in anime, films, and video games.


title: Todd Haberkorn

text: While Haberkorn was working in theater, he joined Funimation as a voice actor, with minor roles in "One Piece", "Black Cat", and "Peach Girl". Since then, he has voiced characters such as Natsu Dragneel in "Fairy Tail", Italy in "", Hikaru Hitachiin in "Ouran High School Host Club", Allen Walker in "D.Gray-man", Death the Kid in "Soul Eater", Tsukune Aono in "Rosario + Vampire", Kimihiro Watanuki in "xxxHolic", and Yamato Akitsuki in "Suzuka". He has also worked in Los Angeles as an actor, director, producer and writer.


title: Todd Haberkorn

text: He also played Aru Akise, one of the main set of characters in "Future Diary" and provided the English dub voice for Hiroki Hasegawa in "Shin Godzilla", as well as Razor for "Genshin Impact".


title: Todd Haberkorn

text: Haberkorn is of partial Vietnamese descent on the maternal side of his family. Meanwhile, his father's side of the family is of Scandinavian descent.


title: Todd Haberkorn

text: Haberkorn married Bonnie Vanwinkle on February 29, 2008. They divorced on November 19, 2010. He has one son from a previous relationship, who was born in 2004. In 2021, he married his girlfriend, Nicole Corona.


title: Oryza sativa

text: Oryza sativa, commonly known as Asian rice or indica rice, is the plant species most commonly referred to in English as "rice". It is the type of farmed rice whose cultivars are most common globally, and was first domesticated in the Yangtze River basin in China 13,500 to 8,200 years ago.


title: Oryza sativa

text: "Oryza sativa" belongs to the genus "Oryza" of the grass family Poaceae. With a genome consisting of 430Mbp across 12 chromosomes, it is renowned for being easy to genetically modify and is a model organism for the botany of cereals.


title: Oryza sativa

text: "Oryza sativa" contains two major subspecies: the sticky, short-grained "japonica" or "sinica" variety, and the nonsticky, long-grained "" rice variety. "Japonica" was domesticated in the Yangtze Valley 9–6,000 years ago, and its varieties can be cultivated in dry fields (it is cultivated mainly submerged in Japan), in temperate East Asia, upland areas of Southeast Asia, and high elevations in South Asia, while "indica" was domesticated around the Ganges 8,500-4,500 years ago, and its varieties are mainly lowland rices, grown mostly submerged, throughout tropical Asia. Rice occurs in a variety of colors, including white, brown, black, purple, and red rices. Black rice (also known as purple rice) is a range of rice types, some of which are glutinous rice. Varieties include Indonesian black rice and Thai jasmine black rice.


title: Oryza sativa

text: A third subspecies, which is broad-grained and thrives under tropical conditions, was identified based on morphology and initially called "javanica", but is now known as "tropical japonica". Examples of this variety include the medium-grain 'Tinawon' and 'Unoy' cultivars, which are grown in the high-elevation rice terraces of the Cordillera Mountains of northern Luzon, Philippines.


title: Oryza sativa

text: Glaszmann (1987) used isozymes to sort "O. sativa" into six groups: "japonica", "aromatic", "indica", "aus", "rayada", and "ashina".


title: Oryza sativa

text: Garris "et al." (2004) used simple sequence repeats to sort "O. sativa" into five groups: "temperate japonica", "tropical japonica" and "aromatic" comprise the "japonica" varieties, while "indica" and "aus" comprise the "indica" varieties.


title: Oryza sativa

text: Rice has been cultivated since ancient times and "oryza" is a classical Latin word for rice while "sativa" means "cultivated".


title: Oryza sativa

text: / is a gene that regulates the overall architecture/growth habit of the plant. Some of its epialleles increase rice yield. An accurate and usable Simple Sequence Repeat marker set was developed and used to generate a high-density map in McCouch "et al.", 2002. A multiplex high-throughput marker assisted selection system has been developed by Masouleh "et al.", 2009 but as with other crop HTMAS systems has proven difficult to customize, costly (both directly and for the equipment), and inflexible. Other molecular breeding tools "have" produced results, producing blast resistant cultivars. Xu "et al.", 2014 uses a DNA microarray to substantially advance understanding of hybrid vigor in rice, Takagi "et al.", 2013 uses QTL sequencing to elucidate seedling vigor, and Yano "et al.", 2016 performs a GWAS by WGS to investigate various agronomic traits. (Because the correspondence between genotype and phenotype is more easily understood in rice, translation of results from rice to other non-models may require more work. For example grain size and grain weight in wheat were elucidated in this way by Valluru "et al.", 2014.) Affymetrix offers a 44 thousand pot microarray, a 50 thousand, and a one million, and Illumina has a six thousand and a 50 thousand, all of which have performed well and are commonly used. Rice is one of the earliest uses and validation models for the semi-thermal asymmetric reverse PCR (STARP) method developed in Long "et al.", 2016. The putative homolog for "spindle and kinetochore-associated protein 1" "" is localized to by Hanisch "et al.", 2006.


title: Oryza sativa

text: "O. sativa" has a large number of insect resistance genes specifically for the Brown planthopper. 15 R genes among these have been cloned and characterized including Tamura "et al.", 2014's discovery of ' Guo "et al.", 2018's discovery of ', Zhao "et al.", 2016's discovery of ', Du "et al.", 2009's discovery of ', and Ji "et al.", 2016's discovery of "".


title: Oryza sativa

text: In total 641 copy number variations are known, the combination of results of Ma and Bennetzen 2004 and Yu "et al.", 2011. Exome capture often reveals new single nucleotide polymorphisms in rice, due to its large genome and high degree of DNA repetition. There have been two major results of this type, Saintenac "et al.", 2011 and Henry "et al.", 2014.


title: Oryza sativa

text: Both abscisic acid and salicylic acid are employed by "O. sativa" in its regulation of its own immune responses. Jiang "et al.", 2010 finds SA broadly upregulates and ABA broadly downregulates immunity to "Magnaporthe grisea", and success depends on the balance between their levels.


title: Oryza sativa

text: A triple introgression of resistance genes against "Magnaporthe grisea"—and actual field resistance—have been demonstrated by Khan "et al.", 2018. This is a marker-assisted backcross of "Pi1", "Pi54", and "Pita" into an aromatic cultivar using SSR- and STS-markers.


title: Dave Davies

text: David Russell Gordon Davies (born 3 February 1947) is an English guitarist, singer and songwriter. He was the lead guitarist and backing vocalist for the English rock band the Kinks, which also featured his elder brother Ray Davies. He was inducted into the Rock and Roll Hall of Fame in 1990 as a member of the Kinks.


title: Dave Davies

text: Davies is prolific with his innovative nature on the electric guitar, specifically in being one of the first to utilize electric guitar distortion and exposing the effect to the mainstream. His signature distorted power chord riffs on songs would heavily influence future heavy metal and punk rock acts. In 2003, Davies was ranked 91st in "Rolling Stone" "Magazine"'s list of the "100 Greatest Guitarists of All Time".


title: Dave Davies

text: David Russell Gordon Davies was born at 6 Denmark Terrace, Muswell Hill, North London. He was born the last of eight children, including six elder sisters and an elder brother, later bandmate Ray. As children, the Davies brothers were immersed in a world of different musical styles, from the music hall of their parents' generation, to the jazz and early rock n' roll that their older sisters listened to. The siblings developed a rivalry early on, with both brothers competing for their parents' and sisters' attention.


title: Dave Davies

text: Davies grew up playing skiffle, but soon bought an electric guitar and started experimenting with rock. The Davies brothers and friend Pete Quaife jammed together in the front room of their house. Activities in the Davies household centred around this front room, culminating in large parties, where the parents would sing and play piano together. The front room and these parties were musically nurturing to the Davies brothers, later influencing the Kinks' interpretations of the traditional British music hall style. Dave and his brother worked out the famous two-chord riff of their 1964 hit "You Really Got Me" on the piano in the front room.


title: Dave Davies

text: Davies founded the Kinks with Pete Quaife in 1963. His brother Ray, who became the best-known member and "de facto" leader of the band, joined soon after. The quartet was formed when drummer Mick Avory joined. Dave Davies had a turbulent relationship with Avory, one of the reasons behind the latter's departure from the band in the mid-1980s, although the two had been housemates together in the mid-1960s.


title: Dave Davies

text: Ray and Dave Davies remained the only two steady members of the band. They were accompanied by an oft-changing roster of bassists and keyboardists. Dave played a largely subordinate role to his brother, often staying behind the scenes. Dave would make occasional contributions on Kinks records as lead vocalist and songwriter, with classics such as "Party Line" (the lyrics were written by Ray and the song has been attributed to Ray on many editions of "Face to Face"), "Death of a Clown" and "Strangers".


title: Dave Davies

text: Dave Davies was solely responsible for the signature distorted power chord sound on the Kinks' first hit, "You Really Got Me". He achieved the sound by using a razor blade to slit the speaker cone on his Elpico amplifier, which he then ran through a larger Vox as a "pre-amp". This sound was one of the first mainstream appearances of distortion, which was to have a major influence on many later musicians, especially in heavy metal and punk rock.


title: Dave Davies

text: "You Really Got Me" was the band's third released single, the two previous recordings having failed to chart. They had a three-single contract with Pye Records, and needed a hit to get another. Pye didn't like the song and refused to pay for studio time. The band arranged other financial support to cut the single, which became a hit, topping the charts in the UK and reaching number 7 in the US.


title: Dave Davies

text: The Kinks released three albums and several EPs in the next two years. They also performed and toured relentlessly, headlining package tours with the likes of The Yardbirds and The Mickey Finn, which caused tension within the band. Some legendary on-stage fights erupted during this time as well. The most notorious incident was at the Capitol Theatre in Cardiff in May 1965, involving drummer Mick Avory and Dave Davies. The fight broke out during the second number of the set, "Beautiful Delilah". It culminated with Davies insulting Avory and kicking over his drum set after finishing the first song, "You Really Got Me". Avory responded by knocking down Davies with his hi-hat stand, rendering him unconscious. He then fled from the scene and Davies was taken to Cardiff Royal Infirmary, where he received 16 stitches to the head. Avory later claimed that it was part of a new act in which the band members would hurl their instruments at each other.


title: Dave Davies

text: During the late 1960s the group steadily evolved, as Ray's songwriting skills developed and he began to lead the group in a new direction. The group abandoned the traditional R&B/blues sound and adopted a more nostalgic, reflective style of music, as showcased on songs like "Autumn Almanac" and "Waterloo Sunset", as well as their albums, such as "Something Else by the Kinks" and "The Village Green Preservation Society".


title: Dave Davies

text: In July 1967, Dave Davies released his first solo single, "Death of a Clown", credited entirely under his name as the recording artist, though it was co-written by his brother. In the past, as a member of the Kinks, Dave Davies had only released his own compositions on B-sides and albums. Pye Records, the Kinks' label, sensed potential sales in a solo release from the overlooked Davies and issued "Death of a Clown" as his debut. Although the single was credited to Davies, the backing band was the Kinks, and the track also appeared on "Something Else by the Kinks".


title: Dave Davies

text: "Death of a Clown" rose to number three on the UK Singles Chart. Wanting to profit from the new buzz suddenly surrounding Davies, a solo LP was slated for release sometime in 1968 or 1969. The follow-up single, "Susannah's Still Alive", was released in November 1967; however, it only reached number 20 on the "Melody Maker" chart. The release of the solo album was held back, and it was decided to wait and see how another single would fare. As anticipation grew for the release of the new LP, it was nicknamed "A Hole in the Sock Of". "Lincoln County" was chosen as the next single, but it failed to chart. By the time a fourth single, "Hold My Hand", met with the same result, a combination of his own lack of interest in continuing and Pye's decision to stop killed off any hopes of an album.


title: Dave Davies

text: Eventually, the tracks intended for his first solo album were assembled for a 2011 compilation by Russell Smith & Andrew Sandoval entitled "Hidden Treasures". It combined the singles, B-sides that were released for various Kinks singles and a handful of album tracks that Davies had recorded for Kinks albums. Many of these tracks had been assembled previously for "The Album That Never Was", released in 1987.


title: Dave Davies

text: "The Kinks Are the Village Green Preservation Society" and "Arthur" were released in 1968 and 1969, respectively. Although they received unanimous acclaim, "Village Green" failed to chart internationally, and "Arthur" was met with a mediocre commercial reception. These records, although praised by critics and the rock press, were commercial failures.


title: Dave Davies

text: After "Arthur", the Kinks made a comeback with their hit single "Lola" and the accompanying concept album "Lola versus Powerman and the Moneygoround, Part One" in 1970. Dave recorded two songs of his own for this LP, the acoustic "Strangers" and the hard-rocking "Rats". The rootsy "Muswell Hillbillies", themed on country-rock and Americana, was released in late 1971 and was well-received with critics, but failed to sell strongly. The band's next five albums, "Everybody's in Show-Biz", "", "", "The Kinks Present A Soap Opera" and "Schoolboys in Disgrace", which added a large theatrical ensemble, were critical and commercial failures.


title: Dave Davies

text: The Kinks left RCA Records in 1977, switching to Arista. The group shed all of the extra backing vocalists and brass instrumentalists that had accompanied them throughout their theatrical years, and reverted to a five-piece rock group again. Their debut LP for Arista was entitled "Sleepwalker", and was a commercial and critical comeback for the group. It was the first album in what critics usually call the "arena rock" phase of the group, in which more commercial and mainstream production techniques would be employed. Dave later commented that he was glad to be back to more guitar-oriented songs, and he has listed "Sleepwalker" as one of his favourites.


title: Dave Davies

text: Davies saw the band through both success and failure, as they reached their commercial peak in the early 1980s. The group began adjusting their commercial methods, embracing the MTV culture that was selling records at the time. The music video for their 1982/83 single "Come Dancing" helped hoist the record to number 12 on the UK chart, and number 6 in the US – their biggest hit since "Tired of Waiting for You" in 1965.


title: Dave Davies

text: The Kinks' popularity faltered in 1985, and soon their records ceased to chart altogether. Mick Avory left the band after the Kinks' last album for Arista, "Word of Mouth", mainly due to the growing animosity between him and Dave Davies. Bob Henrit was brought in to take Avory's place. At the invitation of Ray Davies, Avory agreed to manage Konk Studios, where he also served as a producer and occasional contributor on later Kinks albums.


title: Dave Davies

text: The group switched to MCA (US) and London (UK) records in late 1985, and began work on their next album, "Think Visual". The record was released in 1986, but only reached number 81 on the "Billboard" charts. Critics were lukewarm towards it, and it did not receive significant radio play. Stephen Thomas Erlewine of Allmusic.com later commented that the album "represented an artistic dead end for the Kinks, as Ray Davies continued to crank out a series of competent, but undistinguished hard rockers." Dave Davies contributed two songs to "Think Visual", "Rock 'n' Roll Cities" and "When You were a Child".


title: Dave Davies

text: The group recorded several more records for MCA, their last studio effort for them being 1989's "UK Jive". It was received slightly better than "Think Visual", but it failed to enter into the Top 100. Dave Davies contributed the song "Dear Margaret" to the vinyl record – the cassette and CD of the album also contained two further Dave Davies songs, "Bright Lights" and "Perfect Strangers".


title: Dave Davies

text: The group left MCA and struggled to find a record label that would accept them. All four original members were inducted into the Rock and Roll Hall of Fame in 1990, but this failed to revive their career. Eventually the Kinks signed to Columbia Records, who released their final studio album together, "Phobia", on 13 April 1993. Despite publicity and press attention, the record was unsuccessful, peaking at number 166. Singles released failed to chart as well. To "Phobia" Davies contributed the songs "It's Alright (Don't Think About It)" and "Close to the Wire".


title: Dave Davies

text: Columbia dropped the group in 1994, forcing them to retreat back to their old Konk Records. The group released "To The Bone" on the small independent Grapevine Records in 1994.


title: Dave Davies

text: The Kinks took a break from recording and touring in 1996. Ray and Dave reunited onstage to perform "You Really Got Me" at the Islington Assembly Hall in London on 18 December 2015. "Rolling Stone" magazine called their performance "rousing".


title: Dave Davies

text: After the aborted solo effort, Davies's solo career was not revived until 1980, with the release of "Dave Davies (AFL1-3603)", which featured Davies performing all the instruments himself. The album, named after its own catalog number, peaked at number 42 on the "Billboard" 200. He went on to release "Glamour" (1981), which charted at number 152. Davies brought in a back-up band to play with him on this record. "Chosen People" was released in 1983, but failed to crack the Billboard 200.


title: Dave Davies

text: Davies released his first true solo studio album in twenty years, "Bug", in 2002. "Fractured Mindz" followed in January 2007. It was also his first new studio effort since his stroke in the summer of 2004 besides the track "God in my Brain" (which was recorded and released on the compilation album "Kinked" in January 2006).


title: Dave Davies

text: "Two Worlds" was recorded throughout 2010 by The Aschere Project, the production team of Dave Davies and his son Russ. Both members wrote, produced, and recorded all the tracks. About the album's genre, Dave stated "it's a mixture of rock, kinda classical and electronic music." In February 2010, Davies released an autobiographical DVD filmed by his other son, titled "Mystical Journey". His planned US tour in support of the release was postponed per doctor's advice. It was announced in February 2013 that on 4 June 2013, Davies would be releasing his sixth studio album entitled "I Will Be Me" worldwide. Davies undertook a short tour of the US to promote the album. Davies performed his first UK show in thirteen years in February 2014. In October 2014, to celebrate the 50th Anniversary of the Kinks, a new album by Davies, with many tracks looking back to the start of the band, titled "Rippin' Up Time" was released. Davies appeared on "The Tonight Show Starring Jimmy Fallon" to promote the album in 2014. This episode was the highest rated "Tonight Show" episode in 2014.


title: Dave Davies

text: In 2015, the Dave Davies solo album "Rippin Up New York City" was released on Red River Entertainment. He embarked on a solo tour to promote the album in the US in October and November. On 18 December, at his concert at the Islington Assembly Hall in London, he was joined onstage by Ray to perform the Kinks' hit "You Really Got Me" together. This marked the first time in nearly 20 years that the brothers had appeared and performed together.


title: Dave Davies

text: Davies has played a number of guitars over time, the most recognizable of which is his Gibson Flying V. Davies bought it in 1965, and soon began appearing live and on TV performances with it. Davies was one of the few guitarists who played Flying Vs at the time. It was, in that period, out of issue due to lack of interest upon its 1958 test release, and models were numbered. Guitarists such as Lonnie Mack, Jimi Hendrix, Albert King and Davies himself helped stir interest in the instrument, and it would eventually become one of the signature guitars of the heavy metal era.


title: Dave Davies

text: Davies has played many other guitars throughout his career. He has played several models of Gibson Les Pauls over time, including a "Goldtop" model with P90 pickups and a black '78 model. On his website he lists the following:


title: Dave Davies

text: Davies was expelled from school at the age of 15 after being caught having sexual intercourse with his girlfriend, Sue Sheehan, on Hampstead Heath. Shortly thereafter, they were forced to separate by their respective families after Sheehan found out she was pregnant. Their relationship had a profound impact on Davies, who wrote a number of songs about their separation including "Funny Face", "Suzannah's Still Alive", and "Mindless Child of Motherhood". In 1967, Davies married Lisbet (a cousin of Pete Quaife's first wife, Annette) and they divorced in 1990. From that marriage, Davies has four sons: Martin, Simon, Christian, and Russell. His three children Daniel, Lana, and Eddie are from a relationship with Nancy Evans. Dave briefly reunited with Sue Sheehan in the late 90s.


title: Dave Davies

text: Davies published an autobiography, entitled "Kink" in 1996, in which he discussed his bisexuality and brief relationships with Long John Baldry and music producer Michael Aldred in the late 1960s. He also wrote of the tense professional relationship with his brother over the Kinks' career.


title: Dave Davies

text: Davies has been vegetarian since the late 60s, and has said that he does not think meat is good for the nervous system.


title: Dave Davies

text: On 30 June 2004, Davies suffered a stroke while exiting a lift at Broadcasting House, where he had been promoting his album, "Bug". He was taken to University College Hospital near Euston Square tube station. Davies was released from the hospital on 27 August.


title: Dave Davies

text: In September 2013 "Rolling Stone" magazine wrote about Davies and his girlfriend Rebecca G. Wilson. She contributed backing vocals to the songs "Front Room" and "King of Karaoke". Since 2014, Wilson has gone on tour as Dave's backup singer.


title: Dave Davies

text: A second autobiography, "Living on a Thin Line" (), was released in July 2022. The book's title is shared by a Kink's track released in 1984. Davies details in the book how in 1982, while on tour in the US, he started hearing voices. He claims that those voices were alien in origin and the aliens, who he named "the intelligences", controlled both his body and mind. Davies also discussed his leaving of wives and children when relationships were outgrown.


title: Gastric bypass surgery

text: Gastric bypass surgery refers to a technique in which the stomach is divided into a small upper pouch and a much larger lower "remnant" pouch and then the small intestine is rearranged to connect to both. Surgeons have developed several different ways to reconnect the intestine, thus leading to several different gastric bypass procedures (GBP). Any GBP leads to a marked reduction in the functional volume of the stomach, accompanied by an altered physiological and physical response to food.


title: Gastric bypass surgery

text: The operation is prescribed to treat morbid obesity (defined as a body mass index greater than 40), type 2 diabetes, hypertension, sleep apnea, and other comorbid conditions. "Bariatric surgery" is the term encompassing "all" of the surgical treatments for morbid obesity, not just gastric bypasses, which make up only one class of such operations. The resulting weight loss, typically dramatic, markedly reduces comorbidities. The long-term mortality rate of gastric bypass patients has been shown to be reduced by up to 40%. As with all surgery, complications may occur. A study from 2005 to 2006 revealed that 15% of patients experienced complications as a result of gastric bypass, and 0.5% of patients died within six months of surgery due to complications. A meta-analysis of 174,772 participants published in The Lancet in 2021 found that bariatric surgery was associated with 59% and 30% reduction in all-cause mortality among obese adults with or without type 2 diabetes respectively. This meta-analysis also found that median life-expectancy was 9.3 years longer for obese adults with diabetes who received bariatric surgery as compared to routine (non-surgical) care, whereas the life expectancy gain was 5.1 years longer for obese adults without diabetes.


title: Gastric bypass surgery

text: Gastric bypass is indicated for the surgical treatment of morbid obesity, a diagnosis which is made when the patient is seriously obese, has been unable to achieve satisfactory and sustained weight loss by dietary efforts, and has comorbid conditions which are either life-threatening or serious impairment to the quality of life.


title: Gastric bypass surgery

text: Prior to 1991, clinicians interpreted serious obesity as weighing at least more than the "ideal body weight", an actuarially-determined body-weight at which one was estimated to be likely to live the longest, as determined by the life-insurance industry. This criterion failed for persons of short stature.


title: Gastric bypass surgery

text: In 1991, the National Institutes of Health (NIH) sponsored a consensus panel whose recommendations have set the standard for consideration of surgical treatment, the body mass index (BMI). The BMI is defined as the body weight (in kilograms), divided by the square of the height (in meters). The result is expressed as a number in units of kilograms per square meter. In healthy adults, BMI ranges from 18.5 to 24.9, with a BMI above 30 being considered obese, and a BMI less than 18.5 considered underweight.


title: Gastric bypass surgery

text: The Consensus Panel of the National Institutes of Health (NIH) recommended the following criteria for consideration of bariatric surgery, including gastric bypass procedures:


title: Gastric bypass surgery

text: The Consensus Panel also emphasized the necessity of multidisciplinary care of the bariatric surgical patient by a team of physicians and therapists to manage associated comorbidities and nutrition, physical activity, behavior, and psychological needs. The surgical procedure is best regarded as a "tool" that enables the patient to alter lifestyle and eating habits, and to achieve effective and permanent management of obesity and eating behavior.


title: Gastric bypass surgery

text: Since 1991, major developments in the field of bariatric surgery, particularly laparoscopy, have outdated some of the conclusions of the NIH panel. In 2004 the American Society for Bariatric Surgery (ASBS) sponsored a consensus conference which updated the evidence and the conclusions of the NIH panel. This conference, composed of physicians and scientists of both surgical and non-surgical disciplines, reached several conclusions, including:


title: Gastric bypass surgery

text: The gastric bypass, in its various forms, accounts for a large majority of the bariatric surgical procedures performed. It is estimated that 200,000 such operations were performed in the United States in 2008.


title: Gastric bypass surgery

text: Laparoscopic surgery is performed using several small incisions, or "ports": one to insert a surgical telescope connected to a video camera, and others to permit access to specialized operating instruments. The surgeon views the operation on a video screen. Laparoscopy is also called limited access surgery, reflecting the limitation on handling and feeling tissues and also the limited resolution and two-dimensionality of the video image. With experience, a skilled laparoscopic surgeon can perform most procedures as expeditiously as with an open incision—with the option of using an incision should the need arise.


title: Gastric bypass surgery

text: The Roux-en-Y laparoscopic gastric bypass, first performed in 1993, is regarded as one of the most difficult procedures to perform by limited access techniques, but the use of this method has greatly popularized the operation due to associated benefits such as a shortened hospital stay, reduced discomfort, shorter recovery time, less scarring, and minimal risk of incisional hernia.


title: Gastric bypass surgery

text: This variant is the most commonly employed gastric bypass technique, and is by far the most commonly performed bariatric procedure in the United States. The small intestine is divided approximately below the lower stomach outlet and is re-arranged into a Y-configuration, enabling outflow of food from the small upper stomach pouch via a "Roux limb". In the proximal version, the Y-intersection is formed near the upper (proximal) end of the small intestine. The Roux limb is constructed using of the small intestine, preserving the rest (and the majority) of it from absorbing nutrients. The patient will experience very rapid onset of the stomach feeling full, followed by a growing satiety (or "indifference" to food) shortly after the start of a meal.


title: Gastric bypass surgery

text: The small intestine is normally in length. As the Y-connection is moved further down the gastrointestinal tract, the amount available to fully absorb nutrients is progressively reduced, traded for greater effectiveness of the operation. The Y-connection is formed much closer to the lower (distal) end of the small intestine, usually from the lower end, causing reduced absorption (malabsorption) of food: primarily of fats and starches, but also of various minerals and the fat-soluble vitamins. The unabsorbed fats and starches pass into the large intestine, where bacterial actions may act on them to produce irritants and malodorous gases. These larger effects on nutrition are traded for a relatively modest increase in total weight loss.


title: Gastric bypass surgery

text: The mini-gastric bypass procedure was first developed by Robert Rutledge from the US in 1997, as a modification of the standard Billroth II procedure. A mini gastric bypass creates a long narrow tube of the stomach along its right border (the lesser curvature). A loop of the small gut is brought up and hooked to this tube at about 180 cm from the start of the intestine.


title: Gastric bypass surgery

text: Numerous studies show that the loop reconstruction (Billroth II gastrojejunostomy) works more safely when placed low on the stomach, but can be a disaster when placed adjacent to the esophagus. Today thousands of "loops" are used for surgical procedures to treat gastric problems such as ulcers, stomach cancer, and injury to the stomach. The mini-gastric bypass uses the low set loop reconstruction and thus has rare chances of bile reflux.


title: Gastric bypass surgery

text: The MGB has been suggested as an alternative to the Roux-en-Y procedure due to the simplicity of its construction and is becoming more and more popular because of low risk of complications and good sustained weight loss. It has been estimated that 15.4% of weight loss surgery in Asia is now performed via the MGB technique.


title: Gastric bypass surgery

text: This technique has been clinically researched since the mid-2000s. It involves the implantation of a duodenal-jejunal bypass liner between the beginning of the duodenum (first portion of the small intestine from the stomach) and the mid-jejunum (the secondary stage of the small intestine). This prevents the partially digested food from entering the first and initial part of the secondary stage of the small intestine, mimicking the effects of the biliopancreatic portion of Roux-en-Y gastric bypass (RYGB) surgery. Despite a handful of serious adverse events such as gastrointestinal bleeding, abdominal pain, and device migration – all resolved with device removal – initial clinical trials have produced promising results in the treatment's ability to improve weight loss and glucose homeostasis outcomes.


title: Gastric bypass surgery

text: The gastric bypass reduces the size of the stomach by well over 90%. A normal stomach can stretch, sometimes to over 1000 mL, while the pouch of the gastric bypass may be 15 mL in size. The gastric bypass pouch is usually formed from the part of the stomach which is least susceptible to stretching. That, and its small original size, prevents any significant long-term change in pouch volume. What does change, over time, is the size of the connection between the stomach and intestine and the ability of the small intestine to hold a greater volume of food. Over time, the functional capacity of the pouch increases; by that time, weight loss has occurred, and the increased capacity should serve to allow maintenance of a lower body weight.


title: Gastric bypass surgery

text: When the patient ingests just a small amount of food, the first response is a stretching of the wall of the stomach pouch, stimulating nerves that tell the brain that the stomach is full. The patient feels a sensation of fullness, as if they had just eaten a large meal—but with just a thimble-full of food. Most people do not stop eating simply in response to a feeling of fullness, but the patient rapidly learns that subsequent bites must be eaten very slowly and carefully, to avoid increasing discomfort or vomiting.


title: Gastric bypass surgery

text: Food is first churned in the stomach before passing into the small intestine. When the lumen of the small intestine comes into contact with nutrients, a number of hormones are released, including cholecystokinin from the duodenum and PYY and GLP-1 from the ileum. These hormones inhibit further food intake and have thus been dubbed "satiety factors". "Ghrelin" is a hormone that is released in the stomach that stimulates hunger and food intake. Changes in circulating hormone levels after gastric bypass have been hypothesized to produce reductions in food intake and body weight in obese patients. However, these findings remain controversial, and the exact mechanisms by which gastric bypass surgery reduces food intake and body weight have yet to be elucidated.


title: Gastric bypass surgery

text: For example, it is still widely perceived that gastric bypass works by mechanical means, i.e. food restriction and/or malabsorption. Recent clinical and animal studies, however, have indicated that these long-held inferences about the mechanisms of Roux-en-Y gastric bypass (RYGB) may not be correct. A growing body of evidence suggests that profound changes in body weight and metabolism resulting from RYGB cannot be explained by simple mechanical restriction or malabsorption. One study in rats found that RYGB induced a 19% increase in total and a 31% increase in resting energy expenditure, an effect not exhibited in vertical sleeve gastrectomy rats. In addition, pair-fed rats lost only 47% as much weight as their RYGB counterparts. Changes in food intake after RYGB only partially account for the RYGB-induced weight loss, and there is no evidence of clinically significant malabsorption of calories contributing to weight loss. Thus, it appears RYGB affects weight loss by altering the physiology of weight regulation and eating behavior rather than by simple mechanical restriction or malabsorption.


title: Gastric bypass surgery

text: To gain the maximum benefit from this physiology, it is important that the patient eat only at mealtimes, 5 to 6 small meals daily, and "not" graze between meals. Concentration on obtaining 80–100 g of daily protein is necessary. Meals after surgery are – cup, slowly getting to 1 cup by one year. This requires a change in eating behavior and an alteration of long-acquired habits for finding food. In almost every case where weight gain occurs late after surgery, capacity for a meal has not greatly increased. Some assume the cause of regaining weight must be the patient's fault, e.g. eating between meals with high-caloric snack foods, though this has been debated. Others believe it is an unpredictable failure or limitation of the surgery for certain patients (e.g. reactive hypoglycemia).


title: Gastric bypass surgery

text: Any major surgery involves the potential for complications—adverse events that increase risk, hospital stay, and mortality. Some complications are common to all abdominal operations, while some are specific to bariatric surgery.


title: Gastric bypass surgery

text: The overall rate of complications during the 30 days following surgery ranges from 7% for laparoscopic procedures to 14.5% for operations through open incisions. One study on mortality revealed a 0% mortality rate out of 401 laparoscopic cases, and 0.6% out of 955 open procedures. Similar mortality rates—30-day mortality of 0.11%, and 90-day mortality of 0.3%—have been recorded in the U.S. Centers of Excellence program, the results being from 33,117 operations at 106 centers.


title: Gastric bypass surgery

text: Mortality and complications are affected by pre-existing risk factors such as degree of obesity, heart disease, obstructive sleep apnea, diabetes mellitus, and history of prior pulmonary embolism. It is also affected by the experience of the operating surgeon: the learning curve for laparoscopic bariatric surgery is estimated to be about 100 cases. Supervision and experience are important when selecting a surgeon, as the way a surgeon becomes experienced in dealing with problems is by encountering and solving them.


title: Gastric bypass surgery

text: Infection of the incisions or of the inside of the abdomen (peritonitis, abscess) may occur due to the release of bacteria from the bowel during the operation. Nosocomial infections, such as pneumonia, bladder or kidney infections, and sepsis (blood-borne infection) are also possible. Effective short-term use of antibiotics, diligent respiratory therapy, and encouragement of activity within a few hours after surgery can reduce the risks of infections.


title: Gastric bypass surgery

text: Any injury, such as a surgical operation, causes the body to increase the coagulation of the blood. Simultaneously, activity may be reduced. There is an increased probability of formation of clots in the veins of the legs, or sometimes the pelvis, particularly in the morbidly obese patient. A clot that breaks free and floats to the lungs is called a pulmonary embolus, a very dangerous occurrence. Blood thinners are commonly administered before surgery to reduce the probability of this type of complication.


title: Gastric bypass surgery

text: Many blood vessels must be cut in order to divide the stomach and to move the bowel. Any of these may later begin bleeding, either into the abdomen (intra-abdominal hemorrhage) or into the bowel itself (gastrointestinal hemorrhage). Transfusions may be needed, and re-operation is sometimes necessary. The use of blood thinners to prevent venous thromboembolic disease may actually increase the risk of hemorrhage slightly.


title: Gastric bypass surgery

text: A hernia is an abnormal opening, either within the abdomen or through the abdominal wall muscles. An internal hernia may result from surgery and re-arrangement of the bowel and is a cause of bowel obstruction. Antecolic antegastric Roux-en-Y gastric bypass surgery has been estimated to result in internal hernia in 0.2% of cases, mainly through Petersen's defect. An incisional hernia occurs when a surgical incision does not heal well; the muscles of the abdomen separate and allow protrusion of a sac-like membrane, which may contain bowel or other abdominal contents, and which can be painful and unsightly. The risk of abdominal-wall hernia is markedly decreased in laparoscopic surgery.


title: Gastric bypass surgery

text: Abdominal surgery always results in some scarring of the bowel, called adhesions. A hernia, either internal or through the abdominal wall, may also result. When the bowel becomes trapped by adhesions or a hernia, it may become kinked and obstructed, sometimes many years after the original procedure. An operation is usually necessary to correct this problem.


title: Gastric bypass surgery

text: An anastomosis is a surgical connection between the stomach and bowel, or between two parts of the bowel. The surgeon attempts to create a water-tight connection by connecting the two organs with either staples or sutures, either of which actually makes a hole in the bowel wall. The surgeon will rely on the body's natural healing abilities and its ability to create a seal, like a self-sealing tire, to succeed with the surgery. If that seal fails to form for any reason, fluid from within the gastrointestinal tract can leak into the sterile abdominal cavity and give rise to infection and abscess formation. Leakage of an anastomosis can occur in about 2% of Roux-en-Y gastric bypass and less than 1% in mini gastric bypass. Leaks usually occur at the stomach-intestine connection (gastro-jejunostomy).


title: Gastric bypass surgery

text: As the anastomosis heals, it forms scar tissue, which naturally tends to shrink ("contract") over time, making the opening smaller. This is called a "stricture". Usually, the passage of food through an anastomosis will keep it stretched open, but if the inflammation and healing process outpaces the stretching process, scarring may make the opening so small that even liquids can no longer pass through it. The solution is a procedure called gastro endoscopy, and stretching of the connection by inflating a balloon inside it. Sometimes this manipulation may have to be performed more than once to achieve lasting correction.


title: Gastric bypass surgery

text: Normally, the pyloric valve at the lower end of the stomach regulates the release of food into the bowel. When the gastric bypass patient eats a sugary food, the sugar passes rapidly into the intestine, where it gives rise to a physiological reaction called dumping syndrome. The body will flood the intestines with gastric content in an attempt to dilute the sugars. An affected person may feel their heart beating rapidly and forcefully, break into a cold sweat, get a feeling of butterflies in the stomach, and may have an anxiety attack. The person usually has to lie down and could be very uncomfortable for 30–45 minutes. Diarrhea may then follow.


title: Gastric bypass surgery

text: Nutritional deficiencies are common after gastric bypass surgery, and are often not recognized. They include:


title: Gastric bypass surgery

text: After surgery, patients feel fullness after ingesting only a small volume of food, followed soon thereafter by a sense of satiety and loss of appetite. Total food intake is markedly reduced. Due to the reduced size of the newly created stomach pouch, and reduced food intake, adequate nutrition demands that the patient follow the surgeon's instructions for food consumption, including the number of meals to be taken daily, adequate protein intake, and the use of vitamin and mineral supplements. Calcium supplements, iron supplements, protein supplements, multi-vitamins (sometimes pre-natal vitamins are best), and vitamin B (cyanocobalamin) supplements are all very important to the post-operative bypass patient.


title: Gastric bypass surgery

text: Total food intake and absorbance rate of food will rapidly decline after gastric bypass surgery, and the number of acid-producing cells lining the stomach increases. Doctors often prescribe acid-lowering medications to counteract the high acidity levels. Many patients then experience a condition known as achlorhydria, where there is not enough acid in the stomach. As a result of the low acidity levels, patients can develop an overgrowth of bacteria. A study conducted on 43 post-operative patients revealed that almost all of the patients tested positive for a hydrogen breath test, which indicated an overgrowth of bacteria in the small intestine. Bacterial overgrowth causes the gut ecology to change and induces nausea and vomiting. Recurring nausea and vomiting eventually change the absorbance rate of food, contributing to the vitamin and nutrition deficiencies common in post-operative gastric bypass patients.


title: Gastric bypass surgery

text: Proteins are essential food substances, contained in foods such as meat, fish, poultry, dairy products, eggs, vegetables, fruits, legumes and nuts. With reduced ability to eat a large volume of food, gastric bypass patients must focus on eating their protein requirements first, and with each meal. In some cases, surgeons may recommend use of a liquid protein supplement. Powdered protein supplements added to smoothies or any food can be an important part of the post-op diet.


title: Gastric bypass surgery

text: The profound weight loss which occurs after bariatric surgery is due to taking in much less energy (calories) than the body needs to use every day. Fat tissue must be burned to offset the deficit, and weight loss results. Eventually, as the body becomes smaller, its energy requirements are decreased, while the patient simultaneously finds it possible to eat somewhat more food. When the energy consumed is equal to the calories eaten, weight loss will stop. Proximal GBP typically results in loss of 60–80% of excess body weight, and very rarely leads to excessive weight loss. The risk of excessive weight loss is slightly greater with distal GBP.


title: Gastric bypass surgery

text: Vitamins are normally contained in foods and supplements. The amount of food eaten after GBP is severely reduced, and vitamin content is correspondingly lowered. Supplements should therefore be taken to complete minimum daily requirements of all vitamins and minerals. Pre-natal vitamins are sometimes suggested by doctors, as they contain more of certain vitamins than most multi-vitamins. Absorption of most vitamins is not seriously affected after proximal GBP, although vitamin B may not be well-absorbed in some persons: sublingual preparations of B provide adequate absorption. Some studies suggest that GBP patients who took probiotics after surgery are able to absorb and retain higher amounts of B than patients who did not take probiotics after surgery. After a distal GBP, fat-soluble vitamins A, D, and E may not be well-absorbed, particularly if fat intake is large. Water-dispersed forms of these vitamins may be indicated on specific physician recommendation. For some patients, sublingual B is not enough, and patients may require B injections.


title: Gastric bypass surgery

text: All versions of the GBP bypass the duodenum, which is the primary site of absorption of both iron and calcium. Iron replacement is essential in menstruating females, and supplementation of iron and calcium is preferable in all patients. Ferrous sulfate is poorly tolerated. Alternative forms of iron (fumarate, gluconate, chelates) are less irritating and probably better absorbed. Calcium "carbonate" preparations should also be avoided; calcium as citrate or gluconate (with 1200 mg as calcium) has greater bioavailability independent of acid in the stomach, and will likely be better absorbed. Chewable calcium supplements that include vitamin K are sometimes recommended by doctors as a good way to get calcium.


title: Gastric bypass surgery

text: Post-operative gastric bypass patients develop a lowered tolerance for alcoholic beverages because their altered digestive tract absorbs alcohol at a faster rate than people who have not undergone the surgery. It also takes a post-operative patient longer to reach sober levels after consuming alcohol. In a study conducted on 36 post-operative patients and a control group of 36 subjects (who had not undergone surgery), each subject drank a 5 oz. glass of red wine and had the alcohol in their breath measured to evaluate alcohol metabolism. The gastric bypass group had an average peak alcohol breath level at 0.08%, whereas the control group had an average peak alcohol breath level of 0.05%. It took on average 108 minutes for the gastric bypass patients group to return to an alcohol breath of zero, while it took the control group an average of 72 minutes.


title: Gastric bypass surgery

text: There have been reported cases in which pica recurs after gastric bypass in patients with a pre-operative history of the disorder, which are possibly due to iron deficiency. Pica is a compulsive tendency to eat substances other than normal food. Some examples would be people eating paper, clay, plaster, ashes, or ice. Low levels of iron and hemoglobin are common in patients who have undergone gastric bypass. One study reported on a female post-operative gastric bypass patient who was consuming eight to ten 32 oz. glasses of ice a day. The patient's blood test revealed iron levels of 2.3 mmol/L and hemoglobin level of 5.83 mmol/L. Normal iron blood levels of adult women are 30 to 126 µg/dL and normal hemoglobin levels are 12.1 to 15.1 g/dl. This deficiency in the patient's iron levels may have led to the increase Pica activity. The patient was then given iron supplements that brought her hemoglobin and iron blood levels to normal levels. After one month, the patient's eating diminished to two to three glasses of ice per day. After one year of taking iron supplements the patient's iron and hemoglobin levels remained in a normal range and the patient reported that she did not have any further cravings for ice.


title: Gastric bypass surgery

text: Weight loss of 65–80% of excess body weight is typical of most large series of gastric bypass operations reported. The medically more significant effects include a dramatic reduction in comorbid conditions:


title: Gastric bypass surgery

text: A study in a large prospective study of 2010 obese patients showed a 29% reduction in mortality up to 15 years following surgery (hazard ratio 0.71 when adjusted for sex, age, and risk factors), compared to a non-surgically treated group of 2037 patients. A meta-analysis of 174772 participants published in The Lancet in 2021 found that bariatric surgery was associated with 59% and 30% reduction in all-cause mortality among obese adults with or without type 2 diabetes respectively. This meta-analysis also found that median life-expectancy was 9.3 years longer for obese adults with diabetes who received bariatric surgery as compared to routine (non-surgical) care, whereas the life expectancy gain was 5.1 years longer for obese adults without diabetes.


title: Gastric bypass surgery

text: The patient's out-of-pocket cost for Roux-en-Y gastric bypass surgery varies widely depending on method of payment, region, surgical practice and hospital in which the procedure is performed.


title: Gastric bypass surgery

text: Methods of payment in the United States include private insurance, such as Individual & Family coverage, Small Group coverage through an employer (Under 50 full-time employees) and Large Group coverage through an employer (50 or more full-time employees), public insurance (Medicare and Medicaid) and self-pay. Out of pocket costs for a patient with private or public insurance that specifically list bariatric surgery as a covered benefit include several insurance-policy-specific parameters such as deductible levels, coinsurance percentages, copay amounts and out of pocket limits.


title: Gastric bypass surgery

text: Patients without insurance must pay for surgery directly (or through a third party lender), and total out of pocket costs will depend on the surgical practice they choose and the hospital in which the surgical practice performs the procedure. On average, the total cost of gastric bypass surgery is about $24,000 in the United States, although on a state-specific level it ranges from an average of $15,000 (Arkansas) to an average of $57,000 (Alaska).


title: Gastric bypass surgery

text: In Germany a gastric bypass operation, if not covered by health insurance and therefore paid privately, costs up to €15,000; in Switzerland CHF 20,000–25,000, in Poland gastric bypass costs around £4,000, whereas in Turkey it costs £3,200.


title: Gastric bypass surgery

text: Gastric bypass surgery has an emotional and physiological impact on the individual. Many who have undergone the surgery develop depression in the following months as a result of a change in the role food plays in their emotional well-being. Strict limitations on the diet can place great emotional strain on the patient. Energy levels in the period following the surgery can be low, both due to the restriction of food intake and negative changes in emotional state. It may take as long as three months for emotional levels to rebound.


title: Gastric bypass surgery

text: Muscular weakness in the months following surgery is also common. This is caused by a number of factors, including a restriction on protein intake, a resulting loss in muscle mass and decline in energy levels. Muscle weakness may result in balance problems, difficulty climbing stairs or lifting heavy objects, and increased fatigue following simple physical tasks. Many of these issues pass over time as food intake gradually increases. However, the first months following the surgery can be very difficult, an issue not often mentioned by physicians suggesting the surgery. The benefits and risks of this surgery are well established; however, the psychological effects are not well understood.


title: Gastric bypass surgery

text: Even if physical activity is increased, patients may still harbor long term psychological effects due to excess skin and fat. Often bypass surgery is followed up with "body lifts" of skin and liposuction of fatty deposits. These extra surgeries have their own inherent risks but are even more dangerous when coupled with the typical nutritional deficiences that accompany convalescing gastric bypass patients.


title: Gastric bypass surgery

text: The American Society for Metabolic & Bariatric Surgery lists bariatric programs and surgeons in its "Centers of Excellence" network, while the American College of Surgeons accredits providers through its Bariatric Surgery Center Network. For listings of surgeons and centers in other countries, the International Federation for the Surgery of Obesity and Metabolic Disorders lists medical associations by country.


title: Hepatic encephalopathy

text: Hepatic encephalopathy (HE) is an altered level of consciousness as a result of liver failure. Its onset may be gradual or sudden. Other symptoms may include movement problems, changes in mood, or changes in personality. In the advanced stages it can result in a coma.


title: Hepatic encephalopathy

text: Hepatic encephalopathy can occur in those with acute or chronic liver disease. Episodes can be triggered by infections, GI bleeding, constipation, electrolyte problems, or certain medications. The underlying mechanism is believed to involve the buildup of ammonia in the blood, a substance that is normally removed by the liver. The diagnosis is typically based on symptoms after ruling out other potential causes. It may be supported by blood ammonia levels, an electroencephalogram, or a CT scan of the brain.


title: Hepatic encephalopathy

text: Hepatic encephalopathy is possibly reversible with treatment. This typically involves supportive care and addressing the triggers of the event. Lactulose is frequently used to decrease ammonia levels. Certain antibiotics (such as rifaximin) and probiotics are other potential options. A liver transplant may improve outcomes in those with severe disease.


title: Hepatic encephalopathy

text: More than 40% of people with cirrhosis develop hepatic encephalopathy. More than half of those with cirrhosis and significant HE live less than a year. In those who are able to get a liver transplant, the risk of death is less than 30% over the subsequent five years. The condition has been described since at least 1860.


title: Hepatic encephalopathy

text: The mildest form of hepatic encephalopathy is difficult to detect clinically, but may be demonstrated on neuropsychological testing. It is experienced as forgetfulness, mild confusion, and irritability. The first stage of hepatic encephalopathy is characterised by an inverted sleep-wake pattern (sleeping by day, being awake at night). The second stage is marked by lethargy and personality changes. The third stage is marked by worsened confusion. The fourth stage is marked by a progression to coma.


title: Hepatic encephalopathy

text: More severe forms of hepatic encephalopathy lead to a worsening level of consciousness, from lethargy to somnolence and eventually coma. In the intermediate stages, a characteristic jerking movement of the limbs is observed (asterixis, "liver flap" due to its flapping character); this disappears as the somnolence worsens. There is disorientation and amnesia, and uninhibited behaviour may occur. In the third stage, neurological examination may reveal clonus and positive Babinski sign. Coma and seizures represent the most advanced stage; cerebral edema (swelling of the brain tissue) leads to death.


title: Hepatic encephalopathy

text: Encephalopathy often occurs together with other symptoms and signs of liver failure. These may include jaundice (yellow discolouration of the skin and the whites of the eyes), ascites (fluid accumulation in the abdominal cavity), and peripheral oedema (swelling of the legs due to fluid build-up in the skin). The tendon reflexes may be exaggerated, and the plantar reflex may be abnormal, namely extending rather than flexing (Babinski's sign) in severe encephalopathy. A particular smell on an affected person's breath ("foetor hepaticus") may be detected.


title: Hepatic encephalopathy

text: In a small proportion of cases, the encephalopathy is caused directly by liver failure; this is more likely in acute liver failure. More commonly, especially in chronic liver disease, hepatic encephalopathy is triggered by an additional cause, and identifying these triggers can be important to treat the episode effectively.


title: Hepatic encephalopathy

text: Hepatic encephalopathy may also occur after the creation of a transjugular intrahepatic portosystemic shunt (TIPS). This is used in the treatment of refractory ascites, bleeding from oesophageal varices and hepatorenal syndrome. TIPS-related encephalopathy occurs in about 30% of cases, with the risk being higher in those with previous episodes of encephalopathy, higher age, female sex, and liver disease due to causes other than alcohol.


title: Hepatic encephalopathy

text: There are various explanations why liver dysfunction or portosystemic shunting might lead to encephalopathy. In healthy subjects, nitrogen-containing compounds from the intestine, generated by gut bacteria from food, are transported by the portal vein to the liver, where 80–90% are metabolised through the urea cycle and/or excreted immediately. This process is impaired in all subtypes of hepatic encephalopathy, either because the hepatocytes (liver cells) are incapable of metabolising the waste products or because portal venous blood bypasses the liver through collateral circulation or a medically constructed shunt. Nitrogenous waste products accumulate in the systemic circulation (hence the older term "portosystemic encephalopathy"). The most important waste product is ammonia (NH). This small molecule crosses the blood–brain barrier and is absorbed and metabolised by the astrocytes, a population of cells in the brain that constitutes 30% of the cerebral cortex. Astrocytes use ammonia when synthesising glutamine from glutamate. The increased levels of glutamine lead to an increase in osmotic pressure in the astrocytes, which become swollen. There is increased activity of the inhibitory γ-aminobutyric acid (GABA) system and the energy supply to other brain cells is decreased. This can be thought of as an example of brain edema of the "cytotoxic" type.


title: Hepatic encephalopathy

text: Despite numerous studies demonstrating the central role of ammonia, ammonia levels do not always correlate with the severity of the encephalopathy; it is suspected that this means that more ammonia has already been absorbed into the brain in those with severe symptoms whose serum levels are relatively low. Other waste products implicated in hepatic encephalopathy include mercaptans (substances containing a thiol group), short-chain fatty acids, and phenol.


title: Hepatic encephalopathy

text: Numerous other abnormalities have been described in hepatic encephalopathy, although their relative contribution to the disease state is uncertain. Loss of glutamate transporter gene expression (especially EAAT 2) has been attributed to acute liver failure. Benzodiazepine-like compounds have been detected at increased levels as well as abnormalities in the GABA neurotransmission system. An imbalance between aromatic amino acids (phenylalanine, tryptophan and tyrosine) and branched-chain amino acids (leucine, isoleucine and valine) has been described; this would lead to the generation of false neurotransmitters (such octopamine and 2-hydroxyphenethylamine). Dysregulation of the serotonin system, too, has been reported. Depletion of zinc and accumulation of manganese may play a role. Inflammation elsewhere in the body may precipitate encephalopathy through the action of cytokines and bacterial lipopolysaccharide on astrocytes.


title: Hepatic encephalopathy

text: The diagnosis of hepatic encephalopathy can only be made in the presence of confirmed liver disease (types A and C) or a portosystemic shunt (type B), as its symptoms are similar to those encountered in other encephalopathies. To make the distinction, abnormal liver function tests and/or ultrasound suggesting liver disease are required, and ideally a liver biopsy. The symptoms of hepatic encephalopathy may also arise from other conditions, such as bleeding in the brain and seizures (both of which are more common in chronic liver disease). A CT scan of the brain may be required to exclude bleeding in the brain, and if seizure activity is suspected an electroencephalograph (EEG) study may be performed. Rarer mimics of encephalopathy are meningitis, encephalitis, Wernicke's encephalopathy and Wilson's disease; these may be suspected on clinical grounds and confirmed with investigations.


title: Hepatic encephalopathy

text: The diagnosis of hepatic encephalopathy is a clinical one, once other causes for confusion or coma have been excluded; no test fully diagnoses or excludes it. Serum ammonia levels are elevated in 90% of people, but not all hyperammonaemia (high ammonia levels in the blood) is associated with encephalopathy. A CT scan of the brain usually shows no abnormality except in stage IV encephalopathy, when brain swelling (cerebral oedema) may be visible. Other neuroimaging modalities, such as magnetic resonance imaging (MRI), are not currently regarded as useful, although they may show abnormalities. Electroencephalography shows no clear abnormalities in stage 0, even if minimal HE is present; in stages I, II and III there are triphasic waves over the frontal lobes that oscillate at 5 Hz, and in stage IV there is slow delta wave activity. However, the changes in EEG are not typical enough to be useful in distinguishing hepatic encephalopathy from other conditions.


title: Hepatic encephalopathy

text: Once the diagnosis of encephalopathy has been made, efforts are made to exclude underlying causes (such as listed above in "causes"). This requires blood tests (urea and electrolytes, full blood count, liver function tests), usually a chest X-ray, and urinalysis. If there is ascites, a diagnostic paracentesis (removal of a fluid sample with a needle) may be required to identify spontaneous bacterial peritonitis (SBP).


title: Hepatic encephalopathy

text: The severity of hepatic encephalopathy is graded with the West Haven Criteria; this is based on the level of impairment of autonomy, changes in consciousness, intellectual function, behavior, and dependence on therapy.


title: Hepatic encephalopathy

text: A classification of hepatic encephalopathy was introduced at the World Congress of Gastroenterology 1998 in Vienna. According to this classification, hepatic encephalopathy is subdivided in type A, B and C depending on the underlying cause.


title: Hepatic encephalopathy

text: The term "minimal encephalopathy" (MHE) is defined as encephalopathy that does not lead to clinically overt cognitive dysfunction, but can be demonstrated with neuropsychological studies. This is still an important finding, as minimal encephalopathy has been demonstrated to impair quality of life and increase the risk of involvement in road traffic accidents.


title: Hepatic encephalopathy

text: The diagnosis of minimal hepatic encephalopathy requires neuropsychological testing by definition. Older tests include the "numbers connecting test" A and B (measuring the speed at which one could connect randomly dispersed numbers 1–20), the "block design test" and the "digit-symbol test". In 2009 an expert panel concluded that neuropsychological test batteries aimed at measuring multiple domains of cognitive function are generally more reliable than single tests, and tend to be more strongly correlated with functional status. Both the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and PSE-Syndrom-Test may be used for this purpose. The PSE-Syndrom-Test, developed in Germany and validated in several other European countries, incorporates older assessment tools such as the number connection test.


title: Hepatic encephalopathy

text: Those with severe encephalopathy (stages 3 and 4) are at risk of obstructing their airway due to decreased protective reflexes such as the gag reflex. This can lead to respiratory arrest. Transferring the person to a higher level of nursing care, such as an intensive care unit, is required, and intubation of the airway is often necessary to prevent life-threatening complications (e.g., aspiration or respiratory failure). Placement of a nasogastric tube permits the safe administration of nutrients and medication.


title: Hepatic encephalopathy

text: The treatment of hepatic encephalopathy depends on the suspected underlying cause (types A, B, or C) and the presence or absence of underlying causes. If encephalopathy develops in acute liver failure (type A), even in a mild form (grade 1–2), it indicates that a liver transplant may be required, and transfer to a specialist centre is advised. Hepatic encephalopathy type B may arise in those who have undergone a TIPS procedure; in most cases this resolves spontaneously or with the medical treatments discussed below, but in a small proportion of about 5%, occlusion of the shunt is required to address the symptoms.


title: Hepatic encephalopathy

text: In hepatic encephalopathy type C, the identification and treatment of alternative or underlying causes is central to the initial management. Given the frequency of infection as the underlying cause, antibiotics are often administered empirically (without knowledge of the exact source and nature of the infection). Once an episode of encephalopathy has been effectively treated, a decision may need to be made on whether to prepare for a liver transplant.


title: Hepatic encephalopathy

text: In the past, it was thought that consumption of protein even at normal levels increased the risk of hepatic encephalopathy. This has been shown to be incorrect. Furthermore, many people with chronic liver disease are malnourished and require adequate protein to maintain a stable body weight. A diet with adequate protein and energy is therefore recommended.


title: Hepatic encephalopathy

text: Dietary supplementation with branched-chain amino acids has shown improvement of encephalopathy and other complications of cirrhosis.


title: Hepatic encephalopathy

text: Lactulose and lactitol are disaccharides that are not absorbed from the digestive tract. They are thought to decrease the generation of ammonia by bacteria, render the ammonia inabsorbable by converting it to ammonium (NH) ions, and increase transit of bowel content through the gut. Doses of 15-30 mL are typically administered three times a day; the result is aimed to be 3–5 soft stools a day, or (in some settings) a stool pH of <6.0. Lactulose may also be given by enema, especially if encephalopathy is severe. More commonly, phosphate enemas are used. This may relieve constipation, one of the causes of encephalopathy, and increase bowel transit.


title: Hepatic encephalopathy

text: Lactulose and lactitol are beneficial for treating hepatic encephalopathy, and are the recommended first-line treatment. Lactulose does not appear to be more effective than lactitol for treating people with hepatic encephalopathy. Side effects of lactulose and lactitol include the possibility of diarrhea, abdominal bloating, gassiness, and nausea. In acute liver failure, it is unclear whether lactulose is beneficial. The possible side effect of bloating may interfere with a liver transplant procedure if required.


title: Hepatic encephalopathy

text: The antibiotic rifaximin may be recommended in addition to lactulose for those with recurrent disease. It is a nonabsorbable antibiotic from the rifamycin class. This is thought to work in a similar way to other antibiotics but without the complications attached to neomycin or metronidazole. Due to the long history and lower cost of lactulose use, rifaximin is generally only used as a second-line treatment if lactulose is poorly tolerated or not effective. When rifaximin is added to lactulose, the combination of the two may be more effective than each component separately. Rifaximin is more expensive than lactulose, but the cost may be offset by fewer hospital admissions for encephalopathy.


title: Hepatic encephalopathy

text: The antibiotics neomycin and metronidazole are other antibiotics used to treat hepatic encephalopathy. The rationale of their use was the fact that ammonia and other waste products are generated and converted by intestinal bacteria, and killing these bacteria would reduce the generation of these waste products. Neomycin was chosen because of its low intestinal absorption, as neomycin and similar aminoglycoside antibiotics may cause hearing loss and kidney failure if used by injection. Later studies showed that neomycin was indeed absorbed when taken by mouth, with resultant complications. Metronidazole, similarly, is less commonly used because prolonged use can cause nerve damage, in addition to gastrointestinal side effects.


title: Hepatic encephalopathy

text: The combination of "L"-ornithine and "L"-aspartate (LOLA) lowers the level of ammonia in a person's blood. Very weak evidence from clinical trials indicates that LOLA treatment may benefit people with hepatic encephalopathy. LOLA lowers ammonia levels by increasing the generation of urea through the urea cycle, a metabolic pathway that removes ammonia by turning it into the neutral substance urea. LOLA may be combined with lactulose and/or rifaximin if these alone are ineffective at controlling symptoms.


title: Hepatic encephalopathy

text: In those with cirrhosis, the risk of developing hepatic encephalopathy is 20% per year, and at any time about 30–45% of people with cirrhosis exhibit evidence of overt encephalopathy. The prevalence of minimal hepatic encephalopathy detectable on formal neuropsychological testing is 60–80%; this increases the likelihood of developing overt encephalopathy in the future. Once hepatic encephalopathy has developed, the prognosis is determined largely by other markers of liver failure, such as the levels of albumin (a protein produced by the liver), the prothrombin time (a test of coagulation, which relies on proteins produced in the liver), the presence of ascites and the level of bilirubin (a breakdown product of hemoglobin which is conjugated and excreted by the liver). Together with the severity of encephalopathy, these markers have been incorporated into the Child–Pugh score; this score determines the one- and two-year survival and may assist in a decision to offer liver transplantation.


title: Hepatic encephalopathy

text: In acute liver failure, the development of severe encephalopathy strongly predicts short-term mortality and is almost as important as the nature of the underlying cause of the liver failure in determining the prognosis. Historically, widely used criteria for offering liver transplantation, such as King's College Criteria, are of limited use and recent guidelines discourage excessive reliance on these criteria. The occurrence of hepatic encephalopathy in people with Wilson's disease (hereditary copper accumulation) and mushroom poisoning indicates an urgent need for a liver transplant.


title: Hepatic encephalopathy

text: The occurrence of disturbed behaviour in people with jaundice may have been described in antiquity by Hippocrates of Cos (–370 BCE). Celsus and Galen (first and third century respectively) both recognised the condition. Many modern descriptions of the link between liver disease and neuropsychiatric symptoms were made in the eighteenth and nineteenth century; for instance, Giovanni Battista Morgagni (1682–1771) reported in 1761 that it was a progressive condition.


title: Hepatic encephalopathy

text: In the 1950s, several reports enumerated the numerous abnormalities reported previously, and confirmed the previously enunciated theory that metabolic impairment and portosystemic shunting are the underlying mechanisms behind hepatic encephalopathy, and that the nitrogen-rich compounds originate from the intestine. Professor Dame Sheila Sherlock (1918–2001) performed many of these studies at the Royal Postgraduate Medical School in London and subsequently at the Royal Free Hospital. The same group investigated protein restriction and neomycin.


title: Hepatic encephalopathy

text: The West Haven classification was formulated by Professor Harold Conn (1925–2011) and colleagues at Yale University while investigating the therapeutic efficacy of lactulose.


title: Stanozolol

text: Stanozolol (abbrev. Stz), sold under many brand names, is an androgen and anabolic steroid (AAS) medication derived from dihydrotestosterone (DHT). It is used to treat hereditary angioedema. It was developed by American pharmaceutical company Winthrop Laboratories (Sterling Drug) in 1962, and has been approved by the U.S. Food and Drug Administration for human use, though it is no longer marketed in the USA. It is also used in veterinary medicine. Stanozolol has mostly been discontinued, and remains available in only a few countries. It is given by mouth in humans or by injection into muscle in animals.


title: Stanozolol

text: Unlike most injectable AAS, stanozolol is not esterified and is sold as an aqueous suspension, or in oral tablet form. The drug has a high oral bioavailability, due to a C17α alkylation which allows the hormone to survive first-pass liver metabolism when ingested. It is because of this that stanozolol is also sold in tablet form.


title: Stanozolol

text: Stanozolol is one of the AAS commonly used as performance-enhancing drugs and is banned from use in sports competition under the auspices of the International Association of Athletics Federations (IAAF) and many other sporting bodies. It is an anabolic steroid that is known to have a diuretic effect. Additionally, stanozolol has been highly restricted in US horse racing.


title: Stanozolol

text: Stanozolol has been used with some success to treat venous insufficiency. It stimulates blood fibrinolysis and has been evaluated for the treatment of the more advanced skin changes in venous disease such as lipodermatosclerosis. Several randomized trials noted improvement in the area of lipodermatosclerosis, reduced skin thickness, and possibly faster ulcer healing rates with stanozolol. It is also being studied to treat hereditary angioedema, osteoporosis, and skeletal muscle injury.


title: Stanozolol

text: Stanozolol is used for physique- and performance-enhancing purposes by competitive athletes, bodybuilders, and powerlifters.


title: Stanozolol

text: Side effects of stanozolol include virilization (masculinization), hepatotoxicity, cardiovascular disease, and hypertension.


title: Stanozolol

text: As an AAS, stanozolol is an agonist of the androgen receptor (AR), similarly to androgens like testosterone and DHT. Its affinity for the androgen receptor is about 22% of that of dihydrotestosterone. Stanozolol is not a substrate for 5α-reductase as it is already 5α-reduced, and so is not potentiated in so-called "androgenic" tissues like the skin, hair follicles, and prostate gland. This results in a greater ratio of anabolic to androgenic activity compared to testosterone. In addition, due to its 5α-reduced nature, stanozolol is non-aromatizable, and hence has no propensity for producing estrogenic effects such as gynecomastia or fluid retention. Stanozolol also does not possess any progestogenic activity of significance. Because of the presence of its 17α-methyl group, the metabolism of stanozolol is sterically hindered, resulting in it being orally active, although also hepatotoxic.


title: Stanozolol

text: Stanozolol has high oral bioavailability, due to the presence of its C17α alkyl group and the resistance to gastrointestinal and liver metabolism that it results in. The medication has very low affinity for human serum sex hormone-binding globulin (SHBG), about 5% of that of testosterone and 1% of that of DHT. Stanozolol is metabolized in the liver, ultimately becoming glucuronide and sulfate conjugates. Its biological half-life is reported to be 9 hours when taken by mouth and 24 hours when given by intramuscular injection in the form of an aqueous suspension. It is said to have a duration of action of one week or more via intramuscular injection.


title: Stanozolol

text: Stanozolol, also known as 17α-methyl-2<nowiki>'</nowiki>"H"-androst-2-eno[3,2-"c"]pyrazol-17β-ol, is a synthetic 17α-alkylated androstane steroid and a derivative of 5α-dihydrotestosterone (DHT) with a methyl group at the C17α position and a pyrazole ring attached to the A ring of the steroid nucleus.


title: Stanozolol

text: Stanozolol is subject to extensive hepatic biotransformation by a variety of enzymatic pathways. The primary metabolites are unique to stanozolol and are detectable in the urine for up to 10 days after a single 5–10 mg oral dose. Methods for detection in urine specimens usually involve gas chromatography-mass spectrometry or liquid chromatography-mass spectrometry.


title: Stanozolol

text: In 1962, Stanozolol was brought to market in the US by Winthrop under the tradename "Winstrol" and in Europe by Winthrop's partner, Bayer, under the name "Stromba".


title: Stanozolol

text: Also in 1962, the Kefauver Harris Amendment was passed, amending the Federal Food, Drug, and Cosmetic Act to require drug manufacturers to provide proof of the effectiveness of their drugs before approval. The FDA implemented its Drug Efficacy Study Implementation (DESI) program to study and regulate drugs, including stanozolol, that had been introduced prior to the amendment. The DESI program was intended to classify all pre-1962 drugs that were already on the market as effective, ineffective, or needing further study. The FDA enlisted the National Research Council of the National Academy of Sciences to evaluate publications on relevant drugs under the DESI program.


title: Stanozolol

text: In June 1970 the FDA announced its conclusions on the effectiveness of certain AAS, including stanozolol, based on the NAS/NRC reports made under DESI. The drugs were classified as probably effective as adjunctive therapy in the treatment of senile and postmenopausal osteoporosis but only as an adjunct, and in pituitary dwarfism (with a specific caveat for dwarfism, "until growth hormone is more available"), and as lacking substantial evidence of effectiveness for several other indications. Specifically, the FDA found a lack of efficacy for stanozolol as "an adjunct to promote body tissue-building processes and to reverse tissue-depleting processes in such conditions as malignant diseases and chronic nonmalignant diseases; debility in elderly patients, and other emaciating diseases; gastrointestinal disorders resulting in alterations of normal metabolism; use during pre-operative and postoperative periods in undernourished patients and poor-risk surgical cases due to traumatism; use in infants, children, and adolescents who do not reach an adequate weight; supportive treatment to help restore or maintain a favorable metabolic balance, as in postsurgical, postinfectious, and convalescent patients; of value in pre- operative patients who have lost tissue from a disease process or who have associated symptoms, such as anorexia; retention and utilization of calcium; surgical applications; gastrointestinal disease, malnourished adults, and chronic illness; pediatric nutritional problems; prostatic carcinoma; and endocrine deficiencies." The FDA gave Sterling six months to stop marketing stanozolol for the indications for which there was no evidence for efficacy, and one year to submit further data for the two indications for which it found probable efficacy.


title: Stanozolol

text: In August and September 1970, Sterling submitted more data; the data was not sufficient but the FDA allowed the drug to continued to be marketed, since there was an unmet need for drugs for osteoporosis and pituitary dwarfism, but Sterling was required to submit more data.


title: Stanozolol

text: In 1980 the FDA removed the dwarfism indication from the label for stanozolol since human growth hormone drugs had come on the market, and mandated that the label for stanozolol and other steroids say: "As adjunctive therapy in senile and postmenopausal osteoporosis. AAS are without value as primary therapy but may be of value as adjunctive therapy. Equal or greater consideration should be given to diet, calcium balance, physiotherapy, and good general health promoting measures." and gave Sterling a timeline to submit further data for other indications it wanted for the drug. Sterling submitted data to the FDA intended to support the effectiveness of Winstrol for postmenopausal osteoporosis and aplastic anemia in December, 1980 and August 1983 respectively. The FDA's Endocrinologic and Metabolic Drugs Advisory Committee considered the data submitted for osteoporosis in two meetings held 1981 and the data for aplastic anemia in 1983.


title: Stanozolol

text: In April 1984, the FDA announced that the data was not sufficient, and withdrew the marketing authority for stanozolol for senile and postmenopausal osteoporosis and for raising hemoglobin levels in aplastic anemia.


title: Stanozolol

text: In 1988, Sterling was acquired by Eastman Kodak for $5.1 billion and in 1994 Kodak sold the drug business of Sterling to Sanofi for $1.675 billion.


title: Stanozolol

text: Sanofi had stanozolol manufactured in the US by Searle, which stopped making the drug in October 2002. Even with no drug in production, Sanofi sold the stanozolol business to Ovation Pharmaceuticals in 2003, along with the two other drugs. At that time, the drug had not been discontinued and was considered a treatment for hereditary angioedema. In March 2009, Lundbeck purchased Ovation


title: Stanozolol

text: In 2010, Lundbeck withdrew stanozolol from the market in the US; as of 2014 no other company is marketing stanozolol as a pharmaceutical drug in the US but it can be obtained via a compounding pharmacy.


title: Stanozolol

text: Pfizer had marketed stanozolol as a veterinary drug; in 2013 Pfizer spun off its veterinary business to Zoetis and in 2014 Pfizer transferred the authorizations to market injectable and tablet forms of stanozolol as a veterinary drug to Zoetis.


title: Stanozolol

text: It is used in veterinary medicine as an adjunct in the management of wasting diseases, to stimulate the formation of red blood cells, arouse appetite, and promote weight gain, but the evidence for these uses is weak. It is used as a performance-enhancing drug in race horses. Its side effects include weight gain, water retention, and difficulty eliminating nitrogen-based waste products and it is toxic to the liver, especially in cats. Because it may promote the growth of tumors, it is contraindicated in dogs with enlarged prostates.


title: Stanozolol

text: Stanozolol and other AAS were commonly used to treat hereditary angioedema attacks, until several drugs were brought to market specifically for treatment of that disease, the first in 2009: Cinryze, Berinert, ecallantide (Kalbitor), icatibant (Firazyr) and Ruconest. Stanozolol is still used long-term to reduce the frequency of severity of attacks.


title: Stanozolol

text: "Stanozolol" is the generic name of stanozolol in English, German, French, and Japanese and its , , , , , and , while "stanozololum" is its name in Latin, "stanozololo" is its name in Italian and its , and "estanozolol" is its name in Spanish. "Androstanazole", "androstanazol", "stanazol", "stanazolol", and "estanazolol" are unofficial synonyms of stanozolol. It is also known by its former developmental code name "WIN-14833".


title: Stanozolol

text: Brand names under which stanozolol is or has been marketed include Anaysynth, Menabol, Neurabol Caps., Stanabolic (veterinary), Stanazol (veterinary), Stanol, Stanozolol, Stanztab, Stargate (veterinary), Stromba, Strombaject, Sungate (veterinary), Tevabolin, Winstrol, Winstrol Depot, and Winstrol-V (veterinary).


title: Stanozolol

text: In the United States, like other AAS, stanozolol is classified as a controlled substance under federal regulation; they were included as Schedule III controlled substances under the Anabolic Steroids Act, which was passed as part of the Crime Control Act of 1990. In New York, the state legislature classifies AAS under DEA Schedule III.


title: Stanozolol

text: Stanozolol and other synthetic steroids were first banned by the International Olympic Committee and the International Association of Athletics Federations in 1974, after methods to detect them had been developed. There are many known cases of doping in sports with stanozolol by professional athletes. Stanozolol is especially widely used by the athletes from post-Soviet countries. As of 2015, it is banned by World Anti-Doping Agency and United States Anti-Doping Agency.


title: Stanozolol

text: Stanozolol has been investigated in the treatment of a number of dermatological conditions including urticaria, hereditary angioedema, Raynaud's phenomenon, cryofibrinogenemia, and lipodermatosclerosis.


title: PT boat

text: A PT boat (short for patrol torpedo boat) was a motor torpedo boat used by the United States Navy in World War II. It was small, fast, and inexpensive to build, valued for its maneuverability and speed but hampered at the beginning of the war by ineffective torpedoes, limited armament, and comparatively fragile construction that limited some of the variants to coastal waters. In the USN they were organized in Motor Torpedo Boat Squadrons (MTBRONs).


title: PT boat

text: The PT boat was very different from the first generation of torpedo boat, which had been developed at the end of the 19th century and featured a displacement hull form. These first generation torpedo boats rode low in the water, displaced up to 300 tons, and had a top speed of . During World War I Italy, the US, and UK developed the first high-performance gasoline-powered motor torpedo boats (often with top speeds over ) and corresponding torpedo tactics, but these projects were all quickly disbanded after the Armistice. World War II PT boats continued to exploit some of the advances in planing hull design borrowed from offshore powerboat racing and by using multiple lightweight but more powerful marinized aircraft-derived V-12 engines were able to grow in both size and speed.


title: PT boat

text: During World War II, PT boats engaged enemy warships, transports, tankers, barges, and sampans. Some were converted into gunboats, which could be effective against enemy small craft, especially armored barges used by the Japanese for inter-island transport. Several saw service with the Philippine Navy, where they were named "Q-boats".


title: PT boat

text: Primary anti-ship armament on the standard PT boat was four 21-inch Mark 8 torpedoes, each had a TNT warhead and had a range of at . Two twin .50-inch (12.7 mm) M2 Browning heavy machine guns were mounted for anti-aircraft defense and general fire support. Some boats carried a Oerlikon cannon.


title: PT boat

text: Propulsion was via a trio of Packard 4M-2500 and later 5M-2500 supercharged gasoline-fueled, liquid-cooled V-12 marine engines.


title: PT boat

text: Nicknamed "the mosquito fleet" and "devil boats" by the Japanese, the PT boat squadrons were hailed for their daring and earned a durable place in the public imagination that remains strong into the 21st century. Their role was replaced in the U.S. Navy by fast attack craft.


title: PT boat

text: At the outbreak of war in August 1914, W. Albert Hickman devised the first procedures and tactics for employing fast maneuverable seaworthy torpedo motorboats against capital ships, and presented his proposal to Rear Admiral David W. Taylor, the Chief of the US Navy's Bureau of Construction and Repair. In September 1914, Hickman completed plans for a "Sea Sled" torpedo boat and submitted these to the Navy in hopes of obtaining a contract. While favorably received, Secretary of the Navy Josephus Daniels rejected the proposal since the US was not at war, but Hickman was advised to submit his plans and proposal to the British Admiralty, which was done the following month. The Admiralty found it interesting but thought that "no fast boat of 50' to 60'


title: PT boat

text: length would be sufficiently seaworthy", so Hickman built and launched his own privately financed Sea Sled capable of carrying a single 18-inch Whitehead Mark 5 torpedo. In February 1915, this Hickman sea sled demonstrated speeds in rough winter seas off Boston to both US and foreign representatives but again, he received no contracts. The Admiralty representative for this sea sled demonstration was Lieutenant G.C.E. Hampden. In the summer of 1915, Lieutenants Hampden, Bremner, and Anson approached John I. Thornycroft & Company about developing a small high speed torpedo boat, and this effort eventually led to the Coastal Motor Boat which first went into service in April 1916.