The incidence of metabolic syndrome and its reversal in a cohort of schizophrenic patients followed for one year

Cross-sectional studies showed a high prevalence of metabolic syndrome in patients with schizophrenia. This study aimed to identify the incidence of metabolic syndrome and its reversal in a non-preselected cohort of chronic psychotic patients in routine practice in one year follow-up and to find variables to describe development and reversal of metabolic syndrome. This cohort study was conducted as part of a disease management program and patients were included if they had two complete assessments in a one year follow-up. We conducted two logistic regressions to find variables to describe the development of metabolic syndrome and the reversal of metabolic syndrome. At the time of the first assessment 35% (n = 92) of the 260 included patients had metabolic syndrome. Within one year 21 patients developed metabolic syndrome and 30 patients had it reversed. This was an incidence of 13% (21/168) and a reversal of 33% (30/92). Smoking, family history of cardiovascular diseases, and duration of disease >6 years was associated with a higher risk of developing metabolic syndrome as well as abdominal obesity and dyslipidemia. Patients with abdominal obesity had a smaller chance of reversing metabolic syndrome. Other variables included in the logistic regression such as receiving cardiovascular/antidiabetic drug treatment or duration of disease >6 years did not alter the risk of reversing the metabolic syndrome. Our study showed that the natural course of metabolic syndrome is dynamic. A considerable number of patients developed or reversed the metabolic syndrome in one year follow-up. (C) 2009 Elsevier Ltd. All rights reserved

A 12-month follow-up study of treating overweight schizophrenic patients with aripiprazole

Objective: To investigate the feasibility of switching overweight schizophrenic patients to aripiprazole and to assess the impact of 12 months of aripiprazole treatment on weight in routine practice. Method: This was a non-controlled cohort study in overweight schizophrenic patients. Data were collected before treatment with aripiprazole was started and at 12-month follow-up. Results: A total of 53 patients were included; of these 55% continued using aripiprazole for 12 months. Aripiprazole treatment for 12 months (P = 0.027) and stopping clozapine or olanzapine treatment (P = 0.038) predicted weight loss (>= 3 kg). Patients receiving aripiprazole monotherapy (n = 16, mean -3.0 kg) had similar weight loss than patients receiving aripiprazole in addition to another antipsychotic drug (n = 13, mean -4.4 kg). Conclusion: In routine practice once aripiprazole treatment was started, more than half of the patients remained on aripiprazole and most of them lost weight. Adding aripiprazole to clozapine gave similar weight loss as monotherapy with aripiprazole

The human environmental balance

A future policy instrument for assessing the consequences of changes (already made) to the physical environment can be found in the instrument known as the human environmental balance. By taking all relevant aspects into account when using this instrument, present and future serious defects along with necessary areas of focus will become clear. In this way, the balance will fulfil an important evaluative and indicative function, serving as an integral conceptual framework to find out what investments to make and where they should be made. This report describes a survey, representing an initial step on the road to a balanced physical environment, charting further work along the way. It is also meant to stimulate a broad debate on how to audit this physical environment and what to study. The concept of the physical environment is defined as consisting of (stocks of) various objects in a certain (spatial) arrangement. These objects are evaluated from three perspectives: ecological, economic and social/psychological. The first two perspectives focus on long-term issues on sustainability. In the third perspective the central theme is the perception of the environment by humans themselves; here, we are concerned about short-term issues on the sub-national (local) level. The 1970-1995 draft balance also saw its first elaboration in this report.De leefomgevingsbalans is een door VROM voorgesteld toekomstig beleidsinstrument om gedane ingrepen in het fysieke milieu op hun integrale gevolgen voor de leefomgeving te beoordelen. De leefomgevingsbalans zou hiermee een belangrijke evaluerende en signalerende functie hebben: door beschouwing van alle relevante aspecten maakt de balans zichtbaar waar tekorten zijn of dreigen te ontstaan en waar extra inspanningen nodig zijn. Hiermee vormt de leefomgevingsbalans een integratief raamwerk dat richtinggevend kan zijn voor de aard en locatie van gewenste investeringen. Dit rapport is een verkenning van een mogelijk invulling van een dergelijke leefomgevingsbalans en dient uitsluitend als basis voor discussie. Het beschouwt de fysieke leefomgeving als een verzameling van (voorraden) van allerlei objecten in een bepaalde ruimtelijke configuratie. Deze objecten worden vanuit verschillende invalshoeken verschillend gewaardeerd. Hierbij is onderscheid gemaakt in een ecologisch, economisch en sociaal-psychologisch perspectief. De eerste twee perspectieven zijn vooral gericht op lange termijn-vraagstukken waarbij duurzaamheid voorop staat. Bij het laatste perspectief gaat om de individuele leefbaarheid van de burger, veelal handelend over korte termijn-vraagstukken op vooral lokaal niveau. Op deze wijze wordt het 'leefomgevingskapitaal' gepresenteerd als een drieluik van economische, ecologische en sociaal-psychologische waarden. In het rapport is ook een eerste uitwerking van dit concept voor de periode 1970-1995 gegeven

B-cell lymphoma in retrieved femoral heads: a long term follow up

<p>Abstract</p> <p>Background</p> <p>A relatively high incidence of pathological conditions in retrieved femoral heads, including a group of patients having low grade B-cell lymphoma, has been described before. At short term follow up none of these patients with low-grade B-cell lymphoma showed evidence of systemic disease. However, the long term follow up of these patients is not known.</p> <p>Methods</p> <p>From November 1994 up to and including December 2005 we screened all femoral heads removed at the time of primary total hip replacement histopathologically and included them in the bone banking protocol according to the guidelines of the American Associations of Tissue Banks (AATB) and the European Association of Musculo-Skeletal Transplantation (EAMST). We determined the percentage of B-cell lymphoma in all femoral heads and in the group that fulfilled all criteria of the bone banking protocol and report on the long-term follow-up.</p> <p>Results</p> <p>Of 852 femoral heads fourteen (1.6%) were highly suspicious for low-grade B-cell lymphoma. Of these 852 femoral heads, 504 were eligible for bone transplantation according to the guidelines of the AATB and the EAMST. Six femoral heads of this group of 504 were highly suspicious for low-grade B-cell lymphoma (1.2%). At long term follow up two (0.2%) of all patients developed systemic malignant disease and one of them needed medical treatment for her condition.</p> <p>Conclusion</p> <p>In routine histopathological screening we found variable numbers of low-grade B-cell lymphoma throughout the years, even in a group of femoral heads that were eligible for bone transplantation. Allogenic transmission of malignancy has not yet been reported on, but surviving viruses are proven to be transmissible. Therefore, we recommend the routine histopathological evaluation of all femoral heads removed at primary total hip arthroplasty as a tool for quality control, whether the femoral head is used for bone banking or not.</p

Impaction grafting and cemented acetabular revision

No abstract

Histological evaluation of allograft incorporation after cemented and non-cemented hip arthroplasty in the goat

No abstract