EEG alterations during treatment with olanzapine

The aim of this naturalistic observational study was to investigate EEG alterations in patients under olanzapine treatment with a special regard to olanzapine dose and plasma concentration. Twenty-two in-patients of a psychiatric university ward with the monodiagnosis of paranoid schizophrenia (ICD-10: F20.0), who received a monotherapy of olanzapine were included in this study. All patients had a normal alpha-EEG before drug therapy, and did not suffer from brain-organic dysfunctions, as verified by clinical examination and cMRI scans. EEG and olanzapine plasma levels were determined under steady-state conditions (between 18 and 22 days after begin of treatment). In 9 patients (40.9%), pathological EEG changes (one with spike-waves) consecutive to olanzapine treatment were observed. The dose of olanzapine was significantly higher in patients with changes of the EEG than in patients without changes (24.4 mg/day (SD: 8.1) vs. 12.7 mg/day (SD: 4.8); T = −4.3, df = 21, P < 0.001). In patients with EEG changes, the blood plasma concentration of olanzapine (45.6 μg/l (SD: 30.9) vs. 26.3 μg/l (SD: 21.6) tended to be also higher. The sensitivity of olanzapine dosage to predict EEG changes was 66.7%, the specificity 100% (Youden-index: 0.67). EEG abnormalities during olanzapine treatment are common. These are significantly dose dependent. Thus, EEG control recordings should be mandatory during olanzapine treatment with special emphasis on dosages exceeding 20 mg per day, although keeping in mind that EEGs have only a limited predictive power regarding future epileptic seizures

Auditor human capital and audit firm survival; the Dutch audit industry in 1930-1992

This paper studies the relationship between auditor human capital and audit firm survival. Specifically, the effects are investigated of the human capital of auditors on the survival chances of newly established audit firms. Human capital is analyzed both at the time of entry of a new audit firm and during the lifetime of an audit firm. The data set contains 1693 firms that entered into the Dutch audit market in the period 1930-1992. To analyze the data, the technique of event history analysis is applied. There are two key results of the study. First, a higher level of education of the firm's auditors, both at founding and during the lifetime of an audit firm, generally increases audit firm performance. Second, the effects of experience at founding and experience during the lifetime of an audit firm vary considerably. Higher levels of experience at founding have a positive influence on audit firm performance. However, higher levels of experience during the lifetime of an audit firm, i.e., the aging of the firm's auditors, have a negative effect on firm performance. (C) 2004 Elsevier Ltd. All rights reserved

Auditor human capital and audit firm survival - The Dutch audit industry in 1930-1992

This paper studies the relationship between auditor human capital and audit firm survival. Specifically, the effects are investigated of the human capital of auditors on the survival chances of newly established audit firms. Human capital is analyzed both at the time of entry of a new audit firm and during the lifetime of an audit firm. The data set contains 1693 firms that entered into the Dutch audit market in the period 1930-1992. To analyze the data, the technique of event history analysis is applied. There are two key results of the study. First, a higher level of education of the firm's auditors, both at founding and during the lifetime of an audit firm, generally increases audit firm performance. Second, the effects of experience at founding and experience during the lifetime of an audit firm vary considerably. Higher levels of experience at founding have a positive influence on audit firm performance. However, higher levels of experience during the lifetime of an audit firm, i.e., the aging of the firm's auditors, have a negative effect on firm performance. (C) 2004 Elsevier Ltd. All rights reserved