Olanzapine‐associated dose‐dependent alterations for weight and metabolic parameters in a prospective cohort

Metabolic abnormalities have been associated with olanzapine treatment. We assessed if olanzapine has dose-dependent effects on metabolic parameters with changes for weight, blood pressure, lipid and glucose profiles being modelled using linear mixed-effects models. The risk of metabolic abnormalities including early weight gain (EWG) (≥5% during first month) was assessed using mixed-effects logistic regression models. In 392 olanzapine-treated patients (median age 38.0 years, interquartile range [IQR] = 26.0-53.3, median dose 10.0 mg/day, IQR = 5.0-10.0 for a median follow-up duration of 40.0 days, IQR = 20.7-112.2), weight gain was not associated with olanzapine dose (p = 0.61) although it was larger for doses versus ≤10 mg/day (2.54 ± 5.55 vs. 1.61 ± 4.51% respectively, p = 0.01). Treatment duration and co-prescription of >2 antipsychotics, antidepressants, benzodiazepines and/or antihypertensive agents were associated with larger weight gain (p 10 mg/day were at higher EWG risk (odds risk: 2.15, 1.57-2.97). EWG might be prominent in high-dose olanzapine-treated patients with treatment duration and co-prescription of other medications being weight gain moderators. The lack of major dose-dependent patterns for weight gain emphasizes that olanzapine-treated patients are at weight gain risk regardless of the dose

Arbeitsmedizin

Das Kapitel ist in vier Unterkapital gegliedert. "Allgemeines zur Arbeitsmedizin" beinhaltet die Rolle und Ziele der Arbeitsmedizin und die wesentlichen gesetzlichen Grundlagen. "Berufskrankheiten" umfasst die Berufs- und Arbeitsplatzanamnese sowie die wichtigsten Berufskrankheiten und Noxen. Das dritte Unterkapitel behandelt die arbeitsassoziierten Gesundheitsstörungen, die Ergonomie, Arbeitsorganisation und Arbeitslosigkeit. Die Kapitel "Absenzen- und Case Management" sowie "Betriebliche Gesundheitsförderung und Arbeitsgestaltung" zeigen Möglichkeiten auf, wie ein Betrieb die Gesundheit und Arbeitsfähigkeit seiner Mitarbeiter aufrechterhalten und fördern kann. Das Kapitel befähigt die Studierenden, die Interaktion zwischen Arbeit und Gesundheit zu erkennen und adäquate Massnahmen zu ergreifen.[Autoren]]]> Occupational Medicine ; Occupational Diseases oai:serval.unil.ch:BIB_EFD9005BC107 2020-05-30T01:25:30Z phdthesis urnserval https://serval.unil.ch/notice/serval:BIB_EFD9005BC107 Résultats à court terme des arthroplasties totales de hanche non cimentées chez des patients de moins de 60 ans Larequi, Ivan-Philippe Université de Lausanne, Faculté de médecine info:eu-repo/semantics/doctoralThesis phdthesis 1999 fre https://serval.unil.ch/resource/serval:BIB_EFD9005BC107.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_EFD9005BC1073 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_EFD9005BC1073 info:eu-repo/semantics/restrictedAccess Restricted: indefinite embargo Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_EFD90D5BB70B 2020-05-30T01:25:30Z openaire documents urnserval https://serval.unil.ch/notice/serval:BIB_EFD90D5BB70B Association Between Plasma Caffeine and Other Methylxanthines and Metabolic Parameters in a Psychiatric Population Treated With Psychotropic Drugs Inducing Metabolic Disturbances info:doi:10.3389/fpsyt.2018.00573 info:eu-repo/semantics/altIdentifier/doi/10.3389/fpsyt.2018.00573 info:eu-repo/semantics/altIdentifier/pmid/30473668 Delacrétaz, Aurélie Vandenberghe, Frederik Glatard, Anaïs Levier, Axel Dubath, Céline Ansermot, Nicolas Crettol, Séverine Gholam-Rezaee, Mehdi Guessous, Idris Bochud, Murielle von Gunten, Armin Conus, Philippe Eap, Chin B. info:eu-repo/semantics/article article 2018-11-09 Frontiers in Psychiatry, vol. 9 info:eu-repo/semantics/altIdentifier/pissn/1664-0640 <![CDATA[Importance: Multiple studies conducted in the general population identified an association between self-reported coffee consumption and plasma lipid levels. To date, no study assessed whether and which plasma methylxanthines (caffeine and/or its metabolites, i.e., paraxanthine, theophylline, and theobromine) are associated with plasma lipids. In psychiatric patients, an important coffee consumption is often reported and many psychotropic drugs can induce a rapid and substantial increase of plasma lipid levels. Objective: To determine whether plasma methylxanthines are associated with metabolic parameters in psychiatric patients receiving treatments known to induce metabolic disturbances. Design, Setting, and Participants: Data were obtained from a prospective study including 630 patients with metabolic parameters [i.e., body mass index (BMI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and fasting triglycerides (TG)] monitored routinely during psychotropic treatment. Exposures: Plasma methylxanthines levels. Main Outcomes and Measures: Metabolic variables including BMI and plasma lipid levels. Results: Multivariate analyses indicated that BMI, TC, HDL-C, and non-HDL-C increased significantly with increasing total methylxanthines (pcorrected &lt;= 0.05). In addition, compared to patients with plasma caffeine concentration in the lowest quartile, those with caffeine concentration in the highest quartile were twice more prone to suffer from non-HDL hypercholesterolemia (p(corrected) = 0.05), five times more likely to suffer from hypertriglyceridemia (p(corrected) = 0.01) and four times more susceptible to be overweight (p(corrected) = 0.01). Conclusions and Relevance: This study showed that plasma caffeine and other methylxanthines are associated with worsening of metabolic parameters in patients receiving psychotropic treatments known to induce metabolic disturbances. It emphasizes that important caffeine consumption could be considered as an additional environmental risk factor for metabolic worsening in patients receiving such treatments

Quantification of cyclosporine and tacrolimus in whole blood. Comparison of liquid chromatography-electrospray mass spectrometry with the enzyme multiplied immunoassay technique

OBJECTIVES: The aim of this work was to compare a validated liquid chromatography-mass spectrometry (LC-MS) method with the commercial enzyme multiplied immunoassay technique (EMIT) for cyclosporine and tacrolimus whole blood quantification. DESIGN AND METHODS: Samples of transplant patients receiving cyclosporine (n=38) or tacrolimus (n=41) were analyzed successively by LC-MS and EMIT. Several statistical approaches for method comparison were evaluated and Passing-Bablok and Bland-Altman analyses chosen. RESULTS: Overestimations of the concentrations measured with EMIT compared to LC-MS were observed with means of 23% (range: 6% to 46%) for cyclosporine and 30% (range: -3% to 73%) for tacrolimus. CONCLUSION: The EMIT demonstrated significant positive biases due to cross-reactions with metabolites. This indicates that, in some clinical situations, a selective method such as LC-MS is preferable for therapeutic drug monitoring in transplant patients

The P450 oxidoreductase genotype is associated with CYP3A activity in vivo as measured by the midazolam phenotyping test

BACKGROUND CYP3A4, CYP3A5 and CYP3A7 are hepatic enzymes that metabolize about 50% of drugs on the market, with a large overlap in their specificities. We investigated the genetic bases that contribute to the variation of CYP3A activity. METHODS We phenotyped 251 individuals from two independent studies (182 patients treated with methadone and 69 patients with clozapine) for CYP3A activity using the midazolam phenotyping test and genotyped them for CYP3A4, CYP3A5, and CYP3A7 genetic variants, including the single nucleotide polymorphism (SNP) rs4646437C>T in intron 7 of CYP3A4. Owing to the fact that CYP enzymes require electron transfer through the P450 oxidoreductase (POR), and functional impairment has been shown for the POR*28 SNP, this polymorphism was also analysed. RESULTS We show that CYP3A4, CYP3A5 and CYP3A7 genotypes, including the SNP rs4646437C>T, do not reflect the inter-individual variability of CYP3A activity (P>0.1). In contrast, POR*28 TT genotype presents a 1.6-fold increase in CYP3A activity compared with POR*28C carriers (n = 182, P = 0.004). This finding was replicated in the second independent dataset (n = 69, P = 0.04). CONCLUSION The SNP POR*28 seems to be a better genetic marker of the variability of total CYP3A activity in vivo than CYP3A4, CYP3A5 and CYP3A7 genetic variants