An epidemiologic study of psychotropic medication and obesity-related chronic illnesses in older psychiatric patients

Objective: Adverse effects from medication vary with age. Weight gain with several psychotropics is well known in adults but less information is available related to extent and complications of psychotropic-induced weight gain in older psychiatric patients. We determined the relative incidence of 2 obesity-related conditions (diabetes and hypertension) in older psychiatric patients receiving antipsychotics, antidepressants, and mood stabilizers. Method: A population-based case-control study of all psychiatric patients aged 67 years or older in contact with either specialist services or primary care using administrative data from Nova Scotia. Results: We identified incident cases of diabetes (n = 608) and of hypertension (n = 1056), as well as an equal number of control subjects for each condition. Amitryptiline, selective serotonin reuptake inhibitors (SSRIs), and olanzapine were associated with an increased risk of presenting with hypertension 6 months after initial prescription. By contrast, conventional antipsychotics were associated with a reduced incidence of hypertension. Olanzapine was also significantly associated with diabetes after 6 months (OR = 2.58, 95% CI 1.12 to 5.92). The findings for SSRIs and olanzapine remained significant after adjusting for potential confounders such as sociodemographic characteristics, schizophrenia, beta blockers, thiazide diuretics, and corticosteroids. Conclusions: Our results suggest that the association of psychotropics and 2 obesity-related conditions, hypertension and diabetes, applies to older psychiatric patients as well as younger populations. Within drug classes, there are drugs that have a greater association than others, and this may be a factor when choosing a specific agent

Nuclear Data for Sustainable Nuclear Energy

Final report of a coordinated action on nuclear data for industrial development in Europe (CANDIDE). The successful development of advanced nuclear systems for sustainable energy production depends on high-level modelling capabilities for the reliable and cost-effective design and safety assessment of such systems, and for the interpretation of key benchmark experiments needed for performance and safety evaluations. High-quality nuclear data, in particular complete and accurate information about the nuclear reactions taking place in advanced reactors and the fuel cycle, are an essential component of such modelling capabilities. In the CANDIDE project, nuclear data needs for sustainable nuclear energy production and waste management have been analyzed and categorized, on the basis of preliminary design studies of innovative systems. Meeting those needs will require that the quality of nuclear data files be considerably improved. The CANDIDE project has produced a set of recommendations, or roadmap, for sustainable nuclear data development. In conclusion, a substantial long-term investment in an integrated European nuclear data development program is called for, complemented by some dedicated actions targeting specific issues.JRC.D.5-Neutron physic

Comparing population health in the United States and Canada

<p>Abstract</p> <p>Background</p> <p>The objective of the paper is to compare population health in the United States (US) and Canada. Although the two countries are very similar in many ways, there are potentially important differences in the levels of social and economic inequality and the organization and financing of and access to health care in the two countries.</p> <p>Methods</p> <p>Data are from the Joint Canada/United States Survey of Health 2002/03. The Health Utilities Index Mark 3 (HUI3) was used to measure overall health-related quality of life (HRQL). Mean HUI3 scores were compared, adjusting for major determinants of health, including body mass index, smoking, education, gender, race, and income. In addition, estimates of life expectancy were compared. Finally, mean HUI3 scores by age and gender and Canadian and US life tables were used to estimate health-adjusted life expectancy (HALE).</p> <p>Results</p> <p>Life expectancy in Canada is higher than in the US. For those < 40 years, there were no differences in HRQL between the US and Canada. For the 40+ group, HRQL appears to be higher in Canada. The results comparing the white-only population in both countries were very similar. For a 19-year-old, HALE was 52.0 years in Canada and 49.3 in the US.</p> <p>Conclusions</p> <p>The population of Canada appears to be substantially healthier than the US population with respect to life expectancy, HRQL, and HALE. Factors that account for the difference may include access to health care over the full life span (universal health insurance) and lower levels of social and economic inequality, especially among the elderly.</p

Structures spiralées dans une instabilité de Taylor en présence de champ magnétique

An experimental study of the flow of mercury between two steady concentric cylinders, in the presence of an external magnetic field, is described. At large values of the magnetic field, the first instability of the laminar state is in the form of non-axisymmetric modes (spiral vortices).L'étude expérimentale d'un écoulement de mercure entre deux cylindres coaxiaux fixes, en présence d'un champ magnétique extérieur est décrite. Aux valeurs élevées du champ magnétique, nous montrons que la première instabilité du régime laminaire correspond à l'apparition de modes non axisymétriques possédant une structure spatiale en forme de cellules spiralées

Preoperative nested reverse transcription-polymerase chain reaction for prostate specific membrane antigen predicts non-organ confined disease in radical prostatectomy specimens

The aim of this study was to access the utility of the reverse transcriptase-polymerase chain reaction (RT-PCR) assay for prostatic specific membrane antigen (PSMA) in predicting non-organ confined (NOC) disease in final radical prostatectomy (RP) specimens. Nested RT-PCR for PSMA was performed on the blood of 33 patient candidates for RP, 20 patients with untreated metastatic disease and 20 healthy men. The final pathology report on the 33 RP patients was compared with the RT-PCR results and Partin nomograms. In the RP group, 4/18 patients with confined disease and 9/15 with NOC disease had positive RT-PCR assays. Sensitivity, specificity, positive and negative predictive values for RT-PCR were 60%, 77.7%, 69% and 70%, respectively. The Partin tables for this group of patients showed a sensitivity, specificity, positive and negative predictive values of 75%, 71%, 60% and 83%, respectively. P-values for the Partin tables and the RT-PCR assay were respectively 0.014 and 0.037. RT-PCR of PSMA has an independent predictive value and could help predict NOC disease in clinically localized prostate cancers, but is still less efficient than Partin tables

The prognostic value of p53 and DNA ploidy following radical prostatectomy

This study assesses the correlation of p53 immunoreactivity and DNA ploidy status with biochemical recurrence after radical prostatectomy. p53 protein expression and DNA ploidy were evaluated on 84 archival paraffin-embedded radical prostatectomy specimens. Patients were divided into two groups: those with low (38/84, 45%) and those with high (46/84, 55%) p53 immunoreactivity. The results were correlated with Gleason score, stage and serum PSA. Kaplan-Meier biochemical recurrence free survival and the Cox hazard-regression model were used for analysis. Multivariate analysis revealed p53, DNA ploidy, Gleason score, PSA and stage to be independent prognostic factors in this order. Kaplan-Meier analysis showed a significant difference in biochemical recurrence when p53 high expression and DNA aneuploidy were combined. The results of this study suggest that stratification for p53 expression and DNA ploidy status can provide additional prognostic information for patients with prostate carcinoma after radical prostatectomy

Lactate dehydrogenase isoenzymes in patients with acute exacerbation of chronic obstructive pulmonary disease: An exploratory cross-sectional study

We aimed to evaluate differences in serum lactate dehydrogenase (LDH) isoenzymes between patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and other lower respiratory tract infections (LRTIs). Based on self-reported COPD diagnosis, 71 participants were divided into AECOPD (n = 38, 29 males, mean age 70.5 years) and LRTI (n = 33, 12 males, mean age 70.4 years) groups. Information on demographics, comorbidities, and COPD severity markers, as well as arterial blood gases and laboratory data were collected, while serum LDH electrophoresis was performed to examine the LDH isoenzymes. Adjusting for sex, age, comorbidities, degree of hypoxemia, inflammation markers, muscle and myocardial enzymes, and total serum LDH, the mean differences (95 % confidence intervals) in the ratios of serum LDH isoenzymes to total serum LDH between groups (LDHxAECOPD − LDHxLRTI) were statistically significant for LDH1 [4.9 (1.4 to 8.3)], LDH2 [3.0 (0.1 to 5.8)], LDH3 [−4.3 (−6.3 to −2.3)], and LDH4 [−3.2 (−4.9 to −1.5)]. A sum of LDH3 and LDH4 ratios below 29 % had the highest discriminative ability to classify a subject in the AECOPD group (AUC 0.841, sensitivity 76 %, specificity 87 %). Aerobic metabolic adaptive mechanisms in respiratory muscles during AECOPD could explain the above differences. © 2020 Elsevier B.V

DNA ploidy as a prognostic factor in muscle invasive transitional cell carcinoma of the bladder

Radical cystectomy represents the treatment of choice for muscle-infiltrative bladder carcinoma; however, about 50% of patients relapse and die from the disease. In the present study, the prognostic significance of the DNA ploidy in transitional cell carcinoma of the urinary bladder (TCCB) is analyzed. The study was carried out on 66 patients with TCCB who underwent radical cystectomy. DNA ploidy was determined by flow cytometry (FCM) on paraffin-embedded specimens, and the results were analyzed and correlated with the tumor malignancy grade and stage and the clinical course. Forty of the 66 tumors studied (63%) were aneuploid. Aneuploid status was correlated with higher tumor T stage (P &lt; 0.001) and grade (P &lt; 0.001). Median follow up was 68 months (range: 12-105). Median survival was significantly longer in patients with diploid tumors (&gt; 60 vs 45 months, P &lt; 0.001). All patients with diploid tumors were alive and free of bladder cancer during follow-up, in contrast to only 30% of patients with aneuploid tumors. DNA ploidy was an independent prognostic factor, as shown by multivariate analysis (P=0.006). All patients with pT &gt;= 3b and diploid tumors were alive at the time of analysis as opposed to none with aneuploid tumors. The results of this study suggest that DNA ploidy can provide prognostic information on patients with muscle invasive carcinoma of the bladder and might represent a means of selection for postoperative management

Cytomegalovirus pneumonia in an immunocompetent host with primary ciliary dyskinesia: A case report

Primary ciliary dyskinesia (PCD) is an autosomal-recessive inherited disease caused by mutations in genes involved in ciliary structure and function leading to impaired mucociliary clearance and repeated or chronic, usually bacterial, infections of the upper and lower airways and decreased lung function and bronchiectasis. Cytomegalovirus (CMV) is a DNA virus that usually causes subclinical infection and in 10% of the patients causes a mononucleosis-like syndrome. CMV is a causative agent of serious illness in vulnerable immunocompromised groups such as transplant recipients, patients with immunodeficiency or malignancy and neonates. Life-threatening infection due to CMV, including CMV pneumonia, is not common in immunocompetent patients. In this report we describe a case of an otherwise immunocompetent woman, suffering from PCD, who developed severe CMV pneumonia