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

Focused Solar Ablation: A Nanosat-Based Method for Active Removal of Space Debris

A novel concept for the active removal of space debris using solar power is proposed. Focused solar ablation is an in-space propulsion concept based on using concentrator mirrors on nanosats and using the solar power to evaporate material from the debris to produce deceleration thrust thereby providing the ∆V necessary to deorbit. An energy balance is used along with free-molecular effusion theory to estimate the thrust produced by the concept and the corresponding deorbit times for an aluminum debris masses of 10 kg and 0.27 kg for various concentrator mirror areas and the diameter of the spot on which the solar power is concentrated. The analysis shows that the deorbit times of a few hours for both masses showing that the method is attractive for active space debris removal. Experiments performed using electron beams to evaporate aluminum in a vacuum chamber show that the method is also practically feasible to deorbit space debris using solar power available in low earth orbit (LEO)

The Survival Paradox of Elderly Patients After Major Liver Resections

The objective of this study is to assess the outcome of liver resections in the elderly in a matched control analysis. From a prospective single center database of 628 patients, 132 patients were aged 60 years or over and underwent a primary major liver resection. Of these patients, 93 could be matched one-to-one with a control patient, aged less than 60 years, with the same diagnosis and the same type of liver resection. The mean age difference was 16.7 years. Patients over 60 years of age had a significantly higher American Society of Anaesthesiologists (ASA) grade. All other demographics and operative characteristics were not different. In-hospital mortality and morbidity were higher in the patients over 60 years of age (11% versus 2%, p=0.017 and 47% versus 31%, p=0.024). One-, 3-, and 5-year survival rates in the patients over 60 years of age were 81%, 58%, and 42%, respectively, compared to 90%, 59%, and 42% in the control patients (p=0.558). Unified model Cox regression analysis showed that resection margin status (hazard ratio 2.51) and ASA grade (hazard ratio 2.26), and not age, were determining factors for survival. This finding underlines the important fact that in patient selection for major liver resections, ASA grade is more important than patient age