Monitoring and prevalence rates of metabolic syndrome in military veterans with serious mental illness

Background: Cardiovascular disease is the leading cause of mortality among patients with serious mental illness (SMI) and the prevalence of metabolic syndrome-a constellation of cardiovascular risk factors-is significantly higher in these patients than in the general population. Metabolic monitoring among patients using second generation antipsychotics (SGAs)-a risk factor for metabolic syndrome-has been shown to be inadequate despite the release of several guidelines. However, patients with SMI have several factors independent of medication use that predispose them to a higher prevalence of metabolic syndrome. Our study therefore examines monitoring and prevalence of metabolic syndrome in patients with SMI, including those not using SGAs. Methods and Findings: We retrospectively identified all patients treated at a Veterans Affairs Medical Center with diagnoses of schizophrenia, schizoaffective disorder or bipolar disorder during 2005-2006 and obtained demographic and clinical data. Incomplete monitoring of metabolic syndrome was defined as being unable to determine the status of at least one of the syndrome components. Of the 1,401 patients included (bipolar disorder: 822; schizophrenia: 222; and schizoaffective disorder: 357), 21.4% were incompletely monitored. Only 54.8% of patients who were not prescribed SGAs and did not have previous diagnoses of hypertension or hypercholesterolemia were monitored for all metabolic syndrome components compared to 92.4% of patients who had all three of these characteristics. Among patients monitored for metabolic syndrome completely, age-adjusted prevalence of the syndrome was 48.4%, with no significant difference between the three psychiatric groups. Conclusions: Only one half of patients with SMI not using SGAs or previously diagnosed with hypertension and hypercholesterolemia were completely monitored for metabolic syndrome components compared to greater than 90% of those with these characteristics. With the high prevalence of metabolic syndrome seen in this population, there appears to be a need to intensify efforts to reduce this monitoring gap

Le musée français: guerras napoleônicas, coleções artísticas e o longínquo destino de um livro

This paper is about Le Musée Français [The French Museum], a book found in the collection of the library of the Imperial Academy of Fine Arts in Rio de Janeiro. As a catalog of the Napoleon Museum, it bears witness to the reorganization of the arts in Europe as a result of the Napoleonic wars and the project of making Paris a true successor to Athens and Rome, as the center of a new republic of the arts. This process was the object of a dispute where Quatremère de Quincy and Joachim Lebreton played an important role. It was also one of the causes leading to the exile of a group of artists who then helped to lay the foundations for an academic environment in Rio de Janeiro.O artigo trata de Le musée français, livro que fez parte da coleção da biblioteca da Academia Imperial das Belas Artes, no RiodeJaneiro. Como catálogo do Museu Napoleão, é testemunho do processo de reordenamento, resultante das guerras napoleônicas, do universo das artes na Europa e do projeto de fazer de Paris a legítima herdeira de Atenas e Roma, como centro de uma nova idéia de república das artes. Processo esse que foi objeto de disputa, em que se destacaram Quatremère de Quincy eJoachim Lebreton, e foi uma das causas do exílio do grupo de artistas que esteve na origem da formação do ambiente acadêmico no Rio de Janeiro

Mourning and melancholia revisited: correspondences between principles of Freudian metapsychology and empirical findings in neuropsychiatry

Freud began his career as a neurologist studying the anatomy and physiology of the nervous system, but it was his later work in psychology that would secure his place in history. This paper draws attention to consistencies between physiological processes identified by modern clinical research and psychological processes described by Freud, with a special emphasis on his famous paper on depression entitled 'Mourning and melancholia'. Inspired by neuroimaging findings in depression and deep brain stimulation for treatment resistant depression, some preliminary physiological correlates are proposed for a number of key psychoanalytic processes. Specifically, activation of the subgenual cingulate is discussed in relation to repression and the default mode network is discussed in relation to the ego. If these correlates are found to be reliable, this may have implications for the manner in which psychoanalysis is viewed by the wider psychological and psychiatric communities

Euer Excellenz umfaßten während Ihres Aufenthaltes an unserm Rhein die Kunst gegenwärtiger' sowohl als längsverflossener Zeiten mit dem Scharfblicke des Kenners und zugleich einer Kunstliebe ...

EUER EXCELLENZ UMFASSTEN WÄHREND IHRES AUFENTHALTES AN UNSERM RHEIN DIE KUNST GEGENWÄRTIGER' SOWOHL ALS LÄNGSVERFLOSSENER ZEITEN MIT DEM SCHARFBLICKE DES KENNERS UND ZUGLEICH EINER KUNSTLIEBE ... Euer Excellenz umfaßten während Ihres Aufenthaltes an unserm Rhein die Kunst gegenwärtiger' sowohl als längsverflossener Zeiten mit dem Scharfblicke des Kenners und zugleich einer Kunstliebe ... ([1]) Euer Excellenz umfaßten während Ihres Aufenthaltes an unserm Rhein die Kunst gegenwärtiger' sowohl als längsverflossener Zeiten ... ([1]

Beyträge zur Geschichte der Schaumünzen aus neuerer Zeit

BEYTRÄGE ZUR GESCHICHTE DER SCHAUMÜNZEN AUS NEUERER ZEIT Beyträge zur Geschichte der Schaumünzen aus neuerer Zeit (I) Einband ( - ) Text (I

Faust : Compositionen für Pianoforte

FAUST : COMPOSITIONEN FÜR PIANOFORTE Faust : Compositionen für Pianoforte (1) Einband (1) Titelblatt (6) Faust-Quadrille (7) Marg(a)re(the) am Spinnrade (11) Damen-Album (13