13 research outputs found
How the 1977 World Health Organization report on alcohol-related disabilities came to be written: a provisional analysis
Comparison of Surrogate Markers as Measures of Uncomplicated Insulin Resistance in Korean Adults
BACKGROUND: Metabolic syndrome (MS) is known to increase the risk of various cardiometabolic diseases and in-sulin resistance (IR) has known to have central role in the development of MS. Many surrogate indices of IR have been proposed and the detection of MS might be a suitable model for assessing the accuracy of surrogate indices. The aims of our study are to invest the most appropriate index by assessment of the diagnostic capacity of IR among each surrogate index and identifying cut-off values for discriminating uncomplicated MS in Korean adults. METHODS: A cross-sectional study was performed, assessing 294 Korean adults, 85 of whom were diagnosed with uncomplicated MS. The sensitivities and specificities of five surrogate IR indices were compared to discriminate MS from healthy subjects; these included fasting serum insulin, homeostasis model assessmentâinsulin resistance index, quantitative insulin sensitivity check index, McAuley index, and Disse index. Correlations between each index value were assessed using Pearson's and Spearman's correlation methods. RESULTS: The McAuley index showed the highest area under the curve (0.85), specificity (86.12%), accuracy (82.31%), positive predictive value (68.13%), and negative predictive value (88.67%) to distinguish MS, with a cut-off point of 5.3 defined. Correlation coefficients of the five indices showed that the McAuley index had the strongest correlation with IR. CONCLUSION: The McAuley index showed the best accuracy in the detection of MS as a surrogate marker of IR. To establish more effective and accurate standards of measuring IR, comprehensive and multi-scaled studies are required
Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care
The lifespan of people with severe mental illness (SMI) is shorter compared
to the general population. This excess mortality is mainly due to physical
illness. We report prevalence rates of different physical illnesses as well
as important individual lifestyle choices, side effects of psychotropic treatment
and disparities in health care access, utilization and provision that contribute
to these poor physical health outcomes. We searched MEDLINE (1966 â
August 2010) combining the MeSH terms of schizophrenia, bipolar disorder and
major depressive disorder with the different MeSH terms of general physical
disease categories to select pertinent reviews and additional relevant studies
through cross-referencing to identify prevalence figures and factors contributing
to the excess morbidity and mortality rates. Nutritional and metabolic diseases,
cardiovascular diseases, viral diseases, respiratory tract diseases, musculoskeletal
diseases, sexual dysfunction, pregnancy complications, stomatognathic diseases,
and possibly obesity-related cancers are, compared to the general population,
more prevalent among people with SMI. It seems that lifestyle as well as treatment
specific factors account for much of the increased risk for most of these
physical diseases. Moreover, there is sufficient evidence that people with
SMI are less likely to receive standard levels of care for most of these diseases.
Lifestyle factors, relatively easy to measure, are barely considered for screening;
baseline testing of numerous important physical parameters is insufficiently
performed. Besides modifiable lifestyle factors and side effects of psychotropic
medications, access to and quality of health care remains to be improved for
individuals with SMI