88 research outputs found

    Predictors and correlates for weight changes in patients co-treated with olanzapine and weight mitigating agents; a post-hoc analysis

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    <p>Abstract</p> <p>Background</p> <p>This study focuses on exploring the relationship between changes in appetite or eating behaviors and subsequent weight change for adult patients with schizophrenia or bipolar disorder treated with olanzapine and adjunctive potential weight mitigating pharmacotherapy. The aim is not to compare different weight mitigating agents, but to evaluate patients' characteristics and changes in their eating behaviors during treatment. Identification of patient subgroups with different degrees of susceptibility to the effect of weight mitigating agents during olanzapine treatment may aid clinicians in treatment decisions.</p> <p>Methods</p> <p>Data were obtained from 3 randomized, double-blind, placebo-controlled, 16-week clinical trials. Included were 158 patients with schizophrenia or bipolar disorder and a body mass index (BMI) ≥ 25 kg/m<sup>2 </sup>who had received olanzapine treatment in combination with nizatidine (n = 68), sibutramine (n = 42), or amantadine (n = 48). Individual patients were analyzed for categorical weight loss ≥ 2 kg and weight gain ≥ 1 kg. Variables that were evaluated as potential predictors of weight outcomes included baseline patient characteristics, factors of the Eating Inventory, individual items of the Eating Behavior Assessment, and the Visual Analog Scale.</p> <p>Results</p> <p>Predictors/correlates of weight loss ≥ 2 kg included: high baseline BMI, low baseline interest in food, and a decrease from baseline to endpoint in appetite, hunger, or cravings for carbohydrates. Reduced cognitive restraint, increase in hunger, and increased overeating were associated with a higher probability of weight gain ≥ 1 kg.</p> <p>Conclusion</p> <p>The association between weight gain and lack of cognitive restraint in the presence of increased appetite suggests potential benefit of psychoeducational counseling in conjunction with adjunctive pharmacotherapeutic agents in limiting weight gain during antipsychotic drug therapy.</p> <p>Trial Registration</p> <p>This analysis was not a clinical trial and did not involve any medical intervention.</p

    The Effectiveness of Pharmacological and Non-Pharmacological Interventions for Improving Glycaemic Control in Adults with Severe Mental Illness: A Systematic Review and Meta-Analysis

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    People with severe mental illness (SMI) have reduced life expectancy compared with the general population, which can be explained partly by their increased risk of diabetes. We conducted a meta-analysis to determine the clinical effectiveness of pharmacological and non-pharmacological interventions for improving glycaemic control in people with SMI (PROSPERO registration: CRD42015015558). A systematic literature search was performed on 30/10/2015 to identify randomised controlled trials (RCTs) in adults with SMI, with or without a diagnosis of diabetes that measured fasting blood glucose or glycated haemoglobin (HbA1c). Screening and data extraction were carried out independently by two reviewers. We used random effects meta-analysis to estimate effectiveness, and subgroup analysis and univariate meta-regression to explore heterogeneity. The Cochrane Collaboration’s tool was used to assess risk of bias. We found 54 eligible RCTs in 4,392 adults (40 pharmacological, 13 behavioural, one mixed intervention). Data for meta-analysis were available from 48 RCTs (n = 4052). Both pharmacological (mean difference (MD), -0.11mmol/L; 95% confidence interval (CI), [-0.19, -0.02], p = 0.02, n = 2536) and behavioural interventions (MD, -0.28mmol//L; 95% CI, [-0.43, -0.12], p<0.001, n = 956) were effective in lowering fasting glucose, but not HbA1c (pharmacological MD, -0.03%; 95% CI, [-0.12, 0.06], p = 0.52, n = 1515; behavioural MD, 0.18%; 95% CI, [-0.07, 0.42], p = 0.16, n = 140) compared with usual care or placebo. In subgroup analysis of pharmacological interventions, metformin and antipsychotic switching strategies improved HbA1c. Behavioural interventions of longer duration and those including repeated physical activity had greater effects on fasting glucose than those without these characteristics. Baseline levels of fasting glucose explained some of the heterogeneity in behavioural interventions but not in pharmacological interventions. Although the strength of the evidence is limited by inadequate trial design and reporting and significant heterogeneity, there is some evidence that behavioural interventions, antipsychotic switching, and metformin can lead to clinically important improvements in glycaemic measurements in adults with SMI

    Hydrothermal Synthesis of Delafossite-Type Oxides

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    The syntheses of copper and silver delafossite-type oxides from their constituent binary metal oxides, oxide hydroxides and hydroxides, by low temperature (<210 °C) and low pressure (<20 atm) hydrothermal reactions are described. Particular emphasis is placed on how the acid-base character of a constituent oxide determines its solubility and therefore whether a particular delafossite-type oxide can be synthesized, a strategy utilized by geologists and mineralogists to understand the conditions necessary for the synthesis of various minerals. Thus, the geochemical and corrosion science literature are shown to be useful in understanding the reaction conditions required for the syntheses of delafossite-type oxides and the relationship between reactant metal oxide acid-base character, solubility, aqueous speciation, and product formation. Manipulation of the key parameters, temperature, pressure, pH, and reactant solubility, results in broad families of phase-pure delafossite-type oxides in moderate to high yields for copper, CuBO2 (B) Al, Sc, Cr, Mn, Fe, Co, Ga, and Rh), and silver, AgBO2 (B ) Al, Sc, Fe, Co, Ni, Ga, Rh, In, and Tl)

    Increased susceptibility to bacterial wilt in tomatoes by nematode galling and the role of the Mi gene in resistance to nematodes and bacterial wilt

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    The soil-borne bacterial pathogen Ralstonia solanacearum commonly coexists with polyspecific nematode populations in tropical and subtropical areas. The wounding of roots by nematodes is usually invoked to explain the correlation between nematode infection and bacterial wilt, since this wounding increases the number of sites for bacterial entry. Bacterial wilt development on tomato was investigated in a controlled environment on the susceptible tomato cultivar Floradel and the polygenically wilt-resistant cultivar Caraïbo. The bacterial isolate GMI 8217 and two different sedentary plant parasitic nematodes, the endoparasitic root-knot nematode, Meloidogyne incognita, and semi-endoparasitic reniform nematode, Rotylenchulus reniformis, were cross-infected. At low temperatures (22-27°C), the bacterium GMI 8217 was slightly pathogenic on all tomato lines, except on Floradel coinfected by root-knot nematode. At high temperatures (27-32°C), the root-knot nematode greatly increased wilt severity in susceptible Floradel and resistant Caraïbo, but the reniform nematode had no such effect regardless of temperature x cultivar combination. This showed that infection of tomato roots by root-knot nematodes reduced genetic resistance to bacterial wilt. The effects of combining bacterial wilt resistance with the Mi gene for resistance to root-knot nematode (Mi, resistant ; Mi+, susceptible) was investigated using the near-isogenic lines Caraïbo (Mi+/Mi+)/Carmido (Mi/Mi) and CRA 66 (Mi+/Mi+/Cranita (Mi/Mi), which differ by the size of the segment of L. peruvianum DNA carrying the Mi gene. The presence of the Mi gene was associated with a marked decrease in bacterial wilt resistance. It is suggested that at least one gene governing part of the bacterial wilt resistance is closely linked or allelic to the Mi gene in the tomato lines used in this experiment

    Evaluation of bacterial wilt resistance in tomato lines nearly isogenic for the Mi gene for resistance to root-knot

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    Resistance to bacterial wilt, caused by #Ralstonia solancearum, in tomato lines CRA 66 and Caraïbo is reported to be decreased by root-knot nematode galling and by introduction of the #Mi gene for nematode resistance. The #Mi gene is located on tomato chromosome 6, which also carries a major quantitative trait locus (QTL) for resistance to bacterial wilt. Bacterial wilt resistance was evaluated in F3-progenies derived from two crosses between near-isogenic lines Caraïbo x Carmido and CRA 66 x Cranita, differing for small and large introgressions from #Lycopersicon peruvianum that carry the #Mi gene, respectively. These introgressed regions were mapped using RFLP markers. Plants homozygous Mi+/Mi+ (susceptible to the nematode) and homozygous Mi/Mi (resistant) for the #Mi gene were selected in F2 and used to produce F3 progenies. Parents and F3-lines with Mi/Mi had resistance to bacterial wilt reduced by 30% in Caraïbo x Carmido and by 15% in CRA 66 x Cranita. Caraïbo and Carmido were demonstrated to be isolines and the small introgression from #L. peruvianum resulted in loss of the QTL for bacterial wilt resistance, which is probably allelic or linked in repulsion to the #Mi gene. In contrast, resistance to bacterial wilt segregated in the F3 lines from the cross CRA 66 x Cranita, giving families varying in resistance between the levels shown by the parents. Consequently, two hyopotheses were considered : (i) after only four backcrosses, the parents were not isolines and the genes for resistance to bacterial wilt from CRA 66 were still segregating, and (ii) the parents were isolines and variation in resistance to bacterial wilt in F3 was due to recombination events among the large "L. peruvianum$ introgressed chromosome region from Cranita. (Résumé d'auteur
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