Weight Changes during Clozapine Treatment

1998 ◽  
Vol 32 (5) ◽  
pp. 718-721 ◽  
Author(s):  
Dianne Briffa ◽  
Thomas Meehan

Objective: The aim of this study was to assess the prevalence and magnitude of weight changes pre- and post-clozapine and to explore the ability of demographic and clinical factors to predict weight gain at 12 months post-clozapine. Method: Weight changes in a sample of 51 patients were assessed at 3 months pre-clozapine, at baseline, and at 3 and 12 months post-clozapine. In addition, demographic data and information concerning changes in appetite and activity level at 3 months was gathered and used to predict weight gain at 12 months. Results: Seventy percent of patients gained an average of 7.5 kg (10.6% increase in baseline body weight) over the 12-month period. Although post-clozapine weight gain for the total group was significant at 12 months, weight gain for the female sub-sample (n = 16) did not reach significance at either the 3 or 12 month assessments. The only factors associated with marked weight gain (> 15% increase) at 12 months were increased food intake early in treatment and having gained weight at 3 months. Conclusion: Clozapine treatment was found to be associated with significant weight gain in patients prescribed clozapine, especially male patients. Considering the long-term health risks associated with excess weight gain, health professionals can play an important role in educating clients about the potential for weight gain with clozapine treatment.

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Lucia Taramasso ◽  
Paolo Bonfanti ◽  
Elena Ricci ◽  
Giancarlo Orofino ◽  
Nicola Squillace ◽  
...  

Abstract Background An unexpected excess in weight gain has recently been reported in the course of dolutegravir (DTG) treatment. The aim of the present study was to investigate whether weight gain differs among different DTG-containing regimens. Methods Adult naïve and experienced people with HIV (PWH) initiating DTG-based antiretroviral therapy (ART) between July 2014 and December 2019 in the Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) prospective cohort were included. We used an adjusted general linear model to compare weight change among backbone groups and a Cox proportional hazard regression model to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for weight increases >10% from baseline. Results A total of 713 participants, 25.3% women and 91% Caucasian, were included. Of these, 195 (27.4%) started DTG as their first ART regimen, whereas 518 (72.6%) were ART-experienced. DTG was associated with abacavir/lamivudine in 326 participants, tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in 148, boosted protease inhibitors in 60, rilpivirine in 45, lamivudine in 75, and tenofovir alafenamide (TAF)/FTC in 59. At 6 and 12 months, weight gain was highest among PWH on TDF/FTC+DTG and TAF/FTC+DTG. Baseline CD4 <200 cells/mm3 (HR, 1.84; 95% CI, 1.15 to 2.96), being ART-naïve (HR, 2.24; 95% CI, 1.24 to 4.18), and treatment with TDF/FTC+DTG (HR, 1.92; 95% CI, 1.23 to 2.98) or TAF/FTC+DTG (HR, 3.80; 95% CI, 1.75 to 8.23) were associated with weight gain >10% from baseline. Higher weight (HR, 0.97 by 1 kg; 95% CI, 0.96 to 0.99) and female gender (HR, 0.54; 95% CI, 0.33 to 0.88) were protective against weight gain. Conclusions Naïve PWH with lower CD4 counts and those on TAF/FTC or TDF/FTC backbones were at higher risk of weight increase in the course of DTG-based ART.


2019 ◽  
Vol 8 (11) ◽  
pp. 1950
Author(s):  
Giulia Scioscia ◽  
Rosanel Amaro ◽  
Victoria Alcaraz-Serrano ◽  
Albert Gabarrús ◽  
Patricia Oscanoa ◽  
...  

Background: Bronchiectasis exacerbations are often treated with prolonged antibiotic use, even though there is limited evidence for this approach. We therefore aimed to investigate the baseline clinical and microbiological findings associated with long courses of antibiotic treatment in exacerbated bronchiectasis patients. Methods: This was a bi-centric prospective observational study of bronchiectasis exacerbated adults. We compared groups receiving short (≤14 days) and long (15–21 days) courses of antibiotic treatment. Results: We enrolled 191 patients (mean age 72 (63, 79) years; 108 (56.5%) females), of whom 132 (69%) and 59 (31%) received short and long courses of antibiotics, respectively. Multivariable logistic regression of the baseline variables showed that long-term oxygen therapy (LTOT), moderate–severe exacerbations, and microbiological isolation of Pseudomonas aeruginosa were associated with long courses of antibiotic therapy. When we excluded patients with a diagnosis of community-acquired pneumonia (n = 49), in the model we found that an etiology of P. aeruginosa remained as factor associated with longer antibiotic treatment, with a moderate and a severe FACED score and the presence of arrhythmia as comorbidity at baseline. Conclusions: Decisions about the duration of antibiotic therapy should be guided by clinical and microbiological assessments of patients with infective exacerbations.


2018 ◽  
Vol 39 (6) ◽  
pp. 694-703 ◽  
Author(s):  
Aleksi Reito ◽  
Hanna-Liina Logren ◽  
Katri Ahonen ◽  
Heikki Nurmi ◽  
Juha Paloneva

Background: Nonoperative treatment is feasible in most patients with acute Achilles tendon rupture. Risk factors associated with failed nonoperative treatment are poorly understood. We investigated risk factors associated with rerupture after nonoperative treatment and otherwise failed nonoperative treatment of Achilles tendon rupture. Methods: All patients diagnosed with acute Achilles tendon rupture between January 2009 and June 2016 and who underwent 8 weeks of nonoperative treatment with functional rehabilitation were included in the study. Patients with rerupture or otherwise failed nonoperative treatment were identified retrospectively. Time to rerupture and association of age, sex, time from injury, diabetes, and visits to the physiotherapist for cases of reruptures and otherwise failed nonoperative treatment were investigated. A total of 210 patients were included in the study. Results: Fifteen patients sustained a rerupture. Rerupture incidence was 7.1%. Incidence of late reruptures, those occurring after return to daily activities at 12 weeks, was 1.9%. Six patients had otherwise failed nonoperative treatment. Median time to rerupture was 23 days (6 to 61) after the end of the treatment. The incidence of all-cause failure was 10.0%. Male gender was associated with reruptures ( P = .013) and failed nonoperative treatment for any reason ( P = .029). Conclusion: It is important to highlight the increased risk of rerupture in male patients during the first month after the end of the nonoperative treatment. Age alone, even in male patients, was a poor indication for operative treatment since it did not predict early failure. Further studies will hopefully clarify the influence of activity level on the risk of rerupture. Level of Evidence: Level IV, retrospective case series.


2021 ◽  
Vol 45 (1) ◽  
pp. 33-41
Author(s):  
Bo Seong Jang ◽  
Jun Young Park ◽  
Jae Hyun Lee ◽  
Young Joo Sim ◽  
Ho Joong Jeong ◽  
...  

Objective To investigate the clinical factors associated with successful gastrostomy tube weaning in patients with prolonged dysphagia after stroke.Methods This study involved a retrospective medical chart review of patients diagnosed with prolonged dysphagia after stroke who underwent gastrostomy tube insertion between May 2013 and January 2020. Forty-seven patients were enrolled and consequently divided into gastrostomy tube sustaining and weaning groups. The numbers of patients in the sustaining and weaning groups were 31 and 16, respectively. The patients’ demographic data, Korean version of Mini-Mental State Examination (K-MMSE) score, Korean version of the Modified Barthel Index (K-MBI), Functional Dysphagia Scale (FDS) score, and Penetration-Aspiration Scale (PAS) score were compared between the two groups. A videofluoroscopic swallowing study was performed before making the decision of gastrostomy tube weaning. The clinical factors associated with gastrostomy tube weaning were then investigated.Results There were significant differences in age; history of aspiration pneumonia; K-MMSE, FDS, and PAS scores; and K-MBI between the groups. In the multiple logistic regression analysis, the FDS (odds ratio [OR]=0.791; 95% confidence interval [CI], 0.634–0.987) and PAS scores (OR=0.205; 95% CI, 0.059–0.718) were associated with successful gastrostomy tube weaning. In the receiver operating characteristic curve analysis, the FDS and PAS were useful screening tools for successful weaning, with areas under the curve of 0.911 and 0.918, respectively.Conclusion In patients with prolonged dysphagia, the FDS and PAS scores are the only factors associated with successful gastrostomy tube weaning. An evaluation of the swallowing function is necessary before deciding to initiate gastrostomy tube weaning.


Haemophilia ◽  
2019 ◽  
Vol 25 (3) ◽  
pp. 447-455 ◽  
Author(s):  
Ricardo Andrade Carmo ◽  
Marina Lobato Martins ◽  
Daniel Gonçalves Chaves ◽  
Lorenza Nogueira Campos Dezanet

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Kazuyuki Numakura ◽  
Hideaki Kagaya ◽  
Ryohei Yamamoto ◽  
Naoki Komine ◽  
Mitsuru Saito ◽  
...  

We determined the prevalence of dyslipidemia in a Japanese cohort of renal allograft recipients and investigated clinical and genetic characteristics associated with having the disease. In total, 126 patients that received renal allograft transplants between February 2002 and August 2011 were studied, of which 44 recipients (34.9%) were diagnosed with dyslipidemia at 1 year after transplantation. Three clinical factors were associated with a risk of having dyslipidemia: a higher prevalence of disease observed among female than male patientsP=0.021and treatment with high mycophenolate mofetilP=0.012and prednisoloneP=0.023doses per body weight at 28 days after transplantation. The genetic association between dyslipidemia and 60 previously described genetic polymorphisms in 38 putative disease-associated genes was analyzed. The frequency of dyslipidemia was significantly higher in patients with the glucocorticoid receptor (NR3C1)Bcl1G allele than in those with the CC genotypeP=0.001. A multivariate analysis revealed that theNR3C1 Bcl1G allele was a significant risk factor for the prevalence of dyslipidemia (odds ratio = 4.6; 95% confidence interval = 1.8–12.2). These findings may aid in predicting a patient’s risk of developing dyslipidemia.


2011 ◽  
Vol 15 (5) ◽  
pp. 876-884 ◽  
Author(s):  
Yifeng Zhang ◽  
Hui Tan ◽  
Xuan Dai ◽  
Honger Huang ◽  
Gengsheng He

AbstractObjectiveThe present study aimed to characterize the dietary patterns of newlyweds married within one year and to examine the factors associated with weight changes.DesignA cross-sectional study was carried out in 2009.SettingBaoshan District, Shanghai, China.SubjectsA total of 342 pairs of newlyweds were recruited at their first visit. Weight and height were measured and food intake was measured based on an FFQ with forty-nine items. Dietary patterns were identified through factor analysis, and the factors associated with weight changes were determined by multiple regression models.ResultsAverage weight gain of the participants during marital transition was 1·9 kg (2·2 kg for men and 1·6 kg for women). Four major dietary patterns were identified: vegetable pattern, sweets and fats pattern, legume pattern and poultry, beef and mutton pattern. In multivariate analyses, the highest quintile of factor 2 (sweets and fats pattern) was significantly associated with weight gain after marriage in a comparison with the lowest quintile (β= 2·94; 95 % CI 0·75, 5·15;P= 0·01) in men. The highest quintile of factor 4 (poultry, beef and mutton pattern) was inversely associated with weight gain after marriage in a comparison with the lowest quintile (β= −1·21; 95 % CI −2·32, −0·11;P= 0·03).ConclusionsOur results suggest that a pattern rich in sugar, oil and condiments may lead to greater marital weight gain in men; another pattern rich in poultry, beef and mutton may lead to less marital weight gain in both men and women.


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