Weight gain in an eating disorders day program.

Background: Day treatment programs have increasingly become an important level of care in the medical and psychiatric management of patients with eating disorders, yet there is little in the literature describing the weight gain patterns of patients in these programs.

Methods: Weight gain accomplished by 198 patients admitted to a day program over a 2-year period was studied. Weight gain was analyzed by demographic, diagnostic and program-related variables and was compared for weekdays and weekends.

Pituitary volume in first-episode schizophrenia.

Pituitary volumes were measured in 55 first-episode schizophrenia patients at a baseline timepoint with 38 receiving a followup scan after antipsychotic treatment. Fifty-nine healthy volunteers had baseline scans with 34 receiving a followup scan. There were no baseline group differences in pituitary volumes or changes in volume following antipsychotic treatment.

Effects of age on prefrontal subregions and hippocampal volumes in young and middle-aged healthy humans.

There are limited data available regarding the effects of age and sex on discrete prefrontal gray and white matter volumes or posterior and anterior hippocampal volumes in healthy humans. Volumes of the superior frontal gyrus, anterior cingulate gyrus, and orbital frontal lobe were computed manually from contiguous magnetic resonance (MR) images in 83 (39M/44F) healthy humans (age range = 16-40) and segmented into gray and white matter. Volumes of the posterior and anterior hippocampal formation were also computed with reliable separation of the anterior hippocampal formation from the amygdala.

Dysmetabolic Signals in "Metabolically Healthy" Obesity.

BACKGROUND: Obesity is associated with decreased insulin sensitivity, atherogenic dyslipidemia and hypertension, but clinical studies have also identified a "metabolically healthy" obese phenotype. OBJECTIVE: To compare the characteristics of so-called "metabolically healthy" obese (MHO), normal weight subjects (MHNW) and obese with insulin resistance in a nationally representative sample in the United States. DESIGN, SETTING AND PARTICIPANTS: Insulin resistance was defined by a homeostatic model assessment (HOMA) value in the upper tertile for the entire NHANES cohort.

Dysmetabolic signals in "metabolically healthy" obesity.

Background: Obesity is associated with decreased insulin sensitivity, atherogenic dyslipidemia and hypertension, but clinical studies have also identified a "metabolically healthy" obese phenotype.

Objective: To compare the characteristics of so-called "metabolically healthy" obese (MHO), normal weight subjects (MHNW) and obese with insulin resistance in the United States National Health and Nutrition Examination Survey, 1999-2004 (NHANES).

Design, Setting And Participants: Insulin resistance was defined by a homeostatic model assessment (HOMA) value in the upper tertile for the entire NHANES cohort.

Palliative medicine consultation impacts DNR designation and length of stay for terminal medical MICU patients.

Objective: The purpose of this study was to assess the impact of a palliative medicine consultation on medical intensive care unit (MICU) and hospital length of stay, Do Not Resuscitate (DNR) designation, and location of death for MICU patients who died during hospitalization.

Method: A comparison of two retrospective cohorts in a 17-bed MICU in a tertiary care university-affiliated hospital was conducted. Patients admitted to the MICU between January 1, 2003 and June 30, 2004 (N = 515) were compared to MICU patients who had had a palliative medicine consultation between January 1, 2005 and June 1, 2009 (N = 693).

Time to treatment response in first-episode schizophrenia: should acute treatment trials last several months?

Objective: Response patterns may differ between patients with first-episode and multiepisode schizophrenia. This analysis explored trial duration with first-episode patients and asked whether early limited improvement predicts ultimate lack of treatment response with first-episode patients as it does with multiepisode patients.

Method: One hundred twelve subjects (mean age = 23.

Quantifying internal medicine resident clinical experience using resident-selected primary diagnosis codes.

Background: While experiential learning is a desirable goal of residency education, little is known regarding the actual clinical experience of internal medicine residents during their training.

Methods: We modified an electronic patient handoff tool to include a system for resident entry of a primary diagnosis for each of their patients. Using the International Classification of Diseases, Ninth Revision (ICD-9) system, we created two methods to select the code: 1) an organ system-based dropdown list containing frequently used codes; and 2) a search option for the complete ICD-9 database.

Olanzapine vs. risperidone in patients with first-episode schizophrenia and a lifetime history of cannabis use disorders: 16-week clinical and substance use outcomes.

The purpose of this study is to compare the efficacy of olanzapine and risperidone for the acute treatment of first-episode schizophrenia patients with cannabis use disorders. This secondary analysis of a previously published study included 49 first-episode patients with a diagnosis of schizophrenia, schizophreniform disorder, or schizoaffective disorder and a co-occurring lifetime diagnosis of cannabis use disorders randomly assigned to treatment with either olanzapine (n=28) or risperidone (n=21) for 16weeks. The olanzapine group did not differ significantly from the risperidone group for initial response rates of positive symptoms, and rates of cannabis use or alcohol use during the study.

Predictors of insulin resistance in the obese with metabolic syndrome.

Background: In the obese, the metabolic syndrome (MetS) is assumed to reflect insulin resistance.

Objective: To determine the predictors of insulin resistance in obese subjects with MetS.

Design: We used the 90th percentile of the homeostasis model assessment (HOMA) to define insulin resistance in 4958 nondiabetic adults evaluated in the National Health and Nutrition Examination Surveys, 1999-2004, and compared the 373 obese subjects who were insulin-resistant (HOMA 9.

DRD2 promoter region variation predicts antipsychotic-induced weight gain in first episode schizophrenia.

Many antipsychotic medications carry a substantial liability for weight gain, and one mechanism common to all antipsychotics is binding to the dopamine D2 receptor. We therefore examined the relationship between -141C Ins/Del (rs1799732), a functional promoter region polymorphism in DRD2, and antipsychotic-induced weight gain in 58 first episode schizophrenia patients enrolled in a randomized trial of risperidone versus olanzapine. Carriers of the deletion allele (n=29) were compared with Ins/Ins homozygotes (noncarriers, n=29) in a mixed model encompassing 10 weight measurements over 16 weeks.

Are cannabis use disorders associated with an earlier age at onset of psychosis? A study in first episode schizophrenia.

Introduction: The purpose of this study is to determine if an earlier age at onset of positive symptoms in schizophrenia is associated with cannabis use disorders (CUD).

Methods: 49 first-episode schizophrenia subjects with CUD were compared to 51 first-episode schizophrenia subjects with no substance use disorders for demographic and clinical variables. A multivariate logistic regression was performed to determine the joint relationship between variables significantly associated with CUD on univariate testing and ascertain if these variables independently predict CUD.

Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents.

Context: Cardiometabolic effects of second-generation antipsychotic medications are concerning but have not been sufficiently studied in pediatric and adolescent patients naive to antipsychotic medication.

Objective: To study the association of second-generation antipsychotic medications with body composition and metabolic parameters in patients without prior antipsychotic medication exposure.

Design, Setting, And Patients: Nonrandomized Second-Generation Antipsychotic Treatment Indications, Effectiveness and Tolerability in Youth (SATIETY) cohort study, conducted between December 2001 and September 2007 at semi-urban, tertiary care, academic inpatient and outpatient clinics in Queens, New York, with a catchment area of 4.

Cadmium concentrations in blood and seminal plasma: correlations with sperm number and motility in three male populations (infertility patients, artificial insemination donors, and unselected volunteers).

To investigate a possible common environmental exposure that may partially explain the observed decrease in human semen quality, we correlated seminal plasma and blood cadmium levels with sperm concentration and sperm motility. We studied three separate human populations: group 1, infertility patients (Long Island, NY, USA); group 2, artificial insemination donors (AID) (Rochester, NY, USA); and group 3, general population volunteers (Rochester, NY, USA). Information about confounding factors was collected by questionnaire.

Long-term outcomes in younger men following permanent prostate brachytherapy.

Purpose: We reviewed the long-term outcomes in men undergoing permanent prostate brachytherapy with a focus on those presenting before age 60 years.

Materials And Methods: Between 1992 and 2005 a total of 2,119 patients with clinical stage T1-T2, N0, M0 prostate cancer treated with permanent prostate brachytherapy were included in this study. Treatment regimens consisted of permanent prostate brachytherapy with or without hormone therapy, permanent prostate brachytherapy with external beam radiotherapy, or all 3 modalities.

Lack of an inverse relationship between duration of untreated psychosis and cognitive function in first episode schizophrenia.

This study assessed the relationship between duration of untreated psychosis (DUP) and cognitive measures in order to assess if longer DUP was associated with worse performance. One hundred two patients with first episode schizophrenia or schizoaffective disorder were assessed on cognitive measures of speed of processing, episodic memory, executive function, and visual spatial processing at baseline (when patients were drug naive and after 16 weeks of olanzapine or risperidone treatment), so that a change score could be derived. DUP was defined by the emergence of psychiatric symptoms and the emergence of psychotic symptoms.

DISC1 is associated with prefrontal cortical gray matter and positive symptoms in schizophrenia.

Background: DISC1 is considered a susceptibility gene for schizophrenia and schizoaffective disorder, but little is known regarding the potential mechanisms through which it may confer increased risk. Given that DISC1 plays a role in cerebral cortex development, polymorphisms in this gene may have relevance for neurobiological models of schizophrenia that have implicated cortical deficits in its pathophysiology.

Methods: We investigated whether the DISC1 leu607phe polymorphism was associated with prefrontal gray matter volumes using magnetic resonance imaging in a cohort of patients with schizophrenia (N=19) and healthy volunteers (N=25) and positive and negative symptoms in 200 patients with schizophrenia.

Anterior cingulate grey-matter deficits and cannabis use in first-episode schizophrenia.

Background: Despite the high prevalence of cannabis use in schizophrenia, few studies have examined the potential relationship between cannabis exposure and brain structural abnormalities in schizophrenia.

Aims: To investigate prefrontal grey and white matter regions in patients experiencing a first episode of schizophrenia with an additional diagnosis of cannabis use or dependence (n=20) compared with similar patients with no cannabis use (n=31) and healthy volunteers (n=56).

Method: Volumes of the superior frontal gyrus, anterior cingulate gyrus and orbital frontal lobe were outlined manually from contiguous magnetic resonance images and automatically segmented into grey and white matter.

Randomized comparison of olanzapine versus risperidone for the treatment of first-episode schizophrenia: 4-month outcomes.

Objective: The authors compared 4-month treatment outcomes for olanzapine versus risperidone in patients with first-episode schizophrenia spectrum disorders.

Method: One hundred twelve subjects (70% male; mean age=23.3 years [SD = 5.

Emotion-based decision-making in healthy subjects: short-term effects of reducing dopamine levels.

Introduction: Converging evidences from animal and human studies suggest that addiction is associated with dopaminergic dysfunction in brain reward circuits. So far, it is unclear what aspects of addictive behaviors are related to a dopaminergic dysfunction.

Discussion: We hypothesize that a decrease in dopaminergic activity impairs emotion-based decision-making.

Deficits in memory strategy use are related to verbal memory impairments in adolescents with schizophrenia-spectrum disorders.

Objective: To assess the nature of learning and verbal memory deficits in adolescents with schizophrenia-spectrum disorders (SzS) (i.e., schizophrenia, schizoaffective disorder, and schizophreniform disorder).

Early-onset schizophrenia is associated with impaired adolescent development of attentional capacity using the identical pairs continuous performance test.

The authors examined performance on the Continuous Performance Test-Identical Pairs "numbers" task in adolescents with schizophrenia (n=59) and healthy controls (n=55). Adjusting for an estimate of premorbid intelligence and socioeconomic status, patients performed worse than normal controls on all three d' conditions (2-digit, 3-digit, 4-digit). However, there was a significant group-by-age-by-condition interaction (F[4,100]=4.

Hematological adverse events in clozapine-treated children and adolescents.

Objective: To retrospectively examine rates of hematological adverse events (HAEs) in psychiatrically ill, hospitalized children treated with clozapine.

Method: Clozapine treatment was administered in an open-label fashion using a flexible titration schedule, and data from weekly complete blood counts was obtained. The rate of neutropenia and agranulocytosis (HAEs) development was determined for 172 eligible patients (mean age at clozapine initiation, 15.

Comparison of lung area by chest radiograph, with estimation of lung volume by helium dilution during prone and supine positioning in mechanically ventilated preterm infants: a pilot study.

Measurement of lung volume may be useful in determining the degree of lung disease and for optimizing an infant's mechanical ventilator settings. A chest radiograph (CXR) is often used to estimate lung volume, because direct measurement, e.g.

Bilateral increased apoptosis and bilateral accumulation of cadmium in infertile men with left varicocele.

Background: Varicoceles are associated with venous flux that may cause increased heat and interstitial pressure within the testes, but these effects are variable. Some men with varicocele have infertility, but others do not. We question whether other factors contribute to the infertility, and whether these other factors could be identified by specific molecular/genetic markers.