The document discusses the risks of weight gain and metabolic side effects from different antipsychotic medications, recommends monitoring weight and metabolic markers when prescribing antipsychotics, and outlines strategies for preventing and managing antipsychotic-induced weight gain through lifestyle interventions, switching medications, and collaboration with primary care physicians.
Brain tumors are relatively common with an annual incidence of 9/100000 for primary brain tumors and 8.3 /100000 for metastatic brain tumors.
In India , incidence of primary brain tumor is 3.4 per 100,000 populations for males and 1.2 per 100,000 populations for females
Most brain tumors present with specific neurologic signs due to mass effect. However, in rare cases they may present primarily with psychiatric symptoms.
A study reported that 78% of 530 patients with brain tumors had psychiatric symptoms of which only 18% presented with these symptoms as the first clinical manifestation of a brain tumor.
Due to the neuronal connections of the brain, a lesion in one region may manifest a multitude of symptoms depending on the function of the underlying neuronal foci.
This seminar explores the potential connection between two inositol stereoisomers supplements and improvements in insulin sensitivity and various metabolic parameters.
EFFECT OF A LIFESTYLE PROGRAM ON HOLIDAY STRESS, CORTISOL, AND BODY WEIGHTShawn Talbott
Cortisol overexposure is well-known in the scientific literature to increase appetite and
promote fat storage in the abdominal area. The holidays are often cited as a stressful time of the year (Thanksgiving to New Year’s Day) ñ and a time during which many people
gain weight. Our hypothesis was that a comprehensive lifestyle program would attenuate stress and weight gain in this group of “stress-eaters.”
Brain tumors are relatively common with an annual incidence of 9/100000 for primary brain tumors and 8.3 /100000 for metastatic brain tumors.
In India , incidence of primary brain tumor is 3.4 per 100,000 populations for males and 1.2 per 100,000 populations for females
Most brain tumors present with specific neurologic signs due to mass effect. However, in rare cases they may present primarily with psychiatric symptoms.
A study reported that 78% of 530 patients with brain tumors had psychiatric symptoms of which only 18% presented with these symptoms as the first clinical manifestation of a brain tumor.
Due to the neuronal connections of the brain, a lesion in one region may manifest a multitude of symptoms depending on the function of the underlying neuronal foci.
This seminar explores the potential connection between two inositol stereoisomers supplements and improvements in insulin sensitivity and various metabolic parameters.
EFFECT OF A LIFESTYLE PROGRAM ON HOLIDAY STRESS, CORTISOL, AND BODY WEIGHTShawn Talbott
Cortisol overexposure is well-known in the scientific literature to increase appetite and
promote fat storage in the abdominal area. The holidays are often cited as a stressful time of the year (Thanksgiving to New Year’s Day) ñ and a time during which many people
gain weight. Our hypothesis was that a comprehensive lifestyle program would attenuate stress and weight gain in this group of “stress-eaters.”
The Eating Behavior Questionnaire of Hendricks & Obesity Treatment FoundationEd J. Hendricks, M.D.
The EBQ is a novel behavioral psychometric scale for clinical evaluation of treatment effectiveness in treating overweight and obese patients with diet, lifestyle modification and pharmacotherapy.
Weight diabetes and metabolic problems in patients taking atypical antipsycho...Alex J Mitchell
Free slide show on weight gain, diabetes and metabolic problems in those taking atypical antipsychotic medication in schizophrenia, bipolar disorder and related conditions. Image credits retained by original authors. Please give correct acknolwedgements if you present any material from here.
[ppt] RCpsych - Failing medical care of psychiatric patients (vMar11)Alex J Mitchell
This is a 30min talk given at the RCPsych liaison conference 2011 on the topic of the failing (suboptimal) medical care provided to psychiatric patients by physicians and psychiatrists. Available in free full text PPT for a limited period.
Jeffrey A. Meyerhardt, MD, MPH
Associate Professor of Medicine, Harvard Medical School Active Medical Staff, Medical Oncology, Dana-Farber Cancer Institute - speaker for Tuesday Call-on Congress 2012
Anti-Obesity Pharmacotherapy: Where are we now? Where are we going?InsideScientific
Obesity is a treatable chronic disease. With nearly 2 billion individuals worldwide classified as being overweight and 650 million as having obesity, it is critical to optimize implementation of existing treatment interventions and develop novel therapies to mitigate the obesity pandemic. Anti-obesity medications are one of the essential tools in our medical toolbox to help patients achieve their health and weight goals.
In this webinar, Dr. Jastreboff discusses current use of anti-obesity pharmacotherapy, mechanisms involved, and agents in various stages of development with considerations for next steps. The presentation aims to inspire development of innovative therapeutics while optimizing use of existing agents to address the urgent need to effectively and sustainably treat millions of individuals with obesity around the world.
Key Topics Include:
- Understand the role of anti-obesity pharmacotherapy in the treatment of obesity
- Describe current anti-obesity pharmacotherapy
- Discuss anti-obesity medications under development
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
1. Antipsychotic Medications &
Weight Gain
Rohan Ganguli, MD, FRCP
Professor & Canada Research Chair
University of Toronto
Executive Vice President
Center for Addiction & Mental Health
2. CONFLICTS OF INTEREST
Current
• Investments in Pharmaceutical
Companies
– NONE
• Investments in healthcare-related industry
– NONE
• Slides provided by Pharmaceutical or
other companies
– NONE
3. POTENTIAL CONFLICTS OF
INTEREST
• Research grants - current
– Canadian Institutes of Health Research,
Public Health Agency of Canada, Canadian
Diabetes Association
• Research grants - past
– National Institute of Mental Health (US),
Stanley Research Foundation (US), Eli Lilly,
Janssen, Bristol Myers-Squibb, Pfizer
• Past Consultations & Speaker’s Honoraria
– Janssen, Bristol Myers Squibb, Eli Lilly, Pfizer
4. WHAT WILL BE PRESENTED?
• Evidence for role of antipsychotics in
weight gain
• Comparison of weight gain risk with
different antipsychotics
• Treatment and reduction/reversal of
anti-psychotic associated adverse
metabolic changes
5. YEARS OF POTENTIAL LIFE
LOST
Year AZ MO OK RI TX UT VA
1997 26.3 25.1 28.5
Average years of life lost=25 years
1998 27.3 25.1 28.8 29.3 15.5
1999 32.2 26.8 26.3 29.3 26.9 14.0
2000 31.8 27.9 24.9 13.5
Sixteen-State Study on Mental Health Performance Measures
Parks et al., Nat Assoc State Mental Health Program Directors, 2006
6. “CATIE STUDY”: Prevalence of
Metabolic Syndrome at Baseline
*
60
CATIE (N = 689)
50 NHANES (N = 687)
*
% with MetS
40
30
20
10
0
NHANES = National Health and Nutrition Examination Survey. *P = 0.0001 CATIE vs NHANES.
Males Females
McEvoy JP, et al. Schizophr Res. 2005; 80:19-32 Rohan Ganguli, M.D.
7. Prevalence of Metabolic Syndrome
in Clozapine Patients
60
53.8
% with MetS
40
20.7
20
0
Controls Clozapine Patients
Lamberti JS, et al., Am J Psychiatry. 2006; 163:1273-1276
8. RISK OF METABOLIC SYNDROME:
HIGHLY CORRELATED WITH BODY MASS (weight)
N=12,363 Healthy
70 Overweight
Obese
60
Prevalence (%)
50
40 Men Women
30
20
10
0
Healthy=BMI ≤25 kg/m2 ; Overweight=BMI 25-29.9 kg/m2; Obese=BMI ≥30 kg/m2.
Park YW et al. Arch Intern Med. 2003;163:427-436. Rohan Ganguli, M.D.
9. BMI among ambulatory
schizophrenia patients
N=276
19%
NORMAL WEIGHT
OVER WEIGHT
OBESE
59% 22%
Normal weight: BMI 19-25
Overweight: BMI 25-30
Obese: BMI >30
Strassing M, Brar JS, Ganguli R. Schizophr Bull. 2003;29:393-397.
10. COMPREHENSIVE RESEARCH SYNTHESIS OF
ANTIPSYCHOTIC-INDUCED WEIGHT GAIN
Allison et al., Am J Psychiatry,Rohan 156, 1999
Vol Ganguli, M.D.
11. Conclusions
• Antipsychotic medications vary in terms of the
risk of weigh gain associated with their use
• This needs to be discussed with a patient and
her/his caregivers, when initiating treatment
– And the risks of alternatives also need to be
presented
• If a patient is gaining weight on a high
risk medication, can switching to a low
risk medication help?
12. Switching to ziprasidone
Weiden et al., Neuropsychopharmacology 2008
6 10 14 19 23 27 32 36 40 45 49 53 58
5
LS Mean Change (lb)
0 *
-5 ***
**
-10
*** **
-15
*P<0.05
**P<0.01
-20
***P<0.0001
***
-25 Switched from
Conventionals Risperidone Olanzapine
13. Switching to Aripiprazole
Ganguli et al. Clin. Schizophrenia & Related
Psychoses, 2011
33 schizophrenia patients who had
gained weight, and who agreed to
switch from other antipsychotics to
aripiprazole in an open, flexible-dose,
eight-week trial
14. Switching to aripiprazole
Ganguli et al. Clin. Schizophrenia & Related
Psychoses, 2011
Metabolic changes, based on antipsychotic prior to switching
18. Prevention of Antipsychotic-
Associated Weight Gain
• 49 patients with schizophrenia or
schizoaffective disorder
– Starting a novel antipsychotic
• Risperidone, olanzapine, quetiapine, ziprasidone, clozapine
• Randomized to
– “intervention” – stepped care, based on observed
weight gain
– “usual care” – weight monthly
• Follow up for 16 weeks
Ganguli R, Brar JS. Schizophr Bull. 2005;31:561.
19. Prevention of Weight Gain
Stepped Interventions
• STEP 1
– self-monitoring
• daily weight, food consumed and physical activity
– controlling urges to overeat and snack
• covert procedures & limiting eating to one area
• STEP 2
– decreasing food cues
– developing good eating habits
– self-control of overeating
• STEP 3
– Exercise
• STEP 4
– changing snack habits
Ganguli R, Brar JS. Schizophr Bull. 2005;31:561.
20. Prevention of Weight Gain
Results
10
8
Final – baseline weight in kg
6 (P=.003)
4
2
0
Control
-2
-4 Treatment
Ganguli R, Brar JS. Schizophr Bull. 2005;31:561.
21. Behavior Therapy to Prevent
Weight Gain
100
No Some
weight weight
gain gain
No Gain
50
Gain
Intervention 17 10
Control 5 17
0
Intervention Control
P = 0.009
Ganguli R, Brar JS. Schizophr Bull. 2005;31:561.
22. Conclusions
Primary prevention
• Recommend and use agents with the
lowest potential for adverse metabolic
effects
• Discuss possibility of weight gain and
suggest strategies to prevent this
• Self monitoring
• Nutrition
• Physical activity
23. Conclusions
Secondary Prevention
Monitor weight at regular intervals (at the
very least)
– Monitor lipid and fasting blood
sugar/HbA1c at least annually
24. Conclusions
Secondary Prevention
• Switching from metabolically high risk to
low risk medications should be
considered
– and presented to patient (and caregiver) as
an option
• The probability of metabolic benefit
must be weighed against the risk of
worsening or relapse
25. Conclusions
Tertiary Prevention
• Refer individuals who have gained
weight to programs which specialize in
weight loss interventions
– Or develop these in your program
• Make sure that your patients have
primary care physicians for treatment of
metabolic complications
– And that the see them regularly
– And that you collaborate with the PCP