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4 results

  • Metabolic side effects of atypical antipsychotics in older adults

  • Emme Chacko, Stephen Boyd, Rinki Murphy
  • Journal:
    International Psychogeriatrics / Volume 30 / Issue 10 / October 2018
    Published online by Cambridge University Press:
    25 May 2018, pp. 1557-1566
  • Background:

    The atypical antipsychotics (AAPs) are associated with a recognized class effect of glucose and lipid dysregulation. The use of these medications is rapidly increasing in elderly patients with, and without, dementia. However, the metabolic risks specific to elderly remain poorly studied.

    Methods:

    Design: A case-control study.

    Setting: Psychogeriatric service in Auckland, New Zealand.

    Participants: Elderly patients either receiving AAP treatment (cases) or not (controls) between 1 Jan 2008 and 1 Jan 2014.

    Main outcome measures: metabolic data of glucose, HbA1c, lipids, and cardiovascular events and death. The data were analyzed using t-tests and linear regression models for each metabolic outcome.

    Results:

    There were 330 eligible cases and 301 controls from a total study population of 5,307. There was a statistically significant change in the HbA1c over time, within the cases group of −1.14 mmol/mol (p = 0.018, 95% CI −0.19 to −2.09). Also statistically significant was the reduction in total cholesterol of −0.13 mmol/L (p = 0.036, 95% CI −0.008 to −0.245). The only significant difference found between cases and controls was in the change in cholesterol ratio of 0.16 mmol/L between groups (95%CI 0.01–0.31, p = 0.036).

    Conclusions:

    AAP use was not associated with any clinically significant change in metabolic outcomes in this study population.

  • 17 - Optimizing the use of mechanical ventilation and minimizing its requirement with capnography

  • from 1 - Ventilation
  • Edited by J. S. Gravenstein, University of Florida, Michael B. Jaffe, Nikolaus Gravenstein, University of Florida, David A. Paulus, University of Florida
  • Book:
    Capnography
    Published online:
    05 August 2011
    Print publication:
    17 March 2011, pp 148-159

  • Summary

    Continuous monitoring of end-tidal carbon dioxide (PETCO2) is a long-established standard of care in the operating room (OR). Carbon dioxide can be useful to monitor the mechanically ventilated patient when used in conjunction with other monitors of the patient's clinical status. CO2 monitoring is affected by changes in metabolism or CO2 production, cardiovascular function, and respiratory function. Comparison of the gradient between arterial and end-tidal CO2 (PaCO2-PetCO2) can offer valuable information regarding a patient's clinical status. In newborns, the therapeutic administration of CO2 in the ventilator circuit has been used in the preoperative management of hypoplastic left heart syndrome. Volumetric capnography or volumetric CO2 (VCO2) is the measurement of CO2 as a function of volume as opposed to time. When CO2 production increases with constant minute ventilation, PaCO2 will increase. Alveolar minute ventilation can be used as a guide for predicting the PaCO2 that may result from adjusting ventilation parameters.

  • Structure and function of the ectomycorrhizal association between Paxillus involutus and Betula pendula. II. Metabolic changes during mycorrhiza formation

  • D. BLAUDEZ, M. CHALOT, P. DIZENGREMEL, B. BOTTON
  • Journal:
    The New Phytologist / Volume 138 / Issue 3 / March 1998
    Published online by Cambridge University Press:
    01 March 1998, pp. 543-552
    Print publication:
    March 1998

  • Seedlings of Betula pendula Roth. were grown in the presence of Paxillus involutus (Batsch) Fr., and metabolic changes during mycorrhiza formation were examined by measuring organic acid and amino acid pools and related enzyme activities, following sequential harvests. Glutamine, aspartate and asparagine pools were always lower in infected roots than in non-infected roots, especially during Hartig net initiation and formation. Glutamate concentration was similar in both tissues. Citrate and malate were the two major organic acids detected and their concentrations were equal in infected and non-infected roots. Aspartate aminotransferase, glutamine synthetase, NAD-dependent malate dehydrogenase and glucose-6-phosphate dehydrogenase activities were higher in infected roots than non-infected roots. For all enzymes revealed on polyacrylamide gels, both root and fungal isoforms were present in infected roots. Quantitative changes in enzyme capacities and metabolite pools indicated that mycorrhiza formation caused a re-arrangement of the main metabolic pathways during the very early stages following contact, which might be related to the structural changes.