What are the uses of Weighted means?
Mar 21, 2022 · The treatment of weight control issues requires a comprehensive approach, as disordered eating permeates the individual, home, and social environments. Cognitive behavioral therapy (CBT) emphasizes the process of changing habits and attitudes that maintain psychological disorders.
What is the most effective medication for weight loss?
Feb 18, 2009 · Exenatide is an anti-diabetic medication that is associated with weight loss and improved glucose regulation. Therefore, the overall goal of the proposed study is to conduct a 16-week double-blind placebo-controlled study of exenatide for the treatment of weight gain associated with olanzapine in 60 obese adults with bipolar disorder treated with olanzapine.
What are the four basic causes of weight loss?
Background and aims: Transoral outlet reduction (TORe) is a common endoscopic treatment for patients with weight regain after Roux-en-Y gastric bypass (RYGB) with a dilated gastrojejunal anastomosis (GJA). This study aims to assess long-term efficacy of TORe.
What is included in patient education about weight management in antipsychotics?
Oct 14, 2018 · This article has been cited byother articles in PMC. Abstract. Introduction. Laparoscopic sleeve gastrectomy (LSG) has become one of the most commonly performed weight loss procedures due to its simpler technique and lower complication rate as compared to the Roux-en-Y gastric bypass and duodenal switch.
What are the factors that contribute to weight gain in schizophrenia?
Many factors contribute to weight gain in patients with schizophrenia or psychosis. Sedentary lifestyle, unhealthy food habits, genetic susceptibility and antipsychotic treatment are considered the main contributors.
How does metformin affect insulin?
It exerts its action by inhibiting hepatic gluconeogenesis and improving the sensitivity of insulin in skeletal muscles via adenosine monophosphate kinase. 58 It also reduces low-density lipoprotein cholesterol and triglycerides. 59 The main mechanism of weight loss may be by reduction of insulin resistance and suppression of appetite. 60 Increased level of glucagon-like peptide-1 (GLP-1) may contribute.
Does olanzapine cause weight gain?
The risk appears to be highest with olanzapine and clozapine. Weight increases rapidly in the initial period after starting antipsychotics. Patients continue to gain weight in the long term. Children appear to be particularly vulnerable to antipsychotic-induced weight gain.
What are the factors that contribute to rapid weight gain?
Factors associated with rapid weight gain in the initial period were younger age, lower baseline body mass index (BMI), more robust response to antipsychotic and increase in appetite. Rapid weight gain of more than 5% in the first month is the best predictor for significant long-term weight gain. 25.
How does d-fenfluramine work?
d-Fenfluramine, an anorectic drug, exerts its action by strengthening the serotonergic function in the brain. d-Fenfluramine releases serotonin through a carrier-dependent mechanism. Goodall et al conducted the only RCT to examine the effect of d-fenfluramine on antipsychotic-induced weight gain. 73 d-Fenfluramine administered to overweight patients with schizophrenia on depot antipsychotics showed significant weight reduction compared to placebo. This drug was removed from the US market in 1997 after reports of heart valve disease and pulmonary hypertension.
Does metformin cause weight loss?
Both nonpharmacologic prevention and intervention strategies have shown modest effects on weight. Multiple compounds have been investigated as add-on medications to cause weight loss. Metformin has the best evidence in this respect. Burden of side effects needs to be considered when prescribing weight loss medications.
What is the difference between pharmacologic and nonpharmacologic interventions?
Pharmacologic interventions consist of switching to another antipsychotic which has less potential to cause weight gain or adding an adjuvant. Nonpharmacologic interventions consist of lifestyle modification and cognitive-behavioral strategies.
Why do elderly people lose weight?
Elderly patients with unintentional weight loss are at higher risk for infection, depression and death. The leading causes of involuntary weight loss are depression (especially in residents of long-term care facilities), cancer (lung and gastrointestinal malignancies), cardiac disorders and benign gastrointestinal diseases.
What is management in healthcare?
Management is directed at treating underlying causes and providing nutritional support. Consideration should be given to the patient's environment and interest in and ability to eat food, the amelioration of symptoms and the provision of adequate nutrition.
How to know if a patient is not hungry?
It should be possible to determine if the patient is predominantly not hungry or is feeling nauseated (or even vomiting) after meals , if the patient is having difficulty eating or swallowing, or if the patient is having functional or social problems that may be interfering with the ability to obtain or enjoy food. A combination of these factors may be present.
Who is Dr. Huffman?
GRACE BROOKE HUFFMAN, M.D., is associate medical director at Brooke Grove Foundation (providing clinical long-term care for the elderly), Sandy Spring, Md. Dr. Huffman graduated from St. George's University School of Medicine, Grenada, and completed a family practice residency at St. Mary Hospital, Hoboken, N.J. She is board-certified in family practice and holds a certificate of added qualifications in geriatrics. Dr. Huffman is an associate medical editor for American Family Physician. ...
Is weight loss a predictor of death?
The risk of mortality was significantly higher in the men who lost weight than in those whose weight did not decrease. In patients with Alzheim er's disease , weight loss correlates with disease progression, and a weight loss of at least 5 percent is a significant predictor of death. 8.
Why is accurate evaluation important?
Accurate evaluation is essential, however, because this problem is associated with increased morbidity and mortality. 1, 2 When a patient has multiple medical problems and is taking several medications, the differential diagnosis of unintentional weight loss can be extensive.
What are the effects of weight loss?
Involuntary weight loss can lead to muscle wasting, decreased immunocompetence, depression and an increased rate of disease complications. 3 Various studies have demonstrated a strong correlation between weight loss and morbidity and mortality. 4
Does exenatide work for weight gain?
The purpose of this research study is to test the safety and efficacy (how well it works) of exenatide as a treatment for weight gain associated with olanzapine in obese adults with Bipolar Disorder, Major Depressive Disorder, Schizophrenia or Schizoaffective Disorder
Is olanzapine good for bipolar?
Detailed Description: Double-blind studies suggest that olanzapine is highly effective for the treatment of individuals with bipolar disorder. However, weight gain and impaired glucose tolerance remain significant concerns associated with olanzapine. Exenatide is an anti-diabetic medication that is associated with weight loss ...
Is exenatide a placebo?
Exenatide is an anti-diabetic medication that is associated with weight loss and improved glucose regulation. Therefore, the overall goal of the proposed study is to conduct a 16-week double-blind placebo-controlled study of exenatide for the treatment of weight gain associated with olanzapine in 60 obese adults with bipolar disorder treated ...
Why use weighted mean?
Weighted means are useful in a wide variety of scenarios. For example, a student may use a weighted mean in order to calculate his/her percentage grade in a course.
What is weighted mean in finance?
In the context of finance, weighted means are used to calculate expected values or returns on certain investments. For instance, suppose that financial analysts observe the behavior of certain securities under different market conditions.
How to calculate weighted mean?
The weighted mean is a type of mean that is calculated by multiplying the weight (or probability) associated with a particular event or outcome with its associated quantitative outcome and then summing all the products together. It is very useful when calculating a theoretically expected outcome where each outcome has a different probability ...
What is the difference between a bear market and a bull market?
A bear market is typically considered to exist when there has been a price decline of 20% or more from the peak, and a bull market is considered to be a 20% recovery from a market bottom. over a large period of time.
Why is uric acid excreted?
Uric acid must be excreted because it cannot be metabolized. Uric acid output should be between 0.8 and 1g/day if the patient is on an ordinary diet. Increased elimination is observed after ingestion of proteins and nitrogenous foods, after exercise, after administration of cytotoxic agents, and in gout and leukemia.
What is edetic acid?
a chelating agent that binds calcium and other metals; used as an anticoagulant for pres erving blood specimens. Also used medicinally; see edetate. Called also edetic acid. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc.
How is arachidonic acid metabolized?
The acid is found in many foods. It is metabolized primarily by the cyclo-oxygenase or 5-lipoxygenase pathways to produce prostaglandins and leukotrienes, which are important mediators of inflammation. Corticosteroids inhibit formation of arachidonic acid from phospholipids when cell membranes are damaged.
Which acid is a salt in bile?
Any of the complex acids that occur as salts in bile, e.g., cholic, glycocholic, and taurocholic acids. They give bile its foamy character, are important in the digestion of fats in the intestine, and are reabsorbed from the intestine to be used again by the liver. See: enterohepatic circulation
Where does HCOOH occur?
HCOOH, the first and strongest member of the monobasic fatty acid series. It occurs naturally in certain animal secretions, e.g., the sting of insects such as bees and ants, and in muscle, but it is also prepared synthetically.
Is fatty acid soluble in water?
Fatty acids are insoluble in water. This insolubility would prevent their being absorbed from the intestines, but the action of bile salts on the fatty acids enable thems to be absorbed. Fatty acids include acetic, butyric, capric, caproic, caprylic, formic, lauric, myristic, palmitic, and stearic acids.
What acid gives vinegar its sour taste?
C 2 H 4 O 2 , the acid that gives the sour taste to vinegar. It is also used as a reagent. Glacial (highly purified) acetic acid contains at least 99.5% acetic acid by weight.
Causes
Effects
- Involuntary weight loss can lead to muscle wasting, decreased immunocompetence, depression and an increased rate of disease complications.3 Various studies have demonstrated a strong correlation between weight loss and morbidity and mortality.4
Prognosis
- One study5 showed that nursing home patients had a significantly higher mortality rate in the six months after losing 10 percent of their body weight, irrespective of diagnoses or cause of death. In another study,6 institutionalized elderly patients who lost 5 percent of their body weight in one month were found to be four times more likely to die within one year.
Epidemiology
- Another study7 found a 13.1 percent annual incidence of involuntary weight loss in outpatient male veterans older than 64 years of age. The risk of mortality was significantly higher in the men who lost weight than in those whose weight did not decrease. In patients with Alzheimer's disease, weight loss correlates with disease progression, and a weight loss of at least 5 percent …
Risks
- A loss of approximately 5 to 10 percent of body weight in the previous one to 12 months may indicate a problem in an elderly patient. This degree of weight loss should not be considered a normal part of the aging process. Continued weight loss necessitates a discussion with the patient or family members about whether long-term tube feeding is desired. The physician need…
Diagnosis
- The differential diagnosis of unintended weight loss in the elderly can be extensive. The most commonly identified causes are depression, cancer and gastrointestinal disorders1 (Table 1).1418 Pulmonary disease, cardiac disorders (e.g., congestive heart failure), dementia, alcoholism and prescription medications have also been implicated in the problem.3 Although a…
Significance
- An interview with a knowledgeable care-giver is essential because the elderly patient may deny or be unaware of the weight loss or the aforementioned difficulties. If the patient's measured weights over time are not available, the caregiver may be able to estimate the amount of weight that the patient has lost through changes in the patient's clothing size.
Assessment
- A nutritional assessment should be performed. The dietary history includes the availability of food, the patient's use of nutritional (and herbal) supplements, the adequacy of the patient's diet (amount of food consumed, balance of nutrients, etc.) and the patient's daily caloric intake. The Mini Nutritional Assessment, a tool that has been validated in the elderly for measuring nutrition…
Issues
- A review of systems can reveal problems with specific organ systems. Questions directed at identifying symptoms related to the pulmonary and digestive systems are important because lung and gastrointestinal cancers are the malignancies most likely to be implicated in unexpected weight loss. Prostate and breast cancers are also prevalent in the elderly, and symptoms relate…
Prevention
- The use of formal screening instruments for depression, such as the Geriatric Depression Scale,25 may be necessary in the elderly patient with unintentional weight loss. One study,26 although not performed in the elderly, found that simply asking the patient if he or she is depressed and has recently lost pleasure in doing things can reliably screen for depression.
Clinical significance
- The physical examination of an elderly patient with unintentional weight loss is directed by the information gathered during the history-taking process. It is particularly important to evaluate the oral cavity and the respiratory and gastrointestinal systems.
Treatment
- If the decision is made to provide nutritional supplementation in a patient with unintended weight loss, the serum prealbumin, transferrin or albumin level can be used to guide supplement selection. For example, a patient with weight loss and depleted visceral protein stores, as reflected in a low serum albumin level, may need a supplement with a high protein content. The t…
Staff
- Interviews with the caregivers and the dietary staff of the facility are crucial to understanding the problem. The staff should have a good grasp of the patient's ability to chew foods of various consistencies, to feed himself or herself, and to attend to the various tasks involved in eating.
Benefits
- Patients may benefit simply from being offered frequent small servings of foods that they like. Large portions may be overwhelming and may actually discourage intake.
Medical uses
- Dronabinol (Marinol) is a cannabinoid indicated for the treatment of anorexia with weight loss in patients with acquired immunodeficiency syndrome (AIDS). This drug has also been studied, with some promising results, in patients with Alzheimer's disease.34 Because of side effects of dizziness, confusion and somnolence, dronabinol should not be used in patients whose cognitiv…
Overview
- Cyproheptadine (Periactin) is an antihistaminic and antiserotoninergic medication that causes a mild increase in appetite. In one study,37 patients (median age: 65 years) who received cyproheptadine had a decrease in their rate of weight loss but no weight gain. Drowsiness and dizziness are side effects that may make the use of this medication particularly problematic in e…
Interactions
- Metoclopramide (Reglan), a prokinetic agent, may relieve nausea-induced anorexia.38 However, this drug can cause serious dystonia and precipitate parkinsonian symptoms in elderly patients. Metoclopramide is also associated with a number of drug interactions.
Contraindications
- Although medications may help promote appetite and weight gain in an elderly patient with unintentional weight loss, drugs should not be considered first-line treatment. Even if drugs are successful in inducing weight gain, long-term effects on quality of life are unknown.