These data suggest that AAP treatment is associated with specific representation of gut bacterial families in AAP-treated patients. In addition, AAP treatment is associated with decreased species richness in female AAP-treated patients.

It is important for clinicians to be able to recognize DIP and TD in patients using antipsychotics so that they can minimize the impact of these adverse events on their patients' quality of life. Accurate diagnosis will drive the selection of the correct treatment. Plain language summary available for this article.

Unless both entrance and exit sites are limited to the lower limbs, direct and splash lightning strikes cause myocardial damage as assessed by abnormal serum enzyme determinations or abnormal echocardiographic findings. Only direct hits resulted in echocardiographic abnormalities or a prolonged QTc interval. The degree of myocardial injury can be severe with left and right ventricular ejection fraction < 15% and can be reversible.

This dose-escalation study was performed to evaluate safety and efficacy of imiquimod 5% cream in the treatment of uncircumcised men with penile warts associated with the foreskin. The cream was applied 3 times/week (n=34) or once per day (n=30) over 8+/-2 h. Imiquimod 5% cream was safe in both treatment groups. However, the 3 times/week regimen was better tolerated with a lower incidence of local skin reactions. In both groups, the 2 most frequently reported local skin reactions were erythema and erosion; they were more severe with the once-daily dosing. The most frequently reported application site reactions were burning, pruritus and irritation or pain (once-daily patients only). Total clearance was achieved in 62% of the patients in the 3 times/week group and by 57% in the once-daily group. Thus, imiquimod 5% cream administered 3 times/week was the optimal dosing regimen in the treatment of penile warts in uncircumcised men.

Study Objective: Previous studies have identified shifts in gut microbiota associated with atypical antipsychotic (AAP) treatment, which may link AAPs to metabolic burden. Dietary prebiotics such as resistant starch may be beneficial in obesity and glucose regulation, but little is known mechanistically about its ability to modify gut microbiota in AAP-treated individuals. This investigation was undertaken to mechanistically delineate the effects of AAP treatment and resistant starch supplementation on gut microbiota in a psychiatric population. Design: Cross-sectional cohort study. Setting: The study was performed in an outpatient setting. Patients: Thirty-seven adults with a diagnosis of bipolar disorder or schizophrenia who were treated with an AAP (clozapine, olanzapine, risperidone, quetiapine, or ziprasidone [21 patients]) or lithium and/or lamotrigine (16 patients) for at least 6 months. Intervention: Patients in the AAP group received raw unmodified potato starch (resistant starch) daily for 14 days. Measurements and Main Results: Of the 37 patients, the mean ± SD age was 52.2 ± 12.5 years, and 57% were male. The primary outcome was gut microbiome DNA composition. Microbiome DNA obtained from stool samples from all patients was subject to 16S rRNA gene sequencing before and during resistant starch supplementation. Inter-and Intragroup microbial diversity measures were performed by permutational multivariate analysis of variance and Inverse

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