Objective: To report a case of a patient treated with clozapine who developed pericarditis with pericardial effusion that resolved when the drug was discontinued. Method: Case report of a 21-year-old man with psychotic disorder that had been stable on clozapine therapy for five months (after failure of atypical antipsyhotic agents) presented to the emergency department complaining of chest pain and progressive shortness of breath that had lasted for a few days. Echocardiography showed a pericardial effusion suggestive of a cardiac tamponade, and the fluid was removed by pericardiocentesis. All other possible causes of the pericardial effusion were ruled out and clozapine was suspected as the most likely explanation. Clozapine was discontinued and the patient's symptoms improved markedly. Discussion: According to the Naranjo probability scale, clozapine is a probable cause of pericarditis. Although clozapine is a known cause of myocarditis and cardiomyopathy, there are only several reports in the literature describing clozapine-induced pericarditis and pericardial effusion. In our patient, the pericardial effusion cleared within several days following clozapine discontinuation. Conclusion: There have been only a few cases of clozapine-induced pericarditis reported in the literature, however this adverse effect of clozapine can occur, as this case report clearly demonstrates. Cardiac adverse effects of clozapine are potentially life threatening, hence early recognition is essential to prevent serious outcomes.

gained inspiration into making good lifestyle choices. A nursing research project designed as a research in action project was established. Method: Firstly a hermeneutic-phenomenological study was designed intended to gain insight in patient outcome from lifestyle conversation. Qualitative analyses of interviews was used. Secondly a programme was planned to create awareness of nursing conduct in these situations and thirdly another study investigated the impact of the new nursing methods. Six patients were interviewed five to six months after discharge. Seven were interviewed after the changes in communication. Results: The research showed that patients treated for ischaemic heart disease after five to six months were having difficulties remembering even having had a conversation with a nurse about lifestyle changes. It was established that knowledge was lectured on to the patient, the patient did not set the agenda and they were not met as an individual person, all which did not create meaningfulness within the patient. Developing a written invitation to a conversation is the most visible outcome. Having the conversation in a separate room and leaving the patients time to prepare a few hours before the conversation is another. Changing nurses' approach and communication skills through learning about empowerment philosophy and Self Determination Theory is an ongoing priority. Findings from new interviews show more verbalized determination in making lifestyle changes. Conclusions: Shared responsibility between the patient and the nurse into what they want to discuss with a nurse has a positive effect on what they remember and incorporate into their lifestyle in future.

Сажетак Увод. Утицај гојазности на развој кардиоваскуларних болести, првенствено исхемијске болести срца (ИБС), објашњава се њеним двоструким деловањем: директним, непосредним утицајем на настанак атеросклерозе и индиректно, агравирајућим ефектом на друге факторе ризика (артеријска хипертензија, шећерна болест, хиперлипопротеинемија). Циљ. Утврдити повезаност антропометријских параметара и параметара телесне композиције са параметрима фактора ризика за исхемијску болест срца. Материјал и методе. Испитивање је обухватило 200 пацијената (100 мушкараца и 100 жена) са дијагнозом ИБС, старосне доби од 18 до 65 година. Подаци су прикупљени током кардиолошке контроле у Дому здравља "Нови Сад" у периоду 2007-2008. године и чине их резултати добијени из медицинске документације, физикалним прегледом, антропометријским мерењима и лабораторијским анализама. Резултати. Пацијенти са хипертензијом били су у великом проценту гојазни, 81% жене, 56% мушкарци (p<0,05). Повишен ниво триглицерида имали су гојазни испитаници у односу на нормално ухрањене категорисане према процентуалном учешћу масне масе у телу (p<0,05). Испитаници са централним типом гојазности имали су повишене вредности нивоа гликемије и триглицерида у односу на испитанике са периферним типом гојазности (p<0,05).