Background and AimBarrett's esophagus (BE) is a premalignant condition for esophageal adenocarcinoma. Although risk factors exist for screening patients in the West, we aimed to determine the factors in terms of demographics and symptoms for patients in an Asian setting.MethodsWe recruited 1378 patients over a 7‐year period as part of an ongoing gastric cancer screening program. An appropriately designed questionnaire was utilized to determine the necessary risk factors and symptoms with endoscopic analysis and subsequent histological confirmation as the gold standard. We utilized the existence of intestinal metaplasia of the distal esophagus as the primary diagnostic pathology.ResultsWe demonstrated that no symptoms were indicative of BE in an Asian setting. Age (odds ratio 1.081, 95% confidence interval 1.022–1.143) and male gender (odds ratio 4.808, 95% confidence interval 1.727–13.33) proved significant demographic factors for the presence of intestinal metaplasia (P 0.007, 0.003, respectively).ConclusionsWe advocate the utilization of increasing age and male gender as the primary risk factors for patients at risk of BE. We also recommend astute examination of the distal esophagus whilst patients undergo simultaneous gastric cancer screening.

Life expectancy in people with schizophrenia is 20% lower than in others, and men with schizophrenia die, on average, 20 years earlier than those without this condition. Although levels of suicide and other violent deaths are higher in people with schizophrenia, most of the increased mortality in this group is the result of higher levels of cardiovascular disease and other physical health problems. The major risk factors for cardiovascular disease include adverse lifestyle (cigarette smoking; physical inactivity; atherogenic diet), diabetes, dyslipidemia, hypertension, obesity, as well as non-modifiable risk factors such as age and family history of premature coronary heart disease.In the latest National Audit of Schizophrenia in UK, a major finding was the very significant deficiencies in the monitoring and management of physical health problems in people with schizophrenia. This finding prompted the College to work with several professional bodies to develop a quality improvement tool, the Lester Cardiometabolic Resource, to promote better physical health care for people with psychosis. The resource recommends these monitoring measures following initiation or change of antipsychotics and/or mood stabilizers: Weight -at baseline, weekly in the first 6 weeks, at 12 weeks and annually; Lifestyle review (i.e. smoking, diet and physical activity); Blood pressure (BP); Fasting plasma glucose (FPG)/HbA1c; Lipid profile -at baseline, at 12 weeks and annually; Personal/Family history of cardiovascular disease (CVD); Waist circumference (WC) -at baseline and annually.Here at the Institute of Mental Health, Singapore (IMH), the recommendation is for patients on atypical antipsychotics to have at least the following monitoring: Weight/BMI -at baseline and quarterly; WC -at baseline and annually; BP/FPG/Lipid profile -at baseline, at 12 th -24 th week and annually. In practice, there have been anecdotal reports of monitoring frequency far exceeding the recommended duration for various reasons.

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