Media and Book Reviews.

Media and book reviews.

Filed under: Depression Treatment

Neurology. 2012 Dec 11; 79(24): e209

At first glance, Neurobiology of the Parental Brain, edited by Robert S. Bridges, seems to be a textbook from which many students of neurology-ranging from medical students on up to clinical neurologists-could benefit. A quick look on the back cover reveals a range of topics that the book covers, including postpartum depression, maternal anxiety, and imaging the parental brain. After that first glance at the back cover, a closer look at the text reveals that in practice, this book may have a much narrower audience than originally anticipated. Of the book’s 34 chapters, 23 focus virtually exclusively on animal research. Another chapter includes a mathematical model for the roles of oxytocin and dopamine on mating-induced secretion of the hormone prolactin. For the neurologist interested in delving deeper into the broad topic of the neurobiology of being a parent, these chapters may offer many insights: the text includes information on parenting in the prairie vole, the family unit of marmoset monkeys, the effects of hormones on rat mothers and babies, and the differential equations used to model the effects of dopamine and oxytocin on prolactin rhythm. However, for those looking to simply gain some basic knowledge on the neurologic basis of being a (human) mother or father, these 2 dozen chapters will likely be judged as too specialized to offer high-yield information, and will likely be skimmed or skipped entirely.
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Diagnostic and therapeutic challenges in the thrombotic thrombocytopenic purpura and hemolytic uremic syndromes.

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Hematology Am Soc Hematol Educ Program. 2012; 2012: 604-9
George JN, Al-Nouri ZL

Evaluation and management of patients with suspected thrombotic thrombocytopenic purpura (TTP) continue to be a critical challenge for hematologists. The diagnostic criteria are not precise, often causing uncertainty about whether it is appropriate to initiate plasma exchange (PEX), the essential treatment for TTP. Initiation of PEX remains a clinical decision; severe ADAMTS13 (< 10% activity) deficiency alone is neither sufficiently sensitive nor specific for the diagnosis of TTP. However, patients who do have severe acquired ADAMTS13 deficiency define the characteristic clinical features of TTP, the response to treatment, and the long-term outcomes. Patients with severe acquired ADAMTS13 deficiency are predominantly young women and the relative frequency of blacks is increased. Patients may present with only microangiopathic hemolytic anemia and thrombocytopenia, neurologic and renal abnormalities are often not present, fever rarely occurs; the complete "pentad" of these clinical features almost never occurs in current practice. Response to PEX is typically rapid but may not be sustained when PEX is stopped. Use of corticosteroids and rituximab has decreased the number of PEX treatments required to achieve a remission and has resulted in fewer PEX-related major complications. Relapse (in approximately 40% of patients) may be the most apparent risk after recovery, but long-term health outcomes are also very important. Minor cognitive abnormalities are common, the frequency of depression is increased, and the frequency of hypertension is increased. Careful long-term follow-up of TTP patients is essential. HubMed – depression

 

Mental illness in homicide-suicide: a review.

Filed under: Depression Treatment

J Am Acad Psychiatry Law. 2012; 40(4): 462-8
Roma P, Pazzelli F, Pompili M, Lester D, Girardi P, Ferracuti S

Homicide followed by suicide (H-S) is a lethal event in which an individual kills another individual and subsequently dies by suicide. This article presents a review of research carried out in Asia, Australia, Canada, Europe, and the United States of America over the past 60 years on the prevalence of mental illness among the perpetrators of H-S. Analysis of the available data indicated a great disparity in the results of the different studies. Overall, depression was the most frequent disorder reported (about 39% of the cases in the 20 studies that assessed depressive disorders), followed by substance abuse (about 20% in 10 studies) and psychosis (about 17% in 11 studies). This review, therefore, indicated that mental illness plays an important role in H-S. The prevention of these events depends on the identification and treatment of psychiatric disorder in potential perpetrators.
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