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Valproic Acid and hypersensitivity syndrome.
Roepke S, Treudler R, Anghelescu I, Orfanos CE, Tebbe B.
Publication Types:
PMID: 14992991 [PubMed - indexed for MEDLINE]
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Completed suicide after a suicide attempt: a 37-year follow-up study.
Suominen K, Isometsa E, Suokas J, Haukka J, Achte K, Lonnqvist J.
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland. kirsi.suominen@ktl.fi
OBJECTIVE: Attempted suicide is the strongest known predictor of completed suicide. However, suicide risk declines over time after an attempt, and it is unclear how long the risk persists. Risk estimates are almost exclusively based on studies of less than 10 years of follow-up. METHOD: The authors followed a cohort of 100 consecutive self-poisoned patients in Helsinki in 1963, for whom forensically classified causes of death during the following 37 years were investigated. RESULTS: They found that suicides continued to accumulate almost four decades after the index suicide attempt. CONCLUSIONS: A history of a suicide attempt by self-poisoning indicates suicide risk over the entire adult lifetime.
PMID: 14992984 [PubMed - indexed for MEDLINE]
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Neurocognitive dysfunction in first-episode psychosis: correlates with symptoms, premorbid adjustment, and duration of untreated psychosis.
Rund BR, Melle I, Friis S, Larsen TK, Midboe LJ, Opjordsmoen S, Simonsen E, Vaglum P, McGlashan T.
Department of Psychiatry, Ulleval University Hospital, Oslo, Norway. b.r.rund@psykologi.uio.no
OBJECTIVE: The authors examined the relationship of neurocognitive function with duration of untreated psychosis, premorbid illness factors, and clinical symptoms to determine whether long duration of untreated psychosis independently compromises cognitive function. METHOD: Patients recruited to a study of the effect of an early detection program on the duration of untreated first-episode psychosis in two catchment areas were compared to patients in a similar treatment program in two other catchment areas without an early detection program. The median duration of untreated psychosis was 10.5 weeks for all patients. A total of 301 patients entered the study, and 207 completed a comprehensive neuropsychological test battery that assessed working memory/fluency, executive function, verbal learning, impulsivity, and motor speed. The median time from start of treatment to neuropsychological testing was 108 days; all patients were tested within 9 months. RESULTS: No significant association was found between duration of untreated psychosis and any of the cognitive measures. Strong associations were demonstrated between poorer premorbid school functioning and neurocognitive deficits, especially in verbal learning and working memory. No relationship was found between neurocognitive functions and clinical measures, except for an inverse correlation of Positive and Negative Syndrome Scale negative symptoms and working memory and a positive correlation between positive symptoms and motor speed. CONCLUSIONS: The data contribute to a disconfirmation of the hypothesis of an association between duration of untreated psychosis and neurocognitive performance at baseline.
PMID: 14992972 [PubMed - indexed for MEDLINE]
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Mania during treatment of chronic hepatitis C with pegylated interferon and ribavirin.
Onyike CU, Bonner JO, Lyketsos CG, Treisman GJ.
Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA. conyike1@jhem.jhmi.edu
Publication Types:
- Case Reports
- Clinical Conference
PMID: 14992966 [PubMed - indexed for MEDLINE]
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Lower risk for tardive dyskinesia associated with second-generation antipsychotics: a systematic review of 1-year studies.
Correll CU, Leucht S, Kane JM.
Department of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Schneider Children's Hospital, Glen Oaks, NY 11004, USA. ccorrell@lij.edu
OBJECTIVE: Based on lower rates of acute extrapyramidal side effects associated with second-generation antipsychotics, compared to first-generation antipsychotics, and based on preliminary data, second-generation antipsychotics are expected to cause less tardive dyskinesia than first-generation antipsychotics. This hypothesis was examined in a systematic review of studies involving open or controlled treatment with any second-generation antipsychotic. METHOD: Studies of treatment with second-generation antipsychotics lasting > or =1 year and reporting on new cases of tardive dyskinesia or dyskinesia were systematically reviewed. RESULTS: In 11 studies, 2,769 patients received treatment with risperidone (five studies, N=1,235), olanzapine (two studies, N=610), quetiapine (two studies, N=386), amisulpride (one study, N=331), or ziprasidone (one study, N=207) for a weighted mean and median duration of 263 and 306 days, respectively. Study designs were double blind and randomized (N=3); open-label extensions of double-blind, randomized trials (N=4); and open label (N=4). Of the four trials that had a comparator (all involving adults with schizophrenia spectrum disorders), three used haloperidol (N=408) and one used placebo (N=71). Studied populations included children (N=77), adults (N=1,419), adults and elderly persons (N=794), and exclusively patients age 54 years or older (N=479). The weighted mean annual incidence of tardive dyskinesia for second-generation antipsychotics was 0% in the children, 0.8% (range=0.0%-1.5%) in the adults, 6.8% in the mixed adult and elderly population, and 5.3% (range=0.0%-13.4%) in the patients age 54 years and older, compared to 5.4% (range=4.1%-7.4%) in adults treated with haloperidol. CONCLUSIONS: Results from 11 long-term studies support the idea that second-generation antipsychotics have a reduced risk for tardive dyskinesia, compared to first-generation antipsychotics, although the doses of haloperidol used in the comparator studies were relatively high. More carefully designed studies, ideally lasting beyond 1 year and comparing the effects of different second-generation antipsychotics in patients who have never taken first-generation antipsychotics, are needed to estimate the true risk. It would not appear premature for clinicians to consider these findings in making long-term treatment decisions.
Publication Types:
PMID: 14992963 [PubMed - indexed for MEDLINE]
New case of acute hepatitis following the consumption of Shou Wu Pian, a Chinese herbal product derived from Polygonum multiflorum.
Mazzanti G, Battinelli L, Daniele C, Mastroianni CM, Lichtner M, Coletta S, Costantini S.
Publication Types:
PMID: 15069011 [PubMed - indexed for MEDLINE]
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Montelukast-induced hepatitis.
Goldstein MF, Anoia J, Black M.
Publication Types:
PMID: 15069001 [PubMed - indexed for MEDLINE]
Acute pancreatitis induced by telmisartan overdose (June).
Baffoni L, Durante V, Grossi M.
Emergency Department, Rimini Hospital, Via Parmense 18, 47900 Rimini, Italy, strocchi@med.unibo.it
PMID: 15100392 [PubMed - as supplied by publisher]
Lepromatous leprosy and reversal reaction in a Micronesian immigrant.
Ross RR, Herron MD, Florell SR.
Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
A 25-year-old Micronesian man from the island of Otia developed erythematous plaques on his legs. He was diagnosed with erythema nodosum and treated with systemic prednisone. Two months later, he presented with erythematous nodules on his forehead, cheeks, and chin (Fig. 1). Examination revealed scattered violaceous papules on his chest, arms, forearms, hands, and feet, and deep purple macules on his palms and soles. Laboratory evaluation included negative serologies for human immunodeficiency virus, rapid plasma reagin, and hepatitis A, B, and C. Routine histopathology revealed nodular aggregates of histiocytes, plasma cells, and lymphocytes. Histiocytes showed basophilic clusters of organisms within vacuoles, suggesting globi. Acid-fast stain revealed numerous acid-fast-positive rod-shaped organisms. The bacterial index on the Fite stain was four (bacterial index/Ridley's logarithmic scale, indicating 10-100 bacteria/high power field) (Fig. 2). An acid-fast stain obtained from a smear of tissue was positive for acid-fast bacilli, but no acid-fast bacilli were cultured. After the first day of treatment with dapsone 100 mg, rifampin 600 mg, and clofazimine 50 mg, the patient complained of burning and pain in his ankles and wrists. There was intense erythema within the lesions. Edema developed in his hands and feet. Consultation with the Gillis W. Long Hansen's Disease Center in Carville, Louisiana, recommended prompt treatment with corticosteroids. The edema of the hands and wrists was treated as a type I reversal reaction with prednisone 1 mg/kg/day. Subsequently, the edema and neuralgia quickly resolved in his distal extremities.
Publication Types:
PMID: 14636206 [PubMed - indexed for MEDLINE]
Carbon monoxide poisonings resulting from open air exposures to operating motorboats--Lake Havasu City, Arizona, 2003.
Centers for Disease Control and Prevention (CDC).
During February 1997-August 2002, two fatal and six nonfatal cases of carbon monoxide (CO) poisoning occurred in vacationers who were wading in or boating near the Bridgewater Channel of Lake Havasu (Lake Havasu City [LHC], Arizona). The vacationers were near operating motorboats, primarily in the channel area, where large numbers of boaters congregate during holiday weekends. One person had a carboxyhemoglobin (%COHb) level of 40% on autopsy. To evaluate CO exposure among municipal employees working in the channel, CDC and the Havasu Regional Medical Center Emergency Department (HRMCED) conducted an initial investigation during Labor Day weekend 2002 (August 31-September 1). CO concentrations in channel air exceeded all short-term exposure criteria; four of 12 patients reporting to HRMCED because of boating-related activities had %COHb levels of >9%. In May 2003, LHC requested assistance from CDC, the Mohave County Department of Public Health (MCDPH), the Arizona Department of Health Services (ADHS), and a private consulting firm to assess CO exposures in the channel during Memorial Day weekend 2003 (May 23-26). Follow-up environmental surveys were conducted during June-September 2003. This report summarizes the findings of these surveys, which documented excessive CO exposure and confirmed the health risk among vacationers and employees working in the channel near crowded motorboat gatherings. Community leaders and safety officials should 1) be aware that employees and vacationers in close proximity to operating motorboats can be exposed to potentially lethal levels of CO, 2) evaluate exposures, and 3) take steps to prevent poisonings.
PMID: 15103294 [PubMed - indexed for MEDLINE]
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