Postpartum psychiatric disorders

Pregnancy is a complex and vulnerable period that presents a number of challenges to women, including the development of postpartum psychiatric disorders (PPDs). These disorders can include postpartum depression and anxiety, which are relatively common, and the rare but more severe postpartum psychosis. In addition, other PPDs can include obsessive–compulsive disorder, post-traumatic stress disorder and eating disorders. The aetiology of PPDs is a complex interaction of psychological, social and biological factors, in addition to genetic and environmental factors. The goals of treating postpartum mental illness are reducing maternal symptoms and supporting maternal–child and family functioning. Women and their families should receive psychoeducation about the illness, including evidence-based discussions about the risks and benefits of each treatment option. Developing effective strategies in global settings that allow the delivery of targeted therapies to women with different clinical phenotypes and severities of PPDs is essential

The Effect of Endothelium on the Response To Propofol on Bovine Coronary-Artery Rings

WOS: A1995TG82700018PubMed ID: 8607314In this study the effect of propofol on isolated bovine coronary artery tone was studied in artery rings precontracted with PGF(2 alpha). Propofol, in concentrations of 10(-6)-10(-5) M did not change vascular smooth muscle tone, but at high concentrations (10(-4)10(-1) M) produced relaxation in rings with intact endothelium. In rings denuded of endothelium or treated with methylene blue, propofol produced relaxation at 10(-3)-10(-1) M concentrations, but there was a significant decrease in relaxation compared to endothelium intact rings. In the presence of a calcium agonist (Bay K 8644; 10(-5) M), propofol produced constriction in rings denuded of endothelium. These results suggest that high concentrations of propofol may hale vasorelaxant effect on bovine coronary artery and that these effects may be due to actions on the endothelium and mediated by calcium channels

Relative performance of commonly used physical function questionnaires in rheumatoid arthritis and a patient-reported outcomes measurement information system computerized adaptive test

OBJECTIVE: To evaluate and compare the measurement precision and sensitivity to change of the Health Assessment Questionnaire disability index (HAQ DI), the Short Form 36 physical functioning scale (PF-10), and simulated Patient-Reported Outcomes Measurement Information System (PROMIS) physical function computer adaptive tests (CATs) with 5, 10, and 15 items, using item response theory-based simulation studies. METHODS: The measurement precision of the various physical function instruments was evaluated by calculating root mean square errors (RMSEs) between true physical function levels (latent physical function score) and estimated physical function levels. Measurement precision was evaluated at 9 levels of physical function, with 5,000 simulated response patterns per level. Sensitivity to change was evaluated by the ability of a simple statistical test to detect simulated change scores of small to moderate magnitude (standardized effect sizes 0.20, 0.35, and 0.50). RESULTS: RMSEs were smaller for the PROMIS physical function 15-item CAT (CAT-15) and CAT-10 than for the HAQ DI and PF-10 across all levels of the latent physical function scale. Only marginal improvement in performance was observed for the CAT-15 compared with the CAT-10, and the CAT-5 performed quite similarly to the HAQ DI and PF-10 across most levels of the latent physical function scale. Substantially improved sensitivity to change was observed for the CAT-10 compared with the HAQ DI and PF-10, particularly in detecting moderate effect sizes. CONCLUSION: Clearly higher measurement precision was observed for the PROMIS CAT compared with the HAQ DI and PF-10. Higher reliability also translated into lower sample size requirements for detecting changes in clinical status