This year, more than 1311 physicians of all specialties responded to the survey . . . 287 of the respondents are psychiatrists. The charts you see show how those 287 responded to just a few of the survey questions. Read More
Psychiatric Times presents coverage of the US Psychiatric and Mental Health Congress, covering the latest research on the assessment and treatment of psychiatric disorders. PsychCongress 2012 is on November 8-11 in San Diego, California. Read More
In this video, Senior Advisor to the NIMH Director and Professor of Psychiatry at Georgetown University School of Medicine explains how some of the latest developments in neuroscience can be used in everyday practice to treat bipolar and other mental disorders. Read More
We've put many of the clinical scales online, hoping healthcare professionals—whether in specialty practices, primary-care settings, or emergency services—will find this format convenient. … Read More
Osteoporosis is a disorder characterized by low bone mass and microarchitectural deterioration with resulting compromised bone strength and increased risk of fracture.1 The World Health Organization defines osteoporosis based on T-scores, which reflect bone mineral density (BMD) relative to mean BMD for healthy 25-year-old same-sex populations. A... More »
Hepatitis C is a common cause of chronic liver disease, often leading to immunosuppressive therapy and hepatic transplantation in some cases. Comorbid substance use disorders may complicate treatment for both the hepatologist and psychiatrist. Comprehensive assessment of psychiatric illness and psychopharmacological management may be critical. More »
Telepsychiatry has been hailed as the future of psychiatry. Proponents have claimed that it can reduce costs and allow access to difficult-to-reach patients. What are the promises and pitfalls of this new technology? More »
There are approximately 1 million divorces in the United States each year. When disputes arise concerning custody and visitation, mental health care professionals can inform and assist judges by performing competent custody evaluations that are conducted in an unbiased and systematic manner, consider the critical factors relevant to the court, and... More »
The issue of psychiatrists serving as forensic expert witnesses has long been controversial. What are the rules for serving as an expert witness, and what is expected of a psychiatrist who serves as an expert witness? More »
Whenever a suicide happens in the New Asylums, a palpable, muted dread descends over the institution...it is added as another sedimentary layer to the strata and culture of the particular institution. Before things get too deeply buried, it is important to excavate...
Gabe was in prison for killing a prostitute. During a bout of hyper-sexuality, intoxication, and paranoia, he believed the prostitute intended to rob him.
Here, Psychiatric Times presents the first recorded version of Dr James Knoll's Tales from the New Asylum—Yesterday. Download, listen, enjoy. "He was five floors up, grasping the outside railing of a medium-security prison dormitory balcony . . ."
Hypernatremia has been causally linked with subdural hematoma (SDH), but more recently this has been called into question. Conversely, there is a well-established link between SDH and injury. We wish to examine the evidence base that hypernatremia in infants and young children causes SDH.We present 2 cases of children with severe hypernatremia whose intracranial contents were assessed by imaging in the first case and postmortem examination in the second. Neither demonstrated SDH. The first case was important as the hypernatremia was iatrogenic occurring in a controlled hospital environment.We also searched the literature from 1950 to 2007, collecting data on all reported cases of hypernatremia in children younger than 7 years whose intracranial contents were examined by imaging, surgery, and/or postmortem examination. Of 124 cases reported in 31 articles, 112 cases developed hypernatremia in the community, and 12 in the hospital. Subdural hematoma was demonstrated in 7 cases, all of
Several trials have demonstrated that oral delayed-release mesalamine might be administered once daily. We aimed to conduct a meta-analysis to investigate this.|A comprehensive and multiple-source literature search was carried out. Only randomized-controlled trials (RCTs) were investigated by comparing a once daily-dosing regime with a divided (twice or thrice daily)-dosing regime of oral delayed-release mesalamine formulations for induction or maintenance of remission in patients with mild-to-moderate ulcerative colitis. The quality of RCTs was assessed using the Jadad scores. Meta-analysis of pooled odds ratios was carried out using Review Manager 5.1.|Nine RCTs were finally included. With regard to meta-analyses for induction trials, there were no significant differences for all comparisons between the once daily and the divided groups, including maintenance of just clinical remission (P=0.52) and just endoscopic remission (P=0.23), maintenance of combined clinical and endoscopic
Previous reviews have reported cognitive and motor deficits in childhood and adolescence among individuals who later develop schizophrenia. However, these reviews focused exclusively on studies of individuals with affected relatives or on population/birth cohorts, incorporated studies with estimated measures of pre-morbid intelligence, or included investigations that examined symptomatic at-risk participants or participants 18 years or older. Thus, it remains unclear whether cognitive and motor deficits constitute robust antecedents of schizophrenia. Meta-analyses were conducted on published studies that examined cognitive or motor function in youth aged 16 years or younger who later developed schizophrenia or a schizophrenia spectrum disorder (SSD) and those who did not.|Twenty-three studies fulfilled the following inclusion criteria: (1) written in English; (2) prospective investigations of birth or genetic high-risk cohorts, or follow-back investigations of population samples; (3)
In the absence of photographic or DNA evidence, a credible eyewitness, or perpetrator confession, forensic evaluators in cases of alleged child sexual abuse must rely on psychosocial or "soft" evidence, often requiring substantial professional judgment for case determination. This article offers a three-part rebuttal to Herman's (2009 ) argument that forensic decisions based on psychosocial evidence are fundamentally unreliable and that this conclusion represents settled science. The article also discusses the potentially adverse consequences of Herman's proposed reforms to forensic practice on child protection and prosecution efforts.
Polychlorinated biphenyls (PCBs) are synthetic chlorinated hydrocarbons that have extensively polluted the environment and bioaccumulated in the food chain. PCBs have been deemed to be probable carcinogens by the Environmental Protection Agency, and exposure to high levels of PCBs has been consistently linked to increased risk of non-Hodgkin lymphoma (NHL). In the present article we present a forensic epidemiologic evaluation of the causal relationship between NHL and elevated PCB levels via application of the Bradford-Hill criteria. Included in the evaluation is a meta-analysis of the results of previously published case-control studies in order to assess the strength of association between NHL and PCBs, resulting in an odds ratio in which the lowest percentile PCB concentration (quartile, quintile, or tertile) has been compared with the highest percentile concentration in the study groups. The weight-adjusted odds ratio for all PCB congeners was 1.43 with a 95% confidence interval
Intraductal papillary mucinous neoplasm (IPMN) is a type of tumor that grows within the pancreatic ducts. It is a progress from hyperplasia to intraductal adenoma (IPMA), to noninvasive carcinoma, and ultimately to invasive carcinoma (IPMC). The objective of this study was to explore the molecular mechanism of the progression from IPMA to IPMC. By using the GSE19650 affymetrix microarray data accessible from Gene Expression Omnibus (GEO) database, we first identified the differentially expressed genes (DEGs) between IPMA and IPMC, followed by the protein-protein interaction and single-nucleotide polymorphism (SNP) analysis of the DEGs. Our study identified thousands of DEGs which involved regulation of cell cycle and apoptosis in this progression from IPMA to IPMC. Protein-protein interaction network construction found that MYC, IL6ST, NR3C1, CREBBP, GATA1 and LRP1 might play an important role in the progression. Furthermore, the SNP analysis confirmed the association between BRAC1
Single-strand conformation polymorphism by capillary electrophoresis (SSCP-CE) has been developed to detect single nucleotide mutations. This method is used to identify the ABO alleles A(1), A(1v), B, O(1), O(1v), and O(2) in this chapter. Four amplicons (112, 121, 123, and 160 bp) labeled with fluorescence are separately amplified by polymerase chain reaction from exons 6 and 7 of ABO gene. These four fragments are combined into a single tube for SSCP-CE analysis using native gel to identify their single nucleotide polymorphism. This method can fast screen ABO genotypes from unknown samples and will be valuable in clinical transfusion or forensic applications.
This article provides an overview of the challenges encountered by mental health staff involved in the transfer of offenders with mental health problems between prisons and secure hospital settings. The article presents a case study demonstrating the importance of identifying offenders with mental health needs to provide appropriate care and support, prevent further mental deterioration and reduce the risk of offenders harming themselves or others.
A high-profile diving death occurred in 2003 at the site of the wreck of the SS Yongala off the Queensland coast. The victim's buddy, her husband, was accused of her murder and found guilty of manslaughter in an Australian court. A detailed analysis of all the evidence concerning this fatality suggests alternative medical reasons for her death. The value of decompression computers in determining the diving details and of CT scans in clarifying autopsy findings is demonstrated. The victim was medically, physically and psychologically unfit to undertake the fatal dive. She was inexperienced and inadequately supervised. She was over-weighted and exposed for the first time to difficult currents. The analysis of the dive demonstrates how important it is to consider the interaction of all factors and to not make deductions from individual items of information. It also highlights the importance of early liaison between expert divers, technicians, diving clinicians and pathologists, if
The purpose of this article is to introduce the concept of the balanced scorecard into the laboratory management environment. The balanced scorecard is a performance measurement matrix designed to capture financial and non-financial metrics that provide insight into the critical success factors for an organization, effectively aligning organization strategy to key performance objectives. The scorecard helps organizational leaders by providing balance from two perspectives. First, it ensures an appropriate mix of performance metrics from across the organization to achieve operational excellence; thereby the balanced scorecard ensures that no single or limited group of metrics dominates the assessment process, possibly leading to long-term inferior performance. Second, the balanced scorecard helps leaders offset short term performance pressures by giving recognition and weight to long-term laboratory needs that, if not properly addressed, might jeopardize future laboratory performance.
Ancillary applications: drug prescription/dispensing and forensics. In: Laboratory medicine practice guidelines: guidelines and recommendations for laboratory analysis and application of pharmacogenetics to clinical practice.
Primary Care Can't Thrive Without Nurse Practitioners Courtney H. Lyder, ND, May 17, 2013 With a projected shortfall of primary-care physicians, it's time for alternate solutions to patient care. Nurse practitioners are one logical remedy.
Whenever a suicide happens in the New Asylums, a palpable, muted dread descends over the institution...it is added as another sedimentary layer to the strata and culture of the particular institution. Before things get too deeply buried, it is important to excavate...
Gabe was in prison for killing a prostitute. During a bout of hyper-sexuality, intoxication, and paranoia, he believed the prostitute intended to rob him.
Here, Psychiatric Times presents the first recorded version of Dr James Knoll's Tales from the New Asylum—Yesterday. Download, listen, enjoy. "He was five floors up, grasping the outside railing of a medium-security prison dormitory balcony . . ."
In the second in his series of podcasts, Dr Phillip Resnick answers questions psychiatrists often ask about assessing the risk of violence.
