losartan-potassium and Psychotic-Disorders

Based on the established rhEPO treatment of anemia in endstage renal failure, which results in improved quality of life, and on the clinical observation that patients with postpartum anemia treated with rhEPO seemed to gain a more stable mood, we inferred that there is a beneficial side-effect of rhEPO on postpartum blues. The aim of this study was to test the hypotheses 1) that postpartum anemia aggravates, and 2) that treatment of postpartum anemia with rhEPO reduces maternity blues. The results show that on the fifth day postpartum anemic patients score consistently worse than nonanemic women on the Symptom Checklist SCL-90-R, indicating more symptoms and distress in general, and also more symptoms characteristic of maternity blues (p < 0.05). On a "Blues Questionnaire," postpartum anemia expresses itself with a reduced "well-being" (p < 0.001). Thus, our first hypothesis was verified. There were no differences by the fifth day postpartum between anemic patients receiving either rhEPO or placebo. Our second hypothesis was thus not confirmed within this limited time. We conclude as clinicians that postpartum anemia should be treated effectively to reduce distress and hence the risk for postpartum affective disorders. Follow-up studies after rhEPO treatment beyond the first week post partum are needed. In addition, in investigations on postpartum affective disorders, the hemoglobin concentration should be considered.

Topics: Anemia; Double-Blind Method; Erythropoietin; Female; Hematocrit; Hemoglobins; Humans; Placebos; Pregnancy; Prospective Studies; Psychotic Disorders; Puerperal Disorders; Recombinant Proteins

This article describes the method by which the repatriation to the Netherlands of psychiatric patients living abroad is carried out. On the basis of one case, namely that of a psychotic male with low Hb and fear of HIV, it is shown that the repatriation of psychiatric patients can be extremely complex and that a psychiatrist's active involvement in the patient's repatriation can be extremely important.

Topics: Adult; Anemia; Epoetin Alfa; Erythropoietin; Hematinics; Hemoglobins; Holidays; Humans; Male; Netherlands; Psychotic Disorders; Recombinant Proteins; Senegal; Transportation of Patients

Haemolytic anaemia is a well-recognised but rare complication of heart-valve prostheses. The authors report a case of an 80-year-old woman with severe haemolytic anaemia previously treated with valvuloplasty and annuloplasty without rings. To our knowledge, no cases of haemolysis have been described with this type of surgery.

Topics: Aged, 80 and over; Anemia, Hemolytic; Atrial Fibrillation; Diagnosis, Differential; Echocardiography; Echocardiography, Transesophageal; Erythrocyte Indices; Erythrocyte Transfusion; Erythropoietin; Female; Hematocrit; Hemoglobinometry; Humans; Mitral Valve Annuloplasty; Mitral Valve Insufficiency; Postoperative Complications; Psychotic Disorders; Recombinant Proteins; Respiratory Insufficiency; Suture Techniques; Ultrasonography, Doppler, Color