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Biomedical subjects

M Berk

Publications and source records attributed to M Berk.

At least 55 records · Page 3Linked to original sources
PubMed1998

A double-blind randomised placebo controlled trial of postnatal norethisterone enanthate: the effect on postnatal depression and serum hormones.

OBJECTIVES: To determine the effect of postnatal administration of the long-acting progestogen contraceptive, norethisterone enanthate, on postnatal depression and on serum hormone concentrations, and their association with depression. DESIGN: Double-blind randomised placebo-controlled trial. SETTING: A tertiary care hospital in Johannesburg, South Africa. POPULATION Postnatal women using a non-hormonal method of contraception (n = 180). METHODS: Random allocation within 48 hours of delivery to norethisterone enanthate by injection, or placebo. MAIN OUTCOME MEASURES: Depression scores in the three months postpartum as rated by the Montgomery-Asberg Depression Rating Scale (MADRS) and the Edinburgh Postnatal Depression Scale (EPDS); 2. serum 17beta-oestradiol, progesterone, testosterone and the 17beta-oestradiol:progesterone ratio at six weeks postpartum. RESULTS: There was a chance excess of caesarean section deliveries in the progestogen group. Mean depression scores were significantly higher in the progestogen group than in the placebo group at six weeks postpartum (mean MADRS score 8.3 vs 4.9; P = 0.0111; mean EPDS score 10.6 vs 7.5; P = 0.0022). Mean serum 17beta-oestradiol and progesterone concentrations were significantly lower in the progestogen group compared with the placebo group at six weeks postpartum. There were no correlations between any of the hormone parameters and depression at six weeks except in the formula feeding subgroup of the placebo group, where formula feeding and 17beta-oestradiol concentrations were positively associated with depression. CONCLUSIONS: Long-acting norethisterone enanthate given within 48 hours of delivery is associated with an increased risk of developing postnatal depression and causes suppression of endogenous ovarian hormone secretion.

Adult↗
PubMed1998

Anesthetic induction for ECT with etomidate is associated with longer seizure duration than thiopentone.

Many factors influence seizure duration associated with electroconvulsive therapy (ECT). This is a chart review study to assess seizure duration measured with both electroencephalography and electromyography after anesthetic induction with either thiopentone or etomidate. Thirty-seven patients receiving ECT for depression were entered into the study, and a pair of seizures was measured from each patient. Alternate induction agents were used in sequential pairings, and the study was controlled for interval between seizures, laterality, and percent energy. Etomidate was associated with a significantly (p = 0.0002, F = 15.84, df = 1, analysis of variance) longer seizure duration (mean = 34.43 s, SD = 16.06) than thiopentone (mean = 21.73 s, SD = 9.33).

Adolescent↗
PubMed1998

Citalopram enhances the activity of chloroquine in resistant plasmodium in vitro and in vivo.

Citalopram, is an extremely potent inhibitor of neuronal serotonin reuptake. It is structurally unrelated to other antidepressants, but it contains the chemical features associated with reversal of drug resistance and exhibits minimal cardiotoxic side effects and fewer of the anticholinergic and adrenolytic side effects associated with other psychotropic agents. Sensitivity tests to citalopram alone and in combination with chloroquine were performed against chloroquine-resistant and chloroquine-sensitive strains of Plasmodium falciparum and Plasmodium chabaudi. Citalopram alone showed intrinsic activity against the chloroquine-resistant strains of P. falciparum (IC50 = 1.51 +/- .6 microM) but only limited activity against the chloroquine-sensitive strain (IC50 = 33.27 +/- 5.87 microM) and no activity in vivo. The interaction of chloroquine and citalopram in vitro resulted in a synergistic response in the chloroquine-resistant strain but there was no interaction between the drugs in the chloroquine-sensitive strain--a pattern found with other reversal agents. Citalopram enhanced chloroquine susceptibility in both strains of P. chabaudi, however, the potentiating effect was seen at lower doses in the chloroquine-resistant strain. The results of this study suggest that citalopram may have potential as a chemosensitizer in Plasmodium infections on the basis of the low toxicity of citalopram at concentrations potentiating chloroquine activity both in vitro and in vivo.

Animals↗
PubMed1998

Fluoxetine treatment of acral lick dermatitis in dogs: a placebo-controlled randomized double blind trial.

The aim of the study was to assess the efficacy and tolerability of fluoxetine treatment of acral lick dermatitis (ALD) in dogs and to investigate ALD as an animal model of obsessive-compulsive disorder (OCD). Sixty-three dogs with ALD were treated with fluoxetine 20 mg daily, or placebo, for 6 weeks. In the fluoxetine group, owners rated both appearance of the lesion (t = 10.2, df = 29, P < 0.0001) and licking behavior (t = 10.2, df = 29, P < 0.0001) as significantly improved by the end of the trial. Veterinarian-rated pre- and post-treatment photographs showed statistically significant improvement in the fluoxetine group (mean = 2.55). There were no significant changes in the placebo group as rated by owners and veterinarians. These results demonstrate the efficacy of fluoxetine in the treatment of ALD and lend further support to ALD as an animal model of OCD.

Animals↗
PubMed1998

Validation of the Edinburgh Postnatal Depression Scale on a cohort of South African women.

UNLABELLED: Postnatal depression occurs in 10-15% of women. The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item self-report scale designed specifically as a screening instrument for the postnatal period. It was initially validated for use in the UK, but has subsequently been validated for other communities. It has not been validated for an African community. OBJECTIVE: To determine whether the EPDS is a valid screening scale for depression in a Johannesburg community cohort. PARTICIPANTS AND SETTING: 103 women attending the postnatal clinic at Coronation Hospital, Johannesburg, South Africa. METHOD: The EPDS was validated against the Diagnostic and Statistical Manual (DSM-IV) criteria for depression. It was administered verbally to participants and translated into one of six South African languages where necessary. RESULTS: A threshold of 11/12 on the EPDS identified 100% of women with major depression and 70.6% of women with minor depression. For major and minor depression combined, sensitivity was 80%, specificity 76.6%, positive predictive value 52.6% and negative predictive value 92.2%. CONCLUSION: The EPDS, administered verbally, is a valid screening instrument in this urban South African community.

Cohort Studies↗
PubMed1997

Mice lacking the ski proto-oncogene have defects in neurulation, craniofacial, patterning, and skeletal muscle development.

The c-ski proto-oncogene has been implicated in the control of cell growth and skeletal muscle differentiation. To determine its normal functions in vivo, we have disrupted the mouse c-ski gene. Our results show a novel role for ski in the morphogenesis of craniofacial structures and the central nervous system, and confirm its proposed function as a player in skeletal muscle development. Homozygous mutant mice show perinatal lethality resulting from exencephaly, a defect caused by failed closure of the cranial neural tube during neurulation. The timing of the neural tube defect in ski -/- embryos coincides with excessive apoptosis in the cranial neuroepithelium, as well as in the cranial mesenchyme. Homozygous ski mutants also exhibit a dramatic reduction in skeletal muscle mass, consistent with a defect in expansion of a myogenic precursor population. Nestin is an intermediate filament expressed in highly proliferative neuroepithelial stem cells and in myogenic precursors. Interestingly, we find decreased nestin expression in both the cranial neural tube and the somites of ski -/- embryos, compared with their normal littermates, but no reduction of nestin in the caudal neural tube. These results are consistent with a model in which ski activities are required for the successful expansion of a subset of precursors in the neuroepithelial or skeletal muscle lineages.

Animals↗
PubMed1997

The augmented platelet intracellular calcium response to serotonin in anorexia nervosa but not bulimia may be due to subsyndromal depression.

OBJECTIVE: Serotonergic dysregulation is associated with both bulimia and anorexia nervosa. This study attempted to measure the levels of basal and serotonin-stimulated intracellular calcium in patients with bulimia and anorexia Nervosa. METHOD: In this study, basal levels of platelet intracellular calcium as well as the effects of serotonin on intracellular calcium were studied using the Fura-2 method in subjects with bulimia (N = 11), anorexia nervosa (N = 12), and in matched normal controls (N = 17). Depressed patients, defined as meeting DSM-IV criteria for major depression or having a Hamilton Depression Scale score over 16 were excluded from the study. RESULTS: An enhanced serotonin-mediated mobilization of intracellular calcium was found in anorexia compared to both bulimics and controls at serotonin concentrations of 100 nM (p < .002), 500 nM (p < .001), and 1 microM (p < .001, ANOVA), respectively. However, when the anorexic group was subdivided into high and low Hamilton Depression scale groups, only the high Hamilton group demonstrated an augmented intracellular response to serotonin, with the low Hamilton group not differing from controls. DISCUSSION: These results suggest that the augmented intracellular calcium response to serotonin in anorexia may be due to subsyndromal depression in that group rather than to a primary eating disorder.

Adult↗
PubMed1997

Acute phase proteins in major depression.

Extensive evidence exists associating depression with changes in the immune system. The present study evaluates the levels of complement components C3 and C4, C-reactive proteins, and IL-6 in patients who met DSM-III-R diagnostic criteria for major depressive disorder, as well as controls. Whereas no significant differences between the mean levels of C3 could be detected between depressed patients and controls, the levels of C4, IL-6 (where detected), and C-reactive protein were significantly raised in the group with a depressive disorder. Our study suggests an interaction between psychological state and immune systems operative in host defenses.

Acute-Phase Proteins↗
PubMed1997

A neuropsychological study of prefrontal lobe function in the positive and negative subtypes of schizophrenia.

The symptoms of schizophrenia are frequently divided into positive and negative subtypes. It has been suggested that the negative symptoms are similar to those seen with prefrontal lobe cortical dysfunction. Several neuropsychological investigations of that hypothesis have been carried out, but none have directly compared a negative symptom group with a positive symptom group on the same test battery. In the present study, the Positive and Negative Syndrome Scale (PANSS; Kay, Fiszbein, & Opler, 1987) was used to distinguish two groups of 20 patients with schizophrenia with predominant positive or negative symptoms. A battery of 7 neuropsychological tests considered capable of isolating prefrontal lobe dysfunction was administered. A significant group difference was noted on 6 of the tests; the negative symptom group performed much worse than the positive symptom group. The results of this study support the hypothesis that a relationship exists between the negative symptoms of schizophrenia and prefrontal lobe dysfunction.

Adolescent↗
PubMed1997

An open-label study of duloxetine hydrochloride, a mixed serotonin and noradrenaline reuptake inhibitor, in patients with DSM-III-R major depressive disorder. Lilly Duloxetine Depression Study Group.

Duloxetine hydrochloride, a mixed reuptake inhibitor of serotonin and noradrenaline, was studied in a 6 week open-label uncontrolled multicentre design at a dose of 20 mg daily both in in- and outpatients meeting DSM-III-R criteria for unipolar major depressive disorder. Seventy-nine patients took part in the study. The mean score on the 17-item Hamilton Depression Rating Scale at baseline was 24.9 (SD 4.4), decreasing to 8.5 (SD 7.8) after 6 weeks using a last observation carried forward analysis. Clinical response, defined as a 50% reduction in 17-item Hamilton Depression Rating Scale scores, occurred in 78.2% of patients, whereas remission, defined as a 17-item Hamilton Depression Rating Scale score of < or = 6, occurred in 60.3% of patients. Duloxetine hydrochloride was safe and well tolerated in this patient population.

Adolescent↗
PubMed1996

Antidepressant induced mania in obsessive compulsive disorder.

Five cases of obsessive compulsive disorder (OCD) and antidepressant (clomipramine, fluoxetine and citalopram) treatment emergent manic symptoms are presented. This is of relevance in terms of management, and may suggest an association between OCD and bipolar disorder.

Adult↗
PubMed1996

Lithium blocks 45Ca2+ uptake into platelets in bipolar affective disorder and controls.

The basal uptake of radiolabelled 45Ca2+ into platelets and the effect of 1 mM lithium on uptake was measured in manic (n = 13) and depressed (n = 15) patients with bipolar disorder and in controls (n = 13). Lithium was significantly associated with inhibition of uptake of 45Ca2+ into platelets in all three groups. There were no significant intergroup differences in either basal levels of calcium uptake or the effects of lithium on calcium uptake (analysis of variance).

Adult↗
PubMed1996

Season of birth and schizophrenia: southern hemisphere data.

OBJECTIVE: The association between winter birth and increased incidence of schizophrenia is well documented in the northern hemisphere. The present study examined season of birth and schizophrenia in a southern hemisphere population from a mild temperate climate. METHOD: The seasonal incidence of birth in schizophrenic patients was compared, using Chi-squared tests, to normative population birth rates. RESULTS: A statistically significant seasonal pattern, with a peak in late spring and early summer, was obtained. CONCLUSION: This supports northern hemisphere findings regarding calendar month, but not season, of excess schizophrenic births. This has implications for viral and other aetiological hypotheses dependent on meteorological factors.

Birth Rate↗
PubMed1996

Superiority of lithium over verapamil in mania: a randomized, controlled, single-blind trial.

BACKGROUND: Both case reports and small controlled studies suggest the efficacy of verapamil in the treatment of mania. METHOD: Forty patients with DSM-IV mania were studied in a 28-day randomized, controlled, single-blind trial of either lithium or verapamil. RESULTS: The patients receiving lithium showed a significant improvement on all rating scales (Brief Psychiatric Rating Scale [BPRS], Mania Rating Scale [MRS], Global Assessment of Functioning [GAF], and Clinical Global Impression [CGI]) compared with those receiving verapamil. The mean MRS score at Day 28 in the lithium group was significantly lower than that in the verapamil group (17.47 vs. 24.43, respectively; F = 6.17, df = 1, p = .018). A similar pattern was seen with the BPRS (12.68 vs. 20.57; F = 10.69, df = 1, p = .002), CGI (2.31 vs. 3.33; F = 6.05, df = 1, p = .019), and GAF (43.52 vs. 52.31; F = 4.36, df = 1, p = .044) (ANCOVA). CONCLUSION: This study suggests that lithium is superior to verapamil in the management of acute mania.

Acute Disease↗
PubMed1996

Lyme disease in South Africa.

OBJECTIVE: This article presents an overview of Lyme disease (LD) as it applies to neuropsychiatry and summarises research results on the epidemiology of LD in South Africa. METHOD: The study is based on a review of research papers from various medical disciplines that focused on the epidemiology of LD in South Africa. RESULTS: Assessment of the incidence of LD in South Africa is based on a few anecdotal studies. The results of the studies are dominated by experimental weeknesses. CONCLUSIONS: The sporadic nature of LD Incidence in South Africa may either reflect a restriction of research efforts or be a true indication of the epidemiology of the disease. This review lends support to the former hypothesis. The low reported incidence of LD in South Africa is probably due to a lack of awareness and research effort.

Humans↗