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Biomedical subjects

M P Freeman

Publications and source records attributed to M P Freeman.

18 recordsLinked to original sources
PubMed2006

Omega-3 fatty acids and perinatal depression: a review of the literature and recommendations for future research.

INTRODUCTION: Perinatal depression refers to major depression in the context of pregnancy and postpartum. In consideration of its prevalence and consequences, the treatment and prevention of perinatal depression should be important public health priorities. Omega-3 fatty acids are attractive for consideration in perinatal women, due to known health benefits for the mother and baby. Antidepressant medications may pose risks in utero and in breastfeeding. METHODS: MEDLINE and manual searches were conducted. RESULTS: Epidemiological and preclinical data support a role of omega-3 fatty acids in perinatal depression. Two studies failed to support a role of omega-3 fatty acids for postpartum depression prophylaxis, although one included a small sample, and the other utilized a low dosage. Two pilot studies suggest good tolerability and potential efficacy in the acute treatment of perinatal depression. CONCLUSIONS: Further research studies are warranted to determine the role of omega-3 fatty acids in the treatment of perinatal depression.

Depression, Postpartum↗
PubMed2006

Randomized dose-ranging pilot trial of omega-3 fatty acids for postpartum depression.

OBJECTIVE: Postpartum depression (PPD) affects 10-15% of mothers. Omega-3 fatty acids are an intriguing potential treatment for PPD. METHOD: The efficacy of omega-3 fatty acids for PPD was assessed in an 8-week dose-ranging trial. Subjects were randomized to 0.5 g/day (n = 6), 1.4 g/day (n = 3), or 2.8 g/day (n = 7). RESULTS: Across groups, pretreatment Edinburgh Postnatal Depression Scale (EPDS) and Hamilton Rating Scale for Depression (HRSD) mean scores were 18.1 and 19.1 respectively; post-treatment mean scores were 9.3 and 10.0. Percent decreases on the EPDS and HRSD were 51.5% and 48.8%, respectively; changes from baseline were significant within each group and when combining groups. Groups did not significantly differ in pre- or post-test scores, or change in scores. The treatment was well tolerated. CONCLUSION: This study was limited by small sample size and lack of placebo group. However, these results support further study of omega-3 fatty acids as a treatment for PPD.

Adult↗
PubMed2005

Bipolar disorder in women: reproductive events and treatment considerations.

OBJECTIVE: Bipolar disorders are prevalent in women. Women with bipolar disorder often present with different clinical features than men. Reproductive events and hormonal treatments may impact the course of bipolar disorder. Our main objectives are to i) assess the impact of reproductive events on the course of the disorder, and ii) to discuss the relationships between reproductive events and psychiatric treatments. METHOD: A literature search was conducted of MEDLINE journals from 1965 to present. Manual literature searches were also conducted. We review the presentation, clinical course, and treatment considerations of bipolar disorder in women, with emphasis on treatment considerations in the context of reproductive events. Treatment-related issues such as teratogenicity, breastfeeding, polycystic ovarian syndrome, weight gain and obesity, and medication interactions with oral contraceptives are reviewed. RESULTS: Women with bipolar disorder may be more vulnerable to mood episodes in the context of reproductive events, particularly postpartum. In women of reproductive age, mood stabilizers must be selected with teratogenic risks in mind, with the highest reported risks in pregnancy with valproate, and the greatest concern during breastfeeding with lithium use. In the areas of the perimenopause and polycycstic ovarian syndrome, more data are needed to advise treatment decisions. CONCLUSION: We urgently need further study in these areas to deliver care that is appropriate to women with bipolar disorder.

Anticonvulsants↗
PubMed2001

The in vivo fate of hydroxytyrosol and tyrosol, antioxidant phenolic constituents of olive oil, after intravenous and oral dosing of labeled compounds to rats.

In vitro studies have shown phenolics in olive oil to be strong radical scavengers. The absorption and elimination of two radiolabeled phenolic constituents of olive oil, hydroxytyrosol and tyrosol were studied in vivo using rats. Compounds were administered intravenously (in saline) and orally (in oil- and water-based solutions). For both compounds, the intravenously and orally administered oil-based dosings resulted in significantly greater elimination of the phenolics in urine within 24 h than the oral, aqueous dosing method. There was no significant difference in the amount of phenolic compounds eliminated in urine between the intravenous dosing method and the oral oil-based dosing method for either tyrosol or hydroxytyrosol. Oral bioavailability estimates of hydroxytyrosol when administered in an olive oil solution and when dosed as an aqueous solution were 99% and 75%, respectively. Oral bioavailability estimates of tyrosol, when orally administered in an olive oil solution and when dosed as an aqueous solution were 98% and 71%, respectively. This is the first study that has used a radiolabeled compound to study the in vivo biological fates of hydroxytyrosol and tyrosol.

Administration, Oral↗
PubMed2000

Omega-3 fatty acids in psychiatry: a review.

Omega-3 fatty acids are long-chain, polyunsaturated fatty acids found in plant and marine sources. Unlike saturated fats, which have been shown to have negative health consequences, omega-3 fatty acids are polyunsaturated fatty acids that have been associated with many health benefits. Omega-3 fatty acids may prove to be efficacious in a number of psychiatric disorders. Mood disorders have been associated with abnormalities in fatty acid composition. Several lines of evidence suggest that diminished omega-3 fatty acid concentrations are associated with mood disorders. Clinical data are not yet available regarding omega-3 fatty acids in the treatment of major depression. However, one double-blind treatment trial has been conducted in bipolar disorder. Also, substantial evidence does exist supporting a potential role of omega-3 fatty acids in schizophrenia, although treatment data are needed. A case has been reported in which a patient with schizophrenia was successfully treated with omega-3 fatty acids. Controlled studies are necessary to explore the potential treatment of schizophrenia with omega-3 fatty acids. Omega-3 fatty acids may also be helpful in the treatment of dementia. Furthermore, omega-3 fatty acids may prove to be a safe and efficacious treatment for psychiatric disorders in pregnancy and in breastfeeding.

Clinical Trials as Topic↗
PubMed1999

Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial.

BACKGROUND: Omega3 fatty acids may inhibit neuronal signal transduction pathways in a manner similar to that of lithium carbonate and valproate, 2 effective treatments for bipolar disorder. The present study was performed to examine whether omega3 fatty acids also exhibit mood-stabilizing properties in bipolar disorder. METHODS: A 4-month, double-blind, placebo-controlled study, comparing omega3 fatty acids (9.6 g/d) vs placebo (olive oil), in addition to usual treatment, in 30 patients with bipolar disorder. RESULTS: A Kaplan-Meier survival analysis of the cohort found that the omega3 fatty acid patient group had a significantly longer period of remission than the placebo group (P = .002; Mantel-Cox). In addition, for nearly every other outcome measure, the omega3 fatty acid group performed better than the placebo group. CONCLUSION: Omega3 fatty acids were well tolerated and improved the short-term course of illness in this preliminary study of patients with bipolar disorder.

Adult↗
PubMed1999

Clinical picture and etiologic models of mixed states.

Although conceptualized as polar opposites, manic and depressive symptoms often co-occur in bipolar disorder. This article explores the clinical characteristics, prevalence, biologic features, and response to treatments of mixed states. Issues of diagnosis and cause are considered. The course is often protracted beyond acute episodes, psychotic symptoms are common, and suicide is a major risk. Bipolar mixed states are over represented in women. Mixed states respond poorly to lithium salts; mood stabilizers, particularly divalproex, are the mainstay of modern treatment. Electroconvulsive therapy is also effective, and can be used in severe cases.

Antidepressive Agents↗
PubMed1999

Emergency department presentation of idiopathic intracranial hypertension.

Idiopathic intracranial hypertension (IIH), or pseudotumor cerebri, is a syndrome characterized by an elevated intracranial pressure in the absence of a focal lesion, infective process, or hydrocephalus. New onset IIH may present to the emergency department in a variety of ways. To describe the etiologic associations and clinical features in this disorder, we performed a retrospective analysis of consecutive emergency department patients with new onset IIH during the calendar years 1987-1996. A total of 52 patients met all study criteria. The mean patient age was 27+/-8.9 years; the female-to-male ratio was 7:1. An etiologic association could be identified in 85% of cases and included obesity, hypertension, drugs, endocrine, and systemic disorders. Headache was a dominant complaint in most patients (48/52) and associated with dizziness, nausea, and/or visual complaints. Fourteen patients (27%) were not diagnosed on their initial ED visit and were more likely to have atypical clinical features (71% vs. 24%; P = .004). Atypical features included paraesthesias, neck/back pain, unilateral headache, vertigo, and nystagmus. Papilledema, the ophthalmoscopic hallmark of IIH, was not detected initially in 11 patients (21%). These results suggest that IIH is a relatively uncommon neurological illness that may have a variety of causes. The emergency department diagnosis may be complicated by atypical clinical features and a lack of detectable papilledema.

Adolescent↗
PubMed1998

Mood stabilizer combinations: a review of safety and efficacy.

OBJECTIVE: Polypharmacy is common in the treatment of refractory bipolar disorder. The purpose of this article is to review the safety and efficacy of mood stabilizers in combinations. METHOD: A manual and computer (MEDLINE) search was performed for combinations of the most commonly used mood-stabilizing agents. RESULTS: The authors review safety and efficacy data on the more frequently encountered combinations of established and putative mood stabilizers. CONCLUSIONS: There have been few controlled studies of the use of combinations of mood stabilizers. The interactions of such combinations are sometimes complex, often very useful, and potentially dangerous. One general rule that may reduce the risks of toxic drug interactions is to add medication to the patient's current regimen in modest doses and increase the dose slowly. The safest and most efficacious mood stabilizer combinations appear to be the mixtures of anticonvulsants and lithium, particularly valproate plus lithium. Once the mechanisms of the mood stabilizers are identified, it is possible that a more rational approach to combination therapy will emerge, based on synergism at the sites of action.

Acetates↗
PubMed1986

Persistent sciatic artery. Report of three cases and literature review.

Persistence of the sciatic artery (SA) is a rare vascular anomaly, resulting from lack of regression of an embryonal artery to the lower extremity. Forty-nine cases have been published in the world literature since 1832. The persistent sciatic artery (PSA) is particularly prone to undergo aneurysm formation or atherosclerosis. It originates from the internal iliac artery, courses in close proximity to the sciatic nerve, and provides the main supply to the popliteal artery because a hypoplastic superficial femoral artery (SFA), contributing only collaterals to the knees, is usually associated with a PSA. This anomaly should be kept in mind in the clinical assessment of a pulsatile gluteal mass. It also presents a potential hazard during hip and renal transplant surgery.

Adult↗
PubMed1986

Regenerating nodules in cirrhosis: sonographic appearance with anatomic correlation.

A sonographic-anatomic correlation study was undertaken to define the sonographic appearance of regenerating nodules in cirrhotic livers. Three cirrhotic livers with multiple regenerating nodules were obtained from patients undergoing liver transplantation. Sonograms of the resected livers were made and correlated directly with the anatomic specimens. Using a 3-MHz transducer, no discrete alterations in the echo texture of the livers were seen to correspond to the regenerating nodules. With a 7.5-MHz transducer, discrete islands of liver parenchyma were identified corresponding to regenerating nodules anatomically. The nodules were recognized because of visualization of thin, slightly more echogenic borders, which corresponded pathologically to fibrous and fatty connective tissue surrounding and separating the nodules.

Humans↗
PubMed1985

Transcatheter embolization of the dorsal pancreatic artery to control massive postoperative bleeding.

We report a severely traumatized patient who developed massive bleeding through surgical drains in the postoperative period. Superselective dorsal pancreatic arteriography demonstrated extravasation of contrast material in the pancreatic bed. Embolization with Gel-foam particles successfully controlled this severe bleeding. Transcatheter embolization is the procedure of choice for controlling pancreatic bleeding in acutely traumatized patients.

Abdominal Injuries↗
PubMedDate not supplied

Ewing sarcoma of the skull with an unusual pattern of reactive sclerosis: MR characteristics.

A case of primary Ewing sarcoma involving the occipital bone with an unusual radiographic feature--markedly thickened bone--is described. Magnetic resonance imaging was more helpful than CT in determining the lesion extent due to lack of bone artifact and since it showed the precise relationship of the neoplasm to the tentorium on direct coronal imaging.

Adolescent↗
PubMedDate not supplied

Craniopharyngioma: CT and MR imaging in nine cases.

Magnetic resonance (MR) imaging and CT examinations were performed in nine patients with surgically proven craniopharyngioma. Computed tomography was found to be superior to MR in detection of calcification and cyst formation. Extent of involvement of adjacent structures (e.g., optic chiasm, third ventricle, and intracavernous carotid artery) was more clearly delineated by MR. Craniopharyngioma fluid collections were found to be uniformly bright on T2-weighted sequences. However, on T1-weighted sequences, the signal intensity of the fluid ranged from hypointense to hyperintense, reflecting the heterogeneous contents of cysts in these tumors. Since calcification and cyst formation are hallmarks of craniopharyngiomas, we believe that CT is more specific than MR in diagnosis of craniopharyngiomas. Magnetic resonance, however, offers a more accurate assessment of the tumor extent.

Adolescent↗