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Bipolar disorders are characterized by recurrent manic and depressive phases with early onset and poor prognosis for chronic symptoms and premature death. Almost a third of patients do not improve with the available treatments. Atypical antipsychotics have been tested in the treatment of bipolar disorder as an alternative to typical neuroleptics due to their safer side effect profile and have been hypothesized to be mood stabilizers on the basis of their activity on affective symptoms of schizophrenia. The most significant studies published up to now, concerning the use of clozapine, olanzapine, risperidone, quetiapine and ziprasidone in bipolar disorders are reviewed here. The receptor profile of these drugs is related to their side effects. Finally, the current indications of atypical antipsychotics and future research are discussed.

Objective: The aim of this study is to evaluate the presence of triggering life-events for the onset of Obsessive-Compulsive Disorder in women (OCD)., Design: Clinical controlled study., Setting: Service for depressive and anxiety disorders; Department of Neuroscience, Psychiatric Unit, University of Turin., Methods: The study compares twenty-nine women with OCD (DSM-IV criteria) with twenty-nine healthy control women matched for demographic features and with twenty-nine women with Bulimia Nervosa (DSM-IV criteria) matched for age, age at onset, education and marital status. All patients were assessed with the Clinical Structured Interview for DSMIII-R (SCID) and with the Interview for Recent Life Event by Paykel. Moreover, OCD patients were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and bulimic patients with the Eating Disorder Inventory (EDI)., Results: The study demonstrates that the only specific life event that is significantly associated with the onset of OCD is "having a new born child" No significant differences in frequency and severity of stressing life events were found in the three groups., Conclusions: The results confirms the findings of our previous study: post partum is the only risk factor for the onset of OCD in female population, compared to healthy control. Furthermore, this research points-out the importance and the specificity of this association showing that post partum is not a risk factor in all psychiatric disorders.

The authors report on 13 patients with chronic myeloid leukemia (CML) studied by serial karyotyping and fluorescence in situ hybridization (FISH) of their bone marrow cells. Ten patients had complex translocations of the Ph chromosome while the remaining three were Ph negative. FISH analysis revealed in all 13 patients the translocation of the ABL protooncogene into chromosome 22 at band q11. Moreover, in all complex translocations but one, FISH with a chromosome 22 painting probe demonstrated on one chromosome 9 at band q34 the presence of material from chromosome 22, in addition to signals on the third chromosome involved in complex changes. Therefore, in this study complex translocations appeared as secondary changes resulting from two consecutive translocations with a total of at least four breaks. The first translocation gave rise to the standard t(9;22)(q34;q11). The second one included a break distal to the original breakpoint at band 9q34 and another one on a third chromosome. Furthermore FISH using S1 and S15 probes, mapped at band 22q11.2 or 22q12, gave evidence that in complex translocations the secondary breakpoint on der(9) was in the translocated segment 22q11-qter between bands q11 and q12. FISH analysis also disclosed the presence of material from chromosome 22 on one chromosome 9 in the three patients with Ph negative CML, demonstrating that in these cases a retranslocation between chromosomes 9q+ and 22q- had occurred. Consequently, the four-break mechanism could also be invoked for the three Ph negative CML patients.

The authors describe three patients with myelodysplastic syndrome without a history of exposure to chemical agents and who showed many chromosome rearrangements not previously reported in this hematologic disorder, and a rapid outcome of the disease. The authors discuss the significance of the chromosome changes, suggesting, in agreement with others, that patients with complex rearrangements have a poor prognosis.

In 420 pregnant women who delivered during the third trimester at the "Istituto di I Clinica Ostetrica e Ginecologica", University of Catania, routine blood tests were performed in 95.5% of cases (401 women), urine tests in 95.5% (401), Hb-phoresis in 42.6% (179), HBsAg in 51.4% (216), TORCH and urine cultures in 37.8% (159), cardiotocograph in 73.1% (307), plasma RIA of E3 and/or HPL in 35% (147), maternal ECG and pseudocholinesterasemia in 83.6% (351) and 37.6% (158) respectively. No routine diagnostic tests were performed in 4.5% (19 women) of cases. Diagnostic tests are less frequently performed in women, plurigravida, and in pregnancies which follow a physiological course. Several diagnostic tests, except for TCTG and HBsAg, are performed more frequently in pregnancies with complications. Lastly, there is a marked difference between the number of diagnostic tests performed and the individual woman's place of residence.

The authors report on a cytogenetic survey of 61 patients with preleukemic syndrome (PLS). Of these, 41 had a myeloproliferative disease (MPD) and 20 a myelodysplastic syndrome (MDS). Clonal chromosome abnormalities appeared in 24 patients (39.3%) at disease onset. Such changes had a frequency of 26.8% in patients with MPD and 65% in those with MDS. The authors stress the usefulness of ethidium bromide high resolution techniques. They allow obtaining a larger number of metaphases and elongated chromosomes with higher banding resolution and could account for the frequent detection of chromosome changes in most groups of MDS patients in the present series. Moreover, they discuss the possible significance of some chromosome aberrations suggesting that patients with MPD may live longer than those with MDS because of their higher frequency of normal karyotypes.

The authors describe the case of a 36 years old woman suffering from muscular weakness with proximo-distal distribution to legs, and proximal to arms. The disease, appeared during the third decade of life, is slowly becoming more serious. Hematochemical analyses are all within a normal standard; EMG and histopathologic findings prove the existence of both a protopathic and neurogenic trouble in studied muscles. A therapy based on prednisone (50 mg/die) and ACTH (1 mg each 5 days) for a fourty days period doesn't cause essential changes in symptomatology. A cousin (on her mother's side) of our patient suffers from probable "sporadic distal myopathy". The authors discuss if the disease, shown by this patient, may be considered as an atypical form of SDM or if, what appears more probable, it must be nosographically framed as "scapuloperoneal atrophy".

The authors study the correlation between sexual activity and parity in 106 pluriparous Sicilian women divided into 3 groups with parity, respectively, of 1 (57 cases), 2 (29 cases), and greater than or equal to 3 (20 cases). Sexual desire, frequency of coitus and orgasm, type of extracoital activity, preferred position during coitus, the partner who took the first initiative in sexual activity, and the contraceptive methods used were studied. The results show that in women of parity greater than or equal to 3 there is a significantly lower frequency of very frequent coitus, higher frequency of extravaginal sexual activity, and that the male more frequently took the first initiative in sexual intercourse.

Two-hundred women with sexual dysfunction were compared with 160 without. The number of the practising religious (46.0% vs 28.8%; p less than 0.05), of married women (58.0% vs 47.8%; p greater than 0.05), widows (4.0% vs 0%; p less than 0.01) or the separated were found in significantly higher numbers. Nulliparity does not appear to be a risk factor in sexual dysfunction. The use of contraceptive technique such as the pill and the intrauterine device is significantly lower in women with sexual dysfunction. Also significantly higher is the number of women with sexual dysfunction who report that they are not satisfied with their sexual relationship (63.0% vs 6.2%; p less than 0.001) or who would like to change the sexual behaviour of their partner (50.0% vs 7.5%; p less than or equal to 0.001) or whose husband would like a change in the sexual behaviour of the partner (64.0% vs 10.0%; p less than or equal to 0.001). 7.5% of women without sexual dysfunction consider their relationship with the current partner to be unsatisfactory. Most of these women experience their partner's request as a "problem". In conclusion, the presence of sexual dysfunction is unacceptable to women in the majority of cases as it is accompanied by a negative opinion on the quality of the sexual relationship. It is the Authors' opinion that anamnesis of the sexual life of the couple should be offered to all women who have a gynaecological examination. The absence of sexual dysfunction does not necessarily mean that the women or the couple consider their sexual relationship to be sexually satisfactory or that they do not need or would not accept, if expressly asked, sexual counseling.

Preliminary clinical results with an association of high doses of vincamine and chlordiazepoxide in subjects with recurrent depression are presented. It is felt that vincamine has a clinically appreciable psychoactive action.

Non-pretrained, randomized adult rats were tested in a panic-inducing model of passive avoidance. Intravenous treatment with alkalinizing agents (sodium lactate 0.5 M, 0.5 ml/100 g b.wt., or NaHCO3, 0.5 mEq/100 g b.wt.), but not with a hypocalcemic dose of EDTA (75 mg/kg) 3 min before testing, significantly increased panic behavior. These data may support the hypothesis that panic attacks are due to alkalosis and not to lactate-induced hypocalcemia.