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34 results

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Obstetric Anesthesia and Uncommon Disorders
  • 3rd edition
  • Edited by David R. Gambling, M. Joanne Douglas, Grace Lim
  • Published online:
    26 January 2024
    Print publication:
    01 February 2024
  • A thoroughly revised third edition of the acclaimed textbook for caregivers involved in the management of pregnant women with uncommon diseases or an unusual or rare condition. The book offers valuable case reports and experience collated by an international team of editors and contributors who are leading experts in the field. This edition contains five additional chapters covering topics like cardiac and neuraxial point of care ultrasound, substance abuse, rare inherited conditions, and anesthesia for rare fetal and placental conditions. Clear, concise management guidelines and algorithms are provided, and each chapter is written from the viewpoint of the obstetric anesthesiologist. Numerous tables, figures and photographs provide visual aids and each chapter contains valuable clinical insights highlighting the essential facts. Featuring updated figures and references, links to useful websites for further reading and a list of commonly used abbreviations. A valuable resource for obstetric anesthetists, perinatologists and other obstetric care providers.

  • Air quality and mental health: evidence, challenges and future directions

  • Kamaldeep Bhui, Joanne B. Newbury, Rachel M. Latham, Marcella Ucci, Zaheer A. Nasir, Briony Turner, Catherine O'Leary, Helen L. Fisher, Emma Marczylo, Philippa Douglas, Stephen Stansfeld, Simon K. Jackson, Sean Tyrrel, Andrey Rzhetsky, Rob Kinnersley, Prashant Kumar, Caroline Duchaine, Frederic Coulon
  • Journal:
    BJPsych Open / Volume 9 / Issue 4 / July 2023
    Published online by Cambridge University Press:
    05 July 2023, e120
    • Article
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      • Open access
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  • Background

    Poor air quality is associated with poor health. Little attention is given to the complex array of environmental exposures and air pollutants that affect mental health during the life course.

    Aims

    We gather interdisciplinary expertise and knowledge across the air pollution and mental health fields. We seek to propose future research priorities and how to address them.

    Method

    Through a rapid narrative review, we summarise the key scientific findings, knowledge gaps and methodological challenges.

    Results

    There is emerging evidence of associations between poor air quality, both indoors and outdoors, and poor mental health more generally, as well as specific mental disorders. Furthermore, pre-existing long-term conditions appear to deteriorate, requiring more healthcare. Evidence of critical periods for exposure among children and adolescents highlights the need for more longitudinal data as the basis of early preventive actions and policies. Particulate matter, including bioaerosols, are implicated, but form part of a complex exposome influenced by geography, deprivation, socioeconomic conditions and biological and individual vulnerabilities. Critical knowledge gaps need to be addressed to design interventions for mitigation and prevention, reflecting ever-changing sources of air pollution. The evidence base can inform and motivate multi-sector and interdisciplinary efforts of researchers, practitioners, policy makers, industry, community groups and campaigners to take informed action.

    Conclusions

    There are knowledge gaps and a need for more research, for example, around bioaerosols exposure, indoor and outdoor pollution, urban design and impact on mental health over the life course.

  • Visual Perceptual Organization Ability in Autopsy-Verified Dementia with Lewy Bodies and Alzheimer’s Disease

  • Micaela Mitolo, Joanne M. Hamilton, Kelly M. Landy, Lawrence A. Hansen, Douglas Galasko, Francesca Pazzaglia, David P. Salmon
  • Journal:
    Journal of the International Neuropsychological Society / Volume 22 / Issue 6 / July 2016
    Published online by Cambridge University Press:
    25 May 2016, pp. 609-619

  • Objectives: Prominent impairment of visuospatial processing is a feature of dementia with Lewy bodies (DLB), and diagnosis of this impairment may help clinically distinguish DLB from Alzheimer’s disease (AD). The current study compared autopsy-confirmed DLB and AD patients on the Hooper Visual Organization Test (VOT), a test that requires perceptual and mental reorganization of parts of an object into an identifiable whole. The VOT may be particularly sensitive to DLB since it involves integration of visual information processed in separate dorsal and ventral visual “streams”. Methods: Demographically similar DLB (n=28), AD (n=115), and normal control (NC; n=85) participants were compared on the VOT and additional neuropsychological tests. Patient groups did not differ in dementia severity at time of VOT testing. High and Low AD-Braak stage DLB subgroups were compared to examine the influence of concomitant AD pathology on VOT performance. Results: Both patient groups were impaired compared to NC participants. VOT scores of DLB patients were significantly lower than those of AD patients. The diagnostic sensitivity and specificity of the VOT for patients versus controls was good, but marginal for DLB versus AD. High-Braak and low-Braak DLB patients did not differ on the VOT, but High-Braak DLB performed worse than Low-Braak DLB on tests of episodic memory and language. Conclusions: Visual perceptual organization ability is more impaired in DLB than AD but not strongly diagnostic. The disproportionate severity of this visual perceptual deficit in DLB is not related to degree of concomitant AD pathology, which suggests that it might primarily reflect Lewy body pathology. (JINS, 2016, 22, 609–619)

Obstetric Anesthesia and Uncommon Disorders
  • 2nd edition
  • Edited by David R. Gambling, M. Joanne Douglas, Robert S. F. McKay
  • Published online:
    19 October 2009
    Print publication:
    20 March 2008
  • This edition of Obstetric Anesthesia and Uncommon Disorders provides a convenient resource for practitioners suddenly faced with a parturient who has an unusual medical or surgical condition. The book considers the impact of a condition on pregnancy, labor and delivery, or the fetus and the impact of pregnancy on a condition, or the effect of therapy for the disorder on the fetus or neonate. Case reports and experience from the world literature, and clinical advice from many specialists, are drawn together by an international team of editors and contributors who are leading experts in the field. Clear, concise management guidelines and algorithms are provided, and each chapter is written from the viewpoint of the obstetric anesthesiologist. Thoroughly revised, with chapters on chronic pain in pregnancy and malignancy and pregnancy, this book will be an invaluable resource for any anesthesiologist involved in the clinical management of these complex patients.

  • 17 - Blood disorders

  • from Section 5 - Other disorders
    • By M. Joanne Douglas, Department of Anesthesia, BC Women's Hospital, Vancouver, Canada, Penny Ballem, Clinical Professor, Department of Medicine, School of Hematology, Faculty of Medicine, University of British Columbia, Victoria, BC, Canada
  • Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
  • Book:
    Obstetric Anesthesia and Uncommon Disorders
    Published online:
    19 October 2009
    Print publication:
    20 March 2008, pp 293-320

  • Summary

    Background

    Normal hematological indices during pregnancy

    Multiple changes occur to the hematological system during pregnancy as outlined in Table 17.1. It is essential that the clinician be familiar with these in order to determine what is normal and what is abnormal when reviewing laboratory results in the pregnant woman.

    Hematological testing during pregnancy

    A routine, complete blood count during early pregnancy (first trimester) is important to identify common, preexisting hematological disorders that may impact on the pregnancy. In the uncomplicated pregnancy, a repeat blood count in the third trimester is done to assess the hematocrit in preparation for delivery.

    Coagulation screening is performed only:

    • to investigate a significant bleeding history

    • to follow factor levels in patients with established disorders

    • during acute peripartum complications such as preeclampsia, massive hemorrhage or disseminated intravascular coagulation (DIC)

    • to monitor anticoagulation therapy.

    Screening assays include platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT), and fibrinogen (see Table 17.2). The subjective nature of the bleeding time as a measure of platelet function and its established lack of sensitivity and specificity as a predictor of clinical bleeding, has precluded its usefulness.

    Currently, several centers use thromboelastography (TEG) to detect the risk of clinical bleeding; however, the sensitivity and specificity of this test remain unproven. Another point of care instrument, the platelet function analyzer (PFA-100®), is thought to represent an “in vitro” bleeding time.

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