Cognitive function, thyroid status and postpartum depression.

Impairment of cognitive function can occur with thyroid disorder and also with depression. Since depression occurs in conjunction with postpartum autoimmune thyroiditis, the question arises as to whether any impairment of cognitive function in postpartum women is related to change in thyroid status or to depressed mood. A total of 242 women (110 thyroid antibody-positive and 132 antibody-negative) were assessed at 8, 12, 20 and 28 weeks postpartum in the outpatients of a district general hospital. Thyroid antibody levels (antimicrosomal and antithyroglobulin) were monitored at monthly intervals, together with plasma T3, T4 and thyroid-stimulating hormone. The main outcome measures were Research Diagnostic Criteria for depression, the 17-item Hamilton Depression Rating Scale and the Edinburgh Postnatal Depression Scale, together with reaction time and digit span. Subjects with postnatal depression showed detectable cognitive impairment independent of thyroid antibody status and actual thyroid dysfunction.

Anorexia nervosa complicating inflammatory bowel disease.

Two cases of inflammatory bowel disease, occurring in adolescence and complicated by anorexia nervosa, are presented. The management of the bowel disease with corticosteroids appeared to precipitate the eating disorder in one case whereas covert withdrawal of steroid treatment led to life threatening complications of inflammatory bowel disease in the other. The difficulties of managing two serious conditions, each ideally treated in a specialist centre, are discussed and the dangers of treating adolescents with shape modifying drugs are highlighted.

Anticholinergic drugs in psychiatry.

This paper summarizes the research evidence pertaining to the use of anticholinergic drugs in psychiatric practice. Indications for use, efficacy and unwanted effects are discussed. The questions of withdrawal, association with tardive dyskinesia and abuse of these drugs is also covered. Finally there are some general recommendations regarding clinical use.

'Puerperal psychosis' following male-to-female sex reassignment?

Psychosis is reported following abrupt withdrawal of oestrogen and surgery for male-to-female sex reassignment. The resemblance of the patient's mental state to puerperal psychosis suggested a hormonal aetiology.

Acrosome loss in human sperm incubated in vitro under capacitating conditions.

Human sperm were incubated under capacitating conditions and, at selected points up to 24 h of incubation, motile cells were fixed and assessed with the electron microscope for the presence or absence of the acrosome. Two methods of sample preparation were compared. In the first, semen samples were washed, incubated and filtered through glass beads to select motile cells before fixation. In the second, motile sperm were allowed to swim up into medium; this produced greater than 95% motile cells which were then incubated and fixed as required. In both series of experiments a significant increase in acrosome loss with time was observed (P = 0.00013), although only 10.5% of cells had lost the acrosome after 24 h. It is concluded that overt acrosome loss occurs less frequently in human sperm than in those of commonly used laboratory animals.

A rapid method for the isolation of kidney brush border membranes.

A simple rapid method for the preparation of purified brush border membranes from rabbit kidney proximal tubules is described. The method is based on hypotonic lysis, Ca2+ aggregation of contaminants and differential centrifugation. In contrast to most other published methods, the brush border membranes are free of contamination by basolateral membranes.