Acute ethanol consumption by fasting male volunteers decreases circulating trytophan (Trp) concentration and availability to the brain as determined by the ratio of (Trp) to the sum of its five competitors ([Trp]/[CAA]ratio). These effects of alcohol are specific to Trp, because levels of the 5 competitors are not increased. The decrease in circulating (Trp) is not associated with altered binding to albumin and may therefore be due to enhancement of hepatic Trp pyrrolase activity. It is suggested that, under these conditions brain serotonin synthesis is likely to be impaired and that, as a consequence, a possible strong depletion of brain serotonin in susceptible individuals may induce aggressive behaviour after alcohol consumption. The possible implications of these findings in the relationship between alcohol and depression are also briefly discussed.
Sterilisation and the mentally handicapped DEARSIRS In the first paragraph on the Position Statement on Sterilisation and the Mentally Handicapped by the Section of Psychiatry of Mental Handicap (Psychi atric Bulletin, April 1989,13,215) I read: ... "all psychiatrists involved in clinical decisions con cerning sterilisation of mentally handicapped people are advised to consult their Medical Defence Unions im mediately." In the third paragraph in relation to mildly men tally handicapped people who are able to give valid consent, the statement adds: ... "for this group the existing procedural arrangements are entirely satisfactory and appropriate."
A senior registrar 'shadowed' a district general manager and a unit general manager for one week each as a management training exercise. The three principal participants describe the exercise from their different perspectives. Consequent issues and the value of such 'shadowing' as a mode of training are discussed.
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