This review article aims to provide insight into the mechanisms of action, pharmacokinetics, clinical efficacy, safety and tolerability of four novel antidepressants including desvenlafaxine, vortioxetine, vilazodone, and levomilnacipran. Following keywords are used in PubMed and Scopus to search for relevant articles: (depression) AND (psychopharmacology OR desvenlafaxine OR levomilnacipran OR vortioxetine OR vilazodone). Patients with a lack of effectiveness or tolerability to certain antidepressants may get benefit from selecting a new antidepressant with different mechanism of action. These medications can be an option in the selection of newer antidepressants. Depression may not be caused by the simple deficiency of serotonin in the brain, but rather a complex interplay of various neurotransmitters including serotonin, norepinephrine, glutamate, and histamine at certain brain areas. The above-mentioned novel antidepressants exert their therapeutic benefits by acting on multiple neurotransmitters. The complexity of underlying the neurobiological mechanism should be considered while formulating a plan of care.

IntroductionIn recent years, several non-specialist mediated interventions have been developed and tested to address problematic symptoms associated with autism. These can be implemented with a fraction of cost required for specialist delivered interventions. This review represents a robust evidence of clinical effectiveness of these interventions in improving the social, motor and communication deficits among children with autism.MethodsAn electronic search was conducted in eight academic databases from their inception to 31st December 2018. A total of 31 randomized controlled trials were published post-2010 while only 2 were published prior to it. Outcomes pertaining to communication, social skills and caregiver-child relationship were meta-analyzed when reported in > 2 studies.ResultsA significant improvement was noted in child distress (SMD = 0.55), communication (SMD = 0.23), expressive language (SMD = 0.47), joint engagement (SMD = 0.63), motor skills (SMD = 0.25), parental distress (SMD = 0.33) parental self-efficacy (SMD = 0.42) parent-child relationship (SMD = 0.67) repetitive behaviors (SMD = 0.33), self-regulation (SMD = 0.54), social skills (SMD = 0.53) symptom severity (SMD = 0.44) and visual reception (SMD = 0.29).ConclusionNon-specialist mediated interventions for autism spectrum disorder demonstrate effectiveness across a range of outcomes for children with autism and their caregivers.

No abstract

No abstract

No abstract

e21591 Background: Blood transfusion has immune-modulating effect which may affect outcome in women with breast cancer including cancer recurrence and survival. Methods: PubMed, Embase and Cochrane libraries were searched by utilizing different combinations of keywords: blood transfusion, survival, mortality and breast cancer. Inclusion criteria were: (1) English articles and (2) studies with an adult population with the diagnosis of breast cancer undergoing resection which may or may not have received blood transfusion. Four hundred and seventy studies were reviewed, 13 studies meeting inclusion criteria were pooled for Meta-analysis. Results: Twenty five datasets from 13 studies with total N = 7384 subjects (transfused 2264, not transfused 5120) were pooled. Survival rates recorded at a specified time frame, this range from 4-12 years. Major confounding factors effecting survival in this population may include age, presence of other chronic illnesses, spread of breast cancer to lymph nodes, stage of cancer and extent of cancer treatment. Type, group and number of blood units transfused may also play a role. Survival rates among not transfused group range from 34% to 79% while in transfused group range from 41% to 78%. Significant heterogeneity was detected among studies; therefore random effect model was used. Comparing women without blood transfusion, women with transfusion have Odd ratio of overall survival 0.79 (0.72 to 0.86, I2= 47.3, P = 0.001). we also performed sensitivity and subgroup analysis. Conclusions: Perioperative blood transfusion appears to adversely impact survival among women with breast cancer

Pregnancy can be a colossal change for some women, with the commencement of motherhood possibly generating emotional health problems, including peripartum depression (PPD). PPD significantly affects the parent-child relationship, which is the foundation for the socioemotional development of the child. In this article, we reviewed the association between PPD and resilience, and identified their mediators and moderators. Eight studies were included after a rigorous screening process. There was a significant relationship between PPD and childhood resiliency, resulting in an increased risk of psychiatric disorders in children and adolescents. Maternal sensitivity and emotional availability were possible mediators. Maternal education, income level, maternal trauma, life adversities, marital conflicts, and perceived social support were reported moderators. This article highlights the need for timely recognition and treatment of PPD with targeted interventions to improve the parent-child relationship. [ Psychiatr Ann . 2021;51(7):322–330.]

No abstract