Mirtazapine in combination

Depression is undoubtedly a particularly important disease in terms of personal suffering and death as well as social, family, and economic costs. Pharmacological treatment is a reasonably effective therapeutic approach;however, a delayed therapeutic response and the persistence of depressive symptoms represent serious drawbacks to clinical recovery.Although the pharmacological action of anti depressants begins a few hours after the start of treatment, an antidepressant response usually takes between 2 and 6 weeks.The persistence of depressive symptoms after the first weeks of treatment is indicative of a poor prognosis in terms of chronicity and a return to normal social function.The combination of mirtazapine with other antidepressants may significantly lessen these drawbacks.Its antagonist effect on the presynaptic receptors reduces the latency of the antidepressant response. Moreover, its robust noradrenergic effect enhances the serotoninergic effects of the most common antidepressants. In addition, the side effects of mirtazapine can be partially neutralized by the pharmacodynamic activity of other antidepressants, while mirtazapine can ameliorate the serious adverse effects, such as sexual dysfunction, of other medications.

Feeding problems in nursery children: prevalence and psychosocial factors

AIM

In this study we analyze the prevalence of feeding problems in a sample of nursery children and examine the environmental and psychopathological factors related to such problems.

METHODS

We used the Early Childhood Inventory-Parents Checklist to assess 851 Spanish children aged between 3 and 6 years from both urban and rural samples. This screens emotional and behavioural problems and is based on the Diagnostic and Statistical Manual of Mental Disorders-IV. We collected sociodemographic data and information about life events and the psychopathology of the children's parents (General Health Questionnaire-28).

RESULTS

Our results showed that the prevalence of feeding problems was 4.8% and that there were no differences between gender. Sample subtype, socioeconomic level and family characteristics were not linked to feeding problems. Children with feeding problems had significantly more symptoms of psychological problems and somatic complaints and had experienced more life events in the previous 12 months. The psychopathology of the mother, especially in terms of anxiety problems, increased the risk of feeding problems in children.

CONCLUSION

When there are complaints of feeding problems in preschools, the psychological problems of children and their mothers should be taken into consideration during paediatric consultation, irrespective of gender or socioeconomic status.

Burr hole cover for ventriculoperitoneal shunts and ventriculostomy: technical note

In patients who have undergone intracranial procedures, bone gaps or burr holes often result in small but undesirable scalp or skin depressions. The authors designed a burr hole cover for hydrocephalus shunt system or external ventricular drainage, which is shaped to alleviate the deformity of the burr hole by filling the bone defect and allowing the passage of the ventricular catheter. The specifications of this device and its clinical application are described.

[Capillary testicular hemangioma: a case report]

Testicular tumors in infants are rare and most of them are malignant. Hemangioma of the testis is an extremely rare tumor in infants. We report on an intratesticular capillary hemangioma that appeared in a 10 month-old child subsequently undergoing orchidectomy and on the patient's evolution at 4 years. The histological characteristics showed proliferation of small blood vessels, lined with endothelial cells. Mitoses and atypias were not found. Permitting differential diagnosis with other vascular tumors: Masson's vegetant intravascular hemangio-endothelioma and angiosarcoma.