Improving Quality of Emergency Care Through Integration of Mental Health.

The goal of this study was to better integrate emergency medical and psychiatric care at a large urban public hospital, identify impact on quality improvement metrics, and reduce healthcare cost. A psychiatric fast track service was implemented as a quality improvement initiative. Data on disposition from the emergency department from January 2011 to May 2012 for patients impacted by the pilot were analyzed.

The pharmacologic treatment of anxiety and depression in African Americans. Considerations for the general practitioner.

A growing pool of recent research points to the importance of ethnicity in psychopharmacologic management of depression and anxiety disorders, with sometimes profound implications for efficacy and safety. Such research has provided provocative findings that illustrate important interethnic pharmacogenetic, pharmacokinetic, and pharmacodynamic differences, especially for African Americans. We did a systematic literature review of psychopharmacologic treatment considerations among African Americans with anxiety and mood disturbance seen by primary care physicians, who provide most psychopharmacologic treatment.

Regulation of signal transduction pathways by mood-stabilizing agents: implications for the delayed onset of therapeutic efficacy.

A series of investigations were performed to elucidate the mechanisms of action of lithium, valproate, and carbamazepine. We have found that lithium exerts major effects on G proteins, most likely via a posttranslational process stabilizing the inactive heterotrimeric (alpha beta gamma) form of the protein. We also find that chronic lithium and valproate exert major, very similar effects on the PKC signaling pathway, with both drugs decreasing the levels of membrane-associated PKC alpha and epsilon, and have similar effects on the DNA binding activity of the transcription factor, AP-1.

Ethnic considerations in the pharmacotherapy of mood disorders.

In the past several years, there has been an increased appreciation for the importance of including cultural and ethnic factors in the evaluation and treatment of patients in psychiatry. Most of the focus has been on understanding the patients' psychosocial milieu and how these factors contribute to the patient's overall clinical presentation. Few studies have addressed the significance of pharmacogenetic heterogeneity among various cultural, ethnic, and racial groups.

Regulation of corticotropin-releasing factor secretion and synthesis in the human neuroblastoma clones- BE(2)-M17 and BE(2)-C.

The BE(2)-M17 and BE(2)-C human neuroblastoma cell lines have been shown to synthesize and secrete corticotropin-releasing factor (CRF) following retinoic acid treatment. It has been demonstrated that CRF secretion and intracellular synthesis increases in response to forskolin treatment. In this report, we have further characterized these cells in response to protein kinase C activators, dexamethasone, interleukin-1 alpha, as well as various neurotransmitters and peptides.