A register of violence incidents showed a progressive increase in in-patient violence from 1976 to 1984, followed by a slight decline to 1987. The case notes of all 137 in-patients committing assaults during 1982 were analysed and compared with those of matched controls. Violence was often repetitive. The most common victims were nurses and then patients. The violent patients were more likely to be schizophrenic, deluded and hallucinated, and to have been repeatedly admitted. The violent and control groups had similar backgrounds, and both showed high levels of social isolation and unemployment. Violence tended to be repetitive, and the violent patients were usually identifiable from previous aggressive and disturbed behaviour. There was a high proportion of Afro-Caribbean patients who tended to be younger, more psychotic, and more seriously violent. Afro-Caribbeans were particularly likely to be detained compulsorily and treated in a locked ward.

Pancreatitis related to hypertriglyceridemia can occasionally occur during pregnancy, particularly if there are underlying genetic abnormalities in lipid metabolism. We report the case of a 27-year-old female with hypertriglyceridemic pancreatitis in pregnancy that was treated initially with lipid lowering medications, followed by plasma exchange for persistently elevated triglyceride levels. Despite multiple interventions, she developed recurrent pancreatitis and simultaneously had a preterm birth. In this case report, we highlight the various therapies and the use of plasmapharesis in secondary prevention of hypertriglyceridemic pancreatitis in pregnancy.

-

Growing evidence shows that women with a history of preeclampsia, pregnancy-induced hypertension or gestational diabetes are at increased long-term risk of cardiovascular disease (CVD).  This was incorporated in the American Heart Association’s 2011 guideline on the prevention of CVD in women and was recently reflected in the 2016 Canadian Cardiovascular Society’s guidelines, suggesting that young women who would not formerly have been considered for primary CVD prevention may benefit from screening for dyslipidemia.  However, the indications and targets for medical treatment of dyslipidemia postpartum remain unclear.  We present the case of a 31yo G1P1L2 woman with preeclampsia, preterm delivery and dyslipidemia who had active vascular risk reduction postpartum, including adjustment of antihypertensives, diet and exercise counselling for low-density lipoprotein cholesterol reduction and weight loss promotion, and consideration of an HMG-CoA reductase inhibitor, which was ultimately decided against given the improvements seen with conservative management.