Editorial AUGUST - Profesor Dr. Aurel ROMILA

                                           

                                                                          O   CONCLUZIE


    Sinuciderea care a dat nastere la interminabile comentarii in media a aratat unde ne gasim cu aceasta realitate. A aratat cum se baga in fata toti ignorantii, care par ca stiu ceva despre cauze. Media da cauza mortii (raportul medico-legal). De ce nu se face o expertiza psihiatrica post-mortem?
    Din datele care s-au spus la tv, probabil ca a fost o sinucidere un caz de melancolie (la o psihoza periodica) neglijata. Neglijata de prejudecatile actuale ale societatii noastre.
    Singura concluzie preventiva ar fi ca, in caz de tentativa de suicid care ajunge la urgenta, dupa ajutorul pentru supravietuire, bolnavul sa fie trimis la tratament obligatoriu la psihiatrie. Conform legii va fi supus unei comisii care trimite recomandarea de tratament de 1-3 luni la procuratura. Legislatia actuala (europeana?) cere aviz dela bolnav sau familie.
    Si vedeti unde s-a ajuns pentruca frica de stigmatizare sociala este mai mare decit salvarea cazului. Ar fi bine ca cineva din Ministerul Sanatatii sa-si dea seama de importanta acestei recomandari si sa dea un ordin guvernamental in acest sens.
    Ceea ce este uimitor este ca avem societati si fundatii pentru animale si nu putem face ceva pentru bolnavii psihici. APLR preconizeaza in toamna o renastere  a organizarii parintilor de schizofreni pentru ai putea sa se resocializeze. Cei interesati pot scrie la revista.
                                                                                                                    Prof.Romila

American Journal of Psychiatry -Up-to-Date - August

American Journal of Psychiatry Table of Contents Alert

A new issue of American Journal of Psychiatry is available online:
1 August 2010; Vol. 167, No. 8
The below Table of Contents is available online at: http://ajp.psychiatryonline.org/content/vol167/issue8/index.dtl



In This Issue

In This Issue
Am J Psychiatry 2010;167 A24
http://ajp.psychiatryonline.org/cgi/content/full/167/8/A24


Editorials

The Complexity of Complex PTSD
Richard A. Bryant
Am J Psychiatry 2010;167 879-881
http://ajp.psychiatryonline.org/cgi/content/full/167/8/879

An Opioid Deficit in Borderline Personality Disorder: Self-Cutting, Substance Abuse, and Social Dysfunction
Antonia S. New and Barbara Stanley
Am J Psychiatry 2010;167 882-885
http://ajp.psychiatryonline.org/cgi/content/full/167/8/882

Abrupt Withdrawal of Antidepressant Treatment
Robert Freedman
Am J Psychiatry 2010;167 886-888
http://ajp.psychiatryonline.org/cgi/content/full/167/8/886

S-Adenosyl Methionine (SAMe) Augmentation in Major Depressive Disorder
J. Craig Nelson
Am J Psychiatry 2010;167 889-891
http://ajp.psychiatryonline.org/cgi/content/full/167/8/889


Clinical Case Conference

Bipolar Disorder and Pregnancy: Maintaining Psychiatric Stability in the Real World of Obstetric and Psychiatric Complications
Vivien K. Burt, Caryn Bernstein, Wendy S. Rosenstein, and Lori L. Altshuler
Am J Psychiatry 2010;167 892-897
http://ajp.psychiatryonline.org/cgi/content/full/167/8/892


Images in Psychiatry

Samuel Tuke's Description of the Retreat
Raymond Raad and George Makari
Am J Psychiatry 2010;167 898
http://ajp.psychiatryonline.org/cgi/content/full/167/8/898


Reviews and Overviews

Copy Number Variations in Schizophrenia: Critical Review and New Perspectives on Concepts of Genetics and Disease
Anne S. Bassett, Stephen W. Scherer, and Linda M. Brzustowicz
Am J Psychiatry 2010;167 899-914
http://ajp.psychiatryonline.org/cgi/content/abstract/167/8/899


Articles

Treatment for PTSD Related to Childhood Abuse: A Randomized Controlled Trial
Marylene Cloitre, K. Chase Stovall-McClough, Kate Nooner, Patty Zorbas, Stephanie Cherry, Christie L. Jackson, Weijin Gan, and Eva Petkova
Am J Psychiatry 2010;167 915-924
http://ajp.psychiatryonline.org/cgi/content/abstract/167/8/915

Dysregulation of Regional Endogenous Opioid Function in Borderline Personality Disorder
Alan R. Prossin, Tiffany M. Love, Robert A. Koeppe, Jon-Kar Zubieta, and Kenneth R. Silk
Am J Psychiatry 2010;167 925-933
http://ajp.psychiatryonline.org/cgi/content/abstract/167/8/925

Illness Risk Following Rapid Versus Gradual Discontinuation of Antidepressants
Ross J. Baldessarini, Leonardo Tondo, Carmen Ghiani, and Beatrice Lepri
Am J Psychiatry 2010;167 934-941
http://ajp.psychiatryonline.org/cgi/content/abstract/167/8/934

S-Adenosyl Methionine (SAMe) Augmentation of Serotonin Reuptake Inhibitors for Antidepressant Nonresponders With Major Depressive Disorder: A Double-Blind, Randomized Clinical Trial
George I. Papakostas, David Mischoulon, Irene Shyu, Jonathan E. Alpert, and Maurizio Fava
Am J Psychiatry 2010;167 942-948
http://ajp.psychiatryonline.org/cgi/content/abstract/167/8/942

Genome-Wide Association Study of Major Recurrent Depression in the U.K. Population
Cathryn M. Lewis, Mandy Y. Ng, Amy W. Butler, Sarah Cohen-Woods, Rudolf Uher, Katrina Pirlo, Michael E. Weale, Alexandra Schosser, Ursula M. Paredes, Margarita Rivera, Nicholas Craddock, Mike J. Owen, Lisa Jones, Ian Jones, Ania Korszun, Katherine J. Aitchison, Jianxin Shi, John P. Quinn, Alasdair MacKenzie, Peter Vollenweider, Gerard Waeber, Simon Heath, Mark Lathrop, Pierandrea Muglia, Michael R. Barnes, John C. Whittaker, Federica Tozzi, Florian Holsboer, Martin Preisig, Anne E. Farmer, Gerome Breen, Ian W. Craig, and Peter McGuffin
Am J Psychiatry 2010;167 949-957
http://ajp.psychiatryonline.org/cgi/content/abstract/167/8/949

Efficacy of Meta-Cognitive Therapy for Adult ADHD
Mary V. Solanto, David J. Marks, Jeanette Wasserstein, Katherine Mitchell, Howard Abikoff, Jose Ma. J. Alvir, and Michele D. Kofman
Am J Psychiatry 2010;167 958-968
http://ajp.psychiatryonline.org/cgi/content/abstract/167/8/958

Telescoping and Gender Differences in Alcohol Dependence: New Evidence From Two National Surveys
Katherine M. Keyes, Silvia S. Martins, Carlos Blanco, and Deborah S. Hasin
Am J Psychiatry 2010;167 969-976
http://ajp.psychiatryonline.org/cgi/content/abstract/167/8/969

Basal Ganglia Surface Morphology and the Effects of Stimulant Medications in Youth With Attention Deficit Hyperactivity Disorder
Loren J. Sobel, Ravi Bansal, Tiago V. Maia, Juan Sanchez, Luigi Mazzone, Kathleen Durkin, Jun Liu, Xuejun Hao, Iliyan Ivanov, Ann Miller, Laurence L. Greenhill, and Bradley S. Peterson
Am J Psychiatry 2010;167 977-986
http://ajp.psychiatryonline.org/cgi/content/abstract/167/8/977

Cannabis Use and the Course of Schizophrenia: 10-Year Follow-Up After First Hospitalization
Daniel J. Foti, Roman Kotov, Lin T. Guey, and Evelyn J. Bromet
Am J Psychiatry 2010;167 987-993
http://ajp.psychiatryonline.org/cgi/content/abstract/167/8/987


Letters to the Editor

Analysis of Antipsychotic Dose Reduction
Hiroyuki Uchida, Takefumi Suzuki, Hiroyoshi Takeuchi, and David C. Mamo
Am J Psychiatry 2010;167 994
http://ajp.psychiatryonline.org/cgi/content/full/167/8/994

Reply to Uchida et al. Letter
Chuan-Yue Wang, Yu-Tao Xiang, and Gabor S. Ungvari
Am J Psychiatry 2010;167 994-995
http://ajp.psychiatryonline.org/cgi/content/full/167/8/994-a

The Value of Data on Suicidality by Treatment Arm
Eric G. Smith
Am J Psychiatry 2010;167 995
http://ajp.psychiatryonline.org/cgi/content/full/167/8/995

Reply to Smith Letter
Pierre Blier
Am J Psychiatry 2010;167 995-996
http://ajp.psychiatryonline.org/cgi/content/full/167/8/995-a

Placebo Group Needed for Interpretation of Combination Trial
Rif S. El-Mallakh, Gagandeep Kaur, and Steven Lippman
Am J Psychiatry 2010;167 996
http://ajp.psychiatryonline.org/cgi/content/full/167/8/996

Reply to El-Mallakh et al. Letter
Pierre Blier and A. John Rush
Am J Psychiatry 2010;167 996-997
http://ajp.psychiatryonline.org/cgi/content/full/167/8/996-a

The Difficulty of Making a Sole Diagnosis of Anti­social Personality Disorder
Scott A. Freeman
Am J Psychiatry 2010;167 997
http://ajp.psychiatryonline.org/cgi/content/full/167/8/997

Reply to Freeman Letter
Daniel Antonius
Am J Psychiatry 2010;167 997-998
http://ajp.psychiatryonline.org/cgi/content/full/167/8/997-a

Elevated Prevalence of Generalized Anxiety Disorder in Adults With 22q11.2 Deletion Syndrome
Wai Lun Alan Fung, Rebecca McEvilly, Jessica Fong, Candice Silversides, Eva Chow, and Anne Bassett
Am J Psychiatry 2010;167 998
http://ajp.psychiatryonline.org/cgi/content/full/167/8/998-a


Book Forum

The Rise and Fall of the Biopsychosocial Model: Reconciling Art and Science in Psychiatry
Kenneth S. Kendler
Am J Psychiatry 2010;167 999-1000
http://ajp.psychiatryonline.org/cgi/content/full/167/8/999

Personal Identity and Fractured Selves: Perspectives From Philosophy, Ethics, and Neuroscience
Victor I. Reus
Am J Psychiatry 2010;167 1000
http://ajp.psychiatryonline.org/cgi/content/full/167/8/1000

Principles and Practice of Child and Adolescent Forensic Mental Health
Roslyn Seligman
Am J Psychiatry 2010;167 1000-1001
http://ajp.psychiatryonline.org/cgi/content/full/167/8/1000-a

Depersonalization: A New Look at a Neglected Syndrome
Eric Hollander
Am J Psychiatry 2010;167 1001
http://ajp.psychiatryonline.org/cgi/content/full/167/8/1001


Books Received

Books Received
Am J Psychiatry 2010;167 1002
http://ajp.psychiatryonline.org/cgi/reprint/167/8/1002

* mentinerea slabirii in obezitate

For 6 months preceding the trial, patients reduced caloric intake and exercised in an effort to slim down. Those who lost 4 kg or more — the average reduction was 8.6 kg, or 19 pounds — were randomly assigned to 3 groups for weight maintenance. One group was self-directed, another contacted a health counselor once a month, and a third group relied on an interactive Website.

Serial Psihologic FENOMENAL!!!

Salutare dragilor...si pentru ca este vacanta si marea majoritate a studentilor prefera sa se relaxeze in diferite moduri am o propunere pentru voi :
 
Mai jos aveti  un link catre un site unde veti putea urmarii un film serial (online si fara nici o taxa) despre diferite cazuri de boli psihice aparute in spitalele de specilitate, in fiecare episod se treateaza cel putin o persoana diagnosticata cu o boala psihica.
Sper ca am reusit sa aduc putina bucurie in sufletele voastre (si in acelasi timp putin material psihologic) si va doresc O VACANTA MINUNATA !!!!
 
 
-- Material trimis pe Forum APLR
*CBT Psychotic depression, posttraumatic stress disorder, and engagement in cognitive-behavioral therapy within an outpatient sample of adults with serious mental illness Comprehensive Psychiatry, 07/20/2010 Gottlieb JD et al. – Patients with psychotic depression exhibited significantly higher levels of depression and anxiety, a weaker perceived therapeutic alliance with their case managers, more exposure to traumatic events, and more negative beliefs related to their traumatic experiences, as well as increased levels of maladaptive cognitions about themselves and the world, compared with participants without psychosis. Implications for cognitive–behavioral therapy treatment aimed at dysfunctional thinking for this population are discussedCBT

* astm si suicid

Asthma and suicide mortality in young people: A 12-year follow-up study
American Journal of Psychiatry, 07/20/2010

Kuo CJ et al. – The authors investigated the association between asthma and suicide mortality in a large population-based cohort of young people. These results highlight evidence of excess suicide mortality in young people with asthma. There is a need to improve mental health care for young people, particularly those with more severe and persistent asthma symptoms.

Methods
  • Total of 162,766 high school students 11 to 16 years of age living in a catchment area in Taiwan from October 1995 to June 1996 enrolled in study of asthma and allergy
  • Each student and his or her parents completed structured questionnaires
  • Participants were classified into 3 groups at baseline: current asthma (symptoms present in the past year), previous asthma (history of asthma but no symptoms in the past year), and no asthma
  • Participants were followed to December 2007 by record linkage to the national Death Certification System
  • Cox proportional hazards models were used to study association between asthma and cause of death
Results
  • Incidence rate of suicide mortality in participants with current asthma at baseline was more than twice that of those without asthma (11.0 compared with 4.3 per 100,000 person-years)
  • No significant difference in incidence of natural deaths
  • Adjusted HR for suicide was 2.26 (95% CI=1.43–3.58) in current asthma group and 1.76 (95% CI=0.90–3.43) in previous asthma group
  • Greater number of asthma symptoms at baseline associated with higher risk of subsequent suicide
  • Population attributable fraction was 7.0%.

OBEZITATEA

* obezitatea

July 15, 2010 (Winter Park, Florida) — Treatment with the investigational obesity drug lorcaserin (Arena Pharmaceuticals, San Diego, CA) results in significantly greater weight loss than placebo in obese or overweight patients, a new study shows [1]. After one year of treatment, patients treated with the novel weight-loss drug lost 4 kg more than those treated with placebo, with significantly more lorcaserin-treated patients losing more than 5% of their body weight compared with the placebo-treated patients.

* bipolaritatea e mai reazistenta la obezi

Medical comorbidity in bipolar disorder: relationship between illnesses of the endocrine/metabolic system and treatment outcome
Bipolar Disorders, 07/14/2010

Kemp DE et al. – Among patients with rapid–cycling bipolar disorder receiving lithium and valproate, endocrine/metabolic illnesses, including overweight and obesity, appear to be associated with greater depressive symptom severity and poorer treatment outcomes.

MedScape Up To Date

Redefining Alzheimer's Disease: NIA and Alzheimer's Association Float New Draft Diagnostic Criteria
Medscape Medical News , 2010-07-14

 

 

 

 

Endocrine Society Issues Position Statement on Menopausal Hormone Therapy
Medscape Medical News , 2010-06-29

Each of us is...

Lessons of Reflection
Interfering
Each of us is on our own path and we all learn differently. Because of this it is important to not interfere with another's path of growth.



When we care about people, we want to save them from pain by offering them the benefit of our experience. Sometimes we feel like we know what is best for them. Sometimes, like when their safety is involved, we need to step in, but those times are rare. More often we find ourselves becoming frustrated when our close friends or family members do not use our relationship insights or follow our dietary advice, and this is where we find our challenge. We may even find ourselves becoming angry when they choose another path. This strength of feeling is usually a sign that our motivations go beyond merely helping another to indicate that there is a lesson there for us.

First, we need to keep in mind that each of us is on our own path and that we all learn differently. When we trust the universe, we know that there is a higher power at work that knows what is best for our loved one. Since we do not want to deny them experiences of deep feeling that are essential steps in the growth of their spirit, we can instead offer them our counsel. After we have given our gift, it is time to release it, along with our expectations of them and their choices, with love.

Once that is done, we can remind ourselves that our relationships are mirrors that allow us to see ourselves more clearly in the reflection. That is why it is easier for us to see solutions to other people's problems than to see answers for our own. We can also learn from these experiences when we ask ourselves if we ever do the same thing. Maybe we do not share experiences with relationships, but we do with our finances or our food choices. In being willing to look at ourselves and see why we are being irritated by what other people choose to do with their lives, we can be like an oyster and make irritations into pearls. With these pearls of wisdom, we learn to release the desire for control over others and instead enrich their lives as we enrich our own.

 

 

 

 

 

Time for Wellness
A Self-Healing Day

Set aside a day for focus on yourself. Start the day by setting the intention that you are dedicating this time to healing yourself.



Human beings carry within themselves the seed of healing. Our choices affect us more than we realize, and it is because of this that we tend to place responsibility for our wellness in the hands of others. As beneficial as regular visits to a healer can be, we have the power to heal ourselves at will. When we dedicate a day to the pursuit of wellness, we can relax and renew ourselves in a nourishing and comfortable environment. A sincere desire to open ourselves to the highest realities of our physical and spiritual selves is the key to self-healing so that healing energy can flow into us unimpeded.

A self-healing day should address the vital needs of the self as a whole while directing healing energy where it is needed most. Solitude is an important part of the process as is the ability to take refuge in a space that is both beautiful and peaceful. Start your healing day by setting the intention that you are dedicating this time to healing yourself. Flowers, candlelight, incense, and music can guide our focus toward a more tranquil state. For a more intense session, try listening to music through headphones since tuning out can help you tune in. It is up to us to decide what we need to do to cultivate wellness in our lives. For some, it may be time spent in reflection. Others will turn to calming activities that help them remember their purpose, such as journal writing, being in nature, or studying. Our healing may even take a more direct form as we use color, sound, or crystals to balance and ground ourselves.

Ultimately, your wholesome intentions transform what might otherwise be a simple day of rest into a day of healing. Grant yourself permission to relax and savor the stillness. If you attune yourself to the calm around you, worldly distractions will be minimized and the unadulterated flow of your consciousness will reestablish itself in the forefront of your mind. The needs of the body, the heart, and the soul will then be revealed to you, empowering you to tap into the essential healing energy of the universe. The mechanism you use to channel this energy will be dependent on your shifting requirements, so each day of healing you enjoy will be unique. All will replenish you, however, allowing you to recreate yourself in a perfect image of health.

 

 

 

 

Opening to Receive Comfort
Sharing Grief

Grief is part of the human experience. Sharing our grief allows us to ease our burden by letting someone else help carry it.



When we experience something that causes us to feel shock and sadness, we may feel the urge to withdraw from life. It may seem like remaining withdrawn will keep us protected from the world, but during these times it is important to reach out to those trusted and precious people who care about us the most. Even with our best information and reasoning, we never know when someone else's experience or perspective can give us additional information that we need. The universe speaks to us through many channels, and when we open ourselves up to receive its messages, we also receive nurturing care from a loving partner in life's journey.

Grief is part of the human experience, and sharing our vulnerability is what creates truly close bonds in our relationships. Opening ourselves up in this way gets to the core of our being, past all of our defenses and prejudices. When life seems to crack the outer shell of our world, we are both raw and fresh at the same time. It is then that we discover who is truly willing to walk with us through life. We also see that some of those sent to us may not be the ones we expected to see. Regardless, we learn to trust in the universe, in others, in our own strength and resilience, and in the wisdom of life itself.

Sharing grief allows us to ease our burden by letting someone else help carry it. This helps us process our own inner thoughts and feelings through the filter of a trusted and beloved someone. We may feel guilty or selfish, as if we are unloading on someone who has their own challenges. Although, if we think about it, we know we would do the same for them, and their protests would seem pointless. Remember that not sharing feelings with others denies them the opportunity to feel. We may be the messenger sent by the universe for their benefit, and it is on this mission that we have been sent. By sharing our hopes and fears, joys and pains with another person, we accept the universe's gifts of wisdom and loving care.

 

 

 

 

 

Beyond the Physical
We are Beings of Light

We are all beings of light, spiritual beings having a human experience. We are filled with divine grace and power that is ours for the asking.


We are all beings of light. Put another way, we are spiritual beings having a human experience. As children, most of us know this, but other human beings who have forgotten what they really are and who cannot help us to know ourselves train us to forget. As a result, we are led to believe that magic is not real, that our invisible playmates do not really exist, and that we are limited beings with only one earthly life to live. There is enormous pressure to conform to this concept of ourselves and so we lose touch with our full potential, forgetting that we are beings of light.

At this time, many of us are reawakening to the truth of who we are, because we are living amidst such large-scale changes in the world. We need to access this light in order to not only survive but thrive as we shift into a new order of consciousness. As the changes around us proceed in rapid progression, we will want to be able to trust our own ability to sense what is happening and how we can best respond. We are no longer living in a predictable world in which we can trust external authority figures and prior ideas about reality to guide us. We need to be able to access the information that will help us navigate these uncertain waters, and the ultimate authority resides in our awareness of ourselves as beings of light.

It is through our connection to this light that we know things beyond what the visible world can tell us, and we see things beyond what the physical world reveals. In order to access this wisdom, we can simply allow ourselves to remember that we are not limited, as we have been taught. In fact, we are filled with divine grace and power that is ours for the asking. A daily practice of tuning into this vast potential, conversing with it, and offering ourselves up to it opens the door through which we can reclaim our true identity, taking ownership of the calling that the time has come to create bliss on earth.

inj.depot de olanzapina

Treatment With Depot Olanzapine

John Davis, M.D.

Chicago, Ill.

To the Editor: I wish to expand on two points made in my editorial (1), published in the February 2010 issue of the Journal, and correct an error. An accidental injection of depot olanzapine into or near a vein can result from much of the dose being administered as one bolus, producing an overdose, which is manifested as confusion, disorientation, deliria, somnolence, dysarthria, ataxia, and coma or seizure (2). This occurs in approximately 0.07% (the correct value) of individuals per injection, or approximately 1% of patients each year, which cumulates year by year. Hopefully, clinicians will be meticulous about injection techniques, reducing the incidence. Eighty percent of the time, this syndrome starts within 1 hour after injection, 17% of the time within 1–3 hours, and 3% of the time after 3 hours, with the median time to incapacitation being 60 minutes (range: 10–300 minutes). There was no relationship of dose to seriousness of this adverse reaction. In addition, there were no fatalities. Patients completely recovered in a few days, and most agreed to go back on depot medication It is important to prevent the consequences of adverse effects (e.g., auto accidents) by observing the patient for 3 hours after the injection; having the patient leave the clinic with a responsible caregiver; being attentive to the nonspecific prodrome (feeling weak, dizzy, or generally bad); and avoiding sedative medications as well as epinephrine, dopamine, and other beta agonists because they may possibly worsen hypotension as a result of olanzapine's apha-1 properties.

I do not think there is sufficient evidence to recommend tapering or not tapering oral drug doses or using a loading or intramuscular booster dose when switching to depot olanzapine, based on the following evidence. It takes 3–5 injections to reach steady state. Plasma levels decrease after the first injection, to as low as 5%–20% of the levels observed with oral drug formulation, but the half-life of D2 receptor blockade for oral and depot formulations is at least three times as long as that for plasma (3). Kane et al. (4) found the rate of relapse to be approximately 50% greater (not statistically significant) in the first few dosage intervals than the rate observed at steady state. The 405 mg per month dose was almost as effective as the dose of 300 mg every 2 weeks, indicating that monthly injection intervals can be of use.

The dosage of 150 mg every 2 weeks is too low for many patients, and may possibly double the number of relapses when the observed difference is projected over years.

* Bipolar II

Is There a Role for Antidepressants in the Treatment of Bipolar II Depression?

Trisha Suppes, M.D., Ph.D.

Amsterdam and Shults in this issue of the Journal (1) present results from their study of patients with bipolar II depression whose depression responded to an open-label trial of fluoxetine and who were then randomly assigned to double-blind treatment with fluoxetine, lithium, or placebo. At first blush, the Amsterdam and Shults article appears to answer a long-term controversy over the use of antidepressants in patients with bipolar II disorder. In patients initially found responsive to fluoxetine by achieving a depression score below 8 on the Hamilton Depression Scale and then randomly assigned to continue fluoxetine or to start either lithium or placebo, the fluoxetine group had the fewest recurrences and the lowest hazard ratio for recurrence of depression. Is this answer definitive enough to guide clinical practice?

As someone involved in clinical trials, my bias is that despite their limitations, clinical trials provide us with scientific data that should carry more weight than hypothesis-generating data derived from case/control, retrospective, or case studies. An important strength of this particular study is its detailed application of placebo-controlled, randomized methodology. However, its strength should be juxtaposed to its equally strong limitation of using this methodology in an enriched-responder, small-sample population, where the primary outcome was depression recurrence and not a metric of overall mood stability in this group of patients with bipolar disorder. An enriched maintenance sample may be a reasonable step forward, but a controlled trial of treatment from the initial acute illness to the continuation phase would be a more compelling demonstration of efficacy.

The issue of whether to use antidepressants in bipolar disorder has been passionately debated in the literature, but few long-term, well-controlled studies have been done. There are warnings and cautions about and prohibitions against using antidepressants at any point in a patient's course of illness (2, 3), but there are others who have pointed to the potential utility of longer-term antidepressants for some patients (4). Acute studies of antidepressants in bipolar disorder show limited efficacy—although some patients do indeed report benefit—but overall placebo-controlled, double-blind maintenance studies do not demonstrate that antidepressants produce significantly better results than placebo (5). Even in acute depression, antidepressants, either as monotherapy or as adjunctive therapy, provide little benefit for most patients with bipolar disorder. Bipolar II depression seems to be no different than bipolar I in this regard (5, 6).

Because the authors made syndromal depression the primary outcome for assessing the benefit of treatment, it may not be surprising that patients treated with lithium did not do as well as those treated with fluoxetine. Lithium treatment also did not do as well as placebo in terms of the time to relapse. However, significant attrition (from 50% of initial sample to about 28 or so randomized to each of three groups, with less than 50% of these patients completing the study for an overall attrition of more than 75%) also needs to be considered as limiting the certainty of the results.

Although depression is a major component of the burden of bipolar disorder, a critical point that needs to be carefully considered in assessing the overall benefit of each treatment is the prevention of mood instability. Amsterdam and Shults clearly define criteria for hypomania and subsyndromal hypomania. Using a Young Mania Rating Scale threshold of ≥8, fluoxetine-treated patients were three times more likely than lithium-treated patients to have a hypomanic study visit; the findings were also present, but attenuated, using a threshold ≥12. Overall, the proportion of patients receiving fluoxetine meeting their various definitions of hypomania was 50% versus about 34% for those patients on blinded lithium or placebo (Table 3: including events noted of mood lability, subsyndromal hypomania, or hypomania). Does this mean fluoxetine treatment prevented the recurrence of depression, but at the risk of some degree of mood instability? This conclusion is reinforced by the Young Mania Rating Scale individual profile plots (Figure 3), which show noticeably greater excursions above 0 for fluoxetine and for placebo, compared to lithium.

These findings of mood instability reinforce the need for caution. While we already know that patients with bipolar II disorder are less prone to hypomania then patients with bipolar I disorder (7, 8), recent work by Frye et al. (9) suggests that even subsyndromal low levels of hypomania can be predictive of switch into more manic states and be early warning signs of mood lability. Amsterdam and Shults may also be minimizing the development of mixed states, which have concerned others who study the course of bipolar disorder (10). For example, their attribution of symptoms such as insomnia to either hypomania or depression based on the rater's judgment is a nonstandard approach that has not been validated by other groups. Can the researchers or the patient know with certainty if insomnia, for example, is due to depression, hypomania, or is part of a complex mixed presentation?

Is there a group of patients who might do better with antidepressants than without them? The clinical message would seem to be there are some patients with bipolar II depression who may benefit from fluoxetine or potentially other SSRI antidepressants, but clinicians need to watch for mood lability and other signs of destabilization. Overall recommendations for long-term treatment of bipolar II depression are not resolved by this study, but neither can we dismiss the apparent well-being of many of the patients in this study.

* suicid

Rethinking the Role of Mental Illness in Suicide

Michael R. Phillips, M.D., M.P.H.

Psychological autopsy studies in high-income countries (1) have consistently found that at least 90% of persons who die of suicide are suffering from a mental disorder at the time of death. In China, however, there are now two well-designed independent psychological autopsy studies that have found substantially lower rates of mental disorders in suicide decedents. A nationally representative psychological autopsy study of 895 adult suicide victims conducted about a decade ago (2) reported a prevalence of mental disorders of 63%. In this issue, in a study of 392 rural suicide victims 15–34 years of age, Zhang and colleagues (3) report that only 48% had a current mental illness. The prevalence in the subsample of the earlier study who were 18–34 years of age (N=114) was 45% (4), similar to the rate seen in this new study.

Are these low rates of mental illness in Chinese suicide victims reliable? Zhang et al. used a Chinese version of the Structured Clinical Interview for DSM-IV (SCID) with proxy informants to make psychiatric diagnoses. All psychological autopsy studies employ proxy informants to make diagnoses, so this should not in itself explain the lower rate of mental disorders in Chinese suicide decedents. But in China a low proportion of individuals with mental illnesses ever receive treatment (5), so unlike in Western studies, the proxy-based diagnoses cannot be augmented by referring to information in clinical records. Studies have found that the SCID can be used reliably in China (5), but clinicians need to be flexible in their use of the SCID probes to make the instrument sensitive to cultural variation in the manifestation and expression of symptoms. Thus, the main methodological concern with the Zhang et al. study is whether or not the use of nonpsychiatric interviewers—who may be less able to flexibly change probes when respondents do not understand the standard SCID probes—led to an underestimation of the rate of mental illness. Interrater reliability was assessed by having interviewers code three taped mock interviews. But three interviews are too few to assess diagnostic reliability, and this method assesses interviewers' ability to code a standard interview conducted by someone else—it does not assess their ability to independently conduct the interview. And the much lower rate of mental illnesses in the 416 comparison subjects (3.8%) relative to that reported in community members 18–34 years of age (12.5%) who participated in a large psychiatric epidemiologic study in China in which the SCID was administered by psychiatrists (5) suggests that the interviewers in the Zhang et al. study may have been less thorough in their investigation of comparison subjects or that the proxy informants of living comparison subjects may have been more reluctant to report psychological problems in their associates. Despite these caveats, the close similarity of the study's reported prevalence of mental disorders in young suicide decedents to that of the previous independent psychological autopsy study (48% and 45%, respectively) gives us some reassurance that the overall prevalence reported in the suicide decedents is reasonably close to the actual rate.

There are many potential factors that could explain the relatively low reported prevalence of mental disorders among suicide decedents in China compared to rates reported in high-income countries. Although the prevalence of substance use problems has recently increased, it still remains much lower in China than in high-income countries, particularly among women (5). Psychological autopsy studies in China have not considered the full range of personality disorders—primarily because of doubts about the validity of the DSM-IV personality disorders in China. A study of 505 suicides in China showed that impulsive personality traits are an important risk factor for suicide (6), but the impulsive individuals among these suicide decedents did not have the serious psychosocial dysfunction that is required to diagnose a personality disorder. Another potential factor is the dichotomous nature of psychiatric diagnoses; the risk of suicide in China is linearly related to the severity of depressive symptoms (7), so many individuals without a diagnosis are still at substantial risk of suicide as a result of subsyndromal symptoms. This may be a more important factor in China and other cultures where the manifestation of dysphoric affect may not neatly match diagnostic criteria that were established using Western samples. And, finally, the frequent use of pesticides as a method of self-harm—used in 58% of suicides and 28% of suicide attempts in China (8)—increases the overlap between nonfatal and fatal suicidal behavior and thus could increase the proportion of suicide decedents without mental illnesses who carried out impulsive acts with little intention to die (6).

Why is this important? China accounts for up to one-third of global suicides (1), so the lower prevalence of mental disorders in Chinese suicide decedents has important implications for both the theoretical modeling of suicidal behavior and the development of international suicide prevention strategies. If a current mental illness is not a prerequisite for suicide, models of suicide in which risk and protective factors exert their influence via their effect on the occurrence and severity of mental disorders will need to be reconsidered. And if a substantial minority of suicide decedents do not have a mental illness, preventive approaches focused solely on the recognition and management of mental illnesses will need to be supplemented with other strategies. Moreover, 85% of suicides worldwide occur in low- and middle-income countries (9), and ingestion of pesticides is the most common method of suicide (10), so the situation in China may not be as atypical as it appears from the Western perspective.

Building more mental health centers in rural China or training more village doctors to identify and treat depression may be useful for other reasons, but these strategies will not prevent impulsive pesticide ingestion in persons who are in the midst of an intense argument with their spouse. The study by Zhang et al. highlights the importance of low social support both as an independent risk factor for suicide in young rural residents and as a magnifier of the risk due to mental illness. This new finding suggests that developing family-based and community-based social and psychological support networks should be a central component of suicide prevention activities. Given the high proportion of suicides by pesticide ingestion and the frequent occurrence of acute interpersonal conflicts in suicide decedents, other important suicide prevention strategies that should be considered in this setting are means restriction and enhancement of conflict resolution skills in children and young adults.

The conventional wisdom that suicide is almost always the outcome of mental illness will not be altered by one or two studies from China. Psychological autopsy studies, dependent as they are on retrospective data from proxy informants, have several fundamental problems, so there will always be some methodological nuance that supporters of the conventional wisdom can cite to question the validity of such studies. What we can do is gradually improve the methodology of these studies and increase the number of such studies conducted in rural areas of low- and middle-income countries, where the majority of suicides worldwide occur. Zhang et al. recommend increasing the case-control ratio in such studies, thus allowing for a better assessment of the relative importance of factors that may be uncommon in comparison subjects. I would also recommend several other steps: cultural adaptation of the probes used to assess symptoms (while maintaining the DSM or ICD diagnostic criteria); rigorous assessment of interviewer reliability by having instrument-trained clinicians conduct independent interviews with the same respondents; inclusion of continuous measures of symptom severity and personality traits in addition to the dichotomous diagnostic categories; assessment of the magnitude of the psychological impact of negative life events rather than simply recoding the number of negative life events; identification and assessment of culturally relevant protective factors; recording information about decedents' access to means; parallel studies of attempted and completed suicide to assess the degree of overlap between the two types of self-harm; and inclusion of qualitative in-depth interviews with informants to help clarify the local meaning of the quantitative results obtained.

* psihiatria de legatura cu medicul de familie

July 1, 2010 — Brief therapies — including cognitive behavior therapy (CBT), problem-solving therapy (PST), and counseling — are all effective for treating depression and mixed anxiety and depression in a primary care setting, according to a new meta-analysis that included more than 3000 patients.

* Vit B antidepresiva

July 1, 2010 — High total intakes of vitamins B6 and B12 are associated with a lower risk for depressive symptoms over time in community-residing older adults, according to the results of a cohort study reported online June 2 in the American Journal of Clinical Nutrition.

* testosteron la batrini

July 1, 2010 — Testosterone treatment in men aged 65 years and older who have limitations in mobility is associated with an increased risk for cardiovascular events, including myocardial infarction and hypertension, according to a study published online June 30 in the New England Journal of Medicine.

* deprsia la "celebritati"

Take the Celebrity Depression Quiz!

"From supermodels to movie stars to politicians to painters,

famous people are not immune to the pain of depression. ..."

* ziprasidone

Comparison of the metabolic and economic consequences of long-term treatment of schizophrenia using ziprasidone, olanzapine, quetiapine and risperidone in Canada: a cost-effectiveness analysis
Journal of Evaluation in Clinical Practice, 07/28/2010

Roussy JP et al. – Compared with olanzapine and quetiapine, ziprasidone produced savings to the health care system. Although ziprasidone generated incremental expenditures versus risperidone, it resulted in more QALYs. Based on this analysis, ziprasidone treatment possesses cost and therapeutic advantages compared with olanzapine and quetiapine.

* marker in schizofrenie

Neural markers of remission in first-episode schizophrenia: A volumetric neuroimaging study of the hippocampus and amygdala
Schizophrenia Research, 07/28/2010

Bodnar M et al. – A smaller hippocampal tail volume may represent a neural marker in FES patients who do not achieve early remission after the first 6 months of treatment. The early identification of patients with poor outcome with respect to the hippocampus tail may encourage the search for new, more target–specific, medications in hope of improving outcome and moving us towards a better understanding of the pathophysiology of schizophrenia.

* baclofen -nul in alcoolism

Efficacy and safety of baclofen for alcohol dependence: A randomized, double-blind, placebo-controlled trial
Alcoholism, 07/27/2010

Garbutt JC et al. – The purpose of the present study was to test the efficacy and tolerability of baclofen in alcohol dependence in the United States. Baclofen, a GABAB agonist, represents a possible new pharmacotherapeutic approach to alcohol dependence. Despite encouraging preclinical data and prior positive clinical trials with baclofen in Italy, the current trial did not find evidence that baclofen is superior to placebo in the treatment of alcohol dependence.

* marihuana-schizofrenie

A Complex Link Between Marijuana and Schizophrenia
Time, 07/27/2010

Repeatedly, studies have found that people with schizophrenia are about twice as likely to smoke pot as those who are unaffected. Conversely, data suggest that those who smoke cannabis are twice as likely to develop schizophrenia as nonsmokers. One widely publicized 2007 review of the research even concluded that trying marijuana just once was associated with a 40% increase in risk of schizophrenia and other psychotic disorders.

* anxietatea

July 7, 2010 — Patients with stable coronary heart disease (CHD) plus general anxiety disorder (GAD) have a higher risk of experiencing cardiovascular events — such as stroke, myocardial infarction, and death — than patients with CHD only, according to a new cohort analysis from the Heart and Soul Study.

Alzheimer

* Alzheimer

Lowering risk of Alzheimer's disease
Current Psychiatry, 06/03/2010  Free full text  Evidence Based Medicine

Bassil N et al. – This article summarizes the findings of many studies that address AD prevention and includes an online – only bibliography for readers seeking an in–depth review. The evidence does not support a firm recommendation for any specific form of primary prevention and has revealed hazards associated with estrogen therapy and nonsteroidal anti–inflammatory drugs. Most important, it suggests that you could reduce your patients' risk of developing AD by routinely supporting their mental, physical, and social health. The potential benefits of modifying an individual's AD risk factors likely will depend on his or her genetic makeup, environment, and lifestyle. Even so, counseling patients to exercise more and improve their diets – such as by eating more fish, fruits, and vegetables and less saturated fat – might help protect the brain. Your ongoing efforts to manage hypertension, hypercholesterolemia, and diabetes also may reduce their AD risk.

* marker ul cancerului de prostata

July 1, 2010 — New data from a Swedish study show that population screening with prostate-specific antigen (PSA) in men between 50 and 69 years of age reduced prostate cancer mortality by almost half during a follow-up period of 14 years. The finding was published online today in Lancet Oncology.

Vatican 3D

Tineti mouse-ul apasat si miscati imaginea, este superb!
In stanga imaginii, jos, este zoom pentru aproape si departare. 
  
 
http://www.vatican.va/various/basiliche/san_paolo/vr_tour/index-en.html 

 

-- Material trimis de D. Mihaela Dumitru

Bancuri...

Un sot si o sotie stau de vorba. "Draga mea", a spus el, "ce-ar fi sa ducem maine copiii la gradina zoologica?". "Nu, scumpul meu!", a protestat ea ferm. "Cine vrea sa ii vada sa vina acasa!".
........
    Ce e mic, verde si se plimba in sus si in jos: un bob de mazare intr-un lift .
.........
      Cum il pedepseste  pe premier sotia lui Emil Boc? Ii pune cheile pe frigider.
.........
       Un barbat merge la o competitie canina cu un suberb exemplar buldog englez. Organizatorul il priveste nemultumit si exclama:
-Nu domnule, imi pare rau , cainele dvs, nu poate intra in concurs
Stapanul uluit intreaba:
-Poftim? Dar de ce ma rog?
-Nu se poate, domnule, are picioarele prea scurte
-Dar e imposibil, toate-i ajung la pamant !
.........
     Un tip facea autostopul pe o strada pustie, intr-o noapte neagra si in mijlocul unei furtuni de zapada puternice. Timpul trecea, nici o masina pe drum, si furtuna facea sa nu vada nici la 2 pasi in fata lui.La un moment dat apare o masina si se opreste in dreptul lui… Fara sa analizeze mult situatia, tipul se urca in masina. Dupa ce inchide usa , se uita spre cel de la volan …, si incremeneste. La volan nu era NIMENI!!!Masina porneste usor, iar tipul, deja ingrozit, statea lipit de scaun, fara sa poata scoate vreo vorba.
Apare o curba, … tipul incepe sa se roage in gand sa scape cu viata, si exact cand intra masina in curba, apare o mana prin geam si roteste volanul.
Tipul, deja paralizat de groaza, vede cum de fiecare data cand ajunge la o curba, mana apare prin geam si roteste volanul.La un moment dat, vazand ca se apropie de oras, isi face curaj si sare din masina.
Intra in primul bar care ai iese in cale si, ud si inspaimantat, cere 2 pahare de vodca si incepe sa le povesteasca celor din bar experienta groaznica prin care a trecut.
Toti raman pe ganduri cand isi dau seama ca tipul plange, cu toate ca nu era beat.Dupa vreun sfert de ora, alti doi tipi inghetati bocna intra in bar, si vanzandu-l pe primul, unul dintre ei ii zice celuilalt:- Auzi mai, asta nu e tampitul ala, care s-a urcat la noi in masina in timp ce noi o impingeam ?!?
.........
    Sotul vine acasa din delegatie si sotia are trei barbati in casa.
Nu stie unde sa-i piteasca asa ca ii baga repede in trei saci si ii pune pe balcon.
Sotul vrea sa-si aprinda o tigara, vede sacii si intreaba:
- Ce e cu sacii astia?
- A fost mama ta in vizita si ne-a adus cate ceva…
Sotul da un picior la primul sac si dinauntru se aude:
- Guitz, guitz, guitz!
Sotul zice:
- A, un purcelus…e bine!
Da un picior la al doilea sac si aude:
- Muu, muuuuuu!
- A, un vitelus…
Da un picior la al treilea sac si nimic. Mai da inca un picior, mai tare si nimic. Ia o lopata si incepe sa dea in sac cu ea.
Deodata sacul se deschide si iese tipul revoltat rau:
- BA DOBITOCULE, DACA NU SE AUDE NIMIC INSEAMNA CA TI-A ADUS MA-TA CARTOFI!
......
 Intr-o noapte, la spital, o asistenta blonda il scoala pe pacientul care dormea un somn adanc si ii spune:
  1. -Treziti-va, am uitat sa va dau somniferul!
    *****
    Un tata ingrijorat isi asteapta fiul acasa. Intr-un tirziu soseste, si
    este luat la intrebari:
    - Unde ai stat pana la ora aceasta?
    - Tata, azi mi-am pierdut virginitatea.
    - Bravo! Stai jos, sa bem si noi un paharel pentru acest eveniment!
    - Putem sa bem, dar nu pot sa ma asez..
    *****
    Doctorul vine la patul bolnavului si-l intreaba:
    - Fumezi?
    - Nu! vine raspunsul.
    - Pacat! Tocmai vroiam sa-ti interzic…
    *****
    Un studiu sociologic arata ca barbatii, in general,
    ies la baut din doua motive:
    1. N-au nevasta
    2. Au nevasta
    *****
    O mama isi dojeneste fiul:
    - Aha, deci in Spania nu vrei sa te duci, in Italia nu vrei sa te duci,
    fotbal nu stii sa joci, manele nu vrei sa canti…….
    …bine ma, atunci da la facultate……. sa ajungem de rasul blocului!
    *****
    Un politai sta pe marginea drumului, vede o masina care calca linia
    continua si o opreste. Soferul coboara geamul si intreaba:
    - Cat?
    - 500.000
    - Cu prezervativ sau fara?
    *****
    Doi indragostiti, pe o banca, in parc:
    - Iubitule, cand o sa ne casatorim o sa avem doi copii, un baiat si o
    fata.
    - Dar de unde stii?
    - Amandoi sunt la mama, la tara .
    *****
    Inginerul agronom catre badea Vasile:
    - Bade, cu metoda asta invechita nu o sa obtii nici cinci kile de pere
    din pomul asta…
    - Ai dreptate, e prun…
    *****
    Un barbat avea febra mare, asa ca sotia l-a dus la doctor.
    Dupa o consultatie, acesta a spus:
    - Doamna, sotul dvs. are nevoie de odihna. Va prescriu niste somnifere..
    - Bine, domnule doctor. Si cand trebuie sa i le dau?
    - Dar nu sunt pentru el, sunt pentru dumneavoastra!
    *****
    Horoscopul pe luna urmatoare :
    Sanatate: astrele iti surad.
    Bani: astrele iti surad si mai tare.
    Dragoste: astrele fac pe ele de ras…
    *****
    Bula suparat ajunge acasa:
    - Tata am luat un 4 la matematica! Bang, bang, ii da ta-su doua palme. A doua zi iar:
    - Tata am luat un 4 la fizica! Bang 2 palme din nou. A treia zi:
    - Tata am luat un 10 la muzica! Bang inca doua palme..
    - Cu notele astea iti mai arde de cantat ?
    *****
    Un apel telefonic la o agentie de turism:
    - Organizati excursii in Egipt?
    - Da, desigur….
    - Spuneti-mi, va rog, ce statiuni balneare sunt acolo?
    - Sharm-el-Sheick, Hurgada, Taba, Nuveiba…
    - Stop…. Nuveiba. Nuveiba e bun!
    - Când doriti sa plecati, cate persoane?
    - A, nu, nu plecam. Noi doar rezolvam integrame…
    ******
    - Doamnelor si domnilor, avionul nostru se va prabusi in ocean si in jur e plin de rechini. Luati de sub scaune vestele de salvare si cutiuta cu crema… este ca sa va ungeti pe corp, impotriva rechinilor..
    - Si nu ne mai mananca?
    - Ba da, dar cu scarba..
  -- Material trimis de Dna Rita Pana

Terapia cu Apa

Terapia cu Apa
 
In Japonia zilelor nostre este foarte popular obiceiul de a bea apa imediat dupa trezire in fiecare dimineata. Mai mult, testele cercatatorilor au demonstrat valoarea acestui obicei. Publicam mai jos o descriere a acestei metode pentru cititorii nostri.
Tatamentul cu apa a fost considerat de succes de catre o societate medicala japoneza, ca tratament sigur 100% pentru urmatoarele boli: dureri de cap, dureri ale corpului, sistemul circulator, artrita, batai puternice ale inimii, epilepsie, grasimi in exces, astm bronsic, tuberculoza, meningita, boli de ficat si urina, voma, gastrita, diaree, hemoroizi, diabet, constipatie, toate bolile de ochi, cancer la organelle genitale si dereglari menstruale, boli ale urechilor, nasului si gatului.
Aceasta metoda de tratament nu are efecte adverse. Este si mai bine daca continuati acest tratament ca o activitate de rutina in viata voastra. Beti apa si ramaneti sanatosi si activi.
Metoda de tratament
1. Dimineata, imediat dupa trezire, inainte de a va spala pe dinti, beti 4×160 ml apa.
2. Spalati-va pe dinti dar nu mancati si nu beti nimic 45 minute.
3. Dupa 45 minute puteti bea si manca normal.
4. Cei care sunt batrani sau bolnavi si nu pot bea 4 pahare cu apa la inceput pot incepe prin a bea apa mai putina si sa creasca gradual pana la 4 pahare pe zi. Pacientii cu artrita ar trebui sa urmeze tratamentul de mai sus doar 3 zile in prima saptamana si incepand din a doua saptamana zilnic.
Urmatoarea lista da numarul de zile de tratament necesar pentru vindecarea, controlul su reducerea principalelor boli:
1. Presiune ridicata a sangelui: 30 zile
2. Gastrita: 10 zile
3. Diabet: 30 zile
4. Constipatie: 10 zile
5. Cancer: 180 zile
6. Tuberculoza: 90 zile
Asociatia Nationala pentru promovarea Medicinelor Neconventionale recomanda o varianta usor modificata a acestei terapii:
1. Dimineata, imediat dupa trezire, inainte de a va spala pe dinti, beti 1-1,3l apa de izvor sau plata.
2. Nu mancati si nu beti nimic in afara de putina apa timp de 1 ora.
3. Continuati terapia mai multe zile la rand.
Ca perioade de tratament, Asociatia Nationala pentru promovarea Medicinelor Neconventionale recomanda:
1. Constipatia, durerile de cap, tusea, bronsita: 1 zi
2. Durerile de stomac, hiperaciditatea, gastrita: 2 zile
3. Bolile uro-genitale, reumatismul: 1 saptamana
4. Hipertensiunea, diabetul, cancerul in faze incipiente: 1 luna
5. Tuberculoza pulmonara, paralizia, cancerul: 3 luni
Totusi afirma ca aceasta terapie are si unele contraindicatii, in urmatoarele cazuri: hipertensiunea arteriala, insuficenta renala, insuficenta cardiaca, glaucomul, edemele de orice natura, chistele ovariene de dimensiuni crescute, fibroamele uterine mari, tumorile cerebrale, bronsiectaziile, rectocolita ulcero hemoragica si maladia crohn, dizenteria si holera, apendicita acuta, adenomul de prostata, vezica hipertona, ruptura de perineu.
De-a lungul timpului au aparut mai multe metode de a imbunatati calitatea apei. Astfel au aparut apa Pi, apa ionizata, apa vie etc.
Apa ionizata
Mai jos sunt cateva explicatii extrase dintr-o revista de stiinta (Ion Life Detox News r.7/2004), care explica de ce ne ingrasam, ne imbolnavim si imbatranim. In ultimii 30 de ani japonezii si coreenii s-au bucurat de beneficiile aduse sanatatii si conditiei fizice de apa ionizata, restul lumii afland de ea doar de cativa ani. Poate ca cel mai uimitor aspect al fenomenului numit "apa ionizata" este ca, in Japonia, o familie din 5 consuma apa ionizata.
Noi toti avem prea mult aciditate
Hrana pe care o consumam arde impreuna cu oxigenul din celule pentru a produce energie. Dupa ardere, hrana se transforma in reziduuri acide, iar celulele le depoziteaza in circuitul sanguin. Corpul nostru elimina aceste reziduuri prin urina, respiratie si transpiratie, restul fiind depozitate de-a lungul vaselor de sange si tesuturi.


Pentru a putea trai, sangele si celulele noastre trebuie sa fie usor alcaline (sangele are pH-ul de 7,35). Pentru a-si pastra alcalinitatea, organismul nostru face o mica "scamatorie", prin care converteste reziduurile acide in reziduuri acide solide. Daca corpul poate mentine aceste reziduuri nediluate, le poate stoca pe o perioada nedeterminata, neafectand pH-ul in restul corpului. Asa ca le stocheaza intr-o gramada de locuri si moduri, inclusiv in grasime. Ingrasarea poate fi rezultatul necesitatii reziduurilor acide de a avea un mediu de stocare.
Concluzie: prima data suntem acizi si apoi apare grasimea.
Exemple ale reziduurilor acide solide in corpul nostru sunt: colesterolul, acizi grasi, acid uric, pietre la rinichi, urati, sulfati si fosfati. Acumularea acestor reziduuri acide reprezinta procesul imbatranirii. Formula chimica pentru colesterol si acizii grasi este arderea incompleta a carbohidratilor. Colesterolul si acizii grasi sunt rezultatul consumului de paste si paine. Acidul uric si amoniacul provin de la toate tipurile de carne. Acidul fosforic provine de la cereale, cum ar fi orezul si bauturi tip cola. Acidul sulfuric provine de la galbenusul de ou.
Acizii sulfuric si fosforic sunt otravitori. Ei trebuie neutralizati de minerale alcaline, inainte sa devina ceva benign. In absenta unei cantitati suficiente de minerale alcaline in dieta noastra, corpul nu are de ales si va fura calciul din oase, neutralizand acesti acizi, transformandu-i in sulfati, fosfati si urati; asa apare, in timp, osteoporoza.
Una dintre marile probleme ale reziduurilor acide este ca ingroasa sangele si blocheaza capilarele. Din aceasta cauza, multe persoane sufera de hipertensiune arteriala. In functie de locul in organism unde sunt stocate reziduurile acide, circulatia sangelui in acea zona este slaba si este posibil ca un organ vital sa primeasca insuficient sange, devenind disfunctional.
Multe boli degenerative sunt rezultatul proastei circulatii. Un exemplu tipic este diabetul, care este cauzat de acumularile acide in jurul pancreasului.
Celulele canceroase sunt acide, in timp ce celulele sanatoase sunt alcaline. Celulele normale nu pot supravietui in apropierea zonelor cu acumulari de reziduuri acide. Oricum, anumite persoane au gene puternice, care sufera mutatii pentru a supravietui in mediu acid. Asa se dezvolta celulele canceroase. Atata timp cat mediul ramane acid, cancerul va reapare dupa o operatie de extirpare a celulelor canceroase. Oncologistii cu experienta cresc alcalinitatea pacientilor, inainte de operatie.
Reziduurile acide din interiorul vaselor de sange sunt foarte periculoase, putand duce la infundarea capilarelor din zona creierului. Corpul nostru lipeste aceste reziduuri de peretii vaselor de sange, dar in cazul unor eforturi mari, cand presiunea creste, aceste reziduuri se pot dezlipi si bloca vasele capilare din zona creerului provocand accidente cerebrale.
Alcalinul neutralizeaza acidul
Apa alcalina ionizata neutralizeaza reziduurile acide din corpul omenesc si le lichefiaza pentru a fi eliminate de catre rinichi. Un exemplu care ne ajuta sa intelegem acest lucru ar fi grasimea de pe maini, dupa ce spalam carnea. Aceasta grasime nu poate fi indepartata cu apa de la robinet. Avem nevoie de un sapun pentru a lichefia grasimea si a ne curata pielea. Grasimea este acida si sapunul este alcalin.
Ne spalam corpul la exterior, indepartand murdaria, dar neglijam complet murdaria din interior. Deci ne conducem dupa dictonul "Ceea ce ochii nu vad, nu exista".
In functie de fiecare organism, noi stocam reziduurile acide in mod diferit. Simptomele bolilor se manifesta in functie de locul unde sunt stocate reziduurile. Cand vom intelege ca bolile degenerative ale adultilor sunt cauzate de acumularile de deseuri acide, nu va mai fi nici un mister ca utilizarea apei alcaline ionizate ne imbunatateste sanatatea.
Pentru a duce o viata lunga si sanatoasa, mai intai trebuie sa eliminam deseurile acide din corpul nostru. Cel mai bun si usor mod de a scapa de aceste deseuri acide este sa le lichefiem si sa le neutralizam cu apa alcalina ionizata. Prin eliminarea particulelor rezidurilor acide din sange, eliminam riscul imbolnavirilor care pot duce la moarte subita.
Apa alcalina ionizata nu are valoare nutritionala sau de medicament, dar are uimitoarea capacitate de a neutraliza si lichefia deseurile acide, pentru a putea fi eliminate din organism, pastrand alcalinitatea acestuia - deci sanatatea si starea de bine.
 
--Mterial trimis de Dl Dr. Dragos

Zen Story


Daily Zen


On The 
 Way        

      

    

          

Absorption in the Treasury of Light

 

           Zen Master Ejo

 
                                     

There is a chapter on light in the Shobogenzo; the reason for writing this essay now is just to bring out this essential substance, the fact that the countenance of Buddhism is absorption in the treasury of light.

 

The so-called treasury of light is the root source of all Buddhas, the inherent being of all living creatures, the total substance of all phenomena, the treasury of the great light of spiritual powers of complete awareness.  The three bodies, four knowledges, and states of absorption numerous as atoms in every aspect of reality, all appear from within this.

 This great light of Lamplike Illuminate pervades the universe, without differentiating between the mundane and the sacred. Because this one light extends throughout all time, if there were any attaining it, then it would have to be twofold.

 

The Scripture on the Miraculous Empowerment of Vairochana attaining Buddhahood says,

 

 “Oh, Master of the Secret, what is enlightenment? 

 “It means knowing your mind as it really is.  This is unexcelled complete perfect enlightenment, in which there is nothing at all that can be attained.  Why?  Because enlightenment has no form; it has no knowledge and no understanding.

 

Student:  If Buddha-nature is present now within the body, it is not separate from ordinary people. Then why can’t I see it?  Would you please explain this more?

 The same scripture says, “Master of the Secret, the practice of the Great Vehicle awakens the mind that transports you to the unconditioned, guided by selflessness.  Why?

 “Those who have cultivated this practice in the past have observed the basis of the clusters of mental and physical elements, and know they are like illusions, mirages, shadows, echoes, rings of fire, castles in the air.

 

“Thus they relinquish the selfish, and the host of the mind autonomously awakens to the fundamental nonarousal of the essential mind.  Why?  Because what is before mind and what is after mind cannot be apprehended.  Thus knowing the nature of the essential mind, you transcend two eons of yoga practice.” 

 The Flower Ornament Scripture also says, “The body of Buddha radiates great light of infinite colors perfectly pure, like rainbows covering all lands. All who are illumined by the light rejoice; beings with pains have them all removed.  Everyone is inspired with respect and develops a compassionate heart.  This is the independent function of enlightenment.”

 

The knowledge of the enlightened is light, a concentration of the light of immutable knowledge beyond the two extremes of ordinary and holy, or absolute and conventional. It is the light of the nonconceptual knowledge of Manjushri, who represents great knowledge.  This becomes manifest in the effortlessness of simply sitting.

 

 “The practice of the Great Vehicle awakens the mind that transports you to the unconditioned, guided by selflessness.”  The Third Patriarch of Zen said, “Do not seek reality, just stop views.”  Obviously there is no ego in the treasury of light, no opinionated interpretation.  Ego and opinions are different names of spirit heads and ghost faces.  This is just the light alone, not setting up any opinions or views, from the idea of self and ego to the ideas of Buddha and Dharma. 

 

So we should know that this light is the universal illumination of matchless, peerless great light completely filled with infinite meaning.   Sitting meditation is absorption in the treasury of light inherited directly from Shakyamuni.  This is the light that is not two in ordinary people and sages, that is one vehicle in past and present.  It does not let anything inside out and does not let anything outside in:  who would randomly backslide into cramped boredom within the context of discriminatory social and personal relationships?  It cannot be grasped, cannot be abandoned: why suffer because of emotional consciousness grasping and rejecting, hating and loving? 

 

In The Lotus Sutra Manjushri is told, “Great enlightening beings dwell in a state of forebearance, gentle, docile, and not rough, their minds undisturbed.  And they do not ruminate over things, but see the real character of things, and do not act indiscriminately.”  This is simply sitting: without acting indiscriminately, one thereby  goes along in conformity with great light.

 

A verse from the same book says:

 

“Delusion conceives of things as existent or nonexistent,

As being real or unreal, as born or unborn.

In an uncluttered place, concentrate your mind,

Remain steady and unmoving, like a polar mountain.

Observe that all phenomena have no existence,

That they are like space, without solid stability,

Neither being born nor emerging.

Unmoving, unflagging, abide in oneness:

This is called the place of nearness.”

 

This is a direct indication, “only expounding the unexcelled Way, getting straight to the point, setting aside expedients.”

 

In China, the great master Bodhidharma replied to the question of an emperor about the ultimate meaning of the holy truths, “Empty, nothing holy.”  This is the great mass of fire of the light of the Zen of the founding teachers: crystal clear on all sides, there is nothing in it at all.  Outside of this light, there is no separate practice, no different principle, much less any knowledge of objects; how could there  be any practice or cultivation, or deliberate effort to effect specific remedies?

 

            The emperor said to Bodhidharma, “Who is it replying to me?”

Bodhidharma said, “Don’t know.”  This is simply the single light that is empty.

The light is everyone:  Shakyamuni and Maitreya are its servants.  What is not more in Buddhas or less in ordinary beings is this spiritual light, so it is existent in all; it is the whole earth as a single mass of fire.

Zen Master Ejo

 

(1198-1282)

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