Viitoarea intalnire APLR - sambata 31 ianuarie 2015, ora 10:00-12:00, spital Obregia



Intalnirea lunara se reia pe 31 ianuarie 2015 cu tema: E X I S T E N T A

Prof.Dr. Aurel ROMILA



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Sarbatori  fericite si un An Nou plin cu spor,  sanatate si impliniri, impreuna cu  toti cei dragi!
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Mihaela Dumitru


Bucurie pentru toti


Sarbatoarea Craciunului sa va umple sufletele de bucurie, iubirea sa se reverse pentru toti si darurile divine sa va imbratiseze, sa fie acum cea mai frumoasa sarbatoare a tuturor, iar noul an sa va aduca numai sanatate, belsug, lumina si pace.

Suport de curs PSIHOPATOLOGIE 2015 - Master UEB

 
link suport de curs Psihopatologie: Filozofia discernamantului

 
link suport de curs: Meloterapia

 











link suport de curs: Artterapia








Interesting Article from MDLinx

MDLinx  Internal Medicine

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Your Article Summary

New medications for treatment of obesity: metabolic and cardiovascular effects
Canadian Journal of Cardiology, 11/25/14
Pucci A, et al. – The management of obesity remains a major challenge. While hard clinical outcome benefit has yet to be established obesity pharmacotherapy may soon offer to address many of the challenges in the clinical management of obesity, although newer and better drug combinations, and more evidence of benefit from appropriately designed outcome trials, is needed.

  • Dietary therapy often fails, while bariatric surgery although successful, is demanding and applicable to a limited number of patients.
  • Drug therapy has had many setbacks over the past twenty years because of serious adverse effects; however several new drugs for the treatment of obesity are either licensed in some parts of the world, submitted for registration, or completing phase 3 trials.
  • These include combinations (at low dose) of existing drugs e.g. bupropion + naltrexone (Contrave), phentermine + topiramate (Qsymia), higher doses of existing drugs licensed for other indications (liraglutide 3mg) and new entities (lorcaserin).
  • Here, the authors discuss the challenges and opportunities for obesity pharmacotherapy, and review in detail the efficacy of the new drugs in terms of weight loss, and both desirable and potential undesirable cardiovascular and metabolic risk factors.
  • Substantial barriers remain, even if the drugs are approved, in successfully integrating these agents into weight management practice, largely related to cost, patient acceptability and clinician willingness to be engaged in obesity treatment.


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Interesting Article from MDLinx

MDLinx  Internal Medicine

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Weight gain and associated factors in patients using newer antidepressant drugs
General Hospital Psychiatry, 12/03/14
Uguz F, et al. – The aim of the present study was to examine weight gain and its association with clinical and sociodemographic characteristics in patients using newer antidepressants. The study results suggest that patients who take newer antidepressants might have significant problems related to body weight.
Methods
  • The study had a cross-sectional design.
  • A total of 362 consecutive psychiatric patients taking antidepressant drugs for 6 to 36 months were included in the study.

Results
  • The prevalence rate of weight gain was 55.2%; 40.6% of the patients had a weight gain of 7% or more compared to the baseline.
  • Overall, antidepressant use was significantly related to increased body weight.
  • Specifically, citalopram, escitalopram, sertraline, paroxetine, venlafaxine, duloxetine and mirtazapine, but not fluoxetine, were associated with significant weight gain.
  • Multivariate logistic regression analysis indicated that lower education status, lower body mass index at the onset of antidepressant use and family history of obesity were independent predictors of weight gain ≥7% compared to the baseline.

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Interesting Article from MDLinx

MDLinx  Psychiatry

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Antidepressants and the risk of hyponatraemia: A class-by-class review of the literature
Psychosomatics, 09/15/14
De Picker L, et al. – The study aimed to determine the relationship between hyponatraemia and antidepressants, defining incidence and odds ratios (ORs) for antidepressant classes. The authors conclude that hyponatraemia is a potentially dangerous side effect of antidepressants, not exclusive to SSRIs. Current evidence suggests a relatively higher risk of hyponatraemia with SSRIs and venlafaxine, especially combined with patient risk factors, warranting clinicians to be aware of this complication. The risks associated with mirtazapine and TCAs are moderate, supporting these antidepressants as alternative treatments for patients with (an increased risk of) hyponatraemia.
Methods
  • A review of the literature published until March 2013 was performed using Web of Science and PubMed employing combinations of search strings "antidepressants" and antidepressant class and generic drug names with "hyponatr(a)emia", "SIADH" or "inappropriate ADH".

Results
  • 21 effect studies and over 100 case reports were considered, the majority concerning SSRIs.
  • Because of variations in study designs, populations and cut-off values, incidence rates diverged between 0.06-40% for SSRIs and 0.08-70% for venlafaxine.
  • Although based on less solid evidence, incidence figures for mirtazapine and TCAs were lower.
  • Regarding classes, ORs for SSRIs (1.5-21.6) were consistently higher than for TCAs (1.1-4.9).
  • The risks associated with MAO inhibitors, reboxetine and bupropion could not be established due to insufficient information.
  • Patient risk factors included older age (OR 6.3) and concomitant use of (thiazide) diuretics (OR 11.2-13.5).

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Other articles in Psychiatry

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Fluid and electrolyte balance in children
Anaesthesia & intensive care medicine, 11/10/14

Interesting Article from MDLinx

MDLinx  Psychiatry

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Curcumin for the treatment of major depression: A randomised, double-blind, placebo controlled study
Journal of Affective Disorders, 07/17/14
Lopresti AL, et al. – Curcumin, the principal curcuminoid derived from the spice turmeric, influences several biological mechanisms associated with major depression, namely those associated with monoaminergic activity, immune–inflammatory and oxidative & nitrosative stress pathways, hypothalamus–pituitary–adrenal (HPA) axis activity and neuroprogression. Partial support is provided for the antidepressant effects of curcumin in people with major depressive disorder, evidenced by benefits occurring 4 to 8 weeks after treatment.
Methods
  • In a randomised, double-blind, placebo-controlled study, 56 individuals with major depressive disorder were treated with curcumin (500 mg twice daily) or placebo for 8 weeks.
  • The primary measure was the Inventory of Depressive Symptomatology self-rated version (IDS-SR30).
  • Secondary outcomes included IDS-SR30 factor scores and the Spielberger State-Trait Anxiety Inventory (STAI).

Results
  • From baseline to week 4, both curcumin and placebo were associated with improvements in IDS-SR30 total score and most secondary outcome measures.
  • From weeks 4 to 8, curcumin was significantly more effective than placebo in improving several mood-related symptoms, demonstrated by a significant group x time interaction for IDS-SR30 total score (F1,53=4.22, p=.045) and IDS-SR30 mood score (F1,53=6.51, p=.014), and a non-significant trend for STAI trait score (F1,48=2.86, p=.097).
  • Greater efficacy from curcumin treatment was identified in a subgroup of individuals with atypical depression.

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Other articles in Psychiatry

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Interesting Article from MDLinx

MDLinx  Psychiatry

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Melatonin for prevention of metabolic side-effects of olanzapine in patients with first-episode schizophrenia: Randomized double-blind placebo-controlled study
Journal of Psychiatric Research, 03/14/14
Modabbernia A, et al. – The authors aimed to determine the efficacy of melatonin 3 mg/day in prevention of olanzapine–induced metabolic side–effects. In patients treated with olanzapine, short–term melatonin treatment attenuates weight gain, abdominal obesity, and hypertriglyceridemia. It might also provide additional benefit for treatment of psychosis.
Methods
  • In a randomized double-blind placebo-controlled study, 48 patients with first-episode schizophrenia who were eligible for olanzapine treatment, were randomly assigned to olanzapine plus either melatonin 3 mg/day or matched placebo for eight weeks.
  • Anthropometric and metabolic parameters as well as psychiatric symptoms using The Positive and Negative Syndrome Scale (PANSS) were assessed at baseline, week 4, and 8.
  • Primary outcome measure was the change from baseline in weight at week 8.

Results
  • Data were analyzed using t-test, Mann–Whitney U test, and mixed-effects model.
  • Thirty-six patients had at least one post-baseline measurement.
  • At week eight, melatonin was associated with significantly less weight gain [mean difference (MD)=3.2 kg, P=0.023], increase in waist circumference [MD=2.83 cm, P=0.041] and triglyceride concentration [MD=62 mg/dl, P=0.090 (nearly significant)] than the placebo.
  • Changes in cholesterol, insulin, and blood sugar concentrations did not differ significantly between the two groups.
  • Patients in the melatonin group experienced significantly more reduction in their PANSS scores [MD=12.9 points, P=0.014] than the placebo group.
  • No serious adverse events were reported.

Author Commentary Exclusive

Amirhossein Modabbernia 03/18/2014
Olanzapine is one of the most effective antipsychotics, but at the same time is associated with high frequency of weight gain and several other metabolic disturbances. The results of this study underscore the efficacy of low dose melatonin in preventing weight gain and hypertriglyceridemia following olanzapine treatment. Unlike several other medications used to counteract the metabolic side effects of olanzapine, melatonin is associated with minimal side effects. Interestingly and unexpectedly we also show an additional antipsychotic effect of melatonin in treatment of schizophrenia, a finding that needs to be replicated in future studies. Importantly, our results are confined to short term treatment and long term effects of melatonin treatment in patients taking olanzapine has not been studied yet.

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Interesting Article from MDLinx

MDLinx  Psychiatry

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Zolpidem and the risk of Parkinson's disease: A nationwide population-based study
Journal of Psychiatric Research, 08/01/14
Yang YW, et al. – This nationwide population–based study investigated the risk of Parkinson's disease (PD) after zolpidem use in patients with sleep disturbance using the National Health Insurance Research Database (NHIRD) in Taiwan. Among the patients with sleep disturbance, zolpidem use increased the risk of PD after 5 years of follow–up. Further mechanistic research of zolpidem effect in PD is needed.
Methods
  • In total, 59548 adult patients newly diagnosed with sleep disturbance and who used zolpidem were recruited as the study cohort, along with 42171 subjects who did not use zolpidem as a comparison cohort from 2002 to 2009.
  • Each patient was monitored for 5 years, and those who subsequently had PD were identified.
  • A Cox proportional hazards model was used to compare the risk of PD between the study and comparison cohorts after adjusting for possible confounding risk factors.

Results
  • The patients who received zolpidem had a higher cumulative rate of PD than those who did not receive zolpidem during the 5-year follow-up period (1.2% vs. 0.5%, P < 0.001).
  • The adjusted hazard ratios were 1.10 (95% CI, 0.88 to 1.37), 1.41(95% CI, 1.17 to 1.72), and 1.27 (95% CI, 1.05 to 1.55) for zolpidem use with 28 to 90, 91 to 365, and more than 365 cumulative defined daily doses (cDDDs), respectively, compared to those who did not use zolpidem.

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Other articles in Psychiatry

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Editorial decembrie 2014 - Prof.Dr. Aurel ROMILA



                    F O R M U L E  PENTRU  PSIHOTERAPIE

Una din contributiile seminarelor lunare APLR este discutarea unor formule pentru psihoterapie. Ideea deriva din website-ul: aplr-doctorat.blogspot.com cu tema "FILOZOFIA DISCERNAMANTULUI".
Am ales pentru acest editorial formule legate de relatia EGO-SINE.

Seria ordonata ar putea fi;
      
       Normal = EGO – SINE

Din care putem obtine: 
    
     Ego fara Sine = OLIGOFRENIE; 

     Sine fara Ego = SCHIZOFRENIE; 

     Sine cu Ego sufernid = NEVROZA; 

     Ego cu Sine impotriva celorlalti = PSIHOPATIE;
     si 
    Ego transformat prin pierderea Sinelui = DEMENTA. 


Astept parerile voastre.











 Pentru mai multe detalii vedeti LECTIILE de la Revista.


Prof.Dr. Aurel ROMILA 


Destine interesante.;Anastasia Romanov;...Imparateasa Sissi;.Maria de Romania;..Zenobia/Woman who changed the world


LEGILE DESTINULUI
- prima lege zice: "Persoanele pe care le intalnesti sunt  persoanele potrivite". Cu alte cuvinte, nimeni nu intra in viata noastra din intamplare; toate persoanele cu care interactionam se afla alaturi de noi cu un motiv, acela de a ne ajuta sa invatam lectiile de viata care apar si sa continuam drumul personal;
- a doua lege zice:
"Ceea ce ni se intampla este singurul lucru care ni se putea intampla". Nimic, absolut nimic din ceea ce se produce in viata noastra nu ar fi putut sa se intample in alt mod (nici macar detaliul cel mai nesemnificativ)… Nu exista: "daca as fi facut cutare lucru….s-ar fi produs alt cutare lucru…." NU. Toate si fiecare in parte dintre situatiile care se produc sunt perfecte, cu toate ca mintea si egoul nostru nu le accepta …
- a treia lege zice:
"Orice moment in care se incepe este momentul corect". Totul incepe in momentul potrivit, nici inainte, nici dupa; cand suntem pregatiti pentru ca ceva nou sa apara in viata noastra, exact atunci apare (incepe);
- a patra lege zice:
"Cand ceva se termina, se termina". Daca ceva a luat sfarsit in viata noastra, este pentru propria noastra evolutie, deci cel mai bine este sa inchizi capitolul si sa mergi inainte imbogatit cu acea experienta.
 

Cred ca nu este intamplator ca citesti aceste randuri acum; acest text ajunge la tine azi pentru ca esti pregatit(a) sa intelegi ca  "nici un fulg de zapada nu cade niciodata in locul gresit"…

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