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Medscape - UpToDate

 

The Year in Neurology: Studies Not to Miss From 2011
Medscape Neurology, 2011-11-23

Most Emailed Articles on Medscape
1. A Matter of Respect and Dignity: Bullying in the Nursing Profession Medscape Nurses
2. Vitamin D Supplementation: An Update US Pharmacist
3. Overhauling Nursing Education Medscape Nurses
4. The 2010 AHA Guidelines: The 4 Cs of Cardiac Arrest Care Medscape Emergency Medicine
5. The Downward Spiral: Incivility in Nursing Medscape Nurses

 

 

 

APA Answers DSM-5 Critics
Medscape Medical News, 2011-11-09

Most Emailed Articles on Medscape
1. A Matter of Respect and Dignity: Bullying in the Nursing Profession Medscape Nurses
2. Vitamin D Supplementation: An Update US Pharmacist
3. Overhauling Nursing Education Medscape Nurses
4. The 2010 AHA Guidelines: The 4 Cs of Cardiac Arrest Care Medscape Emergency Medicine
5. The Downward Spiral: Incivility in Nursing Medscape Nurses

 

 

 

Petition Calls for Critical Changes to Upcoming DSM-5
Medscape Medical News, 2011-11-04

Most Emailed Articles on Medscape
1. A Matter of Respect and Dignity: Bullying in the Nursing Profession Medscape Nurses
2. Vitamin D Supplementation: An Update US Pharmacist
3. Overhauling Nursing Education Medscape Nurses
4. The 2010 AHA Guidelines: The 4 Cs of Cardiac Arrest Care Medscape Emergency Medicine
5. The Downward Spiral: Incivility in Nursing Medscape Nurses

MDLinx - UpToDate

Evolution of gastro-oesophageal reflux disease over 5 years under routine medical care ? the ProGERD study
Alimentary Pharmacology and Therapeutics, 11/10/11
Malfertheiner P et al. – A total of 6215 patients were enrolled in the study of whom 2721 patients completed the 5–year follow–up. Progression, regression and stability of gastro–oesophageal reflux disease(GERD) severity were followed from baseline to 5 years. Most GERD patients remain stable or improve over a 5–year observation period under current routine clinical care.

 

 

 

Role of bisphosphonates in the management of postmenopausal osteoporosis: an update on recent safety anxieties
Menopause International, 09/09/11

Hollick RJ et al. – This review summarizes the benefits and potential adverse effects of bisphosphonates used in the treatment of postmenopausal osteoporosis. Although evidence of a definitive casual relationship between bisphosphonate therapy and serious adverse effects is lacking, concern remains particularly in relation to atypical subtrochanteric and femoral shaft fractures. This has important consequences in terms of determining optimum duration of therapy and how best to target therapy at those most at risk. Recently, attention has focused on individual fracture risk assessment in order to optimize the risk?benefit ratio of treatment for individual patients. A review of the role of hormone replacement therapy in younger women with significant risk of osteoporotic fractures may be timely in these circumstances.

The British Journal of Psychiatry Future Table of Contents for 1 January 2012; Vol. 200, No. 1

 
A new future TOC for The British Journal of Psychiatry is available online for the issue:
January 2012; Vol. 200, No. 1

This Future Table of Contents is available online at: http://bjp.rcpsych.org/future/200.1.shtml

These articles have been accepted for this issue. Change is possible before publication.





Editorials

The bicentennial volume of the British Journal of Psychiatry: the winding pathway of mental science
P. Tyrer and N. Craddock
The British Journal of Psychiatry 2012 200 (1)

Bipolar depression and treatment with antidepressants
G. M. Goodwin
The British Journal of Psychiatry 2012 200 (1)

Nocturnal enuresis with antipsychotic medication
T. R. E. Barnes, M. J. Drake and C. Paton
The British Journal of Psychiatry 2012 200 (1)


Reappraisal
Transcranial stimulation in depression
C. Allan, U.-G. Kalu, C. E. Sexton and K. P. Ebmeier
The British Journal of Psychiatry 2012 200 (1)


Special article
To meta-analyse or not to meta-analyse: abortion, birth and mental health
T. Kendall, V. Bird, R. Cantwell and C. Taylor
The British Journal of Psychiatry 2012 200 (1)


Review article
Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: systematic review
C. Lewis, J. Pearce and J. I. Bisson
The British Journal of Psychiatry 2012 200 (1)


Papers
Preventing progression to first-episode psychosis in early initial prodromal states
A. Bechdolf, M. Wagner, S. Ruhrmann, S. Harrigan, V. Putzfeld, R. Pukrop, A. Brockhaus-Dumke, J. Berning, B. Janssen, P. Decker, R. Bottlender, K. Maurer, H. J. Moller, W. Gaebel, H. Hafner, W. Maier and J. Klosterkotter
The British Journal of Psychiatry 2012 200 (1)

Regional specificity of thalamic volume deficis in male adolescents with early-onset psychosis
J. Janssen, Y. Aleman-Gomez, S. Reig, H. G. Schnack, M. Parellada, M. Graell, C. Moreno, D. Moreno, J. M. Mateos-Perez, J. M. Udias, C. Arango, M. Desco
The British Journal of Psychiatry 2012 200 (1)

Features of subsyndromal and persistent delirium
D. Meagher, D. Adamis, P. Trzepacz and M. Leonard
The British Journal of Psychiatry 2012 200 (1)

Association between antidepressant resistance in unipolar depression and subsequent bipolar disorder: cohort study
C.-T. Li, Y.-M. Bai, Y.-L. Huang, Y.-S. Chen, T.-J. Chen, J.-Y. Cheng and T.-P. Su
The British Journal of Psychiatry 2012 200 (1)

Transcranial direct current stimulation for depression: 3-week, randomised, sham-controlled trial
C. K. Loo, A. Alonzo, D. Martin, P. B. Mitchell, V. Galvez and P. Sachdev
The British Journal of Psychiatry 2012 200 (1)

Brief psychodynamic interpersonal psychotherapy for patients with multisomatoform disorder: randomised controlled trial
H. Sattel, C. Lahmann, G. Gundel, E. Guthrie, J. Kruse, M. Noll-Hussong, C. Oghmann, J. Ronel, M. Sack, N. Sauer, G. Schneider and P. Henningsen
The British Journal of Psychiatry 2012 200 (1)

Methylphenidate treatment of adult male prison inmates with attention-deficit hyperactivity disorder: randomised double-blind placebo-controlled trial with open-label extension
Y. Ginsberg adn N. Lindefors
The British Journal of Psychiatry 2012 200 (1)

Up To Date - British Journal of Psychiatry

Serotonin, dopamine and addiction

Lower levels of brain 5-hydroxytryptamine (5-HT) have been associated with impulsive and aggressive traits, which in turn are related to increased levels of stimulant misuse. Cox et al (pp. 391–397) used neurochemical imaging to demonstrate that lowering 5-HT levels leads to an increase in cocaine-induced craving and striatal dopaminergic response, a possible mechanism for increased drug-seeking behaviour. In an accompanying editorial, Nutt (pp. 353–354) questions the clinical implications of this finding, commenting on the lack of effect of selective serotonin reuptake inhibitors as anti-addiction agents. He also raises the questions of whether 5-HT may also modulate other neurotransmitters and influence the use of other drugs, and whether one should also examine the role of well-established genetic variation in 5-HT reuptake sites.

Noutati Medicale

 

 

 

 

* tratamenetul primului episod de schizofrenie

Summary

Early treatment of schizophrenia and related psychotic disorders is likely to minimize the risk for complications of untreated psychosis, including dangerous behaviors and functional impairments. Intervention soon after the onset of illness may increase the likelihood of recovery. Choice of antipsychotic agent should be based on the response of the individual patient to the medication trial, including efficacy and tolerability. It is important to remember that negative symptoms may be secondary to the use of an antipsychotic agent, and these secondary negative symptoms may impede functional recovery. Remission should be expected, but once remission from the first episode is reached, the clinician and patient face the difficult issue of maintenance treatment duration. Despite remission, relapse risk is very high, especially if antipsychotic medication is discontinued. Clinically useful predictors of the small minority who maintain in remission without pharmacotherapy have not yet been identified, and the optimal length of maintenance treatment for recovered patients is not known. Prevention of recurrent relapse may reduce the risk for clinical deterioration and the development of chronic and disabling symptoms.

 

 

 

 

* adhd

To summarize, behavioral therapy is the psychosocial intervention that has the greatest amount of evidence to support its use in children with ADHD and for that reason it is prominently mentioned both within the American Academy of Child and Adolescent Psychiatry's Practice Parameters and in American Academy of Pediatrics' clinical guidelines that pertain to ADHD in children. Although medications often grab the headlines, it is important to remember that effective and evidence-based psychosocial treatments exist for children and teenagers with ADHD.

 

 

*alcoholism

Mifepristone reduces relapse in alcoholics

Based on a rodent model, researchers at UCSF have reported in Neuropsychopharmacology that the pregnancy termination agent, mifepristone (RU-486) can reduce relapse in alcoholics. Mifepristone blocks the activity of progesterone and cortisol, which are known to promote alcoholism and relapse. In the study, the rats were trained to press a lever for alcohol or sucrose solutions. After a period of abstinence, the rats were "stressed" by administering yohimbine. Rats that received mifepristone prior to yohimbine sought the alcohol solution less frequently than rats that received yohimbine alone

 

 

* efectul antidepresiv al neurolepticelor atipice

Conclusions There was no substantial difference in anti-depressive effectiveness among olanzapine, quetiapine, risperidone or ziprasidone in this clinically relevant sample of patients acutely admitted to hospital for symptoms of psychosis. Based on our findings we can make no recommendations concerning choice of any particular SGA for targeting symptoms of depression in a patient acutely admitted with psychosis

 

 

*status epi

Conclusion

Super-refractory status epilepticus is a serious condition. The mortality rate is substantial, reported in various series between 30 and 50%. Yet, despite the fact that it remains an important clinical problem in all neurology centres worldwide, for many therapies, and treatment approaches, there is a remarkable lack of published data concerning effectiveness, safety or outcome. Treatment protocols, therefore, are needed and in Fig. 2, a general approach to treatment is proposed, based on the clinical experience and the published literature. Doses and parameters of treatment are shown in Table 2 and Table 3.

Click to zoom Figure 2.

Flowchart for the treatment of super-refractory status epilepticus. The flowchart is proposed as the basis of a protocol for the treatment of super-refractory status epilepticus (SE). The order and choice of therapy proposed will depend on the clinical context and the local facilities. ECT = electroconvulsive therapy; ITU = intensive treatment unit; IV = intravenous; PEX = plasma exchange.

 

 

 

 

*depresia la involutie
Purpose of review This work aims to review the most recent developments in the treatment of mood disorders (major depression and bipolar disorder) in the elderly.
Recent findings In the last years, few new pharmacological interventions for mood disorders have been developed. Recent studies seek to provide alternative treatment strategies to achieve higher remission rates, including the association of antidepressants, mood stabilizers and psychotherapy and the treatment of specific clusters of symptoms, such as the adjunctive treatment of cognitive impairment with cholinesterase inhibitors. Also, recent studies have been assessing the potential of pharmacogenetic information in the prediction of treatment outcomes.
Summary These factors altogether are expected to help the development of personalized treatment strategies that may improve outcomes with fewer adverse effects.
 
 

Dalai Lama despre om!

ZEN


Daily Zen



On The Way          

      

    

      

Guidelines for Studying the Way

 

      Dogen  (1200-1253)

 
                                     

 

What you should know for practicing Zen

 

Practicing Zen, studying the way, is the great matter of a lifetime.  You should not belittle it or be hasty with it.  A master of old cut off his arm and another cut off his fingers.  These are excellent models from China.  Long ago Shakyamuni Buddha abandoned his home and left his country.  This is an excellent precedent for practicing the way.

 

People of the present say you should practice what is easy to practice.  These words are quite mistaken.  They are not at all in accord with the buddha way.  If this alone is what you regard as practice, then even lying down will be wearisome.  If you find one thing wearisome, you will find everything wearisome.  It is obvious that people who are fond of easy practice are not capable of the way.

 

In fact, the dharma spread and is present in the world because our great teacher Shakyamuni practiced with difficulty and pain for immeasurable eons and finally attained this dharma.  If the original source is like this, how could the later streams be easy?

 

Students who would like to study the way must not wish for easy practice.  If you seek easy practice, you will for certain never reach the ground of truth or dig down to the place of treasure.  Even teachers of old who had great capacity said that practice is difficult.  You should know that the buddha way is vast and profound.

 

If the buddha way were originally easy to practice, then teachers of great capacity from olden times would not have said that practice is difficult and understanding is difficult. Compared with the people of old, those of today do not amount to even one hair from nine cows.  With their small capacity and shallow knowledge, even if people of today strive diligently and regard this as difficult and excellent practice, still it does not amount to even the easiest practice and easiest understanding of the teachers of old.

 

What is this teaching of easy understanding and easy practice, which people nowadays like?  It is neither a secular teaching nor Buddha’s teaching. It does not come up to the practice of Papiyas, the Demon King, nor does it come up to the practice of those outside the way or of the Two Lesser Vehicles.  We should regard it as the product of ordinary people’s extreme delusion.  Even though they try to attain liberation, they find nothing but endless rounds of suffering.

 

On the other hand, we can see that breaking bones or crushing marrow is not difficult, but to harmonize the mind is most difficult.  Again, the practice of prolonged austerities is not difficult, but to harmonize bodily activities is most difficult.

 

Do you think crushing bones is of value?  Although many endured such practice, few of them attained dharma.  Do you think people practicing austerities are to be respected?  Although there have been many, few of them have realized the way, for they still have difficulty harmonizing the mind.

 

Brilliance is not primary, understanding is not primary, conscious endeavor is not primary, introspection is not primary.  Without using any of these, harmonize body-and-mind and enter the buddha way.

 

Old man Shakyamuni said, “Avalokiteshavara turns the stream inward and disregards knowing objects.”

 

That is the meaning.  Separation between the two aspects of activity and stillness simply does not arise.  This is harmonizing.

 

If anyone could enter the buddha way by means of brilliance or broad knowledge, then the senior monk Shenxiu would have been the one.  If anyone of ordinary appearance or humble position were excluded from the buddha way, how could Huineng become the Sixth Ancestor?  It is clear that the buddha way’s transmission lies outside brilliance and broad knowledge.  Search and find out. Reflect and practice.

 

Being old or decrepit does not exclude you. Being quite young or in your prime does not exclude you.  Although Zhaozhou first studied when he was over sixty, he became a man of excellence in the ancestral lineage.  Zheng’s daughter had already studied long by the time she was thirteen, and she was outstanding in the monastery.  The power of buddha-dharma is revealed depending on whether or not there is effort, and is distinguished depending on whether or not it is practiced.

 

Those who have studied sutras a long time and those who are accomplished in secular texts, all should study at a Zen monastery.  There have been many examples of this.  Huisi of Nanyue was a very learned man, but still he practiced with Bodhidharma.  Xuanjue of Yongjia was an excellent scholar, and still he practiced with Dajian.

 

When you practice with a teacher and inquire about dharma, clear body and mind, still the eyes and ears, and just listen and accept the teaching without mixing in any other thoughts.  Your body and mind will be one, a receptacle ready to be filled with water. Then you will certainly receive the teaching.

 

Nowadays, there are foolish people who memorize words of texts or accumulate sayings and try to match these words with the teacher’s explanation.  In this case they have only their own views and old words, and have not yet merged with the teacher’s words.

 

For some people their own views are primary; they open a sutra, memorize a word or two, and consider this to be buddha-dharma.  Later when they visit with an awakened teacher or a skilled master and hear the teachings, if it agrees with their own view they consider the teaching right, and if it does not agree with their old fixed standards they consider his words wrong.  They do not know how to abandon their mistaken tendencies, so how could they ascend and return to the true way?  For ages numberless as particles of dust and sand, they will remain deluded.  It is most pitiable. Is it not sad?

 

Students should know that the buddha way lies outside thinking, analysis, prophecy, introspection, knowledge, and wise explanation. If the buddha way were in these activities, why would you not have realized the buddha way by now, since from birth you have perpetually been in the midst of these activities?

Students of the way should not employ thinking, analysis, or any such thing.  Though thinking and other activities perpetually beset you, if you examine them as you go, your clarity will be like a mirror.

 

Practice throughout the way

 

To practice throughout the way is to actualize the limitless realm of the buddha way and to illuminate all aspects of the buddha way.  The buddha way is under everyone’s heel.  Immersed in enlightenment, you are complete.  Therefore, even though you arrive at full understanding, still this is only a part of enlightenment.  This is how it is with practice throughout the way.

 

People nowadays who study the way do not understand where the way leads or ends, so they strongly desire to gain visible results.  Who would not make this mistake?  It is like someone who runs away from his father, leaving a treasure behind and wandering about.  Though he is the only child of a wealthy family, he endlessly wanders as a menial in foreign lands.  Indeed it is just like this.

 

Those who study the way seek to be immersed in the way.  For those who are immersed in the way, all traces of enlightenment perish.  Those who practice the buddha way should first of all trust in the buddha way.  Those who trust in the buddha way should trust that they are in essence within the buddha way, where there is no delusion, no false thinking, no increase or decrease, and no mistake.  To arouse such trust and illuminate the way in this manner, and to practice accordingly, are fundamental to studying the way.

 

You do this by sitting, which severs the root of thinking and blocks access to the road of intellectual understanding.  This is an excellent means to arouse true beginner’s mind.  Then you let body and mind drop away and let go of delusion and enlightenment.  This is the second aspect of studying the way.

 

Generally speaking, those who trust that they are within the buddha way are most rare.  If you have correct trust that you are within the buddha way, you understand where the great way leads or ends, and you know the original source of delusion and enlightenment.  If once, in sitting, you sever the root of thinking, in eight or nine cases out of ten you will immediately attain understanding of the way.

 

Immediately hitting the mark

 

There are two ways to penetrate body and mind: studying with a master to hear the teaching, and devotedly sitting zazen.  Listening to the teaching opens up your conscious mind, while sitting zazen is concerned with practice-enlightenment.

 

Everyone has a body-mind.  In activity and appearance its function is either leading or following, courageous or cowardly.  To realize buddha immediately with this body-mind is to hit the mark.  Without changing your usual body-mind, just to follow buddha’s realization is called “immediate,” is called “hitting the mark.”

 

To follow buddha completely means you do not have your old views.  To hit the mark completely means you have no new nest in which to settle.

 

Dogen

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