Stroke Guidelines

Stroke Guidelines
2006 - Internet Stroke Center

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Handbook of Psychiatric Drugs

Handbook of Psychiatric Drugs


Title:
Handbook of Psychiatric Drugs
Topic:
The Handbook of Psychiatric Drugs is a comprehensive, clear, concise and quick reference to psychiatric drug therapies, designed to guide the clinician on the selection and implementation of treatment for mental illness.
Each chapter is organised by drug class and follows a standard format for ease of use. Concise sections on pharmacology and indications for use are followed by detailed information on drug selection, initiation and maintenance of treatment and withdrawal. Adverse effects, contraindications and drug interactions are also reviewed in detail, along with issues such as treatment resistance and treatment evaluation.
A handy pocket-sized drug reference, the Handbook of Psychiatric Drugs makes it easy to keep up-to-date with new developments. It is an invaluable resource for all clinicians who use psychiatric drugs to treat medical and psychiatric illness, and an informative read for all those with an interest in the subject.


Editors:
Jeffrey A. Lieberman

Professor and Chair Department of Psychiatry Columbia University, College of Physicians and Surgeons, and Director, New York State PsychiatricInstitute, New York, USA

Allan Tasman
Professor and Chair Department of Psychiatry and Behavioral SciencesUniversity of Louisville School of Medicine, Louisville,Kentucky, USA


Publisher:
John Wiley & Sons Ltd,
Publication Date: 2006-06-05


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Acute Medicine: A practical guide to the management of medical emergencies

Acute Medicine: A practical guide to the management of medical emergencies

FOURTH EDITION
By David Sprigings, John B. Chambers
2008 David Sprigings and John B. Chambers
ISBN 978-1-4051-2962-6

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Innere Medizin

Innere Medizin

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Pain Psychological Perspectives

Title:
Pain Psychological Perspectives
Topic:
This volume provides a comprehensive account of the psychology of pain including both applied and basic topics.
This invaluable new resource presents a state-of-the-art account of the psychology of pain from leading researchers. It features contributions from clinical, social, and biopsychological perspectives, the latest theories of pain, as well as basic processes and applied issues. The book opens with an introduction to the history of pain theory and the epidemiology of pain. It then explores theoretical work, including the gate control theory/neuromatrix model, as well as biopsychosocial, cognitive/behavioral, and psychodynamic perspectives. Issues, such as the link between psychophysiological processes and consciousness and the communication of pain are examined. Pain over the life span, ethno-cultural, and individual differences are the focus of the next three chapters.

Editors:
Thomas Hadjistavropoulos
Kenneth D. Craig


Publisher: Lawrence Erlbaum Associates
Publication Date: 2003-12-01

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Home Emergency Guide

Home Emergency Guide
Publisher: DK ADULT | ISBN: 0789493462 | edition 2003 | PDF | 260 pages | 15,2 mb
Providing the key to solving a wide range of problems in the home, the Home Emergency Guide features clear, user-friendly symptom charts to help readers determine whether to call an ambulance or a doctor, or to use self-help measures. From resuscitating a victim or making a sling to learning how to snake a toilet or dealing with a stovetop fire, as well as what to do in case of a hurricane, tornado, or earthquake, this all in one emergency guide explains what steps should be taken in order to keep the reader and family safe, before, during, and after the event.

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Textbook of Cultural Psychiatry

Textbook of Cultural Psychiatry
Publisher: Cambridge University Press | ISBN: 0521856531 | Edition 2007 | PDF | 612 pages | 3,16MB

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'Anti-phobia pill' breaks link between memory and fear

Phobias and post-traumatic stress could be banished for good by taking a commonly prescribed drug for blood pressure.

Previous studies had suggested that people who experienced traumatic events such as rape and car crashes showed fewer signs of stress when recalling the event if they had first been injected with the beta blocker propranolol, but it was unclear whether the effect would be permanent or not. Fearful memories often return, even after people have been treated for them.

To investigate whether propranolol could stop fear returning in the longer term, Merel Kindt and her colleagues at the University of Amsterdam, the Netherlands, conditioned 60 healthy students to associate a picture of a spider with an electric shock, so that they would eventually be startled by the picture even in the absence of a shock.

However, if the conditioned students were given oral propranolol before seeing the picture, their startle response was eliminated. What's more, it didn't return when the students were put through a second round of conditioning that should have reinstated their fear - suggesting that the association may have been permanently broken.

Shock tactics

Those given a placebo pill could eventually be trained not to be startled by the spider picture, by repeatedly showing it to them in the absence of a shock.

A similar technique is often used in phobia clinics - exposing people with arachnophobia to spiders in a safe and calm environment, for example. However, "even after successful treatment of anxiety disorders many fears and phobias come back," says Kindt.

When those in the placebo group were given a series of electric shocks, their fear of the spider also returned, while those in the propranolol group continued to react calmly to the spider picture, suggesting that the association may have been permanently erased, or at least negated to such a point that it has no effect.

When people experience traumatic events, the body releases adrenaline - also called epinephrine - which affects an area of the brain involved in emotional processing called the amygdala, and makes an emotional connection to the memory.

Recurrence fear

Reliving the memory triggers further release of adrenaline, reinforcing the memory still further. Since propranolol blocks adrenaline receptors in the amygdala, Kindt believes it may also block this reinforcement process and break fear association.

"We can't prove that the memory has gone away, but it is at least weakened so much that we can't find it anymore," says Kindt.

However, Chris Brewin, a memory expert at University College London, UK, says the findings are interesting, but cautions that Kindt's group only tested the volunteers over the course of three days.

"The fear might come back if they tested them several weeks later," he says.

Also, Kindt only looked at the degree to which the volunteers were startled - but conditions like post traumatic stress disorder often involve other emotions such as anger and shame, and we don't know how propranolol would affect them, he says.

Depression Influences Cardiovascular Health

Tuesday, Feb 10 (Psych Central) --

Doctors have long noticed that depression dramatically increases the risk of cardiovascular disease and death after a heart attack. However, the explanation of the relationship has been obscure.

Now, researchers at Loyola University Health System may be on the verge of filling in key pieces of that puzzle. In a study just published, the researchers find that depressed patients have higher levels of inflammatory substances in their blood.

Inflammation is the process by which the body responds to infections, injuries or stress.

The increased inflammation is caused by the nervous system’s reaction to the daily stress of daily life and the stress caused by illnesses such as depression, which sets off a series of physiological and biochemical changes in the body that can over time damage the cardiovascular system.

“It’s an insidious pathological change,” said Dr. Angelos Halaris, lead researcher, professor of psychiatry and behavioral neurosciences and assistant dean for translational research at Loyola University Chicago Stritch School of Medicine.

“The changes caused by the inflammation are like a slow-growing cancer that goes undetected because they cause no symptoms.”

The study finds the inflammation, which the researchers identify by means of pro-inflammatory biomarkers in the blood, increases the risk of heart disease by changing the structure of the inner lining of blood vessels.

In addition, stress activates platelets, components of blood that are primarily responsible for clotting. The platelets, which have a tendency to group together and form clots, find their way to the endothelium, the delicate, thin layer of cells that line the interior walls of blood vessels.

The clots get lodged on the endothelium and in small clumps in the lining of the arteries. As the clots pile up, they form plaque, the study finds. Over time the growing plaque causes a condition called atherosclerosis, a narrowing or hardening of the arteries that eventually could cut off the flow of blood and cause a heart attack, stroke and death.

“Unfortunately, clots don’t have boundaries,” said Dr. Omer Iqbal, co-researcher and associate professor, pathology department, Stritch School of Medicine.

“They can dislodge and travel to the vessels of the heart and cause a heart attack, and they can also reach the brain and cause strokes.”

Depression affects about 18 million adults, or about 9 percent of the U.S. population. Potentially hundreds of thousands of these individuals could be at heightened risk from developing heart disease due to their condition. The danger is that their conventional depression treatment may not be adequately addressing their underlying cardiovascular condition, the researchers emphasize.

“The body and the mind are closely connected, and they affect each other,” Halaris said. “We’ve found that even though patients’ depression gets better within six to eight weeks with treatment, it may take up to six months for the inflammation markers to return to normal. Patients may need to stay on medications longer until all of their biomarkers have returned to normal.”

A conclusion the paper strongly suggests is that all people with clinical depression should be routinely screened and monitored for heart disease. This includes having their blood pressure, body mass index, thyroid and cholesterol and lipid levels checked and an electrocardiogram performed. The screenings could also include a stress test, if a medical problem is suspected.

“I have seen women in their early 20s, who were depressed, who already showed changes in inflammatory markers,” Halaris said. “It’s not something that you can say, ‘Well, I don’t have to worry about it until I hit my 50s or 60s.’” Not so. I think we need to be consistently pro-active. Prevention is the key.”

Based on the results of the study, the Loyola researchers are hoping to develop routine screening tools to identify those suffering from depression who are at greater risk for developing heart disease, heart attacks and strokes.

“We hope to develop robust and non-invasive test diagnostic tests that will help us to detect the biomarker changes brought on by depression that we think pre-dispose certain depressed individuals to heart disease,” said John Piletz, co-investigator and researcher, psychiatry and behavioral neurosciences, Stritch School of Medicine.

“We consider those early warning signs very important that may ultimately lead to heart disease.”

Treatments for depression in heart patients include antidepressant drugs, cognitive behavioral therapy, exercise and cardiac rehabilitation. Antidepressant drugs known as SSRIs have the duel benefit of treating depression and suppressing inflammatory processes that can cause heart disease, Halaris said.

The study was recently published in the World Journal of Biological Psychiatry, the widely read journal of the World Federation of Societies of Biological Psychiatry. The organization is a non-profit, international organization composed of over 50 national societies of biological psychiatry, representing over 4,500 professionals.

Source: Loyola University Health System