Saturday, December 15, 2007
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instincts make dreams
In the dream research there is turmoil, and guilt because Mark Solms. The London neuropsychologist has shown that must be on the decades-long formula down prayed "dream sleep like REM-sleep" a little lazy. Now sends the brain researchers to rehabilitate the long-time dream theory as disproved viewed Sigmund Freud.
PSYCHOLOGY TODAY
Dr. Solms, why do we dream?
Mark Solms
This is still a great mystery. I fear that even 100 years after Freud's book The Interpretation of Dreams and almost 50 years after the discovery of REM sleep we have no convincing answer to the question of why we dream. But we have the first answers to the question of how we dream. And new research on the How will hopefully soon provide insight into the why.
Mark Solms (Neuropsychoanylytiker)
PSYCHOLOGY TODAY
Sigmund Freud believed 100 years ago to have an answer to the why. His theory, dreams serve the fulfillment of repressed desires, usually sexual. But half a century later, the Research finds that we do not dream the whole night, but especially in certain phases of sleep, called REM sleep. This phase, then out again in a monotonous rhythm of about 90 minutes and from the brain stem, a very primitive region, triggered: Every 90 minutes the brain stem sends a blind volley activation up to the cerebrum. Dreams, it seemed, are nothing but the subjective aspect of this nocturnal mobilization, the brain tries to make sense of it and "translate" the Zufallsgeknatter its nerve cells in images and scenes, the "mean" nothing, absolutely nothing have. Was Freud's dream theory so dead?
Mark Solms
it seemed. Some psychoanalysts made rescue attempts, arguing for example that the "rising" REM excitement but perhaps could correspond to the instinctual drive in Freud's theory. But this argument was weak, because that region of the brainstem, where REM sleep is triggered, has to do after what we know, not the least with wishes, drives or instinkthaftem urge. On the contrary, acetylcholine, the brain chemical messenger that is released in this region, makes the cerebrum is not "instinctive", but more rational, colder and more focused. As the physiological were mechanisms that underlie the REM sleep is based in the sixties and seventies decrypted by and by, it looked very bleak indeed for Freud's dream theory.
PSYCHOLOGY TODAY
And now the tide has turned?
Mark Solms
Yes, and dramatic. It started with problems with the REM theory of the dream appeared. It was noted that people do not dream of during their REM sleep, but also in other stages of sleep. 20 to 25 percent of dreams occur outside of REM sleep. First, the researchers tried, these non-REM dreams . Wegzudeuten They said that these were in fact dreams of the last REM phase, the recall of subjects in the subsequent stage of sleep yet. This argument, however, proved unsustainable. Dream reports are obtained namely, even if subjects immediately after falling asleep, wakes - before the first REM period. Today there is no doubt anymore that we do outside of REM sleep, a lot of real dreams. It can not therefore agree that REM darstellt.Die the physiological basis of dreaming the most convincing provide evidence against the theory of REM dreaming now neurological findings: If in a person - for example by a stroke - those parts of the brain destroyed that trigger REM sleep, this did not lead to a loss of the dream experience. These persons have no REM sleep more but they still have dreams. In contrast, if certain other regions of the brain destroyed, that have nothing to do with REM sleep, the patient loses the ability to dream. In these patients remain intact despite the loss, the REM dream sleep. REM sleep is therefore not synonymous with dream sleep.
Sigmund Freud (1856-1939)
PSYCHOLOGY TODAY
REM is not the switch, which in our Brain dreams anknipst?
Mark Solms
However, a switch on, switch. REM is the best known of several triggers, but not the physiological basis of dreaming is. This is a huge difference. REM could be a mechanism that triggers the dream events - but one can dream, even without this stimulus SEM.
PSYCHOLOGY TODAY
you have now discovered other brain regions, which contribute significantly to dream.
Mark Solms
Moreover, the two brain areas that we now bear in mind, not just to dream at, but they make the dreams and in those regions, we observe the driving physiological event that the dream is based. Both regions are not in "primitive" but "higher" regions of the first dream Gehirns.Das area is located just above the ears, in the transition zone between the parietal, temporal and occipital lobes of the brain. This district has to do with spatial perception and spatial awareness - which is not very surprising, because as we all know, dreams of spatial mental images so zusammengesetzt.Das second dream area of the brain is a much more interesting. This is the so-called ventromesialen Region of the frontal lobe, located directly behind the eyes. Here, in the "white matter" of the brain, extend the pathways of those neurons, which must have directly to do with dreaming. If one whose activity is stimulated chemically ( by L-dopa administered, a precursor of the brain neurotransmitter dopamine, the editors ), increases the frequency and intensity of dreams. Now we know from brain research that this area of the frontal lobe with a specific form of motivation has to do. They called this area as the search, expectations or need system of the brain. In animal experiments it has been found that this system causes living beings, to search their environment for an object that meets their immediate needs. This system is as active when an addict stops desperate for a cigarette, a sip of alcohol or a shot of the lookout. It controls our behavior when we are affected hungry, thirsty, or sexually, so if we need something on which we keep on the lookout in the world. And just this motivational system is active during our dreams.
PSYCHOLOGY TODAY
What happens to brain injuries that are experiencing this motivational system is down?
Mark Solms
you develop a syndrome called adynamia a massive motivation. All patients who have lost their ability to dream, suffer from this syndrome. These people are indeed capable of running everything that is commanded them. If the patient is then asked: "Mr. Jones, would you cook a pot of tea, then he gets up and makes tea. But by itself it does nothing, he sat motionless in his place.
PSYCHOLOGY TODAY
A loss of dreams seems to be coupled with a loss of drive. Is the region in the frontal lobe, where you think the dream generator, therefore, the stronghold of that instinct, which Freud "libido" called?
Mark Solms
Well, at least, contradict these neuropsychological findings are not Freud's theory, but they are compatible with it. I do not think though, that what Freud meant by libido, due to this brain area is. Many other parts of the brain also have to find the desire to do sexual stimulation and the like, added hormone and peptide systems. The motivation system of the frontal lobe could represent a very specific part of Freud's libido, namely the search for an object to drive removal. This system does not include the urge or impulse itself, but the search mechanism that is activated in order to satisfy this urge. For example, this system channeled the hunting instinct hungry predators by the environment is scanned for potential prey.
PSYCHOLOGY TODAY
sits behind the forehead that is a kind of conductor of the libido?
Mark Solms
So you could see it. Such a mechanism Freud described in 1895 in his design of a psychology. There he coined the term "specific action": humans and other animals have to learn in the course of their development, to locate specific objects in the environment that are able to satisfy their urges. The shoots themselves are nonspecific. ( Freud described in this early, heavily inspired by neurophysiological Paper the "specific action" as an active form of the excitation discharge - to get rid of his excitement, must act on people and looking at the environment of conditions or create "stimulus waiver is possible only through their impact ... and this operation requires a change in the outside world food supply, close to the sexual object, which can be as specific action only on certain routes. The human organism is initially unable to bring about the specific action. It is provided by outside assistance by an experienced individual to ... the state of the child is made aware. This discharge path thus gains the most important secondary function understanding, and the initial helplessness of a people is the source of all moral motives. "- the editors )
PSYCHOLOGY TODAY
Allan Hobson, the most famous author of the theory of dreams as a subjective product of chance of REM sleep, admits one, that this theory can be corrected and expanded. He agrees that recent research by you and other scientists indeed show that dreams play in higher brain regions play an important role, having to do with the processing of images. But, says Hobson, hot far from that now Freud's theory was confirmed that dreams the symbolic fulfillment of desires and needs serve. Because "motivation" is surely a more complex process than "wish fulfillment".
Mark Solms
He is right when he says: The new research does not prove that Freud was right. They can be interpreted in other ways and with other theories. Hobson is also right that Freud's "wish fulfillment" is not the only type of motivation. Hobson speculated in his turn that dream is perhaps the testing mechanisms of instinct, it is not biologically useful to organisms that instinct mechanisms by nightly test runs to keep working. That might be true. But it could also agree that Freud was right, for "fit" the new findings in his theory. appeared in the fifties and sixties, when the previous results of dream research Freudian conflict theory, called many researchers. "Freud is refuted" Now that the research results are in line with Freud, to say the same researchers: "Why should we just explained by Freud's theory 100 years old? "Freud's theory is thus pulled out only when the facts are against them. Would not it be fair to say instead: "We thought we were wrong, and Freud is not refuted"? The research must make it now, the different hypotheses for the function of dreaming - including those of Freud - check to see which comes closest to the truth. has
PSYCHOLOGY TODAY
One of these hypotheses are taken to some popularity. It says that dreams may serve to solidify memory traces: the experiences of the day would be recapitulated in a dream, and remembering values are converted into long-term memory, while trivial is purged.
Mark Solms
This theory is currently in a difficult position because they based on the assumption that REM sleep is equal to REM sleep. The researchers prevented subjects or animals-from falling into REM sleep, and then put down certain memory lapses. But now it appears just that REM sleep is not synonymous with dream sleep. Safe: The REM periods have an important function for the body, have we not yet know - but we now know that REM sleep and dreaming have different functions. I think it is very unlikely that dreaming has a function to consolidate memory traces. Patients who have lost their ability to dream show, is entirely undisturbed memory performance. Your Memory is no worse than that of people who dream at night normal.
PSYCHOLOGY TODAY
But it would be possible but that at night actually memory traces are consolidated - not in dreams, but in REM sleep.
Mark Solms
That would be conceivable, but this has recently been questioned by researchers.
PSYCHOLOGY TODAY
What would Freud say if he heard about the spectacular new findings of neuropsychological dream research?
Mark Solms
Freud was very interested in brain research, and he was careful not to recommend to his colleagues as: "Study is not the brain, study the psyche" But in Freud's lifetime, the methods of brain research is still not very advanced - you could then actually very little learn about the psyche by studying the brain. This has changed thoroughly by the new imaging techniques that can accurately monitor the living people, which is in the brain and violated the structures in a patient think sind.Ich, Freud would receive the new findings of neuroscience with open arms . Freud was indeed skeptical about the possibilities of Brain research of his time went on. But he predicted that would come a time in which the psyche could be investigated promising from the perspective of neuroscience and had success.
PSYCHOLOGY TODAY
Many of today's psychoanalysts brain research seems to be haunted but not quite. They say the mind is too complicated in that they could be studied with such a "reductionist" methods.
Mark Solms
Each method has its limits. There are many questions can be answered with PET images of the brain at best, and on other issues other access routes are more promising. The psychoanalytic method has enormous strengths in addition to their weaknesses. If we in the dream research - and in psychology in general - want to make progress, we must draw consult all available methods.
spoke with Mark Solms Thomas hem Aldehoff.
Mark Solms, born in 1961, neuro-psychologist and psychoanalyst and worked at St. Bartholomew's & Royal London School of Medicine. There, he analyzed, among other case studies brain injuries. He showed that not determine the REM sleep, but other "higher" processes in the brain, the physiological event that the
Interview with Mark Solms Psychology Today 03/2000, page 30, Section:: dreams based
source is http://www.psychologie-heute dream research
(online at . de / )
Sunday, September 16, 2007
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liver advisory week of 17 to 22 September 2007
The liver ( Greek : Hepar) is the central organ the entire metabolism and the largest gland of the body. The main tasks are the production of essential proteins (eg coagulation factors), utilization of food components (eg storage of glucose ), the bile production (fat digestion) and, consequently, the reduction and elimination of metabolites, drugs and toxins. nutrients that are out of the intestine into blood Date proceed via the portal vein to the liver and are then released from this as required to the blood or removed from the blood.
The liver is closely involved in the control of glucose , fat and protein metabolism involved . Glucose is absorbed through the blood vessels of the intestine and are precisely matched to the rest of the body passed. An excess is stored as glycogen . In hunger the memory material to glucose is broken down. The liver influence controlled by hormones (eg insulin and glucagon ) the blood sugar levels and can him, regardless of the food supply kept constant. Insulin causes the liver to convert the sugar into the storage form of glycogen and inhibits the breakdown of fat. The hormone glucagon in turn stimulates the liver to glycogen depletion and thus acts as an antagonist to insulin.
The liver can regenerate itself as the sole organ of the body to some extent. Dies from a part, is injured or otherwise damaged, this tissue can be newly be, provided the cause has been eliminated, less than fifty percent of the functional mass of the body are affected and the liver has yet retain their ability to regenerate. This special property of the liver is used in liver transplantation.
The blood test is currently in liver disease often provide valuable information on the nature and extent of the disease. enzymes as needed throughout the body in the liver to cope with the metabolic activity of the liver. If damage to the liver cells connect these enzymes in the blood serum (liquid portion of blood that is obtained, someone coming from a coagulated blood sample by centrifugation, the cellular components, thus separating the red and white blood cells, which together with the platelets and the clotting factors, the coagulated blood cake) to increase. Depending on which enzymes are elevated, one can often infer the nature of the disease. The amount of enzyme rise in serum corresponds to the extent of damage to liver cells. Cell damage may be caused by viral infections, among other things, alcohol poisoning or cancer. All enzymes in the liver cells are also present in other cells of the body. However, some enzymes are only in liver cell damage in the blood serum increased.
diseases of the liver by the physician must be identified and treated. The week is to give advice
additional information and make offers for preventive or treatment with complementary pharmacy-only medicines. In addition, in the liver counseling weekly tips made for liver-friendly lifestyle.
Who should be interested in advising week?
- people who eat too much and too rich
- Diabetics
-
Older people - people who have to take many medications
- people undergoing chemotherapy
- People who drink alcohol frequently
- Human with functional gastrointestinal disorders
- people who work with toxic substances
Why hurt too much and too rich food the liver?
It can lead to fat accumulation in the liver to the "fat liver". It is not in itself dangerous, and disappears through diet consequences within a few weeks. The fatty liver, however, shows that the liver is not the transport of fat can handle. This results in the storage of fat in the liver and in time could result set further damage to the liver. From the fatty liver can then liver inflammation (hepatitis) and develop it into a reconstruction of the liver tissue to tissue (liver cirrhosis).
fat in food is an issue in itself because there are not only unhealthy fats, but also much needed, useful and healthy fats.
fat stimulates the gallbladder to empty. Who should decrease, which do not quite low in fat, for otherwise there could be an issue of the bile in the gall bladder, which promotes the formation of gallstones.
to support the liver in the digestion of fat too much help from drugs milk thistle, turmeric and artichoke xantorrhiza.
Why should worry about their diabetic liver?
Diabetes is a metabolic disorder associated with a disruption of protein-associated, lipid and sugar homeostasis. As a result, accumulate in poorly controlled blood sugar metabolism products so that they are poisonous. Of which are particularly affected the blood vessels, but also the liver as the central metabolic organ is loaded by it. The processing of the toxins, waste products or drugs can lead to the formation of oxidatively aggressive intermediates that interfere with liver metabolism.
diabetics are also often the people who take many drugs, are overweight or old.
Why should older people interested in the liver consultation?
the age is not the circulation of the body and thus the supply of the liver as good as they were young. To oxidative stress can no longer be responding so well. Also, there are often problems with digestion, can generate complaints and deficiencies. At reduced bile flow, calcium and vitamin D are not well received. In extreme cases, causes osteoporosis.
the age are also taken most drugs.
Why is the liver advice for people interesting
take many drugs?
Many drugs damage the liver optional. This means that the agent easily tolerated by most people, is unpredictable in individual cases are not. Particularly often happens when many drugs are taken.
What Chemotherapy to do with liver?
Unfortunately, there are frequent liver damage by chemotherapeutic agents. Part one can try to avoid milk thistle extract.
For whom alcohol is toxic?
A pint a day for a man is already a rule too much. Women known to tolerate less. Moreover, their brains will be damaged very quickly by alcohol.
Functional digestive disorders and liver?
digestive disorders without organic findings often have involvement of the liver and gallbladder function. Herbal medicines such as artichoke and turmeric, or others, such as in Iberogast ® help very often good.
work with poisons
collect in the liver, many poisons. There they are placed in a excretable form or partly saved. Milk thistle may protect against the effects of toxins.
Hedda Heuer
Saturday, July 21, 2007
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Long hours are harmful
leads to a study by the American Heart Association has extended a few hours weekly working time very often to high blood pressure. The investigation of the University of California at Irvine, which was attended by 24 205 adults and that is very meaningful, therefore, showed in detail:
Even with a 40-hour week increases the high blood pressure risk by 14% compared with those between 11 and 39 hours work per week. In a working week 41-50 hours, the risk increases already by 17% and a working week of 51 hours, the risk is already increased by 29%, or almost 1 / 3 more cases of high blood pressure! Other risk factors were equally distributed in all comparison groups, played here not matter.
Another individual results of this study is noteworthy:
was at office workers and unskilled workers found 23% (41-50 hours) and 50% (51 hours), frequent high blood pressure than high-skilled and thus relatively independent working employees at each of the same working hours.
Self-directed work and shorter working hours so protect against high blood pressure, are a good health care!
Jens Christian Heuer
Sources: American Heart Association
http://hyper.ahajournals.org/cgi/content/short/48/4/744
Thursday, June 7, 2007
Auburn Haired Actress
Folic acid can improve brain power
Regular intake of folic acid in the elderly brain performance improve considerably. The Dutch scientists have demonstrated in a three-year study of more than 800 trial participants aged 50 to 75 years.
The study participants were divided into two groups. Some received a daily 800 microgram (μ = micro grams μικρός, micro = small = 0.000 001 = 1 millionth) folic acid supplementation, the other only a placebo (placebo), so no folic acid. The folic acid group was better and could Gedächnisleistungen Process information faster, the Dutch report as Jane Durga of Wageningen University and colleagues in the British medical journal The Lancet (vol. 369, page 208).
With increasing age, the power from the brain normally, and researchers have long assumed that a low folate value is coupled with an increase of the harmful amino acid homocysteine in the blood responsible for it. An elevated homocysteine blood levels also favors dementia and probably Alzheimer's. All study participants had initially elevated homocysteine in the blood. In the subjects who received folic acid homocysteine blood levels decreased during the study. At various Tests on the perception and reaction rate cut it off even better than that of the placebo group. Their services were on average comparable to those of two to five years younger man.
According to the German Nutrition Society (DGE) take almost all Germans too little folic acid through the diet. We recommend a daily dose of 400 micrograms. Whole grains, liver and vegetables like spinach and broccoli contain this vitamin from the vitamin B complex. A deficiency can lead to diseases of the cardiovascular system and in pregnancy the embryo to birth defects, especially in the central nervous system lead. In countries such as Canada and the U.S. have long folic acid flour-containing foods added. This gives folic acid deficiency-related diseases, particularly in neonates, decreased significantly.
foods containing folic acid
keyword folic acid
Folic acid belongs to the group of the vitamin B complex. The vitamin was discovered in 1941 and then won the first time from spinach leaves. It was named after the Latin word for leaf = folium.
Folic acid plays a key role in vital processes in our bodies: Folic acid is all growth and developmental processes important, because with their help, components made of nucleic acids. The nucleic acids are the material of genes, the biological information storage in the cells.
deoxyribonucleic acid (DNA), the material from which the genes are (Wikipedia)
in the form of tetrahydrofolate (THF) can also bind the vitamin to pass small molecules and carbon. These carbon molecules play an important role in many reactions in metabolism. They each consist of a carbon atom and different binding partners. Shall transfer to the tetrahydrofolic acid such as those Einkohlenstoffmoleküle to certain substances that are only in this way to the starting material for the construction of the genetic hereditary material deoxyribonucleic acid (DNA) and also of many proteins.
is also the folic acid, along with vitamin B 12, essential in the formation of red blood cells, bone marrow. A lack of either of these vitamins can therefore be easily detectable at the CBC. In addition, folate deficiency increases the levels of homocysteine in the blood, because this amino acid normally with the help of tetrahydrofolic acid in the amino acid Methionine is converted in turn wird.Methionin involved in many metabolic processes, such as the protein synthesis in cells. High homocysteine levels promote cardiovascular disease, dementia and Alzheimer's.
Adequate folic acid intake is very important in pregnancy and in young people, particularly because of the growing organism builds up a lot of proteins and genetic information is copied to the new cells.
can in this context, a study by Wissentschaftlern Columbia University, New York sit up (Journal of the American Medical Association, JAMA). , Who evaluated the diet of about 1,000 senior citizens without dementia, and pursued in the years to which participants diagnosed with Alzheimer's disease. For those people taking that folic acid, both with food and with food supplements, the disease was clearly less frequently.
Jens Christian Heuer
Sources:
The Lancet ( http://www.thelancet.com/ )
Jama ( http:// jama.ama-assn.org / )
Thursday, May 24, 2007
How To Make A Moonstone Maplestory
constipation (constipation)
Depending on the food - and life can vary the frequency of bowel movements very much. Between three times a day three times a week and can meet the standard. The average is once a day. Only when the bowel movement less than three times per week is possible, it is in the medical sense to constipation. The frequently encountered fear that a less frequent bowel movements to poison the body by so-called metabolic waste from the intestine is unjustified, because a normal liver function, all controlled substances can be absorbed into the blood, not the case. Blutreinigungstee , which usually also contain laxatives (see below) make so much sense.
Getting to the meal, the chewed food down the esophagus into the stomach first, where the chyme hydrochloric acid and the proteolytic enzyme pepsin be added. Then it goes further into the duodenum and then into the actual small intestine where carbohydrates, proteins and fats are broken down enzymatically and can pass the derived nutrients in the blood. The leached chyme finally reaches the large intestine, where it is most of the water withdrawn. The remainder is excreted through the anus (bowel movement).
Source: http://www.trennkost-regensburg.de
happens, the transport of the chyme by a wavelike contraction and relaxation of intestinal muscles (peristalsis ) and is controlled by the autonomic nervous system reflexes which is caused by a strain of the intestinal wall with good filling.
The bowel is thus promoted by a diet adequate in fiber, which are difficult to digest plant fibers cellulose contains, to fill the colon so far are that transport reflexes triggered reliably. The fiber can also be bound by water swelling and prevent an excessive thickening and hardening of the chair in the large intestine. That is why it is so important to drink enough, because so very often a blockage can be prevented.
A first group of laxatives are the source - and filler, which is vegetable fiber, which are indigestible, wander through the entire intestine and prevent large quantities of water itself and in the gut retention. They swell up and cause transport reflexes. The source - and fillers include, for example Wheat bran, linseed , psyllium and carboxymethylcellulose (CMC ). When taking these supplements must necessarily sufficient to hydration be respected, because otherwise lumps may form a tough, clogging up the intestines. In extreme cases, threatened with a life-threatening intestinal obstruction !
Certain salts such as sodium sulfate ( Glauber's salt) and magnesium sulfate (Epsom salt) also act as a laxative, when dissolved in drinking water. The sulfate is not absorbed through the intestinal wall into the blood ( absorbed ) and remains with his back water solution in the gut and will increase the fill volume , which in turn causes the already-known transport reflexes. If the gut is not enough water is available, through the sulfate additional water from the blood drawn in the intestine ( osmosis). One therefore speaks of osmotically active laxatives. mannitol, sorbitol and lactulose also belong in this group.
A second group of laxative effect of irritation of the intestinal mucosa. This irritation triggers a reflex that triggers bowel movements or at least reinforced, leading to increased water transfer in the gut, with significantly reduced absorption of water from the intestine. For the longer-term use but causes significant losses of sodium and potassium. Potassium deficiency reduces but again the excitability of the intestinal muscles, so that needed correspondingly more of the laxative. A vicious cycle can begin and lead to laxative abuse.
The very unpleasant taste of castor oil has been in the small intestine, while the other laxatives in this group exert their effect only in the large intestine. These include the anthraquinones, for example, in senna are included, and synthetic fabrics such as bisacodyl (Dulcolax ®) and sodium picosulfate ( Laxoberal ®). All these substances are subject to a distinct so-called enterohepatic circuit between intestine and liver.
The active ingredient is absorbed from the intestine and passes (via the portal vein ) in the liver. There the drug by enzymes chemically modified (oxidized), where he is a little water and creates an additional binding site. It is then conjugated that is coupled to a really good water-soluble molecule. As a result excretion by the kidneys is possible. A large part of the active ingredient get back into the intestine, however, is decoupled again and converted back to its original form (reduced), the additional binding site is removed again wird.Das accomplished in enzymatic way through the intestinal bacteria. The cycle is closed. A pronounced enterohepatic circuit delays the excretion of the drug thus extending the duration ( liver = liver, kidney = kidney, GIT = gastrointestinal tract, biliary secretion = secretion of Gallenflüssigkit, renakl excretion = excreted from the kidneys, ingestion = nutrition)
Source: http:// www.uwgi.org/gut/liver_05.asp
Finally, there is a third group of laxatives which soften hard stool and to increase its lubricity in the colon. Mention here should be docusate sodium ( Norgalax ®) and paraffin oil . The extended use of paraffin oil however, is very problematic since the absorption of fat-soluble vitamins is prevented in the intestine. Affected are the vitamins A (retinol visual pigments ), D3 (Cholecalciferol for Knochenauffbau ) and K1 ( phytomenadione for clotting).
If you are healthy and receiving enough fiber in the form of vegetables, fruits and grain products and also drink enough yet, generally requires no laxative!
Jens Christian Heuer
Sources:
Color Atlas of Pharmacology, Heinz Lüllmann and Klaus Mohr
drug reactions, Ernst Mutschler including
Wikipedia ( http://de.wikipedia.org/wiki/Verdauung )
Thursday, April 26, 2007
Over Her Knee In Her Paties
depression and antidepressants
Introduction
Depression is a very common disease. It is estimated that approximately 12-17% of people at least once in their lives like this. Of the elderly over 65 years should be 15 - 25% experience at least one depressive episode. This depression is the most common psychiatric illness in old age.
Vincent Van Gogh (1880), Wikipedia
Sufferers experience depression often much worse than physical illnesses. Tormenting the different symptoms are experienced: uncertainty about themselves through the experience and behavior changes, loss of self-esteem, drive, motivation and loss of will, comprehensive hopelessness, and physical weakness. Fortunately
go past depressive episodes, but they occur at 70 -80% for the first time it ill patients again. Only 20 -30% of patients, they will never return.
antidepressants contribute to depression mood enhancing, anxiolytic and drive-enhancing, but they have substantial side effects. The success of antidepressant therapy can be difficult to assess for several reasons: which helps agents in individual patients is best, one can not clearly predict the disease. Also help with depression and placebo effects, and intensive care of patients. Due to their versatile effects antidepressants are used for other diseases, for example in the treatment of anxiety disorders, panic disorder, social phobia, obsessive compulsive disorder, in pain therapy and palliative medicine.
diagnosis of Depressive episode
diagnosed depression is now an internationally recognized classification system, known as ICD-10 - criteria. An assessment is the presence of typical symptoms and other common symptoms.
are the typical symptoms:
- have increased fatigue due to reduction of the drive
Other common symptoms of depressed mood
- - Loss of interest or pleasure :
- reduced concentration and attention
- reduced self-esteem and confidence
- guilt, feelings of worthlessness
- negative and pessimistic Future prospects
- suicidal thoughts, self harm or Suizdhandlungen
- Sleep
- decreased appetite
The severity will be assessed as follows:
Mild: at least two typical and two of the other symptoms
Moderate: at least two typical and three of the other symptoms
Expert: three typical and at least four of the other symptoms.
Furthermore we distinguish subtypes of depression:
Washed depression, psychotic depression, inhibited depression, atypical depression, depression in the elderly, anankastic depression (where compulsive symptoms in the foreground), recurrent brief depressive disorder, seasonal affective disorder, postpartum depression and dysthymia.
causes and pathophysiological mechanisms of depression
Despite intensive research, the pathogenic causes and mechanisms of depression is not clearly understood. It is certain that heredity may be involved in emotional stress in childhood and acute mental and physical stress on the development of depression.
The hormones from the brain by means of controlled stress regulation is disturbed in depressed people. We speak of the hormonal stress axis is disturbed, and thus thinks the interaction of hypothalamus, pituitary and adrenal gland (HPA axis), which leads to the release of the stress hormone cortisol.
forms Normally, the hypothalamus, when a threat is detected, increases the corticotropin-releasing factor (CRF). On the pituitary secretion of adrenocorticotropic hormone reacts with short ACTH. This hormone stimulates the adrenal gland to pour out the stress hormone cortisol. The whole process makes the body ready to face stress. At the same time are not currently required or disruptive activities inhibited. Cortisol increased as energy supply to the muscles, CRF suppresses appetite and sex drive, but promotes vigilance.
The axis of hormonal control from the brain to the thyroid gland seems to be disturbed. Again, the steering is done with a hypothalamic hormone, TRH, and then a pituitary hormone TSH. TSH on the thyroid response to the release of thyroid hormones that stimulate the metabolism. Depressed patients respond to the stimulation of this system differently than healthy and are found deviating from the normal hormone levels in the body. Other than that it is possible that hypothyroidism presenting as depression, antidepressants do not help then, but thyroid hormones.
imbalance of several neurotransmitter systems
It is thought that disturbances of various neurotransmitter systems of the central nervous system are involved in depression. In particular, the activities of the serotonin and noradrenaline of the system are reduced. Will be found in the brain and spinal fluid of depressed patients significantly less degradation products of these two neurotransmitters in healthy subjects. Additionally, the concentration of serotonin and norepinephrine receptors in the brain of depression increased. A receptor propagation will always occur if too little messenger is available. Antidepressants increase the activity of norepinephrine and serotonin system in the brain. The slow onset of action of antidepressants, however, says that the lack of the two neurotransmitters only part of the depressive state says.
changes in the brain during a depression
changed in different regions of the brain, the activity: It rises in the limbic system and brain stem, and decreases in the frontal lobe.
in the left frontal lobe, both negative emotions and desire and drive controls. Melancholic mood or little desire to go back there, let the activity. This makes it difficult to get grief, fear or anxiety about the future under control. Depression is not only a sequence of dark Feelings, but also from too little content.
The forebrain also serves as a working memory for temporary storage of information. Matching the mood is they regulate the perception. For negative mood, the brain is mainly for negative stimuli open. It thus tries to get the negative mood upright.
For people who have repeatedly suffered in life from a severe depression, take certain neurons in the frontal lobe one-third less space than normal. Previously it was only for depression, a chemical disorder of the transmitter, today it is thought likely that a growth fault of the neurons, which mainly is caused by stress.
Because in a state of depression the patient is under continuous stress from negative thoughts. We speak of uncontrollable stress, if the person does not have for them cognitively and emotionally meaningful strategy to deal with the situation.
In this situation, stress hormones such as cortisol permanent. A permanently increased cortisol release damages nerve connections in the brain and its re-growth is inhibited. A state of paralysis occurs. The brain seems to rest as the vegetation in the winter. The capacity for feeling fades, even mind and concentration to make. Depressed people can not handle even simple everyday tasks as well as healthy people.
flow in this part of the brain together information from different sensory systems, processed and returned from there to the cortex . The hippocampus causes Consolidation of memory, ie the transfer of Gedächnisinhalten from the short-term in the Langzeitgedächnis . People whose hippocampus (there are, strictly speaking, two, one for each side of the brain) is removed or destroyed, can not form new memories and thus have an anterograde amnesia on . Old memories will remain. The hippocampus is thus seen as a structure that generates the memories, while the actual memory contents at various other locations in the cerebral cortex are stored .
It has now been evidence that can be formed even in the adult brain in the hippocampus new connections between existing neurons (synaptic plasticity ) and that this formation is related to the acquisition of new Gedächnisinhalte.
The hippocampus is ultimately responsible for the coordination of the various memories. That is, for example, again important for spatial orientation. Thus, there is the inner mental "map" of a city visited several times from many impressions were gained at different times. In the hippocampus, these together and you can orient themselves.
early traumatic experiences
Stressful experiences in childhood such as neglect or abuse, favor the later onset of depression. Because there is not just an activation of the Stress axis instead, which goes over again, but it increases the activity of CRF neurons in the hypothalamus permanently. These are precisely the nerve cells that respond repeatedly to stress and its activity is elevated in depressed patients always. The sensitivity of the stress axis is then permanently increased by a childhood trauma. How much stress can permanently shape the brain in childhood, shows the following example:
Charles B. Nemeroff and his colleagues at Emory University in Atlanta (Georgia, USA) tested the effect of social deprivation on rat babies. The animals were born during the first three weeks of life to about 10 days each briefly taken away from the mother. After they were weaned, then they grew up without disturbing other operations in a standard colony rats.
By administering an antidepressant, which of course only increases the activity of the neurotransmitters norepinephrine and serotonin, could be the stress response in these animals again ! Normalize
The neurotransmitters
antidepressants not only affect the norepinephrine and serotonin system, but it will also affect other transmitter systems. This explains the numerous side effects of this drug class.
acetylcholine is one of the most important neurotransmitters. It is found in the CNS, but also peripherally: in the neuromuscular synapse and in large parts of the autonomic nervous system. It is an antagonist of dopamine. Anticholinergic drug effects include dry mouth, accommodation disturbances, urinary retention, sweating, tachycardia, memory impairment, confusion.
dopamine is found in the CNS as a transmitter in the synapses of the basal ganglia, the limbic system and the pituitary gland. Basal ganglia have a share in the control of voluntary movement, the limbic system controls mental processes and the pituitary gland has, among other neuroendocrine functions. Dopamine controls wakefulness and draws attention, it raises curiosity, learning ability, creativity and desire for sex. Dopamine is the hormone of anticipation and desire. It makes us ready to turn words into action to leave. Transmitter can either own or act as a signal modulating the strength of a signal. Dopamine acts as a door opener for other neurotransmitters: it works to modulate the signal transmission.
serotonin as a neurotransmitter found in the thalamus, hypothalamus and the cerebral cortex. It is about mood control, pain relief, blood pressure control, sleep-wake cycle, body temperature and nutrition. In the spinal cord to inhibit flexor reflexes. When serotonin is released in the brain a lot, it pays out less stress hormones such as cortisol and nerve cells can grow better, because stress hormones in the brain inhibit the growth of nerve cells. Between the noradrenergic system and the serotonergic system, there are many interactions, and both systems can alter dopaminergic systems.
Serotonin has complex effects on the cardiovascular system. It causes at different serotonin receptors partly contradictory effects. About 5-HT2 receptors in blood vessels it affects pressor, via 5-HT1 receptors in the CNS reduce the Sympathotonus thus expanding blood vessels and blood pressure. It is also involved in blood clotting For serotonin, there are at least 13 different receptors.
histamine occurs mainly in mast cells. It acts as a mediator of allergic reactions and substance to the release of stomach acid. Histaminergic neurons within the CNS modulator function. example, they are involved in the regulation of the sleep-wake cycle.
In the group of Amino acids glutamic acid, aspartic acid, GABA and glycine are important.
glutamic acid is the major excitatory transmitter in the CNS. It is important for learning, memory, voluntary motor and transmission of afferent impulses.
aspartic acid, like glutamic acid, an excitatory neurotransmitter.
GABA is the main central inhibitory transmitter. Ca. 30% of all synapses of the brain GABA-erg. GABA occurs practically everywhere in the CNS, especially abundant in the basal ganglia.
glycine is an inhibitory transmitter. It has significance in the control of voluntary movement.
Other neurotransmitters such as endorphins are neuropeptides and tachykinins, as well as ATP and adenosine.
mode of action of antidepressants
in a variety of antidepressants increase the amount of transmitters in the synaptic gap. As a result, there is increased drive, anxiety and mood brightening solution. However, the antidepressant effect usually starts after one to three weeks. The rather non-specific mode of action brings extensive side effects. This set within a short time after ingestion.
Typical side effects by inhibiting serotonin reuptake are nausea, vomiting, headache, sweating, insomnia, restlessness, sexual dysfunction, decreased appetite, Weight loss.
Typical side effects by inhibiting the reuptake Nordrenalin are tremor, tachycardia, restlessness, headache, urinary retention, micturition disorders. Tricyclic antidepressants, and some others also block receptors for neurotransmitters and thus have more serious side effects such as sedation and impaired cardiac work. Are typical of vegetative disturbances.
It is shown that by antidepressants during continuous administration, the activity of different receptors is changed in the brain: serotonin 5-HT 2 receptors and beta receptors are less active alpha-receptors and GABA receptors are more active. Antidepressants act accordingly as an indirect fertilizer for the growth of neurons; antidepressants increase concentrations of transmitters, which act in turn stimulates the communication of neurons to existing synapses and the formation of new synapses.
antidepressants also weaken the influence of stress on the brain.
To date, we can not for the individual patient based on the clinical picture previously say for sure which medicine will help him. First, needs to be clarified what kind of depression and whether it makes sense to use antidepressants. Then must be tested and maintained. Intensive psychological care proven to promote healing. For moderate depression is estimated that one-third each of the Therapeutic success by placebo effect, Antidepressants and psychological care is achieved.
you have been about fifty years, most available and side effects. Your name points to the chemical structure: A lipophilic three-ring system with a hydrophilic chain. So that they can lodge themselves well in cellular membranes and structures. They block different receptors for neurotransmitters, leading to the acute side effects and acute increased drive. In addition, they also inhibit the reuptake of serotonin and norepinephrine from the synaptic cleft.
particular note is the cardiodepressant effect. This leads to characteristic changes in the ECG. Therefore, tricyclic antidepressants are contraindicated in pre-existing conduction abnormalities. For therapy, an ECG examination is routine before treatment and at intervals. Beware of very high doses and overdose.
side effects of tricyclics by receptor blockade:
receptor in the central nervous system side effects
----------------------------------- -------------------------------------------------- ----------------------------
histamine H1-receptor sedation, weight gain, confusion
muscarinic receptor (transmitter: acetylcholine) dry mouth , accommodation disturbances
tachycardia, constipation, Miktionsstörun-
gene, memory problems, confusion
alpha-1 receptor (norepinephrine, epinephrine), orthostatic hypotension, reflex tachycardia,
dizziness, fatigue
5-HT-2 receptor (serotonin) and decreased appetite and weight gain
dopamine receptor Prolactinanstieg, sexual disorders, disorders of voluntary motor
A very rare but life-threatening side effect is the cholinergic syndrome. This can occur if the patient has Metabolisierungsdefekte or by interaction with anticholinergic agents or overdose. Tricyclic antidepressants should not be combined with other antidepressants, especially not with MAO inhibitors.
Application: Due to the sometimes severe side effects mainly take tricyclic antidepressants in severe depression if better tolerated agents help according to experience worse. In addition, the tricyclic antidepressants different applications in treatment of anxiety, pain management and palliative care.
The effect is in three stages: First week sedation, increased drive second week, third week in sentiment.
examples with classification by 3 types:
amitriptyline-type: strongly absorbing, dissolving depression, anxiolytic. These include:
amitriptyline often called orthostatic Dysregulation forth. Beneficial for sleep disturbances and suicidality. Beware of circulation problems.
Doxepin acts-like amitriptyline, but also antiadrenergic. Frequently used in alcohol withdrawal. It is part of amitriptyline-type.
-Imipramintyp The effect loosening depression, marked mood-enhancing, balanced psychomotor. This includes:
imipramine does not sedating, anticholinergic, antiadrenergic. Use also in pain syndromes.
-Desipramintyp The psychomotor activating effect. This includes Nortriptylen. It causes the least circulatory ailments.
Selective serotonin reuptake inhibitors (SSRIs)
They represented a revolution when it was introduced, because they are relatively well tolerated and effective very effective. Therefore, they are very often used nowadays.
These include substances (called by its trade name): citalopram (escitalopram), fluoxetine (Prozac), fluvoxamine (Fevarin), paroxetine (Seroxat, Tagonis) and sertraline (Zoloft, Glade).
you are in the spectrum is very similar, have no sedation, but seem more exciting. The difference is their inhibitory effect on cytochrome P450 isoenzymes, thus on the metabolism of other substances in the liver. At least this blocking effect citalopram.
because of their favorable therapeutic properties they are used frequently.
Typical side effects include nausea, vomiting, headache, sweating, insomnia, restlessness, weight loss, sexual dysfunction, decreased appetite.
The SSRIs should not be administered concomitantly with moclobemide and other MAO inhibitors, because this can lead to a toxic concentration of serotonin in the brain.
selective norepinephrine reuptake inhibitor (NRI)
This includes the agent reboxetine (Edronax). It works well on drive, motivation and interest. Side effects from all sympathetic autonomic effects: tachycardia, tremor, sweating, urination and bladder emptying disorders.
selective serotonin norepinephrine reuptake inhibitors (SSNRI)
They influence the reuptake of serotonin and norepinephrine, the effect and the side effects are similar to the SSRI.
the only of its kind in Germany antidepressant venlafaxine (Effexor) is. Among the group of substances including duloxetine (Yentreve), which is approved in Germany for the treatment of stress urinary incontinence.
monoamine oxidase inhibitors
monoamine oxidase inhibitors, block the oxidative degradation of monoamines in the synapse, which are here adrenaline, noradrenaline and dopamine and serotonin and histamine. Thus, their availability in the synaptic gap increased. The group consists of only two active ingredients. Moclobemide (Aurorix) is a selective reversible MAO-A inhibitor and is used eg for ineffectiveness of tricyclic antidepressants. Also like the elderly, because it is better tolerated in the gastrointestinal area as SSRIs.
tranylcypromine inhibits irreversible nonselective monoamine oxidase and is therefore difficult to handle. It only has meaning as the reserve.
side effects of moclobemide are dry mouth, insomnia, nausea and headache.
lithium salts for prevention of mania
St. John's St. John's wort extract has
in daily doses of at least 300 mg to 900 mg demonstrated mild to moderate depression. Therefore, it is also paid by the statutory health insurance, although it is not because of its good tolerability prescription in pharmacies, but is. In lower doses could not be demonstrated antidepressant activity. One of the ingredients, hyperforin acts as a non-selective reuptake inhibitors. The extract is apparently in many places simultaneously on the metabolism of monoamines (serotonin, histamine, dopamine, epinephrine, norepinephrine). In contrast
to synthetic antidepressants, it has few side effects. Its effect is, however, were rather weak. It has
interactions by enzyme induction by various means.
Rarely, it causes a photo-allergy.
final consideration
fit antidepressants for the treatment of depression may be as good as automotive tool to repair a clock, because the impact is strong, but not always perfect. Nevertheless, they are an important pillar in the treatment of depression dar. They should not use it as the sole means of healing, because behind depression in general, personal problems, which demand a solution. An antidepressant is better currently researching. For example, with several companies inhibitors of CRF, corticotropin-releasing factor in the testing, but also more selective SSRI is working.
Hedda Heuer
Sources: Scientific American DIGEST, riddles brain
Color Atlas of Pharmacology, Heinz Lüllmann and Klaus Mohr
drug reactions, Ernst Mutschler including
Intensive General and Special Pharmacology, Edward Burgis
depression - symptoms and treatment, Norbert Müller and Dorothea Strobach
The Science of Happiness, Stefan Klein
Brain Modelling, Internet lecture, http://brain.exp.univie.ac.at/
Saturday, March 31, 2007
Primary Care Physician Welcome Letter
Saturday, 31 March 2007
discount contracts with health insurance from April 1
Significant changes for the insured!
million of insured persons must be prepared to get soon prescribed only affordable medicines very specific manufacturer. Thus, the cost of medicines for health insurance will drop. This view of health care reform before new regulations that are to take effect April 1, 2007. This is the first time allows health insurance exclusive discount agreements with certain drug manufacturers abzuschließen.Die General Local Health Insurance had been in early February, the legislative process was still running, announced that they have completed for 43 active ingredients discount agreements. From this, they hope to tens of millions in savings. Why should the doctors AOK insured possible only prescribe the discount means. For the chronically ill, in many cases this will mean a big change, as they increasingly take their familiar will get a new agent, which is mentioned in the discount contracts. Affected are those compounds for which patents have expired and are therefore taken from several manufacturers on the market, the so- called generic drugs.
The AOK has completed nationwide and regional discount agreements at the country level, which ergänzen.Die AOK Baden-Württemberg, for example, negotiated a regional contract discount, will also benefit from the doctors. 30 percent of the savings will by prescription discount drugs leave the AOK get the doctors, the rest will keep it themselves. Save patients the legal supplement of five to ten euro.
The pharmacist can then help the patient, barely, because of the health reform, new regulations enter into force, leaving only little room for maneuver. With the tightening of the so-called "no substitution scheme (exchange control) the pharmacists are forced to leave only the drugs for which the cash register of the patient has signed a rebate agreement. This applies even if the doctor does not discount drugs, such as that which has received the patient had always been prescribed on the prescription. There is one exception only if the doctor explicitly "aut idem" rule out the recipe by making it there a cross.
If pharmacies adhere to these rules do not, or about the customer's request, the prescribed date ever, but do not give the discount agreements included drug, they get no money from health insurance and thus remain sitting on their costs.
Is not that the discount agreement provided for drug available, it may be made, replacement with another same type drug only under certain conditions. The non-deliverable manufacturer has a pharmacy to supply shortage in writing. Only if such written confirmation to the recipe submitted each accompanied by, the pharmacy receives from the health insurance you Geld.Die new rules on the discount contracts will also affect patients of other funds: company health insurance, health insurance funds and the Federal Miners have also signed discount agreements for key ingredients, as well as from the 1st April should apply.
comment
The revisions in the even more controversial health reform, which will now enter into force should, according to its proponents, cut costs, but take little account of a quick and proper care of patients with drugs. The exclusive contract with some very small manufacturers supply problem is difficult to avoid because, as they should within the shortest Time to expand their capacities so that they can keep supplying the whole market. The expansion or even construction of new manufacturing facilities will cost much time and money. Other producers, often those with the largest market shares to be pushed through the discount contracts from the market, regardless of how much they will demand in future for their drugs. This does not necessarily mean more free market economy with freedom of choice for the customer or patient. Many patients are forced in the future of their best means by which they are doing fine, for them to transfer to a new unknown drug which can tolerate, perhaps worse, because although the same active ingredient, but contains other additives. We express regret
the future, not our intended inconvenience that will face many of you. We will continue to do everything in our power to ensure you are served in the future with good drugs without long waiting times. But unfortunately this is becoming increasingly difficult by the legislature.
Wednesday, March 28, 2007
Maria Conchita Alonso Moscow Hudson
Wednesday, Mar 28, 2007
Rotating hexagonal structure at the north pole of Saturn (infrared image from Cassini, NASA)
The giant structure at the north pole of Saturn in my view, it could actually act to such a Bénardzelle, although the flow pattern with a vortex within the hexagon looks different than usual, where the flow outside verläuft.Doch of the rise zone within the hexagon to the relegation zone that could be accounted for: On the Saturn, which is very fast rotates on its axis, the first straight-running currents are deflected by the Coriolis force strongly, creating a vortex within the hexagon. The question remains, why is there only one Bénardzelle at the North Pole of Saturn, although Bénardzellen typically occur more than once? If the neighboring Bénardzellen outside the polar region might be suppressed somehow?
Jens Christian Heuer
Sources:
Cassini mission
http://saturn.jpl.nasa.gov/home/index.cfm
Much ado about vortex
http://www.philippi-trust.de/hendrik/braunschweig/wirbeldoku/index.html