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101.
Therapy of bipolar disorders is a rapidly evolving field. Lithium has efficacy in classic bipolar disorders whereas divalproex sodium and carbamazepine may have broader spectrum efficacy that includes non-classic bipolar disorder. In the last 10 years, a series of anticonvulsants have been approved for marketing in the United States. Gabapentin has indirect g-aminobuytric acid-ergic actions, is generally well tolerated, and appears to have anxiolytic, analgesic, and hypnotic effects. Lamotrigine has antiglutamatergic actions and is generally well tolerated (aside from rash in 1 in 10, and serious rash in 1 in 1,000 patients). Lamotrigine is indicated for maintenance treatment in bipolar disorder. Emerging evidence suggests lamotrigine may have utility in bipolar disorder patients with depression and treatment-refractory rapid cycling, as well as analgesic effects. Topiramate and zonisamide may allow both weight loss, while topiramate may have specific efficacy in bulimia, binge eating disorder, and alcohol dependence. Two small studies found oxcarbazepine had similar efficacy to lithium and haloperidol in acute mania. Phenytoin, an older anticonvulsant, may have adjunctive acute mania efficacy. Levetiracetam, a newer anticonvulsant, may be worth exploring and has minimal drug-drug interactions. None of these newer agents has been shown effective in a large placebo controlled trial for acute mania. Although the clinical profiles of these newer anticonvulsants do not appear to overlap markedly with divalproex and carbamazepine (except perhaps for oxcarbazepine), these novel agents may still offer important new options in relieving a variety of specific target symptoms in patients with bipolar disorder. 相似文献
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现行《医疗事故处理办法》颁布实施10 年之久,新形势下需要对其进行修改和完善。“办法”的修改应该体现平等保护医患双方合法权益原则,合理界定医疗事故范围,调整医疗事故鉴定委员会的组成,建立完善的证据管理制度,明确医疗事故损失赔偿的范围和额度。 相似文献
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现代嫉妒理论的分歧与契合研究 总被引:4,自引:1,他引:3
本文探讨了现代嫉妒研究和应用领域六种主要理论在理论、发生原因、研究方法、分类、治疗诸取向上的观点和分歧,尝试用综合的观点分析各理论的适用范围以及作为一般概括性嫉妒理论的不足,并寻找各理论的契合点。 相似文献
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明末顾炎武曾把易姓改号称为“亡国”,而把道德沦丧称为“亡天下”;清末严复写《救亡决论》一文,为民族救亡大声疾呼。今天中国虽无“亡国”之忧,却有“亡天下”之虞,“得荃忘鱼”的病象,“渔父哲学”的盛行,厚黑之道的猖獗,使“道德救亡”已成为当前中国最迫切的现实课题,中国不应回避也不能头痛医头脚痛医脚地对待这个问题,只有清理历史传统、改造社会生态才是“道德救亡”的唯一出路。 相似文献
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Cardiomyopathy is a genetically and clinically heterogeneous, life threatening disease which affects people of all ages. Recent guidelines provide recommendations for cardiac screening and genetic testing in at-risk relatives, but the uptake and impact of these measures in the United States is unknown. This is a single institution retrospective study that characterizes the uptake of cardiac screening and genetic testing for relatives of a cohort of 57 probands with hypertrophic (HCM) and dilated cardiomyopathy (DCM) who underwent both clinical evaluation and genetic testing. Cardiac screening was indicated for 302 relatives. One hundred and seventy-three (57 %) completed cardiac screening. Forty of the 57 probands were mutation positive and genetic testing was indicated for 213 relatives. Eighty-four (39 %) completed genetic testing. The uptake of cardiac surveillance was greater than the uptake of genetic testing (p?<?0.0001) among relatives of mutation positive probands. Within the group of at-risk, asymptomatic relatives of probands, cardiac screening and genetic testing were positive in 25 % and 40 % of cases, respectively. These data demonstrate the important role and utility of cascade cardiac screening and genetic testing in the care of patients and families with HCM or DCM. The approach to cardiac screening and genetic testing should be family-specific and requires expertise in the genetics of cardiomyopathy. 相似文献
110.
Yin Dake Yu Jiangping Jin Jiangping Shen Chao Zhang Li Li Xudong Zhang Keqin Wang Haitao 《Animal cognition》2023,26(4):1423-1430
Animal Cognition - Birds have the ability to assess the risk of predation in their environment and adjust their antipredation strategies based on this risk information. However, whether nest site... 相似文献