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Monday, June 30, 2008

Sensual Cloud in Florence

The Cloud was build by MIT. It is now part of the “Redesigning Fashion Trade Shows” in Florence, Italy (map here). So if your in the neighborhood go and see. Never thought lights could be this sensual (see clip).

An organic sculptural landmark that responds to human interaction and expresses context awareness using hundreds of sensors and over 15,000 individually addressable optical fibers. Constructed of carbon glass, spanning over four meters, and containing more than 65 kilometers of fiber optics, the Cloud encourages visitors to touch and interact with information in new ways, manifesting emotions and behavior through sound and a dichotomy of luminescence and darkness.

Thanks Bright

The Eye of Science

As a two-person team of photographer and biologist, our aim is to combine scientific exactness with aesthetic appearances, and thereby help to bridge the gap
between the world of science and the world of art

Biologist Nicole Ottawa and photographer Oliver Meckes utilize Scanning Electron Microscopy (SEM). They expose a fascinating world beyond human vision.

Beautiful pictures of bacteria, viruses, from medical science, zoology crystals and many others. Have a look at Eye of Science

Blood, erythrocytes.

Bacteria: E. Coli

Thanks Divine Caroline

Sunday, June 29, 2008

The Evil of Science: Clonie

In this song Nellie McKay sings about the creation of the ultimate companion, clonie.

Listen closely, she sings awfully fast for non native english speakers.

Saturday, June 28, 2008

The Limits of fMRI

fMRI or functional magnetic resonance imaging is the measurement of activity in the brain or more precise it measures the haemodynamic response related to neural activity in the brain or spinal cord of humans or other animals. It is one of the most recently developed forms of neuroimaging.

Often results of research with fMRI have promised that we can now look inside the brain and really see what is happening in the brain during certain tasks such as memory tasks and many others.

Although brain scanner technology is often described as a "window into the brain," Logothetis, in this most recent article, makes it clear that the metaphor of transparency is inappropriate. He cites a long list of factors that complicate the interpretation of fMRI data, from the challenge of distinguishing between excitation and inhibition to the difficulty of measuring the relative activation of different brain areas. If brain scanners are like a window, then the window has some very dirty glass.

In a recent article in Nature these claims are said to be very limited by technical shortcomings of this kind of neuroimaging. The article is written by one of the experts that helped develop the fMRI technique.

Now I am not the first one to write about this nature article, but this news looked important to me so that is why I wanted to point out the other excellent descriptions of this nature article in the blogosphere:

Pure Pedantry, he also describes an excellent example of misuse of fMRI.

The Frontal Cortex

Mind Hacks

Friday, June 27, 2008

How does Chocolate protect the Heart?

A number of studies have shown cardiovascular benefits of eating flavanol rich cocoa. In this post I will discuss the possible underlying mechanisms of these cardioprotective properties of chocolate as published in a recent review article: Flavanol-rich cocoa, a cardioprotective nutriceutical.

  • Cocoa flavanols as antioxidants. Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals.Oxidation of low-density lipoprotein (LDL) has been implicated in atherogenesis. Or LDL, a form fat in your blood that plays an important role in harming especially your larger blood vessels can lead to hypertension, lack of oxygen supply to the heart with as complication a hart attack. Antioxidants such as flavanols in chocolate that prevent LDL from oxidizing may reduce atherosclerosis. Although the precise mechanism of flavanol’s antioxidant action has not been agreed upon, research findings do suggest that the consumption of cocoa flavanols in the diet can significantly improve the
    oxidative defense system.

  • Modulation of vascular function. Impaired arterial endothelial function or impaired function of the inner layer of blood vessels has been shown to be a significant early event in atherogenesis and has been associated with an increased cardiovascular risk. Other diseases such as stress, ischemia (short oxygen supply), atherosclerosis, diabetes mellitus, and hypertension, can disrupt endothelial function. As a result, a dysfunctional endothelium may lose its protective effects on the vascular system. The acute consumption of dark chocolate by healthy volunteers have shown the acute dilatation of muscular arteries and an increased arterial elasticity

  • Inhibition of platelets. Platelet aggregation or the forming of small blood cloths is the critical event occurring during the initiation of coronary thrombosis which can lead to cardial infarction. Several studies have provided strong support for the antiaggregatory effects of cocoa flavanols.

  • Antihypertensive effects. The results of 2 separate studies in healthy subjects and later in hypertensives have shown possible benefits of cocoa in blood pressure lowering.This also can be considered as cardioprotective since hypertension leads to an overload of the heart.

  • Anti-infammatory effect. Cocoa flavanols have also been shown to have potential anti-inflammatory activities that are relevant to cardiovascular health. With inflammation, substances are formed which can produce adverse cardiovascular effects.

Now, Dr Shock will never let a change to promote chocolate consumption slip although lack of positive effects are also published on this blog in: Short-term Chocolate Effects on Health.

Moreover, it should also be noted that the evidence for any cardiovascular benefits of cocoa flavanols has been gathered predominantly from short-term and uncontrolled
studies. Therefore, additional research in well-designed, long-term human clinical studies using cocoa would be most helpful in assessing whether flavanol-rich cocoa
could be a potential candidate for the treatment, or possible prevention of cardiovascular disease. The beneficial effects of chocolate also need to be balanced against its high caloric and high fat contents.
Mehrinfar, R., Frishman, W.H. (2008). Flavanol-Rich Cocoa. Cardiology in Review, 16(3), 109-115. DOI: 10.1097/CRD.0b013e31815d95e2

Thursday, June 26, 2008

Light Therapy And Depression

light therapy depression
Light and depression is of interest in recent scientific publications. On Science Daily the use of bright light elderly group care facilities in the Netherlands leads to improvements.

The use of daytime bright lighting to improve the circadian rhythm of elderly persons was associated with modest improvement in symptoms of dementia, and the addition of the use of melatonin resulted in improved sleep, according to a new study.

According to one of the authors dr Eus van Someren: "elderly are somewhat less depressed and more active due to the use of bright light in the facilities for the elderly". "Even melatonin level in the elderly in the bright light facilities was significantly higher during the night". You can read the abstract in a recent JAMA issue.

A recent systematic review examined the efficacy of light therapy in nonseasonal depression. Light therapy is efficacious in seasonal depression but its role in non seasonal depression is unclear. The authors identified 62 reports from which 15 were selected according to their selection criteria. The sample sizes were small, blindness is a troublesome issue in this kind of research and publication bias is probable. Negative results are seldom published especially in such a difficult fieled of research. Their conclusion about light therapy for nonseasonal depression:
Overall, bright light therapy is an excellent candidate for inclusion into the therapeutic inventory available for the treatment of nonseasonal depression today, as adjuvant therapy to antidepressant medication.

So there is more to see that meets the eye with light and depression. Bright light therapy alone for the treatment of nonseasonal depression is not efficacious according to results to date. Further research especially with nonseasonal depression and circadian rythm disturbaces are needed.

What are your experiences with light and depression?

Related posts on this blog:
4 Nonseasonal Depressive Disorders treated with Light Therapy
Chronotherapeutics what is it good for?
8 articles about seasonal affective disorder
Riemersma-van der Lek, R.F., Swaab, D.F., Twisk, J., Hol, E.M., Hoogendijk, W.J., Van Someren, E.J. (2008). Effect of Bright Light and Melatonin on Cognitive and Noncognitive Function in Elderly Residents of Group Care Facilities: A Randomized Controlled Trial. JAMA: The Journal of the American Medical Association, 299(22), 2642-2655. DOI: 10.1001/jama.299.22.2642

EVEN, C., SCHRODER, C., FRIEDMAN, S., ROUILLON, F. (2008). Efficacy of light therapy in nonseasonal depression: A systematic review. Journal of Affective Disorders, 108(1-2), 11-23. DOI: 10.1016/j.jad.2007.09.008

Wednesday, June 25, 2008

Shrink Rap Grand Rounds: The iPhone 3G Edition

iphone 3G
The three shrinks of Shrink rap did an amazing job with this Grand Rounds, Volume 4, #40. Since the anticipated release of the Apple iPhone 3G is just around the corner (July 11), they asked for submissions to have some connection to the iPhone, no matter how twisted the logic is to make the connection.They made nice graphics and icons to go along with their update of the medical blogosphere.

They even supplied graphics for links to their grand round, see the picture above this post. The red circle is the contribution of Dr Shock, on their site you can click this icon to read the post. Enjoy....

Tuesday, June 24, 2008

Dramatic Decrease in ECT use in Edinburgh

worried doctor

In the years 2006 and 2007 the rates of usage of ECT in Edinburgh were only 0.82 and 0.88 patients per 10 000 total population. This is approximately a third less than the rate in 2005, and three-quarters less than the rate in 1993

For comparison in Belgium in 2000, the ECT rate was 4.8/10,000 inhabitants. By 2006 it had increased to 6.6/10,000 inhabitants. In Spain in 2007 the ECT rate, measured in patients per 10,000 inhabitants, was 0.61. In Portugal in 2007 the ECT-rate was 0.5-1.2/10.000 inhabitants. In The Netherlands in 2000 it was 0.22 per 10.000 inhabitants

The authors suggest that this might be due to the ECT guideline by the NICE. The guideline published in 2003 was very restrictive in indicating ECT. This guideline was controversial and the Royal College of Psychiatrists subsequently published its own ECT guideline.

The other suggestion that ECT is less needed because of all the other therapies available for treatment of depression is to my opinion nonsense. The authors cite the STAR*D trials to oppose this notion with which I can fully agree. Even after four treatments only 67% of patients remitted from their depression.

I fear less patients with severe depression get the right treatment. It also has implications for clinical research, psychiatric ECT clinics have to join forces in order to be able to do future research with ECT. These are the worries of ECT researchers in Edinburgh with a long and excellent history of ECT research.

I will be in Edinburgh on October 8th attending a meeting of the Scottish ECT Accreditation Network (SEAN) with a Dutch delegation. Will ask them about this development and their opinions there on, will let you know.
Scott, A.I., Fraser, T. (2008). Decreased usage of electroconvulsive therapy: implications. The British Journal of Psychiatry, 192(6), 476-476. DOI: 10.1192/bjp.192.6.476

Monday, June 23, 2008

Read Medblogs instead of News Media for Health Issues


After almost two years and 500 stories, the Health News Review project has found that journalists usually fail to discuss costs, the quality of the evidence, the existence of alternative options, and the absolute magnitude of potential benefits and harms.

In the US as well as Canada and Australia health news is reviewed by non profit organizations because an imbalanced picture of health care interventions may have a profound impact on the decision making of American consumers who rely on these news stories.

In a recent article in PLoS Medicine the results of the evaluation of 500 news stories in newspapers, television and weekly magazines were published.
between 62%–77% of stories failed to adequately address costs, harms, benefits, the quality of the evidence, and the existence of other options when covering health care products and procedures

They used a rating instrument including ten criteria used by the Australian and Canadian Media Doctor sites. All of the criteria are addressed in the Association of Health Care Journalists' Statement of Principles.

How does this high rate of inadequate reporting on these health news topics from the news media come about?

  • Many newsrooms across the US have eliminated health and medical reporting positions because of a drop in profits

  • Lack of research time for reporters

  • Lack of sufficient space or time in the newspaper or on broadcast. To much information has to be left out due to insufficient space or time when reporting

  • No training for reporters on medical statistics or on the subject of health care

  • Sensationalism in medical science stories wherein journalists find it easier to get attention for their stories and scientists see “the practical value of media attention to a successful scientific career”

So read medblogs instead, professionals on the topic, some even do requests and there are lots of medblog from all different species.
Schwitzer, G. (2008). How Do US Journalists Cover Treatments, Tests, Products, and Procedures? An Evaluation of 500 Stories. PLoS Medicine, 5(5), e95. DOI: 10.1371/journal.pmed.0050095

Sunday, June 22, 2008

Have mercy on the NHS Doctors

singing detective nhs
Darzi, the minister in charge of a review of the NHS has accused some doctors of being “laggards” for obstructing the introduction of new treatments. But that is not all he even proposed some "innovative measures".

Doctors and nurses should treat there patients as costumers.

He says that if patients don’t like the quality of care they are receiving they should go elsewhere.

His report will include proposals to routinely invite patients to grade the quality of nursing care they receive during their hospital stay, including how comfortable they were made to feel on the ward and if they were treated in a kind and compassionate manner.

Darzi is to set up a new website featuring all the latest innovations in medicine to encourage hospitals to adopt new treatments more quickly.

Donaldson, who as chairman of the World Health Organisation world alliance for patient safety will this week launch an airline-style danger checklist for surgeons

Personally I like the medblog by the NHS Blog Doctor. He writes witty readable posts about "the pleasures and pitfalls of family medicine in the modern British National Health Service." As I think of the NHS in the UK I usually get flash backs from the singing detective. From colleagues who went to the UK for their residency I always got the impression that health care in the UK is in a deplorable state. After Labor being in power for such a long time I had hoped it would improve. Reading Times Online about: Laggard doctors ‘put block’ on new treatments made me understand the problems our colleagues across the Canal are facing.

It is the plague of our times based on a basic mistrust of all professionals by politicians and bureaucrats looking for votes, money and trying to hold on to their jobs no matter what, even by trampling on their "customers" (=patients) backs.

This basic mistrust leads to endless measures of bureaucratic forms and procedures waisting a lot of time not only from doctors but also from the "customers".
By the way it is a flagrant mistake to think of patients as customers. A customer is not suffering from an illness, his or her cure or treatment doesn't depend on good health care, he or she is not in a dependent relationship. A patient hasn't got the knowledge or information beforehand to make the right choices. He or she needs to be informed, taken care of etc.

The only consolation I have for the NHS Blog Doctor: You are not alone

Saturday, June 21, 2008

Putting Numbers into Images

Elective breast augmentation surgery in the United States is performed on 384.000 women per year. It is the most frequent high school graduation gift for girls in the US. How do you picture 32.000 elective breast augmentations a month? Watch this video.
He translates the enormous numbers and statistics in a visual language. A language that can be felt so that they matter.

Artist Chris Jordan shows us an arresting view of what Western culture looks like. His supersized images picture some almost unimaginable statistics -- like the astonishing number of paper cups we use every single day

Related post on this blog: Performance Index UEFA Euro 2008 Championship

Friday, June 20, 2008

Rename the DSM The Book of Fantastikal Magickal Pixies and incorporate it into the Monster Manual

The title of this post is the suggestion of The Last Psychiatrist after reading an editorial in the American Journal of Psychiatry by Jerald Block. In his editorial he explains why he believes Internet Addiction should be considered a psychiatric disorder.

Now I don't feel so lonely anymore. Read his comment on this editorial here. You can read the opinion of dr Shock here.

Related posts on this blog about Internet addiction

Omega-3 fatty acids for bipolar disorder

A Cochrane systematic review investigated the efficacy of omega-3 fatty acids for bipolar disorder. Only one trial out of 5 provided data that could be analysed, investigating ethyl-EPA(=eicosapentaenoic acid) as an adjunctive treatment in a mixed outpatient population. Some positive benefits were found for depressive symptoms but not for mania, and no adverse events were reported.

There is currently insufficient evidence on which to base any clear recommendations concerning omega-3 fatty acids for bipolar disorder. However, given the general health benefits and safety of omega-3, the preliminary evidence from this review provides a strong case for well-powered, high-quality trials in specific index populations.

What are omega-3 fatty acids?
From Medscape
the essential fatty acids omega-3 and omega-6 are taken in through diet and compete with each other for the same elongation enzymes. Omega-6 eventually leads to arachidonic acid and eicosanoids, which promote inflammation, platelet clotting, and the production of prostaglandins. Omega-3 also leads to the production of eicosanoids, but the eicosanoids that are derived from omega-3 -- eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) -- actually possess anti-inflammatory properties and decrease platelet stickiness.

These two main omega-3 fatty acids in fish oil have important biological functions in the brain. DHA is a component of neuronal membranes, and changing the fatty acid composition of neuronal membranes leads to functional changes in the activity of receptors and other proteins embedded in the neuronal membranes. This is why researchers got interested in the use of omega-3 fatty acids in all kinds of psychiatric disorders, also in bipolar disorder. Stabilizing the membrane could possibly mean also stabilizing mood.

The only study used in this review was a 12 week, double-blind, randomised trial with 3 conditions.
Active treatment, receiving a total of 1g/day of EPA, active treatment, receiving a total of 2g/day of EPA, or control treatment, receiving a total of 2g/day of a placebo (liquid paraffin). There was no significant difference between 1 or 2 grams of EPA a day, the groups were combined for analysis.All participants were allowed to continue all associated psychotropic medication during the trial. Participants were recruited on the referral of their treating physicians or through advertisements in patient groups’ newsletters. 75 Patients participated which is a small group.

My opinion is that it is to early to speak of an additional effect, on the other hand no adverse effects were found.

Food rich in omega-3 fatty acids (thanks WHFoods)
Montgomery, P., Richardson, A., Montgomery, P. (2008). Omega-3 fatty acids for bipolar disorder. DOI: 10.1002/14651858.CD005169.pub2

Thursday, June 19, 2008

The Essence of Happiness

orbitofrontal cortex
How are we able to plan activities for pleasure. How is it that we can work the whole month in oreder to be payed and do nice things. How can we postpone direct gratification from our actions. Nature news has an interesting post on new insights into this matter based on animal research.

Animals, they suggest, have a reward system that focuses on specific outcomes — what an action would achieve — which in turn plugs into a more general system that lets us know what feels good.

How do emotion and cognition interact?
The orbitofrontal cortex, which lies at the front of the brain, just above the eyes, is the home of the brain’s cognitive reward system. It acts as a forecaster, predicting the value of different behaviours, learns which ones are ultimately rewarding, and triggers a corresponding emotional response.

The New Hype: Case Reports

The British Medical Journal urges you to submit your case reports.

Accepted cases will initially be published on our beta site but then copy edited and published on the live as soon as it is ready (scheduled for September 2008). This site will have sophisticated searching, browsing and alerting functionality.

Recently I wrote a post about the Cases Journal from BioMed Central(PubMed) So this first cases journal now has some competition.
Cases Journal is a peer-reviewed, open access journal publishing case reports from any area of healthcare that are understandable, ethical, authentic and include all information essential to its interpretation. Case reports will be archived in PubMed Central, and incorporated into our forthcoming database of case reports.

The BMJ offers a case report fellow ship for the authors of case reports.
BMJ Case Reports has a unique subscription model whereby users (whether authors and/or readers) become FELLOWS for an annual fee. But to celebrate the launch of BMJ Case Reports we are offering free fellowships to authors of the first 100 cases submitted (you will be able to submit as many cases as you like and access all the published cases until the end of 2009).

Now why all of a sudden this interest in case reports? According to Cases Journal:
It can potentially help democratize the reporting of health and disease by widening the definition of cases to include those that matter not just to physicians but also to patients, their families, and to the community at large.
They even mention evidence based medicine and introduce case reports as a counterpoise. Or is it the Internet traffic they want to attract to their sites covered with advertisements about their journals?
What do you think, let me know in the comments.

ECT in Baghdad

ECt in baghdad
Despite calls for a ban on the use of ECT without anesthesia, doctors in Baghdad say they often have little choice.

For months the therapy has been administered without anesthesia because the hospital's anesthesiologists all fled the city. The World Health Organization has called for a ban on all ECT therapy without anesthesia.

ABC News has a slide show about A Day in a Baghdad Psych Hospital

Wednesday, June 18, 2008

Grand Rounds from the South Pacific

This week's Grand Rounds are hosted by Dr David Khorram, an eye doc in Saipan. Where the heck is Saipan? See above
His selection of the best of medical blogging from around the world. Take a look here.

Predicting Internet Addiction or Splitting Straws?

internet addiction

  • Problematic Internet Use (PIU) of male students is higher than that of female students. On the Problematic Internet Usage Scale (PIUS) male students scores are higher compared to female students on all subscales such as negative consequences of Internet (NCI; 17 items), social benefit/social comfort (SB/SC; 10 items), except on excessive use(EU; 6 items).

  • The students with psychological symptoms demonstrate more PIU.

  • The students using the Internet from mostly their homes may feel more also have higher PIU scores

  • Those students that use the Internet mostly at night also score higher on the PIU.

  • Using the Internet for social interactions is a risk factor in the development of PIU

  • Solely using the Internet for fun, passing time and feeling relieved can result in problematic Internet use.

  • Scores on the PIUS were not significantly higher for individuals with addiction problems than that of those having no addiction problems.

I am not a firm believer of Internet Addiction. That doesn't mean there is absolutely no problematic Internet use, or using the Internet for gambling or other forms of established addictions. People described as having Internet addiction can have problems and can suffer but this isn't due to the Internet but to other problems such as depression, anxiety and others. This research discussed here confirms this to my opinion.

In this article the authors gathered data from 437 students of a Turkish University. Most recent publications of Internet addiction are by Chinese authors, and the Chinese Government has a very special relationship with Internet. You can read about China's Crackdown on Internet in a post on this blog.

These Turkish students were send instruments to measure problematic internet use the PIUS
Problematic Internet Usage Scale (PIUS). The PIUS is a Likert-type scale developed with Turkish students by Ceyhan et al with the assumption that the severity of Internet use shows continuity from normal to pathologic use. The PIUS consists of 33 items rated on a 5-point scale ranging from not appropriate at all to very appropriate. The range of the PIUS scores varies between 33 and 165, and the high
scores on the scale indicate that an individual’s Internet usage is unhealthy and may create a tendency to Internet addiction.

Brief Symptom Inventory (BSI)
The BSI is composed of the items having the highest distinctive features of Symptom Checklist–90 (SCL-90). The score range of the BSI varies between 0 and 212, and the high scores on the scale indicate high frequency of the individuals’ psychological symptoms.

And a questionnaire developed by the researchers about addictions, online experiences, time of day surfing, and reasons for using the Internet was used.

These were healthy students, they didn't receive the questionnaires because they had complaints or were doing not well on school. One of the main features of addiction is having complaints, suffer complications of the addiction, this was not the case in student selection in this research. The main features of an addiction are social and/or emotional problems leading to doctors visit or other forms of help seeking. Moreover, withdrawal, tolerance, relapse are among the features of a real addiction.

Most of their findings can be explained. Male students use the Internet more to get social benefit/social comfort. This might be explained since males experience more difficulties in establishing intimate relationships, which is one of the developmental tasks, so they prefer communicating through the Internet rather than face to face and express their own feelings and thoughts better when online.

The fact that more psychological symptoms leads to more Internet use can be explained by the fact that the students who experience distress,difficulties, disturbances, and poor psychological well-being may use the Internet excessively for distraction, for coping with or avoiding their problems, and for social relief or rescue.

Using the Internet more at home is because this may be less restricted and cheaper.

So what we are looking for is teenagers using the Internet as there only way to communicate, play and doing that at night. Anyone can explain to them why that isn't healthy. Seeking help for psychological problems on the Internet can be of use but going to a professional for help is more efficient. Internet can't replace professional help yet.
Ceyhan, A.A. (2008). Predictors of Problematic Internet Use on Turkish University Students. CyberPsychology & Behavior, 11(3), 363-366. DOI: 10.1089/cpb.2007.0112

Tuesday, June 17, 2008

Dr Shock is Back

Jack Daniels
While on vacation I didn't suffer from blog withdrawal. Had to post about some grand rounds that were so kind to allow one of my posts to be included.

This resulted in a reprimand by Dr Confabula. She writes an excellent blog in Dutch, more focused on medical students. If you can read Dutch have a look. She has a wiki in which she categorizes here posts by subject.

This gave me the idea of summarizing some of my own posts on a subject and write chapters about these subjects in a wiki.I can make them available for download as pdf. Topics could be genes and depression, treatment resistant depression, adolescents and depression, neurostimulation etc.

What do you think, does this fill a need or is it extra work for which no one is waiting?

Please let me know in the comments.

While on vacation I did have some time to reflect on my blog. A wide range of subjects? Posts about blogging, getting things done, soccer and pens all though part of my interest might be to much away from the writing of a psychiatrist. Maybe I should keep focus on psychiatry as a medical specialty consisting of research and education as well as patient care. What do you think? Please let me know in the comments.

Another new development is the building of a new design for my blog and switching to another blog platform. Wordpress. I have registered a domain name and requested a design with E.Webscapes. Will let you know when it is up.

Tried blogging for more than one year and found it to be fun and of benefit. So I decided to follow the advice of far better and more experienced bloggers to get a domain name and a design. Might need your help with the design later on.

Also registered a Dutch domain name for Dutch readers. This domain points at the same domain name but is probably better to remember for Dutch readers.

The hardest part during my vacation was missing you all, my readers, commenter's, and colleague blog writers. Now I know what they mean by social media. So the first weekend after my return read the entire RSS reader for an update on how you all were doing (more than a 1000 posts).

In case you wonder were I have been: Switzerland and Sardinia. As you know Switzerland is famous for there chocolate. Will definitely keep on posting about chocolate no matter what. In Switzerland they have an enormous amount of different kind of chocolates, even with Jack Daniels in it (see the picture above).
For some recent photos from Switzerland and Sardinia you can visit ectweb on Flickr.

Monday, June 16, 2008

Vitamine D for Depression in the Elderly?

depression elderly
A large population-based study found an association of depression status and severity with decreased Vitamin D (serum 25(OH)D) levels and increased serum parathyroid hormone (PTH) levels in older individuals.

Levels of 25(OH)D were 14%lower in 169 persons with minor depression and 14% lower in 26 persons with major depressive disorder compared with levels in 1087 control individuals

Vitamin D is produced by your skin in response to exposure to ultraviolet radiation from natural sunlight.It is nearly impossible to get adequate amounts of vitamin D from your diet. Sunlight exposure is the only reliable way to generate vitamin D in your own body.It is impossible to generate too much vitamin D in your body from sunlight exposure: your body will self-regulate and only generate what it needs.

As people age, skin cannot synthesize vitamin D as efficiently and the kidney is less able to convert vitamin D to its active hormone form. Homebound individuals, people living in northern latitudes, women who wear long robes and head coverings for religious reasons, and people with occupations that prevent sun exposure are unlikely to obtain adequate vitamin D from sunlight.

Causes of vitamin D deficiency in the elderly are: less sun exposure as a result of decreased outdoor activity, different housing or clothing habits, and decreased vitamin intake.

The question remains whether the vitamin D deficiency is secondary to depression, or is depression the consequence of poor vitamin D status.

Low levels of Vitamin D could be involved in the pathogenesis of depression in several ways.
In human beings, the distribution of the vitamin D receptor seems to be similar to that in rodents, with the strongest staining occurring in the hypothalamus suggesting a role in neuroendocrine functioning. In earlier work,we found that the human hypothalamus is likely implicated in the pathogenesis of depression because a number of neuron types show altered levels of neuropeptides and corresponding gene expression in postmortem brain tissue from depressed patients compared with control subjects

Depression and depression severity, as measured with the Center for Epidemiologic Studies–Depression (CES-D) scale, is strongly associated with lower Vitamin D levels and higher PTH levels, even after adjustment for age, sex, BMI, smoking status, health status, level of physical activity, and level of urbanization. Longitudinal studies are needed to answer the question about cause and consequence of Vitamin D shortage and depression.
Hoogendijk, W.J. (2008). Depression Is Associated With Decreased 25-Hydroxyvitamin D and Increased Parathyroid Hormone Levels in Older Adults. Archives of General Psychiatry, 65(5), 508-512.

Sunday, June 15, 2008

Performance Index UEFA Euro 2008 Championship

soccer player
For all you quick at figures there is a site with all the figures about soccer players during their games in the European Championship. You can see which player made the most meters during the game, was the fastest, or the slowest. There is also a list of the best goal keeper by the number of saves he made, or best defender. And that is only the beginning, numbers numbers etc......

UEFA Euro2008 Match Tracker