Suicide in Lithuania During the Years of 1990 to 2002

Lithuania, among other Eastern European countries, has the highest suicide rates in the world. While the mid 1980's experienced a sharp decline in suicidality, the year of 1991 began a new increase in suicide rates, reaching an estimated 44.7 per 100,000 persons in the year of 2002. The ratio of male to female rates was 4.5 to 6.1 in the years of 1990 to 2002. The suicide mortality of rural inhabitants, especially men, has been growing even more intensely, occurring twice as often as among their urban counterparts. When looking at the age factor, the highest suicide risk is for middle-aged men. Among the males aged 45 to 54 years suicide rates reach 154.6. The most common method of suicide remains hanging, both for males and females. The underlying reasons of the suicide spread in Lithuania are multi determined.     

Healthy Volunteers Immediately Adapt to Submental Stimulation During Swallowing

ObjectivesTranscutaneous stimulation above and below the hyoid is used to assist patients with swallowing disorders (dysphagia) but has shown different effects. Previously, infrahyoid transcutaneous stimulation lowered the hyoid and larynx resisting swallowing movement while suprahyoid stimulation had no effects on hyolaryngeal movement either at rest or during swallowing. More recently, large submental electrodes, covering the submental region, are used for swallowing therapy in combination with resistance therapy. To gain insight into the effects of these electrodes on movement during swallowing, we studied healthy volunteers using videofluoroscopy (VF). We hypothesized that submental electrical stimulation might elevate the hyoid but not the larynx increasing vestibular opening potentially reducing swallowing safety.Materials and MethodsWhile undergoing VF, seven healthy volunteers (mean age 51, 5 males) swallowed 5 mL of liquid barium on at least ten trials randomly ordered across three conditions: stimulation at rest, swallowing without stimulation, and swallowing with stimulation.ResultsDuring stimulation at rest, significant (one tailed p < 0.05) anterior movement occurred in the hyoid and larynx, no superior hyoid and laryngeal movement and an increase in the distance between the hyoid and larynx. When comparing swallowing with and without submental stimulation, during stimulation volunteers significantly reduced anterior hyoid motion (p = 0.028) and increased hyoid elevation (p = 0.043) without changing anterior or superior laryngeal movement or the distance between the hyoid and larynx.ConclusionsThe healthy volunteers immediately corrected for the effects of submental stimulation by reducing hyoid anterior motion and increasing superior hyoid motion without changing laryngeal motion to prevent increased vestibule opening with stimulation. This suggests that healthy volunteers had an internal schema for swallowing movement patterning with feedforward correction for the effects of stimulation.     

Relationship of Carbamazepine Reduction Rate to Seizure Frequency During Inpatient Telemetry

Summary: To establish guidelines for medication reduction during inpatient telemetry, the records of 18 children and young adults with refractory partial seizures undergoing carbamazepine (CBZ) reductions during continuous video/EEG telemetry were reviewed. Six patients were receiving CBZ monotherapy, and 12 patients were treated with an additional antiepileptic drug (AED) maintained at baseline dosage during CBZ taper. Despite relatively rapid mean reductions in dosage of 44% by day 2 of taper, no patients experienced frequent repetitive seizures or status epilepticus (SE). Seizure rate during the entire CBZ reduction period correlated significantly with rate of drug reduction. Linear regression analysis showed drug reduction rate to be a good predictor of seizure rate. Fourteen patients experienced at least three seizures during CBZ taper. On the average, the third seizure occurred on day 5 of taper at a percentage of dose seduction of 79%. In 8 patients, CBZ concentrations were measured both before taper and ≤24 h after the third seizure. For these patients, seizure rate also correlated significantly with reduction in CBZ level. We conclude that manipulation of CBZ dose reduction rate is important in maximizing seizure frequency during telemetry and, in our patients, a relatively rapid rate of dose reduction was safe and effective in promoting seizure recordings.     

Bioavailability of Two Carbamazepine Preparations During Chronic Administration to Epileptic Patients

Two preparations of carbamazepine, as tablets and in syrup, were given for 8 weeks to 20 patients with epilepsy in a randomized crossover study. Weekly plasma levels were 3-21 mg/1 on dosages of 5-24 mg/kg/day. There was no difference in absorption or steady-state level between the two preparations. Carbamazepine 10, 11-oxide was constantly present when the level of carbamazepine was over 5 mg/l, and tended to be lower with the syrup.     

Treatment of Cocaine Abuse During Pregnancy: Translating Research to Clinical Practice

In the late-1980s and early-1990s, much attention in America was focused on cocaine abuse. In particular, the effects of prenatal cocaine use on mothers and infants were in the news spotlight. Risks of adverse effects prompted funding for novel treatment programs. More recently, media attention has shifted elsewhere, and specialized treatment resources have grown scarce. This redirection of funding is unfortunate, as social stigma and fear of legal consequences continue to encourage cocaine-abusing pregnant women to hide drug use and avoid prenatal care. The purpose of this article is to summarize the most prominent adverse maternal and fetal/infant effects associated with prenatal cocaine use; review treatment options, focusing on comprehensive care programs of the 1990s as well as recent research on evidence-based practices and their applicability to pregnant women; and highlight the population of prenatal cocaine-abusing women uninterested in treatment, with a focus on promising strategies to promote drug abstinence and other positive health behaviors.     

Impairment of Consciousness During Epileptic Seizures with Special Reference to Neuronal Mechanisms

Summary: Two neuronal structures, i.e., the cerebral cortex and the subcortical structures, were shown by clinical observations to be involved in maintaining consciousness. The alteration of consciousness during epileptic seizures is discussed with respect to these findings: Alterations of consciousness during epileptic seizures may be produced by subcortical, i.e., reticular formation, and/or cortical dysfunction followed by excessive, hypersynchronous neuronal discharges. An impairment of consciousness during absence seizures may be due mainly to cortical dysfunction; during complex partial seizures (CPS), it may be due to dysfunctional subcortical neuronal structures. The mechanisms underlying an alteration of consciousness are defined as causing "irritative" functional disturbances and/or as having "inhibitory" effects on consciousness-related structures.     

Auditory and Visual Evoked Potentials to Irrelevant Stimuli During Conditioning to a Visual Stimulus

Amplitude changes of evoked responses to irrelevant auditory (click) and visual (optic tract stimulation) stimuli were examined during appetitive conditioning to a flashing light. Four female cats, with chronically implanted electrodes along the visual and auditory pathways, were conditioned with pairings of a flashing light and food reinforcement. The results showed that, as conditioning progressed, the auditory evoked potentials were attenuated while the visual evoked potentials did not change significantly. The data seem to indicate possible differences in the neural processing of irrelevant information.     

Homeostasis of Synapses: Expansion During Wakefulness,Contraction During Sleep

正Sleep is a universal biological process occurring in almost every species of animal,and the loss of sleep has detrimental effects,especially impairments in cognition[1,2].Yet,the neuronal function of sleep is still one of the greatest mysteries.One prominent idea,known as the synaptic homeostasis hypothesis,suggests that high-frequency neuronal activity during wakefulness results in a global increase in synaptic     

Factors Contributing to Psychological Ill-Effects and Resilience of Caregivers of Children with Developmental Disabilities During a Nation-wide Lockdown During the COVID-19 Pandemic

Journal of Autism and Developmental Disorders - We evaluated factors affecting psychological ill-effects and resilience of caregivers of children with developmental disabilities during the...