dysphoric mania

The presence of a depressed or unpleasant mood during an episode of Mania produces a clinical picture called Dysphoric Mania.

Dysphoric features are statistically salient in patients with mania, and the bimodal distribution of the dysphoria factor is consistent with the possibility that mixed bipolar disorder is a distinct state.

Manic and depressed states are not mutually exclusive. Their combination in mixed states has been repeatedly described since Kraepelin. The mixed state, also called depressed or dysphoric mania, is common, potentially severe, can be difficult to treat, and has the potential to reveal much about the psychopathology and pathophysiology of manic depressive illness. Yet, the lack of clear definition and boundaries for mixed states hinders definitive research and clinical work.

Most definitions of mixed states have relied on the application of predetermined criteria for depressed symptoms or depressed syndromes to groups of patients meeting diagnostic criteria for mania . These definitions leave two basic problems unsolved:

1) whether there is a naturalistic division of manic episodes into depressed and nondepressed types, as opposed to a random or continuous distribution of depressed symptoms across patients with manic episodes and

2) the specificity of mixed states themselves - for example, whether there are distinct depressed and dysphoric manic states.

Criteria for Dysphoric Mania or Hypomania

1. Full manic or hypomanic syndrome by DSM-III-R criteria
2. Simultaneous presence of at least 3 associated depressive symptoms of major depression

It has been suggested that Dysphoric Mania may represent a more severe form of Mania (progressing from Hypomania to Euphoric Mania and to Dysphoric Mania). Others consider Dysphoric Mania a separate, independent form of illness with characteristic clinical and therapeutic features.

Vitamin D diet : Top 10 Foods Highest in Vitamin D

Vitamin D is an essential vitamin required by the body for the proper absorption of calcium, bone development, control of cell growth, neuromuscular functioning, proper immune functioning, and alleviation of inflammation. A deficiency in vitamin D can lead to rickets, a disease in which bones fail to properly develop. Further, inadequate levels of vitamin D can lead to a weakened immune system, increased cancer risk, poor hair growth, and osteomalacia, a condition of weakened muscles and bones. Conversely, excess vitamin D can cause the body to absorb too much calcium, leading to increased risk of heart attack and kidney stones. The current U.S. 

DV for vitamin D is 600 IU (international units) and the toxicity threshold for vitamin D is thought to be 10,000 to 40,000 IU/day.² Vitamin D is oil soluble, which means you need to eat fat to absorb it. It is naturally found mainly in fish oils, fatty fish, and to a lesser extent in beef liver, cheese, egg yolks, and certain mushrooms. Vitamin D is also naturally made by your body when you expose your skin to the sun, and thus, is called the sun-shine vitamin. In addition, vitamin D is widely added to many foods such as milk and orange juice, and can also simply be consumed as a supplement. Below is a list of high vitamin D foods.

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#1: Cod Liver Oil
Cod liver oil has been a popular supplement for many years and naturally contains very high levels of vitamin A and vitamin D. Cod liver oil provides 10001IU (1667% DV) per 100 gram serving, or 1360IU (340% DV) in a single tablespoon.

#2: Fish
Various types of fish are high in vitamin D. Typically raw fish contains more vitamin D than cooked, and fatty cuts will contain more than lean cuts. Further, fish canned in oil will have more vitamin D than those canned in water. Raw fish is typically eaten in the form of sushi. Raw Atlantic Herring provides the most vitamin D with 1628IU (1667% DV) per 100 gram serving, 2996IU (499% DV) per fillet, and 456IU (76% DV) per ounce. It is followed by Pickled Herring with 680IU (113% DV) per 100g serving, Canned Salmon (127% DV), Raw Mackerel (60% DV), Oil Packed Sardines (45% DV), Canned Mackerel (42% DV), and oil packed Tuna (39% DV).

#3: Fortified Cereals
A breakfast staple in the Americas, most commercial cereals are fortified with the essential vitamins and nutrients. Exercise caution and check food labels when purchasing cereals, be sure to pick products that have little or no refined sugars, and no partially hydrogenated oils! Fortified cereals can provide up to 342IU (57% DV) per 100 gram serving (~2 cups), and even more if combined with fortified dairy products or fortified soy milk. Products vary widely so be sure to check the nutrition label before buying.

#4: Oysters
In addition to vitamin D, Oysters are a great source of vitamin b12, zinc, iron, manganese, selenium, and copper. Oysters are also high in cholesterol and should be eaten in moderation by people at risk of heart disease or stroke. Raw wild caught Eastern Oysters provide 320IU (80% DV) per 100 gram serving, 269IU (67% DV) in six medium oysters.

 

#5: Caviar (Black and Red)
Caviar is a common ingredient in sushi and more affordable than people think. Caviar provides 232IU (58% DV) of vitamin D per 100 gram serving, or 37.1IU (9% DV) per teaspoon.

#6: Fortified 

Soy Products (Tofu and Soy Milk)
Fortified soy products are often fortified with both vitamin D and calcium. Fortified Tofu can provide up to 157IU (39% DV) of vitamin D per 100 gram serving, or 44IU (11% DV) per ounce. Fortified Soy Milk can provide up to 49IU (12% DV) of vitamin D per 100 gram serving, 119IU (30% DV) per cup. Amounts of vitamin D vary widely between products, so be sure to check nutrition facts for vitamin D content.

#7: Salami, Ham, and Sausages
Salami, Ham, and Sausages are a good source of vitamin b12, and copper. Unfortunately, they are also high in cholesterol and sodium, and so should be limited by people at risk of hypertension, heart attack, and stroke. Salami provides 62.0IU (16% DV) of vitamin D per 100 gram serving, or 16.7IU (4% DV) per ounce (3 slices). It is followed by Bologna Pork 56IU (9% DV) per 100 grams, and Bratwurst 44IU (7% DV) per 100 gram serving.

#8: Fortified Dairy Products
Dairy products are already high in calcium, so it makes sense to fortify them with vitamin D. Milk can provide up to 52.0IU (13% DV) of vitamin D per 100 gram serving, 127IU (32% DV) per cup. Cheese can provide up to 6.6IU (2% DV) in a cubic inch, and butter provides 7.8IU (2% DV) in a single tablespoon. Check nutrition labels for exact amounts.

#9: Eggs
In addition to vitamin D, eggs are a good source of vitamin B12, and protein. Eggs provide 37.0IU (9% DV) of vitamin D per 100 gram serving, or 17.0IU (4% DV) in a large fried egg.

#10: Mushrooms
More than just a high vitamin D food, mushrooms also provide Vitamin B5 (Pantothenic Acid) and copper. Lightly cooked white button mushrooms provide the most vitamin D with 27.0IU (7% DV) per 100 gram serving, or 7.6IU (2% DV) per ounce.

west nile virus

West Nile virus (WNV) is an infectious disease that first appeared in the United States in 1999. Infected mosquitoes spread the virus that causes it. People who contract WNV usually have no symptoms or mild symptoms. Those with symptoms may have a fever, headache, body aches, skin rash or swollen lymph glands.

If West Nile virus enters the brain, however, it can be deadly. It may cause inflammation of the brain, called encephalitis, or inflammation of the tissue that surrounds the brain and spinal cord, called meningitis

Older people are most at risk. There are no specific vaccines or treatments for human WNV disease. The easiest and best way to avoid WNV is to prevent mosquito bites

• pellent
• Get rid of mosquito breeding sites by emptying standing water from flower pots, buckets or barrels
• Stay indoors between dusk and dawn, when mosquitoes are most active
• Use screens on windows to keep mosquitoes out

Legionnaires' disease outbreak in Staffordshire blamed on hot tub

A disease that can lead to lung infection or pneumonia, it is caused by a bacteria which is found widely in rivers and ponds but can thrive in artificially heated water such as that in hot tubs

How is Legionnaires' disease spread?

Legionnaires' disease is mainly spread through exposure to systems where water is kept at a temperature of between 20-45C which encourages bacteria growth. Systems that do this include cooling towers, spa pools and hot water systems. The risk is increased if the system creates and spreads tiny droplets of water which are easily inhaled. 

The Health Protection Agency (HPA) said investigations were taking place at JTF Warehouse in Fenton, Stoke-on-Trent, and the company was co-operating.

A statement from the firm said: "JTF is extremely concerned and the product has been withdrawn from all stores."

A disease that can lead to lung infection or pneumonia, it is caused by a bacteria which is found widely in rivers and ponds but can thrive in artificially heated water such as that in hot tubs

• Find out more about Legionnaires' disease on BBC Health

Seven people diagnosed with the disease are in hospital in Stoke-on-Trent and another is in a stable condition in hospital in Leicester, the agency said.

Legionella and Legionnaires' disease

Legionnaires' disease is a type of pneumonia caused by bacteria. You usually get it by breathing in mist from water that contains the bacteria. The mist may come from hot tubs, showers or air-conditioning units for large buildings. The bacteria don't spread from person to person.

Symptoms of Legionnaires' disease include fever, chills, a cough and sometimes muscle aches and headaches. Other types of pneumonia have similar symptoms. You will probably need a chest x-ray to diagnose the pneumonia. Lab tests can detect the specific bacteria that cause Legionnaires' disease.

The bacteria are more likely to make you sick if you

• Are older than 65
• Smoke
• Have a lung disease
• Have a weak immune system

Legionnaires' disease is serious and can be life-threatening. However, most people recover with antibiotic treatment.

Desmoid tumors

Desmoid tumors, a rare type of soft tissue neoplasm (new abnormal growth or tumor), usually develop in the arms, legs, abdomen or chest of children and adults. 

Sometimes they are called aggressive fibromatosis. Although they typically don't spread to other parts of the body, they can quickly invade nearby tissues and organs. 

Desmoid tumors sometimes occur in people who have a family history of colon cancer, particularly those with familial adenomatous polyposis.

Desmoid tumors are benign myofibroblastic neoplasms originating from the muscle aponeurosis and classified as deep fibromatoses. They constitute 3% of all soft tissue tumors and 0.03% of all neoplasms . Despite their aggressive local infiltration, desmoid tumors lack a metastatic potential . However, because of this local infiltration and compression of surrounding structures, a high recurrence rate exists and in anatomic locations with restricted access to surgical resection desmoid tumors can lead to death . Especially in patients with familial adenomatous polyposis (FAP) undergoing colectomy desmoid tumors are the leading cause of morbidity and mortality 

hantavirus

Infection with hantavirus can progress to Hantavirus Pulmonary Syndrome (HPS), which can be fatal. People become infected through contact with hantavirus-infected rodents or their urine and droppings. The Sin Nombre hantavirus, first recognized in 1993, is one of several New World hantaviruses circulating in the US. Old World hantaviruses, found in Asia, can cause Hemorrhagic Fever with Renal Syndrome (HFRS). Rodent control in and around the home remains the primary strategy for preventing hantavirus infection. All cases of Hantavirus infection are reported to and researched by the Viral Special Pathogens Branch (VSPB) .

Causes

Hantavirus is carried by rodents, especially deer mice. The virus is found in their urine and feces, but it does not make the animal sick.

It is believed that humans can get sick with this virus if they come in contact with contaminated dust from mice nests or droppings. You may come in contact with such dust when cleaning homes, sheds, or other enclosed areas that have been empty for a long time.

Hantavirus does not spread between humans.

Rodents carrying the hantavirus have been found in many U.S. national parks. Campers and hikers may be more likely to catch the disease than most people. This is because they pitch tents on the forest floor and lay their sleeping bags down in musty cabins.

However, only a couple of cases have been directly linked to camping or hiking. Most people who are exposed to the virus have come in contact with rodent droppings in their own homes.