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Willadsen Barlow posted an update 6 months, 3 weeks ago
Internet has become a tool of our daily lives; it can nevertheless be at health risks for excessive users. This is a global and national public health challenge, and health policy responses have been shaping up for a decade. Doctors are key players in health systems for the early detection of these disorders and for the health promotion in this area. In order to be able to play their role, they must benefit from increasing their awareness of the health risks of these uses, the vulnerable people profiles, the possible clinical pictures of these disorders and the strategic and regulatory framework at the national level. This article synthesizes these aspects in Switzerland to facilitate access to this corpus of knowledge for medical practitioners.Use of benzodiazepine and Z-drug is common in Switzerland, also for prolonged periods of time. Physical dependence, psychological dependence and a syndrome of dependence may ensue. Related to a lack of well-established medical guidelines, current clinical practices are subject to debate. Also controversial is the need to request an authorization from the cantonal health authorities before starting treatment with these controlled substances. The present article describes the limited circumstances in which such prior authorization is required.The choice of opioid-assisted treatments for patients with heroin dependence is particularly diverse in Switzerland. check details Since 1994, diacetylmorphine assisted treatments are available. The rules for prescribing and dispensing diacetylmorphine, as laid down by the FOPH, are particularly strict, requiring patients to attend the treatment center several times a day. Thanks to a legislative amendment by the Federal Council, it became possible to extend the dispensing of diacetylmorphine during the Covid-19 epidemic, allowing patients to take the treatment with them for longer periods and thus reducing the number of visits to the clinic. The time freed up could then be invested in other activities, allowing therapies to be refocused more on the patients’ life project.The practice of microdosing, which consists of ingesting a hallucinogen at 5-10% of a dose that would induce a psychedelic effect, has recently been the subject of growing interest by the media. The craze for microdosing has been relayed by the supposed effects of increased performance and creativity reported by professionals, especially in Silicon Valley. Despite this strong public interest, the evidence supporting this practice remains preliminary. Available studies are mostly based on single doses, leaving open the question of a possible stronger effect with regular doses. LSD’s main effect is on the serotonin system, in particular on 5-HT2A receptors, a receptor involved in neurobiological processes underlying learning.On March 31, 2021, the Swiss Federal Council accepted the Ordinance on Pilot Trials under the Narcotics Law, which will come into force on May 15, 2021 and will authorize pilot trials of recreational cannabis use by adults. The purpose of these trials will be to provide a scientific basis for future policy decisions on cannabis regulation. This ordinance is based on the idea that the legislator must give himself the possibility to experiment, as it was already the case in the 1990s with the pilot projects of heroin prescription, which proved to be useful in the legislative process, leading to changes of opinion among specialists, as well as in the general public – and thus in politics.Stroke is the leading neurologic cause of burden operationalized in terms of disability-adjusted life-years. After stroke, motor deficits, cognitive deficits, and depression cause loss of independence, disability, decreased functioning, and reduced quality of life; these persist into the long term. There are theoretical grounds to consider that, through neuroplasticity and other mechanisms, such impairments can be prevented or attenuated by the early introduction of a selective serotonin reuptake inhibitor such as fluoxetine. However, a recent meta-analysis of 13 randomized controlled trials (RCTs; pooled N = 4,145) found that fluoxetine neither improved independence nor reduced disability; whereas fluoxetine did reduce the risk of poststroke depression, it did not improve other outcomes, such as motor and cognitive outcomes, but, rather, was associated with many adverse outcomes. Two very large RCTs were subsequently published. The findings of these RCTs, in combination with the findings of the meta-analysis, suggest that, if fluoxetine is started within 2 weeks of ischemic or hemorrhagic stroke and is administered in a dose of 20 mg/d for 3-6 months, there is a 3%-4% reduced risk of new onset depression; however, there is no improvement in the likelihood of achieving independence or of reduction of disability. The risk of several adverse outcomes is increased; these include falls (by 2%), bone fractures (by 1%-2%), seizures (by 1%), and hyponatremia (by 1%). Fluoxetine is also associated with the theoretical risk of adverse drug interactions in stroke patients. In summary, there does not appear to be a role for the routine use of fluoxetine in poststroke pharmacologic care.Camelina is an oilseed crop in the Brassicaceae family that is currently being developed as a source of bioenergy and healthy fatty acids. To facilitate modern breeding efforts through marker-assisted selection and biotechnology, we evaluated genetic variation among a worldwide collection of 222 camelina accessions. We performed whole-genome resequencing to obtain single nucleotide polymorphism (SNP) markers and to analyze genomic diversity. We also conducted phenotypic field evaluations in two consecutive seasons for variations in key agronomic traits related to oilseed production such as seed size, oil content (OC), fatty acid composition, and flowering time. We determined the population structure of the camelina accessions using 161,301 SNPs. Further, we identified quantitative trait loci (QTL) and candidate genes controlling the above field-evaluated traits by genome-wide association studies (GWAS) complemented with linkage mapping using a recombinant inbred line (RIL) population.
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