Contents lists available at Artiﬁcial Intelligence in Medicine A semantic graph-based approach to biomedical summarisation Laura Plaza , Alberto Díaz, Pablo Gervás Departamento de Ingeniería del Software e Inteligencia Artiﬁcial, Universidad Complutense de Madrid, C/Profesor José García Santesmases, s/n, 28040 Madrid, Spain Objective: Access to the vast body of research literature that is available in biomedicine and related
Guidelines Ayahuasca Regarding the safety related to drinking Ayahuasca I have compiled guidelines. It is important to follow these guidelines when you attend a ceremony. In one of the forms I send you after subscribing for a ceremony you declare for instance not to use certain medication or suffering from a mental illness (which could give complications while using Ayahuasca) and that you participate in the ceremony at your own risk. When in doubt I suggest you consult your doctor or specialist. Naturally follow your doctors or specialists advice while reducing your medication. When in doubt of course you can contact us. Psychological People suffering from or have been diagnosed with borderline or bipolar disorder, psychosis or schizophrenia should not be participating in a ceremony. In general it has been shown that Ayahuasca has positive effects. I oversee your psychological state during the ceremony. If for example you suffer from depression or obsessive-compulsive disorder (OCD) you can report this on the registration form along with your possible medication. Medication On the registration form you can also specify the medication that you have used in the past six months. And of course the medication you are still using. It can seriously effect your health or well-being when you fail to do this. In general you do not use any medication or herbal medicines while drinking Ayahausca so that the energy of the plant medicine can be as effective as possible. The use of medication, supplements or drugs should be reduced to none several days to several weeks prior to the ceremony. However, there are exceptions. For example you can continue to use synthetic hormones with hypothyroidism (underactive thyroid). Some medications such as antihistamines take only three days of non-use before the ceremony. Still I recommend to reduce these to none a few weeks in advance. Specific medication such as SSRIs cause health problems when it is used in conjunction with Ayahuasca and therefore require a longer time to be reduced to none. Consult the list below for a more detailed description of the medication. And always remember to consult your doctor or specialist in reducing the medication. Tell him or her that you plan to use Mao reversible inhibitors. Medication in general Antibiotics, phenylalanine, (pseudo)ephedrine, asthma medication such as berotec, bricanyl, ventolin, salbutamol, terbutaline, pulmadil, serevent and asthma inhalers, drugs with a high caffeine content, narcotics, levodopa, dopamine, intropin, carbamazepine, medication for migraine and allergies, dextromethorphan-containing agents as otrivin, dampo, vapotab, vicks sinex, darolan, prevalin but also ponderal (drug against obesity) and analgesics such as meperidine. Antihypertensives There are various types of antihypertensives which lower blood pressure in different ways. ACE inhibitors: captopril, enalapril, fosinopril, lisinopril, perindopril, quinapril, ramipril, trandolapril, benazepril. Calcium channel blockers: amlodipine, clinidipine, felodipine, isradipine, lercanidipine, levamlodipine, nicardipine, nifedipine, nimodipine, nitrendipine, diltiazem, verapamil. Beta blockers: atenolol, metoprolol, nadolol, nebivolol, oxprenolol, pindolol, propanolol, timolol. Alpha blockers: doxazosin, phentolamine, indoramin, phenoxybenzamine, prazosin, terazosin, tolazoline. Mixed alpha & beta blockers: bucindolol, carvedilol, labetalol. Angiotensin II receptor antagonists: candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, valsartan. Tranquilizers and sleeping pills Medication such as sedatives and tranquillizers and sleeping pills are not tolerated in combination with Ayahuasca as they are increasing the effects of the medication which could lead to a slower heart rate, breathing and brain activity. This type of medication has a shorter half-life and should therefore be phased out a few weeks before drinking Ayahuasca. Benzodiazepines: Valium (diazepam), Xanax (alpazolam), Halcion (triazolam), ProSom (estazolam). Non-benzodiazepine sleep medications: Ambien (zolpidem), Lunesta (eszopiclone), Sonata (zalepon). Barbiturates: Mebaral (mephobarbital), Luminal Sodium (phenobarbital), Nembutal (pentobarbital), and any other barbiturate. Mao inhibitors Ayahuasca includes a powerful and natural MAO inhibitor which should not be used in combination with other MAO inhibitors. Combining MAO inhibitors can lead to complications in the regulation of neurotransmitters and digestion, such as hypertensive crisis with convulsive epilepsy, delirium, coma and circulatory collapse. It is important to consult a doctor to reduce your medication to none - not just because any withdrawal symptoms - but mainly because a MAO inhibitor is an enzyme responsible for the clearing of certain neurotransmitters in the chemicals in your brain. When the activity of this enzyme is inhibited the brain has more norepinephrine, serotonin, and dopamine available to send important messages and regulate mood states. MAO inhibitors: Marplan (isocarboxazid), Nardil (phenelzine), Emsam, Eldepryl, and Zelapar (selegiline), Parnate (tranylcypromine), Aurorix and Manerix (moclobemide), Pirazidol (pirlindole). Antidepressants The combination of Ayahuasca with SSRIs is potentially life threatening. Any drug that has an effect on serotonin as SSRIs can induce a serotonin syndrome. It is very important that you give the medication enough time to leave your body and give yourself time to adjust to not being on medication as side effects may arise. Prozac for example requires several weeks before drinking Ayahuasca because of a longer half-life. Which with other SSRIs is different. Reduce the medication only after you have consulted a doctor or specialist, because Ayahuasca is a MAO inhibitor that allows some neurotransmitters (such as serotonin) to become more available in your brain. SSRIs inhibit the reuptake of serotonin. The combination of the two substances provide an overload of the central nervous system and peripheral serotonin receptors. Other antidepressants such as SNRIs and TCAs can also cause serious problems when taken in conjunction with Ayahuasca and can lead to serious problems. SSRIs: Celexa (citalopram), Lexapro and Cipralex (escitalopram), Luvox (fluvoxamine), Paxil and Seroxat (paroxetine), Prozac (fluoxetine), Zoloft and Lustral (sertraline). SNRIs: Pristiq (desvenlafaxine), Cymbalta (duloxetine), Fetzima (levomilnacipran), Ixel and Savella (milnacipran), Effexor (venlafaxine). SARIs: Axiomin and Etonin (etoperidone), Serzone and Nefadar (nefazodone), YM-992, YM-35,995 (lubazodone), Desyrel (trazodone). NRIs: Strattera (atomoxetine), Edronax (reboxetine), Vivalan (viloxazine) NDRIs: Wellbutrin and Zyban (bupropion) TCAs: Elavil and Endep (amitriptyline), Evadene (butriptyline), Anafril (clomipramine), Norpramin and Pertofrane (desipramine), Prothiaden (dosulepin, dothiepin), Adapin and Sinequan (doxepin), Tofranil (imipramine), Prondol (iprindole), Feprapax, Gamanil, Lomont (lofepramine), Pamelor (nortriptyline), Insidon (opipramol), Vavactil (protriptyline), Surmontil (trimipramine). TeCAs and NaSSAs: Asendin (amoxapine), Ludiomil (maprotiline), Lumin, Bolvidon, Norval, Tolvon (mianserin), Remeron (mirtazapine). SMSs: Viibryd (vilazodone), Brintellix (vortioxetine) Antidepressants and other drugs containing SSRIs or MAO inhibitors such as Prozac, Seroxat, Zoloft, Effexor, Paxil or Welbutrin are also being sold as Zyban or equal medication as a supplement while trying to stop smoking. Drugs I think it is obvious that drugs are not to be combined with Ayahuasca and should therefore always be avoided and be phased out at least two weeks before the ceremony. This applies to heroin, cocaine, amphetamines, phenethylamines (homologs of amphetamines), MDMA (ecstasy), ketamine, MDA or derivatives thereof and DXM (dextromethorphan). Other plant medicines forms a lesser risk and should therefore be phased out several days before the ceremony. Mescaline (peyote and san pedro), barbiturates, LSA (morning glory, Hawaiian Baby Woodrose seeds), marijuana, salvia divanorum and other psychoactive substances. Other stimulants Muscle enhancers like Anabolic Steroids and performance enhancing Clenbuterol should be stopped with well before you can take part in an Ayahuasca ceremony. Food Three days before and one day after the use of Ayahuasca should not be used: alcohol (including alcohol free beer related to the brewer's yeast), to MDA related herbs like calamus and nutmeg, processed dairy products such as yogurt, sour cream and buttermilk, caffeine containing products like coffee, black tea, cola and energy drinks, chocolate, some fruits (figs, bananas, pineapples, avocados, raisins, prunes and raspberries), dried and fermented sausages like salami and saveloy, corned beef, liver, pickled herring, ginseng, yeast products as marmite and tartex, guarana, old cheese, unpasteurized cheeses and cheese spreads and cheeses such as brie, camembert, emmental, gorgonzola, gruyere and mozzarella (cottage cheese and cheddar cheese allowed), peanuts and other nuts, st. John's Wort, soy sauce, soybean paste and tempeh (bean curd is allowed) and related soy products like soy milk, legumes like beans, snow peas, soybeans and lentils and sauerkraut. Physical Some physical disorders can provide moderate to very serious complications when using Ayahuasca. Talk to your doctor or specialist and tell them you want to use Ayahuasca. Especially when you have heart problems or conditions to your liver or kidneys. Diabetes People with diabetes have an increased risk when they want to use Ayahuasca. The use of the MAO inhibitor can alter the blood sugar level and can change the amount of insulin or blood sugar lowering medication. People with severe unstable diabetes are advised to not use Ayahuasca. Heart and vascular disease When you suffer from chronic heart disease or high blood pressure is not advisable to participate in an Ayahuasca ceremony because of the serious risks involved with these complaints. Milder forms of heart disease or vascular disease may be listed on the registration form. Liver and kidneys The use of Ayahuasca may be damaging to the liver and kidneys. The liver and the kidneys play a crucial role in the metabolism of endogenous and exogenous chemicals. Ayahuasca contains harmine and related alkaloids which act as inhibitors of the monoamine oxidase. This inhibition function takes place in the liver and the digestive tract. When you have several monoamines in your body during an Ayahuasca ceremony (food, medicines or drugs) they can accumulate and provide (more) stress on the liver and kidneys. Thyroid When there is an underactive thyroid it is generally safe to participate in an Ayahuasca ceremony. You can mention your underactive thyroid on the registration form. You can continue to use the medication for hypothyroidism. When there is an overactive thyroid gland (hyperthyroidism) it is discouraged to use Ayahuasca. Epilepsy Ayahuasca can cause seizures. Let me know when you suffer from epilepsy or have a history in which there was epilepsy or seizures. Surgery Let me know if you have had surgery within the past six months. Sexuality Related to the energies Ayahuasca is working with three days of abstinence (including masturbation) is recommended before and after the ceremony. This has nothing to do with repression but by refraining from sex you are better able to connect to the process. Sexuality is an area that is usually connected directly with your emotions. By restraining from sex you are better able to focus on your emotional issues instead of getting caught up with them or draining your emotions through sex. Pregnancy An Ayahuasca ceremony is not recommended when you are pregnant or you are breast feeding.
NJOG 2008 May-June; 3(1): 3 - 9 New concepts in pathogenesis and management of polycystic ovarian syndrome: Insulin resistance and role of insulin sensitizers Rashmi Prasad Yadav National Academy of Medical Sciences, Bir Hospital. AbstractPolycystic ovarian syndrome (PCOS) is classically characterized by the clinical triad of androgen excess,anovulation infertility and obesity. Anovulation occurs due to functional ovarian and/or adrenalhyperandrogenism. The etiology and patho physiology of PCOS is unknown .Proposed theories includeexcess of gonadotropins; the effect of which is amplified by disturbances in intrinsic regulatory peptides, suchas inhibin or extrinsic regulatory peptides, such as insulin or insulin like growth factor ( IGF). For over 25years insulin resistance has been known to be associated with PCOS. Improvement in insulin resistance withthe use of insulin sensitizers, such as metformin and thiazoldinediones (TZDs) have been seen to be associatedwith better ovulation and reduced testosterone levels in patients with PCOS.