Friday, June 26, 2015

The DEPARTMENT OF PSYCHIATRY of the VETERANS MEMORIAL MEDICAL CENTER is hiring one (1) Contract of Service Clinical Psychologist (for three to six months contract only with chances for renewal depending on the demand and patients flow) to supplement the worke force of the Psychology Unit.

The following qualifications are required ---

  • BS Psychology graduate from a reputable school
  • Board passer of Psychology / PRC License
  • with adequate knowledge and skills in Psychological testing and evaluation
  • female or male
  • preferably between 24-25 years old
  • computer literate
  • Interested in Clinical Psychology
  • With passion to learn and develop more skills as Psychologist specifically in the Clinical aspect
  • With high tolerance and patience for psychologically challenged/incapacitated individuals
Qualified applicants will have hands on experience and exposure in handling and dealing with psychologically challenged/incapacitated individuals that will provide and equip them with more knowledge, skills and technical know-how in the practice of Clinical Psychology that would rebound to more and better career opportunities in the future locally and abroad.

Interested applicants may email their letter of application and resume with picture to for initial screening prior to personal preliminary interview.

Wednesday, September 26, 2012

VMMC MHD 2012 - 1st VMMC Pa-Utakan!

1st VMMC Pa-Utakan! (Quiz Show)

1. Eligibility : The Contest is open to regular and contractual employees


2. Each team will be composed of three members :
a. One resident
b. One paramedical staff
c. One administrative staff

3. Each team will assign a Team Captain who is one of their members.

4. Each time will have a Team Coach who will represent the team in the audience who may raise concerns from their teams.

5. Teams will be loosely based on the VMMC Summer Festivity Teams :

· Nursing Service Administration
· Department of Pediatrics
· Department of Orthopaedics
· W1 and W6 Nurses and Staff

· Department of Radiology and Radiotherapy
· Dietetic Service
· Social Service Division
· Department of Rehabilitation Medicine
· Department of Obstetrics & Gynecology
· Finance Division
· W7, and W20 Nurses and Staff

· Department of Medicine
· Administrative Division
· Special Service Division
· W3, W4, , W10, W11, W14, W15, W16, W17, W21, E-Ward, MICU, MITU, and PICU Nurses and Staff

· Administrative Division
· Personnel Division
· Supply Division
· Procurement Division
· Management Information System Office
· Department of Family Medicine and OPS
· OPD Nurses and Staff

· Department of Dental Medicine
· Accounting Division
· Department of Otorhinolaryngology
· Department of Anaesthesiology
· W12-AMR, OR and PACU Nurses and Staff

· Office of the Director
· Office of the Chief, Professional Staff
· Office of the Comptroller/ Budget Division
· Department of Pathology
· Department of Ophthalmology
· W12 Nurses and Staff

· Pharmacy Service
· Engineering Division
· Review and Evaluation Unit
· Department of Surgery
· Department of Nuclear Medicine and Research
· W8, W9, and SICU Nurses and Staff

6. Each group will register their contestants by 01 October 2012 12:00 PM.


1. Only three members of the team shall be allowed to participate in any round

2. Substitution of a member may be permitted until only before the contest starts. (Please Approach Dr. Maddatu before the event)

3. Contestants will be provided markers and paper and transparencies to display their answers on

4. Electronic gadgets are not allowed on the stage

5. The competing teams will be asked the same set of questions. Answers must be written down on the transparencies provided by the ushers

6. The quiz show has three (3) rounds
a. Head-to-Head Elimination Round
b. Category Round
c. Lightning Round

Round 1 : Head-to-Head
Format : Team vs. Team
Time Limit : 30 Seconds
Questions : Random Topics; Variable Question Format
Points : All questions are worth 1 point
Penalty : None
Buzzing : Players will all raise their answers when the quizmaster announces that “TIME IS UP”
Conferring : Team member will confer with each other to provide the answer
Goal : First four (4) teams to reach 5 points will advance
Clincher : For an exceeding number of teams, an additional clincher question will be asked until the desired number of teams are left

Round 2 : Category Round
Format : Team vs. Team
Time Limit : 30 Seconds or 60 Seconds
Questions : Picked from a Category. Variable Question Format: Quiz Master chooses first category. Team who successfully answers question will choose next category.
Points : Questions are worth 10, 15, 20, 25 and 30 points, in increasing levels of difficulty. A correct answer gives an opportunity to select the next category and level of question
Buzzing : Teams may buzz in any time, even before the question is fully read. Team members must wait for the quizmaster to call on them by name before answering the question through a microphone only. In the event of a mistaken buzz, the team will be considered to have given a wrong answer. The quizmaster will finish the question and the remaining teams allowed a chance to buzz.
Conferring : Team members are allowed to confer before but not after buzzing in.
Goal : First two (2) teams with the highest scores after the 25 questions have been exhausted or a team reaches 300 points will advance. Third Place will be awarded the prize at this point.

Round 3 : Lightning Round
Format : Team vs Team
Time Limit : 2 minutes
Questions : Random Categories, short answers
Points : all questions worth 20 points
Buzzing : Teams may buzz any time, even before a question is fully read. If they give a correct answer, the quizmaster will recognize it and the next question is immediately asked. If they give a wrong answer, the quizmaster will announce it and the next question is immediately asked. Once the quizmaster is finished asking question, the players will be given 5 seconds to give an answer without the requirement of buzzing in. Otherwise, he will move on to the next question.
Conferring : Team members are allowed to confer before but not after buzzing in.
Goal : Team with higher points declared champion.
Clincher : If teams get an equal number of points, an additional clincher question will be asked until a winner is decided

Clincher Questions – are sudden-death questions. A buzzer will be used and a correct answer will advance the team. Teams may buzz in anytime and must wait to be recognized before announcing their answer. If the buzzing team gives an incorrect answer, or if an answer cannot be given, the opposing teams will be given a chance to answer or buzz to give an answer.

7. The questions will be coming from the following subject areas/categories
a. Music
b. History
c. Science and Technology
d. Entertainment
e. Current Events

8. The questions will be picked out randomly. These questions may be in :
a. Identification
b. Fill-in the blanks
c. Multiple choice

9. The quizmaster shall read each question twice. Contestants can start writing down answers at the moment the quizmaster starts reading the question

10. The quizmaster shall announce the allotted time to contestants before reading each questions

11. The quizmaster shall announce the start time by saying “TIME STARTS NOW.” When the allotted time has elapsed, the official buzzer rings and the quizmaster shall announce “TIME IS UP.”

12. Points return to zero (0) after each round.

13. An official timekeeper is designated to operate the buzzer

14. Once the official buzzer rings, the transparencies will be immediately raised by the teams then collected by ushers/usherettes. A team who fails to raise its transparency immediately as so deemed by judges is considered to have given an incorrect answer. The answer of each team will be shown to the audience one at a time through an overhead projector.

15. In multiple-choice questions, the letter alone is sufficient answer. The OFFICIAL ANSWER has both letter and the number or word answer just to be sure there is no confusion.

16. “Fill-in the blank” and “identification” type of question requires CORRECT SPELLING. Otherwise, the answer is incorrect.

17. If audible coaching from the audience is heard, the question will be disregarded and the quizmaster will move on to the next question.


18. An official list of questions shall be prepared ahead by the organizing committee complete with references and basis for the correct or best answers and similar answers that may be considered correct when deemed necessary

19. The list of questions will be in two (2) copies to be kept in the responsibility of the Senior Clinical Psychologist until the start of the quiz.

20. During the duration of the quiz, a copy of the questions will be provided for the judges and the quizmaster.


21. Judges are selected by the organizers and will be required to make every effort to ensure a fair game.

22. Only the Team Captain or Team Coach has the right to raise questions or complaints during the conduct of the Quiz Show. The Board of judges will resolve any questions or complaints.

23. Any complaint and/or protest regarding the score tally, questions, or answer must be immediately raised before the succeeding question is read; otherwise the complaints will be disregarded

24. For record keeping purposes, the board of judges will be required to mark (by a check), questions on the Judges Copy of Questions, which were already asked, and note which questions were protested and what the protests were

25. The decisions of the Board of Judges are FINAL and UNAPPEALABLE


26. The following prizes (the “Prize” or “Prizes”) are available to be won in this Contest:
a. Champion Php 2,500.xx
b. First Prize Php 1,500.xx
c. Second Prize Php 1,000.xx

27. Prizes can be redeemed in VMMC Ward 5 Department of Psychiatry

28. If a potential Prize winner cannot redeem a Prize for any reason, such potential Prize winner will be disqualified after 30 days and the prize will be donated to the C.R.A.D.L.E. (VMMC Psychiatric Patients Support Group) Funds.

29. The Prizes in this Contest must be accepted as described in these Official Contest Rules and Regulations and cannot be transferred, assigned, changed, substituted for another prize, or exchanged.


1. Team members will be informed of change of rules as soon as possible and will be provided a written notice. Every effort will be made to inform teams of these changes prior to quiz day, but it may be necessary to inform schools of changes before the start of the quiz show.

2. Dress code – all players are expected to dress appropriately. They are required to dress in their team colors and a funny hat or headdress. A Secret Judge will choose one contestant with the best hat/headdress who will win a prize of Php 500.xx

3. Briefing – players will be provided with a copy of this rules and regulations two weeks before the conduct of the quiz. Any concerns regarding the rules can be raised until one week prior to the conduct of the quiz.

4. Conduct – foul or abusive language by any coach or team member will not be tolerated before, during, or after the quiz. Use of such language could result in the disqualification of the team as deemed by the organizers or judges.

5. Misconduct – if a coach or audience member interjects or “signals” any response to a question including but not limited to any hand signals, mouthing, or whispering, game play will cease and the judges will determine the penalty up to and including disqualifying the team to which the concerned is a member of

30. By participating in this Contest, entrants agree that they have read and understood; and agree to be bound by these rules and all decisions of the Judges, Sponsors and Contest Administrator, which are final.

31. In the event that the Contest is not capable of running as planned for any reason, including tampering, unauthorized intervention, fraud, technical failures, including any errors in programming, printing, distribution or production errors or any other errors or other causes of any nature whatsoever beyond the reasonable control of the Sponsors and/or their agencies which corrupt or affect the administration, security, integrity or proper conduct of this Contest, the Sponsors reserve the right to terminate or suspend the Contest, in whole or in part, or modify it in any way at the Sponsors’ sole discretion, without advance notice.

32. The Sponsors, in their sole discretion, reserve the right to disqualify any person suspected of tampering with the entry process or otherwise violating these rules. Sponsors further reserve the right to cancel, suspend, terminate or modify any promotion not capable of completion as planned, including unauthorized intervention, force majeure or technical failures of any sort beyond the reasonable control of Sponsors, which corrupts or impairs the administration, security, fairness or proper play of this promotion. Sponsors reserve the right, in their sole discretion, to suspend or terminate this promotion.

Thursday, March 22, 2012

Saturday, October 22, 2011

New ADHD Guidelines Include Broader Age Range

Fran Lowry

October 17, 2011 (Boston, Massachusetts) — For the first time in a decade, the American Academy of Pediatrics has issued an updated set of guidelines for the diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) that now include younger, preschool children and adolescents.

The guidelines, "ADHD: Clinical Practice Guidelines for the Diagnosis, Evaluation and Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder," were released here at the American Academy of Pediatrics National Conference & Exhibition and simultaneously published online October 16 in Pediatrics.

Dr. Mark Wolraich
"We wrote the original guidelines in 2000 to 2001, and they were written for children between the ages of 6 and 12 because that's where most of the available evidence was at the time," Mark Wolraich, MD, CMRI/Shaun Walters professor of pediatrics and chief of the Section of Developmental and Behavioral Pediatrics at the University of Oklahoma Health Sciences Center, Oklahoma City, told Medscape Medical News.

"Over the years, we have heard about the concern for preschool children and adolescents and what should be done with them. We've expanded the age group to include children aged 4 to 18 because there's certainly new evidence to support recommendations for the broader age group," said Dr. Wolraich, lead author of the guidelines.

Increase in Approved Medications

The last 10 years have also seen an increase in the number of medications that have been approved by the US Food and Drug Administration for the treatment of ADHD, and the new guidelines reflect this. They also emphasize the chronic nature of the disorder

"We had pushed for the idea that ADHD was a chronic illness in the initial guidelines, and that clinicians needed to use chronic illness principles in treating it, and this has been further emphasized," Dr. Wolraich said.

Other key recommendations include:

assessing children for other conditions that might coexist with ADHD, such as oppositional defiant and conduct disorders, anxiety, and depression;
making sure that Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, criteria have been met;
obtaining information primarily from reports from parents or guardians, teachers, and other school and mental health clinicians involved in the child's care;
first line of treatment for preschool-aged children 4 to 5 years old should be evidence-based parent- or teacher-administered behavior therapy;
titrating medication doses to achieve the maximum benefit with the least adverse effects; and
for adolescents, the primary care clinician should prescribe FDA-approved ADHD medications with their consent.
"The challenge in adolescents is you no longer have individual teachers as good reporters of their behavior, because they are going from class to class, and no one has them for a long period of time. It tends to be hard to get good information," Dr. Wolraich said.

He added that it is important to start treating children at a young age.

"When we can identify them earlier and provide appropriate treatment, we can increase their chance of succeeding in school. With our greater awareness now about ADHD and better ways of diagnosing and treating this disorder, more children are being helped."

Clinical Judgment Not Enough

Peter Jensen, MD, codirector of the Division of Child Psychiatry and Psychology at the Mayo Clinic, Rochester, Minnesota, told Medscape Medical News that the updated guidelines give more detailed instructions to help primary care physicians manage these patients.

Dr. Peter Jensen
"What's wonderful about the updated guidelines is they provide additional guidance and specificity over the guidelines that were published back in 2000 to 2001," Dr. Jensen said.

"Some of these kids have very complex problems; many also have anxiety and depression. The guidelines take note of this, and they also emphasize the use of rating scales from teachers and parents. They take us a step further," he added.

Providing more detailed guidance on the diagnosis and treatment of children with ADHD is important, he said.

"Many doctors treat ADHD by the seat of their pants," he said. "They are well intentioned, but when we are in the midst of a busy office day and frantic parents, and understaffed, our clinical judgment isn't enough, and we are prone to miss things. If the mom smiles we think all is well. But that is not as accurate as looking at the rating scale from the parents, from the teacher, and talking with Johnnie.

"Clinical judgment is not enough to replace these kinds of tools, and the guidelines add more of that kind of detail and will be more likely to help us keep from making errors of omission and commission."

Dr. Jensen said he suspected that ADHD may be increasing because so many demands for sustained attention are being placed on today's children.

"We expect our kids to learn more, do more, we expect them not just to go to college but to have 3 or 4 hobbies and activities they do in the afternoon and quickly get that homework done, and then we expose them to many different stimuli.

"They have the TV going, and the Game Boy going. All those things are competitors for attention. If you had a society where homework was not important, almost by definition you'd have fewer parents complaining about their child's inattention," said Dr. Jensen.

Dr. Wolraich disclosed that he is a past consultant to Shire, Lilly, Shinogi and Nextwave all of which produce medications for ADHD. Dr. Jensen has disclosed no relevant financial relationships.

American Academy of Pediatrics National Conference & Exhibition 2011. Presented October 16, 2011.

Pediatrics. Published online October 16, 2011

|| Link to PDF File || From Medscape

Thursday, October 20, 2011

Vaccines for Addiction Gaining Momentum

Ron Zimmerman

October 17, 2011 — Up to now, vaccines have been used effectively against a variety of infectious diseases, but what if they could be developed to treat and/or prevent addiction?

Take smoking, for example. Someone who wanted to quit would go through their usual lighting up routine, but when nicotine does not arrive in the brain, they would probably extinguish the cigarette and not light another. Without feeling nicotine's effects, it is likely they would view smoking as a waste of money.

Or consider a vaccine against methamphetamine: Snorted or injected, the drug would not give the user a high, so what would be the point of going to the trouble of scoring this illegal drug in the first place?

Now both vaccines, for nicotine and for methamphetamine, have gone beyond the dreaming stage. Recently, the National Institute on Drug Abuse (NIDA) awarded "visionary" grants to 2 scientists who believe that in the not-too-distant future, vaccines will be available not just for smallpox and whooping cough but also for substance abuse.

Two scientists proposing to develop vaccines against methamphetamine and nicotine have been selected to receive NIDA's second Avant-Garde Awards for Innovative Medication Development Research.

The scientists, Thomas Kosten, MD, from Baylor College of Medicine, Houston, Texas, and Peter Burkhard, PhD, from the University of Connecticut, Storrs, will each receive $500,000 per year for 5 years from NIDA to support their research.

Addiction vaccines could be life-changing for the estimated 22 million drug abusers in the United States. NIDA estimates that every year, addiction costs the country $84 billion in direct healthcare costs, lost earnings, crime, and accidents. The cost trend is rising, and researchers hope that addiction vaccines may reverse it, not only by treating addicts but also by immunizing young people before they become addicted.

Just like regular vaccines, substance abuse vaccines work by provoking the immune system to produce antibodies, which then causes the body to suspend and reject the drug before it reaches the brain. That is the goal, but thus far, success in humans has been elusive.

Dr. Thomas Kosten
Dr. Kosten is working on a novel human methamphetamine vaccine, and since at this time there is no US Food and Drug Administration (FDA)–approved medication for methamphetamine addiction, his research could have substantial effect.

Dr. Burkhard's peptide nanoparticle antinicotine vaccine would be administered intranasally, which would be easier and less painful than an injection. He believes his de novo peptide design, coupled with nicotine, will induce a strong immune response against nicotine without the need for other chemicals to enhance it, leading to fewer adverse effects and a less expensive vaccine.

Addiction Interrupted

Both vaccines are expected to enter initial clinical trials within 5 years. They both work essentially in the same way: They induce a patient's immune system to generate antibodies that then bind to the target drug, forming compound molecules that are too large to move from the bloodstream to the brain.

Once the drug is denied access to the patient's brain, it cannot produce the reinforcement or "high" that is the major component of the motivation to continue using it. In short, the familiar addiction cycle — drug use, resultant brain stimulation, and then a subsequent desire for continued drug use — is interrupted.
Once the drug is denied access to the patient's brain, it cannot produce the reinforcement or "high" that is the major component of the motivation to continue using it. In short, the familiar addiction cycle — drug use, resultant brain stimulation, and then a subsequent desire for continued drug use — is interrupted.

The science behind vaccines for addiction goes back to the 1950s, when researchers developed a vaccine against fatal overdoses of the heart drug digitalis.

Then, in the 1970s, at the University of Chicago, researchers working with monkey models were successful in creating antibodies to heroin in their subjects by attaching molecules of heroin to a protein from cow's blood. This is the model on which Dr. Kosten has based his research.

Another major precedent for these 2 new addiction vaccines is the work of California researcher Kim D. Janda, PhD, from Scripps Research Institute in La Jolla, who made headlines in July when his team announced it had produced a vaccine against heroin's effects in rats. His laboratory's rodents stopped helping themselves to the drug after they received a vaccine, and it is thought they did so because the heroin stopped having any effect.

However, that success followed a serious setback in Dr. Janda's work on another vaccine: A phase 2 clinical trial for a nicotine vaccine based on his work had disappointing results. Patients receiving the vaccine only quit smoking at the same rate as those receiving placebo, so the trial was halted.

To date, none of Dr. Janda's vaccines has received FDA approval, and despite successes in animal models in his laboratory, they have not yet produced consistent results in humans.

As Dr. Janda recently told the New York Times: "The big problem plaguing these vaccines right now is difficulty predicting in humans how well it's going to work."

That difficulty was revealed in widely anticipated cocaine vaccine studies, in which a bacterial protein plus a molecule that is a cocaine look-alike trained the immune system to produce antibodies that bind to any cocaine in the bloodstream.

"Like Wiping Out Switzerland"

In a 2010 vaccine study at Columbia University, New York City, conducted by Margaret Haney, PhD, with crack cocaine addicts, the level of antibodies in the volunteers varied widely. Only 38% of the cocaine users produced enough antibodies to quell the drug's effects, and of those, only half stayed off the drug more than half the time.

In a 2008 analysis of 34 behavioral studies in cocaine, methamphetamine, and marijuana addictions, improvement was seen in 67% of the addicts. "You can't expect a medication or vaccine alone to take care of addiction," said Dr. Haney."I am entirely humble about that."

Dr. Nora Volkow
NIDA Director Nora D. Volkow, MD, said Dr. Kosten and Dr. Burkhard were awarded the grants because they have already demonstrated proficiency in the laboratory with vaccines.

"They also have clear plans for initiating clinical trials within an accelerated period of time," said Dr Volkow. And that's the goal of NIDA's Avant-Garde Grant Program: "[T]o support investigators of exceptional creativity who propose bold and highly innovative new research approaches that have the potential to produce a major impact on the treatment of drug abuse."

Seven million people die from smoking addiction every year. That's like wiping out Switzerland. It's a tremendous step forward to have a vaccine to prevent smoking, not only for these 7 million who die but also for the other countless millions who are living with their smoking addiction.
"Seven million people die from smoking addiction every year," Dr. Burkhard told Medscape Medical News, "that's like wiping out Switzerland. It's a tremendous step forward to have a vaccine to prevent smoking, not only for these 7 million who die but also for the other countless millions who are living with their smoking addiction."

Nicotine presents a particular challenge in developing a vaccine against it, as on its own it is completely nonimmunogenic. "So you have to couple it to a carrier to induce an immune response," he added.

Dr. Peter Burkhard
Dr. Burkhard heads the Burkhard Protein Design Group at the University of Connecticut, which has developed proprietary methods to synthetically produce nanosize protein particles.

"Our greatest challenge is generating as strong an immune response as possible to induce the effect we're looking for," he said. "The idea has been around for awhile, and other companies have brought it into clinical trials, where they have shown that it works, but it only works if you have really high levels of antibodies. Most of the clinical trials have failed for this reason, because they were only able to induce antibodies in about 30% of the population. And that's simply not good enough."

Dr. Burkhard's 18-nm particles are produced in his group's laboratory after first being designed on a computer.

"We predict a peptide sequence that is then able to self-assemble into a particle with icosahedral symmetry," he said. "Then we go into the lab to synthesize this peptide by biotech procedures, expressing it in [Escherichia coli], purifying it, and then refolding it. With those nanoparticles, the next step is coupling the nicotine molecule to the nanoparticle."

No Guarantees

Under the NIDA grant timeline, Dr. Burkhard plans to spend the first year and a half developing an effective nanoparticle vaccine, "so that we can be sure that we do get enough antibodies."

It will then take a year to manufacture enough vaccine for his 2-year phase 1 clinical trial. "That's our expertise, developing these nanoparticles that have been shown to be very immunogenic, and we have some 'tricks of the trade' to really tweak the immune system to give us a very strong antibody response. There's no guarantee that it will work, but we have confidence that we can achieve that," said Dr. Burkhard.

In addition to his grant to develop a methamphetamine vaccine, Dr. Kosten already has a cocaine vaccine under development.

Known as TA-CD, for Therapy Addiction–Cocaine Addiction, this vaccine uses an inactivated cholera protein to bind to cocaine in the user's bloodstream. The approach is to prevent the addictive substance from ever reaching the brain, and thereby prevent the chemical cascade that results in a euphoric "high."

It is hoped that without that high, the user's addictive cycle will be broken. In fact, a blinded, placebo-controlled study of 114 participants conducted by Dr. Kosten and his wife, neuroscientist Therese Kosten, PhD, showed that individuals who received the vaccine were twice as likely to reduce their cocaine use by at least 50% compared with those who received placebo. The study is now under review, and the Kostens are seeking FDA approval for a larger, 300-person, multicenter trial.

What is the scientific principle behind the vaccine? Dr. Kosten explained that although most foreign substances in the body trigger an immune-system response, drugs like cocaine fail to do so because their molecules are too small. They slip across the blood–brain barrier precisely because the molecules are so tiny.

When cocaine is bound to a much larger protein...the immune system creates antibodies to both the larger protein and the drug that it carries. Then, the next time the user administers the drug, the body's immune defenses attach onto the cocaine and break it down with enzymes.
However, when cocaine is bound to a much larger protein, such as the inactivated cholera protein that has been widely tested and found to be without adverse effects, the immune system creates antibodies to both the larger protein and the drug it carries. Then, the next time the user administers the drug, the body's immune defenses attach onto the cocaine and break it down with enzymes.

"It's like a big sponge for cocaine," Dr. Kosten told Medscape Medical News. "The drug remains trapped in the blood until it's metabolized and made inactive by the liver and secreted in the kidneys."

Users can thwart the vaccine and their fortified immune system responses by taking more cocaine than their immune system can handle, so the user has to want to slow or stop their cocaine use for the vaccine to be effective in curbing their addiction. And that is why TA-CD is currently thought of as a therapeutic drug, not a preventative, said Dr. Kosten.

Made in China

Other researchers have run into a wall in trying to find a substance that will bind to materials such as tetrahydrocannabinol, or THC, in marijuana, so the body can see that substance.

Dr. Janda has tried to make vaccines against alcohol and marijuana use, but so far the effort has failed. He said that in the case of alcohol, its ethanol molecules have proven to be too small to attach a protein to them, and in the case of marijuana, its main ingredient, THC, hides too well for the immune system to react to it.

Using cholera bacterium as a vector was an essential part of Dr. Kosten's new cocaine vaccine, he said, because it allows the vaccine to avoid potential viral syndromes associated with other vaccines. In addition, most people in Western countries where cocaine abuse is most severe do not have natural immunity to cholera.

In Dr. Kosten's methamphetamine vaccine, he is using a Neisseria meningitis protein as a vector.

Dr. Volkow believes the field of drug abuse treatment is on the cusp of a large paradigm shift.

A successful vaccine will make it easier for addicted individuals to establish and maintain abstinence. It will reduce the chances that isolated lapses into drug taking escalate into protracted relapses. Ideally, a single dose will remain effective for months or longer.
"Vaccines have a unique role to play in a comprehensive strategy to help people overcome addictions. A successful vaccine will make it easier for addicted individuals to establish and maintain abstinence. It will reduce the chances that isolated lapses into drug taking escalate into protracted relapses. Ideally, a single dose will remain effective for months or longer," she said.

Although NIDA views vaccines as a potentially powerful tool to aid addicts from their illegal drugs, pharmaceutical companies are not lining up with research grants, say these researchers.

They believe the pharmaceutical companies do not see much money to be made in a shot that is given once every 6 months, and also perhaps because the companies are not anxious to associate their companies with drug addicts.

"Pharma does not see a profit in these vaccines, and only sees great risk in this population due to their lifestyle and [potential for] overdoses," said Dr. Kosten.

Dr. Kosten is taking his methamphetamine vaccine manufacturing and clinical trial to China, as his greatest challenge has been in finding a domestic manufacturer.

"We've had no success doing this in the United States, but we have had success in China. We will manufacture the vaccine in China and do clinical trials there after getting Chinese FDA approval about 3 years from now. A placebo-controlled study will compare vaccinated [groups] to placebo groups during a 6-month outpatient clinical trial. We'll have the vaccine in humans in 4 years and have a commercial product in 10 years," he said.

From : Medscape

Wednesday, October 12, 2011

Mental Health Day Celebration (Photos)

Dr. Alinea, Dr. Laguidao & Dr. Dalisay
with Interns

Dr. Amadeo Alinea, Jr.
Dr. Edessa P. Laguidao
Dr. Rodney Dalisay

Dr. Alinea & Dr. Laguidao with Psychiatry Interns

Dr. Felicitas A. Soriano, MD, FPPA
Head, Department of Psychiatry
Giving her Opening Message

Dr. Georgina Gozo-Oliver, MD, FPPA, FPSCAP
Child & Adolescent Psychiatrist
Lecturer : Teen Stress: When Coping Fails

Dr. Teresa Icasiano, MD, FPPA
Visiting Consultant, Department of Psychiatry
Lecturer: Stress in the Workplace

Nursing Staff
Department of Psychiatry

Poster-Making Contestants at Work

Poster-Making Contestants

Poster-Making Judges

1st Prize Winner Mark
explaining his work

Dr. Shamylle Quinto
Poster-Making Judge

Ms. Irmburgh Calleja
Poster-Making Judge

Mr. Romeo I. Ariola
Chairman of the Panel of Judges
Poster-Making Contest

3rd Prize Winner

2nd Prize Winner

2nd Prize Winner

1st Prize Winner

Department of Psychiatry Staff
with the Poster-Making Winners

Dr. Alinea & Dr. Cariaga
with 2nd Prize Winner and her parent

Contestant at Work

Monday, October 10, 2011

Intranasal Insulin Therapy for Alzheimer Disease and Amnestic Mild Cognitive Impairment: A Pilot Clinical Trial

Craft S, Baker LD, Montine TJ, et al
Arch Neurol. 2011;Sept 12. [Epub ahead of print]


The goal of this randomized, double-blind, placebo-controlled trial was to assess the effects of intranasal insulin administration on cognition, function, cerebral glucose metabolism, and cerebrospinal fluid (CSF) biomarkers in adults with amnestic mild cognitive impairment or Alzheimer disease (AD). At the clinical research unit of a Veterans Affairs medical center, 104 adults (64 with amnestic mild cognitive impairment and 40 with mild-moderate AD) were randomly assigned to receive placebo (n = 30), 20 IU of insulin (n = 36), or 40 IU of insulin (n = 38) for 4 months. A nasal drug delivery device was used to administer all study drugs.

The main study endpoints were delayed story recall score and the Dementia Severity Rating Scale score. Secondary measures were the Alzheimer Disease's Assessment Scale–cognitive subscale (ADAS-cog) score and the Alzheimer's Disease Cooperative Study–activities of daily living (ADCS-ADL) scale. Before and after treatment, 23 participants underwent lumbar puncture and 40 underwent positron emission tomography with fludeoxyglucose F-18 (FDG-PET).

Delayed memory was improved in the group receiving 20 IU of insulin (P < .05). Both insulin groups had preserved caregiver-rated functional ability (P < .01) and general cognition measured by the ADAS-cog score for younger participants and functional abilities measured by the ADCS-ADL scale for adults with AD (P < .05).

Among insulin-treated participants as a group, no changes were detected in CSF biomarkers. However, exploratory analyses revealed that changes in memory and function were associated with changes in the CSF amyloid beta-42 level and tau protein-to- amyloid beta-42 ratio.

Fludeoxyglucose F-18 uptake in the parietotemporal, frontal, precuneus, and cuneus regions decreased in participants receiving placebo, whereas insulin appeared to minimize progression of these deficits. No treatment-related severe adverse events occurred, and the safety profile and compliance were excellent.


Study limitations of this small, single-site pilot study include younger age in the 40-IU dose insulin group than in the placebo group (although age was a covariate in all analyses), availability of CSF and FDG-PET data for only a subset of participants, and lack of verification of increased insulin levels in CSF directly after insulin administration. In addition, treatment duration was relatively short. Nonetheless, on the basis of these findings, longer trials of intranasal insulin treatment are warranted in patients with amnestic mild cognitive impairment or AD. Further mechanistic studies may help clarify the role of insulin in the pathogenesis of AD.


Arch Neurol. 2011 Sep 12. [Epub ahead of print]
Intranasal Insulin Therapy for Alzheimer Disease and Amnestic Mild Cognitive Impairment: A Pilot Clinical Trial.
Craft S, Baker LD, Montine TJ, Minoshima S, Watson GS, Claxton A, Arbuckle M, Callaghan M, Tsai E, Plymate SR, Green PS, Leverenz J, Cross D, Gerton B.
Education, and Clinical Center (Drs Craft, Baker, Watson, Claxton, Callaghan, and Plymate and Mr Arbuckle) and Mental Illness Research, Education, and Clinical Center (Drs Leverenz and Gerton), Veterans Affairs Puget Sound Health Care System, and Departments of Psychiatry and Behavioral Sciences (Drs Craft, Baker, Watson, Claxton, and Leverenz), Pathology (Dr Montine), Radiology (Drs Minoshima and Cross), Medicine (Drs Tsai, Plymate, and Green), and Neurology (Drs Leverenz and Gerton), University of Washington School of Medicine, Seattle, Washington.
To examine the effects of intranasal insulin administration on cognition, function, cerebral glucose metabolism, and cerebrospinal fluid biomarkers in adults with amnestic mild cognitive impairment or Alzheimer disease (AD).

Randomized, double-blind, placebo-controlled trial.

Clinical research unit of a Veterans Affairs medical center.

The intent-to-treat sample consisted of 104 adults with amnestic mild cognitive impairment (n = 64) or mild to moderate AD (n = 40). Intervention  Participants received placebo (n = 30), 20 IU of insulin (n = 36), or 40 IU of insulin (n = 38) for 4 months, administered with a nasal drug delivery device (Kurve Technology, Bothell, Washington).

Primary measures consisted of delayed story recall score and the Dementia Severity Rating Scale score, and secondary measures included the Alzheimer Disease's Assessment Scale-cognitive subscale (ADAS-cog) score and the Alzheimer's Disease Cooperative Study-activities of daily living (ADCS-ADL) scale. A subset of participants underwent lumbar puncture (n = 23) and positron emission tomography with fludeoxyglucose F 18 (n = 40) before and after treatment.

Outcome measures were analyzed using repeated-measures analysis of covariance. Treatment with 20 IU of insulin improved delayed memory (P < .05), and both doses of insulin (20 and 40 IU) preserved caregiver-rated functional ability (P < .01). Both insulin doses also preserved general cognition as assessed by the ADAS-cog score for younger participants and functional abilities as assessed by the ADCS-ADL scale for adults with AD (P < .05). Cerebrospinal fluid biomarkers did not change for insulin-treated participants as a group, but, in exploratory analyses, changes in memory and function were associated with changes in the Aβ42 level and in the tau protein-to-Aβ42 ratio in cerebrospinal fluid. Placebo-assigned participants showed decreased fludeoxyglucose F 18 uptake in the parietotemporal, frontal, precuneus, and cuneus regions and insulin-minimized progression. No treatment-related severe adverse events occurred.

These results support longer trials of intranasal insulin therapy for patients with amnestic mild cognitive impairment and patients with AD. Trial Registration Identifier: NCT00438568.

PMID: 21911655 [PubMed - as supplied by publisher]

From : Medscape