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The article discusses the benefits of psychotherapy in conjunction with pharmacotherapy in the treatment of depression. It says that although pharmacotherapy alone could treat the symptoms of depression, psychotherapy has the added advantage of helping a depressed person develop a sacred and confidential relationship with one's therapist. It adds that working with a therapist becomes a gift when psychotherapy works successfully and makes the person discover that one always has a meaning in life as he begins to understand his own feelings.

Abstract. Phenobarbital sodium has been used in anticonvulsant concentrations (15 to 40 micro g/mL serum) in premature newborns in attempts to prevent periventricular and intraventricular hemorrhages. Although its clinical usefulness in this regard is controversial, phenobarbital treatment has been shown to reduce periventricular and intraventricular hemorrhages after hypertensive insult in newborn beagles. In this study cerebral blood flow values in steady state and during phenylephrine-induced hypertension with and without phenobarbital pretreatment were measured in newborn beagles. At anticonvulsant dosage, phenobarbital sodium decreased mean arterial blood pressure transiently during steady state and significantly reduced total cerebral blood flow during phenylephrine-induced hypertension without reducing mean arterial blood pressure. This phenobarbital sodium effect on cerebral blood flow was not as great in the presence of acidosis, and the initial hypotensive effect of phenobarbital sodium was sustained for a longer period of time during acidosis. Phenobarbital sodium may reduce the incidence of hemorrhages in the newborn brain by providing protection against isolated hemodynamic stresses characterized by acute increases in cerebral blood flow, with or without increased mean arterial blood pressure. Pediatrics 1990;86:501-508; cerebral blood flow, hypertension, intraoentricular hemorrhage, neonate, newborn beagle, phenobarbital, phenylephrine hydrochloride, premature infant. INSET: ROUTINE HOSTPITAL ADMISSION IN TWIN PREGNANCY BETWEEN 26 AND.... [ABSTRACT FROM AUTHOR]

Abstract. Periventricular and intraventricular intracerebral hemorrhages occur frequently in premature newborns and are markers for, or contribute significantly to, neurologic morbidity in survivors. Hemorrhages are hypothesized to result from rapid fluctuations in cerebral perfusion pressure and/or cerebral blood flow. Phenobarbital sodium has been given to premature infants in anticonvulsant dosages in attempts to prevent hemorrhages, but its efficacy in clinical studies has been disputed. In this study, in the 24 to 72-hour-old newborn beagle, an animal model for periventricular and intraventricular intracerebral hemorrhage, phenobarbital sodium was administered to obtain anticonvulsant serum levels prior to phenylephrine-induced hypertensive insult. None of the animals was hypoxic or hypercarbic. Resulting hypertensive systemic mean arterial BPs were 99 +/8 mm Hg in the 15 control pups and 93 +/- 15 mm Hg in the 15 phenobarbital sodium-treated pups (not statistically significantly different). The duration of the hypertension was the same in both groups. Phenobarbital caused a Significant decrease in mean arterial BP in the treated group just after its administration (P < .05). Six of the 15 control pups (40%) and one of the 15 treated pups (7%) demonstrated macroscopic and microscopic periventricular and intraventricular hemorrhage (P < .05, chi[sup 2], Yates correction). Thus, in nonasphyxiated newborn beagles, phenobarbital sodium significantly reduced the incidence of hemorrhage after hypertensive insult. [ABSTRACT FROM AUTHOR]

Controversy over benefits of pulsatile flow after pediatric cardiopulmonary bypass (CPB) continues. Our study objectives were to first, quantify pressure and flow waveforms in terms of hemodynamic energy, using the energy equivalent (EEP) formula, for direct comparisons, and second, investigate effects of pulsatile versus nonpulsatile flow on cerebral and renal blood flow, and cerebral vascular resistance during and after CPB with deep hypothermic circulatory arrest (DHCA) in a neonatal piglet model. Fourteen piglets underwent perfusion with either an hydraulically driven dual-chamber physiologic pulsatile pump (P, n = 7) or a conventional nonpulsatile roller pump (NP, n = 7). The radiolabeled microsphere technique was used to determine the cerebral and renal blood flow. P produced higher hemodynamic energy (from mean arterial pressure to EEP) compared to NP during normothermic CPB (13 ± 3% versus 1 ± 1%, p < 0.0001), hypothermic CPB (15 ± 4% versus 1 ± 1%, p < 0.0001) and after rewarming (16 ± 5% versus 1 ± 1%, p < 0.0001). Global cerebral blood flow was higher for P compared to NP during CPB (104 ± 12 ml/100g/min versus 70 ± 8 ml/100g/min, p < 0.05). In the right and left hemispheres, cerebellum, basal ganglia, and brainstem, blood flow resembled the global cerebral blood flow. Cerebral vascular resistance was lower (p < 0.007) and renal blood flow was improved fourfold (p < 0.05) for P versus NP, after CPB. Pulsatile flow generates higher hemodynamic energy, enhancing cerebral and renal blood flow during and after CPB with DHCA in this model. [ABSTRACT FROM AUTHOR]