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All the surgical information you need to know about is right here. Presented and researched by http://www.medical-mailings.com. We've searched the information super highway far and wide to provide you with the best surgical site on the internet today. The links below will assist you in your efforts to find the information that you are looking for about
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We make surgical searching and shopping easier. We've used our surgical network to get you to be best sites fast and efficiently.

As competition in the surgical world wide marketplace drives the need for ever greater efficiency, the Internet will surely become a better place to do business. The win-win situation between surgical operators and consumers is enormous. Enjoy your surgical adventure by taking advantage of our discoveries. Step one is to click on the links provided in this page.

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Need information on Medical Mailings? Our links will provide you with information on all type of type of Medical Mailings for Physicians over the internet including email and snail mail. For conferencing services to go with your email campagin go to Meetings on the Net - http://www.meetingsonthenet.com
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Netscape Corporation has created the best known secure server technologies. It uses a security protocol called Secure Sockets Layer (SSL) that provides data encryption, server authentication, message integrity and optional client authentication for a TCP/IP connection. When a client seeking to purchase surgical connects with a secure server, they exchange a *handshake* which initiates a secure session. With this protocol, the same server system can run both secure and unsecured web servers simultaneously. This means an surgical organization or company can provide some information to all users using no security, and other information that is secured. For example, a business that sells surgical online can have its storefront (merchandise catalog) unsecured, but ordering and payment forms can be secure.

Why are these developments important? As the Internet becomes a way to buy and sell surgical products and services, financial transactions become essential. Right now, most surgical transactions involve the exchange of credit card information, either directly over the network, or by phone, to complete a transaction initiated online. Eventually, you will be able to use cash as well as credit, directly over the network.

There are two basic kinds of digital cash, anonymous cash and identified cash. Anonymous cash is just like paying for surgical with paper cash but it also carries no information about the person making the transaction, and leaves no transaction trail. You create it by using numbered bank accounts and blind signatures. Identified cash, on the other hand, contains information revealing the identity of the person who withdrew it from the bank. Like credit card transactions, identified cash can be tracked as it moves through the system and involves fully identified accounts and non-blind signatures. Whether you use digital cash when purchasing surgical is entirely up to you. We suggest you employ the purchasing avenues available from the surgical supplier we recommend.

Major Depression and Manic-Depression — Any difference?

 by: Michael G. Rayel, MD

Countless number of patients and their family members have asked me about manic–depression and major depression. "Is there any difference?" "Are they one and the same?" "Is the treatment the same?" And so on. Each time I encounter a chorus of questions like these, I am enthused to provide answers.

You know why? Because the difference between these two disorders is enormous. The difference does not lie on clinical presentation alone. The treatment of these two disorders is significantly distinct.

Let me begin by describing major depression (officially called major depressive disorder). Major depression is a primary psychiatric disorder characterized by the presence of either a depressed mood or lack of interest to do usual activities occurring on a daily basis for at least two weeks. Just like other disorders, this illness has associated features such as impairment in energy, appetite, sleep, concentration, and desire to have sex.

In addition, patients afflicted with this disorder also suffer from feelings of hopelessness and worthlessness. Tearfulness or crying episodes and irritability are not uncommon. If left untreated, patients get worse. They become socially withdrawn and can't go to work. Moreover, about 15% of depressed patients become suicidal and occasionally, homicidal. Other patients develop psychosis—hearing voices (hallucinations) or having false beliefs (delusions) that people are out to get them.

What about manic-depression or bipolar disorder?

Manic-depression is a type of primary psychiatric disorder characterized by the presence of major depression (as described above) and episodes of mania that last for at least a week. When mania is present, patients show signs opposite of clinical depression. During the episode, patients show significant euphoria or extreme irritability. In addition, patients become talkative and loud.

Moreover, this type of patients doesn't need a lot of sleep. At night, they are very busy making phone calls, cleaning the house, and starting new projects. Despite apparent lack of sleep, they are still very energetic in the morning — ready to establish new business endeavors. Because they believe that they have special powers, they involve in unreasonable business deals and unrealistic personal projects.

They also become hypersexual — wanting to have sex several times a day. One–night stands can happen resulting in marital conflict. Like depressed patients, manic patients develop delusions (false beliefs). I know a manic patient who thinks that he is the "Chosen One." Another patient claims that the President of USA and the Prime Minister of Canada ask for her advice.

So the big difference between the two is the presence of mania. This manic episode has treatment implications. In fact the treatment of these disorders is completely different. While major depression needs antidepressant, manic-depression requires a mood stabilizer such as lithium and valproic acid. Recently, new antipsychotics, for example risperidone, olanzapine, and quetiapine, have been shown to be effective for acute mania.

In general, giving an antidepressant to manic–depressed patients can make their condition worse because this medication can precipitate a switch to manic episode. Although there are some exceptions to the rule (extreme depression, lack of response to mood stabilizers, among others), it is preferable to avoid antidepressants among bipolar patients.

When considering the use of antidepressant in a depressed bipolar patient, clinicians should combine the medication with a mood stabilizer and should use an antidepressant (e.g. bupropion) that has a low tendency to cause a switch to mania.

About The Author

Copyright © 2004. All rights reserved. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader's Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Dr. Rayel pioneers the CARE Approach as first aid for mental health. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores.


mike@drrayel.com

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