N. Szajnberg, MD on “Lifelong opioidergic vulnerability through early life separation”

Posted on September 4, 2014 by Maurice Preter MD

 
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Early Childhood Loss and Later Panic: Preter and Klein

Early Childhood Loss and Later Panic: Preter and Klein
N. Szajnberg, MD
Bowlby was a careful observer. His entire volume on Loss spoke to the power of early childhood adversity and later life.  More recently, a pediatric nephrologist at Kaiser in collaboration with others has shown that early childhood adversities, including loss, results in later adulthood medical ailments (Filetti et al); and Szajnberg and Massie followed Brodie’s cohort at thirty years to demonstrate this clinically.
Yet, Preter and Klein, citing the work of others, have shown pharmacological evidence of what appears to be a lifelong disorder in opiodergic systems due to childhood loss.
Here is the careful study:

Click Here to Read:  Lifelong opioidergic vulnerability through early life separation: A recent extension of the false suffocation alarm theory of panic disorder.  by Maurice Preter MD and Donald F. Klein, MD, DSc:  on the Reseach Gate Website on April 16, 2014.

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Neuropsychiatrist Maurice Preter Nominated Castle Connolly Top Doctor

Posted on July 8, 2014 by Maurice Preter MD

Neuropsychiatrist Maurice Preter Nominated Castle Connolly Top Doctor

Each year, Castle Connolly receives nearly 100,000 nominations via peer nominations. Dr. Preter was one of the well-deserved nominees in 2014.

FOR IMMEDIATE RELEASE

PRLog (Press Release) – Jul. 8, 2014 – NEW YORK — With over 15 years of experience, Maurice Preter, MD is an accomplished neuropsychiatrist, psychodynamic psychiatrist, psychopharmacologist, and neurologist in practice on Manhattan’s Upper East Side.One of a few dually board certified experts in both psychiatry and neurology, he is internationally active as lecturer, medical educator and as clinical and medical-legal consultant. He has researched and written about a wide range of neuropsychiatry topics and is an internationally recognized academic expert on anxiety, panic disorder and PTSD. See Bio (https://psychiatryneurology.net/).

In addition to clinical consultation, Dr. Preter may be called upon for forensic psychiatric and neuropsychiatric expertise to assist plaintiff and defense counsel, the courts, federal, State agencies, and international organizations.

“I am pleased and humbled to receive this great honor together with some of the most distinguished doctors in New York City (and beyond). I want to thank my colleagues for expressing their confidence.”

For more than twenty years, Castle Connolly Medical Ltd., America’s trusted source for identifying Top Doctors, has based its selection process on the foundation of peer nominations.

Each year, Castle Connolly receives nearly 100,000 nominations via this process. Dr. Preter was one of the well-deserved nominees.

Physicians nominate other doctors whom they feel are the most outstanding in their medical specialties, in any area of medicine and in any part of the country, indicating also whether they believe that the physician is among the best in their region or among the very best in the nation. However, a physician cannot nominate him/herself.

The Castle Connolly physician-led research team carefully reviews the credentials of every physician being considered for inclusion in Castle Connolly Guides®, magazine articles and website. The review includes, among other factors, scrutiny of medical education, training, board certifications, hospital appointments, administrative posts, professional achievements and malpractice and disciplinary history.

For more information about Maurice Preter, MD please visit his website at the link below:

https://psychiatryneurology.net/

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Sildenafil Use and Increased Risk of Inciden… [JAMA Intern Med. 2014] – PubMed – NCBI

Posted on June 15, 2014 by Maurice Preter MD
JAMA Intern Med. 2014 Jun 1;174(6):964-70. doi: 10.1001/jamainternmed.2014.594.

Sildenafil Use and Increased Risk of Incident Melanoma in US Men: A Prospective Cohort Study.

Li WQ1, Qureshi AA2, Robinson KC3, Han J4.

Author information

Abstract

IMPORTANCE The RAS/RAF/mitogen-activated protein kinase and extracellular signal-regulated kinase (ERK) kinase/ERK cascade plays a crucial role in melanoma cell proliferation and survival. Sildenafil citrate (Viagra) is a phosphodiesterase (PDE) 5A inhibitor commonly used for erectile dysfunction. Recent studies have shown that BRAF activation down-regulates PDE5A levels, and low PDE5A expression by BRAF activation or sildenafil use increases the invasiveness of melanoma cells, which raises the possible adverse effect of sildenafil use on melanoma risk. OBJECTIVE To evaluate the association between sildenafil use and risk of incident melanoma among men in the United States. DESIGN, SETTING, AND PARTICIPANTS Our study is a prospective cohort study. In 2000, participants in the Health Professionals’ Follow-up Study were questioned regarding sildenafil use for erectile dysfunction. Participants who reported cancers at baseline were excluded. A total of 25 848 men remained in the analysis. MAIN OUTCOMES AND MEASURES The incidence of skin cancers, including melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC), was obtained in the self-reported questionnaires biennially. The diagnosis of melanoma and SCC was pathologically confirmed. RESULTS We identified 142 melanoma, 580 SCC, and 3030 BCC cases during follow-up (2000-2010). Recent sildenafil use at baseline was significantly associated with an increased risk of subsequent melanoma with a multivariate-adjusted hazard ratio (HR) of 1.84 (95% CI, 1.04-3.22). In contrast, we did not observe an increase in risk of SCC (HR, 0.84; 95% CI, 0.59-1.20) or BCC (1.08; 0.93-1.25) associated with sildenafil use. Moreover, erectile function itself was not associated with an altered risk of melanoma. Ever use of sildenafil was also associated with a higher risk of melanoma (HR, 1.92; 95% CI, 1.14-3.22). A secondary analysis excluding those reporting major chronic diseases at baseline did not appreciably change the findings; the HR of melanoma was 2.24 (95% CI, 1.05-4.78) for sildenafil use at baseline and 2.77 (1.32-5.85) for ever use. CONCLUSIONS AND RELEVANCE Sildenafil use may be associated with an increased risk of developing melanoma. Although this study is insufficient to alter clinical recommendations, we support a need for continued investigation of this association.

PMID:
24710960
[PubMed – in process]
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New York Magazine Best Doctors Nomination

Posted on June 10, 2014 by Maurice Preter MD

New York Magazine Best Doctors Nomination

Thank you for the votes!
http://nymag.com/nymag/toc/20140609

Maurice Preter MD Nominated To Castle Connolly / New York Magazine Best Doctors of New York 2014

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Maurice Preter MD and Donald F. Klein, MD, DSc: Lifelong opioidergic vulnerability through early life separation: A recent extension of the false suffocation alarm theory of panic disorder.

Posted on April 16, 2014 by Maurice Preter MD

Fresh off the [Epub] press. Of interest to some.

Keywords: Affective neuroscience; Childhood parental loss (CPL); Endogenous opioids; Panic disorder pathophysiology

From the conclusion:
“[…W]e objectively, experimentally showed a physiological link between endogenous opioid system deficiency and panic-like suffocation sensitivity in healthy adults. This is consonant with the expanded Suffocation-False Alarm Theory of panic suggesting an episodic functional endogenous opioid deficit (Preter and Klein, 1998). The specificity of the naloxone + lactate model of clinical panic should be tested using specific anti-panic components, possibly including opioidergic mixed agonist-antagonists such as buprenorphine. If specific, the naloxone + lactate effect in normal humans affords a screening method for testing putative anti-panic drugs which is currently not available. This could obviate the experimental treatment of panic disorder patients in drug development.
Our data also show for the first time that actual separations and losses during childhood, such parental death, parental separation or divorce (CPL), effect lifelong alterations in the physiological reactivity of the endogenous opioid system of healthy adults.
This result encourages epigenetic inquiry into the effects of CPL on endogenous opioid systems, and their role in resilience under extreme stress. In addition, a redefinition of what constitutes a (truly) healthy control in clinical research protocols may be called for.”

Neurosci Biobehav Rev. 2014 Apr 9. pii: S0149-7634(14)00082-7. doi:10.1016/j.neubiorev.2014.03.025.

 [Epub ahead of print]

Lifelong opioidergic vulnerability through early life separation: A recent extension of the false suffocation alarm theory of panic disorder.

Preter M1, Klein DF2.

Author information

1Corresponding Author. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA. Electronic address: mp2285@columbia.edu.

2Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Department of Child and Adolescent Psychiatry, New York University Langone Medical Center 550 1(st) Ave, New York, NY 10016, USA. Electronic address: donaldk737@aol.com.

Abstract

The present paper is the edited version of our presentations at the “First World Symposium On Translational Models Of Panic Disorder”, in Vitoria, E.S., Brazil, on November 16-18, 2012. We also review relevant work that appeared after the conference. Suffocation-False Alarm Theory (Klein, 1993) postulates the existence of an evolved physiologic suffocation alarm system that monitors information about potential suffocation. Panic attacks maladaptively occur when the alarm is erroneously triggered. The expanded Suffocation-False Alarm Theory (Preter and Klein, 2008) hypothesizes that endogenous opioidergic dysregulation may underlie the respiratory pathophysiology and suffocation sensitivity in panic disorder. Opioidergic dysregulation increases sensitivity to CO2, separation distress and panic attacks. That sudden loss, bereavement and childhood separation anxiety are also antecedents of “spontaneous” panic requires an integrative explanation. Our work unveiling the lifelong endogenous opioid system impairing effects of childhood parental loss (CPL) and parental separation in non-ill, normal adults opens a new experimental, investigatory area.

Copyright © 2014. Published by Elsevier Ltd.

KEYWORDS:

Affective neuroscience, Childhood parental loss (CPL), Endogenous opioids, Panic disorder pathophysiology

PMID:

24726574

[PubMed – as supplied by publisher]

via Lifelong opioidergic vulnerability thr… [Neurosci Biobehav Rev. 2014] – PubMed – NCBI.

 

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