Lithium dosage and inositol levels

Estimating the Aboveground Biomass for Planted Forests Based on Stand Age and Environmental Variables

Measuring forest aboveground biomass (AGB) at local to regional scales is critical to understanding their role in regional and global carbon cycles. The Three-North Shelterbelt Forest Program (TNSFP) is the largest ecological restoration project in the world, and has been ongoing for over 40 years. In this study, we developed models to estimate the planted forest aboveground biomass (PF_AGB) for Yulin, a typical area in the project. Surface reflectances in the study area from 1978 to 2013 were obtained from Landsat series images, and integrated forest z-scores were constructed to measure afforestation and the stand age of planted forest. Normalized difference vegetation index (NDVI) was combined with stand age to develop an initial model to estimate PF_AGB. We then developed additional models that added environment variables to our initial model, including climatic factors (average temperature, total precipitation, and total sunshine duration) and a topography factor (slope). The model which combined the total precipitation and slope greatly improved the accuracy of PF_AGB estimation compared to the initial model, indicating that the environmental variables related to water distribution indirectly affected the growth of the planted forest and the resulting AGB. Afforestation in the study area occurred mainly in the early 1980s and early 21st century, and the PF_AGB in 2003 was 2.3 times than that of 1998, since the fourth term TNSFP started in 2000. The PF_AGB in 2013 was about 3.33 times of that in 2003 because many young trees matured. The leave-one-out cross-validation (LOOCV) approach showed that our estimated PF_AGB had a significant correlation with field-measured data (correlation coefficient (r) = 0.89, p < 0.001, root mean square error (RMSE) = 6.79 t/ha). Our studies provided a method to estimate long time series PF_AGB using satellite repetitive measures, particularly for arid or semi-arid areas.

Lithium and psoriasis: what primary care and family physicians should know

OBJECTIVE

This review focuses on the association of lithium treatment and psoriasis. The mechanism of action of lithium in causing psoriasis and the clinical presentation of psoriasis secondary to lithium treatment are considered.

DATA SOURCES

A search of the literature from 1949 to 2007 was performed using MEDLINE, with the following search terms: lithium, psoriasis, skin, dermatology, and psychodermatology.

DATA SYNTHESIS

Lithium is involved in a variety of cutaneous reactions including psoriasis, which may present as exacerbation of preexisting psoriasis, induction of de novo psoriasis, pustular psoriasis, nail changes, and psoriatic arthropathy. The appearance of psoriatic lesions may occur at normal therapeutic serum lithium levels. The refractory period for the development of psoriatic lesions is variable and generally longer in induction and shorter in exacerbation of psoriasis. Lithium-induced psoriasis is often resistant to conventional treatment modalities, and some cases may require dose reduction or discontinuation of lithium treatment.

CONCLUSION

Lithium is the mainstay of treatment in bipolar disorder and is associated with a variety of cutaneous side effects including psoriasis. Primary care providers and family physicians should be knowledgeable about the association of lithium and its dermatologic side effects. Early recognition and management could be beneficial in avoiding the issues of noncompliance and further deterioration of mood symptoms secondary to obviously disfiguring skin appearance. Primary care, psychiatry, and dermatology liaison services will prove helpful in managing these patients.

Administration of inositol to a patient with bipolar disorder and psoriasis: a case report

BACKGROUND

This case report documents the effectiveness of inositol treatment on a chronic patient with bipolar disorder I and severe psoriasis. Her lithium treatment was discontinued due to psoriasis exacerbation and inositol was administered. The remarked positive effect of inositol was noted on her stable mood during the last 4 years, the absence of psoriatic lesions, which lead to an improved quality of life of the patient.

CASE PRESENTATION

A 62-year-old female Caucasian patient suffering from bipolar disorder, since the age of 32, presenting manic episodes when without lithium treatment. Lithium treatment caused severe exacerbation of psoriasis and was discontinued while anti-psoriatic treatment had no effect. The last 4 years the patient receives 3 gr per day of inositol alone and her mood has been stabilized while there is also a remarkable improvement on her psoriatic lesions.

CONCLUSION

Taking into consideration the course of her bipolar disorder when lithium was discontinued previously we consider that the 4 years of follow up assessments of this patient as a satisfactory time period for concluding that inositol has been a very effective treatment, replacing lithium, for mood stabilization and psoriasis.

The effect of inositol supplements on the psoriasis of patients taking lithium: a randomized, placebo-controlled trial

BACKGROUND

Lithium carbonate is the most widely used long-term treatment for bipolar affective disorders, but its ability to trigger and exacerbate psoriasis can become a major problem in patients for whom lithium is the only treatment option. Inositol depletion underlies the action of lithium in bipolar affective disorders and there are good theoretical reasons why the use of inositol supplements might be expected to help this group of patients.

OBJECTIVES

To determine whether inositol supplements improve the psoriasis of patients on lithium therapy.

METHODS

Fifteen patients with psoriasis, who were taking lithium, took part in a randomized, double-blind, placebo-controlled, crossover clinical trial comparing the effect of inositol supplements with those of a placebo (lactose). Changes in the severity of their psoriasis were measured by Psoriasis Area and Severity Index scores recorded before and after the different courses of treatment. The effect of inositol supplements on the psoriasis of 11 patients who were not taking lithium was evaluated in the same way.

RESULTS

The inositol supplements had a significantly beneficial effect on the psoriasis of patients taking lithium. No such effect was detected on the psoriasis of patients not on lithium.

CONCLUSIONS

The use of inositol supplements is worth considering for patients with intractable psoriasis who need to continue to take lithium for bipolar affective disorders.

How does lithium work on manic depression? Clinical and psychological correlates of the inositol theory

How lithium works in manic-depressive illness is unknown. Recently, however, a powerful hypothesis has been gaining momentum. Distinguished by its testability and clinical implications, the inositol depletion hypothesis of lithium action is relevant to treatment of lithium side effects, to the development of new compounds with the clinical profile of lithium, and to new experimental treatment of depression.