Emphysematous pancreatitis is typically managed with broad-spectrum antibiotics and early surgical debridement. Here, a case that supports more recent evidence for conservative therapy.
Extensive condylomata acuminata are beyond the capacity of all topical therapies. The area was initially treated by carbon dioxide laser ablation, and residual small foci of infection were subsequently treated with topical 5% imiquimod cream.
ASH is the largest organization of hypertension researchers and health care providers in the United States committed to preventing and treating hypertension and its consequences. The editors of ConsultantLive bring you updates from the 2013 ASH conference in San Francisco, CA. Read More
Prominent, pigmented polyangular scales on the extensor surfaces of the arms, legs, and trunk suggested recessive X-linked ichthyosis. More in this article.Read More
More than 1300 physicians of all specialties responded to the 2012 survey. Many of the respondents are primary care physicians. See how your colleagues responded and learn what concerns them most.Read more
While it is true that the intense grief of bereavement and major depressive disorder often share some features—for example, tearfulness, insomnia, low mood, and decreased appetite—there are many substantive differences. More »
Young women who report having sleeping difficulties “often” in their early 20s have a 4- to 5-times increased risk of depression within 9 years, according to a new study. More »
Discussing the Neuropsychiatric Outcomes After Heart Surgery study, testing the vascular hypothesis of post-coronary artery bypass graft depression. More »
For patients with treatment-resistant depression—especially geriatric patients—ECT is a viable treatment option . . . one that should no longer be relegated to the option of last resort. More »
Diabetes mellitus and depression symptoms are associated with with decreased self-care and less adherence to exercise, medications, smoking cessation, and eating a healthy diet. More »
People who weren't getting out of bed are getting up and doing productive things. They are re-engaging with their families, and they are focusing on things they want to accomplish before they die. More »
Greater awareness of mental health issues such as these, along with screening for diseases and providing appropriate treatment, may improve symptom control. More »
Patients who are experiencing pseudoexacerbations or confirmed exacerbations of disease should be assessed and monitored for depressive and anxiety symptoms. More »
Commentary on: Straub H, Adams M, Kim JJ, et al. Antenatal depressive symptoms increase the likelihood of preterm birth. Am J Obstet Gynecol 2012;207:329.e1–4.
Implications for practice and research
Screening for prenatal depressive symptoms and pregnancy anxiety is recommended.
In predicting birth outcomes, essential controls include antidepressant use, medical risk conditions, body mass index and smokin
Commentary on: Ski CF, Page K, Thompson DR, et al. Clinical outcomes associated with screening and referral for depression in an acute cardiac ward. J Clin Nurs 2012;21:2228–34.
Implications for practice and research
This study found that nurses on cardiovascular care units were able to administer depression screening tools and document referral activities for positive screens.
Commentary on: BeckieTM, Beckstead JW, Schocken DD, et al.. The effects of a tailored cardiac rehabilitation program on depressive symptoms in women: a randomized clinical trial. <I>Int J Nurs Stud</I>2011;48:3–12.
Commentary on: RakelBABlodgettNPBridget ZimmermanM. Predictors of postoperative movement and resting pain following total knee replacement. Pain2012;153:2192–203.
Implications for practice and research
Younger patients with higher preoperative pain and depression are more likely to have hig
Commentary on: FengCY, Chu H, Chen CH. The dffect of cognitive behavioral group therapy for depression: a meta-analysis 2000–2010. <I>Worldviews Evid Based Nurs</I>2012;9:2–17.
Implications for practice and research
Cognitive behavioural therapy (CBT) is one of the most im
23219571 2013 02 04 2013 02 19 1474-547X 381 9864 Feb 2 Lancet 352-3 10.1016/S0140-6736( 12) 61844-3 S0140-6736( 12) 61844-3 Department of Psychology, Boston University, Boston, MA 02138, USA. mwotto@bu.edu Otto Michael W MW Wisniewski Stephen R SR
Only a third of patients with depression respond fully to antidepressant medication but little evidence exists regarding the best next-step treatment for those whose symptoms are treatment resistant. The CoBalT trial aimed to examine the effectiveness of cognitive behavioural therapy (CBT) as an adjunct to usual care (including pharmacotherapy) for primary care patients with treatment resistant depression compared with usual care alone.|This two parallel-group multicentre randomised controlled trial recruited 469 patients aged 18-75 years with treatment resistant depression (on antidepressants for 6 weeks, Beck depression inventory [BDI] score 14 and international classification of diseases [ICD]-10 criteria for depression) from 73 UK general practices. Participants were randomised, with a computer generated code (stratified by centre and minimised according to baseline BDI score, whether the general practice had a counsellor, previous treatment with antidepressants, and
This article reviews the necessary skills required for clinicians to make informed decisions about the use of medications in women who are breastfeeding. Even without specific data on certain medications, this review of kinetic principles, mechanisms of medication entry into breast milk, and important infant factors can aid in clinical decision making. In addition, common medical conditions and suitable treatments of depression, hypertension, infections and so forth for women who are breastfeeding are also reviewed.
Few studies have investigated the effects of care models that combine interdisciplinary care with nutrition consultation, depression management, and fall prevention in older persons with hip fracture. The purpose of this study was to compare the effects of a comprehensive care program with those of interdisciplinary care and usual care for elderly patients with hip fracture.|A randomized experimental trial was used to explore outcomes for 299 elderly patients with hip fracture receiving three treatment care models: interdisciplinary care (n = 101), comprehensive care (n = 99), and usual care (n = 99). Interdisciplinary care included geriatric consultation, continuous rehabilitation, and discharge planning with post-hospital services. Comprehensive care consisted of interdisciplinary care plus nutrition consultation, depression management, and fall prevention. Usual care included only in-hospital rehabilitation without geriatric consultation, in-home rehabilitation, and home
The purpose of this study was to observe the effect of hyperbaric oxygen (HBO2) therapy on patients with herpes zoster.|A total of 68 cases with herpes zoster were randomly divided into HBO2 and control groups. The patients in the control group were treated with drugs, while the patients in the HBO2 group were treated with both drugs and HBO2. Parameters of therapeutic efficacy including period of blister resolution, scar formation time and percentage of patients developing post-herpetic neuralgia (PHN) were determined for the patients in both groups. Numeric Pain Rating Scale (NPRS) and Hamilton Depression Rating Scale (HAMD) were also scored for the patients before and after treatment.|The therapeutic efficacy in the control group was 81.25%, which was significantly lower than that (97.22%) in the HBO2 group (p < 0.05). The percentage of patients developing PHN, scar formation time and NPRS score in the HBO2 groups were significantly lower than those in the control group (p < 0.05).
Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
Key Differences between FQHCs and RHCs Chastity Werner, RHIT, June 13, 2013 FQHCs and RHCs take up a unique niche among physician practices. And that affects compensation and billing.
Improving Care Coordination in Your Practice Susanne Madden, June 12, 2013 Practices are feverishly working to control the rising costs of healthcare - effective care coordination can help.
Refunding Overpayments: Two Options for Medical Practices Ericka L. Adler, June 12, 2013 Medicare and Medicaid providers must return overpayments once identified. Here are two different refund approaches for practices to consider when necessary.
iPad Alternatives for Mobile Physicians Marisa Torrieri, June 11, 2013 As more physicians are seeing the merits of media tablets, the market is expanding, too.
Emphysematous pancreatitis is typically managed with broad-spectrum antibiotics and early surgical debridement. Here, a case that supports more recent evidence for conservative therapy. 
This compact slide show provides a range of visual presentations of ecchymosis.
