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
Identification of atypical features is important in the treatment of depression for both treatment selection and prognosis, especially when initial measures prove ineffective. The concept of atypical depression has evolved over many years, and now it appears timely for a further revision. More »
It was not until the introduction of this MAOI that the term “atypical depression” began to emerge to describe a particular variant of nonendogenous depression. More »
Despite the high prevalence of depression among youths, there are empirically supported treatments that have been shown to reduce depressogenic symptoms, including the 3 therapies outlined in this article. More »
There are many rapidly effective treatments for mania in bipolar disorder. However, there are relatively few options for bipolar depression, and none that are rapidly effective—even though bipolar depression constitutes between 20% to 50% of all depressive disorders. More »
Comorbid depressive and anxiety disorders are commonly seen in both primary care and the specialty setting. Such comorbidity can present as major depression with subsyndromal anxiety symptoms or unipolar/bipolar depression with an anxiety disorder. More »
October 11th is National Depression Screening Day. But how do you screen, diagnose, and treat effectively given the time constraints of busy office practice? More »
Two recent publications provide clinically relevant information about the risk to benefit ratio of antidepressants for the treatment of MDD in youths, adults, and the elderly. More »
This article provides a practical overview of the available evidence-based treatment and discusses circumstances in which certain interventions may be preferred over others. More »
Of the 3 informative articles included in this special geriatric collection, 1 offers a perspective on the treatment of depression that does not focus on somatotherapy. The others remind us of 2 additional geriatric Ds of importance: drugs and driving. 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.
Five Steps to Improving Patient Access Judy Capko, May 21, 2013 Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.
Growing HIPAA Threat – Ignore Windows XP at Your Own Peril Marion K. Jenkins, May 21, 2013 Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003.
Three Areas to Reduce Costs at Your Medical Practice Greg Mertz, May 19, 2013 By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation.
Dos and Don’ts for Starting a Physician Blog Michael Woo-Ming, MD, May 18, 2013 Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
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.
