Depression

ABSTRACT: Our knowledge of chronic diseases has advanced significantly in recent decades, but patient outcomes have not kept pace. This is largely because the traditional acute care model does not adequately address the needs of patients with chronic disease. Patients play an active role in the management of chronic disease, and successful outcomes are highly dependent on adherence to treatment. Thus, clinicians need to have skills in coaching and encouraging as well as an awareness of factors in patients' backgrounds that are likely to affect their ability or willingness to follow treatment plans. Provider- and system-related factors, such as lack of reimbursement for counseling and high copayments, can also act as barriers to compliance. Among the strategies that can improve adherence are the use of community resources, multidisciplinary approaches, and regular follow-up.

The optimal approach to subclinical hypothyroidism continues to be debated. Experts disagree over screening for thyroid dysfunction, the threshold TSH level for treatment, and the upper limit of normal of the TSH reference range.

An up-to-the-minute review of the array of oral and topical agents as well as those used intraurethrally or for intracavernosal injection.

Over the past few decades, the management of chronic disease has assumed a greater role in health care. Diseases such as diabetes, chronic obstructive pulmonary disease, and depression have replaced acute disorders as the leading cause of morbidity, mortality, and health care expenditures.

BOSTON -- For those who lived through Hurricane Katrina, mental disorders doubled but thoughts of suicide did not rise, with the experience bringing out newly found resiliency.

GRAND FORKS, N.D. -- Long-term effects of West Nile virus infection may emerge irrespective of the severity of initial acute symptoms, according to investigators here.

BOSTON -- For a few survivors of childhood cancer, the pain, depression, and other aspects of diagnosis and treatment can turn thoughts in adulthood to suicide, a study here suggested.

SEATLLE -- Low testosterone may be a signal that a man's body is running down-or maybe out.

CHAPEL HILL, N.C. -- Of U.S. adolescents in the general population, 3.5% have exchanged sex for money or drugs, and two-thirds of these youths were boys, researchers reported.

SAN FRANCISCO -- Postmenopausal women with chronically elevated blood sugar had a nearly fourfold risk of mild cognitive impairment over four years compared with women with blood sugar in the normal range.

NEW YORK -- Severely depressed adults do not seem susceptible to an additional suicide risk from antidepressants as do children and adolescents, a case-control study here suggested.

BETHESDA, Md. -- Symptoms of depression can be made to disappear in less than two hours with a common anesthetic, not the weeks or months required for onset of relief with traditional antidepressants, according to results of a pilot study.

LONDON -- For some patients with cardiovascular disease risk factors, the root cause may be the loneliness of childhood, according to a study that followed more than 1,000 adults from birth.

STOCKHOLM -- Breastfeeding in infancy, even briefly, may help children later bounce back from stressful events like parental divorce.

NEW ORLEANS -- Combat soldiers returning from Iraq don't get over it quickly. Their neuropsychological adaptations to warfare are not easily set aside, according to a VA study reported here.

ABSTRACT: The number of medical therapies for patients with erectile dysfunction (ED) has increased in recent years because of our expanded understanding of the physiologic and neurologic causes of ED. Oral agents range from testosterone to antidepressants to phosphodiesterase inhibitors. Nitroglycerin and minoxidil have shown some effectiveness as topical agents. Alprostadil, which can be applied intraurethrally, is also effective as intracavernosal injection therapy. Prostaglandin E1 and papaverine are effective as intracavernosal injection agents. Some studies have shown that combined use of intracavernosal injection and oral therapy produces satisfactory erections.

ABSTRACT: The number of medical therapies for patients with erectile dysfunction (ED) has increased in recent years because of our expanded understanding of the physiologic and neurologic causes of ED. Oral agents range from testosterone to antidepressants to phosphodiesterase inhibitors. Nitroglycerin and minoxidil have shown some effectiveness as topical agents. Alprostadil, which can be applied intraurethrally, is also effective as intracavernosal injection therapy. Prostaglandin E1 and papaverine are effective as intracavernosal injection agents. Some studies have shown that combined use of intracavernosal injection and oral therapy produces satisfactory erections.

Primary care clinicians are encouraged to use the latest evidence-based diagnostic and therapeutic strategies from prospective randomized, controlled trials in their practice. But are the participants in these trials typical patients?

A succinct review of hyperkalemia . . . its various causes, clinical manifestations and consequences, ECG findings, and treatment approaches.

KINGSTON, Jamaica -- For growth-retarded children, an excess of play, talk, and toys can help avoid psychosocial hurdles in adolescence, according to a 16-year follow-up study.

VIENNA -- Carotid stenting can significantly ease both the frequency and severity of so-called "vascular depression," according to investigators here.

SAN FRANCISCO -- Unopposed transdermal estradiol at an ultra-low dose over two years did not affect cognitive function or health-related quality of life in post-menopausal women, researchers here reported.

BALTIMORE -- Forty years after the psychedelic drug culture proclaimed that psilocybin induces a profound mystical and spiritual experience, investigators at Johns Hopkins have agreed.

GAINSEVILLE, Fla. -- Apathy independent of depression may be a feature of Parkinson's disease for some patients, researchers here have found.

ADANA, Turkey - Illicit anabolic steroids may pump up athletes' gums as well as their muscles, according to periodontists here.