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New Moms at Risk for Depressive Disorders (CME/CE)
www.medpagetoday.com - 3/18/13
CBT Rehab Tackles Chronic Pain, Drug Abuse At Same Time
www.medpagetoday.com - 2/24/12
Medical News: AAPM: Help for Pain and Mood in Fibromyalgia
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Medical News: Childhood Abuse Linked to Migraine
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Medical News: APA: Schizophrenia Patients Go Untreated For Comorbidities
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PATIENT RESOURCES
The AHRQ Multiple Chronic Conditions Research Network: Project Summary
www.ahrq.gov - 10/25/12
Characteristics Associated with Poor Glycemic Control Among Adults with Self-Reported Diagnosed Diabetes National Health and Nutrition Examination Survey, United States, 20072010
www.cdc.gov - 6/14/12
Venous Thromboembolism in Adult Hospitalizations United States, 20072009
www.cdc.gov - 6/7/12
 
CLINICAL TRIALS
Improving Medication Adherence in Comorbid Conditions
www.clinicaltrials.gov -
Effects of Comorbid Personality Disorder on the Treatment of Bipolar I Disorder
www.clinicaltrials.gov -
Metacognitive Therapy for Comorbid Insomnia
www.clinicaltrials.gov -


 
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Comorbidity

 
 
LATEST FEATURES
Showing 1 - 10 of 67 results.
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MEDLINE
Rhythm and blues: animal models of epilepsy and depression comorbidity.
pubmed.gov - 1/14/13
Clinical evidence shows a strong, bidirectional comorbidity between depression and epilepsy that is associated with decreased quality of life and responsivity to pharmacotherapies. At present, the neurobiological underpinnings of this comorbidity remain hazy. To complicate matters, anticonvulsant drugs can cause mood disturbances, while antidepressant drugs can lower seizure threshold, making it difficult to treat patients suffering from both depression and epilepsy. Animal models have been created to untangle the mechanisms behind the relationship between these disorders and to serve as screening tools for new therapies targeted to treat both simultaneously. These animal models are based on chemical interventions (e.g. pentylenetetrazol, kainic acid, pilocarpine), electrical stimulations (e.g. kindling, electroshock), and genetic/selective breeding paradigms (e.g. genetically epilepsy-prone rats (GEPRs), genetic absence epilepsy rat from Strasbourg (GAERS), WAG/Rij rats, swim
Chronic alcohol consumption, abstinence and relapse: brain proton magnetic resonance spectroscopy studies in animals and humans.
pubmed.gov - 1/1/13
This chapter summarizes the peer-reviewed literature of proton magnetic resonance spectroscopy ((1)H MRS) studies on the effects of chronic and excessive alcohol consumption in both the animal and human brain. After a brief summary of the neuropathology of alcohol use disorders (AUD), we describe the primary brain metabolites measured by in vivo (1)H MRS. We then focus on published MRS studies of animal models of alcohol dependence and of treatment-seeking humans with AUD. We also summarize the scant MRS research on the much larger fraction of treatment-nave individuals with AUD and the similarities and discrepancies relative to treatment-seekers. It is exceedingly apparent that premorbid and/or comorbid disorders/conditions, especially chronic smoking, among individuals with AUD contribute to the considerable variability in the pattern and magnitude of neurobiological and neurocognitive abnormalities in AUD. Therefore, we also review studies on the neurobiological consequences of
Evaluation of high-risk, comorbid patients undergoing open ventral hernia repair with synthetic mesh.
pubmed.gov - 12/31/12
The Ventral Hernia Working Group proposed recently a classification system to grade the risk of surgical site occurrence (SSO) during ventral hernia repair (VHR). Accurately predicting the outcomes of synthetic mesh in open VHR for comorbid patients might guide surgeons in appropriate mesh selection in this patient population. Our objective was to determine the incidence of SSO in open, grade II VHR and to examine the use of synthetic mesh in these comorbid patients.|All open, grade II VHR performed by a single surgeon over a 4-year period were reviewed retrospectively.|Eighty-eight patients (43 female; mean age, 57 years) with grade II ventral hernias underwent open VHR with synthetic mesh. Associated comorbidities included obesity in 55 (63%), diabetes mellitus in 43 (49%), chronic obstructive pulmonary disease in 27 (31%), smoking in 21 (24%), and immunosuppression in 18 (21%). The mean number of comorbidities per patient was 1.9 (range, 1-4). SSO occurred in 14 (16%) patients and
Current status of co-occurring mood and substance use disorders: a new therapeutic target.
pubmed.gov - 12/31/12
Mood and substance use disorders commonly co-occur, yet there is little evidence-based research to guide the pharmacologic management of these comorbid disorders. The authors review the existing empirical findings, some of which may call into question current clinical pharmacotherapy practices for treating co-occurring mood and substance use disorders. The authors also highlight knowledge gaps that can serve as a basis for future research. The specific mood disorders reviewed are bipolar and major depressive disorders (either one co-occurring with a substance use disorder). Overall, findings from the relatively small amount of available data indicate that pharmacotherapy for managing mood symptoms can be effective in patients with substance dependence, although results have not been consistent across all studies. Also, in most studies, medications for managing mood symptoms did not appear to have an impact on the substance use disorder. In a recent trial for comorbid major depression
Postoperative adjuvant chemotherapy use in patients with stage II/III rectal cancer treated with neoadjuvant therapy: a national comprehensive cancer network analysis.
pubmed.gov - 12/31/12
Practice guidelines recommend that patients who receive neoadjuvant chemotherapy and radiation for locally advanced rectal cancer complete postoperative adjuvant systemic chemotherapy, irrespective of tumor downstaging.|The National Comprehensive Cancer Network (NCCN) Colorectal Cancer Database tracks longitudinal care for patients treated at eight specialty cancer centers across the United States and was used to evaluate how frequently patients with rectal cancer who were treated with neoadjuvant chemotherapy also received postoperative systemic chemotherapy. Patient and tumor characteristics were examined in a multivariable logistic regression model.|Between September 2005 and December 2010, 2,073 patients with stage II/III rectal cancer were enrolled in the database. Of these, 1,193 patients receiving neoadjuvant chemoradiotherapy were in the analysis, including 203 patients not receiving any adjuvant chemotherapy. For those seen by a medical oncologist, the most frequent reason
 
JOURNAL SCAN
Review of experimental and quasi-experimental studies finds that mindfulness-based interventions are more effective than standard care for reducing depressive symptoms in adults with mental disorders
ebn.bmj.com - 12/3/12

Commentary on: Klainin-Yobas P, Cho MA, Creedy D. Efficacy of mindfulness-based interventions on depressive symptoms among people with mental disorders: a meta-analysis. <I>Int J Nurs Stud</I> 2012;49:109–21.

Implications for practice and research

  • The findings highlight the use of

    • Radiotherapy versus surgery within multimodality protocols for esophageal cancer--a meta-analysis of the randomized trials.
    pubmed.gov - 10/1/12
    During recent years, the curative potential of radiotherapy versus surgery for esophageal cancer was investigated in randomized trials. A PubMED, Medline, and Web of Science search identified six randomized studies comparing definitive (chemo-) radiotherapy with either surgery alone or surgery+/-induction treatment for patients (n=929) with potentially resectable, mainly thoracic squamous cell (810/929 pts.) esophageal cancer. In three of the studies (440 pts.), resection alone was planned in the surgery arm, in three others induction chemoradiotherapy up to a total dose of 30-46 Gy followed by resection was scheduled (489 pts.). In the definitive radiation arms (+/-chemotherapy, conservative arm) total radiation doses of 45-71 Gy with differing fractionation schedules were planned. Summary hazard ratios for survival, loco-regional control and treatment related mortality were calculated from intent-to-treat data. Overall survival was equivalent between surgery and definitive
    Prevention of falls in community-dwelling older adults: U.S. Preventive Services Task Force recommendation statement.
    pubmed.gov - 8/6/12
    Update of the 1996 U.S. Preventive Services Task Force (USPSTF) recommendation statement on counseling to prevent household and recreational injuries, including falls.|The USPSTF reviewed new evidence on the effectiveness and harms of primary care-relevant interventions to prevent falls in community-dwelling older adults. The interventions were grouped into 5 main categories: multifactorial clinical assessment (with or without direct intervention), clinical management (with or without screening), clinical education or behavioral counseling, home hazard modification, and exercise or physical therapy.|The USPSTF recommends exercise or physical therapy and vitamin D supplementation to prevent falls in community-dwelling adults aged 65 years or older who are at increased risk for falls. (Grade B recommendation)The USPSTF does not recommend automatically performing an in-depth multifactorial risk assessment in conjunction with comprehensive management of identified risks to prevent falls
    My treatment approach to rheumatoid arthritis.
    pubmed.gov - 7/1/12
    The past decade has brought important advances in the understanding of rheumatoid arthritis and its management and treatment. New classification criteria for rheumatoid arthritis, better definitions of treatment outcome and remission, and the introduction of biologic response-modifying drugs designed to inhibit the inflammatory process have greatly altered the approach to managing this disease. More aggressive management of rheumatoid arthritis early after diagnosis and throughout the course of the disease has resulted in improvement in patient functioning and quality of life, reduction in comorbid conditions, and enhanced survival.
    Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: a systematic review and meta-analysis.
    pubmed.gov - 6/1/12
    Exposure to traumatic stress is associated with increased risk for posttraumatic stress disorder (PTSD) and alterations of hypothalamic-pituitary-adrenocortical (HPA) function. Research linking traumatic stress with HPA function in PTSD has been inconsistent, however, in part due to (a) the inclusion of trauma-exposed individuals without PTSD (TE) in control groups and (b) a failure to consider comorbid major depressive disorder (MDD) and moderating variables. This meta-analysis of 47 studies (123 effect sizes, N=6008 individuals) revealed that daily cortisol output was lower for PTSD (d=-.36, SE=.15, p=.008) and PTSD+MDD (d=-.65, SE=.25, p=.008) groups relative to no trauma controls (NTC); TE and NTC groups did not differ significantly from each other. Afternoon/evening cortisol was lower in TE (d=-.25, SE=.09, p=.007) and PTSD (d=-.27, SE=.12, p=.021) groups and higher in PTSD+MDD groups (d=.49, SE=.24, p=.041) relative to NTC. Post-DST cortisol levels were lower in PTSD (d=-.40, SE=
     
    PRACTICE GUIDELINES
    Guide to Clinical Preventive Services, 2010-2011: Section 2 (continued)
    www.ahrq.gov - 8/31/10
    Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
    Guide to Clinical Preventive Services, 2010-2011: Section 2
    www.ahrq.gov - 8/31/10
    Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
    Guide to Clinical Preventive Services, 2010-2011: Section 3. Recommendations for Children and Adolescents
    www.ahrq.gov - 8/31/10
    Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
    Figure 3. Adjusted change in utilization for the pharmaceutical care and usual care groups: intention-to-treat analysis. Data adjusted for gender, age, chronic condition group (heart vs. lung), comorbid conditions, and the outcome variable at baseline.
    www.acponline.org -
    Internal Medicine - Doctors for Adults
    Figure 2. Annual mortality risk for men according to age and presence of at least one comorbid condition from the Charlson Index
    www.acponline.org -
    Internal Medicine - Doctors for Adults



     
    CAREER CENTER

     
    FROM PHYSICIANS PRACTICE
    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.
    Finding Physician Work-Life Balance in the Small Moments
    Jennifer Frank, MD,  May 21, 2013
    At my practice and at home, things are always busy. There's laundry or homework, or a patient with needs.
    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.
     

     
     
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