September 16th 2024
Your daily dose of the clinical news you may have missed.
Women With Breast Implants Have Elevated Suicide Rate
September 21st 2006OTTAWA, Ontario -- A large study of women with cosmetic breast implants found they had a suicide rate over two decades that was 73% higher than the general population -- but the rate was similar to that of women who had other cosmetic procedures.
Subclinical Hypothyroidism: REFERENCES: EvidencE-based medicine: Relevant guidelines:
September 1st 2006ABSTRACT: Subclinical hypothyroidism is associated with elevated low-density lipoprotein (LDL) cholesterol levels and several factors related to atherosclerosis, including increased C-reactive protein levels and impaired endothelium-dependent vasodilatation. However, considerable controversy exists about screening for and treating this thyroid disorder. Thyroxine therapy lowers elevated LDL cholesterol levels in patients whose serum thyroid-stimulating hormone (TSH) concentrations are higher than 10 mIU/L ; thus, most experts recommend treatment for such patients. However, there is no consensus regarding the management of patients with TSH levels of less than 10 mIU/L. Although the evidence supporting treatment of these patients is not compelling, it is reasonable to offer a therapeutic trial of thyroxine to those who have symptoms.
Barriers to Care in Chronic Disease: How to Bridge the Treatment Gap
September 1st 2006ABSTRACT: 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.
Barriers to Care in Chronic Disease: How to Bridge the Treatment Gap
September 1st 2006Over 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.
Ketamine May Give 'Almost Instantaneous' Relief for Severe Depression
August 7th 2006BETHESDA, 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.
Why We Need to Know the Limitations of Evidence-Based Medicine
August 1st 2006Primary 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?