JAMA Examines Stress-Caused Disease

October 29, 2007

The biomedical community remains skeptical that stress can cause physical disease, says a commentary in the October 17, 2007 Journal of the American Medical Association. The author goes on to describe the neural pathways by which this may happen and the observational evidence that it does.

It’s time to develop good stress-relief strategies and test them in randomized trials, the article concludes.

Besides mentioning cancer and cardiovascular disease, the editorial notes growing evidence that stress affects the course of HIV disease.

A separate article in the same issue reviews the effects of chronic stress on the heart.

See all SearchMedica search results from JAMA.

Clinical Trials for Patients
A search in this category shows numerous clinical trials underway to treat stress in people who have diseases, and two that simply test stress-relief strategies (reiki and massage therapy).

Practice Guidelines
Find guidance for treating anxiety disorders in patients with HIV/AIDS.

No Comments » | Alternative Medicine, Family Medicine, Internal Medicine | Tagged: , , | Permalink
Posted by Cranky Aged Mama

MRSA Infections More Common than Expected

October 25, 2007

The first results of nationwide surveillance suggest that invasive forms of methicillin-resistant Staphylococcus aureus (which spread to blood and sterile sites such as cerebrospinal fluid) are far more prevalent than previously thought, even the CDC itself.

You’re on call: More than half of cases that were probably contracted in a healthcare setting first showed up somewhere in the world outside.

If the projections are accurate, according to an accompanying editorial in JAMA, the nationwide MRSA death rate would exceed that from HIV.

The editorial calls for practitioners in public health and private practice to “combine efforts to insure judicious antibiotic use”.

SearchMedica’s categories help find useful resources quickly:

Continuing Medical Education
Find an online CME course that will help you to recognize MRSA.

Patient Education Materials
Find information from trusted sources for patients who are concerned about the MRSA infection.

No Comments » | Family Medicine, Respiratory_Infectious | Tagged: , | Permalink
Posted by Cranky Aged Mama

Eating antioxidants won’t prevent AMD either

October 18, 2007

You already knew that antioxidant supplements don’t prevent age-related macular degeneration. A new meta-analysis shows that whether consumed as food or supplements, large amounts of antioxidant vitamins (A, C, E, and beta-carotene) and zinc do not prevent AMD. Posted last week by the British Medical Journal, the study reviewed data involving nearly 150,000 otherwise well-fed individuals in the US and other industrialized countries.

Searching the larger Internet (via SearchMedica) shows what a confusing picture is presented to patients interested in this subject.

Of course there are many other good reasons to eat vegetables. But to date the only known way to reduce the risk of AMD is by not smoking.

Clinically Useful Categories

Evidence Based Medicine and Meta-Analyses: Two recent meta-analyses by the renowned Cochrane Collaboration clarified the issue about antioxidant supplements: They may slow progression of existing AMD, but they do not prevent it.

Clinical Trials for Patients: Further revelations may yet emerge from the multicenter AREDS trial, which is still ongoing.

No Comments » | Alternative Medicine, Geriatrics | Tagged: , , | Permalink
Posted by Cranky Aged Mama

OT Gives Stroke Patients Real Hope

October 11, 2007

A new meta-analysis finds that stroke patients function better in daily activities after they have specific occupational therapy (training in dressing, self-feeding and the like). The researchers say that this should advance the discussion beyond merely whether occupational therapy helps outcomes in stroke, to what kind of OT is best for these patients.

Previous systematic reviews about occupational therapy, they say, have not focused specifically on stroke (although you’ll find a Cochrane review by the same authors on the topic of stroke also published this year).

Clinical Trials for Patients
A look at current clinical trials suggests that this topic is not yet high on the research agenda.

Patient Education Materials
Quickly find an article for patients about what to expect during stroke recovery.

No Comments » | Cardiovascular, Geriatrics | Tagged: , | Permalink
Posted by Cranky Aged Mama

Phone-based Treatment Helps Depressed Workers ANDEmployers

October 8, 2007

A randomized trial from the NIMH shows that not only clinical outcomes but productivity improve through use of telephone-based screening, followup, and even cognitive behavioral therapy. Could this be the boost companies and healthcare plans require to institute remote-contact care management for mental illness?

An accompanying editorial points out that the same strategies have proved successful in primary care treatment of depression.

Clinically Useful Categories

Practical Articles and News: Read about your colleagues’ experience giving therapy on the phone.

Patient Education Materials:You can use SearchMedica to help patients discover Internet-based support groups.

No Comments » | Depression | Tagged: | Permalink
Posted by Cranky Aged Mama

Interviewed Diabetes Patients Prefer Sequelae to Side Effects

October 4, 2007

Researchers from Pritzker School of Medicine asked type 2 diabetes patients about their preferences regarding their illness versus its treatments—with sobering results. For instance, respondents felt that intensive glucose control methods were no more tolerable than having diabetic neuropathy. More than one in ten patients would be willing to lose eight years of perfect health if that was the cost of avoiding diabetes treatment altogether.

This all has important implications if results of the ongoing ACCORD trial justify recommending even lower risk factor goals for type 2 diabetes.

However, an earlier study found that most type 2 diabetes patients who take multiple medications have adequate compliance with treatment.

The authors of the new study suggest that better education of physicians and patients is one way to address the troubling situation.

Clinically Useful Categories:

Practical Articles & News
Use a natural-language search (communicating about patient preferences in diabetes) and click on this category to find an article full of relevant and useful tips.

Patient Education Materials
Give your patients reliable information about what to expect with diabetes treatment.

No Comments » | Diabetes_Endocrine | Permalink
Posted by Cranky Aged Mama

SSRI Rxs for youth drop. Suicides rise. Coincidence?

October 1, 2007

Close on the heels of news from the CDC that youth suicides are up for the first time in 15 years come the results of a new study that explicitly links this increase with a decline in antidepressant prescriptions.

After the FDA and European authorities issued warnings that blamed SSRIs for suicidal thoughts, a multicenter team tracked SSRI prescriptions for adolescents and children with corresponding suicide rates in both the Netherlands and the U.S.

“If the intent of the pediatric black box warning was to save lives, the warning failed,” the authors contend. Suicide rates in both countries rose afterwards—and most obviously among children and adolescents, whose antidepressant use dropped sharply.

The FDA based its decision on a meta-analysis of studies involving non-fatal suicide attempts. Did this overlook a much higher rate of completions among kids not taking part in clinical trials?

A recent re-analysis of the same data found the suicide risk much lower for children taking SSRIs.

Clinically Useful Categories

Practice Guidelines
Authors of the new study suggest that better education of clinicians would be preferable to hasty black box warnings. Review current guidelines about treating depressed adolescents.

Clinical Trials for Patients
Find clinical trials that may offer the safest way to try antidepressants for adolescents in the current situation.

No Comments » | Depression, Pediatrics | Tagged: , , , | Permalink
Posted by Cranky Aged Mama