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Attention Deficit Disorder
Back Pain
Being Pro-Active in Your Personal Health Care
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Alternative & Herbal Medicine


Alternative Medicine headings at MedlinePlus:

  • Children
  • Clinical Trials
  • Dictionaries/Glossaries
  • Directories
  • Financial Issues
  • From the NIH
  • News
  • Organizations
  • Overviews
  • Related Issues
  • Research
  • Seniors
  • Specific Conditions
  • Statistics
  • Teenagers

  • Herbal Medicine headings at MedlinePlus:

  • Clinical Trials
  • From the NIH
  • Organizations
  • Overviews
  • Pictures/Diagrams
  • Related Issues
  • Research
  • Specific Conditions
  • Women

  • An Introduction to Naturopathy - Naturopathy, also called naturopathic medicine, is a whole medical system--one of the systems of healing and beliefs that have evolved over time in different cultures and parts of the world. Naturopathy is rooted in health care approaches that were popular in Europe, especially in Germany, in the 19th century, but it also includes therapies (both ancient and modern) from other traditions. In naturopathy, the emphasis is on supporting health rather than combating disease.*


    Complementary and Alternative Medicine (CAM) - NIH Senior Health - What is CAM? - Today, many people use complementary and alternative medicine, or CAM, for a wide variety of diseases or conditions, and use of CAM has increased in recent years. But what exactly is CAM, and how is it different from standard medical care?

    Definition of CAM - Complementary medicine is used together with standard medical care. An example is using acupuncture to help with side effects of cancer treatment.

    Alternative medicine is used in place of standard medical care. An example is treating heart disease with chelation (pronounced "kee-lay-shen") therapy (which seeks to remove excess metals from the blood) instead of using a standard approach.
    *


    CAM Use and Children - Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicineMedicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals such as physical therapists, psychologists, and registered nurses.. As with adults, a wide range of CAM therapies are used in children, including herbs and dietary supplements, massagePressing, rubbing, and moving muscles and other soft tissues of the body, primarily by using the hands and fingers. The aim is to increase the flow of blood and oxygen to the massaged area., acupunctureA family of procedures that originated in traditional Chinese medicine. Acupuncture is the stimulation of specific points on the body by a variety of techniques, including the insertion of thin metal needles though the skin. It is intended to remove blockages in the flow of qi and restore and maintain health., chiropractic care, naturopathyA whole medical system that originated in Europe. Naturopathy aims to support the body's ability to heal itself through the use of dietary and lifestyle changes together with CAM therapies such as herbs, massage, and joint manipulation., and homeopathyA whole medical system that originated in Europe. Homeopathy seeks to stimulate the body's ability to heal itself by giving very small doses of highly diluted substances that in larger doses would produce illness or symptoms (an approach called "like cures like").. This fact sheet includes issues to consider and resources for more information when making decisions about CAM use and children.*


    An Introduction to Reiki - Reiki (pronounced "ray-kee") is an energy medicine practice that originated in Japan. In Reiki, the practitioner places his hands on or near the person receiving treatment, with the intent to transmit ki, believed to be a life-force energy. Practitioners also believe that they can treat themselves with Reiki and send ki across short or long distances. In the United States, Reiki is part of complementary and alternative medicine (CAM). This Backgrounder provides a general overview of Reiki and suggests some resources you can use to learn more about this practice.*


    Meditation for Health Purposes - Meditation for health purposes is a mind-body practice in complementary and alternative medicine (CAM). There are many types of meditation, most of which originated in ancient religious and spiritual traditions. Generally, a person who is meditating uses certain techniques, such as focusing attention (for example, on a word, an object, or the breath); a specific posture; and an open attitude toward distracting thoughts and emotions. Meditation can be practiced for various reasons--for example, with an intent to increase physical relaxation, mental calmness, and psychological balance; to cope with one or more diseases and conditions; and for overall wellness. This Backgrounder provides a general introduction to meditation and suggests some resources for finding out more.

    Complementary and alternative medicine is medicine used outside of conventional medicine as practiced in the United States--that is, by holders of Doctor of Medicine (M.D.) and Doctor of Osteopathy (D.O.) degrees and their allied health professionals. Complementary medicine is used along with conventional medicine, and alternative medicine is used instead of conventional medicine. Some conventional medicine practitioners are also practitioners of CAM.
    *


    Massage Therapy as Complementary and Alternative Medicine (CAM) - Massage therapy is a practice that dates back thousands of years. There are many types of massage therapy; all involve manipulating the muscles and other soft tissues of the body. In the United States, massage therapy is sometimes part of conventional medicine. In other instances, it is part of complementary and alternative medicine (CAM). This Backgrounder provides a general overview of massage therapy used as CAM and suggests some resources you can use to learn more.*


    National Center for Complementary and Alternative Medicine (NCCAM) - The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Government's lead agency for scientific research on complementary and alternative medicine (CAM). We are 1 of the 27 institutes and centers that make up the National Institutes of Health (NIH) within the U.S. Department of Health and Human Services.*


    Naturopathic Medicine - Founded upon a holistic philosophy, naturopathic medicine combines safe and effective traditional therapies with the most current advances in modern medicine. Naturopathic medicine is appropriate for the management of a broad range of health conditions affecting all people of all ages.

    Naturopathic physicians (N.D.s) are the highest trained practitioners in the broadest scope of naturopathic medical modalities. In addition to the basic medical sciences and conventional diagnostics, naturopathic education includes therapeutic nutrition, botanical medicine, homeopathy, natural childbirth, classical Chinese medicine, hydrotherapy, naturopathic manipulative therapy, pharmacology and minor surgery.
    * Also check out their Find a Naturopathic Doctor & Find Naturopathic Resources pages!!


    Paying for Complementary and Alternative Medicine (CAM) Treatment - If you are using (or thinking about using) complementary and alternative medicine (CAM), you may have financial questions about paying for treatment. This fact sheet answers some frequently asked questions on this topic.*


    Thinking About CAM Therapies for Young People - Can complementary and alternative medicine (CAM) be helpful to children? Are CAM therapies safe? This article presents some general points to consider in addressing these questions.

    How many children are using CAM? There has not yet been a large, nationally representative survey on this topic that covers the full range of CAM therapies. There have been more limited surveys. They support the fact that many young people are using CAM, with some groups having a particularly high rate of use--such as young people who have diseases and conditions that could be described as any or all of the following:

  • Chronic (over 50 percent of children with chronic conditions, by one estimate)
  • Serious
  • Painful or uncomfortable
  • Having an unpredictable course
  • Disabling
  • Not having an established cure.


  • Examples of diseases and conditions in which CAM is used include cancer, asthma, juvenile arthritis, cystic fibrosis, mental health problems, ADHD (attention deficit hyperactivity disorder), diabetes, chronic pain syndromes, upper respiratory illnesses, skin conditions, and headaches. CAM is also used for other health purposes, such as preventing illnesses like colds and ear infections, coping with symptoms like pain and fear, "enhancing" the immune system, weight loss, and general health promotion.
    *


    Using Music in Therapy - The Power of Music as a Coping Skill - Using music in therapy can be a very powerful way to reach children, adolescents, and adults in the therapeutic setting. Music in therapy can be a powerful way to help people express their feelings. Creative therapy can reach people in ways that traditional therapy sometimes cannot.

    Matthew J. Bush, MSW, LSW, licensed therapist, has developed some very exciting and innovative techniques for use in therapy with children and adolescents. Please note, Mr. Bush is not a licensed music therapist, but draws on his own clinical experiences and knowledge. He advocates for the use of creativity in therapy. This includes the use of music, art, games, dance, and anything else creative you can imagine. On this site you will find articles about how popular music can be used in therapy, suggestions of popular music with therapeutic messages, creative techniques for use in the therapeutic setting, and information about Matt's recent publication, Utilizing Music as a Coping Skill: Featuring the Music of Freudian Slip which was recently featured in an issue of Counseling Today!

    Also featured on this site is Freudian Slip, Matt's therapeutic rock band which features original music which takes a direct look at human emotion. The songs focus on topics such as depression, abuse, addiction, and so forth. These songs have been composed by Matt throughout his years as a therapist and represent struggles in his own life as well as those of his clients. Includes songs written by children in therapy! Matthew J. Bush, MSW, LSW is an experienced clinical and state licensed therapist who has successfully applied his techniques to countless children and adolescents in his work. He has worked and performed for children in public and private schools, residential treatment facilities, and the community. Matt has also spoken at statewide conferences, educating colleagues on the power of music as a coping skill.
    *


    WholeHealthMD.com - WholeHealthMD.com is dedicated to providing the best in complementary and alternative medicine. All of our information is developed by a team of leading board- certified doctors and specialists.

    Our integrative medicine experts will guide you through a range of safe and effective options that will positively impact your health.
    *




    Attention Deficit Disorder


    Attention Deficit Disorder with Hyperactivity headings at MedlinePlus:

  • Adults
  • Alternative Therapy
  • Children
  • Clinical Trials
  • Coping
  • Diagnosis/Symptoms
  • Directories
  • From the NIH
  • Newsletters/Print Publications
  • Organizations
  • Overviews
  • Related Issues
  • Research
  • Teenagers
  • Treatment
  • Women

  • ADHD Medication Misuse by Those Aged 12 to 17 Results in Higher Number of Visits to Emergency Department

    People ages 18 to 25 have a higher rate of nonmedical use of the two medications used to treat attention-deficit/hyperactivity disorder (ADHD), but those 12 to 17 may be at greater risk for adverse health effects, particularly from nonmedical use, a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA) shows.

    The latest Drug Abuse Warning Network (DAWN) Report, Emergency Department Visits Involving ADHD Stimulant Medications, explains that during 2004 almost 8,000 visits to the emergency department involved methylphenidate (marketed as Ritalin or Concerta) or amphetamine-dextroamphetamine (marketed as Adderal), two medications used to treat ADHD.   The rates of emergency department visits resulting from use of either of these two drugs by patients aged 12 to 17 were higher in 2004 than the rates for patients aged 18 or older.  In addition, the data suggest that polydrug use-one or more drugs being used in addition to ADHD medication—was common in the emergency department visits involving the misuse of ADHD medication and may increase the possible health risks.

    “These findings suggest an alarming level of nonmedical use that could have life-threatening consequences, such as heart attack or stroke.  Parents need to help break this dangerous pattern of behavior by carefully monitoring their child’s use of ADHD medication,” said Assistant Surgeon General Eric Broderick, D.D.S., M.P.H., SAMHSA Acting Deputy Administrator.
    *


    Adult ADD Strengths - Blogging News and Views on Adult Attention Surplus Condition.* - Check out Pete Quily's article titled Top 10 Advantages of ADD in a High Tech Career - I believe there are many people who work in the high tech industry who have ADD, much more than the average of the population. Approximately five per cent of the population has ADD and 85 per cent of adults with ADD don’t know they have it. It seems to me ADD and the technology industry is a natural fit. The constant change of the high tech world can be stressful and troubling for some people but it’s often stimulating and energizing for the ADDer. A great source of Dopamine hits. Although, there are no specific statistics a number of other ADD experts I’ve talked to agree with my observation.* Read the Whole Article... I am amazed by this article as he sounds like he's talking directly about/to me! This is a Must Read if you have ADD!!


    Brain Matters Imaging Centers utilizes the latest in high-resolution brain SPECT (Single Photon Emission Computed Tomography) imaging to evaluate brain activity by tracing blood flow in the brain. Tracing blood flow allows us to observe the brain's actual metabolic process and its activities.

    By using a brain SPECT scan to examine those areas of the brain that have too much or too little blood flow, we can determine which areas of the brain are and are not functioning properly. Contrast this to MRI and CT scans that typically show only structural brain abnormalities such as tumors and lesions, and you can see why this is such an exciting new advance in the field of brain imaging.
    *




    Back Pain


    Back Exercises - Flash Tutorial With Questions, Self-Playing Flash Tutorial Without Questions, and Text Summary in a PDF File.


    Back Pain headings at MedlinePLUS:

  • Alternative Therapy
  • Anatomy/Physiology
  • Children
  • Clinical Trials
  • Diagnosis/Symptoms
  • Directories
  • From the NIH
  • Health Check Tools
  • Organizations
  • Overviews
  • Prevention/Screening
  • Rehabilitation/Recovery
  • Related Issues
  • Research
  • Specific Conditions
  • Teenagers
  • Treatment
  • Women

  • Back pain: Will chiropractic treatment help? - A Mayo Clinic Staff Article - How well does chiropractic care stack up against more conventional treatments for low back pain? Here's what the researchers have to say.

    For many people, low back pain follows a fairly predictable course. Nagging back pain lasts a few weeks — maybe letting up temporarily when you take a pain reliever — and then it goes away.

    So where does chiropractic care fit into the picture? That's up to you.
    * Read More...


    New Therapeutic Hope for Degenerative Disc Disease - Study Suggests Possible Role of Embryonic Cells from the Notochord of Dogs to Regenerate Disc Cartilage

    Degenerative disc disease is one of today's most common and costly medical conditions. Marked by the gradual erosion of cartilage between the vertebrae, this destructive disease of the spine routinely provokes low back pain, the leading cause of disability in people under age 45 in the United States. This condition is also confounding: the factors that account for the vulnerability of the disc to degeneration and the limited capacity of the disc for repair remain largely unknown.

    For some domestic mammals, including sheep, goats, and dogs, the occurrence of degenerative disc disease is extremely rare. Intrigued by this fact and how it might apply to humans, researchers in Toronto, Canada, decided to conduct a gene expression study on intervertebral discs from canines. Their results, presented in the December 2006 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), shed light on the regenerative potential of early embryonic cells within the disc nucleus.
    *


    Study Shows Surgery Is More Effective Than Other Treatments for Common Back Problem - When it comes to low back pain, physicians generally advise exhausting nonsurgical options before resorting to surgery. But a new study shows that for degenerative spondylolisthesis with spinal stenosis, surgery provides significantly better results than nonsurgical alternatives. The study, published in the May 31 issue of the New England Journal of Medicine, is the second in a series reporting findings of the Spine Patients Outcomes Research Trial (SPORT), a five-year, multicenter study supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the National Institutes of Health.

    Degenerative spondylolisthesis is a condition in which breakdown of the cartilage between the vertebrae of the spine causes one vertebra to slip over the one below. This can result in narrowing of the spinal column (spinal stenosis), which can put pressure on the nerves, resulting in pain in the buttocks or legs with walking or standing. The condition generally occurs after age 50 and it affects six times as many women as men.

    The management of degenerative spondylolisthesis with spinal stenosis is controversial, says James N. Weinstein, D.O., M.Sc., lead author and chairman of the Departments of Orthopaedics at Dartmouth-Hitchcock Medical Center and Dartmouth Medical School. Surgery is widely used, but its effectiveness in comparison with nonsurgical treatment had not been demonstrated in controlled clinical trials. The purpose of this arm of the SPORT trial was to make that comparison.
    *




    Being Pro-Active in Your Personal Health Care


    How to Get a Second Opinion - Even though their training can be similar, doctors have their own opinions, experiences, and thoughts on how to practice, including diagnosing and treating conditions or diseases. Some doctors opt to take a more conservative, or traditional, approach, while other doctors are more aggressive and tend to use the newest tests and therapies. Because health care (including mental health) is a highly specialized and constantly changing field, it can be difficult for every doctor to be skilled in the latest technology. Getting a second opinion from a different doctor might give you a fresh perspective and more information on how to treat your condition. You can weigh your options and make a more informed choice about what to do. If you are given similar opinions from two doctors, you also can talk with a third doctor. Here are some tips for how to get a second opinion.*


    How to Talk to Your Health Care Provider - Waiting in your doctor’s office can be a nerve-wracking experience. As you flip through old magazines in the waiting room, you might worry about what’s wrong or become aggravated about getting behind schedule. Then, when you see your doctor, the visit seems to fly by, leaving only a few minutes for you to explain your symptoms and concerns. Later that night, you remember something you forgot to mention and wonder if it matters. Knowing how to talk to your doctor or other members of your health care team will help you get the information you need, when you need it, especially when visits are oftentimes short. Here are some tips for talking with your doctor.*


    Questions Are the Answer: Get More Involved with Your Health Care - Clinicians, the Government, and many other groups are working hard to improve health care quality, but improving health care quality is a team effort. You can improve your care and the care of your loved ones by taking an active role in your health care. Ask questions. Understand your condition. Evaluate your options.

    Medical errors cause tens of thousands of deaths each year. But you can help. Get more involved with your health care.
    *


    Symptoms of Serious Health Conditions - This chart shows some symptoms that could be signs of serious health conditions, which should be checked by a doctor or nurse. It is important to note that you might feel symptoms in one part of your body that could actually mean a problem in another part. Even if the symptoms don’t seem related, they could be. Keep track of your symptoms. If you have any of these symptoms, make an appointment to see your doctor. Listen to what your body is telling you, and be sure to describe every symptom in detail to your doctor.*


    Talking with Your Doctor - How well you and your doctor talk to each other is one of the most important parts of getting good health care. Unfortunately, talking with your doctor isn't always easy. In the past, the doctor typically took the lead and the patient followed. Today, a good patient-doctor relationship is a partnership. You and your doctor can work as a team.

    Table of Contents:
    Planning Your Doctor Visit
    Your Visit to the Doctor
    Asking Questions
    Conversations After Diagnosis
    Frequently Asked Questions
    MedlinePlus - more information on Talking with Your Doctor
    *




    Chronic Pain


    Pain Relievers headings at MedlinePlus:

  • Children
  • News
  • Organizations
  • Overviews
  • Related Issues
  • Research
  • Seniors
  • Specific Conditions
  • Women

  • Search Results at MedlinePlus for Chronic Pain.


    Chronic Pain: How to Get Relief - There are 2 types of pain: acute and chronic. Acute pain doesn't last long and usually goes away as your body heals. Chronic pain lasts at least 6 months after your body has healed. Sometimes, when people have chronic pain they don't know what is causing it. Along with discomfort, chronic pain can cause low self-esteem, depression and anger, and it can interfere with your daily activities.*


    Comparison of Yoga, Exercise, and Education for the Treatment of Chronic Low Back Pain


    Expectations of Pain: I Think, Therefore I Am - an article by the National Institute of Neurological Disorders and Stroke - While the theory that “mind over matter” exists is an ancient belief, the scientific studies to support this idea have remained elusive. A new study provides brain imaging evidence that positive thinking interacts with and shapes the sensory experience of pain. This study suggests that decreasing the expectation of pain can reduce both the pain-related brain activity and perception of pain intensity. This knowledge may lead to new and effective ways to manage chronic pain.*


    NIDA Begins Its First-Ever Public Discussion on Pain Relief and Addiction - “Who is most at risk for addiction to pain killers?” and “How do you balance getting adequate pain relief with the risk of addiction?” were only two of the many questions discussed at today’s Pain, Opioids, and Addiction: An Urgent Problem for Doctors and Patients conference, sponsored by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH). More than 500 researchers, clinicians and interested consumers gathered on the NIH campus to discuss the growing problem of prescription painkiller abuse and the potential for addiction in patients with chronic pain conditions. The conference is being held in collaboration with the NIH Pain Consortium and the American Medical Association.

    “This meeting brings together experts on both the research and clinical sides to discuss issues surrounding both the benefits and risks of prescription pain relievers, and to look at best practices that minimize the risk of addiction,” said NIH Director Dr. Elias A. Zerhouni. “It is part of our ongoing commitment to use the best science available to inform medical practice.”

    “We are meeting to discuss how scientific research can contribute to safer solutions for patients in need of pain relief,” said NIDA Director Dr. Nora D. Volkow, who gave welcoming remarks at the conference. “With high rates of non-medical abuse of opioid pain relievers, particularly among young people, we view this as an urgent priority.”
    *




    Clinical Trials & Research Programs


    Clinical Trials headings at MedlinePLUS:

  • Children
  • Dictionaries/Glossaries
  • Directories
  • Financial Issues
  • From the NIH
  • Law and Policy
  • News
  • Organizations
  • Overviews
  • Related Issues
  • Research
  • Specific Conditions

  • Clinical Trials: A Chance to Try Evolving Therapies - Clinical trials offer a chance to participate in the development of potentially effective therapies. But how safe are the trials? Are they a good idea? - You may have heard about clinical trials — studies of possible new treatments or medications — but wonder what exactly they are and if one might be right for you. Whether or not to participate in a clinical trial can be a complex decision. In order to make that decision, it may help you to know more about what exactly clinical trials are and how new treatments are studied and approved for wider use.*


    NIH Clinical Alerts and Advisories - NLM began offering clinical alert notices online in January 1991. Clinical alerts are provided to expedite the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality.*


    NIH Clinical Center - The Clinical Center is home to the National Institutes of Health intramural clinical research program. Located on the NIH Bethesda, Maryland campus, the Clinical Center complex is where clinical biomedical research occurs. Participating in NIH Research, a new online newsletter for current and prospective volunteers in clinical trials. Search the Collection of Research Studies being conducted at the NIH Clinical Center.*


    Participating in Clinical Trials

  • What is a Clinical Trial?

  • Finding a Clinical Trial

  • Informed Consent

  • Should I Join a Clinical Trial?

  • Frequently Asked Questions

  • MedlinePlus - more information on Participating in Clinical Trials
  • *


    Should Your Child Be in a Clinical Trial? - Up until the last decade, children were rarely included in studies of medical treatments. As a result, much is still unknown about how children respond to drugs, some biologics (such as gene therapy), and medical devices.

    "We had the peculiar situation of demanding a very high level of proof before a product was marketed for adults, but then having it used 'off-label' in children," says Dianne Murphy, M.D., Director of the Office of Pediatric Therapeutics at the Food and Drug Administration. This means that FDA did not have studies on how the product did or did not work in children, what different kinds of reactions children might have, or what the proper dose would be over the wide range of children's ages, weights, and developmental stages, Murphy says.

    But FDA's pediatric program, backed by federal laws, has helped propel more clinical trials to be conducted in children. And more parents may be considering whether to enroll a child in a clinical trial.

    By taking part in a trial, your child may be offered a new treatment that may or may not be better than those that already exist. Your child can also help the medical community understand how the treatment works and how it should be used in children. "Some studies have shown that children, especially with chronic diseases, have a strong altruistic tendency and may want to contribute to knowledge of their own disease," Murphy says.

    For More Information:

  • FDA's Office of Pediatric Therapeutics

  • www.fda.gov/oc/opt

  • For safety issues found when products were studied in children

  • www.fda.gov/oc/opt/pediatricsafety.html

  • For brief summaries of trials that have been conducted in children

  • www.fda.gov/cder/pediatric/Summaryreview.htm

  • Basic questions and answers about clinical trials

  • www.fda.gov/oashi/clinicaltrials/clintrialdoc.html

  • To search for clinical trials now being conducted

  • www.clinicaltrials.gov
    *


    Women's Health Initiative - The Women's Health Initiative (WHI) is a long-term national health study that focuses on strategies for preventing heart disease, breast and colorectal cancer and fracture in postmenopausal women. This 15-year project involves over 161,000 women ages 50-79, and is one of the most definitive, far reaching programs of research on women's health ever undertaken in the U.S.

    The purpose of this site is to provide WHI participants others interested in the WHI findings a way of obtaining information about research results directly from the study rather than through news reports.
    *




    Connective Tissue Disorders


    Connective Tissue Disorders headings at MedlinePLUS:

  • Children
  • Clinical Trials
  • Dictionaries/Glossaries
  • From the NIH
  • Genetics
  • Organizations
  • Related Issues
  • Research
  • Specific Conditions
  • Treatment

  • You may also be interested in these MedlinePlus related pages:

  • Bones, Joints and Muscles
  • Cartilage Disorders
  • Ehlers-Danlos Syndrome
  • Lupus
  • Marfan Syndrome
  • Osteogenesis Imperfecta
  • Scleroderma
  • Soft Tissue Sarcoma



  • Depression


    Antidepressants headings at MedlinePlus:

  • Alternative Therapy
  • Children
  • Coping
  • From the NIH
  • News
  • Nutrition
  • Organizations
  • Overviews
  • Related Issues
  • Research
  • Specific Conditions
  • Teenagers
  • Treatment

  • Depression headings at MedlinePlus:

  • Alternative Therapy
  • Children
  • Clinical Trials
  • Coping
  • Directories
  • From the NIH
  • Health Check Tools
  • Men
  • News
  • Nutrition
  • Organizations
  • Other Languages
  • Overviews
  • Related Issues
  • Research
  • Seniors
  • Specific Conditions
  • Statistics
  • Teenagers
  • Treatment
  • Women

  • Decision Support in Primary Care and Depression Outcomes - The summary below is from the full report titled "Depression Decision Support in Primary Care. A Cluster Randomized Trial." It is in the 3 October 2006 issue of Annals of Internal Medicine (volume 145, pages 477-487). The authors are S.K. Dobscha, K. Corson, D.H. Hickam, N.A. Perrin, D.F. Kraemer, and M.S. Gerrity. [Abstract] [Summary] [Full Text]:

  • What is the problem and what is known about it so far? - Depression causes sadness or loss of interest in or enjoyment of life to a degree that interferes with daily activities. It is a medical condition, not a normal reaction to such life situations as the death of a loved one or the loss of a job. About 1 of every 5 people experiences depression at some time in his or her life, and it is common among patients who see primary care providers. Common symptoms are lack of energy, change in sleep or appetite, and prominent thoughts of worthlessness or guilt. Sometimes the condition goes away on its own, but many people with depression need treatment with counseling or medication to speed recovery. Treating depression can be difficult. Treatment strategies that involve collaboration between primary care doctors and mental health specialists have been shown to improve depression outcomes. However, such strategies have been difficult to implement outside of research settings.
  • Why did the researchers do this particular study? To find out whether strategies in primary care settings that are less intensive than those previously studied could also improve outcomes for patients with depression.
  • Who was studied? 375 patients with depression who were receiving care from 41 primary care clinicians within 5 clinics in 1 Veterans Affairs medical center.
  • How was the study done? The researchers assigned each primary care clinician to provide either depression decision support or usual depression care. Depression decision support was provided by a team that included a psychiatrist and a nurse care manager. Within 1 to 2 weeks after participant enrollment in the study, the nurse called patients of primary care clinicians assigned to depression decision support to teach them about depression and encourage them to talk to their clinicians about depression. Patients also received invitations to a 2-hour group education program and received written materials about depression by mail. The depression decision support team reviewed patient records at least monthly and mailed a progress report to clinicians every 3 months. If depression scores did not improve, the team contacted patients' clinicians to discuss treatment strategies. The researchers compared depression scores, patient satisfaction, and use of depression treatments for patients who received depression decision support and those who received usual care.
  • What did the researchers find? Patients who received depression decision support were more likely to have received an antidepressant medication and were more satisfied with their care than patients who received usual care. However, patients who received depression decision support had depression scores similar to those who received usual care.
  • What were the limitations of the study? The study included few women.
  • What are the implications of the study? Providing depression decision support for patients with depression in primary care settings improved satisfaction and increased the number of patients who received medications for depression but did not improve depression scores. More intensive strategies may be necessary to improve depression outcomes in primary care settings.
  • *


    Genes Linked to Suicidal Thinking During Antidepressant Treatment - Specific variations in two genes are linked to suicidal thinking that sometimes occurs in people taking the most commonly prescribed class of antidepressants, according to a large study led by scientists at the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH). Depending on the particular mix inherited, these versions increased the likelihood of such thoughts from 2- to15-fold, the study found. About 1 percent of adult patients were deemed to be at high genetic risk, 41 percent at elevated risk and 58 percent at lower risk.

    If confirmed, the findings may hold promise for genetic testing, as more such markers are identified.

    Risk increased proportionately if a participant had two, as opposed to just one of the suspect versions. Both genes code for components of the brain's glutamate chemical messenger system (http://www.nimh.nih.gov/science-news/2007/faster-acting-antidepressants-closer-to-becoming-a-reality.shtml), which recent studies suggest is involved in the antidepressant response.

    Overall, about 6 percent of 1,915 patients with depression (http://www.nimh.nih.gov/health/topics/depression/index.shtml) reported that they started to have suicidal thoughts while taking an antidepressant. This rate soared to 36 percent among the few patients with both of the suspect gene versions; 59 percent of the patients who had suicidal thoughts had at least one of the versions.
    *


    Healthline Depression Learning Center - Depression is more than just occasionally having the blues. Depression is a mood disorder. You feel sad and have no joy in life. You may feel that you have nothing to live for. There are many types of depression, from simple depressed mood to Major Depression - a life-threatening illness.*


    Male depression: Understanding the issues - Are you irritable, isolated and withdrawn? Do you find yourself working all the time, drinking too much alcohol, using illicit drugs or seeking thrills from risky activities?

    If so, perhaps you're being chased by what Winston Churchill called his "black dog" — male depression. Churchill attempted to ward off his black dog of male depression with compulsive overwork and excessive drinking. For male depression, the coping strategies — unhealthy ones — may be reckless driving, risky sex or shutting yourself off from the world.

    But none of these can keep male depression at bay for long. Even worse: When you have male depression, you're also at an increased risk of suicide.
    *


    Mouse Model May Reveal Anxiety Gene, Marker for Antidepressant Failure - Provides valuable tool for exploring basis of human anxiety and response to SSRIs.

    Studies of a new mouse model suggest that a specific gene variation plays a role in the development of anxiety disorders and in resistance to common medications for anxiety and depression.

    With further research, the findings could eventually help explain part of the genetic underpinnings of anxiety disorders, which affect 40 million American adults, and lead to biological markers that predict whether or not selective serotonin reuptake inhibitors will be effective for a given patient. Finding the right medication for each person is often a lengthy process in treatment of anxiety and depression, during which illness may worsen; biological markers could help narrow the search on an individualized basis.

    The study was funded by NIMH and the National Institute of Neurological Disorders and Stroke. Results were reported in the October 6 issue of Science by Francis Lee, Zhe-Yu Chen, and colleagues from Weill Medical College of Cornell University, Shandong University (China), and The Rockefeller University.
    *


    National Mental Health Association (NMHA) is the country's oldest and largest nonprofit organization addressing all aspects of mental health and mental illness. With more than 340 affiliates nationwide. NMHA works to improve the mental health of all Americans, especially the 54 million individuals with mental disorders, through advocacy, education, research and service.* Check out the NMHA's Mental Health Information Fact Sheets and Mental Health Resource List.


    Newer Class of Antidepressants Similar in Effectiveness, but Side Effects Differ - Today's most commonly prescribed antidepressants are similar in effectiveness to each other but differ when it comes to possible side effects, according to an analysis released today by the Department of Health & Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ).

    The findings, based on a review of nearly 300 published studies of second-generation antidepressants, show that about six in 10 adult patients get some relief from the drugs. About six in 10 also experience at least one side effect, ranging from nausea to sexual dysfunction.

    Patients who don't respond to one of the drugs often try another medication within the same class. About one in four of those patients recover, according to the review. Overall, current evidence on the drugs is insufficient for clinicians to predict which medications will work best for individual patients.

    Second-generation antidepressants, which include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), are often prescribed because first-generation antidepressants (such as tricyclic antidepressants, or TCAs) can cause intolerable side effects and carry high risks.

    "Second-generation antidepressants provide hope for many of the millions of Americans who struggle with depression," said AHRQ Director Carolyn M. Clancy, MD. "But often trying to find the right drug is trial and error, and in many cases relief is temporary or comes with serious side effects. It's clear we need more evidence to help patients and their doctors make the best choices."
    *


    New NIMH Research Strives to Understand How Antidepressants May Be Associated with Suicidal Thoughts and Actions - The National Institute of Mental Health (NIMH), part of the National Institutes of Health, is funding five new research projects that will shed light on antidepressant medications, notably selective serotonin reuptake inhibitors (SSRIs), and their association with suicidal thoughts and actions (suicidality).

    Studies have shown that most individuals suffering from moderate and severe depression, even those with suicidal thoughts, can substantially benefit from antidepressant medication treatment. However, use of SSRIs in children and adolescents has become controversial. In 2005, the U.S. Food and Drug Administration (FDA) adopted a “black box” warning — the most serious type of warning in prescription drug labeling — for all SSRIs. The notice alerts doctors and patients of the potential for SSRIs to prompt suicidal thinking in children and adolescents, and urges diligent clinical monitoring of individuals of all ages taking the medications. This can be particularly challenging because it is difficult for patients, their family members and practitioners to determine whether suicidal thoughts may be related to the depression, the medication, or both.

    “These new, multi-year projects will clarify the connection between SSRI use and suicidality,” said NIMH Director Thomas Insel, M.D. “They will help determine why and how SSRIs may trigger suicidal thinking and behavior in some people but not others, and may lead to new tools that will help us screen for those who are most vulnerable,” he added.
    *


    New Strategies Help Depressed Patients Become Symptom-Free - Results of the nation’s largest depression study show that one in three depressed patients who previously did not achieve remission using an antidepressant became symptom-free with the help of an additional medication and one in four achieved remission after switching to a different antidepressant. The study, funded by the National Institutes of Health’s National Institute of Mental Health (NIMH), shows that people whose depression is resistant to initial treatment can achieve remission — the virtual absence of symptoms — when treated with a second strategy that either augments or switches medications. This is the first study to examine the effectiveness of different treatment strategies for those who did not become symptom-free after initial medication.*


    Sequenced Treatment Alternatives to Relieve Depression (STAR*D): An NIMH Study to Guide Treatment Choices for Resistant Depression - Initial results of the nation's largest clinical trial for depression have helped clinicians to track "real world" patients who became symptom-free and to identify those who were resistant to the initial treatment. Participants treated in both medical and specialty mental health care settings experienced a remission of symptoms in 12 to 14 weeks during well-monitored treatment with an antidepressant medication. The study, funded by the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH), used flexible adjustment of dosages based on quick and easy-to-use clinician ratings of symptoms and patient self-ratings of side effects.* STAR*D: Landmark Depression Treatment Study Releases Final Results (PDF file)


    Women With Major Depression at Risk of Relapse During Pregnancy - Contrary to a common belief that the hormonal changes associated with pregnancy provide a protective effect against depression, women with major depression who discontinue antidepressant medication during pregnancy are at risk of relapse, according to a study in the February 1 issue of the Journal of the American Medical Association.*




    Diabetes


    Diabetes headings at MedlinePlus:

  • Alternative Therapy
  • Children
  • Clinical Trials
  • Coping
  • Diagnosis/Symptoms
  • Dictionaries/Glossaries
  • Directories
  • Disease Management
  • Financial Issues
  • From the NIH
  • Genetics
  • Health Check Tools
  • Law and Policy
  • Men
  • News
  • Newsletters/Print Publications
  • Nutrition
  • Organizations
  • Overviews
  • Prevention/Screening
  • Related Issues
  • Research
  • Specific Conditions
  • Statistics
  • Seniors
  • Treatment
  • Women

  • Blood Glucose Control - Keeping your blood glucose as close to normal as possible is the best way to avoid or delay complications of diabetes. These research reports provide some insight into new ways to control your blood glucose.*


    Diabetes.org - The American Diabetes Association is the nation's leading nonprofit health organization providing diabetes research, information and advocacy. Founded in 1940, the American Diabetes Association conducts programs in all 50 states and the District of Columbia, reaching hundreds of communities. Find out what is happening in your area.

    The mission of the Association is to prevent and cure diabetes and to improve the lives of all people affected by diabetes.

    To fulfill this mission, the American Diabetes Association funds research, publishes scientific findings, provides information and other services to people with diabetes, their families, health professionals and the public. The Association is also actively involved in advocating for scientific research and for the rights of people with diabetes.
    *


    Diabetic Foot Care - People with diabetes can develop many different foot problems, including infections and sores. Even ordinary problems can get worse and lead to loss of mobility, or even loss of a leg. Foot problems most often happen when diabetic nerve and blood vessel diseases affect the legs and feet. The latest research is helping us know how to avoid these serious complications.*


    Diabetic Heart and Blood Vessel Disease - Two out of three people with diabetes today will die from heart disease or stroke. Diabetes often goes hand in hand with high blood pressure or high cholesterol, which can add to the risk for heart problems. However, by keeping up with the latest research, you can learn new ways to prevent or treat heart problems.*


    Diabetes Medications - More pills and types of insulin are available to control diabetes than ever before. There is also a broad range of drugs available to take care of problems like high blood pressure and high cholesterol that tend to go along with diabetes. New research is pointing the way toward new drugs and better ways to use the drugs we already have.*


    Diabetes Overview:

  • What is diabetes?
  • What are the types of diabetes?
  • How is diabetes diagnosed?
  • What is pre-diabetes?
  • What are the scope and impact of diabetes?
  • Who gets diabetes?
  • How is diabetes managed?
  • Hope Through Research
  • What will the future bring?
  • Points to Remember
  • For More Information


  • Almost everyone knows someone who has diabetes. An estimated 20.8 million people in the United States—7.0 percent of the population—have diabetes, a serious, lifelong condition. Of those, 14.6 million have been diagnosed, and 6.2 million have not yet been diagnosed. In 2005, about 1.5 million people aged 20 or older were diagnosed with diabetes. For additional statistics, see the National Diabetes Statistics fact sheet online at www.diabetes.niddk.nih.gov/dm/pubs/statistics or call the National Diabetes Information Clearinghouse at 1–800–860–8747 to request a copy.*


    FDA Diabetes Information - FDA regulates nearly all of the foods you eat and the medical products you use to treat your diabetes, including glucose meters, insulin pumps, diabetes medicines, and insulin. We have tried to include information about many products that help you check and control your blood sugar. Our mission is to assure that these products are safe and that they work as well as claimed.

    When you select the diabetes news button, you will find information about new diabetes findings, new product approvals, upcoming panel meetings, and other current information about diabetes care. You may use the search button to search this site or the entire FDA web site.
    *


    National Diabetes Information Clearinghouse (NDIC) - Newly diagnosed or at risk? Overview of diabetes, pre-diabetes, diagnosis information, pregnancy and diabetes, and a dictionary of diabetes terms. What I need to know about Eating and Diabetes - A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

  • Eating and Diabetes
  • Blood Glucose Levels
  • Your Diabetes Medicines
  • Your Physical Activity Plan
  • The Food Pyramid
  • Starches
  • Vegetables
  • Fruits
  • Milk
  • Meat and Meat Substitutes
  • Fats and Sweets
  • Alcoholic Drinks
  • Your Meal Plan
  • Measuring Your Food
  • When You’re Sick
  • Where can I get more information?
  • *


    Psychological Therapy to Improve Control of Type 1 Diabetes - Type 1 diabetes mellitus (also called childhood diabetes) occurs when the pancreas stops making insulin. Insulin helps the body use the energy that foods provide. Without insulin, blood sugar levels become high. Over time, high blood sugar levels can lead to blindness, kidney failure, damage to nerves, and heart disease. To keep blood sugar levels in the normal range, people with type 1 diabetes must inject insulin and monitor their diet and exercise. Psychological issues can interfere with a patient's ability and confidence to manage their diabetes, and it is possible that psychological treatments could improve diabetes control.

    Combined psychological therapies (motivational enhancement therapy plus cognitive behavior therapy) resulted in clinically relevant improvements in blood sugar control in type 1 diabetes compared with usual care.
    *


    Relationship of Intensity of Diabetes Disease Management Programs and Quality of Care - Diabetes mellitus is a common disease that interferes with the body's ability to store energy from food. The result is high blood sugar levels. Over time, high blood sugar levels can lead to blindness, kidney failure, nerve damage, and heart disease. Fortunately, good care with diet, exercise, and medications to keep blood sugar, blood pressure, and cholesterol under control can prevent the development of these complications.

    Because it is possible to accomplish so much with good diabetes care, it is important to know about strategies that doctors and health care organizations can use to improve care. Disease management programs use a variety of strategies to encourage recommended tests and treatments. These strategies include reminders to doctors and patients, regular reports to doctors about the care they provide, and structured care management (structured care management refers to nurses or other health care providers helping patients manage diabetes issues between doctor visits). Although diabetes disease management programs are becoming more common, we don't know much about whether they actually improve care.
    *


    What People With Diabetes Need to Know About Osteoporosis - Type 1 diabetes is linked to low bone density, although researchers don’t know exactly why. Insulin, which is deficient in type 1 diabetes, may promote bone growth and strength. The onset of type 1 diabetes typically occurs at a young age when bone mass is still increasing. It is possible that people with type 1 diabetes achieve lower peak bone mass, the maximum strength and density that bones reach. People usually reach their peak bone mass by age 30. Low peak bone mass increases one’s risk of developing osteoporosis later in life. Some people with type 1 diabetes also have celiac disease which is associated with reduced bone mass. It is also possible that cytokines, substances produced by various cells in the body, play a role in the development of both type 1 diabetes and osteoporosis.

    Recent research also suggests that women with type 1 diabetes may have an increased fracture risk, since vision problems and nerve damage associated with the disease have been linked to an increased risk of falls and related fractures. Hypoglycemia, or low blood sugar reactions, may also contribute to falls.

    Increased body weight can reduce one’s risk of developing osteoporosis. Since excessive weight is common in people with type 2 diabetes, affected people were long believed to be protected against osteoporosis. However, while bone density is increased in people with type 2 diabetes, fractures are increased. As with type 1 diabetes this may be due to increased falls because of vision problems and nerve damage. Moreover, the sedentary lifestyle common in many people with type 2 diabetes also interferes with bone health.
    *




    Family Issues


    Family Issues headings at MedlinePlus:

  • Children
  • Directories
  • Law and Policy
  • Organizations
  • Overviews
  • Related Issues
  • Seniors
  • Statistics
  • Teenagers
  • Treatment
  • Women

  • Caring Connections - Caring Connections, a program of the National Hospice and Palliative Care Organization (NHPCO), is a national consumer engagement initiative to improve care at the end of life, supported by a grant from The Robert Wood Johnson Foundation.

    Caring Connections:

  • Provides free resources and information to help people make decisions about end-of-life care and services before a crisis.
  • Helps people connect with the resources they need, when they need them.
  • Brings together community, state and national partners working to improve end-of-life care.
  • Spearheads a national consumer engagement campaign called It's About How You LIVE.


  • Free Resources: - www.caringinfo.org Provides a variety of free resources on topics including:
  • Advance care planning
  • Caregiving
  • Pain
  • Financial issues
  • Hospice and palliative care
  • Grief and loss

  • Disaster or Emergency Preparedness Plan for Women - You never know when an emergency situation is going to arise. Being prepared for a disaster or crisis can help you and your family stay safe until help arrives. Here are three tips to keep in mind when thinking about your family's emergency plan:

  • Know what natural or other disasters could occur in your area and how to prepare for them.
  • Make an emergency plan and give family members a copy of it. Talk with your family members so they know the potential disasters or emergencies that could happen in your area and explain how to respond to each of them.
  • Pack emergency supplies in your home to meet your needs for three days.
  • *


    End of Life Issues - Also called: Death and dying, Terminal care - Sometimes, in spite of treatment, a condition or illness will cause death. In those cases, patients can decide what they do and do not want done. They can decide whether they want aggressive treatment that might prolong life or whether they prefer to stop treatment, which could mean dying sooner but more comfortably. They may want to plan their own funeral. Advance directives can help make the patient's wishes clear to families and health care providers.

    Care at the end of life focuses on making patients comfortable. They still receive medicines and treatments to control pain and other symptoms. Some patients choose to die at home. Others enter a hospital or a hospice. Either way, services are available to help patients and their families deal with issues surrounding death.
    *


    Healthy marriage: Why love is good for you - The benefits of a healthy marriage include lower rates of disease, a longer life span and a greater sense of well-being. Reasons include advantages of cohabitation, financial stability and strong support networks.

    The benefits of a healthy marriage have been carefully studied for decades. Statistically, people who are happily married live longer than do their single counterparts. They have lower rates of heart failure, cancer and other diseases and develop tighter networks of emotional support.
    * Read the Whole Article...


    U.S. Surgeon General's Family History Initiative - Health care professionals have known for a long time that common diseases - heart disease, cancer, and diabetes - and even rare diseases - like hemophilia, cystic fibrosis, and sickle cell anemia - can run in families. If one generation of a family has high blood pressure, it is not unusual for the next generation to have similarly high blood pressure. Tracing the illnesses suffered by your parents, grandparents, and other blood relatives can help your doctor predict the disorders to which you may be at risk and take action to keep you and your family healthy.

    To help focus attention on the importance of family health history, U.S. Surgeon General Richard H. Carmona, M.D., M.P.H., in cooperation with other agencies within the U.S. Department of Health and Human Services (HHS) has launched a national public health campaign, called the U.S. Surgeon General's Family History Initiative, to encourage all American families to learn more about their family health history.

    In addition to the Office of the Surgeon General, other HHS agencies involved in this project include the National Human Genome Research Institute (NHGRI) at the National Institutes of Health, the Centers for Disease Control and Prevention (CDC), the Agency for Healthcare Research and Quality (AHRQ), and the Health Resources and Services Administration (HRSA).
    *

    My Family Health Portrait - Americans know that family history is important to health. A recent survey found that 96 percent of Americans believe that knowing their family history is important. Yet, the same survey found that only one-third of Americans have ever tried to gather and write down their family's health history.

    Because family health history is such a powerful screening tool, the Surgeon General has created a new computerized tool to help make it fun and easy for anyone to create a sophisticated portrait of their family's health.

    This new, revised version of the tool, called "My Family Health Portrait" is a web-enabled program that runs on any computer that’s connected to the web and running an up-to-date version of any major Internet browser. The new version of the tools offers numerous advantages over last year’s version, which had to be downloaded to the user’s computer, but only those running the Microsoft Windows operating system.

    The web-based tool helps users organized family history information and then print it out for presentation to the family doctor. In addition, the tool helps users save their family history information to their own computer and even share family history information with other family members.
    *

    My Family Health Portrait Download - Welcome to the My Family Health Portrait download page. From this page, you can download the My Family Health Portrait software and install it on your home computer, or you can use the new Web-based version.*




    First Aid


    First-Aid Guide from www.MayoClinic.com - Medical emergencies don't occur every day. But when they do, information can help you deal with these situations.

    Disclaimer: This information is not intended as a substitute for professional medical advice, emergency treatment or formal first-aid training. Don't use this information to diagnose or develop a treatment plan for a health problem or disease without consulting a qualified health care provider. If you're in a life-threatening or emergency medical situation, seek medical assistance immediately.
    *




    Heart Disease


    Beta Blockers - Some Blood Pressure Drugs Boost Diabetes Risk - Some common blood pressure drugs can substantially increase the risk of diabetes, especially among those already at risk for the condition, U.S. researchers report.

    According to the report, angiotensin-receptor blockers (ARBs) and angiotensin-converting-enzyme (ACE) inhibitors are the blood pressure drugs least associated with diabetes. These are followed by calcium-channel blockers.

    Beta blockers and diuretics are the drugs most associated with the condition.*


    Beta blockers decrease the heart rate and cardiac output, which lowers blood pressure. They're also used with therapy for cardiac arrhythmias and in treating angina pectoris. Some commonly prescribed beta blockers include:

  • Acebutolol (Sectral)
  • Atenolol (Tenormin, Tenormin I.V., Tenoretic)
  • Betaxolol (Kerlone)
  • Bisoprolol (Zebeta, Ziac)
  • Carteolol Oral (Cartrol)
  • Metoprolol (Lopressor, Lopressor HCT, Toprol XL)
  • Nadolol (Corgard, Corzide)
  • Propranolol Oral (Inderal, Inderal LA, Inderide, Innopran XL, Propranolol Hydrochloride Intensol)
  • Sotalol (Betapace AF, Betapace, Sorine)
  • Timolol Oral (Blocadren, Timolide)

  • Blood Pressure-Lowering Drugs - Blood pressure-lowering drugs can help control blood pressure when appropriate diet and regular physical activity alone have not succeeded.

    Chronic Stress and the Heart - Emotional and physical stresses have a negative impact on the heart and the vascular system. Acute stress happens all at once; chronic stress occurs over a longer time period. Stress hormones (catecholamines, including epinephrine, which is also known as adrenaline) have damaging effects if the heart is exposed to elevated catecholamine levels for a long time. Stress can cause increased oxygen demand on the body, spasm of the coronary (heart) blood vessels, and electrical instability in the heart’s conduction system.

    Chronic stress has been shown to increase the heart rate and blood pressure, making the heart work harder to produce the blood flow needed for bodily functions. Long-term elevations in blood pressure, also seen with essential hypertension (high blood pressure not related to stress), are harmful and can lead to myocardial infarction (heart attack), heart failure, abnormal heart rhythms, and stroke.

    The October 10, 2007, issue of JAMA contains an article about the effects of chronic job stress on the heart and the cardiovascular system.
    * This article is available in the PDF format, meaning you'll need the free Adobe Acrobat Reader.


    What is cardiovascular disease? - Cardiovascular disease (CVD) is not one single disease or condition. It is a group of different disorders that affect your heart and blood vessels. Some types of CVD occur from birth, and others are developed over a lifetime.

    To learn more about specific cardiovascular conditions and diseases go to the following links:


  • Angina - Chest Pain

  • Atherosclerosis - Hardening of the Arteries

  • Congestive Heart Failure

  • Coronary Artery Disease

  • Heart Attack
  • *


    Acute Emotional Stress and the Heart - Experiencing emotional or physical stress causes an increase in heart rate, elevation of blood pressure, and release of stress hormones. All these result in a greater workload for the heart, which can be dangerous. Stress can cause a heart attack, sudden cardiac death, heart failure, or arrhythmias (abnormal heart rhythms) in persons who may not even know they have heart disease. Individuals with congestive heart failure, coronary heart disease, known arrhythmias, or other heart or blood vessel diseases should avoid emotional stress whenever possible and learn to manage the effects of stress. Excessive physical exertion and emotional stress may cause problems in both men and women, but women seem to be particularly susceptible to developing heart problems in the face of emotional stress. Ask your doctor about any limitations on physical activity or vigorous exercise if you have heart disease.

    The July 18, 2007, issue of JAMA includes an article about acute emotional stress and its effects on the heart.
    *


    What Is an Aneurysm? - An aneurysm (AN-u-rism) is an abnormal bulge or “ballooning” in the wall of an artery. Arteries are blood vessels that carry oxygen-rich blood from the heart to other parts of the body. An aneurysm that grows and becomes large enough can burst, causing dangerous, often fatal, bleeding inside the body.

    Most aneurysms occur in the aorta. The aorta is the main artery that carries blood from the heart to the rest of the body. The aorta comes out from the left ventricle (VEN-trih-kul) of the heart and travels through the chest and abdomen. An aneurysm that occurs in the aorta in the chest is called a thoracic (tho-RAS-ik) aortic aneurysm. An aneurysm that occurs in the aorta in the abdomen is called an abdominal aortic aneurysm.

    Aneurysms also can occur in arteries in the brain, heart, intestine, neck, spleen, back of the knees and thighs, and in other parts of the body. If an aneurysm in the brain bursts, it causes a stroke.


  • Types of Aneurysm
  • Other Names for Aneurysm
  • What Causes an Aneurysms?
  • Who Is At Risk for an Aneurysm?
  • What Are the Signs and Symptoms of an Aneurysm?
  • How Is an Aneurysm Diagnosed?
  • How Is an Aneurysm Treated?
  • How Can an Aneurysm Be Prevented?
  • Key Points
  • Links to Other Information About Aneurysm
  • *


    Aneurysms headings at MedlinePlus:

  • Clinical Trials
  • Diagnosis/Symptoms
  • Dictionaries/Glossaries
  • Directories
  • From the NIH
  • Overviews
  • Information from the Medical Encyclopedia
  • News
  • Organizations
  • Prevention/Screening
  • Rehabilitation/Recovery
  • Research
  • Specific Conditions
  • Treatment



  • Herniated Disks


    Herniated Disk headings at MedlinePlus:

  • Anatomy/Physiology
  • Clinical Trials
  • Diagnosis/Symptoms
  • Directories
  • News
  • Organizations
  • Overviews
  • Specific Conditions
  • Treatment

  • Herniated Lumbar Disks - The vertebrae (bones of the spine) are cushioned by blocks or pads of tissue called disks. These disks are round and flat and made up of 2 parts: the annulus (a tough outer capsule or ring) and the nucleus (an inner, spongy core of jellylike material). When these disks are healthy, they act as shock absorbers for the spine and are essential in keeping the spine flexible. The normal, everyday pressures on the spine force the outer surface to bulge slightly. When these disks are damaged from an injury, normal wear and tear, or disease, they may bulge abnormally or rupture (break open). When a damaged disk bulges abnormally or ruptures, it is called a herniated (slipped) disk. Herniated disks can occur in any part of the spine but most often affect the lumbar spine (lower back). The abnormal disk material can place pressure on the adjacent spinal cord or nerve roots, resulting in pain, numbness, or weakness in areas of the lower back, buttocks, and legs. The November 22/29, 2006, issue of JAMA includes 2 articles about surgery for herniated disks.

    For More Information:
    American Academy of Family Physicians
    American Association of Orthopaedic Surgeons
    American Association of Neurological Surgeons
    *


    Study Shows Patients With Herniated Disks Improve Over Time – Even Without Surgery - A new study supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the National Institutes of Health, gives doctors and patients reason to reconsider surgery when planning treatment for herniated disks. In the 13-center study of candidates for lumbar diskectomy, researchers found that those who forwent surgery for nonoperative care fared similarly to those who had the surgery. In general, surgery patients experienced slightly more improvement over the study period, and particularly in the first 3 months, than those who opted for other treatments.

    Lumbar diskectomy – the surgical removal of all or part of an intervertebral disk – is the most commonly performed surgical procedure for patients having back or leg pain. Intervebral disks are cartilage-like structures situated between the individual bones, or vertebrae, of the spine. Each disk consists of a tough outer coating and jelly-like filling that helps absorb shock from the body’s movement. However, when a disk protrudes from its normal position, it can place pressure on surrounding nerves, causing pain in the back as well as down one or both legs. While removing the disk is often effective in alleviating the associated pain, there has been little research to support the surgery’s effectiveness over other therapies. Thus, the optimal treatment for herniated (slipped) disks has not been clear.

    The observational portion of the study, however, showed some significant benefit of surgery over nonoperative treatments, at least in the short term. Of the 743 patients enrolled in this arm of the study, 528 received surgery and 191 received the usual nonoperative care. The benefits of surgery were seen as early as 6 weeks and were maintained for at least 2 years.

    "While lumbar diskectomy is a common surgical procedure, its necessity in treating herniated disks has not been established," says Dr. Weinstein. Magnetic resonance imaging often reveals herniated disks in patients without symptoms, and some herniations regress in time without surgery, he says. Furthermore, a 15-fold variation in regional diskectomy rates in the United States and lower rates internationally in patients raise questions about the surgery’s appropriateness in some cases. "This study is important in that it offers assurance that indeed, lumbar diskectomy is generally effective in relieving pain from herniated disks. It also offers assurance to patients who are able to wait out the pain that in time their symptoms will likely subside even without surgery."
    *


    Treatment for Lumbar Disk Herniation - Two articles in this issue of JAMA report results of the Spine Patient Outcomes Research Trial (SPORT), a randomized trial that evaluated the efficacy of standard open diskectomy vs nonoperative ("usual care") treatment for lumbar disk herniation. In the first article, Weinstein and colleagues (SEE ARTICLE) report that intent-to-treat analyses demonstrated small but not statistically significant improvements in pain and function that favored diskectomy during the 2-year follow-up period. However, since large numbers of patients crossed over from their assigned treatment to the alternate treatment, the authors could not reach definitive conclusions regarding treatment superiority or equivalence. In the second article, the authors (SEE ARTICLE) report results for patients who refused random assignment to operative or nonoperative treatment and were enrolled in a parallel observational cohort study. Among these patients, those who chose surgery reported greater improvement in pain and function compared with patients who chose nonoperative care. In an editorial, Flum (SEE ARTICLE) discusses the interpretation of trials with subjective outcomes and the potential value of sham-controlled surgical trials. In a second editorial, Carragee (SEE ARTICLE) discusses lumbar disk herniation and factors that influence patients' treatment preference.*




    Insurance


    Health Care Insurance: The Basics - To cope with the potentially high costs of medical care, insurance policies provide some financial protection. Many individuals with insurance are covered under an employer-based plan (options offered and partially funded by their employer). Individual health insurance coverage, though more costly, can be obtained through some companies. Uninsured persons depend on their own ability to pay, qualifying for government insurance, or the care that physicians and institutions donate to those unable to pay. The March 14, 2007, issue of JAMA is a theme issue on access to health care.*


    HealthInsuranceInfo.net - Consumer Guides for Getting and Keeping Health Insurance - The Georgetown University Health Policy Institute has written A CONSUMER GUIDE FOR GETTING AND KEEPING HEALTH INSURANCE for each state and the District of Columbia — fifty-one in all. These Consumer Guides are available at this web site and will be updated periodically as changes in federal and state policy warrant.

    The Guides summarize your protections, and so may not answer all of your questions. They are not a substitute for legal, accounting, or other professional advice. Please consult a qualified expert before making any decisions about your own health insurance. The authors, the Health Policy Institute, and Georgetown University specifically disclaim any personal liability, loss or risk incurred as a consequence of the use and application, either directly or indirectly, of any information presented herein.
    *


    Relationship of Insurance Type with the Care of Acute Coronary Syndromes - The summary below is from the full report titled "Insurance Coverage and Care of Patients with Non–ST-Segment Elevation Acute Coronary Syndromes." It is in the 21 November 2006 issue of Annals of Internal Medicine (volume 145, pages 739-748). The authors are J.E. Calvin, M.T. Roe, A.Y. Chen, R.H. Mehta, G.X. Brogan Jr., E.R. DeLong, D.J. Fintel, W.B. Gibler, E.M. Ohman, S.C. Smith Jr., and E.D. Peterson.

    What is the problem and what is known about it so far?

    Acute coronary syndromes occur when there are blockages in blood flow to heart muscle. If the blockage lasts long enough, an area of heart muscle dies, a condition commonly known as a heart attack. Guidelines recommend treatments for acute coronary syndromes to keep heart muscle alive and prevent bad outcomes, such as heart attack or death. In the first 24 hours following heart attack, recommended treatments include medications to control heart rate and decrease blockages, cardiac catheterization to determine the extent of blockages, and procedures to open up or bypass blocked blood vessels in certain situations. Treatments recommended at the time of hospital discharge include some of the same medications recommended in the first 24 hours, medications and dietary advice to control cholesterol levels, counseling to stop smoking, and cardiac rehabilitation programs. Unfortunately, not all patients receive all recommended treatments.

    Who was studied?

    37,345 patients younger than 65 years of age and 59,550 patients 65 years of age or older who received care for acute coronary syndromes at 1 of 521 U.S. hospitals participating in a program to improve the care of patients with heart conditions. To be in the study, patients had to have insurance through Medicaid (if they were younger than 65 years of age), Medicare (if they were 65 years of age or older), a health maintenance organization (HMO), or other private insurance company. Medicaid is state-based insurance coverage for people with low incomes. Medicare is the federal insurance program for people 65 years of age or older.

    What did the researchers find?

    Patients younger than age 65 years with Medicaid insurance were less likely to receive some recommended services and were more likely to die than patients of a similar age with HMO or other private insurance. Patients older than age 65 years were just as likely to receive recommended treatments and had similar mortality rates, regardless of insurance type.

    What were the limitations of the study?

    The study did not include patients without insurance and was unable to identify reasons for the differences in care by insurance type. Possible explanations could be that patients with Medicaid are sicker than those with HMO or other private insurance or that the quality of care is worse for patients with Medicaid.

    What are the implications of the study?

    Further research is needed to identify reasons for variation in care and outcomes by insurance type and to identify strategies to reduce these differences.
    *




    Medicare


    Medicare Prescription Drug Plan headings at MedlinePlus:

  • Directories
  • Dictionaries/Glossaries
  • Financial Issues
  • News
  • Organizations
  • Other Languages
  • Overviews
  • Related Issues
  • Specific Conditions


  • You may also be interested in these MedlinePlus related pages:
  • Financial Assistance
  • Health Insurance
  • Medicare
  • Health System
  • Seniors' Health

  • Medicare Beneficiaries To Be Covered For Prescription Drugs As of January 1, 2006 - More than 21 million seniors and people with disabilities will get prescription drug coverage as of Jan. 1, 2006, HHS Secretary Mike Leavitt said today. The number includes more than one million Americans who signed up for the new stand-alone coverage in the first 28 days it was offered. Another 500,000 are expected to be enrolled by the end of January.

    “The new prescription drug benefit is off to a strong start,” Secretary Leavitt said. “With more than 21 million participating in coverage as of January 1, we are well on the way of meeting our goal of 28-30 million enrolled in the first year of the program. While there is still much work to do, we are encouraged by the early results.”*
    Read The Whole Article...


    Medicare Prescription Drug Coverage: A Workbook for Mental Health Consumers (Adobe Acrobat Reader Required)


    Medicare Releases Data on 2007 Drug Plan Options - Seniors who are satisfied with their current Medicare prescription drug coverage will not have to take any action when the Medicare Open Enrollment period begins November 15th, but those who wish to make a change will find new options with lower costs and more comprehensive coverage available for 2007. They will also find new tools from Medicare to help them make a choice. Surveys consistently show over 80 percent of Medicare beneficiaries are satisfied with their current coverage and drug plans. As a result of the Medicare prescription drug benefit, more than 38 million seniors and people with disabilities now have some form of drug coverage.

    The monthly premium beneficiaries will pay in 2007 will average $24 if they stay in their current plan -- about the same as in 2006. While some people will see an increase in their current plan premiums, they have the option to switch plans. Nationally, 83 percent of beneficiaries will have access to plans with premiums lower than they are paying this year, and beneficiaries will also have access to plans with premiums of less than $20 a month.*
    Read The Whole Article...




    Medications


    Drug Safety headings at MedlinePlus:

  • Children
  • Law and Policy
  • News
  • Newsletters/Print Publications
  • Organizations
  • Overviews
  • Related Issues
  • Seniors
  • Specific Conditions

  • Avoiding Drug Interactions - People often combine foods. For example, chocolate and peanut butter might be considered a tasty combination. But eating chocolate and taking certain drugs might carry risks. In fact, eating chocolate and taking monoamine oxidase (MAO) inhibitors, such as Nardil (phenelzine) or Parnate (tranylcypromine), could be dangerous.

    MAO inhibitors treat depression. Someone who eats an excessive amount of chocolate after taking an MAO inhibitor may experience a sharp rise in blood pressure.

    Other foods that should be avoided when taking MAO inhibitors: aged cheese, sausage, bologna, pepperoni, and salami. These foods can also cause elevated blood pressure when taken with these medications.

    There are three main types of drug interactions:

  • Drugs with food and beverages
  • Drugs with dietary supplements
  • Drugs with other drugs


  • "Consumers should learn about the warnings for their medications and talk with their health care professionals about how to lower the risk of interactions," says Shiew-Mei Huang, Ph.D., deputy director of the Office of Clinical Pharmacology in FDA's Center for Drug Evaluation and Research (CDER).
    *

    And, check out their Tips to Avoid Problems advice too.


    FDA Cautions Consumers Against Filling U.S. Prescriptions Abroad - Drugs With Same or Similar Names May Contain Different Active Ingredients Than in U.S. and Pose Health Risks - The U.S. Food and Drug Administration (FDA) is warning healthcare professionals and consumers that filling their prescriptions abroad may have adverse health consequences because of confusion with drug brand names that could inadvertently lead consumers to take the wrong medication for their condition. An FDA investigation has found that many foreign medications, although marketed under the same or similar-sounding brand names as those in the United States, contain different active ingredients than in the United States. Taking a different active ingredient may not help, and may even harm, the user.

    "Consumers who fill U.S. prescriptions abroad, either when traveling or when shopping at foreign internet pharmacies, need to be aware of this potential health hazard," said Dr. Murray Lumpkin, Deputy Commissioner for International and Special Programs. "The name of a drug bought from another country may be identical or similar to the name on the U.S. prescription, but the active ingredient in the medicine may be different and not provide the right treatment."*


    "My Medicines" - This Brochure Can be a Lifesaver - Can carrying around a brochure help save your life? Yes, if it's the "My Medicines" brochure offered by FDA's Office of Women's Health (OWH). It's designed to help consumers track the medications they use.

    My Medicines features a chart that allows you to list information about your prescription medicines, including the names of the medicines, how much you take, when you take them, what condition they are treating, and the number of refills.

    The brochure also offers advice on how to use labeling information, how to avoid problems with your medicines, and questions you should ask your doctor or pharmacist about your prescriptions.

    The brochure is available online at www.fda.gov/womens/taketimetocare/mymeds.html, as well as through the mail and from insurance providers, pharmacies, hospitals, health fairs, senior centers, and other venues.

    My Medicines, which is available in 14 languages, is part of an outreach initiative called "Take Time to Care" (TTTC), which was launched by OWH in 1998 to provide reliable, science-based health information. Millions of My Medicine brochures have been distributed since the program's launch.

    OWH now offers more than 50 easy-to-read publications that include fact sheets and medication guides. The following free materials, which are also available in many languages, can be downloaded at www.fda.gov/womens/pubs.html

    Use Medicines Wisely - www.fda.gov/womens/taketimetocare/usemeds.html

    Take Time To Care About Diabetes - www.fda.gov/womens/taketimetocare/diabetes/default.htm

    Menopause and Hormones - www.fda.gov/womens/menopause/default.htm

    For More Information:
    To order "My Medicines" through the mail, visit: www.pueblo.gsa.gov/results.tpl?id1=16&startat=1&--woSECTIONSdatarq=16&--SECTIONSword=ww

    Or call the Federal Citizen Information Center toll-free at 1-888-878-3256 and order publication 556R.

    Free Publications for Women and Their Families - www.fda.gov/womens/pubs.html

    FDA Office of Women's Health - www.fda.gov/womens/*




    Mental Health


    Mental Health and Behavior Topics at MedlinePlus.


    Mental Health Topics at MedlinePlus:

  • Alternative Therapy
  • Clinical Trials
  • Coping
  • Diagnosis/Symptoms
  • Dictionaries/Glossaries
  • Directories
  • Financial Issues
  • Law and Policy
  • Men
  • News
  • Nutrition
  • Organizations
  • Overviews
  • Related Issues
  • Research
  • Seniors
  • Specific Conditions
  • Statistics
  • Treatment
  • Women

  • Adult Children of Depressed Parents Have Higher Risk of Mental and Physical Illness - As children of depressed parents enter adulthood, they continue to suffer greater risk of mental disorders and begin to report more physical illnesses than grown-up children of non-depressed parents. Researchers funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH), published their findings from a 20-year follow-up study on offspring of depressed and non-depressed parents in the June issue of the American Journal of Psychiatry.

    At the 20-year follow-up, the average age of the study participants was 35. Those with at least one depressed parent had about a threefold higher risk for developing mood disorders (mostly major depressive disorder) and anxiety disorders (mostly phobias), more than twofold greater risk for alcohol dependence, and sixfold greater risk for drug dependence. Though occurring at greater rates in children of depressed parents, the peak ages of onset for mood and anxiety disorders were similar to those seen in children of non-depressed parents.
    *


    American Psychiatric Association - The American Psychiatric Association is a medical specialty society recognized world-wide. Its over 35,000 U.S. and international member physicians work together to ensure humane care and effective treatment for all persons with mental disorder, including mental retardation and substance-related disorders. It is the voice and conscience of modern psychiatry. Its vision is a society that has available, accessible quality psychiatric diagnosis and treatment.*


    Intermittent Explosive Disorder (IED) - Intermittent Explosive Disorder Affects up to 16 Million Americans

    A little-known mental disorder marked by episodes of unwarranted anger is more common than previously thought, a study funded by the National Institutes of Health’s (NIH) National Institute of Mental Health (NIMH) has found. Depending upon how broadly it’s defined, intermittent explosive disorder (IED) affects as many as 7.3 percent of adults — 11.5-16 million Americans — in their lifetimes. The study is based on data from the National Comorbidity Survey Replication, a nationally representative, face-to-face household survey of 9,282 U.S. adults, conducted in 2001-2003.

    People with IED may attack others and their possessions, causing bodily injury and property damage. Typically beginning in the early teens, the disorder often precedes — and may predispose for — later depression, anxiety and substance abuse disorders. Nearly 82 percent of those with IED also had one of these other disorders, yet only 28.8 percent ever received treatment for their anger, report Ronald Kessler, Ph.D., Harvard Medical School, and colleagues. In the June, 2006 Archives of General Psychiatry, they suggest that treating anger early might prevent some of these co-occurring disorders from developing.

    To be diagnosed with IED, an individual must have had three episodes of impulsive aggressiveness “grossly out of proportion to any precipitating psychosocial stressor,” at any time in their life, according to the standard psychiatric diagnostic manual. The person must have “all of a sudden lost control and broke or smashed something worth more than a few dollars…hit or tried to hurt someone…or threatened to hit or hurt someone.”

    People who had three such episodes within the space of one year — a more narrowly defined subgroup — were found to have a much more persistent and severe disorder, particularly if they attacked both people and property. The latter group caused 3.5 times more property damage than other violent IED sub-groups. Affecting nearly 4 percent of adults within any given year — 5.9-8.5 million Americans — the disorder leads to a mean of 43 attacks over the course of a lifetime and is associated with substantial functional impairment.

    Evidence suggests that IED might predispose toward depression, anxiety, alcohol and drug abuse disorders by increasing stressful life experiences, such as financial difficulties and divorce.
    *


    Mental Health - We all feel worried, anxious or sad from time to time. But, a true mental health disorder makes it hard for a woman to function normally. Women suffer twice as often as men by most forms of depression and anxiety disorders, and nine times as often by eating disorders. While there are different mental health disorders, they all are real illnesses that can't be willed or wished away. You aren't at fault if you have one, and you should not suffer in silence. Be patient with yourself and reach out to others for help. These illnesses can be treated successfully so that you can get back to enjoying life — not only for yourself, but for your family too.

    During Mental Health Month (May), you might want to learn more about the different resources WomensHealth.gov has about mental health.


    Frequently Asked Questions About Mental Health: - www.womenshealth.gov/mh/faq
    Women with Mental Health Disabilities - www.womenshealth.gov/wwd/conditions
    Mental Health and Girls - www.girlshealth.gov/mind
    Mental Health and Men - www.womenshealth.gov/mens/mental
    Links to Consumer Hotlines - www.womenshealth.gov/mh/hotlines*


    SAMHSA Issues Consensus Statement on Mental Health Recovery - The Substance Abuse and Mental Health Services Administration today unveiled a consensus statement outlining principles necessary to achieve mental health recovery. The consensus statement was developed through deliberations by over 110 expert panelists representing mental health consumers, families, providers, advocates, researchers, managed care organizations, state and local public officials and others.

    “Recovery must be the common, recognized outcome of the services we support,” SAMHSA Administrator Charles Curie said. “This consensus statement on mental health recovery provides essential guidance that helps us move towards operationalizing recovery from a public policy and public financing standpoint. Individuals, families, communities, providers, organizations, and systems can use these principles to build resilience and facilitate recovery.”
    *


    The Effects of Adolescent Mental Disorders Last Into Adulthood - Coping with a mental disorder during the teen years can negatively affect a person's overall quality of life in adulthood, say researchers from Columbia University in New York City.*


    What a Difference a Friend Makes - Welcome! This site is here for people living with mental illness—and their friends. You'll find tools to help in the recovery process, and you can also learn about the different kinds of mental illnesses, read real-life stories about support and recovery, and interact with the video to see how friends can make all the difference.*




    *These sites have been quoted directly as I believe what they say about their sites or they already know what to say, better than I do.
    These names and logos belong to and are copyrighted or trademarked by the site owners.



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