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Static.www.bmj
1
6

Interpreting raised serum prolactin results

A 29 year old woman working in a solicitor’s office presented with secondary amenorrhoea and was found to have a serum prolactin concentration of 2940 mIU/L (upper reference limit <600) and thyroid stimulating hormone (TSH) concentration of 5.2 mIU/L (reference range 0.27-4.2 mIU/L). She had a history of depression and had previously been treated for anxiety and hyperthyroidism. There was no history of acne or hirsutism, and, until eight months before presentation, her periods had been regular. Her body mass index (BMI) was 18 compared with 19.8 the previous year.  
bmj.com
over 7 years ago
Static.www.bmj
1
7

Interpreting raised serum prolactin results

A 29 year old woman working in a solicitor’s office presented with secondary amenorrhoea and was found to have a serum prolactin concentration of 2940 mIU/L (upper reference limit <600) and thyroid stimulating hormone (TSH) concentration of 5.2 mIU/L (reference range 0.27-4.2 mIU/L). She had a history of depression and had previously been treated for anxiety and hyperthyroidism. There was no history of acne or hirsutism, and, until eight months before presentation, her periods had been regular. Her body mass index (BMI) was 18 compared with 19.8 the previous year.  
bmj.com
over 7 years ago
Static.www.bmj
1
14

Interpreting raised serum prolactin results

A 29 year old woman working in a solicitor’s office presented with secondary amenorrhoea and was found to have a serum prolactin concentration of 2940 mIU/L (upper reference limit <600) and thyroid stimulating hormone (TSH) concentration of 5.2 mIU/L (reference range 0.27-4.2 mIU/L). She had a history of depression and had previously been treated for anxiety and hyperthyroidism. There was no history of acne or hirsutism, and, until eight months before presentation, her periods had been regular. Her body mass index (BMI) was 18 compared with 19.8 the previous year.  
bmj.com
over 7 years ago
Static.www.bmj
1
6

Interpreting raised serum prolactin results

A 29 year old woman working in a solicitor’s office presented with secondary amenorrhoea and was found to have a serum prolactin concentration of 2940 mIU/L (upper reference limit <600) and thyroid stimulating hormone (TSH) concentration of 5.2 mIU/L (reference range 0.27-4.2 mIU/L). She had a history of depression and had previously been treated for anxiety and hyperthyroidism. There was no history of acne or hirsutism, and, until eight months before presentation, her periods had been regular. Her body mass index (BMI) was 18 compared with 19.8 the previous year.  
bmj.com
over 7 years ago
Static.www.bmj
2
15

Interpreting raised serum prolactin results

A 29 year old woman working in a solicitor’s office presented with secondary amenorrhoea and was found to have a serum prolactin concentration of 2940 mIU/L (upper reference limit <600) and thyroid stimulating hormone (TSH) concentration of 5.2 mIU/L (reference range 0.27-4.2 mIU/L). She had a history of depression and had previously been treated for anxiety and hyperthyroidism. There was no history of acne or hirsutism, and, until eight months before presentation, her periods had been regular. Her body mass index (BMI) was 18 compared with 19.8 the previous year.  
bmj.com
over 7 years ago
Preview
0
10

Untangling Brain Circuits in Mental Illness

Funded through President Obama's Brain Initiative, a UCSF-led team is embarking on a $26 million project to develop a revolutionary and long-lasting treatment for depression, anxiety disorders, addiction and other neuropsychiatric disorders.  
ucsf.edu
over 7 years ago
Preview
1
12

Biological basis of depression

Visit us (http://www.khanacademy.org/science/healthcare-and-medicine) for health and medicine content or (http://www.khanacademy.org/test-prep/mcat) for MCAT...  
YouTube
about 7 years ago
Preview
1
9

Anxiety and depression twice as prevalent in military - study says - BBC News

Members of the UK armed forces are twice as likely to develop anxiety or depression than those in the general working population, a study suggests.  
BBC News
almost 7 years ago
Static.www.bmj
1
24

Opioids for low back pain

Back pain affects most adults, causes disability for some, and is a common reason for seeking healthcare. In the United States, opioid prescription for low back pain has increased, and opioids are now the most commonly prescribed drug class. More than half of regular opioid users report back pain. Rates of opioid prescribing in the US and Canada are two to three times higher than in most European countries. The analgesic efficacy of opioids for acute back pain is inferred from evidence in other acute pain conditions. Opioids do not seem to expedite return to work in injured workers or improve functional outcomes of acute back pain in primary care. For chronic back pain, systematic reviews find scant evidence of efficacy. Randomized controlled trials have high dropout rates, brief duration (four months or less), and highly selected patients. Opioids seem to have short term analgesic efficacy for chronic back pain, but benefits for function are less clear. The magnitude of pain relief across chronic non-cancer pain conditions is about 30%. Given the brevity of randomized controlled trials, the long term effectiveness and safety of opioids are unknown. Loss of long term efficacy could result from drug tolerance and emergence of hyperalgesia. Complications of opioid use include addiction and overdose related mortality, which have risen in parallel with prescription rates. Common short term side effects are constipation, nausea, sedation, and increased risk of falls and fractures. Longer term side effects may include depression and sexual dysfunction. Screening for high risk patients, treatment agreements, and urine testing have not reduced overall rates of opioid prescribing, misuse, or overdose. Newer strategies for reducing risks include more selective prescription of opioids and lower doses; use of prescription monitoring programs; avoidance of co-prescription with sedative hypnotics; and reformulations that make drugs more difficult to snort, smoke, or inject.  
bmj.com
almost 7 years ago
Preview
1
43

Initial management of Parkinson’s disease

Parkinson’s disease is one of the most common neurodegenerative disorders seen in the United States and United Kingdom. The disease is characterised by two processes—cellular degeneration and the resulting biochemical deficiency of dopamine. Although these processes are inter-related, they are approached separately in the clinical setting. Currently, no proven neuroprotective or disease modifying treatment is available for Parkinson’s disease. Several agents can be used to treat the motor symptoms associated with dopamine deficiency, and it is important to choose wisely when starting treatment. Drugs can have mild, moderate, or high potency, and the patient’s goals, comorbidities, and the short and long term implications of choosing a specific agent should be taken into account when selecting the appropriate agent. Non-motor symptoms, such as depression, fatigue, and disorders of sleep and wakefulness, also need to be evaluated and treated. Research is under way to deliver dopaminergic therapy more effectively, but studies aimed at slowing or stopping disease progression have not shown promise.  
bmj.com
almost 7 years ago
Www.bmj
1
33

Assessment and management of behavioral and psychological symptoms of dementia

Behavioral and psychological symptoms of dementia include agitation, depression, apathy, repetitive questioning, psychosis, aggression, sleep problems, wandering, and a variety of inappropriate behaviors. One or more of these symptoms will affect nearly all people with dementia over the course of their illness. These symptoms are among the most complex, stressful, and costly aspects of care, and they lead to a myriad of poor patient health outcomes, healthcare problems, and income loss for family care givers. The causes include neurobiologically related disease factors; unmet needs; care giver factors; environmental triggers; and interactions of individual, care giver, and environmental factors. The complexity of these symptoms means that there is no “one size fits all solution,” and approaches tailored to the patient and the care giver are needed. Non-pharmacologic approaches should be used first line, although several exceptions are discussed. Non-pharmacologic approaches with the strongest evidence base involve family care giver interventions. Regarding pharmacologic treatments, antipsychotics have the strongest evidence base, although the risk to benefit ratio is a concern. An approach to integrating non-pharmacologic and pharmacologic treatments is described. Finally, the paradigm shift needed to fully institute tailored treatments for people and families dealing with these symptoms in the community is discussed.  
bmj.com
over 6 years ago
Www.bmj
1
3

Integrated primary care for patients with mental and physical multimorbidity: cluster randomised controlled trial of collaborative care for patients with depression comorbid with diabetes or cardiovascular disease

Objective To test the effectiveness of an integrated collaborative care model for people with depression and long term physical conditions.  
bmj.com
over 6 years ago
Static.www.bmj
1
44

Opioids for low back pain

Back pain affects most adults, causes disability for some, and is a common reason for seeking healthcare. In the United States, opioid prescription for low back pain has increased, and opioids are now the most commonly prescribed drug class. More than half of regular opioid users report back pain. Rates of opioid prescribing in the US and Canada are two to three times higher than in most European countries. The analgesic efficacy of opioids for acute back pain is inferred from evidence in other acute pain conditions. Opioids do not seem to expedite return to work in injured workers or improve functional outcomes of acute back pain in primary care. For chronic back pain, systematic reviews find scant evidence of efficacy. Randomized controlled trials have high dropout rates, brief duration (four months or less), and highly selected patients. Opioids seem to have short term analgesic efficacy for chronic back pain, but benefits for function are less clear. The magnitude of pain relief across chronic non-cancer pain conditions is about 30%. Given the brevity of randomized controlled trials, the long term effectiveness and safety of opioids are unknown. Loss of long term efficacy could result from drug tolerance and emergence of hyperalgesia. Complications of opioid use include addiction and overdose related mortality, which have risen in parallel with prescription rates. Common short term side effects are constipation, nausea, sedation, and increased risk of falls and fractures. Longer term side effects may include depression and sexual dysfunction. Screening for high risk patients, treatment agreements, and urine testing have not reduced overall rates of opioid prescribing, misuse, or overdose. Newer strategies for reducing risks include more selective prescription of opioids and lower doses; use of prescription monitoring programs; avoidance of co-prescription with sedative hypnotics; and reformulations that make drugs more difficult to snort, smoke, or inject.  
bmj.com
over 6 years ago
Www.bmj
1
2

Diagnosis and management of depression in children and young people: summary of updated NICE guidance

There is little clear evidence to favour one psychological therapy over another for the treatment of depression in children and young people. Clinicians should discuss this uncertainty when recommending treatments  
bmj.com
over 6 years ago
Www.bmj
1
48

Adjunctive treatment with quetiapine for major depressive disorder: are the benefits of treatment worth the risks?

Quetiapine was approved in 2009 and 2010 for the adjunctive treatment of major depressive disorder (MDD) in several countries worldwide, including the European Union, Canada, the United States, and Australia. These approvals followed three industry sponsored trials of quetiapine versus placebo added to an antidepressant for depression in adults who had an inadequate response to at least six weeks of antidepressant treatment. All three trials showed statistically significant improvements in symptoms of depression compared with placebo.1  
bmj.com
over 6 years ago
Www.bmj
1
17

Antidepressant use and risk of suicide and attempted suicide or self harm in people aged 20 to 64: cohort study using a primary care database

Objective To assess the associations between different antidepressant treatments and the rates of suicide and attempted suicide or self harm in people with depression.  
bmj.com
over 6 years ago
11
0
7

Is adolescent depression seen in chimpanzees?

Is it true that adolescent depression is also seen in chimpanzees? Does that originate from chimpanzees?  
sampath kumar
over 8 years ago