Search Results for "depression"

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Review: In patients with depressive disorders, EPA-predominant omega-3 HUFAs improve depression symptoms

Source Citation Hallahan B, Ryan T, Hibbeln JR, et al. Efficacy of omega-3 highly unsaturated fatty acids in the treatment of depression. Br J Psychiatry. 2016 Apr 21. [Epub ahead of print] 27103682

Review: Omega-3 HUFAs added to antidepressant therapy may reduce depression symptoms

Source Citation Sarris J, Murphy J, Mischoulon D, et al. Adjunctive nutraceuticals for depression: a systematic review and meta-analyses. Am J Psychiatry. 2016;173:575-87. 27113121

Review: In acute depression, interpersonal psychotherapy is more effective than control but not other therapies

Source Citation Cuijpers P, Donker T, Weissman MM, Ravitz P, Cristea IA. Interpersonal psychotherapy for mental health problems: A comprehensive meta-analysis. Am J Psychiatry. 2016;173:680-7. 27032627

In older adults with treatment-resistant depression, adding aripiprazole to venlafaxine increased remission at 12 wk

Source Citation Lenze EJ, Mulsant BH, Blumberger DM, et al. Efficacy, safety, and tolerability of augmentation pharmacotherapy with aripiprazole for treatment-resistant depression in late life: a randomised, double-blind, placebo-controlled trial. Lancet. 2015;Sep 24. [Epub ahead of print.] 26423182

An intervention to treat depression and increase social support did not prolong event-free survival in coronary heart disease | ACP Journal Club

Source Citation ENRICHD Investigators. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA. 2003;289:3106-16. 12813116

In patients with dementia and depression, several nondrug interventions vs. usual care reduce depression symptoms

Source Citation Watt JA, Goodarzi Z, Veroniki AA, et al. Comparative efficacy of interventions for reducing symptoms of depression in people with dementia: systematic review and network meta-analysis. BMJ. 2021;372:n532. 33762262

In older adults with subclinical hypothyroidism, levothyroxine therapy did not reduce depressive symptoms at 12 mo

Source Citation Wildisen L, Feller M, Del Giovane C, et al. Effect of levothyroxine therapy on the development of depressive symptoms in older adults with subclinical hypothyroidism: an ancillary study of a randomized clinical trial. JAMA Netw Open. 2021;4:e2036645. 33566107

Review: In older adults with acute major depression, SNRIs, but not SSRIs, increase adverse events vs placebo

Source Citation Sobieraj DM, Martinez BK, Hernandez AV, et al. Adverse effects of pharmacologic treatments of major depression in older adults. J Am Geriatr Soc. 2019;67:1571-81. 31140587

In treatment-resistant depression, adding esketamine nasal spray to an oral antidepressant improved symptoms at 28 days

Source Citation Popova V, Daly EJ, Trivedi M, et al. Efficacy and safety of flexibly dosed esketamine nasal spray combined with a newly initiated oral antidepressant in treatment-resistant depression: a randomized double-blind active-controlled study. Am J Psychiatry. 2019;176:428-38. 31109201

Adding mirtazapine to ongoing SNRIs or SSRIs did not improve symptoms of treatment-resistant depression

Source Citation Kessler DS, MacNeill SJ, Tallon D, et al. Mirtazapine added to SSRIs or SNRIs for treatment resistant depression in primary care: phase III randomised placebo controlled trial (MIR). BMJ. 2018;363:k4218. 30381374

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Displaying 51 - 60 of 75 in Annals of Internal Medicine: Clinical Cases

Recurrent Diarrhea Induced by Immune Checkpoint Inhibitor Therapy: Importance of Endoscopic Evaluation to Identify Causes Other Than Acute Immune-Related Colitis | Annals of Internal Medicine: Clinical Cases

Immune checkpoint inhibitors have revolutionized cancer therapy. Immune-related adverse events affect multiple organ systems, most commonly the gastrointestinal tract. Early recognition and management are essential to prevent morbidity and mortality. We report a patient with diarrhea initially managed as immune-related colitis. Recrudescent symptoms prompted further endoscopic work-up demonstrating celiac disease and microscopic colitis. We encourage clinicians to have high clinical suspicion for causes other than immune-related colitis for patients presenting with diarrhea in the setting of immunotherapy. We propose early involvement of the gastroenterology service for endoscopic evaluation and biopsy for appropriate diagnosis and management.

Exploring Azathioprine as a Trigger for Lymphomatoid Granulomatosis | Annals of Internal Medicine: Clinical Cases

Lymphomatoid granulomatosis is a rare Epstein–Barr virus–associated B-cell lymphoproliferative disorder. The disease commonly manifests with respiratory symptoms, often leading to the discovery of bilateral pulmonary nodules on imaging. We present a 77-year-old woman with a history of Sjögren syndrome who was receiving azathioprine, was found to have bilateral pulmonary nodules initially concerning for metastatic disease, and who was later diagnosed with lymphomatoid granulomatosis. Azathioprine was discontinued, and the patient was observed without receiving chemotherapy. Subsequent scans revealed a decrease in disease burden. Awareness of this rare but serious side effect is important for all clinicians managing patients who are receiving long-term immunosuppressive therapy.

Unveiling the Link: Exploring the Association Between Cancer and Leukocyte Chemotactic Factor 2 (ALECT2) Amyloidosis | Annals of Internal Medicine: Clinical Cases

We present a case of a 53-year-old Hispanic man with mantle cell lymphoma who developed progressive decline in estimated glomerular filtration rate despite no previous kidney disease or predisposing conditions. Findings of a renal biopsy revealed leukocyte chemotactic factor 2 (ALECT2) amyloidosis. Remarkably, after treatment of his lymphoma, the patient's estimated glomerular filtration rate normalized. Given the correlation between the patient's cancer and the improvement in kidney function after treatment, we hypothesize that his lymphoma may have acted as a trigger for ALECT2 amyloidosis through 1 or more potential mechanisms, including dysregulated Wnt/β-catenin signaling, tumor-related inflammatory pathways, or a second hit on an underlying genetic predisposition.

Acute Severe Enteritis by HSV-1 Variant in a Young Patient Who is Immunocompetent | Annals of Internal Medicine: Clinical Cases

We present a unique case of a 26-year-old man who is immunocompetent with severe abdominal pain and diarrhea, diagnosed with acute severe enteritis caused by a herpes simplex virus type 1 (HSV-1) variant, with intestinal inflammatory changes observed through computed tomography imaging, necessitating an empirical antibiotic. Biopsies from the esophagus and terminal ileum confirmed the presence of HSV-1, with immunostaining highlighting viral inclusion bodies. Notably, the genomic characterization of the HSV-1 variant was elucidated through next-generation sequencing analysis of mucosal biopsy samples from the gastrointestinal tract. The findings contribute to understanding atypical presentations of HSV-1 infection in patients who are immunocompetent and the role of advanced molecular techniques in HSV tropism.

Paraneoplastic Leukemoid Reaction in High-Grade Lung Adenocarcinoma Complicated by Triple Co-Mutations | Annals of Internal Medicine: Clinical Cases

Paraneoplastic leukemoid reaction occurs secondary to cytokine-secreting tumors or cancers with high tumor burden. We report a case of extreme leukocytosis in a 58-year-old man presenting with a clavicular mass. Biopsy revealed a high-grade, non–small cell carcinoma of unknown origin, and genetic studies identified a lung adenocarcinoma with triple mutations in STK11, KRAS, and TP53 along with programmed death-ligand 1 positivity. Leukocytosis persisted despite treatment, so the diagnosis of paraneoplastic leukemoid reaction was made. Treatment of underlying malignancy is imperative in management, but this case was complicated by tumor mutations that rendered the most optimal treatments less effective.

Succinate Dehydrogenase–Deficient Paraganglioma of the Prostate | Annals of Internal Medicine: Clinical Cases

Paragangliomas emerging in unusual locations may represent a diagnostic pitfall. We report clinical, genetic, imaging, and histopathologic features of succinate dehydrogenase–deficient paraganglioma arising within the prostate gland. This patient had multiple and recurrent paragangliomas since the age of 18 years. During the course of surveillance for a pathogenic germline SDHB variant, he developed 2 separate foci of disease in the prostate and retroperitoneum. Both lesions were gallium 68 DOTATATE positron emission tomography–avid and proved to be separate paragangliomas histologically. We emphasize that the prostate represents a site for paragangliomas, particularly in genetically predisposed patients who develop enlargement of the gland with normal prostatic-specific antigen.

Disseminated Bartonella quintana Causing Osseous Lytic Lesions | Annals of Internal Medicine: Clinical Cases

Bartonella, a gram-negative bacterium, causes various clinical syndromes such as cat scratch disease (B henselae), Carrion disease (B bacilliformis), and trench fever (B quintana). Given the pathogenicity, it is imperative to understand the diverse manifestations of each disease for early diagnosis and treatment. In the literature, B henselae has been described to cause lytic bone lesions, especially in children. However, it is rare for B quintana to cause bony lesions, especially in adults. We describe a case of disseminated B quintana in a male patient with AIDS who presented with bacillary angiomatosis, hepatic peliosis, and innumerable lytic lesions.

Spontaneous Resolution of Myocardial Inflammation in Cardiac Sarcoidosis: A Case Report | Annals of Internal Medicine: Clinical Cases

Sarcoidosis is a multisystem disease characterized by granulomatous inflammation of virtually any organ or tissue. Atrioventricular block, arrhythmias, cardiomyopathies, and sudden cardiac death are known manifestations of cardiac sarcoidosis (CS), and, thus, diagnosis of CS is considered an absolute indication to initiate treatment of sarcoidosis with disease-modifying anti-inflammatory immunosuppressives. To our knowledge, spontaneous resolution of CS has not been documented. Here, we report what we believe is the first documented case of spontaneous-resolution CS-related myocardial inflammation without corticosteroid or other immunosuppressive therapy for nearly 5 years following initial presentation.

Rifampin-Associated Renal Failure | Annals of Internal Medicine: Clinical Cases

Rifampin is an effective and widely used for the treatment of both active and latent tuberculosis. Although significant side effects are rare, severe side effects such as acute renal failure have been reported in the literature, usually secondary to acute interstitial nephritis. We report a case of rifampin-induced acute renal failure due to heme pigment–related injury in a patient who was receiving daily rifampin as therapy for latent tuberculosis. The patient case illustrates considering rifampin as a potential cause of acute renal failure when no other cause is identified.

Recurrent Plaque Erosion in a Young Patient | Annals of Internal Medicine: Clinical Cases

Plaque erosion is one of the important mechanisms of acute coronary syndromes. We report the first case of recurrent plaque erosion in a different vessel 9 years after the initial episode.

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