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 86 in Annals of Internal Medicine: Clinical Cases

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.

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.

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.

Cholecystalgia: An Atypical Presentation of Congestive Heart Failure in a New Diagnosis of Alcohol-Induced Cardiomyopathy | Annals of Internal Medicine: Clinical Cases

Right upper quadrant (RUQ) pain is a frequent presenting symptom in the emergency department, and gallstone-induced acute cholecystitis is one of the main causes; in addition, RUQ pain can be a consequence of several other conditions. Although rare, it may also indicate cholecystalgia from gallbladder edema, which is usually related to other conditions, such as congestive heart failure (CHF), alcoholic and nonalcoholic liver cirrhosis, acute viral or drug-induced hepatitis, renal failure, and hypoproteinemia. We present a case of cholecystalgia resulting from gallbladder edema in a patient with a newly diagnosed alcohol-induced cardiomyopathy without the common CHF signs and symptoms.

Therapeutic Management of Symptomatic Calcification in a Patient With Normophosphatemic Tumoral Calcinosis | Annals of Internal Medicine: Clinical Cases

Tumoral calcinosis is a rare autosomal recessive disorder marked by lobulated soft tissue calcifications not associated with physiologic osteogenesis but rather phosphate metabolism dysregulation. Management of this rare condition involves symptomatic medical management to slow progression of disability from growth of calcifications. Controversially, surgical management in acute presentations has been implemented with varying results. We report a case of a 31-year-old African American man with known history of tumoral calcinosis who presented complaining of acute pain/inflammation of his right ankle. Medical management alone was found to be inadequate, requiring calcification partial resection, of which this patient benefitted from without recurrence.

What and Where Else: Hypervirulent Klebsiella pneumoniae With Pyogenic Liver Abscess and Disseminated Multifocal Osteomyelitis | Annals of Internal Medicine: Clinical Cases

Hypervirulent Klebsiella pneumoniae (hvKp), a pathotype of Klebsiella pneumoniae presents many clinical challenges. hvKp often causes disseminated, invasive disease in immunocompetent hosts. It is primarily associated with pyogenic liver abscesses, but also causes osteomyelitis, necrotizing fasciitis, endophthalmitis, and meningitis. The diagnosis of hvKp is largely clinical because many laboratories lack the ability to test for the associated biomarkers. To emphasize the need to assess for disseminated invasive infection in such patients, we present a patient with hvKp who had bacteremic and tibial osteomyelitis, but also pyogenic liver abscess and multifocal osteomyelitis with a pathologic fracture.

ACTH-Dependent Cushing Syndrome in Metastatic Acinic Cell Carcinoma: A Poor Prognostic Factor | Annals of Internal Medicine: Clinical Cases

Acinic cell carcinoma (ACC) with high-grade transformation is an aggressive subtype of salivary gland neoplasm. Only a few cases of adrenocorticotropic hormone (ACTH) production in metastatic ACC have been documented. We present a patient case of ACTH-dependent Cushing syndrome (CS) that developed 18 months after surgical resection of ACC. The original tissue sample was found to stain positive for ACTH, and the development of CS coincided with aggressive progression of ACC. Our case highlights the potential significance of ACTH staining in ACC and the development of CS as a signal of dedifferentiation, disease progression, and a poorer prognosis.

When Community-Acquired Pneumonia Guidelines Provide Misguided Guidance | Annals of Internal Medicine: Clinical Cases

Limited diagnostic testing and empirical antimicrobial therapy are recommended in practice guidelines for adults with community-acquired pneumonia (CAP). Although following CAP guidelines is cost-effective with high cure rates, consideration should be given to the possibility that CAP is caused by pathogens not effectively treated by the recommended antibiotic regimens. Expanding the differential diagnosis based on potential pathogen exposures and comorbid conditions can prevent delays in diagnosis and appropriate treatment. As an example, mucormycosis should be considered in a patient presenting with pneumonia in the setting of diabetic ketoacidosis.

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