Gene/Protein Disease Symptom Drug Enzyme Compound
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 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Palpitations are a common problem seen in family medicine; most are of cardiac origin, although an underlying psychiatric disorder, such as anxiety, is also common. Even if a psychiatric comorbidity does exist, it should not be assumed that palpitations are of a noncardiac etiology. Discerning cardiac from noncardiac causes is important given the potential risk of sudden death in those with an underlying cardiac etiology. History and physical examination followed by targeted diagnostic testing are necessary to distinguish a cardiac cause from other causes of palpitations. Standard 12-lead electrocardiography is an essential initial diagnostic test. Cardiac imaging is recommended if history, physical examination, or electrocardiography suggests structural heart disease. An intermittent event (loop) monitor is preferred for documenting cardiac arrhythmias, particularly when they occur infrequently. Ventricular and atrial premature contractions are common cardiac causes of palpitations; prognostic significance is dictated by the extent of underlying structural heart disease. Atrial fibrillation is the most common arrhythmia resulting in hospitalization; such patients are at increased risk of stroke. Patients with supraventricular tachycardia, long QT syndrome, ventricular tachycardia, or palpitations associated with syncope should be referred to a cardiologist.
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PMID:Outpatient approach to palpitations. 2176 57

Mental illnesses account for a larger proportion of disability in developed countries than any other group of illnesses, including cancer and heart disease. In 2004, an estimated 25% of adults in the United States reported having a mental illness in the previous year. The economic cost of mental illness in the United States is substantial, approximately $300 billion in 2002. Population surveys and surveys of health-care use measure the occurrence of mental illness, associated risk behaviors (e.g., alcohol and drug abuse) and chronic conditions, and use of mental health-related care and clinical services. Population-based surveys and surveillance systems provide much of the evidence needed to guide effective mental health promotion, mental illness prevention, and treatment programs. This report summarizes data from selected CDC surveillance systems that measure the prevalence and impact of mental illness in the U.S. adult population. CDC surveillance systems provide several types of mental health information: estimates of the prevalence of diagnosed mental illness from self-report or recorded diagnosis, estimates of the prevalence of symptoms associated with mental illness, and estimates of the impact of mental illness on health and well-being. Data from the CDC 2005-2008 National Health and Nutrition Examination Survey indicate that 6.8% of adults had moderate to severe depression in the 2 weeks before completing the survey. State-specific data from the CDC 2006 Behavioral Risk Factor Surveillance System (BRFSS), the most recent BRFSS data available, indicate that the prevalence of moderate to severe depression was generally higher in southeastern states compared with other states. Two other CDC surveys on ambulatory care services, the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, indicate that during 2007-2008, approximately 5% of ambulatory care visits involved patients with a diagnosis of a mental health disorder, and most of these were classified as depression, psychoses, or anxiety disorders. Future surveillance should pay particular attention to changes in the prevalence of depression both nationwide and at the state and county levels. In addition, national and state-level mental illness surveillance should measure a wider range of psychiatric conditions and should include anxiety disorders. Many mental illnesses can be managed successfully, and increasing access to and use of mental health treatment services could substantially reduce the associated morbidity.
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PMID:Mental illness surveillance among adults in the United States. 2188 50

The medical community continues to acknowledge a connection between depression and physical health, for example, cardiac disease. This study addresses public awareness about depression's effects on physical health, the relationship between cardiac disease and depression, and preferred sources of health information, in an effort to inform future health education programs. A survey, administered to 816 adults ages 40-69, focused on public awareness, perception of depression as an illness, its impact on other illnesses such as heart disease, and sources of health information. (1) Eighty-three percent (83%) of respondents felt depression was an illness; (2) a slightly higher percentage (85.8%) felt a mental disorder, like depression, could affect the course of a physical illness; (3) respondents' awareness of links between depression and cardiac disease ranged from 29.8% (awareness of depression as a risk factor for coronary artery disease) to 31.6% (awareness that depression can increase the risk of having a second heart attack); (4) print media were the most frequently cited sources of health information (22.7%); and (5) more highly educated respondents were more informed about depression than respondents with less education. Although a majority of respondents (1) recognized depression as an illness (2) thought it could complicate recovery from a physical illness, less than a third of them were aware of links between cardiac disease and depression. Demographic groups differed in their preferred sources of health information, especially across educational levels, demonstrating a need for targeted health educational outreach in efforts to reach a variety of populations.
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PMID:Public awareness about the connection between depression and physical health: specifically heart disease. 2205 71

To facilitate the development of a therapeutic alliance in genetic counseling, it is important that the counselor understands how families might perceive the condition that constitutes the reason for the referral. Through training and professional practice, genetic counselors develop a thorough understanding of families' perceptions of the conditions that are common indications for genetic counseling. But, for referral indications that are less frequent, like serious mental illnesses, genetic counselors may feel less confident in their understanding of the family's experience, or in their ability to provide psychosocial support when serious mental illness is reported in a family history. This may impede the establishment of a therapeutic alliance. As research shows that most referrals for genetic counseling related to serious mental illness are for female first-degree family members of affected individuals, we sought to explore how this group perceives serious mental illness. To provide a frame of reference with which genetic counselors may be more familiar, we explored how women perceived serious mental illness compared to other common complex disorders in their family. We conducted semi-structured interviews with women who had a child with a serious mental illness (schizophrenia, schizoaffective disorder, bipolar disorder) and a first-degree relative with another common complex disorder (diabetes, heart disease, cancer). Interviews were transcribed and subjected to thematic analysis. Saturation was reached when nine women had participated. Serious mental illness was perceived as being more severe and as having a greater impact on the family than diabetes, heart disease, or cancer. Themes identified included guilt, stigma, and loss. Some of the most important issues that contribute to mothers' perceptions that serious mental illness is more severe than other common complex disorders could be effectively addressed in genetic counseling. Developing a heightened awareness of how family members experience a relative's mental illness may help genetic counselors to be better able to provide psychosocial support to this group, whether serious mental illness constitutes the primary reason for referral or appears in the family history during counseling for a different referral reason.
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PMID:Mothers' perspectives on their child's mental illness as compared to other complex disorders in their family: insights to inform genetic counseling practice. 2208 36

Life expectancy in members of the general population has steadily improved in most countries since 1960. However, during the same period, the life expectancy of people with serious mental illness (SMI) has actually reduced. The majority of premature deaths result from natural causes, such as coronary heart disease. Obesity, a key risk factor for heart disease in this client group, might be caused both by unhealthy lifestyle behaviours and the side-effects of antipsychotic medication. Mental health nurses (MHN) nurses have an important role to play in improving the physical health of people with SMI. Evidence, however, suggests that they are often ambivalent about this role, and might perceive themselves as being inadequately trained and lacking in confidence. In this paper, we will argue that MHN need to re-evaluate their practice and recognize that the provision of physical health care is as important as other roles they occupy in relation to the care of people with SMI. We will also consider examples of best practice in physical health care, and discuss how these might be adopted by MHN and other professionals, in order to begin to improve services and to reduce health inequalities in this client group.
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PMID:Evolving role of mental health nurses in the physical health care of people with serious mental health illness. 2253 34

F Scott Fitzgerald spent the 1930s writing about illness themes while he struggled with tuberculosis, insomnia, alcoholism, heart disease and the mental illness of his wife Zelda. During this decade, Fitzgerald published six stories that prominently feature hospitals and healthcare professionals. These stories, the 'doctor-nurse stories', along with nine additional published stories that touch upon medical themes have not previously been investigated as a thematic grouping. This paper explores the 1930s stories in the context of Fitzgerald's life and career in order to highlight his significant yet previously undervalued contribution to the canon of illness literature and his work's relevance to the field of literature and medicine.
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PMID:A lost decade: exploring F Scott Fitzgerald's contribution to the illness canon through the doctor-nurse series and other healthcare stories of the 1930s. 2262 6

Psychotropic drugs can produce cardiovascular side effects associated with a degree of cardiotoxicity. The coexistence of a heart disease complicates the management of mental illness, can contribute to a reduced quality of life and a worse illness course. The co-occurrence of psychiatric disorders in cardiac patients might affect the clinical outcome and morbidity. Moreover, the complex underlying mechanism that links these two conditions remains unclear. This paper discusses the known cardiovascular complications of psychotropic drugs and analyzes the important implications of antidepressive treatment in patients with previous cardiac history.
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PMID:Cardiologic side effects of psychotropic drugs. 2278 11

Rapid urbanisation in the 20th century has been accompanied by the development of slums. Nearly one-third of the world's population and more than 60% of urban populations in the least developed countries live in slums, including hundreds of millions of children. Slums are areas of broad social and health disadvantage to children and their families due to extreme poverty, overcrowding, poor water and sanitation, substandard housing, limited access to basic health and education services, and other hardships (eg, high unemployment, violence). Despite the magnitude of this problem, very little is known about the potential impact of slum life on the health of children and adolescents. Statistics that show improved mortality and health outcomes in cities are based on aggregated data and may miss important intraurban disparities. Limited but consistent evidence suggests higher infant and under-five years mortality for children residing in slums compared with non-slum areas. Children suffer from higher rates of diarrhoeal and respiratory illness, malnutrition and have lower vaccination rates. Mothers residing in slums are more poorly educated and less likely to receive antenatal care and skilled birth assistance. Adolescents have earlier sexual debut and higher rates of HIV, and adopt risky behaviours influenced by their social environment. We also know little about the consequences of this form of early childhood on long-term health-related behaviour (eg, diet and exercise) and non-communicable disease outcomes, such as obesity, heart disease and mental illness. Further attention to understanding and addressing child health in slum settings is an important priority for paediatricians and those committed to child health worldwide.
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PMID:Children's health in slum settings. 2389 20

In this paper, we estimate a copula-based bivariate dynamic hurdle model of prescription drug and nondrug expenditures to test the cost-offset hypothesis, which posits that increased expenditures on prescription drugs are offset by reductions in other nondrug expenditures. We apply the proposed methodology to data from the Medical Expenditure Panel Survey, which have the following features: (i) the observed bivariate outcomes are a mixture of zeros and continuously measured positives; (ii) both the zero and positive outcomes show state dependence and inter-temporal interdependence; and (iii) the zeros and the positives display contemporaneous association. The point mass at zero is accommodated using a hurdle or a two-part approach. The copula-based approach to generating joint distributions is appealing because the contemporaneous association involves asymmetric dependence. The paper studies samples categorized by four health conditions: arthritis, diabetes, heart disease, and mental illness. There is evidence of greater than dollar-for-dollar cost-offsets of expenditures on prescribed drugs for relatively low levels of spending on drugs and less than dollar-for-dollar cost-offsets at higher levels of drug expenditures.
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PMID:Cost-offsets of prescription drug expenditures: data analysis via a copula-based bivariate dynamic hurdle model. 2395 47

Chronic non-communicable diseases such as heart disease, cancer and diabetes are the biggest killers worldwide. Chronic conditions include heart disease, stroke, diabetes, cancer, chronic respiratory disease and are often comorbid with mental illness. Over 60 years ago, the British Medical Journal reported an association between mental illness and poor physical health (Philips, 1934). Comorbid mental illness and physical illness incrementally worsens health compared with mental illness alone or any of the chronic non-communicable diseases such as cardiovascular diseases, cancers, chronic respiratory diseases and diabetes alone. This paper aims to open the dialogue related to optimising, through nursing intervention, a patient's self-righting and self-management factors in the context of comorbid chronic conditions such as heart disease, stroke, diabetes, cancer, chronic respiratory disease, with mental illness. Self-management and self-righting capabilities are now being considered integral to reducing the negative impact of chronic conditions such as mental illness. Personal characteristics associated with resilience comprise optimism, an active or adaptable coping style and the ability to elicit social support. Existing resilience factors can be assessed for by nurses and optimised through interventions when patients with chronic conditions are in care. Representing over 70% of the global health workforce, nurses are well positioned to enact such practice enhancements to facilitate better outcomes for patients.
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PMID:Chronic illness and wellbeing: using nursing practice to foster resillence as resistance. 2426 Oct 88


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