Cleveland Clinic journal of medicine
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We systematically searched published empirical research on depression and cardiovascular disease (CVD) and found 494 unique articles published in 2009. Several particularly notable and provocative findings and controversies emerged from this survey of the 2009 literature. ⋯ Finally, the vigorous debate on whether patients with CVD should be routinely screened (and subsequently treated) for depression continued in 2009 even as some observed that routine screening for CVD in depressed patients is more evidence-based and appropriate. This article reviews these selected provocative findings and controversies from our search and explores their clinical implications.
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Recovery of consciousness after severe brain injury involves reconstitution of brain arousal mechanisms and cerebral integrative function. This review discusses several aspects of neuroanatomy and neuropathology relevant to the process of recovery. Particular emphasis is placed on the role of the anterior forebrain and circuit mechanisms linking the frontal lobe, striatum, and central thalamus. The article concludes with some observations on the heart-brain interface and future research directions in the context of recovery from severe brain injury.
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When patients who have frequent, disabling migraines take medications to relieve their symptoms, they run the risk that the attacks will increase in frequency to daily or near-daily as a rebound effect comes into play. This pattern, called medication overuse headache, is more likely to happen with butalbital and opioids than with migraine-specific drugs, as partial responses lead to recurrence, repeat dosing, and, eventually, overuse. Breaking the cycle involves weaning the patient from the overused medications, setting up a preventive regimen, and setting strict limits on the use of medications to relieve acute symptoms.