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Strategies for Treating Depression Associated With Chronic Pain Part 1: Psychotherapy

In last month's Pain Perspectives, I discussed the importance of assessing patients with chronic pain for depression – as it is extremely prevalent in this population and has been found to interfere with physical treatment. This month, we will begin to look at what the primary care physician can do to ensure that their patients with chronic pain have their depression addressed adequately.

Loving Littleton and the Glory of the Granite State

Does low on-treatment diastolic blood pressure influence prognosis in systolic hypertension patients?

From the Hypertension and Cardiovascular Rehabilitation Unit, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium.

Holiday Shopping Remedy: Buy Online

Rising Medical Costs, but No Solution in Sight

Nearly everyone agrees that the rising cost of healthcare is unsustainable and that the current efforts at healthcare reform will do little if anything to reduce healthcare expenditures. Although there seems to be no shortage of proposals on what should be done, there is little consensus on whether any of them will succeed.

Symptomatic carotid plaques and ischemic symptoms

We assessed the histologic features of 526 carotid plaques from consecutive patients undergoing endarterectomy for symptomatic carotid stenosis and found a high prevalence of coronary-type plaque instability, with strong correlations between macrophage infiltration and both cap rupture and time since stroke. Temporal trends were much weaker after a transient ischemic attack than after a stroke, with a tendency for plaque features to persist for a longer period, suggesting heterogeneity in the underlying pathological mechanisms.

Lipid-lowering therapy and atherosclerotic aortic plaques

We showed that a significant reduction in thoracic aortic plaques and low-density lipoprotein cholesterol levels occurred after 12 months of treatment with atorvastatin. In the abdominal aorta, however, the change in atherosclerotic plaques correlated with age. These results show that plaques in the thoracic and abdominal aortas may respond differently to lipid-lowering therapy, and other factors, such as aging, may be more important for plaque progression in the abdominal aorta.

A Generation of Debt, Part III: Mature Families and Empty Nesters

Overcoming the Hurdles to EHR Adoption

A survey conducted by the Institute for Health Policy between late 2007 and early 2008 found that only 4% of physicians are using a fully functional EHR.

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