bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression Medication Treatment Adherence in Later Life
Authors: Zivin Kara , Kavanagh Janet , Maixner Susan , Sirey Jo Anne , Kales Helen C. 
Published: May 2013

Abstract
While depression in older adults has been detected, diagnosed, and treated more frequently in recent years, substantial gaps in effective treatment remain. Improving adherence to depression treatment can be viewed as the “next frontier” in the treatment of late-life depression. In this chapter, we conceptualize and review the current evidence for key patient-level factors associated with depression treatment adherence among older adults. Factors are categorized according to whether their potential for impact on adherence might be influenced by specialized treatment approaches or interventions, as: 1) modifiable; 2) potentially modifiable; and 3) non-modifiable. A number of these factors are illustrated by a real-world clinical case. Finally, we discuss developing effective interventions to improve adherence to depression treatment in older adults.
Depression in Long-Term Care
Authors: Hui Christina , Sultzer David L. 
Published: May 2013

AbstractDepression is common in long-term care settings, particularly among the nursing home population. The nursing home is a unique venue in which to provide psychiatric care. The characteristics of the LTC population, the psychosocial environment, and federal legislation are all factors that influence delivery and subsequent outcomes of mental health services in the nursing home. This chapter reviews the epidemiology, assessment, and treatment of depression in the context of the nursing home. The role of the mental health consultant and the changing nature of LTC are also discussed.
Late-Life Depression in the Primary Care Setting
Authors: Wittink Marsha , Duberstein Paul , Lyness Jeffrey M. 
Published: May 2013

AbstractThe primary care setting is critical for recognizing and addressing a wide range of depression symptoms in late-life. However, multiple factors discourage older adults and their primary care physicians from taking a proactive role in addressing depression. In this chapter, we explain the limitations of a biomedical approach to depression care, which emphasizes particular treatments but ignores fundamental behaviors, namely communication and decision-making, that are vital to patient-centered treatment outcomes. We introduce an alternative approach to patient-centered mental health care that leverages recent developments in communication and decision-making and is consistent with the legitimization of patients as decision makers with expertise in their own circumstances.
Molecular Imaging in Late-Life Depression
Authors: Kumar Anand , Ajilore Olusola , Forester Brent , Deseda Jaime , Woodward Matthew , Rhodes Emma 
Published: May 2013

Abstract
“Molecular imaging” elucidates discrete biological processes, including levels of cerebral proteins, measures of axonal and myelin integrity and biochemical pathways. Positron Emission Tomography (PET) has been used to demonstrate an abnormal deposition of neuritic plaques and the presence of neurofibrillar tangles in Alzheimer’s disease. Recent PET studies have shown similar pathophysiology in geriatric depression. Diffusion Tensor Imaging (DTI) has been used to detect microstructural brain changes in white matter. These findings have been associated with disease severity, treatment response/resistance and cognitive impairment in late-life depression. Magnetic Resonance Spectroscopy (MRS) can be used to quantify the regional or global concentrations of cerebral proton and phosphorus biochemical markers. This methodology may yield insight into facets of neuropsychiatric disorders including neurotransmission, bioenergetic metabolism and cell membrane integrity. This chapter serves as an introduction to these neuroimaging techniques and their application in studying geriatric neuropsychiatric illnesses.
Cognitive Biomarkers in Depression
Authors: Robinson Oliver J. , Sahakian Barbara J. 
Published: May 2013

Abstract
This chapter provides an overview of the altered cognitive performance in depression and discusses how measuring this impairment using neurocognitive tasks can reveal cognitive biomarkers. The difference between state biomarkers (which may aid in the treatment of disorders) and trait biomarkers (which may detect risk for disorders prior to their onset) is discussed, and the distinct effects of late-life depression on biomarkers are examined. The putative underlying causes of the biomarkers are then examined via functional imaging, models in healthy individuals, and genetic studies. The effects of treatment on biomarkers are discussed before concluding by emphasizing the possibility of using cognitive biomarkers to promote resilience in younger people and hence prevent the onset of late-life depression.
Pharmacogenetics of Late-Life Depression
Authors: Murphy Greer M. 
Published: May 2013

Abstract
There have been relatively few studies on pharmacogenetic predictors of antidepressant response in the elderly. The focus has been primarily on either pharmacokinetic markers such as CYP2D6 polymorphisms that affect drug levels, or pharmacodynamic markers such as serotonin receptor and transporter polymorphisms that influence drug interactions with neurons. So far, nothing of demonstrated clinical value has emerged from these investigations of antidepressant pharmacogenetics in late-life depression. Psychiatric pharmacogenetics is handicapped by small sample sizes, lack of replication studies, and problems in study design. Many of these difficulties are shared with the broader pharmacogenetics field as a whole. However, with further research the potential exists to identify genetic markers that could guide prescribing of antidepressants specifically in the elderly population.
The Hpa Axis and Late-Life Depression
Authors: Sudheimer Keith , Flournoy John , Gershon Anda , Demuth Bevin , Schatzberg Alan , O’Hara Ruth 
Published: May 2013

AbstractHPA dysregulation may be an important mechanism underlying the pathophysiology of depression. The involvement of HPA impairment is all the more complex in late life depression due to a) age-associated changes in HPA function; b) the significant number of medical comorbidities experienced by older adults; and c) increased variability with age in terms of exposure and response to environmental stressors. In this chapter we describe the HPA axis and the effects of aging on this system, addressing associations between HPA functioning, depression, and aging. Finally we discuss potential mediators and moderators that could underlie interactions between HPA axis function, aging and depression, including genetic markers, stress, and medical comorbidities.
Clinical Prediction Models
Authors: Wesley K. Thompson Ji-in Choi, , Anderson Stewart 
Published: May 2013

Abstract
Clinical trials of mood disorders in late-life frequently use time to the occurrence of an event as the primary study outcome. In recent years it has become common to collect additional variables repeatedly over multiple time points, augmenting the primary time-to-event outcome, including variables related to physical health and functioning, biological correlates of illness, contextual variables such as negative life events, and cognitive impairments. In this chapter we describe “joint models,” which incorporate these longitudinal data to predict future time-to-event outcomes. These predictive models can be useful in a clinical setting where interest centers on using a set of patient characteristics, obtained over multiple time points, to obtain a prognosis regarding onset of mental illness. Joint models also allow for updatable individualized prediction of clinical outcomes as more data become available on a given patient over time.
Integration of Biological, Clinical, and Psychosocial Predictors of Treatment Response Variability in Late-Life Depression
Authors: Garand Linda , Whyte Ellen M. , Butters Meryl A. , Skidmore Elizabeth R. , Karp Jordan F. , Dew Mary Amanda 
Published: May 2013

Abstract
Progress has been made in delineating factors that contribute to treatment response variability in late life depression, yet large gaps remain in the literature. Much of the scientific effort to date has focused on understanding factors’ individual rather than combined effects. Within studies of individual effects, the emphasis has been on the impact of biological and clinical factors on the magnitude and speed of late-life treatment response. Less attention has been given to the role of intrapersonal and environmental factors in treatment outcomes. Although durability of response has less often been the focus of research than magnitude and speed of initial response, the same pattern of emphasis on biological and clinical factors appears, with considerably less information on intrapersonal and environmental influences on patient outcomes.
Genetic Techniques and Their Application to Bipolar Disorder
Authors: Vederman Aaron C. , McInnis Melvin G. 
Published: May 2013

AbstractThe last decade has witnessed a dramatic increase in the advancement and use of genetic technique to investigate the potential causes and treatment targets for a variety of medical conditions. Bipolar disorder is strongly familial, with very high heritability rates, making it an ideal candidate for genetic investigations. This chapter discusses some of the recent advances in these techniques and provides examples of use in bipolar disorder to provide context for additional genetics discussions in this book. In particular, this chapter outlines how these techniques let away from single genes as comprehensive risks for bipolar disorder to broader models that consider additive effects of small risks from multiple genetic variants. The chapter also examines epigenetic approaches to studying bipolar illness and how these approaches might complement standard genetic techniques. Other more specialized approaches including functional genetics and pharmacogenetics are considered. The chapter ends by integrating these discussions into consideration of a systems biology approach to complex conditions like bipolar disorder.
General Genetics of Bipolar Disorder
Authors: Nurnberger John I. 
Published: May 2013

AbstractBipolar disorder runs in families and is strongly heritable,. Twin and adoption studies suggest that the phenomenology of bipolar disorder is under strong genetic control, although there are clearly environmental factors as well. The population rates of mood disorders are increasing, particularly in familieswith a history of mood disorder, consistent with a genetic-environmental interaction. Genetic liability for mood disorders may exist across a spectrum of phenotypes (e.g., Bipolar I Disorder, Bipolar II Disorder, Major Depression), which makes isolating specific genetic factors for any single phenotype more challenging. Nonetheless, various genetic approaches, including linkage studies, candidate gene association studies, epigenetic and gene expression studies, high-risk studies, and genome-wide association studies have identified a growing list of gene variants that may contribute to the risk of developing bipolar disorder. In this chapter, we review these findings and summarize current knowledge regarding the genetics of bipolar illness.
Integrating Imaging and Genetic Research
Authors: Perlis Roy H. , Blumberg Hilary P. 
Published: May 2013

AbstractNeuroimaging studies demonstrate a convergence of findings in showing abnormalities in a corticolimbic system including the ventral prefrontal and anterior cingulate cortices and amygdala, their limbic, striatothalamic and cerebellar connections sites, and in the structure and function of the connections. Genetic association studies likewise have begun to implicate common variation in genes that may moderate development, plasticity and functioning of the corticolimbic system. This chapter reviews combined imaging and genetics studies of bipolar disorder that hold promise for further elucidating the molecular mechanisms that contribute to the brain changes of bipolar disorder. In addition to considering their direct implications for understanding the pathophysiology of this illness, the chapter addresses how such studies may inform future investigations by establishing more homogeneous patient populations. Finally, it takes an even broader perspective and considers the point at which such integrated studies may be directly applied to guide clinical practice and personalized treatment.
Decisions in Persistent Vegetative State
Authors: Wijdicks Eelco F. M , Rabinstein Alejandro A 
Published: May 2013

Abstract
Early on the diagnosis of a persistent vegetative state and its important long-term implications remains tentative at best. Long-term care of debilitated neurologic patients requires placement of a tracheostomy and percuteous gastrostomy. Timing and indications are discussed in this chapter.
Applied Anatomy of the Heart and Great Vessels
Authors: Wright R. Scott 
Published: May 2013

Abstract
An understanding of the anatomy of the heart and great vessels is vital to the practice of cardiology. This chapter covers the following components of cardiac anatomy: mediastinum, pericardium, the great vessels (aorta, pulmonary artery, superior and inferior venae cavae), cardiac chambers (atria, ventricles), valves, leaflets, coronary circulation, and the cardiac conduction system. Enlargement of a cardiac chamber or great vessel may displace or compress an adjacent noncardiac structure. Congenital heart diseases related to anatomy are also reviewed.
Noncardiac Surgery in Patients With Heart Disease
Authors: Askew III J. Wells , Shub Clarence 
Published: May 2013

Abstract
The guidelines for the perioperative evaluation and management of patients undergoing noncardiac surgery focus on patients undergoing noncardiac surgery who are at risk of perioperative cardiac morbidity or mortality. This at-risk group includes patients with known CAD, patients with recent signs or symptoms suggestive of CAD, and asymptomatic patients older than 50 years who have the potential for coronary artery atherosclerosis. In general, a conservative approach is recommended. Expensive, noninvasive or invasive preoperative testing (eg, coronary angiography and revascularization) is rarely warranted just “to get the patient through an operation.” Rather, the indications for extensive perioperative testing or revascularization are generally similar to those in a nonoperative setting, and its use should be limited to clinical scenarios in which the results will specifically influence patient management.
Positron Emission Tomography
Authors: Chareonthaitawee Panithaya 
Published: May 2013

Abstract
Positron emission tomography (PET) has emerged as a valuable clinical tool for the management of known or suspected coronary artery disease. Several factors have contributed to its increased use: greater availability of PET scanners, FDA approval for clinical cardiac application, reimbursement by the Centers for Medicare and Medicaid Services, and greater access to the tracers needed. With increased use of cardiac PET imaging, evidence for its clinical usefulness is rapidly expanding and demonstrating high diagnostic accuracy and incremental prognostic value. Several inherent characteristics of PET contribute to its high spatial, temporal, and contrast resolution: coincidence detection, built-in attenuation correction, and high-energy tracers. Risks, contraindications and clinical applications are reviewed.
Cardiac Radiography
Authors: Breen Jerome F. , Callahan Mark J. , Lloyd Margaret A. 
Published: May 2013

Abstract
Chest radiographs that show cardiac abnormality are a very important part of cardiology examinations. The image of the heart and great vessels on the chest radiograph is a 2-dimensional display of dynamic 3-dimensional structures. The cardiovascular silhouette varies not only with the abnormality but also with body habitus, age, respiratory depth, cardiac cycle, and position of the patient. Cardiac radiography can be used to assess chamber size, blood flow, pericardial disease, and cardiac masses. Radiography in the setting of implanted cardicac devices is also reviewed.
Stress Test Selection
Authors: Allison Thomas G. 
Published: May 2013

Abstract
Cardiac stress testing is an integral part of clinical cardiology. This chapter focuses on the relative advantages and limitations of each technique to ensure that the appropriate test is performed on the appropriate patient. This chapter addresses stress testing from the standpoint of making a diagnosis or establishing prognosis in patients with suspected or known CAD. Exercise ECG testing can ultimately provide adequate detection of CAD and risk stratification in the majority of patients. In those who require further assessment with imaging, the choice of stress imaging technique requires careful consideration of the individual patient characteristics. In many cases, either stress echocardiography or myocardial perfusion imaging may be appropriate; the preferred test often depends on local expertise, available facilities, and considerations of cost-effectiveness.
Indications for Invasive and Noninvasive Electrophysiologic Testing
Authors: Boilson Barry A. , Brady Peter A. 
Published: May 2013

Abstract
Electrophysiologic testing can be used with the following goals: accurate diagnosis of an arrhythmia and its mechanisms; establishment of the etiologic factors of syncope; determination of prognosis in the clinical setting of arrhythmia; risk stratification for sudden cardiac death; acquisition of data regarding indications for ICD or pacemaker implantation; and guidance of antiarrhythmic therapy with drugs, ablation, or surgery. The maneuvers performed during an EP study vary depending on the indication. The decision to proceed with invasive EP testing should include consideration of risks to the patient versus potential yield, and informed consent is essential.
Arrhythmias in Congenital Heart Disease
Authors: Mcleod Christopher J. , Brady Peter A. 
Published: May 2013

Abstract
The number of persons with congenital heart disease who survive into adulthood has increased dramatically in the past few decades. In this population, arrhythmias are a major cause of late morbidity and mortality and may herald worsening underlying hemodynamic changes and associated poorer outcomes. In addition, the risk of sudden cardiac death is high, especially in certain repaired malformations. Device (pacing and defibrillator) therapy is often complicated and may require thoracotomy for epicardial lead placement. Common types of congenital heart disease, including atrial septal defects, ventricular septal defects, tetralogy of Fallot, and Ebstein anomaly, are reviewed.
Implantable Cardioverter-Defibrillator Troubleshooting
Authors: Boilson Barry A. 
Published: May 2013

Abstract
This chapter reviews common problems that present on ICD interrogation which are likely to be encountered in clinical practice. Since their adoption over 20 years ago, ICDs are now commonplace, and the ability to understand basic ICD interrogation and troubleshooting is an essential requirement in most general cardiology practices. The evolution of ICD technology has resulted in increasing complexity of arrhythmia-recognition algorithms used by modern ICD microprocessors, but the basic principles have not changed in that an ICD can still be considered a sophisticated pacemaker device which has a limited capacity to analyze and treat ventricular tachyarrhythmia.
Autonomic Function Testing
Authors: Venkatachalam K. L. 
Published: May 2013

Abstract
Syncope may be defined as a transient loss of consciousness due to a temporary limitation in cerebral blood flow. Causes of syncope include the following: low systemic blood pressure, reduced cerebral blood flow, and miscellaneous causes of cerebral dysfunction (metabolic, endocrine, and electrolyte abnormalities). The autonomic nervous system may have a role in syncopal and near-syncopal episodes. The focus of this chapter is autonomic function assessment related to cardiology and, specifically, to the evaluation of a patient referred for syncope.
Surgery for Cardiac Valve Disease
Authors: Suri Rakesh M. , Orszulak Thomas A. 
Published: May 2013

Abstract
The decision to perform an operation for valvular disease is complex and requires a meld of multidisciplinary expertise and considerable diagnostic effort. However, the history and physical examination are as important as everything else for making diagnostic and therapeutic decisions. The indications for operation are based on historical events in cardiac surgery, natural history studies, and current published studies. This chapter discusses the approach to correcting valvular heart disease and illustrates a major concept: Repair of any valve is always preferable to replacement if it can be done safely and durably.
Peripheral Vascular Disease
Authors: Spittell Peter C. 
Published: May 2013

Abstract
Different types of peripheral vascular disease, including claudication, pseudoclaudication, acute arterial occlusion, aneurysms, thromboangiitis obliterans, livedo reticularis, chronic pernio, and erythromelalgia are reviewed in this chapter. Causes, pathophysiology, clinical presentation, evaluation, natural history, and treatment of peripheral vascular disease are covered as well.
Renal Artery Disease
Authors: Mathew Verghese 
Published: May 2013

Abstract
Obstructive disease of the renal arteries can be categorized as either atherosclerosis (the majority of renal artery stenosis cases) or fibromuscular dysplasia. Atherosclerotic renal artery stenosis may result in hypertension or ischemic nephropathy (or both), and renal artery stenosis is the most commonly identified cause of secondary hypertension. Renal fibromuscular dysplasia occurs in younger patients, in females more than males, and often in secondary or distal branches. Renal artery revascularization for patients with renal fibromuscular dysplasia is often curative for hypertension control. Diagnostic testing methods are also reviewed.
Dyslipidemia
Authors: Murphy Joseph G. , Allison Thomas G. , Wright R. Scott 
Published: May 2013

Abstract
Abnormal cholesterol and lipoprotein metabolism, together with endothelial injury are the major progenitors of atherosclerosis, the leading cause of obstructive coronary artery and vascular diseases worldwide. Dyslipidemia in particular is considered an essential risk factor because atherosclerotic plaques are formed in large part from cholesterol. Low-density lipoprotein (LDL) is a heterogenous collection of lipoproteins and can be separated into subtypes of different size and density. However, not all LDL particles have the same atherosclerotic potential. High-density lipoprotein (HDL) in the blood exists in small, intermediate, and large-sized particles, designations which reflect their cholesterol content. A large body of epidemiological data certainly suggests an inverse relationship between HDL levels in populations and risk of coronary heart disease, and that this risk is independent of LDL cholesterol.
Chronic Stable Angina
Authors: Bishu Kalkidan G. , Brozovich Frank V. 
Published: May 2013

Abstract
Angina pectoris typically manifests as a retrosternal discomfort in the chest and adjacent areas and can vary from being “constricting,” “crushing,” or “squeezing” to mild and pressure-like, with an occasional associated numbing or burning sensation. Typical angina is usually characterized by a crescendo increase in the intensity of pain over minutes, neither lasting hours nor occurring in brief spurts of only a few seconds. It is often precipitated by exercise, exposure to cold, or carbohydrate-rich meals and relieved within minutes by rest or nitroglycerin (or both). Diagnostic testing, risk stratification and prognosis, and therapy options for chronic stable angina are reviewed in this chapter.