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This July 2009 report considers different populations in need of care coordination, summarizes current evidence of effectiveness, describes the various entities that can serve as focal points for coordinating care, and details the possible financing and payment options that can support these approaches.

By Niloofar Afari, PhD and Dedra Buchwald, MD.

Vitamin D, nervous system and aging.\nP. Tuohimaa, T. Keisala, A. Minasyan, J. Cachat and A. Kalueff. .\nPsychoneuroendocrinology, Volume 34, Supplement 1, December 2009, Pages S278-S286\n NEUROACTIVE STEROIDS: EFFECTS and MECHANISMS ofACTION\n \n\nReview of vitamin D3, its active metabolites, and their functioning in the central nervous system (CNS), especially in relation to nervous system pathologies and aging. The vitamin D3 endocrine system consists of 3 active calcipherol hormones: calcidiol (25OHD3), 1α-calcitriol (1α,25(OH)2D3) and 24-calcitriol (24,25(OH)2D3). The impact of the calcipherol hormone system on aging, health and disease is discussed. Low serum calcidiol concentrations are associated with an increased risk of several chronic diseases including osteoporosis, cancer, diabetes, autoimmune disorders, hypertension, atherosclerosis, and muscle weakness ~ all of which can be considered aging-related diseases. The relationship of many of these diseases and aging-related changes in physiology show a U-shaped response curve to serum calcidiol concentrations. Clinical data suggest that vitamin D3 insufficiency is associated with an increased risk of several CNS diseases, including multiple sclerosis, Alzheimers, Parkinsons, seasonal affective disorder (SAD), and schizophrenia. In line with this, recent animal and human studies suggest that vitamin D insufficiency is associated with abnormal development and functioning of the CNS. * Overall, imbalances in the calcipherol system appear to cause abnormal function, including premature aging, of the CNS. *

Rescue workers and volunteers who helped in the aftermath of the Twin Towers attack are suffering chronic medical conditions.

Recent insights on chronic heart failure, cachexia and nutrition. Miján-de-la-Torre A.

"There are very few large, well-designed human studies testing the health effects of DHEA supplements. For example, there is not enough scientific evidence to rate the effectiveness of DHEA supplements in treating adrenal insufficiency, metabolic syndrome, depression, HIV/AIDS, Addison's disease, chronic fatigue syndrome, menopausal symptoms, heart disease, breast cancer, infertility, diabetes, or Parkinson's disease according to the National Institutes of Health (NIH). In addition, there isn't enough evidence to support the use of DHEA supplements as an anti-aging remedy or weight-loss aid. The NIH also cautions that DHEA supplements appear to be ineffective for boosting libido, enhancing muscle strength in elderly people, protecting against Alzheimer's disease and improving thinking in healthy older people."

Diosmin is a naturally occurring flavonoid glycoside that can be isolated from various plant sources or derived from the flavonoid hesperidin. # Diosmin is considered to be a vascular-protecting agent used to treat chronic venous insufficiency, hemorrhoids, lymphedema, and varicose veins. As a flavonoid, diosmin also exhibits anti-inflammatory, free-radical scavenging, and antimutagenic properties.

New findings in rodents and human brain shed light on the mechanisms of major depressive disorder (MDD), uncovering over-expression of MKP-1 (mitogen-activated protein kinase [MAPK] phosphatase-1)...and identifying a new therapeutic target. MKP-1, also known as dual-specificity phosphatase-1 (DUSP1), is a member of a family of proteins that dephosphorylate both threonine and tyrosine residues and thereby serves as a key negative regulator of the MAPK cascade4, a major signaling pathway involved in neuronal plasticity, function and survival This study identifies MKP-1 as a key factor in MDD pathophysiology, and as a new target for therapeutic interventions.f Here we use whole-genome expression profiling of postmortem tissue and show significantly increased expression of mitogen-activated protein kinase (MAPK) phosphatase-1 (MKP-1, encoded by DUSP1, but hereafter called MKP-1) in the hippocampal subfields of subjects with MDD compared to matched controls. MKP-1, also known as dual-specificity phosphatase-1 (DUSP1), is a member of a family of proteins that dephosphorylate both threonine and tyrosine residues and thereby serves as a key negative regulator of the MAPK cascade4, a major signaling pathway involved in neuronal plasticity, function and survival. We tested the role of altered MKP-1 expression in rat and mouse models of depression and found that increased hippocampal MKP-1 expression, as a result of stress or viral-mediated gene transfer, causes depressive behaviors. Conversely, chronic antidepressant treatment normalizes stress-induced MKP-1 expression and behavior, and mice lacking MKP-1 are resilient to stress. These postmortem and preclinical studies identify MKP-1 as a key factor in MDD pathophysiology and as a new target for therapeutic interventions.

Understanding High Value Care and Reducing Unwarranted Variation in Health Care Delivery: A Collaborative Project of the Mayo Clinic, Intermountain Health Care and The Center for the Evaluative Clinical Sciences

Conservatively speaking, there are thousands of people with chronic illnesses who have educated themselves about their conditions via the internet. They quickly managed to become more familiar with their diseases than the physicians who treat them.