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https://www.readbyqxmd.com/read/28214073/older-adults-with-ptsd-brief-state-of-research-and-evidence-based-psychotherapy-case-illustration
#1
Joan M Cook, Elissa McCarthy, Steven R Thorp
Although lifetime exposure to potentially traumatic events among older adults is fairly high, rates of full-blown post-traumatic stress disorder (PTSD) are estimated at about 4.5%, a rate lower than that for middle-aged and young adults. Nevertheless, PTSD seems to be an under-recognized and under-treated condition in older adults. Assessment and treatment can be challenging in this population for various reasons, including potential cognitive or sensory decline and comorbid mental and physical disorders. This article provides highlights of the empirical research on PTSD in late life, including information on its effects on cognition and physical health...
January 4, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#2
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28212912/pulmonary-embolism-in-the-postanesthesia-care-unit-a-case-study
#3
Debbie Smith, Jackie Murauski
Pulmonary embolism (PE) is a complication that can occur at any time during the perioperative period. The patient undergoing surgery to repair a hip fracture is at a high risk of developing a PE due to venous thrombosis, tissue, or fat emboli. The signs and symptoms of a PE are often nonspecific and can be obscured in the patient receiving or recovering from general anesthesia. This case study describes the presentation, diagnosis, and treatment of a patient experiencing a pulmonary embolism in the postanesthesia care unit (PACU) after surgery to repair a hip fracture...
February 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28208203/acute-pulmonary-embolism-after-discharge-duration-of-therapy-and-follow-up-testing
#4
Cecilia Becattini, Laura Franco, Giancarlo Agnelli
Pulmonary embolism (PE) is a frequent cause of death and serious disability with a risk extending far beyond the acute phase of the disease. Anticoagulant treatment reduces the risk for death and recurrent VTE after a first PE. The optimal duration of anticoagulation after a first episode of PE remains controversial and should be made on an individual basis, balancing the estimated risk for recurrence without anticoagulant treatment against bleeding risk under anticoagulation. Current recommendations on duration of anticoagulation are based on a 3% per year risk of major bleeding expected during long-term warfarin treatment...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208201/catheter-based-approaches-for-the-treatment-of-acute-pulmonary-embolism
#5
Victor F Tapson, David Jimenez
Except when contraindicated, anticoagulation should be initiated when pulmonary embolism (PE) is strongly suspected and the bleeding risk is perceived to be low, even if the evaluation has not been completed. Low-risk patients with acute PE are simply continued on anticoagulation. Severely ill patients with high-risk (massive) PE require aggressive therapy, and if the bleeding risk is acceptable, systemic thrombolysis should be considered. However, despite clear evidence that parenteral thrombolytic therapy leads to more rapid clot resolution than anticoagulation alone, the risk of major bleeding including intracranial bleeding is significantly higher with thrombolytic therapy...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208199/systemic-thrombolytic-therapy-for-acute-pulmonary-embolism-who-is-a-candidate
#6
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of both acute and long-term morbidity for a large number of patients worldwide, and massive PE is frequently fatal. Right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of PE. Patients with clinically overt RV failure, that is, with cardiogenic shock or persistent hypotension at presentation (acute high-risk PE), are clearly in need of immediate reperfusion treatment with systemic thrombolysis or, alternatively, surgical or catheter-directed techniques...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208198/the-pulmonary-embolism-response-team-what-is-the-ideal-model
#7
Josanna Rodriguez-Lopez, Richard Channick
Treatment of patients with intermediate- and high-risk pulmonary embolism (PE) is a controversial area. Many therapeutic options exist, and deciding on appropriate treatment can be difficult. In addition, multiple specialties are often involved in the care of PE patients. To better organize the response to serious PE patients, several hospitals and academic centers across the United States, spearheaded by Massachusetts General Hospital, have created pulmonary embolism response teams (PERTs). The goal of a PERT is to have a single multidisciplinary team of experts in thromboembolic disease, who can respond rapidly to patients with acute PE, and offer consultation with the full spectrum of therapeutic options...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208194/risk-stratification-for-proven-acute-pulmonary-embolism-what-information-is-needed
#8
Deisy Barrios, Roger D Yusen, David Jiménez
Classification of risk drives treatment decisions for patients with acute symptomatic pulmonary embolism (PE). High-risk patients with acute symptomatic PE have hemodynamic instability (i.e., shock or hypotension present), and treatment guidelines suggest systemically administered thrombolytic therapy in this setting. Normotensive PE patients at low risk for early complications (low-risk PE) might benefit from treatment at home or early discharge, while normotensive patients with preserved systemic arterial pressure deemed as having a high risk for PE-related adverse clinical events (intermediate-high-risk PE) might benefit from close observation and consideration of escalation of therapy...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28206731/thrombus-resolution-and-right-ventricular-functional-recovery-using-ultrasound-accelerated-thrombolysis-in-acute-massive-and-submassive-pulmonary-embolism
#9
Evren Ozcinar, Mehmet Cakici, Nur Dikmen Yaman, Cagdas Baran, Anar Aliyev, Bahadir Inan, Serkan Durdu, Ahmet R Akar, Mustafa Sirlak
BACKGROUND: This study aims to evaluate the efficacy and safety of ultrasound-accelerated catheter- directed thrombolysis (UACDT) in the treatment of massive and submassive pulmonary embolism (PE). METHODS: We conducted a prospective, observational cohort study of consequtive patients with massive or submassive PE treated with low-dose UACDT using EKOS EkoSonic® system at single center from May 2014 until April 2015. Overall, thirty-eight patients (median age, 64...
February 15, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28199429/-emotional-processing-theory-and-prolonged-exposure-therapy-for-posttraumatic-stress-disorder
#10
Rafael Kichic, Noelí D'Alessio
Prolonged exposure therapy is a first-line treatment for posttraumatic stress disorder. In this article we discuss the theoretical underpinnings and underlying mechanisms of PE, its efficacy and safety. We briefly describe the procedures involved in PE with special emphasis in imaginal exposure. Also, we present examples of efforts to integrate evidence-based treatments that concurrently target PTSD and borderline personality disorder. Next, we review efforts made to adapt the intervention to Hispanics. Finally, obstacles for disseminating and implementing PE are discussed...
March 2016: Vertex: Revista Argentina de Psiquiatriá
https://www.readbyqxmd.com/read/28197219/factors-determining-altered-perfusion-after-acute-pulmonary-embolism-assessed-by-quantified-single-photon-emission-computed-tomography-perfusion-scan
#11
Marc Meysman, Hendrik Everaert, Walter Vincken
AIM OF THE STUDY: The aim of the study was to analyze the evolution of perfusion (Q)-defects in patients treated for acute pulmonary embolism (PE), correlation with baseline parameters and evaluation of recurrence risk. METHODS: This is a single-center prospective observational cohort study in symptomatic normotensive PE. Comparison of the ventilation/perfusion single-photon emission computed tomography (V/Q-SPECT) acquired at baseline with a quantified SPECT (Q-SPECT) repeated at 1 week and 6 months...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28195640/subcutaneous-unfractionated-heparin-for-the-initial-treatment-of-venous-thromboembolism
#12
REVIEW
Lindsay Robertson, James Strachan
BACKGROUND: Venous thromboembolism (VTE) is a prevalent and serious condition. Its medical treatment requires anticoagulation, usually with either unfractionated or low molecular weight heparin (LMWH). Administration of unfractionated heparin (UFH) is usually intravenous (IV) but can be subcutaneous as well. This is an update of a review first published in 2009. OBJECTIVES: To assess the effects of subcutaneous UFH versus intravenous UFH, subcutaneous LMWH or any other anticoagulant drug for the initial treatment of venous thromboembolism...
February 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28193193/observation-management-of-pulmonary-embolism-and-agreement-with-claims-based-and-clinical-risk-stratification-criteria-in-united-states-patients-a-retrospective-analysis
#13
Elaine Nguyen, Craig I Coleman, W Frank Peacock, Philip S Wells, Erin R Weeda, Veronica Ashton, Concetta Crivera, Peter Wildgoose, Jeff R Schein, Thomas J Bunz, Gregory J Fermann
BACKGROUND: Guidelines suggest observation stays are appropriate for pulmonary embolism (PE) patients at low-risk for early mortality. We sought to assess agreement between United States (US) observation management of PE and claims-based and clinical risk stratification criteria. METHODS: Using US Premier data from 11/2012 to 3/2015, we identified adult observation stay patients with a primary diagnosis of PE, ≥1 PE diagnostic test claim and evidence of PE treatment...
February 13, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28187753/survival-of-people-living-with-hiv-who-defaulted-from-tuberculosis-treatment-in-a-cohort-recife-brazil
#14
R Cunha, M Maruza, U R Montarroyos, I Coimbra, D de B Miranda-Filho, M de F Albuquerque, H R Lacerda, Raa Ximenes
BACKGROUND: Tuberculosis is a serious public health problem worldwide. It is the leading cause of death amongst people living with HIV, and default from tuberculosis (TB) treatment in people living with HIV increases the probability of death. The aim of this study was to estimate the survival probability of people living with HIV who default treatment for TB compared to those who complete the treatment. METHODS: This was a longitudinal cohort study of people living with HIV, from June 2007 to December 2013 with two components: a retrospective (for those who started tuberculosis treatment before 2013 for whom failure (death) or censoring occurred before 2013), and prospective (those who started tuberculosis treatment at any time between 2007 and June 2013 and for whom death or censoring occurred after the beginning of 2013), at two referral hospitals for people living with HIV (Correia Picanço Hospital - HCP and at Hospital Universitário Oswaldo Cruz - HUOC), in Recife/PE...
February 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28183533/chronic-embolic-pulmonary-hypertension-caused-by-pulmonary-embolism-and-vascular-endothelial-growth-factor-inhibition
#15
Evandro M Neto-Neves, Mary Beth Brown, Maria V Zaretskaia, Samin Rezania, Adam G Goodwill, Brian P McCarthy, Scott A Persohn, Paul R Territo, Jeffrey A Kline
Our understanding of the pathophysiological basis of chronic thromboembolic pulmonary hypertension (CTEPH) will be accelerated by an animal model that replicates the phenotype of human CTEPH. Sprague-Dawley rats were administered a combination of a single dose each of plastic microspheres and vascular endothelial growth factor receptor antagonist in polystyrene microspheres (PE) + tyrosine kinase inhibitor SU5416 (SU) group. Shams received volume-matched saline; PE and SU groups received only microspheres or SU5416, respectively...
February 6, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28182456/the-impact-of-service-connected-disability-and-therapist-experience-on-outcomes-from-prolonged-exposure-therapy-with-veterans
#16
Jason T Goodson, Amy W Helstrom, Emily J Marino, Rachel V Smith
OBJECTIVE: Although prolonged exposure therapy (PE) has been shown to be effective in treating posttraumatic stress disorder (PTSD), a sizable minority do not benefit. Examining patient and therapist characteristics that impact treatment outcome may improve treatment delivery and identify individuals who are less likely to respond to treatment or are at risk to prematurely discontinue treatment. The current study uses a sample from a large urban Veterans' Affairs (VA) hospital to build on a previous report that identified correlates of treatment outcome for Veterans who received PE...
February 9, 2017: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/28168009/antioxidants-of-phyllanthus-emblica-l-bark-extract-provide-hepatoprotection-against-ethanol-induced-hepatic-damage-a-comparison-with-silymarin
#17
Renuka Chaphalkar, Kishori G Apte, Yogesh Talekar, Shreesh Kumar Ojha, Mukesh Nandave
Phyllanthus emblica L. (amla) has been used in Ayurveda as a potent rasayan for treatment of hepatic disorders. Most of the pharmacological studies, however, are largely focused on PE fruit, while the rest of the parts of PE, particularly, bark, remain underinvestigated. Therefore, we aimed to investigate the protective effect of the hydroalcoholic extract of Phyllanthus emblica bark (PEE) in ethanol-induced hepatotoxicity model in rats. Total phenolic, flavonoid, and tannin content and in vitro antioxidant activities were determined by using H2O2 scavenging and ABTS decolorization assays...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28167510/preclinical-development-of-a-non-toxic-oral-formulation-of-monoethanolamine-a-lipid-precursor-for-prostate-cancer-treatment
#18
Roopali Saxena, Chunhua Yang, Mukkavilli Rao, Ravi Chakra C Turaga, Chakravarthy Garlapati, Sushma Reddy Gundala, Kimberly Myers, Ahmed Ghareeb, Shristi Bhattarai, Golnaz Kamilinia, Sangina Bristi, Dan Su, Giovanni Gadda, Padmashree Cg Rida, Guilherme Cantuaria, Ritu Aneja
PURPOSE: Most currently-available chemotherapeutic agents target rampant cell division in cancer cells, thereby affecting rapidly-dividing normal cells resulting in toxic side-effects. This non-specificity necessitates identification of novel cellular pathways that are reprogrammed selectively in cancer cells and can be exploited to develop pharmacologically superior and less-toxic therapeutics. Despite growing awareness on dysregulation of lipid metabolism in cancer cells, targeting lipid biosynthesis is still largely uncharted territory...
February 6, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28166600/prognostic-scores-for-acute-pulmonary-embolism
#19
Raquel Morillo, Lisa Moores, David Jiménez
Rapid and accurate risk stratification is critical in determining the optimal treatment strategy for patients with acute pulmonary embolism (PE). Early identification of patients with normal blood pressure and a favorable prognosis (low-risk PE) might select a subset of patients for outpatient treatment, which is associated with reduced cost and improved patient satisfaction, and has been shown to be effective and safe. Alternatively, identification of normotensive patients deemed as having a high risk for PE-related adverse clinical events (intermediate-high-risk PE) might select a subset of patients for close observation and consideration of escalation of therapy...
February 6, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28165268/using-the-research-domain-criteria-framework-to-track-domains-of-change-in-comorbid-ptsd-and-sud
#20
Laura Zambrano-Vazquez, Hannah C Levy, Emily L Belleau, Emily R Dworkin, Katianne M Howard Sharp, Samantha L Pittenger, Julie A Schumacher, Scott F Coffey
OBJECTIVES: Comorbidity in diagnosis raises critical challenges for psychological assessment and treatment. The Research Domain Criteria (RDoC) Project, launched by the National Institutes of Mental Health, proposes domains of functioning as a way to conceptualize the overlap between comorbid conditions and inform treatment selection. However, further research is needed to understand common comorbidities (e.g., posttraumatic stress disorder [PTSD] and substance use disorder [SUD]) from an RDoC framework and how existing evidence-based treatments would be expected to promote change in the RDoC domains of functioning...
February 6, 2017: Psychological Trauma: Theory, Research, Practice and Policy
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