Articles: treatment.
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Military sexual trauma (MST) has been associated with long-term negative outcomes such as increased rates of cardiovascular disease, post-traumatic stress disorder (PTSD), and suicidal thoughts and behaviors. While evidence supports the effectiveness of psychotherapeutic approaches as treatments for MST and related PTSD symptoms, these interventions have limited impact, attributed to perceived stigma with high dropout rates in female Veterans. Complementary and integrative health (CIH) interventions provide an alternative that may be more acceptable and can help transition Veterans into mental health treatments. Although evidence supports the utility of individual CIH interventions to be both effective and acceptable treatments for MST-related PTSD amongst female Veterans, there are limited evaluations of interventions that combine multiple CIH modalities, specifically in populations of at-risk female Veterans with histories of suicidal ideation or behavior. Thus, this quality improvement (QI) project aimed to assess the impact of a multimodal CIH intervention on mental and physical health symptoms specifically in female at-risk Veterans with MST. ⋯ The results of this QI evaluation add to the growing body of evidence demonstrating that CIH interventions can be effective in attenuating mental health symptom-related MST and particularly within female Veteran populations at-risk for suicide, underscoring the potential importance of investigating integration of multiple CIH interventions for treatment of at-risk populations in future clinical research studies.
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Pediatric emergency care · Dec 2024
Pediatric Emergency Medicine Physicians' Perspectives of Concussion in Young Children.
Traumatic brain injury (TBI) during early childhood (before 6 years) is prevalent, accounting for rising rates of emergency department visits. These injuries may lead to postconcussive symptoms, which may be subtle and difficult to diagnose in young children. Inadequate discharge counseling may lead to prolonged duration of symptoms and possible developmental delays. We aimed to explore pediatric emergency medicine (PEM) physicians' perspectives on "concussion" terminology, diagnosis, and management, specifically in a young child with mild TBI. ⋯ Variability exists among PEM physicians in diagnosis and management of concussions in young children. Discomfort with lack of reliability of symptoms and underappreciation of typical early childhood characteristics may account for findings. Educational initiatives, age-appropriate clinical tools and treatment-guided outcomes research are needed to guide PEM physicians in the care of young children with head injuries.
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6.2 million Americans live with heart failure (HF) and are at risk for hospitalization due to hypertensive emergencies. Optimal treatment strategy for acute hypertensive heart failure remains unclear. Our study investigates what treatment modality is most effective in achieving guideline-directed blood pressure control. ⋯ Acute hypertensive heart failure was managed adequately with any treatment modality. Use of IV bolus therapy in these patients was associated with shorter ICU length of stay. Our results add to growing evidence that hypertensive emergencies may be less clinically significant than previously thought.
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Case Reports
Hematopoietic cell transplantation for blood cancer patients living with HIV in Taiwan - A case series.
People living with HIV (PLWH) have an increased risk of developing cancers, especially hematologic malignancies (HM). Hematopoietic stem cell transplantation (HSCT) has been an important treatment modality for patients with HM. ⋯ In these PLWH patients, HSCT procedures, either autologous (auto-HSCT) or allogeneic (allo-HSCT), were feasible with acute toxicity profiles comparable to those in non-HIV patients. However, auto-HSCT seemed unable to lead toward durable remission in PLWH with relapsed/refractory lymphoma, implicating that allo-HSCT might warrant early considerations for consolidation purposes in this distinct patient group.
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To describe the delay in the diagnosis of breast cancer in primary care and to identify the patient, care process and disease variables involved in the delay to diagnosis and treatment. ⋯ Most are diagnosed in early stages at the health centre. The duration of the «health system interval» is shorter in preferential referrals, when the form of presentation is a breast lump, with risk factors and in advanced stages.