Permanent Injury Beyond Medical Intervention: Disguising Death in U.S. Immigrant Detention

The WHO theme for the year 2017 is Depression. Depression (major depressive disorder) is a common and serious medical illness that negatively affects how a person feels, thinks and behaves. Psychotherapy if incorporated along with medications can be of substantial help in depression. It is also called ‘talking therapy’ and is based on personal interaction with the patient. Patients suffering from this disorder do not easily accept it and hence do not feel the need to seek medical intervention or counselling. In this process the symptoms might get aggravated and suicidal tendency (which is the worst effect of this disease) may develop. So it is extremely essential for the patient, family and society to accept, talk, discuss and seek treatment for this disease. This ‘talking therapy’ is of utmost importance in today’s life where concept of privacy is taking its toll. This therapy is mentioned in Ayurveda as Aashwasan Chikitsa. Aashwasan Chikitsa consists of good, pleasing and benevolent thoughts, spiritual ideas, positive attitude, ethics and communication with near ones. So in the treatment of psychological disorders, along with medications counselling therapy plays a very important role. Finally counselling can act as a part of preventive, curative therapy and also aids to avoid recurrence in the patients of depression.

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Validity of the Gender Dysphoria diagnosis and incidence trends in Sweden: a nationwide register study

Scientific Reports ◽

10.1038/s41598-021-95421-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Malin Indremo ◽

Richard White ◽

Thomas Frisell ◽

Sven Cnattingius ◽

Alkistis Skalkidou ◽

...

Keyword(s):

Gender Dysphoria ◽

Age Groups ◽

Medical Intervention ◽

Future Research ◽

Advantages And Disadvantages ◽

Incidence Trends ◽

Interaction Terms ◽

Definition Of ◽

The Individual ◽

Nationwide Register Study

AbstractThe aim of this study was to examine the validity of the Gender Dysphoria (GD) diagnoses in the Swedish National Patient Register (NPR), to discuss different register-based definitions of GD and to investigate incidence trends. We collected data on all individuals with registered GD diagnoses between 2001 and 2016 as well as data on the coverage in the NPR. We regarded gender confirming medical intervention (GCMI) as one proxy for a clinically valid diagnosis and calculated the positive predictive value (PPV) for receiving GCMI for increasing number of registered GD diagnoses. We assessed crude and coverage-adjusted time trends of GD during 2004–2015 with a Poisson regression, using assigned sex and age as interaction terms. The PPV for receiving GCMI was 68% for ≥ 1 and 79% for ≥ 4 GD-diagnoses. The incidence of GD was on average 35% higher with the definition of ≥ 1 compared to the definition of ≥ 4 diagnoses. The incidence of GD, defined as ≥ 4 diagnoses increased significantly during the study period and mostly in the age categories 10–17 and 18–30 years, even after adjusting for register coverage. We concluded that the validity of a single ICD code denoting clinical GD in the Swedish NPR can be questioned. For future research, we propose to carefully weight the advantages and disadvantages of different register-based definitions according to the individual study’s needs, the time periods involved and the age-groups under study.

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Placenta-Expanded Stromal Cell Therapy in a Rodent Model of Simulated Weightlessness

Cells ◽

10.3390/cells10040940 ◽

2021 ◽

Vol 10 (4) ◽

pp. 940

Author(s):

Linda Rubinstein ◽

Amber M. Paul ◽

Charles Houseman ◽

Metadel Abegaz ◽

Steffy Tabares Ruiz ◽

...

Keyword(s):

Health Risks ◽

Stromal Cells ◽

Therapeutic Potential ◽

Medical Intervention ◽

Hindlimb Unloading ◽

Simulated Weightlessness ◽

Potential Health ◽

Long Duration ◽

Induced Changes ◽

Splenic Atrophy

Long duration spaceflight poses potential health risks to astronauts during flight and re-adaptation after return to Earth. There is an emerging need for NASA to provide successful and reliable therapeutics for long duration missions when capability for medical intervention will be limited. Clinically relevant, human placenta-derived therapeutic stromal cells (PLX-PAD) are a promising therapeutic alternative. We found that treatment of adult female mice with PLX-PAD near the onset of simulated weightlessness by hindlimb unloading (HU, 30 d) was well-tolerated and partially mitigated decrements caused by HU. Specifically, PLX-PAD treatment rescued HU-induced thymic atrophy, and mitigated HU-induced changes in percentages of circulating neutrophils, but did not rescue changes in the percentages of lymphocytes, monocytes, natural killer (NK) cells, T-cells and splenic atrophy. Further, PLX-PAD partially mitigated HU effects on the expression of select cytokines in the hippocampus. In contrast, PLX-PAD failed to protect bone and muscle from HU-induced effects, suggesting that the mechanisms which regulate the structure of these mechanosensitive tissues in response to disuse are discrete from those that regulate the immune- and central nervous system (CNS). These findings support the therapeutic potential of placenta-derived stromal cells for select physiological deficits during simulated spaceflight. Multiple countermeasures are likely needed for comprehensive protection from the deleterious effects of prolonged spaceflight.

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Nursing Teleconsultation for the Outpatient Management of Patients with Cardiovascular Disease during COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042087 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2087

Author(s):

Vincenzo Russo ◽

Roberta Cassini ◽

Valentina Caso ◽

Chiara Donno ◽

Annunziata Laezza ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Continuity Of Care ◽

Medical Intervention ◽

Lipid Lowering ◽

Outpatient Management ◽

Medical Interventions ◽

Artery Disease ◽

Clinical Conditions ◽

Mean Time

Introduction: During the COVID-19 outbreak, non-urgent clinic visits or cardiac interventional procedures were postponed to a later date, and the implementation of telemedicine has guaranteed continuity of care for patients with chronic diseases. The aim of our study was to describe the medical interventions following nursing teleconsultation for the outpatient management of patients with cardiovascular diseases during the COVID-19 pandemic. Materials and Methods: All patients who did not attend the follow-up visit from 4 to 15 April 2020 at our institution and who were re-scheduled due to the COVID-19 lockdown were selected to be enrolled in the study. Each patient was followed by a semi-structured telephonic interview performed by a nurse. The outcomes of our study were to assess the patients’ adherence to nursing teleconsultation and the usefulness of nursing teleconsultation to detect clinical conditions in need of medical intervention. Results: In total, 203 patients (81%) underwent nursing teleconsultation in a mean time of 7 ± 3 days from the outpatient visit lost due to the COVID-19 lockdown. Furthermore, 53 patients (26%) showed poor adherence to nursing teleconsultation. Among the 150 patients (mean age 67 ± 10 years; 68% male) who completed the telephonic interview, the nursing teleconsultation revealed the need of medical intervention in 69 patients (46%), who were more likely at very high cardiovascular risk (77% vs. 48%; p < 0.0003) and who showed a higher prevalence of dyslipidemia (97% vs. 64%; p < 0.0001) and coronary artery disease (75% vs. 48%, p < 0.0008) compared to those not in need of any intervention. The up-titration of the lipid-lowering drugs (n: 32, 74%) was the most frequent medical intervention following the nursing teleconsultation. The mean time between the nursing teleconsultation and the date of the rescheduled in-person follow-up visit was 164 ± 36 days. Conclusions: Nursing teleconsultation is a simple and well-tolerated strategy that ensures the continuity of care and outpatient management for patients with cardiovascular diseases during the COVID-19 pandemic.

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Osteonecrosis of the Femoral Head in Patients with Hypercoagulability—From Pathophysiology to Therapeutic Implications

International Journal of Molecular Sciences ◽

10.3390/ijms22136801 ◽

2021 ◽

Vol 22 (13) ◽

pp. 6801

Author(s):

Elena Rezus ◽

Bogdan Ionel Tamba ◽

Minerva Codruta Badescu ◽

Diana Popescu ◽

Ioana Bratoiu ◽

...

Keyword(s):

Femoral Head ◽

Oral Anticoagulants ◽

Direct Oral Anticoagulants ◽

Medical Intervention ◽

Rapid Progression ◽

Anticoagulant Treatment ◽

Early Medical Intervention ◽

Therapeutic Implications ◽

Early Stages ◽

Hereditary Thrombophilia

Osteonecrosis of the femoral head (ONFH) is a debilitating disease with major social and economic impacts. It frequently affects relatively young adults and has a predilection for rapid progression to femoral head collapse and end-stage hip arthritis. If not diagnosed and treated properly in the early stages, ONFH has devastating consequences and leads to mandatory total hip arthroplasty. The pathophysiology of non-traumatic ONFH is very complex and not fully understood. While multiple risk factors have been associated with secondary ONFH, there are still many cases in which a clear etiology cannot be established. Recognition of the prothrombotic state as part of the etiopathogeny of primary ONFH provides an opportunity for early medical intervention, with implications for both prophylaxis and therapy aimed at slowing or stopping the progression of the disease. Hereditary thrombophilia and hypofibrinolysis are associated with thrombotic occlusion of bone vessels. Anticoagulant treatment can change the natural course of the disease and improve patients’ quality of life. The present work focused on highlighting the association between hereditary thrombophilia/hypofibrinolysis states and ONFH, emphasizing the importance of identifying this condition. We have also provided strong arguments to support the efficiency and safety of anticoagulant treatment in the early stages of the disease, encouraging etiological diagnosis and prompt therapeutic intervention. In the era of direct oral anticoagulants, new therapeutic options have become available, enabling better long-term compliance.

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Beta-Blockade in Intraseptal Anomalous Coronary Artery With Reversible Myocardial Ischemia

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135120954818 ◽

2021 ◽

Vol 12 (1) ◽

pp. 145-148

Author(s):

Tam T. Doan ◽

Athar M. Qureshi ◽

Shagun Sachdeva ◽

Cory V. Noel ◽

Dana Reaves-O’Neal ◽

...

Keyword(s):

Coronary Artery ◽

Myocardial Ischemia ◽

Dobutamine Stress ◽

Medical Intervention ◽

Beta Blockade ◽

Fractional Flow ◽

Flow Reserve ◽

Reversible Ischemia ◽

Improve Patient

Anomalous aortic origin of a left coronary artery (L-AAOCA) with an intraseptal course is a rare anomaly and can be associated with myocardial ischemia and sudden cardiac death. No surgical or medical intervention is known to improve patient outcomes. A 7-year-old boy with intraseptal L-AAOCA presented with nonexertional chest pain, syncope, and had reversible myocardial ischemia on provocative testing. The patient was started on β-blockade, following which his symptoms improved and resolved over a period of six years. A follow-up dobutamine stress magnetic resonance imaging no longer showed reversible ischemia, and cardiac catheterization with fractional flow reserve did not show coronary flow compromise.

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Natural Death Versus Known Date-Of-Death: A Qualitative Study of Views on Voluntary Assisted Dying in an Online Course About Death

OMEGA - Journal of Death and Dying ◽

10.1177/00302228211008771 ◽

2021 ◽

pp. 003022282110087

Author(s):

Deb Rawlings ◽

Megan Winsall ◽

Lauren Miller-Lewis ◽

Jennifer Tieman

Keyword(s):

Medical Intervention ◽

Online Course ◽

Assisted Dying ◽

Societal Factors ◽

Massive Open Online Course ◽

Advance Care Directives ◽

Advance Care ◽

Dying At Home ◽

Study Participants ◽

The Impact

The study aimed to describe views on Voluntary Assisted Dying (VAD), gleaned through qualitative analysis of participant responses to a set activity, run during the 2018 ‘Dying2Learn’ Massive Open Online Course (MOOC). Data from 508 participants, most of whom identified as health professionals, were analysed using thematic content analysis, and themes generated. A large proportion of participants discussed their personal views related to VAD, specifically around choice, control, dignity, palliative care and dying at home, medical intervention, societal factors, the impact on those left behind, laws and regulations, dying ‘naturally’, advance care directives, and being in pain. In this study, participants had many different views on the act itself, often divisive, but also with common concepts such as respecting the choices and decisions of others.

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