Enhanced mental reinstatement of exposure to improve extinction generalization: A study on claustrophobia and MRI fear

Fear of enclosed spaces prevents many people from receiving magnetic resonance imagining (MRI) scans. Although exposure therapy can effectively treat such fears, reductions in fear during exposure often do not generalize beyond the context in which they took place. This study tested a strategy designed to increase generalization, which involved revisiting the memory of a prior exposure to enhance retrieval of extinction learning. Forty-five participants with claustrophobia that included fear of MRI scans underwent a series of exposures lying inside a narrow cabinet. One week later, participants were randomly assigned to enhanced mental reinstatement (EMR) or control procedures. Prior to entering a mock MRI scanner, EMR participants recalled the memory of exposure training and listened to an audio recording of themselves describing what they learned, whereas control participants recalled a neutral memory. Compared to the control condition, EMR led to significantly reduced heart rate reactivity in the mock MRI scanner, but not self-reported fear or avoidance. There were no differences between conditions in claustrophobia symptoms or MRI fear at one-month follow-up. Results suggest some benefits of mental reinstatement for improving generalization of gains following exposure training for claustrophobia, with measures of subjective fear and physiological arousal showing discordant outcomes.

Chemodectoma located in the left atrium in 11 month survival dog with the use of palliative therapy

The aim of this study was to present a clinical case of chemodectoma located in the left atrium in a dog. Chemodectoma is a heart base tumor, neoplasms that occur in the proximity of major blood vessels. A presumptive diagnosis is made based on location and appearance of the tumor in echocardiography examination. In advanced diagnostics computed tomography (CT) and magnetic resonance imagining (MRI) are used. Final diagnosis is made mainly during autopsy based on histopatological examination or less commonly in veterinary medicine on a histopathological examination of the tissue taken during a biopsy or of the entire removed tumor. In literature few methods of treatment are presented, including surgery, chemotherapy and radiotherapy. In an 8-year-old male French bulldog a tumor in the left atrium was detected. The tumor filled almost the entire left atrium, additionally pericardial effusion and ascites were observed. For treatment, tarantula cubensis extract (Theranecron) was used. After the introduction of Theranecron the patient felt significantly better. Theranecron may be one of the possibilities of palliative therapy in the case of diagnosing inoperable chemodectoma.

Penile masses: Shear Wave Elastography correlated with Magnetic Resonance Imagining. A two cases report.

Definitive diagnosis of penile masses usually depends on clinical symptoms and patient history but in some challenging cases the help of radiologic diagnostic tools is required. Although ultrasound is an effective tool for detecting penile masses, unlike magnetic resonance imagining, it is not able to differentiate benign and malignant pathologies. Shear wave elastography (SWE) is a novel method, which has the ability to differentiate malignant and benign tissues by giving quantitative information about tissue elasticity. In this paper we present two cases with penile masses to demonstrate the potential use of SWE in the differential diagnosis of penile masses.

Vehicle-associated closed trauma-induced stroke in a 27-day-old girl

Birth trauma, but not postnatal trauma, has been recognized as a cause of cerebral infarction in newborns. We report a case of cerebral infarction in a 27-day-old girl after a car accident. During the car accident, the child was properly restrained to the child’s safety seat. The patient was admitted to the hospital for observation because of pronounced irritability. There were no focal neurological symptoms on admission. Twenty-eight hours after the accident, the child developed focal tonic-clonic seizures and mild right-sided hemiparesis. The seizures were successfully treated with phenobarbital at a dose of 30 mg per day. Computed tomography and magnetic resonance imagining performed on the second and third days after the accident, respectively, showed subdural hemorrhage in the occipital regions and cerebral ischemia in the left parieto-occipital region. Control imaging 10 days later showed signs of reperfusion. Persistent child irritability after head trauma is one of the indicating factors for performing an emergency computed tomography scan of the head.