Post integration processes: The therapeutic work is not over

1986 ◽  
Author(s):  
Sally H. Barlow ◽  
Shawn L. Christian
Keyword(s):  
Therapeutic Work

Contrast-Enhanced Ultrasound: a Simple and Effective Tool in Defining a Rapid Diagnostic Work-up for Small Nodules Detected in Cirrhotic Patients during Surveillance

2016 ◽  
Vol 25 (2) ◽  
pp. 205-211 ◽  
Author(s):  
Antonio Giorgio ◽  
Luca Montesarchio ◽  
Piero Gatti ◽  
Ferdinando Amendola ◽  
Paolo Matteucci ◽  
...  
Keyword(s):  
Predictive Value ◽  
Imaging Modality ◽  
Dynamic Imaging ◽  
Contrast Enhanced Ultrasound ◽  
Histologic Diagnosis ◽  
Therapeutic Work ◽  
Contrast Enhanced ◽  
Arterial Vascularization ◽  
Cirrhotic Patients ◽  
Work Up

  Background & Aims: Disappearance of portal blood flow and arterial vascularization is the hallmark of hepatocarcinogenesis. The capability of a dynamic imaging modality detecting arterial hypervascularization of small nodules is crucial to promote a rapid diagnostic and therapeutic work-up improving survival. We aimed to evaluate the capability of CEUS to detect arterial vascularization of ≤ 2 cm HCC nodules arising during surveillance so as to shorten the diagnostic and therapeutic work-up. Methods: From October 2009 to September 2014, among 1757 consecutive cirrhotic patients under surveillance with ultrasound (US), 243 patients had new single nodules 7-20 mm; 229/243 had a conclusive histologic diagnosis and comprised the study group. All patients underwent CEUS followed by enhanced MRI and US guided percutaneous 18G needle core biopsy of the nodules. Of the 229 nodules, 27 were hyperechoic, 171 hypoechoic and 31 isoechoic lesions. Results: The histology results revealed that 199/229 nodules were HCC and 30 were benign. Of 199 HCC, CEUS evidenced arterial hypervascularity in 190 nodules (95.5%) (sensitivity 94.48 %, specificity 100%, PPV 100%, NPV 76.92 %). Of the 39 CEUS arterial-unenhanced nodules, 30 were benign and 9 (23%) were well-differentiated HCC. eMRI showed arterial hypervascularity in 199 nodules (86,9%). Of these, only 193 (97%) were histologically HCCs while 6 were benign (sensitivity: 97%, specificity: 80%, PPV: 97%, NPV: 80%). Conclusions: CEUS has a great capability to detect arterial hypervascularity of small HCC. Because only 4.5% of new nodules escape the demonstration of arterial hyervascularity, CEUS must be performed immediately after conventional US to contrast the malignant fate of small lesions arising in a cirrhotic liver.. Abbreviations: CEUS: contrast-enhanced ultrasound; CT: computed tomography; HCC: hepatocellular carcinoma;MRI: magnetic resonance; NPV: negative predictive value; PPV: positive predictive value; US: ultrasonography.

MAIN DIRECTIONS OF PREVENTION OF INCREASED WEATHER SENSITIVITY AND TREATMENT OF WEATHER-DEPENDENT PATIENTS

2020 ◽  
pp. 45-48
Author(s):  
Kolyagina N.M. ◽  
Berezhnova T.A. ◽  
Klepikov O.V. ◽  
Kulintsova Ya.V.
Keyword(s):  
Chronic Diseases ◽  
Climatic Factors ◽  
Weather Factors ◽  
Educational Work ◽  
Pathological Effect ◽  
Term Care ◽  
Cardiovascular Pathology ◽  
Therapeutic Work ◽  
Weather Sensitivity ◽  
Voronezh Region

Currently, and over the past decade, intensive research is being conducted in the field of organizational, preventive and therapeutic work with weather-sensitive and weather-dependent patients suffering from cardiovascular pathology. One of the most discussed issues in practical medicine is the application of climate conditions, with a fixed frequency and time of exposure. Conditions of influence of climatic factors, in some cases, can exceed the limits of the norm and, accordingly, have a pathological effect on the functional state of a person. Thus, we used data from statistically reliable results of 928 questionnaires processed and analyzed, reflecting the medical and social characteristics of patients with cardiovascular pathology. Direct results were evaluated by analyzing changes in the dynamics of indicators. According to a questionnaire survey, 62% of patients who have chronic diseases and seek medical help for diseases of the cardiovascular system believe that weather factors have a significant impact on their health. of the patients who do not have chronic diseases, 38% gave positive answers to the question about the weather sensitivity of their health. As part of the pilot project to create a system of long-term care for elderly and disabled citizens in the Voronezh region, patients are informed about the sources of obtaining specialized medical weather forecasts in the region; interaction between the parties is organized to conduct sanitary and educational work; medical examinations are organized and conducted; training sessions are organized for relatives of citizens who have lost the ability to self-service. Further organizational, preventive and therapeutic work with weather-sensitive and weather-dependent patients in the Voronezh region is characterized by an increase in the quality of medical care for patients with cardiovascular diseases.

Evaluating therapeutic work with abused children

1995 ◽  
Vol 1 (4) ◽  
pp. 1-13
Author(s):  
Stephen Knox ◽  
Rosemary Kilpatrick
Keyword(s):  
Abused Children ◽  
Therapeutic Work

scholarly journals Embodiments and co-actions: The function of trust and re-enactment in the practice of psychotherapy

2020 ◽  
Vol 13 (2) ◽  
Author(s):  
Sarah Bro Trasmundi ◽  
Johanne S. Philipsen
Keyword(s):  
Emotion Regulation ◽  
Therapeutic Alliance ◽  
Human Interaction ◽  
Embodied Interaction ◽  
Multiple Timescales ◽  
Therapeutic Work ◽  
Deep Breath ◽  
Theoretical Contribution ◽  
Incremental Change ◽  
Interaction Approach

AbstractThis paper is an empirically-based theoretical contribution to the field of research that investigates the function of trust and re-enactment in psychotherapeutic interaction. We use an ecological, embodied approach that pays attention to how human interaction is constrained by multiple timescales (past, present and future). The analysis sheds light on how trust, here in terms of a therapeutic alliance, is enabled, performed and maintained in interaction through the work with embodied re-enactments of previous events. Specifically, we describe how this therapeutic work constitutes an emerging, situated opportunity for teaching/practising embodied emotion regulation in the form of a co-participated enaction of “taking a deep breath,” and we emphasise how embodied, co-participated re-enactment of past (dys)functional behaviours outside of therapy can be a resource for redirecting, teaching and reinforcing therapeutically relevant behaviours in the context of therapy presenting themselves as fruitful opportunities for facilitating incremental change. Further, psychotherapy serves as a useful case for demonstrating the relevance of such an embodied interaction approach far more generally.

MO436PLASMA OXALATE VALUES IN PATIENTS WITH END-STAGE KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ella Metry ◽  
Sander Garrelfs ◽  
Michiel Oosterveld ◽  
Aegida Neradova ◽  
Joost Bijlsma ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Plasma Concentrations ◽  
Maintenance Hemodialysis ◽  
Healthy Individuals ◽  
End Stage Kidney Disease ◽  
Waste Products ◽  
Therapeutic Work ◽  
Reference Limit ◽  
End Stage ◽  
Work Up

Abstract Background and Aims Patients with end-stage kidney disease (ESKD) are known to have higher plasma concentrations of metabolic waste products than healthy individuals. Patients with Primary Hyperoxaluria (PH), a rare congenital cause of ESKD, suffer from hepatic overproduction of the metabolic end product oxalate. Plasma oxalate (POx) levels are determined in the diagnostic and therapeutic work-up for PH. Remarkably, correct interpretation of these values is hampered by the absence of knowledge concerning POx levels in patients with ESKD due to common causes. Method In this observational study, we obtained POx values in patients with ESKD due to another cause than PH, to establish reference values in this patient group. We collected blood samples from 120 adults with eGFR < 15 mL/min/1.73 m2 who required maintenance hemodialysis or peritoneal dialysis at the Amsterdam UMC. Results While there was a wide variation in POx levels in patients with ESKD, the median was 50 umol/L and lowest values were twice the upper reference limit that applies to healthy individuals (6.7 umol/L). Conclusion This study shows that POx levels of 50 umol/L are not necessarily suggestive for PH which contradicts the current literature. This study could lead to a paradigm shift in the diagnostic and therapeutic work-up for patients with ESKD.

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