An Integrative EMDR and Family Therapy Model for Treating Attachment Trauma in Children: A Case Series

2018 ◽  
Vol 12 (4) ◽  
pp. 196-207 ◽  
Author(s):  
Debra Wesselmann ◽  
Stefanie Armstrong ◽  
Cathy Schweitzer ◽  
Meghan Davidson ◽  
Ann Potter
Keyword(s):  
Statistical Analysis ◽  
Family Therapy ◽  
Traumatic Stress ◽  
Case Series ◽  
Small Sample ◽  
Attachment Trauma ◽  
Attachment Relationships ◽  
Case Series Study ◽  
History Of ◽  
Therapy Model

This case series study investigated the effectiveness of an integrative eye movement desensitization and reprocessing (EMDR) and family therapy model, specifically the Integrative Attachment Trauma Protocol for Children (IATP-C), for improving traumatic stress, attachment relationships, and behaviors in children with a history of attachment trauma; specifically, adopted children with a history of maltreatment and foster or orphanage care. Of the 23 child participants, one family dropped out at 6 months, and 22 completed treatment in 6–24 months. Mean treatment length was 12.7 months. Statistical analysis demonstrated significant improvement in scores on children's traumatic stress symptoms, behaviors, and attachment relationships by the end of treatment. Statistical analysis of secondary measures showed significant improvement in mothers' scores related to symptomology and attitudes toward their child. Gains were maintained for the 15 families who complied with completion and returning of follow-up measures. Limitations of the study include the lack of a control group and small sample size. Future directions include controlled efficacy studies with larger sample sizes as well as exploration of application of the model to a similar population of children in other cultures and to children who are not residing in permanent placements.

Case series: COVID-19 infection causing new-onset diabetes mellitus?

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Rujuta Katkar ◽  
Narasa Raju Madam
Keyword(s):  
Diabetes Mellitus ◽  
Severe Acute Respiratory Syndrome ◽  
Cell Damage ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Onset Diabetes ◽  
History Of ◽  
New Onset Diabetes Mellitus ◽  
New Onset

Objectives: This paper seeks to explore the hypothesis of the potential diabetogenic effect of SARS-COV-2 (Severe Acute respiratory syndrome coronavirus). Case series presentation: We present a case series of observation among 8 patients of age group ranging from 34 to 74 years with a BMI range of 26.61 to 53.21 Kilogram/square meters that developed new-onset diabetes after COVID-19 infection. Severe Acute Respiratory Syndrome Coronavirus (SARS-COV-2), commonly known as Coronavirus or COVID-19(Coronavirus infectious disease), gains entry into the cells by binding to the Angiotensin-converting enzyme-2(ACE-2) receptors located in essential metabolic tissues including the pancreas, adipose tissue, small intestine, and kidneys. The evidence reviewed from the scientific literature describes how ACE 2 receptors play a role in the pathogenesis of diabetes and the plausible interaction of SARS-COV-2 with ACE 2 receptors in metabolic organs and tissues. Conclusion: The 8 patients without a past medical history of diabetes admitted with COVID-19 infection developed new-onset diabetes mellitus due to plausible interaction of SARS-COV-2 with ACE 2 receptors. The resulting downregulation of ACE-2 and ACE-2 receptors expression caused islet-cell damage resulting into diabetes. The resulting observation has the potential to adversely impact significant number of the globally affected population. Screening patients with COVID-19 for diabetes routinely can help in early detection, significantly reducing morbidity and mortality associated with diabetes. Due to limitations of observational study with a small sample size will require further investigation in the form of Clinical trial.

scholarly journals Management of Pseudotumor Cerebri Secondary to Dural Venous Sinus Thrombosis in Children

2021 ◽  
Vol 3 (3(September-December)) ◽  
pp. e892021
Author(s):  
Mohamed M Elsherbini ◽  
Hatem Badr ◽  
Mohamed Kassem ◽  
Amr Farid Khalil
Keyword(s):  
Sinus Thrombosis ◽  
Case Series ◽  
Rare Condition ◽  
Pseudotumor Cerebri ◽  
Dural Sinus ◽  
Time Interval ◽  
Pediatric Clinic ◽  
Case Series Study ◽  
History Of ◽  
Csf Diversion

Background: The purpose of this study is to follow the clinical course and required management of children suffering from Pseudotumor cerebri (PTC) secondary to Dural Sinus Thrombosis (DST) to understand the natural history of a rare condition and its need for surgery as well as outcome after Cerebro-Spinal Fluid (CSF) diversion surgeries. Methods: A retrospective consecutive case series study based on examining medical records of patients who were referred to neurosurgical pediatric clinic  suffering from PTC secondary to DTS. Data review included patients’ archives for clinical, radiological, surgical records and follow up visits. Only patients below 18 years old were included. Results: Fourteen patients met inclusion criteria, 7 of them required CSF diversion procedure, while the other 50% responded to medical conservative therapy. Headache improved immediately for most of the surgical group, while took 7 weeks to reach satisfactory results for medical group. Visual improvement took place for both groups approximately at the same time interval with average 5 weeks. Conclusion: Surgical intervention in the form of CSF diversion procedure was required for 50 % of the patients, which is safe and effective line of treatment to prevent further deterioration of vision for case who were not responsive to medical therapy.

scholarly journals Brain Injury and Mental Health Among the Victims of Intimate Partner Violence: A Case-Series Exploratory Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Gunnur Karakurt ◽  
Kathleen Whiting ◽  
Stephen E. Jones ◽  
Mark J. Lowe ◽  
Stephen M. Rao
Keyword(s):  
Mental Health ◽  
Intimate Partner Violence ◽  
White Matter ◽  
Partner Violence ◽  
Exploratory Study ◽  
Case Series ◽  
Intimate Partner ◽  
Self Report ◽  
Case Series Study ◽  
History Of

Intimate partner violence (IPV) survivors frequently report face, head, and neck as their injury site. Many mild traumatic brain injuries (TBIs) are undiagnosed or underreported among IPV survivors while these injuries may be linked to changes in brain function or pathology. TBI sustained due to IPV often occurs over time and ranges in severity. The aim of this case-series study was to explore risk factors, symptoms, and brain changes unique to survivors of intimate partner violence with suspicion of TBI. This case-series exploratory study examines the potential relationships among IPV, mental health issues, and TBI. Participants of this study included six women: 3 women with a history of IPV without any experience of concussive blunt force to the head, and 3 women with a history of IPV with concussive head trauma. Participants completed 7T MRI of the brain, self-report psychological questionnaires regarding their mental health, relationships, and IPV, and the Structured Clinical Interview. MRI scans were analyzed for cerebral hemorrhage, white matter disturbance, and cortical thinning. Results indicated significant differences in resting-state connectivity among survivors of partner violence as well as differences in relationship dynamics and mental health symptoms. White matter hyperintensities are also observed among the survivors. Developing guidelines and recommendations for TBI-risk screening, referrals, and appropriate service provision is crucial for the effective treatment of TBI-associated IPV. Early and accurate characterization of TBI in survivors of IPV may relieve certain neuropsychological consequences.

Pattern of breast diseases in Kuwait Cancer Control Center, Kuwait

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10754-10754 ◽  
Author(s):  
S. A. Alawadi ◽  
M. D. Delvadiya
Keyword(s):  
Breast Cancer ◽  
Hormone Replacement ◽  
Case Series ◽  
Breast Diseases ◽  
Age At Menarche ◽  
Female Breast ◽  
N2 Disease ◽  
Case Series Study ◽  
History Of ◽  
Second Degree

10754 Background: The aim of this case series study is to evaluate the outline and pattern of female breast cancers in Kuwait. Methods: Our study consisted of data from 300 cases of female breast cancer seen in our outpatient department. Data on profile of their disease at presentation and known risk factors was retrieved. The analysis indented to examine the pattern of the disease and risk factor profile of the patients. Results: Out of 300 patients, 52% were Kuwaiti citizens, 24% were Arabs from other countries, 23% were of Asian origin and 1% was of other nationality. Their median age ± SD (Standard Deviation) was 50 ± 9.7 years. Most patients were younger than 55 years (77.4%) and were predominantly premenopausals (63%). Only 18% had stage I disease at presentation, whilst 54 %, 24 %, and 4% had stage II, III and IV disease, respectively. Among patients with known axillary nodal status (298 patients) 44.3% were node-negative whilst 39.6% and 16.8% had N1 and N2 disease, respectively. History of benign breast disease was positive in 9% and only 1% had breast biopsy done before the biopsy which diagnosed cancer. In 20.7% there was family history of breast cancer. Among them 11.7% had first degree relative with breast cancer, 3.3%, 7.3% and 1% patients had either mother, sister or both with history of breast cancer. Whilst 12% patients had second degree relatives with breast cancer, 3% patients out of them had both first and second degree relatives with breast cancer. History of alcohol ingestion was rare, only 0.7% patients were taking alcohol. 9.7% patients were nulliparous, while 10.7% patients had their first child after the age of 30 years. Breast feeding was common, 80 % patients breast fed their children and 43.3 % did that for more than 6 months. Age at menarche was 12 years or less in 34 % patients and age at menopause was more than 55 years in only 6.3% patients. Oral contraceptives were used by 38.7% patients, 12%, 9.3% and 17.3% patients used them for 2 or less, 2 to 5 or more than 5 years, respectively. Only 3% patients took hormone replacement therapy, 7 of them took that fore more than 2 years. Only 6 % patients gave history of smoking and only half of them were currently smoking. Conclusions: This data analysis suggested that pattern of breast cancer in Kuwait is similar to other countries in this region. No significant financial relationships to disclose.

scholarly journals SMILE After DALK to Reduce Residual Refraction: Two-Year Results

2021 ◽  
Author(s):  
Hassan Hashemi ◽  
Mohammadreza Aghamirsalim ◽  
Saied Shahhoseini ◽  
Alireza Moghaddasi ◽  
Soheila Asgari
Keyword(s):  
Visual Acuity ◽  
Spherical Aberration ◽  
Case Series ◽  
Lamellar Keratoplasty ◽  
Distance Visual Acuity ◽  
Case Series Study ◽  
History Of ◽  
Deep Lamellar Keratoplasty ◽  
Induced Astigmatism ◽  
Axis Rotation

Abstract PurposeTo determine the two-year results of small incision lenticule extraction (SMILE) for correcting post-keratoplasty myopia and myopic astigmatism.MethodsIn this case-series study, 10 eyes of 10 patients with a 6-10-year history of successful deep lamellar keratoplasty (DALK) underwent SMILE using VisuMax laser platform. Ophthalmologic examinations and visual acuity and refraction measurement were done pre- and 1, 3, 6, 12, and 24 months postoperatively. Pentacam and Sirius imaging was done in the first and last follow-up session.ResultsThe mean age of the patients was 39.60±7.86 years. Six subjects were male. After two years, uncorrected distance visual acuity did not change in one eye and improved 1-6 lines in other eyes. Corrected distance visual acuity decreased in one eye, did not change in four eyes, and improved 1-8 lines in other eyes. The mean decrease of spherical equivalent, spherical error, and cylinder power was 1.92±1.96 diopter (D) (P=0.013), 0.70±3.05D (P=0.213), and 2.42±2.91D (P=0.024), respectively. The vector mean target induced astigmatism, surgical induced astigmatism, and difference vector was 1.30D@44˚, 1.11D@24˚, and 0.86D@73˚, respectively. Two years after surgery, vertical coma, horizontal coma, and spherical aberration increased by 0.44±0.51, 0.23±0.32, and 0.02±0.16µm respectively (all P>0.05) while trefoil reduced by 0.29±0.75µm (P=0.428).ConclusionSMILE is a successful procedure for reducing refraction and astigmatism after DALK in patients with moderate myopia and moderate to severe astigmatism and improves the visual acuity in these patients. Axis rotation during surgery may result in under-correction of astigmatism. Refinement of SMILE treatment nomogram for post-DALK cases seems necessary.

scholarly journals Orbital cholesterol granuloma: a retrospective case series

2021 ◽  
Author(s):  
Yun Zhao ◽  
Jingwen Hui ◽  
Shasha Yu ◽  
Jinyong Lin ◽  
Hong Zhao
Keyword(s):  
Case Series ◽  
Recurrence Time ◽  
Cholesterol Granuloma ◽  
Pathological Features ◽  
Retrospective Case ◽  
Orbital Trauma ◽  
Retrospective Case Series ◽  
Lateral Orbitotomy ◽  
Case Series Study ◽  
History Of

Abstract Background To review the clinical features, radiographic features, therapy, pathological features and prognosis of orbital cholesterol granuloma(CG). Methods Twelve patients with orbital CG who were referred to Tianjin Eye Hospital between January 2002 and December 2020 were include in this retrospective case series study. Data collected included patient ophthalmic manifestations, imaging finding, treatment strategies, pathological features and prognosis were retrospectively reviewed. Results The patients comprised 10 males and 2 females. The mean age was 34.5±8.9 years(range 16 to 45 years). Four patients had a history of orbital trauma. The clinical manifestations at first visit were proptosis ( 7/12, 58.3%), periorbital or eyelids swelling (6/12,50%), limitation of eye displacement (4/12,33.3%), ptosis(2/12,16.7%), decreased visual acuity (1/12,8.3%).CT showed a non-enhancing,well-circumscribed lesion in the orbit with extensive erosion of the adjacent frontal bone and temporal bone.MRI showed a non-enhancing mass with intermediate to high signal intensity on T1- and T2-weighted imaging. Ten patients underwent lateral orbitotomy, and two patient underwent supraorbital orbitotomy,.All patients had aggressive bone erosion. Histopathologic evaluation of the cyst contents and wall revealed cholesterol clefts,multinucleated giant cells,histiocytes, foamy macrophages,and altered blood pigments. The median recurrence time of 79.6±49.8 months (range 19 month to 193 months). Three patients were lost to follow-up. No postoperative diminution of vision was noted,and no recurrence was observed. Conclusions Cholesterol granulomas can present as superiotemporal or temporal orbital lesions. The diagnosis can be established based on CT and MRI. Most of patients can have no history of orbital trauma.

Frequency of High Neutrophil and Lymphocyte Ratio (NLR) Among NSTEMI/USA patients

2021 ◽  
Vol 15 (8) ◽  
pp. 2031-2034
Author(s):  
Afaq Shamim ◽  
Aijaz Zeeshan Khan Chachar ◽  
Miqdad Haider ◽  
Mohsin Asif ◽  
Sajjad Ali ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chronic Stable Angina ◽  
Case Series ◽  
Neutrophil To Lymphocyte Ratio ◽  
Total Leucocyte Count ◽  
P Value ◽  
Lymphocyte Ratio ◽  
Case Series Study ◽  
History Of ◽  
St Elevation

Background: Neutrophil to lymphocyte ratio (NLR) is comparatively a new prognostic marker used in patients with chronic stable angina (CSA). NLR can help in predicting short and long term moralities in NSTEMI patients. Aim: To evaluate the frequency of high neutrophil and lymphocyte ratio among NSTEMI/USA patients and to compare frequency of mortality in patients of NSTEMI/USA having high NLR with those without high NLR. Study design& duration: Descriptive, case series study from 25th November 2020 to 24th May 2021. Study settings: Department of Medicine and Cardiology, Fatima Memorial Hospital, Lahore. Methods: 185 patients having non ST elevation myocardial infarction (NSTEMI) and/or unstable angina (UA) having 30 to 70 years age and both males and females were included. Patients with sepsis having total Leucocyte count (TLC>11,000/<4000), history of surgery or on steroids in the past three months, history of hematological malignancy, late for fibrinolysis or those with contraindication to fibrinolysis were excluded were excluded. Demographic information (name, age, address, and education) was also noted. Results: Mean age of the participants was 57.99 ± 6.10 years while the age range was from 30 to 70 years. Most of patients 164 were included in the age group of 51 to 70 years. 110 (59.46%) patients were male and 75 (46.54%) of them were females. Frequency of neutrophil and lymphocyte ratio among NSTEMI/USA patients was found in 91 (49.19%) patients. My study has shown higher frequency of mortality in patients of NSTEMI/USA having high NLR 26 (28.57%) compared to normal NLR 06 (6.38%) with p value = 0.0001. Conclusion: Frequency of high neutrophil and lymphocyte ratio among NSTEMI/USA patients is very high with higher mortality in high Neutrophil-to-lymphocyte ratio group as compared to low NLR group. Keywords: Myocardial infarction, Non ST elevation, Neutrophil-to-lymphocyte ratio

scholarly journals Equine Assisted Therapy for Patients with Post Traumatic Stress Disorder: A Case Series Study

2019 ◽  
Vol 184 (9-10) ◽  
pp. 394-399 ◽  
Author(s):  
Assaf Shelef ◽  
Dorit Brafman ◽  
Thom Rosing ◽  
Abraham Weizman ◽  
Rafael Stryjer ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Case Series ◽  
Post Traumatic Stress ◽  
Case Series Study ◽  
Open Case ◽  
Post Traumatic ◽  
Equine Assisted ◽  
Series Study

Abstract Introduction Equine assisted therapy (EAT) which includes therapeutic horseback riding (THR), grooming, horsemanship and ground level work with horses, has been studied as treatment for children with special needs and/or autistic spectrum disorder. Preliminary evidence indicates that EAT is also effective for improving self-efficacy and self-esteem in adults with psychiatric disorders. Empowerment, bonding and building trust with the horses, may promote functioning of patients struggling with post traumatic stress disorder (PTSD). The authors performed a prospective, pilot open case series study to assess the effect of EAT on patients with PTSD in terms of symptoms and functioning in work, family and social interaction. Methods Patients with PTSD received EAT once a week for 3 consecutive hours for 6 months. The Short Post Traumatic Stress Disorder Rating Interview (SPRINT) and the Sheehan Disability Scale (SDS) were assessed at baseline, the SDS after 1 and 6 months, and the SPRINT after 6 months. Results Thirteen of 23 participants completed the study. Ten participants withdrew from the study for various reasons including discomfort from horses. Total SPRINT scores showed a statistically significant improvement in PTSD symptoms (baseline vs. 6 months: 24.38 ± 6.4 vs. 21.54 ± 7.94 points; p &lt; 0.05). SPRINT scores indicated improvement in the ability to work and perform daily tasks (p &lt; 0.05). A statistically significant improvement in the total SDS score was revealed following 1 month (p &lt; 0.03) and after 6 months (p &lt; 0.02) of EAT. There was also a significant decline in the days of inefficiency (baseline vs. 6 months: 4.15 ± 2.73 vs, 1.88 ± 2.18 days per week, p &lt; 0.02). Conclusion This preliminary pilot open case series study suggests that EAT may be a beneficial treatment for patients suffering from PTSD. The study demonstrated improved ability to work and perform daily tasks and reduction in the number of days of inefficiency. Further large-scale long-term studies are warranted to substantiate our observation.

scholarly journals Can pleural packing be an effective solution for uncontrollable intra or post-operative hemorrhage

2020 ◽  
Vol 7 (7) ◽  
pp. 2087
Author(s):  
Hazem Zribi ◽  
Abderrahmen Ammar ◽  
Amina Abdelkbir ◽  
Imen Bouacida ◽  
Sarra Maazaoui ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Invasive Pulmonary Aspergillosis ◽  
Case Series ◽  
Good Alternative ◽  
Common Point ◽  
Retrospective Case ◽  
Case Series Study ◽  
History Of ◽  
The Common ◽  
The Mean

Background: Uncontrollable bleeding during thoracic surgery has been a challenging problem faced by surgeons. The aim of this study was to clarify the usefulness of pleural packing as a good alternative to control hemorrhage and to deduce the common point between those patients.Methods: This was a retrospective case series study of eight patients who underwent thoracic surgery with uncontrollable intrathoracic haemorrhage and shock which required intrathoracic packing from January 2014 to December 2019.Results: During the study period, eight patients underwent thoracic surgery with uncontrollable intrathoracic haemorrhage and needed packing.  Successful hemostasis was achieved in all cases after pleural packing. The mean age was 58.5 years and six patients were males. The common point was the history of pulmonary tuberculosis which was with invasive pulmonary aspergillosis for two patients. Incision was a posterolateral thoracotomy in all cases and six patients required pulmonary resection (five lobectomy and one bilobectomy), one patient required decortication, and one had tumorectomy of a paragonglioma located in the Barety’s space. The unpacking took place right after 48 hours. An arrest of the bleeding was noticed in all the remaining patients. The mean time of the mechanical ventilation was 11 days. Complications included atelectasis and infectious pneumonitis. We noted one case of death.Conclusions: Intrathoracic packing may be an effective and feasible technique in managing uncontrollable post-operative hemorrhage when the life of patients is in danger. This technique should always be considered for patients with tuberculosis history.

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