Explore the vast range of titles available.

The safety, feasibility, and efficacy of a 12-week structured exercise program targeting post-traumatic stress disorder (PTSD) in women Veterans of childbearing age was tested in a pilot study. Thirty-one women Veterans of childbearing age were enrolled in the study, 22 remained eligible after the baseline assessment, and 16 completed the exercise protocol. The exercise program consisted of moderate intensity aerobic exercise (brisk walking), 4 times a week, for 12 weeks. Data were collected on duration, intensity, and side effects. The Clinician Administered PTSD Scale was administered at baseline and at the end of 12 weeks. Weekly assessments provided data on PTSD and depression symptoms, pain, and quality of life. Both post-traumatic and depressive symptoms improved significantly by the end of study. There were no adverse events related to exercise. A small focus group provided subjective experiences supporting positive effects of exercise on emotion and physical health. The preliminary results of this study suggests that 12 weeks of moderate intensity aerobic exercise may be a promising intervention for PTSD in women Veterans of childbearing potential. Further controlled studies are warranted to determine efficacy of moderate intensity exercise as a treatment modality for this population.

Although poor partner support is a key risk factor for depression in pregnant and postpartum women, partners are not generally involved in treatment beyond psychoeducation. The aim of this \"proof of concept\" study was to test safety, acceptability, and feasibility of Partner-Assisted Interpersonal Psychotherapy (PA-IPT), an intervention that includes the partner as an active participant throughout treatment. Women more than 12 weeks estimated gestational age and less than 12 weeks postpartum were invited to participate if they fulfilled DSM-IV criteria for Major Depressive Disorder and reported moderate symptom severity (HAM-D 17 ≥16). The open trial included eight acute-phase sessions and a 6-week follow-up assessment. Ten couples completed the acute phase treatment and nine presented for a 6-week follow-up assessment. There were no study-related adverse events, and no women had symptomatic worsening from intake to Session Eight. All partners attended all sessions, no couples dropped out of treatment, and all reported positive treatment satisfaction at the conclusion of the study. Nine of ten women (90 %) met the criteria for clinical response (HAM-D 17  = 9) at the conclusion of acute phase treatment, and eight of the nine (89 %) presenting at a 6-week follow-up assessment met criteria for symptomatic recovery. Incorporating partners in the treatment of major depressive disorders during the perinatal period is safe, acceptable, and feasible, but needs further testing in a larger population to evaluate efficacy.

Background The period after psychiatric hospital discharge is one of elevated risk for suicide‐related behaviors (SRBs). Post‐discharge clinical outreach, although potentially effective in preventing SRBs, would be more cost‐effective if targeted at high‐risk patients. To this end, a machine learning model was developed to predict post‐discharge suicides among Veterans Health Administration (VHA) psychiatric inpatients and target a high‐risk preventive intervention. Methods The Veterans Coordinated Community Care (3C) Study is a multicenter randomized controlled trial using this model to identify high‐risk VHA psychiatric inpatients (n = 850) randomized with equal allocation to either the Coping Long Term with Active Suicide Program (CLASP) post‐discharge clinical outreach intervention or treatment‐as‐usual (TAU). The primary outcome is SRBs over a 6‐month follow‐up. We will estimate average treatment effects adjusted for loss to follow‐up and investigate the possibility of heterogeneity of treatment effects. Results Recruitment is underway and will end September 2024. Six‐month follow‐up will end and analysis will begin in Summer 2025. Conclusion Results will provide information about the effectiveness of CLASP versus TAU in reducing post‐discharge SRBs and provide guidance to VHA clinicians and policymakers about the implications of targeted use of CLASP among high‐risk psychiatric inpatients in the months after hospital discharge. Clinical trials registration ClinicalTrials.Gov identifier: NCT05272176 (https://www.clinicaltrials.gov/ct2/show/NCT05272176).

Healthy Start programs have made tremendous contributions toward improving the health of mothers and infants through the screening and early detection of perinatal depression. In a collaborative partnership with the Dallas Healthy Start (DHS) program, this pilot study investigated rates of follow-up to systematic referrals for the treatment of perinatal depression in the DHS, as well as identified specific barriers and predictors or treatment follow-up. Results of this study support strengthening existing community-based treatment programs for perinatal depression.

Fuchs endothelial corneal dystrophy (FECD) is a leading cause of corneal endothelial (CE) degeneration resulting in impaired visual acuity. It is a genetically complex and age-related disorder, with higher incidence in females. In this study, we established a nongenetic FECD animal model based on the physiologic outcome of CE susceptibility to oxidative stress by demonstrating that corneal exposure to ultraviolet A (UVA) recapitulates the morphological and molecular changes of FECD. Targeted irradiation of mouse corneas with UVA induced reactive oxygen species (ROS) production in the aqueous humor, and caused greater CE cell loss, including loss of ZO-1 junctional contacts and corneal edema, in female than male mice, characteristic of late-onset FECD. UVA irradiation caused greater mitochondrial DNA (mtDNA) and nuclear DNA (nDNA) damage in female mice, indicative of the sex-driven differential response of the CE to UVA, thus accounting for more severe phenotype in females. The sex-dependent effect of UVA was driven by the activation of estrogen-metabolizing enzyme CYP1B1 and formation of reactive estrogen metabolites and estrogen-DNA adducts in female but not male mice. Supplementation of N-acetylcysteine (NAC), a scavenger of reactive oxygen species (ROS), diminished the morphological and molecular changes induced by UVA in vivo. This study investigates the molecular mechanisms of environmental factors in FECD pathogenesis and demonstrates a strong link between UVA-induced estrogen metabolism and increased susceptibility of females for FECD development.

Background The incidence of and mortality from colorectal cancers (CRC) can be reduced by early detection. Currently there is a lack of established markers to detect early neoplastic changes. We aimed to identify the copy number variations (CNVs) and the associated genes which could be potential markers for the detection of neoplasia in both ulcerative colitis-associated neoplasia (UC-CRN) and sporadic colorectal neoplasia (S-CRN). Methods We employed array comparative genome hybridization (aCGH) to identify CNVs in tissue samples of UC nonprogressor, progressor and sporadic CRC. Select genes within these CNV regions as a panel of markers were validated using quantitative real time PCR (qRT-PCR) method along with the microsatellite instability (MSI) in an independent cohort of samples. Immunohistochemistry (IHC) analysis was also performed. Results Integrated analysis showed 10 overlapping CNV regions between UC-Progressor and S-CRN, with the 8q and 12p regions showing greater overlap. The qRT-PCR based panel of MYC, MYCN, CCND1, CCND2, EGFR and FNDC3A was successful in detecting neoplasia with an overall accuracy of 54 % in S-CRN compared to that of 29 % in UC neoplastic samples. IHC study showed that p53 and CCND1 were significantly overexpressed with an increasing frequency from pre-neoplastic to neoplastic stages. EGFR and AMACR were expressed only in the neoplastic conditions. Conclusion CNVs that are common and unique to both UC-associated and sporadic colorectal neoplasm could be the key players driving carcinogenesis. Comparative analysis of CNVs provides testable driver aberrations but needs further evaluation in larger cohorts of samples. These markers may help in developing more effective neoplasia-detection strategies during screening and surveillance programs.

Background: Evidence suggests that liberal transfusion and anemia correction have negative effects on patients with acute brain injuries (ABI). Such patients with indications for decompressive surgeries require precise and real-time monitoring technology for estimation of intraoperative hemoglobin in order to assess the need for transfusion. Aims: The primary objective was to evaluate non-invasive hemoglobin (SpHb) monitoring as a guide for red blood cell transfusion (RBCT) during emergency decompressive craniotomy in ABI patients. The secondary objectives were to evaluate the incidence of postoperative infections, length of ICU stay, duration of mechanical ventilation, 30-day mortality, and extended Glasgow outcome scale (E-GOS) score at 90 days. Methods and Material: Eighty patients (aged 18-65) with ABI requiring decompressive surgery were randomized into two groups of 40 patients each: group A (SpHb monitoring group) and group B (standard care group). They were compared for RBCT management, and postoperative infections, ventilator days, length of stay in ICU, E-GOS, and mortality. RESULTS: The number of patients requiring a single RBCT was significantly higher in group A as compared to Group B (P < 0.0001). However, patients requiring two transfusions and the total volume of RBCT were higher in group B (P < 0.01). Three or more RBCT were required only in Group B (P 0.07). The duration of mechanical ventilation was higher in group B as opposed to group A (P 0.07). However, there was no significant difference in the hemodynamic variables between the two groups. Conclusions: The inclusion of continuous SpHb monitoring during decompressive procedures in ABI patients may assist in the optimal management of blood transfusion, thereby reducing transfusion-related complications.

Background: The correct position of the endotracheal tube is confirmed by various modalities, most of which are not entirely reliable. Ultrasound is now increasingly available to anesthesiologists in the operating theater and is an attractive alternative. To investigate the usefulness of sonography in identifying the correct tracheal tube position in human cadavers. Materials and Methods: Endotracheal tubes placed randomly into trachea or esophagus was identified with a linear ultrasound probe placed transversely just above the suprasternal notch by a single anesthesiologist. Results: Of the 100 intubations performed at random, 99 were correctly identified to give a sensitivity of 100% and a specificity of 97.9%. Conclusion: Sonography is a useful technique to identify correct position of the tracheal tube.

Abstract Background The relationships between first-line drug concentrations and clinically important outcomes among patients with tuberculosis (TB) remain poorly understood. Methods We enrolled a prospective cohort of patients with new pulmonary TB receiving thrice-weekly treatment in India. The maximum plasma concentration of each drug was determined at months 1 and 5 using blood samples drawn 2 hours postdose. Subtherapeutic cutoffs were: rifampicin <8 µg/mL, isoniazid <3 µg/mL, and pyrazinamide <20 µg/mL. Factors associated with lower log-transformed drug concentrations, unfavorable outcomes (composite of treatment failure, all-cause mortality, and recurrence), and individual outcomes were examined using Poisson regression models. Results Among 404 participants, rifampicin, isoniazid, and pyrazinamide concentrations were subtherapeutic in 85%, 29%, and 13%, respectively, at month 1 (with similar results for rifampicin and isoniazid at month 5). Rifampicin concentrations were lower with human immunodeficiency virus coinfection (median, 1.6 vs 4.6 µg/mL; P = .015). Unfavorable outcome was observed in 19%; a 1-μg/mL decrease in rifampicin concentration was independently associated with unfavorable outcome (adjusted incidence rate ratio [aIRR], 1.21 [95% confidence interval {CI}, 1.01–1.47]) and treatment failure (aIRR, 1.16 [95% CI, 1.05–1.28]). A 1-μg/mL decrease in pyrazinamide concentration was associated with recurrence (aIRR, 1.05 [95% CI, 1.01–1.11]). Conclusions Rifampicin concentrations were subtherapeutic in most Indian patients taking a thrice-weekly TB regimen, and low rifampicin and pyrazinamide concentrations were associated with poor outcomes. Higher or more frequent dosing is needed to improve TB treatment outcomes in India. In a prospective cohort of patients with newly diagnosed pulmonary tuberculosis receiving standard thrice-weekly antituberculosis treatment in India, lower rifampicin concentration was associated with Human Immunodeficiency Virus coinfection and independently associated with unfavorable treatment outcomes.