bluuebunny/crossref_metadata_2025 huggingface dataset:
Aortic regurgitation
Authors: Rosenhek Raphael
Published: May 2015

The workup of patients with aortic regurgitation is routinely based on echocardiography and includes a detailed morphologic assessment of the aortic valve with the determination of disease aetiology. The quantification of aortic regurgitation is based on an integration of qualitative and quantitative parameters. Haemodynamic consequences of aortic valve disease on left ventricular size, hypertrophy, and function, as well as potentially coexisting valve lesions, are assessed. Predictors of outcome and indications for surgery are substantially defined by echocardiographic parameters. Cardiac magnetic resonance has become an important complementary technique, both for the quantification of regurgitant severity and for the assessment of ventricular function. While the proximal parts of the ascending aorta are routinely visualized by transthoracic echocardiography, transoesophageal echocardiography (TOE) and in particular cardiac magnetic resonance (CMR) and cardiac computed tomography (CT) allow a more comprehensive assessment of the thoracic aorta.
Heart failure—CMR to assess viability
Authors: Carpenter John-Paul , Pennell Dudley J. , Prasad Sanjay K.
Published: May 2015

This chapter will discuss how cardiovascular magnetic resonance (CMR) can assess myocardial viability in patients with chronic heart failure and help to identify those who may derive improvement in left ventricular function and (potentially) prognosis from revascularization. The following CMR parameters as markers of viability will also be discussed: end-diastolic wall thickness; dobutamine stress ventriculography; late gadolinium enhancement and transmurality of infarction; and new techniques (including MR spectroscopy and myocardial tagging).
History of imprisonment
Authors: Arrigo Bruce A. , Lorén Trull S.
Published: May 2015

This chapter focuses on the evolution of the U.S. imprisonment system and examines the relevance of the system’s development in relation to correctional psychiatry. The first section of the chapter reviews the history of American prisons, including their shifting purposes, standards, and practices. The second portion of the chapter highlights the persistent lack of regard for prisoners with mental illness throughout the history of American penology, and explains how rehabilitation theory has intersected with the diagnostics and treatment of persons experiencing psychiatric disorders while criminally confined. Moreover, the swelling number of inmates with psychiatric disorders found in correctional settings today has converted jails and prisons into ill-equipped de facto institutions that warehouse the mentally ill much like the practice of the 19th century. Indeed, while American prison systems are beginning to implement some novel accommodations for persons with psychiatric disorders, they are often subjected to the same punitive treatment of isolative confinement that was popularized during the 19th century. The chapter concludes by discussing the current status of imprisonment in the United States, noting that as a consequence of the War on Drugs more than 31 million people have been arrested and convicted for these criminal offenses, leading to systematic mass incarceration that adversely and unequally impacts people of color.
Human rights
Authors: Fellner Jamie
Published: May 2015

In this chapter, North American and international issues are reviewed covering the range of human rights issues, challenges, and controversies that exist in correctional mental health care. This chapter provides a brief overview of the key internationally recognized human rights that should inform the work of correctional mental health professionals. Human rights reflect a humanistic vision predicated on the foundation of human dignity, which complement the ethical principles of beneficence and non-maleficence. The human rights framework supports correctional mental health staff in their efforts to protect patients from harm and provide them the treatment they need. Human rights provide a universally acknowledged set of precepts that can be used during internal and external advocacy. Mental health professionals should not – consistent with their human rights and ethical obligations – acquiesce silently to conditions of confinement that harm prisoners and violate human rights. They are obligated not only to treat inmates with mental illness with independence and compassion, but to strive to change policies and practices that abuse inmates and violate their rights, even those that involve custodial decisions (e.g. segregation, use of force, restraints). In short, for practitioners who want improved policies and practices, human rights offers a powerful rationale and vision for a different kind of correctional mental health services. The more correctional mental health practitioners embrace and advocate for human rights, the greater the likelihood prisoners’ rights will be respected.
Management of sleep complaints in correctional settings
Authors: Elger Bernice S.
Published: May 2015

Inmates of correctional settings often seek health care for sleep and drug problems. Studies on insomnia in correctional institutions are scarce. Sleep problems among detainees are frequent. Appropriate evaluation and treatment remains a challenge in correctional settings. Correctional health professionals need appropriate education regarding insomnia evaluation and management. Guidelines should be based on the principle of equivalence of care and take into account all evidence from research in the community and in correctional settings. Priority should be given to assessing modifiable causes and contributions to disturbed sleep and to non-pharmacological treatment such as targeted cognitive behavior therapy. Pharmacologically, there is no evidence-based justification to replace short-term pharmacologic management using benzodiazepines with antipsychotics or antidepressants. In correctional settings, prescriptions of antipsychotics and antidepressants for sleep problems can increase risk due to polypharmacy and higher suicide risks. Correctional physicians should monitor and document the evaluation and treatment practice concerning insomnia complaints in order to improve safe, evidence-based treatment. This chapter outlines treatment guidelines for insomnia that apply in community settings and then presents an overview of the clinical and ethical issues of insomnia management in correctional institutions and provides evidence-based recommendations.
Transition of pharmacology from community to corrections
Authors: Trestman Robert L.
Published: May 2015

Psychopharmacology in general is a challenging field that includes much art as well as science. Clinicians usually depend upon self-report in making decisions regarding medication selection and dosing. When a patient becomes incarcerated, there are multiple potentially conflicting, or synergistic, situations. There are issues of different formularies, different environmental stressors, changed support groups, and practice patterns that all may contribute differentially to medication management decisions. Current community medications may have been determined while ongoing illicit drug use confounded the diagnostic picture. Collaboration between clinician and patient may have been poor, and subsequently treatment adherence may in turn have been marginal. Many similar issues apply when a patient transfers from a jail to a prison or from one prison to another. Preparation and review of transfer summary sheets and more detailed records are just as important in these situations and should be seen as the minimum standard in policy and in practice. Ideally, continuity of care, and any concerns about diagnosis or treatment are best shared through direct communication. A telephone exchange between treating psychiatrists is always better than simple written documentation. This chapter discusses both the issues and pragmatic management opportunities that can lead to improved patient care and enhanced functioning.
Evaluation of malingering in corrections
Authors: Knoll James L.
Published: May 2015

Recognizing when someone is not being truthful is challenging. Multiple tests of malingering have been developed for forensic purposes. Malingered mental illness in the correctional setting poses a complicated dilemma. Many factors change the typical presentation and detection strategies, and inaccurate determinations have serious consequences. Detection requires a thorough knowledge of the characteristics of genuine psychiatric illness, a systematic approach to evaluation, identification of objective indicators, and use of scientifically validated psychological tests when necessary. The detection of malingering in corrections is necessary to ensure the judicious use of limited resources, and to bring diagnostic accuracy to assessments. A comprehensive, systematic approach is required. The clinician must assemble evidence from a thorough evaluation, clinical records, collateral data, and psychological testing when necessary. A conclusion of malingering is best supported with multiple factual bases. The correctional setting provides many unique challenges to detecting malingered mental illness. The finding that an inmate patient has malingered symptoms does not rule out the presence of true mental illness, and a determination of malingering should not exclude the inmate from receiving needed mental health services. How structured tests and other clinical skills may be used in treatment decisions in jail and prison settings is the content of this chapter.
Formulary management/pharmacy and therapeutics committees
Authors: Berger Robert H. , Wahl Robyn J. , Paul Chaplin M.
Published: May 2015

While the cost of health care rises in all public healthcare organizations, budgets for that care have remained the same or have decreased. This is most certainly true in correctional settings. Because pharmaceutical expenditures are a substantial percentage of a health care organization’s budget, medication utilization is closely scrutinized. Clinicians must consider the appropriateness, effectiveness, and safety of medications prescribed to incarcerated patients. The abundance of available drugs and the complex issues with respect to their safe and effective use make a sound program for maximizing rational drug use critical. This is a challenging task in jails and prisons that requires a reexamination of the treatments provided. This is not a process of arbitrarily limiting prescriber choices or their decision-making authority solely based on cost-saving incentives. Evidence-based, best practices that inform the development of, and adherence to, disease management guidelines and a preferred, restricted medication formulary enhances the quality, safety, and effectiveness of the care provided. This chapter details the process and procedures to develop, implement, and monitor prescription practice change by establishing an effective Pharmacy & Therapeutics Committee (P & TC). The chapter further addresses: the roles and responsibilities of a P & TC; P & TC decision-making processes; formulary development and modification; formulary process decision-making; medication therapy management guidelines; prescriber education; and data analytics to assist in monitoring outcomes, medication use, and prescriber adherence to P & TC policies.
Individual psychotherapy
Authors: Knoll James L.
Published: May 2015

The abandonment of the medical model in corrections almost half a century ago left a scorched earth policy in terms of rehabilitation, and in turn, psychotherapeutic efforts with inmates. Fortunately, the promise of new progress is returning. Along with the imperative of improving psychiatric treatment in corrections, mental health has brought the science of psychotherapeutic intervention back into corrections, this time reinforced by a social science evidence base. In practice, much of the psychotherapy in jails and prisons is indeed based on individual interaction. It includes crisis intervention, the more traditional approach of supportive psychotherapy, and a growing body of manual-guided therapies. This chapter discusses practical and fundamental aspects of individual psychotherapy with inmate patients, followed by an overview of evidence based paradigms for psychotherapy in corrections. Therapeutic style, strategies to minimize the risks of therapeutic nihilism, the context of the treatment setting, and the limits of confidentiality are each reviewed. While much of the evidence base supports cognitive behavioral approaches (including motivational interviewing and mindfulness, among others), the importance of maintaining competence in psychodynamically informed therapy is discussed. Of enduring importance, recognition of countertransference themes in correctional settings is also explored in this chapter.
Dual diagnosis
Authors: Taxman Faye S.
Published: May 2015

Substance abuse and mental illness are concentrated in correctional populations. Further, nearly half of female inmates and one-third of male inmates with substance use disorders have a diagnosable mental illness. Even with the higher rates of comorbid disorders of substance use and mental health, studies find that justice-involved individuals with mental illness tend to subscribe to a criminal lifestyle, criminal identity, and criminal values. Treatment for this population needs to address the syndemic of criminal lifestyle, mental illness, and substance abuse in order to effectively reduce recidivism and symptoms. The substance abuse population in most correctional settings is not homogeneous in terms of the type of drug abuse, the age and gender of the population, the criminal justice history, criminal lifestyle and value system, and mental health needs. In the justice system, there is a temptation to provide generic types of drug treatment. Treatment services need to be tailored to the individual in order to reduce symptoms and improve overall justice outcomes. For dually diagnosed patients, the need to provide treatment for both substance abuse and mental illness along with criminal lifestyle and thinking is widely recognized. This chapter reviews current knowledge about treatments for dually diagnosed patients. Included is a discussion of the factors that are unknown or unclear in the literature. Best practices and implementation issues regarding treatment for dual diagnosis patients are then discussed. An important part of these implementation issues are the systems factors required to support treatment in correctional settings. The chapter concludes with a research agenda for the future of dual diagnosis treatment in corrections.
Behavior management plans
Authors: Schmidt III Henry , Ivanoff André M.
Published: May 2015

The processes in behavior management include many strategies and methods found in sound cognitive-behavioral clinical practice. Broadly speaking, we define behavior management as the point of interaction between staff and inmate patients within the facility (or any other location in which they work together). It is always occurring, although not always planful or well-executed. A behavior management plan (BMP) takes into consideration staff abilities, specific characteristics of the unit, and the capacity of the patient for whom the plan is developed. A well-constructed BMP specifies who will do what, for whom, and in what contexts. Behavior management plans are most often developed and implemented for behaviors that pose high risk to inmate or staff health within the facility, or high risk to disrupt the safety and programming within the facility. We distinguish ‘behavior management’, which we define as a series of interventions designed to reduce behaviors which destabilize unit or facility functioning, from ‘treatment.’ Treatment is viewed as a series of interventions designed to reduce the future frequency, intensity and/or severity of a given behavior in the unit and upon return to the community. Thus, while there may be treatment characteristics included in BMPs, the scope of the intervention is typically more limited. A BMP may focus on a particular disruptive behavior in the unit, for instance, without any consideration of whether the behavior may occur in the community following release. In this chapter we review concepts related to behavior management and the creation of behavior management plans.
A roadmap for providing psychiatric services to incarcerated veterans
Authors: DeGroot James F.
Published: May 2015

The incarcerated population includes an increasing number of veterans with issues specific to their past military service. The demographics, criminogenic risk factors, and life experiences of incarcerated veterans, both combat and noncombat, differ substantially from nonveteran offenders. The trend observed with Vietnam veterans suggests that there is a gap between the time veterans are discharged from the military and the time they are incarcerated. With over two million personnel having served in Iraq and Afghanistan, the number of incarcerated veterans is likely to rise unless community resources are increased. Nonveterans are being treated with evidence-based correctional mental health and substance abuse treatment programs; however, similar programs have not been developed with the unique characteristics of veterans in mind. The pervasive trauma and posttraumatic stress disorders (PTSD) in this population can be profound. There is a critical need to create and implement evidence-based programs to treat the emotional, behavioral, and neurological needs of mentally ill and traumatized veterans. Society also struggles with the ambivalence of wanting to simultaneously punish and rescue them; mental health care providers struggle with their own emotional responses as they treat these distressed people. To help mental health care providers meet their personal and professional challenges in working with this complex population, an informational road map is presented in this chapter in order to navigate difficult terrain. The goal of this map is to help providers avoid potholes (of burn-out, cynicism, and malevolence) and head-on collisions with prison leadership and/or offenders resulting in a loss of credibility.
Juveniles
Authors: Bell Carl C.
Published: May 2015

The incarceration of juveniles occurs in both juvenile systems and adult correctional systems, depending on jurisdiction, age, and criminal charges. Holding adolescents responsible for behavior that sometimes leads to juvenile crimes ensures that offenders will be held accountable, but also provides justice to victims. However, children are still developing, and their brains develop from bottom up and inside out causing their flight, fight, or freeze (limbic) systems to be fully engaged before their judgment and wisdom (frontal lobe) systems are in place to mediate their behavior. Children are not little adults. More simply put - children are essentially all gasoline and no brakes or steering wheel, and they need mature adults to provide braking and steering until they can develop their own internal control systems. Accordingly, the mechanisms of accountability for juveniles should not mimic adult punishments. Suicide risk, developmental disabilities such as fetal alcohol spectrum disorder, and trauma histories are each of particular importance in this age group. Considering the complexity of the mental, emotional, and behavioral disorders of youth in corrections, there are several best-practice approaches to screening, assessment, and treatment. This chapter reviews the history of juvenile incarceration, and best or evidence-based practices in the management and treatment of incarcerated juvenile offenders.
Aging prisoners and the provision of correctional mental health
Authors: Cloyes Kristin G. , Burns Kathryn A.
Published: May 2015

The incarcerated population is aging. Newly arrested individuals and those aging in prison from mandatory lengthy sentences contribute to this dynamic. Screening for impairment and developing effective interventions and treatment for the incarcerated elderly has become a substantial challenge. The number of U.S. prisoners aged 65 or older grew at 94 times the rate of the overall prison population between 2007-2012. In 2011 7.9% of state and federal inmates were 55 or older; there were 26,700 over age 65. The number of inmates over 60 years of age in U.K. prisons increased by 120% between 2002 and 2013. Similar growth trends are reported in Sweden, Japan, Australia and Canada. This growth is complicated by the fact that chronological age does not necessarily match ‘health age’ or health status in prison. As a result, many prison systems have adjusted their definition of ‘elderly’ down to age 55 (and some as low as 40) to reflect the relatively poor health status of aging men and women in their institutions. Typical correctional health services in prisons across the U.S. are already hard-pressed to keep up with increasing demands for care of aging inmates. The responsibility to provide adequate health services for prisoners remains despite shrinking local, county, state and federal budgets. This chapter reviews the current status and prevalence of the incarcerated elderly, and presents best practice models for their care.
Cultural competence
Authors: Kapoor Reena , Griffith Ezra E. H.
Published: May 2015

Disparities exist in the rate of incarceration of minorities, with substantial elevations occurring in African American, Latino, and Native populations. Cultural competence is an essential aspect of providing mental health care in any setting. An understanding of culture is even more important in correctional settings, as several unique factors may lead to conflict and misunderstanding if not adequately addressed. First, minority ethnic groups are vastly overrepresented in prisons and jails, so a familiarity with the predominant culture of those groups is necessary to engage inmates in treatment and diagnose them accurately. Second, mental health clinicians may be unfamiliar with law enforcement culture, which heavily influences the practices of corrections officers and differs significantly from health care culture. Third, many correctional psychiatrists grow up and train outside the United States, bringing their own cultural beliefs about crime and punishment into the American health care system. As the field of cultural psychiatry has developed, scholars have attempted to apply its principles to the correctional setting to deliver competent care in prisons and jails. These papers have provided guidance to correctional mental health clinicians on matters such as immigrant populations, language barriers, validity of psychological testing in different ethnic groups, stigma of mental illness in prison, religion’s role in coping with the stress of incarceration, and many others. This chapter reviews the evolution of cultural competence skills in correctional settings and current best practices in jails and prisons to optimize effective treatment outcomes.
Forensic issues
Authors: Roskes Erik J. , Vanderpool Donna
Published: May 2015

A range of forensic psychiatry issues frequently present themselves in correctional settings. Incompetency to stand trial is one such concern. In some states, defendants found incompetent to stand trial must be managed in jail. Litigation is another important issue. Psychiatrists working in correctional settings often have increased litigation risks regarding professional negligence and other forms of liability. Especially important is understanding whether their insurer covers correctional work. One common form of litigation is habeas corpus. For example, a habeas petition could be brought to seek medical interventions denied by the detaining institution, and as such, the medical staff could be named defendants. Many class actions have involved correctional mental health care. Often clinicians working in correctional settings welcome these litigations, as they focus the attention of the courts on deficiencies in care related to inadequate resources. While such lawsuits can be sensitive, especially in the earlier phases when the outcome is in doubt, correctional psychiatrists and other clinicians may also serve as sources of information for each party to the case and to the court. Another key topic is the correctional disciplinary process. Mental health input into the disciplinary process does not address issues of responsibility but is limited to identifying mitigating factors related to mental illness when present, dispositional recommendations when clinically appropriate, and competency-to-proceed issues in the context of the disciplinary hearing. This chapter reviews key issues of relevance to correctional psychiatrists, such as competency restoration, court collaboration, and litigation related concerns.
Standards and accreditation for jails, prisons, and juvenile facilities
Authors: Penn Joseph V.
Published: May 2015

Numerous challenges confront correctional health staff in serving the needs of incarcerated adults and juveniles. Effective screening, timely referral, and appropriate treatment are critical. Their implementation requires interagency collaboration, adherence to established national standards of care, and implementation of continuous quality improvement practices and research on the health needs of this vulnerable patient population. Effective evaluation and treatment during incarceration meets important public health objectives and helps improve health services and effective transition into the community upon release. Many types of ‘free world’ health care organizations—such as hospitals, nursing homes, and psychiatric facilities—are accredited by the Joint Commission. Similarly, jails, prisons, juvenile detention, and other correctional facilities may be accredited by the National Commission on Correctional Health Care (a spinoff from the American Medical Association), the American Correctional Association, the Joint Commission, or a combination of the above. Although national accreditation is typically voluntary, it is often a contractual requirement for universities, other health care systems, and private vendors who provide health care services to correctional systems. In addition, when facilities undergo investigation or litigation, or are placed in receivership or federal oversight, they are often mandated to establish and maintain national accreditations. This chapter presents a brief historical narrative of the events that resulted in the development and adoption of national jail, prison, and juvenile correctional health care standards; a cogent review of jail and prison standards with particular relevance to psychiatry and mental health; and discussion of accreditation programs.
Systems monitoring and quality improvement
Authors: Metzner Jeffrey L.
Published: May 2015

Class action litigation that includes a focus on constitutionally inadequate correctional mental health care systems has been a major and effective force in jail and prison reform during the past four decades. Benefits to correctional mental health systems resulting from such litigation have included increased resources needed to implement basic policies and procedures that are necessary for a constitutionally adequate system. Following the passage of the Prison Litigation Reform Act of 1995, newly initiated consent decrees related to class action litigation involving correctional mental health services significantly decreased. The reduction in litigation related to this act followed from limiting the discretion of judges in approving such decrees that were previously allowed. Private settlement agreements and/or memoranda of agreement or their equivalents (the “Agreement”) have been substituted for the consent decree process. Although the judicial enforcement specific to implementation of these Agreements is weak, the monitoring process of such Agreements is very similar to those previously used with consent decrees. This chapter will summarize the monitoring process frequently involved in an Agreement resulting from a class action lawsuit specific to a correctional mental health care system using a single prison mental health system as an illustrative example. Emphasis will be placed on the importance of developing a quality improvement process that should ultimately eliminate the need for a monitor external to the mental health care system.
Red cell disorders
Authors: Provan Drew , Baglin Trevor , Dokal Inderjeet , de Vos Johannes
Published: May 2015

The peripheral blood film in anaemias - Anaemia in renal disease - Anaemia in endocrine disease - Anaemia in joint disease - Anaemia in gastrointestinal disease - Anaemia in liver disease - Iron (Fe) deficiency anaemia - Vitamin B12 deficiency - Folate deficiency - Other causes of megaloblastic anaemia - Anaemia in other deficiency states - Haemolytic syndromes - Genetic control of haemoglobin production - Sickling disorders - HbS—sickle-modifying therapies - Sickle cell trait (HbAS) - Other sickling disorders - Other haemoglobinopathies - Unstable haemoglobins - Thalassaemias - α thalassaemia - β thalassaemia - Other thalassaemias - Hereditary persistence of fetal haemoglobin - Hb patterns in haemoglobin disorders - Non-immune haemolysis - Hereditary spherocytosis - Hereditary elliptocytosis - Glucose-6-phosphate dehydrogenase (G6PD) deficiency - Pyruvate kinase deficiency - Other red cell enzymopathies - Drug-induced haemolytic anaemia - Methaemoglobinaemia - Microangiopathic haemolytic anaemia - Acanthocytosis - Autoimmune haemolytic anaemia - Cold haemagglutinin disease - Leucoerythroblastic anaemia - Aplastic anaemia - Paroxysmal nocturnal haemoglobinuria - Pure red cell aplasia - Iron (Fe) overload - Transfusion haemosiderosis
White blood cell abnormalities
Authors: Provan Drew , Baglin Trevor , Dokal Inderjeet , de Vos Johannes
Published: May 2015

Neutrophilia - Neutropenia - Lymphocytosis and lymphopenia - Eosinophilia - Basophilia and basopenia - Monocytosis and monocytopenia - Mononucleosis syndromes
Myelodysplasia
Authors: Provan Drew , Baglin Trevor , Dokal Inderjeet , de Vos Johannes
Published: May 2015

Myelodysplastic syndromes (MDS) - Classification of MDS - Clinical features of MDS - Prognostic factors in MDS - Clinical variants of MDS - Management of MDS - Response criteria - Myelodysplastic/myeloproliferative diseases (MDS/MPD)
Haematopoietic stem cell transplantation
Authors: Provan Drew , Baglin Trevor , Dokal Inderjeet , de Vos Johannes , Al-Sader Hassan
Published: May 2015

Haemopoietic stem cell transplantation (SCT) - Indications for haemopoietic SCT - Allogeneic SCT - Autologous STC - Investigations for BMT/PBSCT - Pretransplant investigation of donors - Bone marrow harvesting - Peripheral blood stem cell mobilization and harvesting - Microbiological screening for stem cell cryopreservation - Stem cell transplant conditioning regimens - Infusion of cryopreserved stem cells - Infusion of fresh non-cryopreserved stem cells - Blood product support for SCT - Graft-versus-host disease (GvHD) prophylaxis - Acute GvHD - Chronic GvHD - Veno-occlusive disease (syn. sinusoidal obstruction syndrome) - Invasive fungal infections and antifungal therapy - CMV prophylaxis and treatment - Post-transplant vaccination programme and foreign travel - Longer term effect post-transplant - Treatment of relapse post-allogeneic SCT - Discharge and follow-up
Haemostasis and thrombosis
Authors: Provan Drew , Baglin Trevor , Dokal Inderjeet , de Vos Johannes
Published: May 2015

Assessing haemostasis - The coagulation system - Laboratory tests - Platelets - Bleeding - Bleeding: laboratory investigations - Bleeding: therapeutic products - von Willebrand disease - Haemophilia A and B - Rare congenital coagulation disorders - Congenital thrombocytopenias - Congenital platelet function defects - Congenital vascular disorders - Haemorrhagic disease of the newborn - Thrombocytopenia (acquired) - Specific thrombocytopenic syndromes - Disseminated intravascular coagulation - Liver disease - Renal disease - Acquired anticoagulants and inhibitors - Treatment of spontaneous FVIII inhibitor - Acquired disorders of platelet function - Henoch–Schönlein purpura - Perioperative bleeding and massive blood loss - Massive blood loss - Heparin - Heparin induced thrombocytopenia/with thrombosis (HIT/T) - Oral anticoagulant therapy (warfarin, VKAs) - New oral anticoagulant drugs - Thrombosis - Risk assessment and thromboprophylaxis - Example of VTE risk assessment - Heritable thrombophilia - Acquired thrombophilia - Thrombotic thrombocytopenic purpura (TTP) - Haemolytic uraemic syndrome (HUS) - Heparin-induced thrombocytopenia (HIT)
Histologic RNFL Thickness in Glaucomatous Versus Normal Human Eyes
Authors: Maurice Corinne , Friedman Yael , Cohen Matan J. , Kaliner Ehud , Mimouni Michael , Kogan Michael , Blumenthal Eytan Z.
Published: May 2015

Purpose:

To compare the retinal nerve fiber layer (RNFL) thickness in histologic sections of glaucomatous eyes to nonglaucomatous eyes, to ascertain whether RNFL thinning can be confirmed histologically in human eyes.

Materials and Methods:

Seven postmortem glaucomatous eyes were compared with 17 normal postmortem eyes. The eyes were sectioned using the “umbrella technique” and measurements were performed on 4 concentric peripapillary rings with diameters of 3.0, 3.5, 4.0, and 4.5 mm. An overall average thickness, as well as an average for each of the temporal, superior, nasal, and inferior quadrants was obtained. The RNFL thickness of both groups in each of the quadrants in each of the rings were compared.

Results:

The overall average thickness (μm±SD) of the glaucomatous eyes for the 3.5-mm diameter rings was 36.5±10.6 compared with an average thickness of 60.3±19.5 in the nonglaucomatous eyes (P=0.006). The average sectorial thickness of the 3.5-mm diameter rings for the glaucomatous and normal eyes, respectively, was: temporal 30.9±10.6, 49.2±26.4 (P=0.080); superior 41.0±13.2, 75.3±26.5 (P=0.003); nasal 32.7±7.8, 48.1±15.0 (P=0.023); and inferior 41.6±14.4, 69.4±22.4 (P=0.012). The overall physiological “double hump” pattern was less preserved in the glaucomatous eyes.

Conclusions:

In this study a statistically significant loss of RNFL tissue was demonstrated when comparing glaucomatous to normal postmortem human eyes. These findings strengthen data obtained using imaging techniques that quantify RNFL thickness.
Protective Effects of Tirofiban on Myocardial Ischemia–Reperfusion Injury in Rabbits
Authors: Pan Gang , Long Sheng-Chun , Xu Xi-Ping , Zhao Jian-Hua , Li Zheng-Zai , Zhang Xu-Bin , Lu Yong-Hua , Zhang Zhi-Wei
Published: May 2015

We aimed to explore the different protective effects of tirofiban on myocardial ischemia–reperfusion (IR) injury in New Zealand white rabbits by comparing the results from different administration methods. Fifty New Zealand white rabbits were randomly divided into a sham group (group A, n = 10) and four IR groups (group B, IR group with injection of physiological saline; group C, tirofiban administered through marginal ear vein after reperfusion; group D, tirofiban injected through coronary ostia before reperfusion; group E, tirofiban injected through coronary artery after blood flow restoration; all n = 10). Myocardial IR injury models were prepared in IR groups. An automatic biochemical analyzer (HITACHI 7020, Japan) was applied for testing serum creatine kinase-MB levels. The myeloperoxidase activity, malondialdehyde levels, nitric oxide synthase activity, and nitric oxide (NO) volume were detected 180 minutes after reperfusion. The myocardial apoptosis was identified using the terminal deoxynucleotidyl transferase–mediated dUTP-biotin nick end labeling technique, and the protein expressions of B-cell lymphoma-2, Bcl-2 associated X, and aquaporin-1 were measured through Western blot. The highest and lowest ST-segment resolution among the IR groups was observed in groups E and B, respectively. The creatine kinase-MB levels at 60, 120, and 180 minutes in group E was greatly decreased than in groups B, C, and D. Compared with the sham group, the IR groups demonstrated evidently elevated myeloperoxidase activity, malondialdehyde levels, inducible NOS activity, NO volume, myocardial apoptotic index, and aquaporin-1 expressions; among the IR groups, these indicators were increased and decreased most in groups B and E, respectively. The B-cell lymphoma-2/Bcl-2 associated X ratio in the IR groups were evidently higher than the sham group, with the highest and lowest rate in groups E and B, respectively. Tirofiban injection through coronary artery after blood flow restoration has a better protective effect against myocardial IR injury than tirofiban administration through coronary ostia before reperfusion and tirofiban injection through the auricular vein after reperfusion.
Acute Kidney Injury Associated With Vancomycin When Laxity Leads to Injury and Findings on Kidney Biopsy
Authors: Katikaneni Madhavi , Lwin Lin , Villanueva Hugo , Yoo Jinil
Published: May 2015

The issue of vancomycin-induced acute kidney injury (AKI) has resurged with the use of intravenous vancomycin as a first-line antibiotic, often for prolonged periods of time for the management of serious methicillin-resistant Staphylococcus aureus infections, and with a higher recommended trough level (15–20 μg/mL). We have observed 3 patients on intravenous vancomycin who developed very high trough levels (>40 μg/mL) and severe (stage 3) AKI. Those 3 patients underwent kidney biopsy for unresolving AKI, which revealed findings compatible with acute tubular necrosis. The first patient initially developed asymptomatic acute interstitial nephritis because of a concomitant antibiotic that caused worsening of kidney function, and the dose of vancomycin was not properly adjusted while staying at the nursing home. The second was an emaciated patient (BMI, 14) whose serum creatinine level was a deceptive marker of kidney function for the proper dosing of vancomycin, resulting in a toxic level. The third patient developed vancomycin-related AKI on an initially high therapeutic level, which then contributed to further rising in vancomycin level and subsequently causing severe AKI. One patient required hemodialysis, but all 3 patients ultimately recovered their kidney function significantly. A regular monitoring (preferably twice weekly) of serum creatinine and vancomycin trough level is advisable to minimize vancomycin-associated AKI, primarily acute tubular necrosis, for patients requiring prolonged administration of vancomycin (>2 weeks) on the currently recommended higher therapeutic trough levels (>15 μg/mL).
Investigation of the anticorossion properties of perovskites in epoxy-ester resin based organic coating materials
Authors: Kalendova Andrea , Hejdová Martina , Vesely David
Published: May 2015

Purpose

– The purpose of this paper is to synthesize anticorrosion pigments of the perovskite type, YXO3, where X = Ti, Zr, Mn or Al and Y = Ca, Sr, La or Fe, for coating materials intended for corrosion protection of metals. Also, to synthesize pigments containing hexavalent Mo and W (double perovskites).

Design/methodology/approach

– The anticorrosion pigments were synthesized from oxides or carbonates by a high-temperature process. The following pigments were synthesized: CaTiO3, SrTiO3, CaZrO3, SrZrO3, LaTiO3, LaMnO3, CaMnO3, SrMnO3, LaFe2O3, SrFe2O3, LaAlO3, Ca2ZnWO6 and Ca2ZnMoO6. The pigments were characterized by the physico-chemical properties of the powders, by X-ray diffraction analysis and by scanning electron microscopy. Epoxy-ester coating materials containing the pigments at a volume concentration PVC = 10 per cent were prepared and subjected to tests examining their physico-mechanical properties and tests in simulated corrosion atmospheres.

Findings

– The perovskite structure was identified in the majority of the pigments. The pigments were found to impart good corrosion inhibiting properties to coating materials. The highest calculated anticorrosion efficiency was found for paints containing CaMnO3 or SrMnO3 as the pigments.

Practical implications

– The pigments synthesized can be used with advantage in paints intended for corrosion protection of the substrate metals.

Originality/value

– The use of the above pigments in anticorrosion coating materials to protect metals is new. Especially beneficial are the uses and procedures for the synthesis of anticorrosion pigments which do not contain heavy metals and are acceptable from the environmental protection aspect.
An important world crop – barley – as a new green inhibitor for acid corrosion of steel
Authors: Saadawy M
Published: May 2015

Purpose

– The purpose of this paper was to test the extract of barley as an environmentally friendly inhibitor for the acid corrosion of steel due to its wide availability as a popular major crop and its richness with different chemical constituents reported in literature (40) like alanine, glycine, serine, aspartic acid, leucine, valine, tyrosine and isoleucine with various number of functional groups that are able to chelate metal cations and to discuss the effect of temperature on its inhibition efficiency.

Design/methodology/approach

– Electrochemical impedance spectroscopy (EIS) and polarization measurements were carried out using frequency response analyzer Gill AC instrument. The frequency range for EIS measurements was 0.1 ≤ f ≤ 1 × 103 with an applied potential signal amplitude of 10 mV around the rest potential. Polarization measurements were carried out at a scan rate of 30 mV/min, utilizing a three-electrode cell. A platinum sheet and saturated calomel electrode were used as counter and reference electrodes, respectively. The working electrode was constructed with steel specimens that have the following composition (weight per cent): C, 0.21; S, 0.04; Mn, 2.5; P, 0.04; Si, 0.35; and balance Fe.

Findings

– Barley extract could act as an effective corrosion inhibitor for the acid corrosion of steel. The inhibiting action of the barley extract was attributed to its adsorption over the metal surface that blocks the available cathodic and anodic sites. Adsorption isotherms indicated that the adsorbed extract molecules cover one active center over the metal surface.

Originality/value

– The research included the first use of an important world crop as an effective corrosion inhibitor that can reduce the corrosion of steel to an extent of 94 per cent.
Export marketing assistance and early internationalizing firm performance
Authors: Faroque Anisur R. , Takahashi Yoshi
Published: May 2015

Purpose

– The purpose of this paper is to investigate the contingent relationship between government marketing assistance for export and the performance of early internationalizing firms in a developing country’s low-tech industry.

Design/methodology/approach

– The authors employ hierarchical multiple regression based on the data obtained from Bangladesh, a south Asian developing country and a leading exporter of apparel products worldwide. The authors used a sample of 224 early internationalizing apparel firms to test the hypotheses.

Findings

– Research describes the relationship between export assistance and performance as direct. Recently, some researchers have suggested moderators between them. The authors argue that the relationship between the two is contingent on the level of export commitment. The authors find that neither informational nor experiential marketing assistance is directly related to export performance. The relationship between informational assistance and export performance is significantly, but (unexpectedly) negatively, moderated by export commitment. The effect of experiential assistance is positively, but only marginally, moderated by export commitment.

Originality/value

– Contrary to researchers’ overarching focus on a direct relationship, the authors investigate the moderation on the relationship between export informational and experiential marketing assistance, and early internationalizing firms’ performance in a developing country’s low-tech industry setting. The authors use export commitment as the moderator; it is one of the most important internal determinants of export performance and extremely relevant in early internationalizing firms. The differential impact of informational and experiential assistance provides additional insights.
Three debates in organizational learning: what every manager should know
Authors: Thomas Nobin , Vohra Neharika
Published: May 2015

Purpose

– The present study aims to address three major debates in organizational learning, review past literature and pinpoint practical implications for managers.

Design/methodology/approach

– This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context.

Findings

– Though theoretical contributions have enriched “organizational learning” literature for over five decades, there seems to be little consensus among scholars about its definition, methodology and theoretical perspectives. Little did anyone realize that the construct itself would become so encompassing that its merit of being understood gets overshadowed by the multitude of perspectives. For managers, it requires a basic understanding of these three debates to remain open to the organizational learning efforts in their organization.

Originality/value

– Based on an extensive literature review, the briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.
Why wakeful leadership is more important now than ever
Authors: Marques Joan F.
Published: May 2015

Purpose

– The purpose of this paper is to underscore the need for wakeful leadership, which is manifested through regular reflection.

Design/methodology/approach

– This briefing is prepared by a leadership scholar/practitioner based on a blend of theory and practice.

Findings

– Today’s leadership, whether in a formal or informal setting, and whether with others involved or not, requires reflection to refrain from mindless continuance of obsolete mindsets and behaviors.

Practical implications

– The paper provides strategic insights and practical thinking aimed at constructively influencing current and future leaders.

Originality/value

– A brief but critical emphasis on the urgent need of reflectively leading ourselves, others and our organizations today, considering past and future.
Teaching “other people’s children” in Australia from the 1840s to contemporary times
Authors: Whitehead Kay
Published: May 2015

Purpose

– The purpose of this paper is to explore Australian educators’ work with “other people’s children” (OPCs) (Delpit, 2006) from the informal education market of the 1840s to the mass education market in contemporary times.

Design/methodology/approach

– The paper is structured as a narrative about the expansion of the educational state and the concomitant development of technologies of inclusion and exclusion. Snapshots of various educators’ work with “OPCs” are woven into the narrative.

Findings

– Notwithstanding contemporary efforts to “confront educational disadvantage” and an ever increasing array of technologies with which to differentiate students, OPCs remain on the margins of Australian education.

Originality/value

– This paper is a unique look at Australian educators’ work with “OPCs” over the past 175 years.