A Network Approach to Studying the Associations Between Posttraumatic Stress Disorder Symptoms and Dissociative Experiences

In recent years, there has been a growing recognition of a dissociative subtype of posttraumatic stress disorder (D-PTSD), characterized by experiences of depersonalization (DP) and derealization (DR), among individuals with PTSD. Little is known, however, about how experiences of DP and/or DR are associated with the experience of other PTSD symptoms. The central aim of the present paper was to explore the associations among DP, DR, and other PTSD symptoms by means of a network analysis of cross-sectional data for 557 participants whose overall self-reported PTSD symptom severity warranted a probable PTSD diagnosis. Three notable findings emerged: (a) a strong association between DP and DR, (b) the identification of DP as the most central symptom in the network, and (c) the discovery that clusters of symptoms in the network were roughly consistent with DSM-5 PTSD criteria. We discuss these findings in light of some considerations, including the nature of our sample and the limits of interpreting cross-sectional network models.     

Response of renal and femoropopliteal arteries to Palmaz stent implantation assessed with intravascular ultrasound.

PURPOSE: To establish the processes responsible for late lumen loss in renal and femoropopliteal Palmaz stents using intravascular ultrasound (IVUS). METHODS: The first 7 consecutive patients treated with stents for renal (n = 4) and femoropopliteal (n = 3) arterial occlusive disease were studied with IVUS immediately after angiographically successful stent placement (< 10% residual stenosis) and periodically during follow-up. Images of both stent edges and the most stenotic site inside the stent at followup were matched to the same cross sections captured immediately after stent placement for quantitative analysis. RESULTS: Late lumen loss in renal artery stents at 5 to 34 months was considerably less than in femoropopliteal stents (17% versus 62%, respectively). In the renal location, late lumen loss (3.0 +/- 1.3 mm2) was due to neointimal hyperplasia, whereas stent area remained unchanged (3% decrease). Late lumen loss (7.4 +/- 8.2 mm2) in femoropopliteal stents was due to neointimal hyperplasia and stent area reduction (26%). Overall, in both types of arteries, neointimal development and stent area reduction were larger at the most stenotic site than at the stent edges. CONCLUSIONS: These data suggest that there may be differences between renal and femoropopliteal arteries in the extent of hyperplastic response to stents.     

Stent placement for renal arterial stenosis: where do we stand? A meta-analysis

PURPOSE: To perform a meta-analysis of renal arterial stent placement in comparison with renal percutaneous transluminal angioplasty (PTA) in patients with renal arterial stenosis. MATERIALS AND METHODS: Studies dealing with renal arterial stent placement (14 articles; 678 patients) and renal PTA (10 articles; 644 patients) published up to August 1998 were selected. A random-effects model was used to pool the data. RESULTS: Renal arterial stent placement proved highly successful, with an initial adequate performance in 98% and major complications in 11%. The overall cure rate for hypertension was 20%, whereas hypertension was improved in 49%. Renal function improved in 30% and stabilized in 38% of patients. The restenosis rate at follow-up of 6-29 months was 17%. Stent placement had a higher technical success rate and a lower restenosis rate than did renal PTA (98% vs 77% and 17% vs 26%, respectively; P <.001). The complication rate was not different between the two treatments. The cure rate for hypertension was higher and the improvement rate for renal function was lower after stent placement than after renal PTA (20% vs 10% and 30% vs 38%, respectively; P <.001). CONCLUSION: Renal arterial stent placement is technically superior and clinically comparable to renal PTA alone.     

BOOK REVIEW

Heart Failure: A Practical Guide for Diagnosis and Management (Oxford American Cardiology Library) by Stuart Katz. Oxford University Press, UK, 2013. ISBN: 978‐0‐19‐991708‐2     

Detection and prevention of occupational diseases by physicians from the Dutch Labour Inspectorate (1903-1986)

The Dutch government started to organize medical care for workers at the end of the 19th century in order to prevent work-related damage to health. From 1903 on, medical advisors were appointed by the Labour Inspectorate to signal the development of occupational diseases and to take preventive measures. For this purpose, thousands of medical check-ups of workers were performed. A second main task was the detection and study of occupational diseases in specific branches of industry. With the rise of the industrial health services, as propagated by the medical advisors, the medical department finally closed down in 1986.