RESUMO
Prazosin is an alpha-1 blocker that is commonly given to patients with posttraumatic stress disorder (PTSD) to reduce nightmares and flashbacks. Its use in acute stress disorder (ASD), however, has not been well characterized. There is a moderately positive correlation between ASD and the subsequent development of PTSD, which indicates that there may be some common neurobiological mechanisms that connect the 2 conditions. We present the case of a 51-year-old man who was experiencing symptoms of ASD following a motor vehicle accident that occurred a few days earlier. He was reporting flashbacks and nightmares of the accident, but after being treated with prazosin, his symptoms completely resolved. Prazosin may be effective in treating the symptoms of ASD and, by doing this, it may also play a role in inhibiting the progression of ASD to PTSD.
Assuntos
Prazosina/uso terapêutico , Transtornos de Estresse Traumático Agudo/tratamento farmacológico , Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Sonhos/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Prazosina/farmacologia , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Transtornos de Estresse Traumático Agudo/psicologiaRESUMO
Diabetes mellitus is a devastating disease that has reached epidemic proportions. The surgical patient with diabetes is at increased risk for developing complications when compared with patients without diabetes. A comprehensive preoperative work-up must be performed, including ancillary studies, with optimization of the patient's glucose levels during the perioperative period to decrease the chance of developing surgical complications. A multispecialty team approach for the care of patients with diabetes should be used to produce successful surgical outcomes.
Assuntos
Glicemia/análise , Complicações do Diabetes/prevenção & controle , Fixação Interna de Fraturas/efeitos adversos , Complicações Pós-Operatórias/fisiopatologia , Cuidados Pré-Operatórios/métodos , Fraturas do Tornozelo/cirurgia , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/cirurgia , Feminino , Traumatismos do Pé/cirurgia , Fixação Interna de Fraturas/métodos , Consolidação da Fratura/fisiologia , Humanos , Masculino , Assistência Perioperatória/métodos , Podiatria/métodos , Complicações Pós-Operatórias/terapia , Medição de Risco , Resultado do Tratamento , Cicatrização/fisiologiaRESUMO
Psychometric instruments are products of their time-Their designs and initial purposes are influenced and shaped by the contemporary treatment regimens, context, and cultural and conceptual biases of their developers. In this review article, the authors explore the history of the most influential schizophrenia research tools that have been created over the past several decades. The authors describe the scientific concepts, cultural influences, and challenges of past and present researchers as they strive to develop better assessment tools for schizophrenia. Starting with Moore's Scheme for the Quantitative Measurement of Abnormal Emotional Condition, developed in the early 1900s, and concluding with Kay, Fiszbein, and Opler's Positive and Negative Syndrome Scale, developed in the 80s, the authors describe several scales and illustrate how each scale led to and influenced the development of a later scale. The authors hope that a better understanding of schizophrenia assessment tool evolution and limitations will assist in the development of new instruments that better address the global needs for the evaluation, research, and treatment of psychosis.