Pharmacomechanical thrombolysis in the management of acute inferior vena cava filter occlusion using the Trellis-8 device.

PURPOSE: To evaluate the performance and safety of the Trellis-8 system, a pharmacomechanical thrombolysis infusion catheter, and adjunctive therapies in the treatment of symptomatic inferior vena cava (IVC) filter-related acute thrombotic occlusion. METHODS: Eight consecutive patients (6 men; mean age 57.4 years, range 34-78 years) with acute thrombotic occlusion of the IVC in the presence of an IVC filter underwent percutaneous venous thrombectomy using the Trellis-8 thrombectomy system and adjunctive techniques between January 2009 and November 2013. Demographics, clinical data, procedures, and outcomes were retrospectively reviewed. All patients had clinical signs of lower extremity venous hypertension on presentation. The median time between IVC filter placement and occlusion was 25 months. Patients were followed for the development of thromboembolic complications to the last clinic visit or until they died. RESULTS: The procedure was technically successful in 6 patients, whereas it could not be performed in 2 due to failure to cross the occlusion. The median follow-up period was 7.8 months, at which time all patients undergoing successful Trellis-8 thrombectomy had relief of symptoms without thromboembolic or bleeding complications. CONCLUSION: In this limited performance and safety evaluation, the Trellis-8 thrombectomy system combined with adjunctive therapies, such as mechanical thrombectomy and balloon angioplasty, was effective in 75% of patients with IVC filter-related acute caval occlusion.

El nuevo terapeuta, su rol y compromiso: reflexiones en torno a la formación de los profesionales de la salud mental / The new therapist, his role and commitment: reflections on the training of mental health professionals

La formación de los psicoterapeutas implica el desarrollo de competencias no sólo teóricas y técnicas, sino además, y fundamentalmente, personales, lo que indica que las instituciones comprometidas con este proceso formativo, deben asumir de manera inherente la responsabilidad social implicada. Los nuevos terapeutas son personas sensibles, que no tienen miedo de expresar sus emociones, que se implican con cada persona que atienden, son evolutivos y flexibles, y sobre todo, llevan sobre sus hombros la responsabilidad de acompañar a los demás en la búsqueda de opciones frente a las dificultades que se les presentan. En este artículo se hace una reflexión acerca de los roles, compromisos y responsabilidades de los nuevos terapeutas, constituyendo un llamado a todos los profesionales de la salud mental para que se ocupen de sí mismos en su condición de ser personas, y a las instituciones formadoras para que cumplan su misión de manera comprometida con la sociedad, la ciencia y las profesiones.

The training of psychotherapists implies the development of not only theoretical and technical skills, but also, and fundamentally, personal ones, which indicates that the institutions committed to this training process must inherently assume the social responsibility involved. New therapists are sensitive people, who are not afraid to express their emotions, who are involved with each person they serve, are evolutionary and flexible, and above all, they carry on their shoulders the responsibility of accompanying others in the search for options faced with the difficulties that arise. This article makes a reflection on the roles, commitments and responsibilities of new therapists, constituting a call to all mental health professionals to take care of themselves in their condition of being people, and to training institutions to that fulfill their mission in a way that is committed to society, science and the professions.

Estrés y angustia social: base real o imaginaria / Stress and social anguish: real or imaginary base

Es claro pensar que algunas manifestaciones de angustia tienen que ver con fenómenos sociales característicos de nuestro medio. Si asumimos que vivimos en un medio de por sí amenazante, tomaríamos las manifestaciones de angustia como reacciones normales ante las condiciones ambientales.

It is clear to think that some manifestations of anguish have to do with social phenomena characteristic of our environment. If we assume that we live in a threatening environment, we would take the manifestations of anguish as normal reactions to environmental conditions.

El enfoque teórico cognitivo / The theoretical cognitive approach

Los modelos de la psicoterapia cognitiva constituyen uno de los enfoque más firmemente asentados en la actualidad, y en poco más de cuarenta años de desarrollo, han logrado mostrar no sólo su eficacia clínica sino también la pertinencia de sus postulados teóricos en la explicación de los fenómenos humanos.

Cognitive psychotherapy models constitute one of the most firmly established approaches today, and in just over forty years of development, they have managed to show not only their clinical efficacy but also the relevance of their theoretical postulates in explaining the phenomena humans.