Atypical Rasmussen's Encephalitis.

A three-year-old female patient was admitted to our institution due to subacute fever, intermittent vomiting, persistent bilateral mydriasis after cycloplegia, right central facial palsy, and mild right hemiparesis with hyperreflexia. Brain MRI shows encephalitis in frontal, parietal, insular, and left putamen course and loss of cortical volume and white matter of the entire left hemisphere which are features described in Rasmussen's encephalitis (RE). Therapy with intravenous methylprednisolone bolus was initiated, with adequate clinical response. We consider in this case the diagnosis of atypical RE by imaging criteria in the subacute stage. There are few reports of atypical RE without epilepsy or continuous partial epilepsy. Our purpose is to present a case of a patient with RE images without epilepsy seizures and review the diagnostic and therapeutic approach of RE.

Standardizing the Definition and Analysis Methodology for Complete Coronary Artery Revascularization.

Guideline-based medical therapy is the foundation of treatment for individuals with coronary artery disease. However, revascularization with either percutaneous coronary intervention or coronary artery bypass grafting may be beneficial in patients with acute coronary syndromes, refractory symptoms, or in other specific scenarios (eg, left main disease and heart failure). While the goal of percutaneous coronary intervention and coronary artery bypass grafting is to achieve complete revascularization, anatomical and ischemic definitions of complete revascularization and their methodology for assessment remain highly variable. Such lack of consensus invariably contributes to the absence of standardized approaches for invasive treatment of coronary artery disease. Herein, we propose a novel, comprehensive, yet pragmatic algorithm with both anatomical and ischemic parameters that aims to provide a systematic method to assess complete revascularization after percutaneous coronary intervention or coronary artery bypass grafting in both clinical practice and clinical trials.

The impact of physical, psychological, and sexual intimate male partner violence on women's mental health: depressive symptoms, posttraumatic stress disorder, state anxiety, and suicide.

OBJECTIVE: This study aimed to determine the impact of lifetime physical, psychological, and sexual intimate male partner violence (IPV) on the mental health of women, after controlling for the contribution of lifetime victimization. The comorbidity of depressive symptoms and posttraumatic stress disorder (PTSD) and their relation to state anxiety and suicide were also assessed. METHODS: Physically/psychologically (n = 75) and psychologically abused women (n = 55) were compared with nonabused control women (n = 52). Information about sociodemographic characteristics, lifetime victimization, and mental health status (depressive and state anxiety symptoms, PTSD, and suicide) was obtained through face-to-face structured interviews. RESULTS: Women exposed to physical/psychological and psychological IPV had a higher incidence and severity of depressive and anxiety symptoms, PTSD, and thoughts of suicide than control women, with no differences between the two abused groups. The concomitance of sexual violence was associated with a higher severity of depressive symptoms in both abused groups and a higher incidence of suicide attempts in the physically/psychologically abused group. The incidence of PTSD alone was very rare, and depressive symptoms were either alone or comorbid with PTSD. The severity of state anxiety was higher in abused women with depressive symptoms or comorbidity, as was the incidence of suicidal thoughts in the physically/psychologically abused group. Lifetime victimization was not a predictor of the deterioration of mental health in this study. CONCLUSIONS: These findings indicate that psychological IPV is as detrimental as physical IPV, with the exception of effects on suicidality, which emphasizes that psychological IPV should be considered a major type of violence by all professionals involved.

Assessing physical, sexual, and psychological violence perpetrated by intimate male partners toward women: a Spanish cross-sectional study.

There have been many studies on the impact of intimate partner violence (IPV) on women's health, there being agreement on its detrimental effect. Research has focused mainly on the impact of physical violence on health, with few studies assessing the effect of sexual and psychological violence. Furthermore, there are many differences in the way violence experienced by women is assessed. While some researchers use available instruments, others develop their own questionnaires. This article gives detailed information about physical, sexual, and psychological violence, lifetime history of women's victimization, and aspects of women's behavior and feelings obtained with the questionnaire used in a Spanish cross-sectional study. Our results corroborate that IPV is not homogeneous, it being necessary to ask women about each type of violence they have experienced. Furthermore, to accurately assess the impact of IPV on women's health, it is necessary to control for other variables that also have detrimental effects on health.

Changes in cortisol and dehydroepiandrosterone in women victims of physical and psychological intimate partner violence.

BACKGROUND: Although intimate partner violence (IPV) has a great impact on women's health, few studies have assessed the consequences on physiologic responses. METHODS: Women abused by their intimate male partners either physically (n = 70) or psychologically (n = 46) were compared with nonabused control women (n = 46). Information about sociodemographic characteristics, smoking, pharmacologic treatment, lifetime history of victimization (childhood and adulthood), and mental health status (depression, anxiety, and posttraumatic stress disorder, PTSD) was obtained through structured interviews. Saliva samples were collected at 8 am and 8 pm for 4 consecutive days to determine morning and evening basal levels of cortisol and dehydroepiandrosterone (DHEA). RESULTS: Women who were victims of IPV had more severe symptoms of depression, anxiety, and incidence of PTSD and higher levels of evening cortisol and morning and evening DHEA compared with control women. Intimate partner violence was the main factor predicting the alterations in hormonal levels after controlling for age, smoking, pharmacologic treatment, and lifetime history of victimization. Mental health status did not have a mediating effect on the impact of IPV on hormonal levels. CONCLUSIONS: This study shows that both physical and psychological IPV have a significant impact on the endocrine systems of women.