Early recovery following traumatic brain injury and alcohol withdrawal management.

PURPOSE: To compare recovery experienced during inpatient rehabilitation among individuals with traumatic brain injury (TBI) based on whether their acute care included the Clinical Institute Withdrawal Assessment for Alcohol (CIWA) protocol. DESIGN: Participants included 234 individuals with TBI who completed inpatient rehabilitation at a TBI Model Systems site. Of these, 67 patients were treated using the CIWA protocol (TBI + CIWA); 167 patients were treated for TBI alone (TBI only). Demographic, injury, and treatment variables between the 2 groups were compared. A repeated-measures analysis of variance (ANOVA) compared Disability Rating Scale (DRS) scores between the groups at admission and discharge from inpatient rehabilitation. RESULTS: The 2 groups did not significantly differ on DRS scores at admission to inpatient rehabilitation: TBI + CIWA, M = 9.6 (SD = 3.5) vs. TBI only, M = 10.1 (SD = 4.2). There was a significant difference in DRS scores at discharge, with the TBI + CIWA group having lower scores: TBI + CIWA, M = 6.4 (SD = 1.9) vs. TBI only, M = 7.0 (SD = 2.2). A repeated-measures ANOVA of DRS scores from admission to discharge revealed a significant between-subjects effect based on patients' Mississippi categorization of posttraumatic amnesia (PTA) duration (p < .001) and age (p = .016) but not based on their CIWA status (p = .068). A post hoc comparison including age as a covariate revealed a significant difference based on CIWA status (p = .013) within the "moderate" injury group at discharge, with the TBI + CIWA group having lower discharge DRS scores. CONCLUSIONS: Given the significant symptom overlap between alcohol withdrawal and PTA, it is likely that these 2 delirium presentations are confounded during the initial recovery from TBI, leading to "overestimation" of injury severity-particularly among individuals with moderate TBI. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Survival of patients with spinal cord injury after cardiac arrest in Department of Veterans Affairs hospital: Pilot study.

Survivability characteristics after cardiopulmonary resuscitation in the population with spinal cord injury (SCI) are unclear but may be useful for advanced care planning discussions with patients. Retrospective evaluation from records of all SCI patients over 10 yr at a Department of Veterans Affairs medical center who experienced in-hospital cardiac arrest was performed. Demographic data and other common measurements were recorded. Thirty-six male subjects were identified, and only two patients survived to discharge (5.5% survival rate), both of whom were admitted for nonacute issues and were asymptomatic shortly before the cardiac arrest. The mean age at the time of cardiopulmonary arrest was 62.4 yr, with a mean time from cardiac arrest to death of 3.02 d. No significant demographic parameters were identified. Overall, SCI likely portends worse outcome for acutely ill patients in the situation of a cardiac arrest. Conclusions are limited by sample size.

Colitis after polytrauma: case report.

Across the medical literature, delayed diagnosis and treatment leads to more costly and worse outcomes. Rehabilitation patients, especially those with polytrauma, often have a complex mixture of medical, social, and psychological health problems that can impair effective diagnosis and treatment. The case presentation describes the procession toward the diagnosis of ulcerative colitis in a preinjury asymptomatic male, suggesting a potential mechanism for its emergence and describing the effect of delayed diagnosis on the efficiency of rehabilitative care. As such, the differential diagnosis for early posttraumatic diarrhea should remain broad, particularly if unexplained or ineffectively controlled.

Ensayos científicos sobre la coca

Papel de la coca en la historia, religión y medicina de los indios sudamericanos. Aspectos psicológicos del coqueo. Uso de la hoja de coca en el sur del Perú. Calcio: fuentes raras en la dieta serrana peruana. Valor alimenticio de la coca. Efectos de la coca sobre metabolismo basal en los sujetos no habituados. Metabolismo de la cocaína. Dosis de alcaloídes que ingieren los habituados a la coca. Nueva perspectiva sobre la masticación de la coca. Masticación de la coca y rendimiento en el trabajo entre los indios machiguenga del Perú. Patrones del uso de la coca en Bolivia. Uso social de la coca en el mundo andino

Ensayos científicos sobre la coca

Contiene: El papel de la coca en la historia, religión y medicina de los indios sudamericanos - Aspectos psicológicos del cuerpo - El uso de la hoja de coca en el sur del Perú - Calcio: fuentes en la dieta serrana peruana - El valor alimenticio de la coca - Efectos de la coca sobre el metabolismo basal en los sujetos no habituados - Metabolismo de la cocaína - Dosís de alcaloides que ingieren los habituados a la coca - Una nueva perspectiva sobre la masticación de la coca - Masticación de la coca y rendimiento en el trabajo entre los indios Machiguenga del Perú

Irpa Chico: individuo y comunidad en la cultura aymara

Contiene: Defendiendo la tierra - Ganando la vida - Entrando al mundo - Logrando mayoría de edad - Ganando prestigio - Aplacando a los espiritus - Dejando la vida - Irpa Chico ¿víctima o beneficiario del desarrollo