The implications of borderline personality features for jail inmates' institutional misconduct and treatment-seeking.

Borderline personality disorder (BPD) is common in jails and prisons. In a sample of 506 jail inmates (30% female), we examined whether BPD symptoms assessed upon incarceration predict subsequent institutional misconduct and treatment-seeking. BPD features modestly predicted occurrence (vs. nonoccurrence) of institutional misconduct. Importantly, BPD did not predict the number of institutional misconduct incidents. That is, BPD was not associated with frequent, repeated difficulties in institutional adjustment. Consistent with previous research showing a relationship between BPD and past treatment-seeking in clinical and community samples, jail inmates' BPD features significantly predicted subsequent requests for treatment. Regarding specific types of treatment, the relationship held for substance abuse programs and forensic mental health services but not for psychoeducational services or support groups. There were very few moderators of the link between BPD and subsequent institutional misconduct and treatment-seeking. Most of the observed relationships held across sex, race, and age. Findings of the study indicate that jail staff and clinicians must learn to distinguish between initial adjustment problems and frequent misconduct among inmates high in BPD to facilitate their adjustment. The study further highlights the need for BPD-relevant treatments and services in jails. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Successful systemic fibrinolysis in a patient with Covid-19: Case report / Fibrinólisis sistémica exitosa en un paciente con Covid- 19: Reporte de Caso

Abstract The new coronavirus 2019-nCov or SARS-Cov-2 is responsible for the most important pandemic in the 21st century: the coronavirus disease (COVID-19). The 2019-nCov infection elicits a hyper-coagulable state, conditioning a worse outcome in these patients. The pathophysiology of the exaggerated coagulation activation in these patients is still unknown, and probably involves several mechanisms, different from those involved in sepsis-associated coagulopathy. This article discusses the case of a patient with no remarkable medical history, who after 7 days of fever, diarrhea and epigastric pain was diagnosed with COVID-19 bilateral pneumonia, further aggravated by severe Acute Respiratory Distress Syndrome. In this context, the patient experienced a massive acute pulmonary thromboembolism accompanied by an acute thrombus in the heart's right ventricle, leading to hemodynamic instability. For the first time in our center in these patients, systemic fibrinolysis was successfully performed, with resolution of the intracavitary thrombus and the acute hemodynamic shock.

Resumen El nuevo coronavirus 2019-nCov o SARS-Cov-2 es responsable de la pandemia más importante del siglo XXI: la enfermedad del coronavirus (COVID-19). La infección por 2019-nCov produce un estado de hipercoagulabilidad, que promueve peores desenlaces en estos pacientes. La fisiopatología de la exagerada activación de la coagulación en estos pacientes aún se desconoce y posiblemente involucre varios mecanismos, diferentes a los participan en la coagulopatía asociada a sepsis. El presente artículo presenta el caso de un paciente sin antecedentes médicos y quien luego de 7 días de fiebre, diarrea y dolor epigástrico, fue diagnosticado con neumonía bilateral por COVID-19, agravada por la presencia de Síndrome de Dificultad Respiratoria Aguda. En este contexto, el paciente desarrolla un tromboembolismo pulmonar agudo masivo, acompañado de un trombo agudo en el ventrículo derecho, produciéndole inestabilidad hemodinámica. Por primera vez en nuestro centro, se realizó exitosamente una fibrinólisis sistémica, con resolución del trombo intracavitario y del shock hemodinámico agudo.