The development of a posttraumatic stress disorder (PTSD) consultation program to support system-wide implementation of high-quality PTSD care for veterans.

Among veterans, there is a 7% lifetime prevalence of posttraumatic stress disorder (PTSD; Goldstein et al., 2016), with this diagnosis being linked to poor health and quality of life (Goldstein et al., 2016; Schnurr et al.

Implementation strategies to improve posttraumatic stress disorder care in rural veterans.

Purpose: Prior research has noted treatment inequalities in the care of rural veterans with posttraumatic stress disorder (PTSD). This project sought to increase the delivery, or reach, of recommended PTSD treatments in 2 rural health care systems of the Department of Veterans Affairs (VA) using implementation facilitation.

Methods: The quality improvement project involved 6 months of facilitation to 2 low-reach PTSD clinics within 2 VA health care systems.

Taking the message to the rural patient: evidence-based PTSD care.

The Department of Veterans Affairs and Department of Defense (VA/DoD) Clinical Practice Guideline for PTSD recommends against the use of benzodiazepines. Despite the recommendation, clinicians continue potentially inappropriate benzodiazepine prescribing practices for veterans with PTSD. We designed an educational product aimed at decreasing benzodiazepine use in PTSD care.

Conducting Prolonged Exposure for PTSD During the COVID-19 Pandemic: Considerations for Treatment.

The unprecedented effects and duration of the COVID-19 crisis are likely to elevate the population's level of anxiety due to psychological stress, economic hardship, and social isolation. This effect may be especially potent for individuals with preexisting mental health conditions, such as posttraumatic stress disorder (PTSD). Prolonged Exposure (PE) therapy is a highly effective treatment for PTSD across trauma-exposed populations, and has been implemented effectively via telehealth.

Professional Burnout of Psychiatrists in a Veterans Health Administration: Exploring the Role of the Organizational Treatment.

Psychiatrists in the Veterans Health Administration (VHA) are susceptible to professional burnout due to the unique needs of veterans combined with high organizational demands. The current study examined the mediating role of organizational factors in the direct relationship between providing primarily pharmacological intervention and professional burnout. Data from 125 VHA psychiatrists revealed that fair treatment by superiors and sufficient resources independently mediated the direct relationship that the percent of time devoted to pharmacological intervention had with emotional exhaustion and cynicism.

MMPI-2-RF characteristics of veterans seeking treatment for military sexual trauma.

Military sexual trauma (MST) is defined as experiences of sexual assault or repeated, threatening, harassment during military service. MST events may not qualify within posttraumatic stress disorder (PTSD) Criterion A, making symptoms associated with MST unique from trauma-related disorders. Little research has been done to understand those presenting for MST treatment.

27 ways to meet PTSD: Using the PTSD-checklist for DSM-5 to examine PTSD core criteria.

Posttraumatic stress disorder (PTSD) has been criticized for including symptoms that substantially overlap with other depression and anxiety disorders. To address this concern, Brewin et al. (2009) reformulated the diagnosis around a core symptom set.

Examining the latent structure mechanisms for comorbid posttraumatic stress disorder and major depressive disorder.

Background: Posttraumatic stress disorder (PTSD) is a complex psychiatric illness that can be difficult to diagnose, due in part to its comorbidity with major depressive disorder (MDD). Given that researchers have found no difference in prevalence rates of PTSD and MDD after accounting for overlapping symptoms, the latent structures of PTSD and MDD may account for the high comorbidity. In particular, the PTSD Negative Alterations in Cognition and Mood (NACM) and Hyperarousal factors have been characterized as non-specific to PTSD.

The relationship between DSM-5 PTSD symptom clusters and alcohol misuse among military veterans.

Background And Objectives: Prior research has revealed a strong relationship between Posttraumatic Stress Disorder (PTSD) and alcohol misuse. However, previous attempts to understand nuanced associations between PTSD symptom clusters and alcohol misuse within military veteran samples have produced mixed results. In an attempt to better understand the associations between PTSD and alcohol misuse, the current study examined the unique relationships between the newly classified Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) PTSD symptom clusters and alcohol misuse in an outpatient sample of military veterans seeking treatment for PTSD and Substance Use Disorders.

Pilot study comparing telephone to in-person delivery of cognitive-behavioural therapy for trauma-related insomnia for rural veterans.

Introduction It is estimated that 70% of patients with posttraumatic stress disorder (PTSD) have chronic insomnia. A recent meta-analysis examined cognitive-behavioural therapy for insomnia (CBT-I) in veterans with and without PTSD, and suggested that most studies had questionable methodology, but generally supported its effectiveness in this population. Further, while CBT-I via telehealth (i.

Sometimes Less is More: Establishing the Core Symptoms of PTSD.

Historically, the symptoms of posttraumatic stress disorder (PTSD) have garnered attention and controversy due to symptom overlap with other disorders. To improve diagnostic specificity, researchers have proposed to reformulate PTSD symptoms into a parsimonious set of core criteria. The core symptoms consisted of recurrent distressing dreams or flashbacks; internal or external avoidance; and hypervigilance or exaggerated startle.

Associations between lower order anxiety sensitivity dimensions and DSM-5 posttraumatic stress disorder symptoms.

Anxiety sensitivity (AS), a well-established individual difference variable reflecting a tendency to fear bodily sensations associated with arousal, has been implicated in the development and maintenance of posttraumatic stress disorder (PTSD). Despite these associations, little research has examined the relations between AS subfactors (eg physical, cognitive, and social) and PTSD symptoms and none have examined these associations in the context of DSM-5 (Diagnostic Statistical Manual of Mental Disorders, Fifth Edition) PTSD clusters (ie intrusion, avoidance, negative alterations in cognitions/mood, and arousal). Participants included 50 veterans presenting to an outpatient Veteran Affairs Clinic for psychological services.

Examining potential overlap of DSM-5 PTSD criteria D and E.

The Diagnostic and Statistical Manual, Fifth Edition-5 (DSM-5) has adopted a four-factor symptom model for Posttraumatic Stress Disorder (PTSD) that includes new symptom additions in criterion D (D2, D3, D4), negative alterations in cognition and mood. This article examines potential overlapping endorsement of these symptoms amongst one another and with the behavioral symptoms within PTSD criterion E (E1 and E3; alterations in arousal and reactivity), through the lenses of cognitive-behavioral theory. Responses of veteran participants (N=320) completing the PTSD Checklist-5 were used to determine overlap in symptom reporting.

Face to face but not in the same place: A pilot study of prolonged exposure therapy.

This pilot study examined use of smartphone technology to deliver prolonged exposure (PE) therapy to patients with posttraumatic stress disorder (PTSD) with geographic limitations hindering in-person therapy. The primary goal was to examine the feasibility and acceptability of using video teleconferencing (i.e.

Use of a collagen biomatrix (TissuDura) for dura repair: a long-term neuroradiological and neuropathological evaluation.

Purpose: The aim of this study was to evaluate the clinical, neuroradiological, and neuropathological outcomes of patients treated with equine collagen foil (TissuDura) as a dura mater substitute during cranial and spinal neurosurgical procedures.

Materials And Methods: All patients treated at the Department of Neurosurgery of the Second University of Naples with TissuDura between 2005 and 2009 were included. Dural reconstruction was performed using TissuDura, overlaid 1 cm over the dural defect with additional fixation using fibrin glue.

Ultrastructural profile of microcystic meningioma.

Objective: Microcystic meningioma was originally classified as a subtype of meningioma by the World Health Organization classification of brain tumours in 1993, and accounts for 1.6% of intracranial meningiomas. This subtype is a variety of meningioma in which micro- and macro-cysts are diffuse.

An ultrastructural study of the histogenesis of haemangioblastoma.

Seven cases of cerebellar haemangioblastoma, not associated with von Hippel-Lindau disease (sporadic haemangioblastomas), were studied by light and electron transmission microscopy. Morphological features that might provide information about the histogenesis of the tumour were examined. The ultrastructural data indicate both the common ancestry of the different cytotypes that make up the tumour, and the mesenchymal origin of the elements present, which were also documented by their capacity to synthesise lipid droplets in the cytoplasm (a process of lipidization similar to that of pre-adipocytes).

Burning mouth syndrome and burning mouth in hypothyroidism: proposal for a diagnostic and therapeutic protocol.

Background: Burning mouth syndrome (BMS) is a common disorder frequently affecting women past the 5th decade of age. It is characterized by oral burning, mainly involving the tongue, lip, and anterior palate, but without oral lesions or alteration showing in blood tests and/or instrumental findings.

Objective: We proposed to exclude alterations due to thyroid function and echographic abnormality in formulating BMS diagnosis.

Ultrastructural pathology of pediatric myocardium in acute ischemia: bioptic study before and after treatment with cardioplegic solution.

Protecting the myocardium from the risk of acute ischemia during heart surgery is still an unsolved problem; the problem is even more open and more pressing in pediatric heart surgery. To meet this greater risk it is advisable to use a cardioplegic solution with a composition that is better suited to the particular morphofunctional conditions of the myocardium in the child, i.e.

Morphological and ultrastructural findings of prognostic impact in craniopharyngiomas.

Craniopharyngioma is a slow-growing epithelial tumor with an unpredictable tendency to recur. To verify the reliability in predicting the clinical outcome, some morphological and immunohistochemical findings were analyzed in 37 primitive tumors and in 6 recurrences (one recurred twice). All the tumors were surgically excised and all recurrences exhibited an adamantinomatous pattern; mitotic rate was low (< 5 x 10 HPF) in both recurrent and in nonrecurrent tumors.

Recurrent and atypical meningiomas--a multiparametric study using Ki67 labelling index, AgNOR and DNA Feulgen staining.

Objective: Histological analysis has limited value to predict the biological behavior of meningiomas. In this study, we investigated the utility of indicators of cell proliferation in the evaluation of histologically benign meningiomas.

Materials And Methods: For this purpose, 50 meningothelial meningiomas, 50 atypical meningiomas and 8 primary benign meningiomas with their recurrences were studied.

Gastroprotection by 4-methylpyrazole against ethanol in humans.

4-Methylpyrazole (4-MP), a specific inhibitor of alcohol dehydrogenase, exerts gastroprotection of unusually long duration in rats. We tested the hypothesis that pretreatment with 4-MP might protect the human gastric mucosa against alcohol-induced acute injury. Fourteen healthy volunteers received pretreatment with either 4-MP, 15 mg/kg body weight dissolved in 50 ml of orange juice, or placebo and 2 hr later 100 ml of 40% ethanol.

[Bile canaliculi in chronic hepatitis (ultrastructural study)].

The biliary pole of the hepatocytes is formed by the canaliculus, the intracytoplasmic organelles, the pericanalicular cytoskeleton and by canalicular membranes. As a rule, the set of these sub-structures give risk to the biliary secretion. At present, the canaliculi are not considered as "fixed" structures, but rather entities that can be formed and modulated by intra and extra hepatic factors aiming of regulating the bile secretion in relation to metabolic events and to the body's requirements.

[Proliferative activity of ependymomas. (Quantitative analysis of the expression of Ki67 and AgNOR)].

One of the problems connected to the anatomo-clinical evaluation of ependymomas consist in the difficulty of precisely grading these neoplasms and of making a prognosis. Traditional histopathologic procedures have proven themselves unsuitable to solve these biological problems of neoplastic growth: their solution requires the identification and responsiveness of molecules that are part of cellular kinetic processes such as antigen Ki67 and the granules of AgNOR as indexes of the rDNA transcriptional activity. With the aim of contributing to the knowledge of ependymomas' grading, the Authors performed qualitative and quantitative assays on 35 cases of benign ependymomas (by means of an image analyzer) using the nuclear antigen Ki67 and the AgNOR nucleolar areas.

Immunoglobulin E distribution in atopic nasal mucosa.

The distribution of B lymphocytes and immunoglobulins G, A, M, and E in nasal mucosa was studied in frozen biopsy sections of nasal turbinate from 16 allergic patients and 8 controls. The immunoperoxidase technique was used with monoclonal and polyclonal antibodies. Comparative analyses of serum immunoglobulin levels were also performed.