Must the Reality of Death Be Unspeakable?

Attention to the manifestations of death anxiety in the clinical context is often absent in the discourse of psychoanalytic training. This exchange addresses some of the causes of such an absence: a fraught relation between privacy and secrecy, primacy of psychic reality and interpretation, and cultural underpinnings of sanitization of death.

Prognostic Value of Oxygen Kinetics During Recovery From Cardiopulmonary Exercise Testing in Patients With Chronic Heart Failure.

Background: Peak oxygen uptake (V˙O2peak) is a well-established prognostic marker in chronic heart failure (CHF). Cardiopulmonary exercise testing (CPET) provides physiological parameters other than V˙O2peak that might have prognostic value. We aimed at determining whether exercise recovery data kinetics have prognostic implications over V˙O2peak and Heart Failure Survival Score.

Glucocorticoids and hippocampal atrophy after heart transplantation.

The glucocorticoid cascade hypothesis proposes that hippocampal atrophy may result from excessive steroid exposure. Although demonstrated in animal models and some human hypercortisolemic states, hippocampal damage as a possible consequence of posttransplant steroid immunosuppression has not been investigated in human heart transplant recipients. We report a case of a 37-year-old female heart transplant recipient who had the clinical, neuropsychiatric, and neuroimaging findings consistent with hippocampal atrophy after 5 years of steroid exposure.