The Blood Picture in Correlation with Bloat

Bloat may spell disaster to any farmer on a given day. This kind of disaster is typical and not infrequent in ruminates especially cattle and sheep. Bloat affects polygastrics, why not monogastrics? Ruminants or polygastrics have a four compartment stomach utilizing protozoa and bacteria similar to a fermentation vat which catabolizes complex substrates into simple digestible nutrients while the monogastrics rely on secretions from the stomach lining. Primarily fermentation takes are water and larger amount of free gas, which can accumulate in the rumen when disposal is impaired. Why do animals dispose of these large quantities of gas 364 days out of a year and the following day die because of the inability to discharge this gas? Some investigators suggest that the rumen is unable to function when certain soft materials such as alfalfa are the primary components of the diet. The addition of scabrous materials to the ration is believed to be beneficial for stimulation eructation and the elimination of gas. Others believe that drugs such as penicillin and aureomycin will inhibit gas production sufficiently to prevent bloat. Still another theory is based on evidence that a toxic material is present at times in sufficient quantity to cause death. Despite voluminous amounts of research done in the field of bloat the cause of bloat and the cause of death are still vague. The toxic theory has not been disproven completely, therefore, this seems to be as vital to the overall bloat picture as any. After choosing the toxic theory the assumption that the toxicity would be found in the blood was made. Carbon dioxide, pseudocholinesterase, and methemoglobin were choose are the compounds in the blood which might the greatest potential for causing bloat symptoms or death

Managing medical and psychiatric multimorbidity in older patients.

Aging increases susceptibility both to psychiatric and medical disorders through a variety of processes ranging from biochemical to pharmacologic to societal. Interactions between aging-related brain changes, emotional and psychological symptoms, and social factors contribute to multimorbidity - the presence of two or more chronic conditions in an individual - which requires a more patient-centered, holistic approach than used in traditional single-disease treatment guidelines. Optimal treatment of older adults with psychiatric and medical multimorbidity necessitates an appreciation and understanding of the links between biological, psychological, and social factors - including trauma and racism - that underlie physical and psychiatric multimorbidity in older adults, all of which are the topic of this review

Managing medical and psychiatric multimorbidity in older patients

Aging increases susceptibility both to psychiatric and medical disorders through a variety of processes ranging from biochemical to pharmacologic to societal. Interactions between aging-related brain changes, emotional and psychological symptoms, and social factors contribute to multimorbidity – the presence of two or more chronic conditions in an individual – which requires a more patient-centered, holistic approach than used in traditional single-disease treatment guidelines. Optimal treatment of older adults with psychiatric and medical multimorbidity necessitates an appreciation and understanding of the links between biological, psychological, and social factors – including trauma and racism – that underlie physical and psychiatric multimorbidity in older adults, all of which are the topic of this review

Under-Represented Populations Left Out of Alzheimer’s Disease Treatment with Aducanumab: Commentary on Ethics

Despite controversy about the efficacy and safety of aducanumab, the FDA's fast-tracking of this medicine is truly historic. However, structural problems leading to socioeconomic disparities and systemic racism in science, healthcare, and society have left out under-represented populations. This perspective outlines the racial and socioeconomic health disparities in aducanumab treatment: 1) Disparities in the risk of Alzheimer's disease (AD), 2) Limited participation from under-represented groups in AD trials raising concerns about the generalizability of the results, 3) Questionable applicability of the amyloid hypothesis in groups under-represented in AD research, and 4) Aducanumab's initial sticker price that unfairly singled out those with lower socioeconomic backgrounds. Potential solutions are discussed

Eliciting emotional expressions in psychodynamic psychotherapies using telehealth: a clinical review and single case study using emotional awareness and expression therapy

The COVID-19 pandemic and ensuing social distancing requirements resulted in an abrupt transition in the provision of most mental healthcare to telehealth; yet it was, at first, unclear whether patients' emotional expressions - of great import to the success of many psychodynamic therapies - could be facilitated using teletherapy. This article first presents a targeted literature review focused on emotional expressions in psychotherapy and implementing psychodynamic therapy over telehealth and then describes our clinical experience transitioning a psychodynamically-informed, evidence-based, and experiential group treatment for chronic pain, emotional awareness and expression therapy (EAET), to video telehealth at VA Greater Los Angeles Healthcare System. We discuss barriers we encountered in our implementation of EAET over video telehealth but also illustrate the ultimate success of the approach using verbatim excerpts from our therapeutic work, which aim to demonstrate the potential to facilitate powerful emotional expressions over video telehealth when conducting a psychodynamically-informed treatment. We examine the possible applications for video telehealth to maintain emotionally focused, psychodynamic psychotherapy administration and enhance its teaching and training. Although we describe limitations of our specific approach, ultimately, our experience supports the potential efficacy of experiential, emotion-focused psychodynamic therapies in a telehealth setting