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- Bookeditors, Robert C. Smith, Gerald G. Osborn, Francesca C. Dwamena, Dale D'Mello, Laura Freilich, Heather S. Laird-Fick.Contents:
Three axioms of mental health care for medical settings
Evaluating physical symptoms
Mental health care model
Major depression and related disorders
Generalized anxiety and related disorders
Prescription substance misuse and other substance misuse
The diagnostic interview
Other mental disorders
Psychotic disorders
Personality disorders
Enhancing your own care.Digital Access AccessMedicine 2019 - ArticleProlonged antifibrinolysis: an effective non-surgical treatment for ruptured intracranial aneurysms?Maurice-Williams RS.Br Med J. 1978 Apr 15;1(6118):945-7.The outcome of treatment with an antifibrinolytic agent (tranexamic acid) for six weeks after rupture of an intracranial aneurysm was assessed in a randomised controlled trial. Twenty-two out of 25 (88%) treated patients survived at follow-up of three to 33 months compared with 14 out of 25 (56%) control patients. Among the patients who did not undergo operation the survival rate was 81% (13 out of 16) in treated patients and 42% (8 out of 19) in controls. Antifibrinolytic treatment has so far been assumed merely to postpone rebleeding and has been used to enable surgery to be deferred. These findings suggest that tranexamic acid may actually prevent rebleeding without operation. Prolonged antifibrinolysis may therefore prove useful in those patients in good condition whose aneurysms do not lend themselves to surgical obliteration.