In conclusion, EA and hydrotherapy, both in combination with patient education, induce long-lasting effects, shown by reduced pain and ache and by increased functional activity and quality of life, as demonstrated by differences in the pre- and post-treatment assessments.

SummaryProthrombin complexconcentrates (PCCs) arewidelyadministeredf or emergencyo ral anticoagulation reversal andf or coagulation defects in liver disease.Pharmacokinetic datamay help to optimize treatment.Theobjectiveofthis study was to characterizethe pharmacokineticsofaPCC (BeriplexP/N) containing coagulation factors II (FII),VII (FVII), IX (FIX)and X(FX) and anticoagulant proteins Ca nd S. Fifteen healthyv olunteersr eceived as ingle rapid 50 IU/kgi nfusiono fP CC and underwent frequent blood sampling until 144 hours (h) after infusion. Coagulationfactors and anticoagulantprotein pharmacokinetic parameterswereestimated by non-linear regression.The mean infusionrate of PCC was 7.9ml/min, equivalent to 196.4 IU/min. By the earliestpost-infusion sampling point at 5minutes(min), KeywordsProthrombin complexc oncentrates, pharmacokinetics, safety, blood coagulationfactors, anticoagulation reversal plasma FIX concentration increasedbyamedian of 73%. Median increasesi nF II, FVII and FX at 5m in were 122%,62% and 158%,respectively. Proteins Cand Salsoincreasedrapidly.The median terminal half-lifeofFIX was16.7 h, FII 59.7 h, FVII 4.2 h and FX 30.7 h. Them edian in-vivor ecoveryo fF IX was1 .57 %/IU/kga nd thato ft he othert hree coagulation factors >2 %/IU/kg. Plasma concentration of thrombogenicity marker D-dimer didnot increase,and therewas no clinical evidence of thrombosis.Through up to 12 weeks follow-up there were no laboratoryfindingsindicating PCC-relatedviralexposure.Rapid PCC infusionp roducedp rompts ustained increasesi nc oagulation factors and anticoagulantp roteins with no clinical evidence of thrombosis or viral transmission.

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Background: The feeling of being contaminated (FBC) is a common phenomenon in survivors of childhood sexual abuse (CSA) suffering from posttraumatic stress disorder (PTSD). Thus far, this symptom has been neglected in research and therapy. For this reason, we developed Cognitive Restructuring and Imagery Modification (CRIM), a two-session treatment (lasting 90 and 50 min) that specifically targets the FBC. The present study examined the efficacy of the treatment. Methods: Thirty-four women with CSA-related PTSD (mean age = 37 years) were randomized to either the CRIM group or a waitlist control group. Primary outcomes were intensity, vividness, and uncontrollability of the FBC, associated distress, and PTSD symptoms, which were assessed using the Clinician-Administered PTSD Scale and the Posttraumatic Diagnostic Scale. Outcomes were measured pre- and posttreatment, and at the 4-week follow-up. (M)ANOVAs were used to compare improvements across conditions. Results: All FBC scores yielded a greater reduction in the CRIM group than the waitlist control (WL) group. Between-group effect sizes at follow-up were large and highly significant (intensity: d = 1.52, p < 0.001; vividness: d = 1.28, p < 0.001; uncontrollability: d = 1.77, p < 0.001; distress: d = 1.80, p < 0.001). PTSD symptoms also yielded a greater reduction in the CRIM group than the WL group, with large between-group effect sizes (Clinician-Administered PTSD Scale: d = 0.93, p < 0.001). Conclusions: Our findings support the efficacy of the newly developed CRIM in reducing the FBC and PTSD symptoms in adult survivors of CSA.

Clinical experiences show that many survivors of childhood sexual abuse (CSA) suffer from a distressing feeling of being contaminated (FBC) even years or decades after the last experience of sexual violence. So far, this symptom has been neglected in research. The aim of this article is to illustrate this symptom and the necessity of a specialized treatment. Phenomenology, consequences, and possible concepts of explanation are described. The article presents a newly developed short-time treatment, cognitive restructuring and imagery modification, to reduce the FBC in adult survivors of CSA. Two case studies on women suffering from chronic CSA-related posttraumatic stress disorder (PTSD) plus the FBC demonstrate the outcome of the two-session program that can easily be integrated in a whole treatment program. They show that the treatment results in a reduction of the FBC and PTSD symptoms after CSA.