Summary:We previously reported that during pro-estrus (high endogenous estrogen levels), brain damage after middle cerebral artery occlusion (MCAO) was reduced in stroke-prone spontaneously hypertensive rats (SHRSP) but not in normotensive Wistar Kyoto rat (WKY). In the present study, we examined the effect of exogenous estrogen on brain damage after MCAO in SHRSP and WKY. A 17-estradiol (0.025mg or 0.25mg, 21 day release) or matching placebo pellet was implanted into ovariectomized WKY and SHRSP (3 to 4 months old) who then underwent distal diathermy-induced MCAO 2 weeks later. Plasma 17-estradiol levels for placebo and 17-estradiol groups were as follows: WKY 0.025 mg 16.4 ± 8.5 (pg/mL, mean ± SD) and 25.85 ± 12.6; WKY 0.25 mg 18.2 ± 9.0 and 69.8 ± 27.4; SHRSP 0.25 mg 20.7 ± 8.8 and 81.0 ± 16.9. In SHRSP, infarct volumes at 24 hours after MCAO were similar in placebo and 17-estradiol groups: SHRSP 0.025 mg 126.7 ± 15.3 mm 3 (n ס 6) and 114.0 ± 14.1 mm 3 (n ס 8) (not significant); SHRSP 0.25 mg 113.5 ± 22.3 mm 3 (n ס 8) and 129.7 ± 26.2 mm 3 (n ס 7) (not significant), respectively. In WKY, 17-estradiol significantly increased infarct volume by 65% with 0.025mg dose [36.1 ± 20.7 mm 3 (n ס 8) and 59.7 ± 19.3 mm 3 (n ס 8) (P ס 0.033, unpaired t-test)] and by 96% with 0.25 mg dose [55.9 ± 36.4 mm 3 (n ס 8) and 109.7 ± 6.7 mm 3 (n ס 4) (P ס 0.017)]. Thus, 17-estradiol increased stroke damage in normotensive rats with no significant effect in stroke-prone rats. Despite being contrary to our hypothesis, our findings add substance to the recently reported negative effects of 17-estradiol in clinical studies.
Pseudoaneurysm formation is a rare but potentially dev approximately astating complication of pancreatitis. It can be diag approximately nosed by using various imaging modalities including computer tomography, ultrasound, and angiography and should be entertained in any patient with a history of pancreatitis. We present the imaging findings in three patients with pseudoaneurysm formation secondary to pancreatitis who initially presented with gastrointestinal bleeding.
Aim
The purpose of this study was to identify dimensions for a new pair of supervisory tools: the supervision personalisation form (SPF) and the supervision personalisation form – assessment (SPF‐A). These are intended to help tailor supervisory work to the individual supervisee's needs and preferences.
Method
Semi‐structured qualitative interviews were conducted with 15 accredited supervisors (four males and 11 females), principally counsellors and psychotherapists of an integrative or humanistic orientation, to identify the main dimensions along which their supervision practice varied. Data were analysed thematically using principles from grounded theory.
Results
Eleven dimensions of supervisory practice were identified: (1) Offering more, or less, theoretical input; (2) Focusing on the supervisee's strengths vs. focusing on their difficulties; (3) Focusing more, or less, on the supervisory relationship; (4) Providing more, or less, structure; (5) Focusing on the client's issues vs. focusing on the supervisee's issues; (6) Offering more, or less, self‐disclosure; (7) Drawing from one, or more than one, orientation; (8) Offering more, or less, techniques and exercises; (9) Suggesting reading and reflection outside of supervision vs. not doing this; (10) More, or less, talking; (11) Directly challenging the supervisee vs. not directly challenging them.
Discussion
These 11 dimensions have been transposed into items for the SPF and SPF‐A, which are now available for use in supervisory practice. However, further testing, evaluation and refinement of the forms is needed.
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