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  1. Last 7 days
  2. accessmedicine.mhmedical.com accessmedicine.mhmedical.com
    Superior Vena Caval Obstruction
    1
    1. Arshadbhat 05 Apr 2026
      Urgent treatment for neoplasm consists of (1) cautious use of intravenous diuretics and (2) mediastinal irradiation, starting within 24 hours, with a treatment plan designed to give a high daily dose of radiation but a short total course of therapy to rapidly shrink the local tumor. Intensive radiation therapy combined with chemotherapy will palliate the process in up to 90% of patients. In patients with a subacute presentation, radiation therapy alone usually suffices. Chemotherapy is added if lymphoma or small-cell carcinoma is diagnosed

      endovascular stenting emerging as first-line therapy for rapid symptom relief, while definitive treatment targets the underlying cause

      Glucocorticoids (dexamethasone 4 mg every 6 hours) are commonly prescribed but lack robust supporting data; they may be more beneficial in lymphoma or thymoma and as prophylaxis against radiation-induced edema. [2-4] Importantly, SVC syndrome is no longer considered a medical emergency except in rare cases with life-threatening cerebral edema, laryngeal edema, or altered mental status. When thrombosis is present, catheter-directed thrombolysis or aspiration thrombectomy should be performed within 2-5 days of symptom onset before thrombus organization occurs. [3] The role of long-term anticoagulation after stenting remains unclear, though it is standard when significant thrombosis is present The American College of Chest Physicians recommends obtaining histologic diagnosis before treatment in suspected lung cancer cases, as stenting does not interfere with tissue diagnosis. [2] For small cell lung cancer (SCLC), chemotherapy alone is recommended as first-line treatment given rapid response rates. [2] For non-small cell lung cancer (NSCLC), radiation therapy and/or stent insertion are recommended, with response rates of 59% for chemotherapy and 63% for radiation therapy. [2] Patients with chemotherapy- or radiation-refractory disease should receive vascular stents For device-related thrombosis (catheters, pacemakers), catheter removal should be considered in conjunction with anticoagulation. [4] Endovascular therapy is first-line for device-related obstruction, while surgical bypass may be preferred for mediastinal fibrosis. [7] Both approaches show good mid-term patency, though secondary interventions are common (approximately 27-28%
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  3. accessmedicine.mhmedical.com accessmedicine.mhmedical.com
    Chronic Venous Insufficiency
    1
    1. Arshadbhat 05 Apr 2026
      Treatment of superficial vein reflux (see Varicose Veins, above) has been shown to decrease the recurrence rate of venous ulcers. Where there is substantial obstruction of the femoral or popliteal deep venous system, superficial varicosities supply the venous return and should not be removed.

      Failure of venous insufficiency ulcerations to heal is most often due to inconsistent use of first-line treatment methods. Ongoing control of edema is essential to prevent recurrent ulceration; the use of compression stockings following ulcer healing is critical, with recurrence rates 2–20 times higher if compression stockings are not used

      Duplex ultrasound evaluation should assess blood flow direction, venous reflux, and venous obstruction, and include examination of the deep venous system, great saphenous vein (GSV), small saphenous vein (SSV) and its thigh extension (Giacomini vein), accessory saphenous veins, and perforating veins. Venography is recommended primarily in patients with post-thrombotic disease, especially when intervention is planned, as it provides greater anatomic detail than duplex ultrasonograph The examination also identifies patterns of disease that have treatment implications. Axial reflux is defined as uninterrupted retrograde flow from groin to calf and can occur in either superficial or deep systems. [4] Junctional reflux is limited to the saphenofemoral or saphenopopliteal junction, while segmental reflux occurs in a portion of a truncal vein. [4] Understanding whether reflux originates from superficial junctions versus deep venous incompetence fundamentally changes treatment planning, as superficial disease is amenable to ablation while deep disease typically requires conservative management Management of secondary varicose veins from post-thrombotic syndrome (PTS) is fundamentally different and more challenging. Compression therapy, lifestyle modifications, and symptom management form the cornerstone of PTS treatment. [4-8] Elastic compression stockings (20-30 mm Hg), leg elevation, weight loss, and exercise constitute the primary therapeutic approach Endovascular interventions for PTS—including percutaneous transluminal venoplasty and stenting—are reserved for select patients with significant iliofemoral obstruction who have failed conservative management. [7] These procedures require careful patient selection and standardized criteria. The role of superficial venous ablation in PTS patients with concomitant superficial reflux remains controversial and should be approached cautiously, as the underlying deep venous pathology may limit benefit
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  4. Dec 2021
  5. psyarxiv.com psyarxiv.com
    Face masks impair basic emotion recognition: Group effects and individual variability (Accepted for Publication in Social Psychology)
    1
    1. lucyparfitt16 29 Dec 2021

      McCrackin, S., Ristic, J., Mayrand, F., & Capozzi, F. (2021). Face masks impair basic emotion recognition: Group effects and individual variability (Accepted for Publication in Social Psychology). PsyArXiv. https://doi.org/10.31234/osf.io/2whmp

      is:preprint lang:en emotion recognition face occlusion facial features social competence autistic traits personality traits personality behavioral science psychology facial obstruction mask wearing COVID-19 emotion autism facial expression communication face mask individual differences
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  6. Oct 2020
  7. www.justice.gov www.justice.gov
    report.pdf
    2
    2. chrisaldrich 10 Oct 2020
      if we had confidence after a thorough investigation of the facts that the President clearly did not commit obstruction of justice, we would so state. Based on the facts and the applicable legal standards, we are unable to reach that judgment. Accordingly, while this report does not conclude that the President committed a crime, it also does not exonerate him.

      TL;DR

      This summary is not what Trump or even Barr have been indicating in their communications.

      Barr's statement on the day of the release of the redacted report: https://www.youtube.com/watch?v=7aHPFh2HfSM

      Donald J. Trump obstruction Mueller Report
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    justice.gov/archives/sco/file/1373816/download