56 The finding of increased platelet activation may partially contribute to increased CV risk in those already with pre-existing risk factors. Circulating activated platelets play an important role in thrombosis57 and most, but not all, acute coronary occlusions occur as the result of rupture of an unstable atherosclerotic plaque and superimposed thrombus formation58 Inhibitors,research,lifescience,medical As such, one approach to cardiovascular prevention

for those at increased risk in bereavement could be short-term use of Nutlin-3a mw antithrombotic medications, such as aspirin, in the early weeks of bereavement, as has been previously proposed for other transient periods of increased risk.49 The effect of bereavement interventions on physiological correlates Neuroendocrine Specific interventions designed to reduce cortisol response in bereavement have not been reported, although a randomized controlled clinical Inhibitors,research,lifescience,medical trial that examined the effect of support group sessions on immune response reported significantly lower plasma cortisol levels in the intervention group compared with the control group Inhibitors,research,lifescience,medical following 10 weekly 90-minute support group sessions.59

In this study, a reduction in physician visits was also reported in the intervention group,59 although it is unclear which aspect of the intervention contributed to these findings. Sleep To date two intervention approaches to improve sleep in CG have been reported; one a nonpharmacological approach and the other using a tricyclic antidepressant medication. Inhibitors,research,lifescience,medical Findings from one study suggest that a 16-week Complicated Grief Treatment (CGT) intervention has the potential to improve sleep, albeit modestly, in individuals suffering CG.60 In this study of 67

bereaved individuals with elevated scores greater than or equal to 30 on the Inventory of Complicated Grief,61 suggestive of intense grief reactions, Inhibitors,research,lifescience,medical subjects who were randomized to receive the CGT intervention reported lowered grief scores although scores remained elevated in participants after treatment, and they continued to experience clinically significant sleep problems.61 The potential CYTH4 effectiveness of cognitive behavioral therapy was highlighted in another study of 11 recently bereaved family members.62 In this study, the intervention consisted of cognitive behavioral therapy-insomnia (CBT-I) which included educational information about cognitive restructuring, stimulus control, sleep hygiene, relaxation techniques and goal setting, and monitoring. Self-reported sleep measures and depression scores decreased over the 5-week intervention period, although sleep actigraphy data (that provide limited measures of sleep patterns and circadian rhythms) showed no significant changes over the study period.