bluuebunny/crossref_metadata_2025 huggingface dataset:
Photopolymerization of composite resins with plasma light
Authors: Knežević A. , Tarle Z. , Meniga A. , Šutalo J. , Pichler G. , Ristić M.
Published: March 2003

Summary Everyday improvements in components and characteristics of composite materials have induced faster development of curing units. Besides standard halogen curing units and soft‐start photopolymerization light sources, some experiments with argon and pulsed laser light and low intensity blue superbright light emitting diodes have been made. On the other hand, rapid polymerization with strong plasma light is also clinically applicable. The aim of this study was to measure the degree of conversion and temperature rise for three restorative composite materials: Tetric Ceram (Vivadent, Schaan, Liechtenstein), Pertac II (ESPE, Seefeld, Germany) and Z100 (3M Dental Products, St Paul, MN, USA) during polymerization with plasma light Apollo 95E (DMDS, Dental/Medical Diagnostic Systems, Fleury d'Aude, France) and compare it with the results of polymerization with a halogen curing unit, Elipar Trilight (ESPE, Seefeld, Germany). The results revealed the degree of conversion values in the case of polymerization with plasma light to be almost equal to those obtained by curing with the halogen curing unit, whereas the temperature rise was almost negligible.
Regulation of fluoride ion release from Na2SiF6 contained in resin based on hydrophobic siloxane layer coating
Authors: Nakabo S. , Torii Y. , Itota T. , Yoshiyama M. , Ishikawa K. , Suzuki K.
Published: March 2003

Regulation of fluoride release from restorative resin or sealant is beneficial to patients as it will prevent the occurrence of the secondary caries. In this study, we evaluated whether or not the formation of a hydrophobic polysiloxane layer on the surface of the fluoride compound could contribute to the regulation of fluoride release from resin. First, sodium hexafluorosilicate (Na2SiF6) powder was treated with γ‐methacryloxypropyltrimethoxysilane (γ‐MPTS) and analysed with scanning electronmicroscopy (SEM), Fourier‐transform infrared spectroscopy (FT‐IR) and electron spectroscopy for chemical analysis (ESCA). Analysis revealed that a hydrophobic polysiloxane layer was formed on the surface of Na2SiF6 powder. Heat treatment commonly used during γ‐MPTS treatment was not necessary for the polysiloxane layer formation on the surface of Na2SiF6 powder. Then Na2SiF6 powder treated with γ‐MPTS was loaded in bis‐GMA/TEGDMA resin, immersed in distilled water and fluoride release was measured using a fluoride electrode. We found that the rate of fluoride release was significantly lower from the resin containing Na2SiF6 powder treated with c‐MPTS. We concluded, therefore, that c‐MPTS treatment and the resulting hydrophobic polysiloxane layer formation are very effective for the regulation of fluoride release from resin.
A case–control study of temporomandibular disorders: symptomatic disc displacement
Authors: Velly A. M. , Gornitsky M. , Philippe P.
Published: March 2003

This case–control study was designed to investigate the risk factors for disc displacement (DD) without myofascial pain (MFP). The study population included 59 cases with DD without MFP, selected in two hospital dental clinics, and 100 concurrent controls selected in one of these clinics. The association with DD was evaluated for bruxism, head–neck trauma, orthodontic treatment, and sociodemographic characteristics by using unconditional logistic regression. In the multivariate analysis, excluding psychological factors, an association was found between DD and clenching–grinding (OR=3·57; 95% CI: 1·27–9·98). This association persisted when anxiety (OR=3·07; 95% CI: 1·08–8·70) or depression (OR=4·02; 95% CI: 1·43–11·31) was included in the model. A positive association was noted between orthodontic treatment and DD (OR=3·10; 95% CI: 1·06–9·65). The effect between orthodontic treatment and DD remained and increased with the inclusion of anxiety (OR=3·65; 95% CI: 1·15–11·61) or depression (OR=3·20; 95% CI: 1·06–9·65). A high level of anxiety (OR=2·40; 95% CI: 1·01–5·73), was positively related to DD. We concluded that clenching combined with grinding, and orthodontic treatment are factors related to DD. The interpretation of these associations, however, requires caution because of the inclusion of prevalent cases.
Inlay autograft of intra‐membranous bone for lateral alveolar ridge augmentation: a new surgical technique
Authors: DÖRTBUDAK O. , HAAS R. , BERNHART T. , MAILATH‐POKORNY G.
Published: March 2003

Summary This study describes a new surgical technique for harvesting intra‐membranous bone from the mandibular symphyseal region and using it as an inlay graft. The surgical technique of turning a complex‐shaped defect into a defect of defined size by contour preparation and insertion of an appropriate inlay graft was used in 31 patients. At 4 months, 15 patients (48%) showed negligible graft resorption of 0·33 mm. At 5–8 months the resorption rate in the remaining 16 patients was around 1·22 mm. All in all, a significant positive correlation was found between bone resorption and time (r = 0·574; P < 0·001). All patients received an implant after the fixation screw was removed. A conservative interpretation of the results suggests that, on account of the flush fit and the early revascularization of the graft, implants may and should, in fact, be inserted earlier in order to prevent graft resorption.
The role of posterior guidances under the altered anterior guidance
Authors: Otake T. , Mayanagi A. , Tsuruta J. , Nozawa K. , Miura H. , Hasegawa S.
Published: March 2003

Summary  In five subjects, bilateral condylar movement was assessed during lateral excursions with different tooth guidance angles without changing the intercuspal position. Statistical analysis of anova (P < 0·01) revealed that when the incisal path angle became steeper than the natural tooth guidance, distances of the non‐working side condyle paths (centre of condyle) decreased significantly, while distances of the working side condyle paths (centre of condyle) remained unchanged. Directions of the working side condyle paths were random, while directions of the non‐working side condyle paths remained stable. By analysing six points around the centre of the condyle, it was not possible to confirm any affect on the working side condyle movement by changing the tooth guidance angle. It was revealed that the non‐working side condyle had an ‘active’ role during lateral excursions, and that the working side condyle moved as a result of mandibular movement that was changed because of a steepening of the incisal path angle during lateral excursions. This suggests the possibility that the working side condyle movements were affected ‘passively’ by altering the tooth guidance.
The influence of altered occlusal guidance on condylar displacement
Authors: Okano N. , Baba K. , Akishige S. , Ohyama T.
Published: March 2003

SUMMARY  This study investigated mandibular displacement and masticatory muscle activity during clenching in lateral occlusal position in relation to the lateral occlusal pattern. Twenty healthy human subjects (mean = 26·5 years) volunteered for this study. Metallic occlusal overlays were fabricated for the lower working side canine to second molar and non‐working side second molar in order to simulate a canine protected occlusion, group function occlusion and bilateral balanced occlusion (balancing contact). Three‐dimensional displacements of the bilateral condyle and electromyography (EMG) activities in the bilateral masseter, anterior and posterior temporalis were recorded during maximal clenching. The experimental occlusal pattern was revealed to have statistically significant effects on both condylar displacement and EMG activity (P < 0·001 and P < 0·001, respectively). When compared to the simulated group function occlusion, the simulated canine protected occlusion and balancing contact caused statistically significant smaller superior displacements of the non‐working side condyle, which suggests that they may result in reduced temporomandibular joint (TMJ) loading. Furthermore, the simulated canine protected occlusion was associated with the lowest EMG activity, which suggests that this occlusal pattern has the capacity to reduce the level of parafunctional activity.
Influence of a bite‐plane according to Jeanmonod, on bruxism activity during sleep
Authors: Okkerse W. , Brebels A. , De Deyn P. P. , Nagels G. , De Deyn B. , Van Bogaert P. P. , Braem M.
Published: March 2003

summary  One way to look at nocturnal oral parafunction such as bruxism, is using polysomnography. Although in recent years several studies have been carried out, it is almost impossible to compare the respective results because of the lack of standardization in the methodology used. The nocturnal muscular activity of m. Masseter and m. Temporalis Anterior has been registered in 21 patients suffering from bruxism, prior and after treatment with a bite‐plane made according to Jeanmonod. A group of five persons without any dental or muscular parafunction has been included as a control. A computer program based on the biomechanical principles of muscle contraction has been developed and was used to analyse the raw electromyography (EMG) signal. The data shows a significant decrease (P = 0·008) in nocturnal parafunctional muscle activity with the bite‐plane in situ. The present study shows that by analysing the raw signal obtained via EMG using a specially designed computer program, it becomes possible to isolate the occurrence of parafunctional events in the EMG signal and to study the influence of a given therapy on this EMG signal.
Accuracy of recording horizontal condylar inclination and Bennett angle with the Cadiax compact®
Authors: Celar A. G. , Tamaki K.
Published: March 2003

SUMMARY  This study assessed the accuracy of an electronic hinge axis tracing device (Cadiax compact®) in measuring the horizontal condylar inclination (HCI) and the Bennett angle. The hinge axis movements were simulated with an articulator to which the hinge axis tracer was attached. On the articulator the pre‐set HCI values were 20°, 40° and 60°, the pre‐set Bennett angles were 0°, 5°, 10°, 15°, 20°. The maximum measuring errors ranged from 0 to 3·4° (in average 1·2°) and yielded statistically significant differences between articulator setting and Cadiax compact measurement (P < 0·05) except the HCI of 40° and the Bennett angle of 0°. Because of the small range of the maximum measuring error the Cadiax compact represented reasonable accuracy for clinical application in anterior guidance restorations.
Voluntary and reflex control of the human temporalis muscle
Authors: Scott B. J. J. , Mason A. G. , Cadden S. W.
Published: March 2003

summary  Electromyographic recordings (EMGs) were made in 10 human subjects from the anterior and posterior parts of the temporalis muscle using skin surface electrodes. The activities produced by voluntary maximal clenching tasks and the reflex responses to electrical stimulation of the muco‐gingival junction were studied. In most subjects, maximum activity in both parts of the muscle occurred when clenching in the intercuspal position (anterior temporalis: 7 of 10 subjects; posterior temporalis: 9 of 10 subjects). Clenching maximally in the retruded position usually resulted in less activity; when this activity was expressed as a percentage of the maximum achieved by each subject for that part of the muscle, the median values were: anterior temporalis, 68% and posterior temporalis, 79%. Clenching in the protruded position produced little or no activity (median values: anterior temporalis, 3%; posterior temporalis, 5%). There were no significant differences between the EMG activities of the anterior and posterior parts of the muscle during these tasks when the activities were normalized to the maximum achieved in each part of the muscle. Application of electrical stimuli at the muco‐gingival junction (upper incisor region) produced reflex inhibitions and excitations in both parts of the muscle. There were no significant differences in the thresholds of these reflexes between the anterior and posterior parts of the muscle. Furthermore, there was little difference between the two parts of the muscle in terms of the latencies, durations and magnitudes of the responses. Thus the results of the study suggest that there are similar neural control mechanisms for the anterior and posterior parts of the temporalis muscle despite the common view that these parts of the muscle have different functions.
Differences in chewing strategies used by edentate people
Authors: HEATH M. R. , MORRIS J. R. , FERMAN A. M.
Published: March 2003

Aim:  To examine, in detail, the different masticatory measures that contribute to individual chewing strategies of edentate people.

Measures:  Variables relating to displacement and force were derived using a new three dimensional implant force transducer, a mucosal pressure transducer and measurements of mandibular movements.

Materials:  Five edentate subjects with conventional upper dentures and lower dentures stabilized on two dental implants. The subjects chewed unilaterally on their preferred chewing side. Seven foods were chewed – almond, fruit pastille, chewing gum and four different meats.

Analysis:  The data were analysed by separating each sequence into cycles and ‘phases’ of cycles for which variables were derived.

Results:  As expected, the results showed greater differences between subjects than between foods. From the five subjects, four basic strategies were identified in response to the different foods: one subject primarily modulated force, one subject modulated the number of cycles, two subjects modulated force and the number of cycles and one subject showed little modulation at all. As part of these strategies many striking differences between subjects were observed, e.g. one subject showed little modulation of her ‘default’ chewing pattern for different foods, yet one subject modulated the number of force and manipulation cycles, the force strategy (forces increasing through sequences) and swallow thresholds.

Conclusion:  People appear to develop different strategies to compensate for chewing difficulty by modulating speed, the number of cycles and/or penetration forces.
Acute inflammatory response to dentine‐bonding
Authors: PETERS H. , REZWANI T. , GAENGLER P. , HERTER P. , KINNE R. K. H. , KINNE E.
Published: March 2003

The phlogogenic potential of dentine‐bonding‐agents is still disputed. It was the aim of this study to demonstrate acute pulpal inflammation in teeth that were treated with a glutaraldehyde and HEMA containing primer.

Twenty‐two Wistar rats underwent microsurgical preparation of a lower incisor in accordance with the vital microscopy usage oriented biocompatibility test. Sixteen animals were divided into two test groups. Their teeth were treated with the primer for 20 s (n=8) and 10 min (n=8). Six animals comprised the control group (n=6).

During a 120‐min follow up the pulpal blood circulation was investigated for haemodynamic changes. The animals were killed and pulpal specimens were stained immunohistochemically.

CD43 positive cells were labelled by incubation with W3/13 monoclonal antibodies. CD43 is a highly expressed surface antigen on polymorph neutrophil granulocytes (PMN). By this means, the amount and distribution of infiltrating PMN in the affected pulp could be demonstrated.

Vital microscopic observation of the pulpal blood circulation showed irreversible stasis and thrombosis after primer application. The intensity of the haemodynamic changes was dependent on application duration.

The semiquantitative determined influx of PMN was highest in pulps of teeth that had been primed for 10 min. Control teeth never showed irreversible circulatory changes nor highly elevated PMN influx.

From these results it can be concluded that the tested primer has a phlogogenic potential in pulp‐close cavities.

The combined method of in vivo blood circulation observation and immunofluorescence microscopic demonstration of target cells serves as a good indicator for acute inflammatory responses.
The clinical assessment of TMJ sounds by means of auscultation, palpation or both
Authors: HUDDLESTON‐SLATER J. J. R. , VAN SELMS M. K. A. , LOBBEZOO F. , NAEIJE M.
Published: March 2003

Anterior disc displacements are an important diagnostic subgroup (Group II) of TM disorders according to the Research Diagnostic Criteria (RDC; Dworkin & LeResche, 1992). Although the RDC yields clear‐cut criteria for the diagnosis of a disc displacement, the interobserver reliability for the clinical recognition of joint sounds is highly variable. This high variance may be caused by the fact that the clinical assessment of joint sounds is difficult. In many previous studies, auscultation with a stethoscope was used. This technique is often claimed to be the most reliable one. However, it is unclear whether in these studies, auscultation was performed without simultaneous palpation of the contralateral joint. Therefore, the aim of the present study was to test the interobserver reliability of the clinical assessment of TMJ sounds by means of auscultation, palpation or both. A total of 220 undergraduate students (100 men; 120 women; mean age 21·9 ± 3·6 years) was examined independently by two calibrated dentists for the presence, probable presence or absence of sounds caused by anterior disc displacement, hypermobility, or another cause. The 79 students underwent auscultation only (i.e. without contralateral manual palpation); 87 students underwent bilateral palpation; the remainder (54 students) was subjected to both auscultation and palpation. The results show that the combination technique yields the highest reliability (Cohen's κ=0·53). For other techniques, κ‐values of 0·46 (auscultation) and 0·48 (palpation) were found.

It was concluded that the combination of auscultation and palpation yields the highest interobserver reliability for the recognition of TMJ sounds, although the differences with other techniques were small. (Supported by the IOT)
Removable dentures provided by dentists, denturists and laboratory technicians
Authors: Tuominen R.
Published: March 2003

summary  In several countries removable dentures can be supplied by either dentists or denturists. Dental laboratory technicians, on the other hand, are licensed only to construct dentures on the prescription of a dentist and do not supply dentures directly to patients. This study investigates provision of dentures by dentists, denturists and laboratory technicians to 264 elderly Finnish World War II veterans. The veterans were wearing 454 removable dentures, of which 272 were complete dentures (CD) and 177 were removable partial dentures (RPD). Dentists had supplied one‐quarter of the CD and three‐quarters of the RPD, denturists had supplied two‐thirds of the CD and one‐fifth of the RPD, whereas the dental laboratory technicians had supplied the remaining seven per cent of the CD and four per cent of the RPD. Denturists had provided mainly mandibular partial dentures. A high proportion of the RPD provided illegally by denturists were made to oppose CD. The subjects reported that maxillary CD were good or very good more often than mandibular CD and considered more often CD by dentists or denturists good or very good than CD by dental laboratory technicians.
Facial and glossal distribution of anaesthesia after inferior alveolar nerve block
Authors: Kim H.‐K. , Lee Y.‐S. , Kho H.‐S. , Yum K.‐W. , Chung S.‐C.
Published: March 2003

summary  The aim of this study was to subjectively determine the distribution of anaesthesia by mapping areas of sensory loss following inferior alveolar nerve block. Fifty healthy dental students were the subjects of this study (men 32, women 18). They were asked to draw the anaesthetized area on a diagram of the face and tongue 20 min after inferior alveolar nerve block. They evaluated the degree of anaesthesia by touching their faces and moving their tongues. All of the 50 subjects reported anaesthesia in the facial area. Of these, 21 (42%) reported the cutaneous distribution of anaesthesia on mental nerve territory only. Seventeen subjects (34%) reported anaesthesia on mental and buccal nerve territory. Nine subjects (18%) reported anaesthesia on mental, buccal, and auriculotemporal nerve territory. Two subjects (4%) reported anaesthesia on mental and auriculotemporal nerve territory and one subject (2%) on mental, buccal and infra‐orbital nerve territory. Forty‐seven of the 50 subjects (94%) reported anaesthesia of the tongue with the various degree of anaesthesia according to the area. Of these, 17 subjects (34%) reported strong anaesthesia on the anterior area and weak anaesthesia on the middle part of the tongue. Nineteen subjects (38%) reported strong anaesthesia of the lateral area and weak anaesthesia on the medial area, and 11 subjects (22%) reported anaesthesia on only the lateral side of the tongue. Three subjects (6%) reported no anaesthesia of the tongue. The distribution of anaesthesia of the facial and glossal regions determined subjectively after inferior alveolar nerve block, varies significantly between individuals.
Clinical quality of removable dentures provided by dentists, denturists and laboratory technicians
Authors: Tuominen R.
Published: March 2003

summary  The aim of this study was to evaluate the clinical quality of removable dentures of elderly Finnish men, which had been prepared either by dentists, denturists or dental laboratory technicians. The participants comprised 242 denture‐wearing subjects, with 231 maxillary and 177 mandibular removable dentures which had been prepared either by dentists, denturists or dental laboratory technicians. Clinical examinations were carried out without the examining dentist knowing who had provided the dentures. Complete dentures which had been illegally provided by laboratory technicians had significantly poorer retention and fitted less well in tuber and alveolar areas than those provided by either dentists or denturists. Complete maxillary dentures which had been provided illegally by laboratory technicians had significantly (P < 0·01) higher occurrence (90%) of some unacceptable characteristics than those (43%) provided by dentists or denturists. The difference between complete mandibular dentures was also obvious, 86% versus 59%, although statistically non‐significant. Of those partial maxillary dentures provided by dentists 53% had some unacceptable characteristics, compared with 80% of those illegally provided by denturists or laboratory technicians (NS). In the case of partial mandibular dentures, 36% of those provided by dentists and 32% of those by denturists or laboratory technicians had some unacceptable characteristic (NS). Illegal provision of removable dentures seemed to be related to decreased clinical quality.
Expert practice: the interventions used by a Community Mental Health Nurse with carers of dementia sufferers
Authors: Gunstone
Published: March 2003

The role of the Community Mental Health Nurse working with carers of dementia sufferers is investigated using a case study approach. Ten specific themes (socialising, assessing, coping strategies, advice, family dynamics, liaison, education, counselling, crisis intervention and loving) are identified and discussed. Links are drawn between theory and practice and suggestions for future research are made.
Towards understanding some complex borderline behaviours
Authors: Horsfall J.
Published: March 2003

This article aims to explore and explain some possible antecedents to behaviours revealed by consumers in mental health settings who evoke strong and often negative responses in nurses and other health professionals. The contemporary exemplar par excellence is people who are diagnozed as having a borderline personality disorder. The paper discusses four different but overlapping domains that may contribute to understanding the difficulties many nurses face in relation to working with consumers whose behaviours are complex and distressing. Firstly, these begin with a brief discussion of psychiatric labelling and stereotyping associated with borderline personality disorder. Secondly, the connections between trauma in childhood and psychiatric vulnerability are explored, as nurses and other health professionals sometimes do not appreciate the debilitating and long‐term consequences of the survival of childhood abuse or sexual assault. Thirdly, some unconscious defence mechanisms are outlined to partly explain behavioural interactions often displayed by people with a diagnosis of borderline personality disorder. Finally, behavioural concomitants of projection, splitting and projective identification are discussed: they include identity diffusion, self‐mutilation and suicide attempts. All of these topics are explored to encourage nurses to support consumers to express pain in more constructive ways.
Self‐image and burnout in psychiatric staff
Authors: Jeanneau M. , Armelius K.
Published: March 2003

Burnout was tested for in 754 mental health workers and related to self‐image as assessed with Structural Analysis of Social Behavior (SASB, Benjamin 1974). A positive relation was found between burnout and negative self‐image, and between the experience of personal accomplishment and positive self‐image. Compared to self‐image, gender, age and work setting did not explain any variance in burnout. Highly burned‐out persons had a significantly more negative self‐image than staff who had rated themselves as low burnout. Finally, the relation between self‐image and burnout was studied in 210 subjects who had completed their self‐image ratings one year before burnout was measured, with the same results: a negative self‐image was related to higher burnout one year later. One general conclusion is that a tendency in staff to treat themselves in negative ways may function as a negative filter for coping with difficulties at work and thus be a risk factor for burnout.
‘Sister, I am going crazy, help me’: psychodynamic‐oriented care in psychotic patients in inpatient treatment
Authors: Teising M.
Published: March 2003

A common German expression for ‘crazy’ means literally ‘not sealed’. In psychoses, the boundaries of the ego are brittle and dissolved, the pores are open. Fragmentations occur, fusions of undefined self and object represenations are impending. The self is projected and introjected, always struggling for a sealed‐up, though sufficiently permeable, space. These psychodynamics form a characteristic feature of professional psychiatric care. Providing a sealing up and cohesive relation as a basis for the return into the non‐psychotic world is one of the essential tasks of psychiatric nursing. The nursing relationship forms a sort of virtual membrane which is a point of intensive and accelerated exchange. Clinical vignettes will be used to demonstrate that the creation of reliable, encouraging contact can be successful when psychotic functional patterns are understood in terms of object relations theory.
Developing psychosocial care: the development and evaluation of a short course which aims to introduce psychosocial interventions to inpatient staff
Authors: Baker J. A.
Published: March 2003

Following on from the author's previous article (Baker 2000) which emphasizes the need to develop psychosocial interventions within inpatient care, the author describes the process of developing and implementing a short course aiming to introduce psychosocial interventions to inpatient staff. The article also discusses the evaluation of this course and identifies some of the difficulties for acute staff in developing these skills.
Nursing students’ experience of their first professional encounter with people having mental disorders
Authors: Granskär M. , Edberg A.‐K. , Fridlund B.
Published: March 2003

The aim of the study was to generate a theoretical model of what nursing students experience in their first professional encounter with people having mental disorders. Data was collected by interviewing 11 nursing students, selected by strategic sampling. Grounded theory analysis was chosen for the study. Findings showed that the students’ personal qualities and the patients’ behaviour affected the students’ experience. When nursing students who had their own needs in focus met patients who rejected them, they felt helpless, and patients wishing to establish a relationship with them confirmed their positive or negative expectations. Nursing students who were focused on patients’ needs met the patient as a unique person and felt confident despite being rejected by the patient, as well as proud when the patients wished to establish a relationship with them. Clinical university teachers can use the findings to gain knowledge about how each student feels as well as to guide them through their psychiatric training. The sample is small and further research is needed to generalize the findings of this study and to explore how nursing students, specialist psychiatric nurses and nurses in other disciplines experience the encounter with patients as well as how patients describe encounters with caregivers.
The essence of women's moral perspectives in anger expression situations
Authors: Denham G.
Published: March 2003

This inquiry's purpose was to describe the meaning (essence) of moral perspective in adult women's experiences of anger expression. Moral perspectives have been perceived as pivotal to how one constructs and problem‐solves real life dilemmas. Since some modes of anger expression have been identified as unhealthy, uncovering the meaning of moral perspectives in women's anger expression experiences could be significant to women's health. Through phenomenological interviews, 24 women, aged 21–65 (4 African‐American and 20 Euro‐American), reflected on an experience when they were angry and had to think about the right way to express their anger. Significant statements were extracted and thematized. Next, themes were clustered into the following essences of the experience: the realities of the self as moral, the morality of anger expression and the morality of outcomes.
The practice of early recognition and early intervention to prevent psychotic relapse in patients with schizophrenia: an exploratory study. Part 1
Authors: Van Meijel B. , Van Der Gaag M. , Kahn R. S. , Grypdonck M.
Published: March 2003

In this article we describe the findings of an exploratory study into the application of early recognition and early intervention methods aimed at prevention of psychotic relapses in patients with schizophrenia. We addressed several models of symptom recognition plans and indicated how patients, healthcare professionals and other persons involved may be able to list and evaluate early warning signs systematically. We also paid attention to the role of the patient’s family and to the potential effects of using early recognition and early intervention methods. In a follow‐up article (part 2), we will focus more specifically on factors which favourably or adversely affect the use of early recognition and early intervention methods. The results of this exploratory study will be used to design an intervention protocol for nursing staff to serve as a tool for preparing symptoms recognition plans with the individual patient and his/her social network.
The construction and implementation of a psychosocial interventions care pathway within a low secure environment: a pilot study
Authors: BAKER J. A. , O'HIGGINS H. , PARKINSON J. , TRACEY N.
Published: March 2003

This paper builds on previous articles that explore the use of psychosocial interventions within inpatient settings. There are obvious difficulties in the implementation of psychosocial interventions in practice. The authors suggest that one method of developing psychosocial interventions within services is to provide organizational support to clinicians. This paper explores the development and initial implementation of a psychosocial care pathway within an inpatient setting to provide such support. It concludes with a summary of the immediate effect of the pathway on care.
Early intervention in psychosis: who wins, who loses, who pays the price?
Authors: NEWSTEAD L. , KELLY M.
Published: March 2003

The following article discusses Early Intervention in Psychosis services. It is contextualized with the rapidly changing psychiatric system. There is exploration of the reasons for a focus upon Early Intervention in Psychosis at this current time. The article then proceeds to discuss what may be needed for services to meet government targets. It concludes with some tentative answers and further questions to issues raised within the discussion.
Intrinsic dreams are not produced without REM sleep mechanisms: evidence through elicitation of sleep onset REM periods
Authors: Takeuchi Tomoka , Miyasita Akio , Inugami Maki , Yamamoto Yukari
Published: March 2003

The hypothesis that there is a strict relationship between dreams and a specific rapid eye movement (REM) sleep mechanism is controversial. Many researchers have recently denied this relationship, yet none of their studies have simultaneously controlled both sleep length and depth prior to non‐REM (NREM) and REM sleep awakenings, due to the natural rigid order of the NREM–REM sleep cycle. The failure to control sleep length and depth prior to arousal has confounded interpretations of the REM‐dreams relationship. We have hypothesised that different physiological mechanisms underlie dreaming during REM and NREM sleep, based on recent findings concerning the specificity of REM sleep for cognitive function. Using the Sleep Interruption Technique, we elicited sleep onset REM periods (SOREMP) from 13 normal subjects to collect SOREMP and sleep onset NREM (NREMP) dreams without the confounds described above. Regression analyses showed that SOREMP dream occurrences were significantly related to the amount of REM sleep, while NREMP dream occurrences were related to arousals from NREM sleep. Dream properties evaluated using the Dream Property Scale showed qualitative differences between SOREMP and NREMP dream reports. These results support our hypothesis and we have concluded that although ‘dreaming’ may occur during both REM and NREM periods as previous researchers have suggested, the dreams obtained from these distinct periods differ significantly in their quantitative and qualitative aspects and are likely to be produced by different mechanisms.
The synchronising influence of Substantia Innominata on the thalamus of the cat
Authors: Mariotti Maurizio , Gritti Ivana , Mancia Mauro
Published: March 2003

We examined the stimulating effect of Substantia Innominata pars anterior (SIa), during the waking state, on the ‘central’ part of the Mediodorsal nucleus of the thalamus (MD), combining electrophysiological and anatomical techniques in restrained, undrugged, unanaesthetized cats. Thalamic MD units were recorded, after electrical stimulation of the Substantia Innominata, at 1 Hz, with a single pulse or short trains of four pulses. Responses were studied by poststimulus histograms. In about 64 of the 84 recorded MD neurones (76%), stimulation of the Substantia Innominata, during the waking state, induced a brief cell excitation, followed first by prolonged inhibition of firing and then by a strong excitatory rebound discharge; after this comes a second sequence of inhibition and excitation, of decreasing amplitude. After stimulation of the Substantia Innominata, the MD units tended to start a repetitive discharge at 4–7 Hz. To investigate the connections of Substantia Innominata cells upon the areas where MD units were recorded we injected horseradish peroxidase wheat germ agglutinin (WGA–HRP), combined with immunohistochemistry for glutamic acid decarboxylase (GAD) and choline acetyl transferase (ChAT). Of the total population of retrogradely labelled cells in the Substantia Innominata 53% were GAD positive while less than 16% were ChAT positive. The GAD positive MD‐projecting cells in the Substantia Innominata were triangular to fusiform and small to medium in size. These findings indicate that GABAergic input from the Substantia Innominata may contribute to increasing the hyperpolarizing inhibitory pressure on MD cells in the ‘central’ part during slow wave sleep (SWS).
The effects of alcoholism on auditory evoked potentials during sleep
Authors: Nicholas Christian L. , Sullivan Edith V. , Pfefferbaum Adolf , Trinder John , Colrain Ian M.
Published: March 2003

Normal aging is associated with a reduction in the probability that an auditory stimulus will evoke a K‐complex during sleep. Additional concomitants of aging are a reduction in the amplitude of the K‐complex‐related N550, an augmentation of the P2 component and the appearance of a long‐lasting positivity (LLP) in the auditory evoked potential. Normal aging is also associated with a dramatic reduction in slow wave sleep (SWS) and a reduction in the volume of cortical gray matter, particularly in the frontal and prefrontal regions of the brain. As in aging, alcoholism is associated with reductions in both cortical gray matter and SWS. It can, therefore, be hypothesized that alcoholics would show similar evoked potential changes to those seen in aging. To test this hypothesis, we studied seven middle‐aged abstinent long‐term alcoholics and eight age‐matched normal controls. Each subject spent one night in the laboratory. Electroencephalogram (EEG) was recorded from six midline scalp sites and auditory stimuli were presented during stage 2 non‐rapid eye movement sleep. N550 amplitude in the K‐complex average was lower in the alcoholics as compared with controls as was the likelihood of K‐complex production. No differences were noted in either amplitude or latency of the P2 or N350 components, and both groups displayed a prominent LLP potential. The pattern of reduced K‐complex production and N550 amplitude in alcoholics as compared with age‐matched controls is consistent with an hypothesized association between atrophy of the frontal lobes and reductions in SWS and K‐complexes. The finding also suggests that the evoked K‐complex may be a relatively simple measure of the effect of alcoholism on EEG during sleep.
The pharmacokinetics of clomipramine and desmethylclomipramine in dogs: parameter estimates following a single oral dose and 28 consecutive daily oral doses of clomipramine
Authors: HEWSON C.J. , CONLON P.D. , LUESCHER U.A. , BALL R.O.
Published: March 2003

Clomipramine is a tricyclic antidepressant that has been recommended for the treatment of canine compulsive disorder. The pharmacokinetics of clomipramine in dogs have not been reported. This study describes the pharmacokinetics of clomipramine and its active metabolite, desmethylclomipramine, in six male dogs. Serial blood samples were collected following both a single oral dose of clomipramine (3 mg/kg) and 28 consecutive daily oral doses (3 mg/kg q 24 h). In addition, ‘peak’ and ‘trough’ samples were taken throughout the 28‐day dosing period. Plasma was assayed for total (free and protein‐bound) clomipramine and desmethylclomipramine, using gas‐chromatography with mass spectrometric detection. Various pharmacokinetic parameters were then determined. Following a single dose of clomipramine, time of maximum plasma concentration (tmax) of clomipramine was 0.75–3.1 h, maximum plasma concentration (Cmax) was 16–310 ng/mL and elimination half‐life (t1/2el) was 1.2–16 h;tmaxof desmethylclomipramine was 1.4–8.8 h,Cmaxwas 21–134 ng/mL andt1/2elwas 1.2–2.3 h. Following multiple dosing, there was a numeric increase in these parameters;tmaxof clomipramine was 3–8 h,Cmaxwas 43–222 ng/mL andt1/2elwas 1.2–16 h;tmaxof desmethylclomipramine was 1.4–8.8 h,Cmaxwas 21–134 ng/mL andt1/2elwas 1.2–2.3 h. Clinically significant differences between dogs and humans in the pharmacokinetics of oral clomipramine are discussed.
Pharmacokinetics of indomethacin in sheep after intravenous and intramuscular administration
Authors: Vinagre B. , RodrÍguez C. , San AndrÉs M. I. , Boggio J. C. , San AndrÉs M. D. , Encinas T.
Published: March 2003

The pharmacokinetics of indomethacin (1mg/kg) was determined in six adult sheep after intravenous (i.v.) and intramuscular (i.m.) injection. Plasma concentrations were maintained within the therapeutic range (0.3–3.0 μg/mL) from 5 to 50 min after i.v. and from 5 to 60–90 min after i.m. administration. After two trials, indomethacin best fitted an open two‐compartment model. The mean (±SD) volumes of distribution at steady state (Vdss) were 4.10 ± 1.40 and 4.21 ± 1.93 L/kg and the mean clearance values (ClB) were 0.17 ± 0.06 and 0.22 ± 0.12 L/h.kg for i.v. and i.m. routes, respectively. The elimination phase half‐lives did not show any significant difference between routes of injection (t½β = 17.4 ± 4.6 and 21.25 ± 4.44 h, i.v. and i.m. respectively). After i.m. administration, plasma maximum concentration (Cmax =  1.10 ± 0.68 μg/mL) was reached 10 min after dosing; the absorption phase was fast (Kab = 26 ± 18 h‐1) and short (t½ab = 2.33 ± 1.51 min) and the mean bioavailability was 91.0 ± 32.8%, although there was considerable interanimal variation. In some individuals, bioavailability was higher than 100%. This fact combined with the slower elimination phase after i.m. than after i.v. administration, could be related with enterohepatic recycling.
Endocrine and metabolic responses to plasma volume expansion during halothane anaesthesia in ponies
Authors: Taylor
Published: March 2003

The study was designed to contribute to identification of the stimulus to adrenocortical activity during halothane anaesthesia in equidae. Two groups of six ponies were premedicated with acepromazine before induction of anaesthesia with thiopentone and maintenance for 120 min with halothane in oxygen. In group H Haemaccel® modified gelatine plasma replacer was infused (48 ± 13 mL/kg) to maintain mean arterial blood pressure (MABP) close to preanaesthetic values. In group DH, blood pressure was maintained close to preanaesthetic levels with a lower dose of Haemaccel® (10 mL/kg) combined with an infusion of dobutamine. Measurements were made before anaesthesia, at 20 min intervals during anaesthesia and 20 and 120 min after anaesthesia. MABP and blood gases, pulse and respiratory rates were measured, and blood was withdrawn for assay of cortisol, adrenocorticotrophic hormone (ACTH), glucose and lactate. Ponies in both groups became hyperoxic, hypercapnic and developed a respiratory acidosis; pulse rate increased in both groups but this was more marked in group H. Haematocrit decreased by 50% in H and by 20% in DH. Cortisol and ACTH did not change significantly during anaesthesia in either group and the area under the time curve (AUC(0–140)) was lower in the DH group. Plasma glucose and lactate remained stable. After the H treatment all ponies had a watery nasal discharge and one pony died from endotoxaemia. This investigation demonstrated that the adrenocortical response to halothane anaesthesia in ponies can be ameliorated by manipulation of ABP using plasma expansion with or without inotrope infusion; however, low dose Haemaccel® with dobutamine was safer and more practical. It is suggested that, although hypotension is not the sole stimulus to adrenocortical activity during halothane anaesthesia, it may contribute, probably through an effect on tissue perfusion.
Excretion of flumequine in free‐swimming Atlantic salmon (Salmo salar), determined by cannulation of the dorsal aorta, gall bladder and urethra
Authors: Sohlberg  , Martinsen  , Horsberg  , Søli
Published: March 2003

Abstract here
Comparison of the pharmacokinetics of moxidectin (Equest®) and ivermectin (Eqvalan®) in horses
Authors: Pérez R. , Cabezas I. , García M. , Rubilar L. , Sutra J.F. , Galtier P. , Alvinerie M.
Published: March 2003

A study was undertaken in order to evaluate and compare plasma disposition kinetic parameters of moxidectin and ivermectin after oral administration of their commercially available preparations in horses. Ten clinically healthy adult horses, weighing 390–446 kg body weight (b.w.), were allocated to two experimental groups of five horses. Group I was treated with an oral gel formulation of moxidectin (MXD) at the manufacturers recommended therapeutic dose of 0.4 mg/kg bw. Group II was treated with an oral paste formulation of ivermectin (IVM) at the manufacturers recommended dose of 0.2 mg/kg b.w. Blood samples were collected by jugular puncture at different times between 0.5 h and 75 days post‐treatment. After plasma extraction and derivatization, samples were analysed by HPLC with fluorescence detection. Computerized kinetic analysis was carried out. The parent molecules were detected in plasma between 30 min and either 30 (IVM) or 75 (MXD) days post‐treatment. Both drugs showed similar patterns of absorption and no significant difference was found for the time corresponding to peak plasma concentrations or for absorption half‐life. Peak plasma concentrations (Cmax) of 70.3 ± 10.7 ng/mL (mean ± SD) were obtained for MXD and 44.0 ± 23.1 ng/mL for IVM. Moreover, the values for area under concentration–time curve (AUC) were 363.6 ± 66.0 ng·d/mL for the MXD treated group, and 132.7 ± 47.3 ng·d/mL for the IVM treated group. The mean plasma residence times (MRT) were 18.4 ± 4.4 and 4.8 ± 0.6 days for MXD and IVM treated groups, respectively. The results showed a more prolonged residence of MXD in horses as demonstrated by a four‐fold longer MRT than for IVM. The longer residence and the higher concentrations found for MXD in comparison to IVM could possibly explain a more prolonged anthelmintic effect. It is concluded that in horses the commercial preparation of MXD presents a pharmacokinetic profile which differs significantly from that found for a commercial preparation of IVM. To some extent these results likely reflect differences in formulation and doses.
Pharmacokinetics of carprofen enantiomers in equine plasma and synovial fluid – a comparison with ketoprofen
Authors: Armstrong S. , Tricklebank P. , Lake A. , Frean S. , Lees P.
Published: March 2003

Carprofen is a Non Steroidal Anti‐Inflammatory Drug (NSAID) which is widely used for the treatment of musculoskeletal disorders in horses. The commercial preparation is a racemic mixture of two enantiomers (R and S carprofen). We used HPLC to measure plasma and synovial fluid R and S carprofen concentrations following a single intravenous (i.v.) dose, and computer modelling to determine the pharmacokinetic parameters of the enantiomers in these two body fluids. A comparison was made with results from an identical experiment using ketoprofen.

 The plasma elimination half lives of R and S carprofen were 20 and 16 times longer than those of R and S ketoprofen, and clearance was considerably slower for carprofen than ketoprofen. Plasma R carprofen concentrations were higher than S carprofen concentrations throughout the 48‐h period. Ketoprofen was no longer detectable in synovial fluid after 5 h (S enantiomer) or 12 h (R enantiomer), whereas synovial fluid carprofen concentrations did not peak until 12 h and were still detectable at 48 h. Synovial fluid concentrations of both carprofen enantiomers were significantly lower than plasma concentrations, probably due to high plasma protein binding which could limit transfer through the synovial membrane. Our results indicate significant differences between carprofen and ketoprofen and between the two carprofen enantiomers.