bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative Evaluation of Left Ventricle Performance from Two Dimensional Echo Images
Authors: Manivannan J. , Reddy M. Ramasubba , Thanikachalam S. , Kumar R. Ajay
Published: January 2006

Objectives: We sought to quantify the left ventricle systolic dysfunction by a geometric index from two‐dimensional (2D) echocardiography by implementing an automated fuzzy logic edge detection algorithm for the segmentation. Background: The coronary injuries have repercussions on the left ventricle producing changes on wall contractility, the shape of the cavity, and as a whole changes on the ventricular function. Methods: 2D echocardiogram and M‐mode recordings were performed over the control group and those with the dysfunctions. From 2D recordings, individual frames were extracted for at least five cardiac cycles and then segmentation of left ventricle was done by automated fuzzy systems. In each frame, the volumes are measured and a geometric index, eccentricity ratio (ER), was derived. The endocardial fractional shortening (FS), midwall fractional shortening (mFS), and the relative wall thickness (RWT) were also measured in each case. Results: Depressed value of endocardial FS (20.39 ± 5.43 vs 34.28 ± 9.36, P = 0.0046), mFS (33 ± 8.3 vs 52.5 ± 11.7, P = 0.0047), and the RWT (0.337 ± 0.096 vs 0.525 ± 0.119, P = 0.0002) was observed with dysfunction. ER measured at end‐diastole (2.86 ± 0.703 vs 4.14 ± 0.38) and end‐systole (3.14 ± 0.79 vs 5.48 ± 0.74) was found to be decreased in the dysfunction group and more significant at the end‐systole (P = 0.00017 vs 6.6E−06). Conclusion: This work concludes that the regional and global left ventricle systolic dysfunction can be assessed by the ER measured at end‐diastole and end‐systole from 2D echocardiogram and may contribute to the high rate of cardiovascular disorders.
Stroke Volume and Mitral Annular Velocities: Insights from Uremic Patients with Significant Valvular Regurgitation
Authors: Hsiao Shih‐Hung , Huang Wei‐Chen , Lee Tao Yu , Lin Shih‐Kai , Liu Chun‐Peng
Published: January 2006

Objective: This study investigates the change in new diastolic indices in uremic patients who undergo regular hemodialysis (H/D). Materials and Methods: We studied uremic patients receiving regular H/D. All patients were sinus rhythm before H/D. They had normal left ventricular systolic performance without regional wall motion abnormality. Patients were separated into two groups according to whether they had significant aortic or mitral regurgitation (AR or MR) or not. They received complete transthoracic echocardiographic examinations. Stroke volume (SV) was calculated as the product of the time‐velocity integral (TVI) and cross‐sectional area of aortic annulus.
Flow propagation velocity (FPV) was measured by color M‐mode echocardiography in apical four‐chamber view. Mitral annulus tissue Doppler velocities—peak systolic (Sa), early diastolic, and late diastolic—were measured from septal and lateral wall. All these parameters were obtained immediately before and after H/D. Paired data were compared. Result: H/D amount was strongly correlated with the change of SV. After H/D, the reduction of SV in patients without AR or MR (control group) was obvious but it was not significant in patients with significant AR or MR (study group). There were significant differences in mitral inflow velocities, FPV, and mitral annular velocities (except septal Sa) in the control group. In the study group, predialytic and postdialytic parameters of new diastolic indexes had no statistical difference. Conclusion: New echocardiographic indexes of uremic patients with significant AR or MR were relatively preload‐independent. The phenomenon was possibly related to insignificant change of SV after H/D.
The Usefulness of Doppler Myocardial Imaging in the Study of the Athlete's Heart and in the Differential Diagnosis between Physiological and Pathological Ventricular Hypertrophy
Authors: D'Andrea Antonello , D'Andrea Luigi , Caso Pio , Scherillo Marino , Zeppilli Paolo , Calabrò Raffaele
Published: January 2006

Athlete's heart is a cardiac adaptation to long‐term, intensive training, which includes changes as increased ventricular cavity diameters, wall thickness and mass, produced with a degree consistent with sports activities and exercise programs. The Doppler myocardial imaging (DMI) permits characterization of the velocities of each ventricular myocardial segment by placing the sample volume at the center of the cardiac muscle. Even if the standard two‐dimensional (2D) echocardiography represents an irreplaceable method in the evaluation of cardiac adaptations to physical exercise, the data currently available suggests the usefulness of DMI in the assessment of the myocardial systolic and diastolic functions of the athlete's heart. In particular, an athlete's left ventricular hypertrophy is characterized by a “supernormal” DMI pattern, with increased myocardial early‐diastolic velocity. Therefore, DMI analysis in the trained subject has demonstrated interesting prospective for: (1) the differential diagnosis from pathological, both, left and right ventricular hypertrophy; (2) the prediction of cardiac performance during physical effort; (3) the evaluation of the biventricular interaction; (4) the analysis of the myocardial adaptations to various training protocols; and (5) the early identification of specific genotypes associated with cardiomyopathies. On this ground, a combined use of standard 2D echo and DMI may be taken into account for a valid noninvasive and easy‐repeatable evaluation of both physiological and pathological ventricular hypertrophies
The Utility of Pulsed Tissue Doppler Parameters for the Diagnosis of Advanced Left Ventricular Diastolic Dysfunction
Authors: Wierzbowska‐Drabik Karina , Drożdż Jarosław , Plewka Michał , Trzos Ewa , Krzemińska‐Pakuła Maria , Kasprzak Jarosław D.
Published: January 2006

Objective: The evaluation of diagnostic value of pulsed tissue Doppler (TD) parameters (calculated from six points of mitral annulus and separately measured in the lateral part of mitral annulus) for the detection of pseudonormal mitral inflow pattern. Methods and Results: Among 200 persons examined by transthoracic echocardiography group with E/A value between 1 and 2 was selected and divided to normal (54 subjects, early wave deceleration time, Edt ≥ 150 msec) and pseudonormal (23 patients, Edt < 150 msec together with prolonged difference between duration of atrial reversal flow in pulmonary vein and mitral flow in atrial phase, delta Ar ≥ 20 msec) inflow. Wide spectrum of TD parameters was compared between the selected groups. In normal inflow, average peak velocities of early and atrial phase of diastolic mitral annulus motion were significantly higher: 11.0 ± 2.6 versus 8.9 ± 3.5 cm/sec; (P = 0.005) and 12.0 ± 2.2 versus 10.0 ± 3.0 cm/sec; (P = 0,002), respectively. Ratio of peak early mitral wave velocity to peak velocity of annulus motion in early phase (Ev/E'v avr) was higher in the pseudonormal pattern: 9.8 ± 3.7 versus 7.0 ± 2.0, respectively (P < 0.001). For the value of Ev/E'v avr > 10.2, 70% accuracy for the diagnosis of pseudonormalization was detected. For the parameters measured in the lateral part of mitral annulus similar relationships in the early filling phase were detected but did not reach statistical significance in the atrial phase. Conclusions: Pulsed TD offers good accuracy for the diagnosis of pseudonormalization with increased ratio of peak early mitral wave velocity to peak velocity of mitral annulus being the optimal predictor of advanced diastolic dysfunction.
Relationship Between Plasma Total Antioxidant Capacity and Thoracic Aortic Intima‐Media Thickness
Authors: Demirbag Recep , Yilmaz Remzi , Kunt A. Sami , Gur Mustafa , Ulucay Abdullah , Unlu Durmus
Published: January 2006

It is known that antioxidants have an important role in the prevention of coronary artery disease (CAD). Low total antioxidant capacity (TAC) is a risk factor for ischemic heart disease. However, no data are available concerning the relationship between TAC and severity of thoracic aortic atherosclerosis. This study using multiplane transesophageal echocardiography (TEE) examined the relationship between atherosclerotic thoracic aortic intima‐media thickness (TAIMT) and TAC. Twenty‐nine patients (17 male, 12 female; mean age 36 ± 8 years) without a history of atherosclerotic cardiovascular disease referred for TEE were included. The patients with obesity, hypertension, diabetes, and CAD were excluded. The TAC was measured for each patient using a more recently developed method. TAIMT and grade of thoracic aortic atherosclerosis were evaluated in each patient by using TEE. Mean TAC level was 1.91 ± 0.53 mmol Trolox equiv/l. There was a negative and significant correlation between the TAC levels and TAIMT and grade of thoracic aortic atherosclerosis (r =−0.799, P < 0.001 versus r =−0.827, P < 0.001, respectively). Multiple linear regression analysis showed that TAIMT was independently associated with TAC (β=−0.734, P < 0.001). The mean values of TAC in grade I, II, and III were 2.23 ± 0.31, 1.58 ± 0.31, and 1.04 ± 0.27 mmol Trolox equiv/l, respectively (ANOVA P < 0.001). This study indicates that the TAC is an independent variable for TAIMT and it has a potential for an independent variable for atherosclerotic lesions in the major arterial locations.
Chemical Solution Deposition of (Ba1−xSrx) TiO3 Thin Films and Characterization
Authors: Kumar V. , Packiaselvam I. , Sivanandan K. , Vahab M. A. , Sinha A. K.
Published: January 2006

A simple system has been developed for the preparation of stable precursor solutions for dip coating (Ba1−xSrx)TiO3 thin films. From such stable solutions highly crystalline, uniform and crack‐free thin films are obtained by dip coating, followed by annealing at temperatures as low as 600°C. The pyrolysis behavior, crystallization mechanism, and thin film morphology have been studied using thermogravimetric and differential thermal analysis, X‐ray diffraction, and scanning electron microscopy. The dielectric tunability characteristics have been determined for thin films of composition (Ba1−xSrx)TiO3, x=0.30, to study their suitability for tunable device applications.
Effect of Zn, Sr, and Y Addition on Electrical Properties of PZT Thin Films
Authors: Dalakoti Abhishek , Bandyopadhyay Amit , Bose Susmita
Published: January 2006

We have investigated methods to increase the efficiency of piezoelectric micromachined ultrasonic transducers (pMUTs). pMUTs are driven by a thin piezoelectric layer on a Si membrane. The efficiency of pMUTs can be increased using a film with better ferroelectric properties. We have used Zn, Sr, and Y doping on PZT‐based thin films along the morphotropic phase boundary (MPB) composition to increase their piezoelectric properties. The results obtained were then extended to compositions on both sides of the MPB. The sol–gel method was used to prepare precursor solutions, which were then spin coated on a Pt(100)/Ti/SiO2/Si substrate to prepare the PZT thin films. It was found that Zn and Sr together had the most significant effect on the ferroelectric properties in which a saturation polarization of 108 μC/cm2 and remanent polarization of 54 μC/cm2 were achieved.
Thermal Stability of Nanocrystalline Sm2O3 and Sm2O3–MgO
Authors: Sieger H. , Suffner J. , Hahn H. , Raju A.R. , Miehe G.
Published: January 2006

Nanocrystalline Sm2O3 and Sm2O3–MgO powders have been prepared by spray pyrolysis of aqueous precursor solutions containing citric acid as a complexant. Synthesized powders consist of hollow spheres with thin shells. The two‐phase samples exhibit an improved microstructural stability compared with pure Sm2O3. The microstructure before and after various heat treatments has been investigated by high‐resolution transmission electron microscopy, scanning electron microscopy, nitrogen adsorption, and X‐ray diffraction.
Redilatation with intracameral mydriatics in phacoemulsification surgery
Authors: Bäckström Gunnie , Behndig Anders
Published: January 2006

Purpose:  To determine whether intracameral mydriatics can redilate pupils that contract during phacoemulsification cataract surgery.

Methods:  A total of 80 patients were included in this prospective, randomized, double‐blind study performed at Örnsköldsviks Hospital Eye Clinic. Of these, 60 patients had 0.6 µg/ml of epinephrine added to the balanced salt solution (BSS) used for irrigation and 20 patients did not. The patients in each group were randomized and given either an intracameral mydriatics (ICM) solution or placebo intracamerally after phacoemulsification and cortex cleaning. The pupil size was registered preoperatively, after cortex cleaning, 30 seconds after study injection, 2 mins after study injection and the day after surgery.

Results:  No clinically relevant differences were found preoperatively. In the epinephrine material a significantly longer operation time (p = 0.023) and more procedures requiring Vision Blue™ and Kelman‐type tip in the placebo group might indicate diversity in the grade of cataract. There was a greater degree of contraction in the absence of epinephrine in the irrigation solution (2.3 ± 1.0 mm in the ICM group and 3.2 ± 0.7 mm in the placebo group) compared to in the presence of epinephrine. With no epinephrine ICM significantly redilated the pupils at 30 seconds (p ≤ 0.001) as well as at 2 mins (p = 0.015).

Conclusion:  We have shown that in cases with an intraoperative pupil contraction, ICM is effective in redilating the pupil. Insufficient adrenergic stimulation of the pupil dilator appears to be a major factor causing intraoperative pupil contraction during phacoemulsification cataract surgery.
A multicentre, retrospective study of resource utilization and costs associated with glaucoma management in France and Sweden
Authors: Lindblom Bertil , Nordmann Jean‐Philippe , Sellem Eric , Chen Enping , Gold R. , Polland Werner , Williamson W. , Buchholz Patricia , Walt John G. , Groleau Danielle , Curry Alistair , Evans Stacy J.
Published: January 2006

Purpose:  To assess resource utilization and costs associated with glaucoma management in France and Sweden.

Methods:  A total of 267 patient records (121 in France, 146 in Sweden) with diagnoses of primary open‐angle glaucoma (POAG) and ocular hypertension (OH), treated medically, were reviewed for a 2‐year period (beginning during 1997−99) for relevant clinical and resource utilization data. Economic data were applied to estimate treatment costs.

Results:  The annual cost of treating glaucoma was estimated at SEK5305 (€531)/patient in Sweden and €390/patient in France. In both countries, medication costs comprised about half of the total costs. Surgical procedures and hospitalizations represented greater proportions of total cost in France (7.0% and 9.6%, respectively) than in Sweden (3.7% and 0.6%, respectively).

Conclusion:  Medication costs represent a high proportion of total treatment costs. These findings highlight the relative importance of medical therapy and of assessing the cost‐effectiveness of medications in glaucoma.
Colour vision and retinal nerve fibre layer photography in patients with an Acrysof® Natural intraocular lens
Authors: Vuori Marja‐Liisa , Mäntyjärvi Maija
Published: January 2006

Purpose:  To study colour vision and retinal nerve fibre layer (RNFL) photographs in patients with an Acrysof® Natural intraocular lens (IOL).

Methods:  We carried out a randomized double‐blind study. An Acrysof® Natural IOL (model SN60AT) was implanted in 25 eyes of 19 patients and an Acrysof® IOL (model SA60AT) was implanted in 27 eyes of 18 control patients. The patients returned for colour vision tests and fundus photography 1−6 months after the surgery.

Results:  Standard pseudoisochromatic plates, part 2, were correctly interpreted and the Farnsworth−Munsell 100‐hue test (FM 100) total and individual box scores were normal in all IOL eyes. In the FM 100 hue test there were no significant differences in the results of the total error scores or the error scores of the individual boxes between the eyes with Acrysof® Natural and those with Acrysof® lenses. The yellow coloration of the Acrysof® Natural IOL did not affect the visibility of the RNFL in photographs.

Conclusions:  The Acrysof® Natural IOL did not affect colour vision in the tested patients, even in the blue region of the spectrum, and can be implanted in patients who need to have normal colour vision for the purposes of their occupation. The Acrysof® Natural IOL does not interfere with RNFL photography and can also be used in patients with glaucoma.
An isotonic preparation of 1 mg/ml indocyanine green is not toxic to hyperconfluent ARPE19 cells, even after prolonged exposure
Authors: Kiilgaard Jens Folke , Nissen Mogens Holst , La Cour Morten
Published: January 2006

Purpose:  To investigate the in vitro toxicity of indocyanine green and infracyanine green (ICG) to cultured ARPE19 cells, in particular with respect to the concentration and time dependence of this toxicity.

Methods:  ARPE19 cells were grown for at least 1 week past confluence (hyperconfluent cells) before being subjected to challenge with ICG. Cell survival was tested with the MTT assay.

Results:  When applied in isotonic solutions, ICG in all concentrations (below 5 mg/ml) and at all exposure times tested (2 mins−2 hours) was found not to affect the survival of ARPE19 cells. ARPE19 cultures older than 30 days were more resistant to a 5 mg/ml hypotonic ICG solution than younger cultures.

Conclusion:  When toxicity of ICG was tested in hyperconfluent ARPE19 cultures, these cells were found to be more resistant to the dye than has been previously reported for more immature ARPE19 cells.
One medial triangular Tutoplast sling as a frontalis suspension for adult myogenic blepharoptosis
Authors: Seider Nir , Beiran Itzchak , Kaltreider Sara A.
Published: January 2006

Purpose:  The treatment of choice for medium to severe blepharoptosis with minimal or no levator function is frontalis suspension with a sling, using a rectangular or rhomboid sling placement technique. We describe the short‐term, follow‐up results of frontalis suspension surgery for adult myogenic blepharoptosis using Tutoplast, a commercially available fascia lata allograft.

Methods:  We conducted a consecutive, interventional case study. All adult (>25 years of age) patients operated for non‐traumatic myogenic ptosis during a 1‐year period were included. All underwent frontalis suspension using one medial triangular Tutoplast sling. Success was judged according to lid position and complications.

Results:  Successful surgical results were judged by lid level, lid symmetry and lid contour. During a mean follow‐up of 9 months, the success rate was 91% in all three criteria and 100% in at least two out of three. No major complications were observed. The most prevalent minor complication was the need for lubrication treatment in 26% of the operated patients.

Conclusion:  The use of Tutoplast for frontalis suspension in cases of adult myogenic ptosis is safe and has a high success rate in the early postoperative period. Further large‐scale studies are necessary to ascertain the longterm results and the applicability of this material to other indications.
Age‐related maculopathy and the impact of blue light hazard
Authors: Algvere Peep V. , Marshall John , Seregard Stefan
Published: January 2006

The pathogenesis of age‐related maculopathy (ARM), the most common cause of visual loss after the age of 60 years, is indeed a complicated scenario that involves a variety of hereditary and environmental factors. The pathological cellular and molecular events underlying retinal photochemical light damage, including photoreceptor apoptosis, have been analysed in experimental animal models. Studies of age‐related alterations of the retina and photoreceptors, the accumulation of lipofuscin in retinal pigment epithelium (RPE) cells, and the formation of drusen have greatly contributed to our knowledge. A new concept of an inflammatory response to drusen has emerged, suggesting immunogenic and systemic reactions in Bruch's membrane and the subretinal space. Oxidative stress and free radical damage also impact on the photoreceptors and RPE cells in the ageing eye. Based on the photoelectric effect, a fundamental concept in quantum physics, the consequences of high‐energy irradiation have been analysed in animal models and cell culture. Short‐wavelength radiation (rhodopsin spectrum), and the blue light hazard (excitation peak 440 nm), have been shown to have a major impact on photoreceptor and RPE function, inducing photochemical damage and apoptotic cell death. Following cataract surgery, there is a dramatic change in ocular transmittance. In aphakic or pseudophakic eyes (with clear intraocular lenses), high‐energy (blue) and ultraviolet‐A radiation strikes the retina. Epidemiological data indicate a significantly increased 5‐year incidence of late ARM in non‐phakic eyes compared with phakic eyes. In recent years, putative prophylactic measures against ARM have emerged. The implantation of ‘yellow’ intraocular lenses (IOLs) that absorb high‐energy blue radiation is, from a theoretical point of view, the most rational approach, and, from a practical point of view, is easy to accomplish. With increasing age, RPE cells accumulate lipofuscin (chromophore A2E). It is noteworthy that the yellow IOL not only protects A2E‐laden human RPE cells from blue light (peak 430 nm) damage, but also alleviates the detrimental effects of green (peak 550 nm) and white light. A prophylactic treatment using antioxidants is aimed at counteracting oxidative stress and free radical cellular damage. The Age‐Related Eye Disease Study (AREDS), a randomized clinical trial, showed a significantly lower incidence of late ARM in a cohort of patients with drusen maculopathy treated with high doses of antioxidants than in a placebo group. In recent years, considerable progress in retinal research has been achieved, creating a platform for the search for new prophylactic and therapeutic measures to alleviate or prevent photoreceptor and RPE degeneration in ARM.
Psychiatric services for people with severe mental illness across western Europe: what can be generalized from current knowledge about differences in provision, costs and outcomes of mental health care?
Authors: Becker T. , Kilian R.
Published: January 2006

Objective:  To report recent findings regarding differences in the provision, cost and outcomes of mental health care in Europe, and to examine to what extent these studies can provide a basis for improvement of mental health services and use of findings across countries.

Method:  Findings from a number of studies describing mental health care in different European countries and comparing provision of care across countries are reported.

Results:  The development of systems of mental health care in western Europe is characterized by a common trend towards deinstitutionalization, less in‐patient treatment and improvement of community services. Variability between national mental healthcare systems is still substantial. At the individual patient level the variability of psychiatric service systems results in different patterns of service use and service costs. However, these differences are not reflected in outcome differences in a coherent way.

Conclusion:  It is conceivable that the principal targets of mental healthcare reform can be achieved along several pathways taking into account economic, political and sociocultural variation between countries. Differences between mental healthcare systems appear to affect service provision and costs. However, the impact of such differences on patient outcomes may be less marked. The empirical evidence is limited and further studies are required.
Heavy use of acute in‐patient psychiatric services: the challenge to translate a utilization pattern into service provision
Authors: Junghan U. M. , Brenner H. D.
Published: January 2006

Objective:  There is an inequality in resource utilization among acute psychiatric in‐patients. About 20–30% of them absorb 60–80% of the total resources allocated to this form of treatment. This study intends to summarize findings related to heavy in‐patient service use and to illustrate them by means of utilization data for acute psychiatric wards.

Method:  Longitudinal assessment of consecutive acute in‐patients hospitalized for the first time. Analysis of individual utilization patterns by using latent class cluster analysis.

Results:  Four groups with different utilization patterns were found all including heavy service users. In most cases heavy service use was temporary and could only be poorly predicted.

Conclusion:  Specific preventive interventions to contain heavy service use seem to be out of reach for the majority of high utilizing patients. However, services that have proven effective in reducing admissions to in‐patient treatment and length of stay may nevertheless help to reduce heavy service use.
Do mental health professionals stigmatize their patients?
Authors: Lauber C. , Nordt C. , Braunschweig C. , Rössler W.
Published: January 2006

Objective:  Assessing stereotypes towards people with mental illness among mental health professionals, comparing their view to the Swiss general population and analysing the influence of demographic factors, profession and work place variables (type of ward, employment time and professional experience).

Method:  Conducting a representative telephone survey (n = 1073). Factor analysis was used to achieve one‐dimensional scales, which were analysed by regression analysis.

Results:  Most positive depictions were regarded as less characterizing people with mental illness, whereas most negative descriptions were viewed as more typifying these people. Compared with the Swiss general population, mental health professionals have not consistently less negative or more positive stereotypes against mentally ill people. Of the 22 stereotypes five factors were detected: ‘social disturbance’, ‘dangerousness’, ‘normal healthy’, ‘skills’ and ‘sympathy’. Stereotypes about people with mental illness are influenced by the professional background and if at all only slightly affected by gender, age, ward type, participation rate of the hospital, weekly working hours or years of professional experience.

Conclusion:  Mental health professionals must improve their attitudes towards people with mental illness. Different ways, e.g. improving their professional education or their quality of professional contacts by regular supervision to prevent burn‐out, are discussed.
Severe mental illness in depression
Authors: Möller H.‐J. , Bottlender R.
Published: January 2006

Objective:  The study aimed to evaluate the outcome from in‐patient treatment in major depressive disorders (MDD) and its impact on the patients’ 1 year outcome under the present routine care conditions.

Method:  The reported data stem from a multicentric follow‐up study on the course and outcome of patients with MDD. Patients enrolled in the study had their first or multiple psychiatric hospitalization and fulfilled the ICD‐10 criteria for a depressive disorder. During in‐patient treatment patients were standardized assessed in 2‐weekly intervals, with yearly follow‐up evaluations after discharge.

Results:  The analyses revealed that the elimination of depressive symptoms and a return to premorbid levels of functioning is a rarity in the in‐patient treatment of MDD. Moreover, the analyses revealed that the achieved level of response during in‐patient treatment clearly determines the patients state 1 year after discharge from in‐patient treatment.

Conclusion:  Considering that persisting depressive symptoms are associated with a range of unfavourable outcomes, the present data point to a serious problem in the treatment of MDD and the urgent need to further optimize antidepressive treatment strategies.
Evaluating a community‐based mental health service focusing on severe mental illness. The Verona experience
Authors: Tansella M. , Amaddeo F. , Burti L. , Lasalvia A. , Ruggeri M.
Published: January 2006

Objective:  To describe the development of a community‐based mental health service, the patterns of care provided by this new service established in 1978 and its costs.

Method:  The South‐Verona Psychiatric Case Register, the South‐Verona Outcome Project and studies designed to assess costs provided process and outcome data.

Results:  This paper summarizes descriptive statistics as well as the results of some evaluative studies conducted over the last 25 years in Verona, Italy. It reports patterns of care provided over the years by this new, comprehensive community‐based service, targeted to the severely mentally ill but available also to all other residents in the area who need mental health care.

Conclusion:  Developing community‐based mental health care requires a series of coordinated actions that need to be pursued over a long period of time. Service evaluation, including costs assessment, is an important part of this exercise.
Who decides what evidence is? Developing a multiple perspectives paradigm in mental health
Authors: Rose D. , Thornicroft G. , Slade M.
Published: January 2006

Objective:  To compare different perspectives on evidence in relation to mental health care.

Method:  The method and materials constitute a selective literature review comparing key elements of evidence‐based medicine and evidence‐based policy with perspectives on evidence from users, carers and professionals. The aim was to develop an argument concerning these comparisons.

Results:  What constitutes evidence from the perspectives of different stakeholders is a field of contestation.

Conclusion:  It is timely for a multiple perspective paradigm on evidence in science to be developed and this paper initiates this process in relation to mental health care.
Validity and reliability of the CAPE: a self‐report instrument for the measurement of psychotic experiences in the general population
Authors: Konings M. , Bak M. , Hanssen M. , Van Os J. , Krabbendam L.
Published: January 2006

Objective:  General population longitudinal cohort studies have demonstrated the prognostic validity of self‐reported psychotic experiences, but data on reliability and cross‐validation with interview‐based measures of these experiences are sparse. This study tested the reliability and validity of the Community Assessment of Psychic Experiences (CAPE42).

Method:  At baseline, the CAPE42 was used to measure the subclinical psychosis phenotype in a general population sample (n =  765). At follow‐up (mean interval: 7.7 months), the Structured Interview for Schizotypy, Revised (SIS‐R), the Brief Psychiatric Rating Scale (BPRS), and the CAPE42 were administered (n = 510).

Results:  Baseline self‐reported dimensions of psychosis were specifically and independently associated with their equivalent interview‐based dimension at follow‐up (standardized effect sizes of 0.4–0.5) and with their equivalent self‐reported measure (standardized effect sizes of 0.6–0.8).

Conclusion:  The results indicate that self‐reported dimensions of psychotic experiences in general population samples appear to be stable, reliable and valid.
Attitude towards antipsychotics among out‐patients with schizophrenia in Nigeria
Authors: Adewuya A. O. , Ola B. A. , Mosaku S. K. , Fatoye F. O. , Eegunranti A. B.
Published: January 2006

Objective:  The study aim to assess the attitude of patients with schizophrenia attending out‐patient clinics in Nigeria towards antipsychotic medication and examine the factors associated with such attitude.

Method:  Out‐patients with schizophrenia (n = 312) completed the 10‐item Drug Attitude Inventory. They were also evaluated for sociodemographic details, illness‐related and drug‐related variables.

Results:  Overall, the patients had a good attitude towards antipsychotic medication. The factors significantly associated with poor attitude towards medication include presence of symptoms, presence of side‐effects like dyskinesia and sedation, lack of insight into the illness, and being employed.

Conclusion:  Special attention should be paid to patients with these factors while designing programmes to improve overall compliance in patients with schizophrenia.
Early colonization of non‐submerged dental implants in patients with a history of advanced aggressive periodontitis
Authors: De Boever Annemarie L. , De Boever Jan A.
Published: January 2006

Abstract: The aim of the study was to evaluate the early colonization of non‐submerged implants over a 6‐month period in partially edentulous patients treated for advanced aggressive periodontal disease. In 22 patients treated for advanced aggressive periodontitis and in a supportive maintenance program for a period between 12 and 240 months at implant surgery, a total of 68 non‐submerged dental implants were installed. Patients had a plaque score below 20%, and less than 20% of the pockets around the teeth were bleeding on probing (BOP). Using DNA‐probes (micro‐IDent®), the presence and concentration of five periodontal pathogens (Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythensis (Tf) and Treponema denticola (Td)) were determined in the five deepest pockets of the rest dentition pre‐operatively and after 6 months as well as five places around each implant 10 days, 1 month, 3 months and 6 months after surgery. In each patient, a test to determine the genotype interleukin‐1 (IL‐1) was performed (PST – micro‐IDent®). After 6 months, no difference in microbial composition as compared with baseline was found around the teeth in five patients, in 12 minute differences and in five patients important differences were observed. Ten days after surgery, three patients had a complete similar bacterial composition between teeth and implants. In 14 patients, the composition was fairly similar, while large differences in composition and concentration occurred in five patients. This microbiota around the implants remained almost unchanged over a 6‐month period and did not hamper the clinical and radiographic osseointegration and did not lead to peri‐implantitis, mucositis or initiation of bone destruction.
Dynamics of initial subgingival colonization of ‘pristine’ peri‐implant pockets
Authors: Quirynen Marc , Vogels Roel , Peeters Wouter , van Steenberghe Daniel , Naert Ignace , Haffajee Anne
Published: January 2006

Background: Periodontitis and peri‐implantitis are linked to the presence of several key pathogens. The treatment of these infectious processes therefore involves the reduction/eradication of bacteria associated with periodontitis.

Methods: This prospective, split‐mouth, single‐blind study followed the colonization of ‘pristine’ sulci created in 42 partially edentulous patients during implant surgery (e.g. abutment connection). The hypothesis was that the composition of the maturing subgingival plaque in these ‘fresh’ peri‐implant pockets would soon (within 2 weeks) be comparable to the subgingival microbiota of teeth with similar clinical parameters (reference sites), including the presence of bacteria associated with periodontitis. Per patient, four subgingival plaque samples were taken from shallow and medium pockets around implants (test sites), and teeth within the same quadrant (undisturbed microbiota as control sites), 1, 2, 4, 13, 26 and 78 weeks after abutment connection, respectively. The samples were analysed by either checkerboard DNA–DNA hybridization, or cultural techniques, or real‐time polymerase chain reaction (PCR) for intra‐subject comparisons (teeth vs. implant, for comparable probing depths).

Results: Checkerboard DNA–DNA hybridization and real‐time PCR revealed a complex microbiota (including several pathogenic species) in the peri‐implant pockets within 2 weeks after abutment connection. After 7 days, the detection frequency for most species (including the bacteria associated with periodontitis) was already nearly identical in samples from the fresh peri‐implant pockets (5% and 20% of the microbiota belonging to red and orange complex, respectively) when compared with samples from the reference teeth. Afterwards (e.g. between weeks 2 and 13), the number of bacteria in peri‐implant pockets only slightly increased (±0.1 log value), with minor changes in the relative proportions of bacteria associated with periodontitis (8% and 33% of the microbiota belonging to red and orange complex, respectively). Although small differences were seen between teeth and implants at week 2 with cultural techniques, a striking similarity in subgingival microbiota was found with this technique from month 3 on, with nearly identical detection frequencies for bacteria associated with periodontitis for both abutment types.

Conclusions: This study indicates that the initial colonization of peri‐implant pockets with bacteria associated with periodontitis occurs within 2 weeks.
Representations of the dental surgery profession and the motivations given by second‐year French students for applying for dental surgery
Authors: Jover M. , Doudoux D. , Deveaux E.
Published: January 2006

Aim:  The aim of the present study was to evaluate the representations odontology students had of their career path. Second‐year odontology students were questioned about their own motivations and the motivations they attributed to dentists in choosing this profession.

Methods:  The students were asked to complete a questionnaire during the first course and again after 5 months. It was thus possible to study the evolution of their motivations after 5 months of interactions with their fellow students and professors.

Results:  Whether or not students were able to choose their career path following the selection examination at the end of the first year of the medical programme was an important variable in determining individual motivations and the motivations they attributed to dentists in choosing the dental profession. For example, students who were unable to choose their career path reported that they would like to work in the public health system, while those who were able to choose said they chose odontology as a vocation. The closing of the gap between the two groups during the period between the two questionnaires highlighted the increasing cohesion of the group.

Conclusion:  Beyond the differences between the motivations provided, this study showed that students who had not planned to become dentists before the selection examination needed some time to familiarise themselves with the situation and accept the change in their career path.
Undergraduate and postgraduate dental students’‘reflection on learning’: a qualitative study
Authors: Ashley F. A. , Gibson B. , Daly B. , Lygo Baker S. , Newton J. T.
Published: January 2006

Abstract  The aim of this study was to explore undergraduate and postgraduate dental students’ understanding of a good learning experience by using ‘reflection on learning’ as described by Schon. Four groups of Year 4 BDS students and one group of postgraduate students in dental public health took part in a series of focus group discussions. The responses were grouped into four broad themes (a) active, practical and positive learning; (b) interactive/together learning; (c) personal learning; (d) theory into practice. Six educational models of good learning proposed by the students are described.
Noise levels in dental schools
Authors: Sampaio Fernandes J. C. , Carvalho A. P. O. , Gallas M. , Vaz P. , Matos P. A.
Published: January 2006

Objective:  To measure and analyse noise levels in the learning–teaching activities at the Dental School of the University of Porto (Portugal).

Materials and methods:  Sound levels were measured in five different practice areas and laboratories, selected as representative of a variety of learning–teaching activities. The noise levels were determined using a precision sound level meter that was positioned at ear level and at 1 m distance from the operator.

Results:  The noise levels registered vary between 60 and 99 dB(A) and are similar to the data of other international studies. The results recorded differences in sound levels when the equipment was merely turned on and during cutting operations. Differences between brand new and used equipment were also noted. It appears that hearing damage risk may be lesser amongst dentists who use brand new equipment.

Conclusion:  The noise levels detected in this study are considered to be close to the limit of risk of hearing loss.
Teaching of posterior composite resin restorations in undergraduate dental schools in Ireland and the United Kingdom
Authors: Lynch C. D. , McConnell R. J. , Wilson N. H. F.
Published: January 2006

Purpose:  The aim of this study was to investigate the current teaching of posterior composite resin restorations to undergraduate dental students in Ireland and the United Kingdom (UK). The investigation was a follow‐up to a survey undertaken in 1997.

Materials and methods:  A questionnaire was distributed by e‐mail to the Heads of Departments of Restorative Dentistry/Units of Operative Dentistry in each of the 15 dental schools with undergraduate dental degree programmes in Ireland and the UK. The questionnaire sought information relating to the teaching of posterior composite resin restorations in each dental school.

Results:  Fifteen completed questionnaires were returned (response rate = 100%). All schools (n = 15) taught the placement of composite resin restorations in occlusal cavities, 14 schools taught composite resin placement in two‐surface occlusoproximal cavities and nine schools taught composite resin placement in three‐surface occlusoproximal cavities. Respondents anticipated that the amount of preclinical teaching of posterior composite resin placement will increase twofold over the next 5 years, whilst the corresponding teaching of amalgam will fall to two‐thirds its current level. Variation was found between dental schools in the teaching of the principles of cavity design, contraindications to placement, indications for lining and basing techniques, matrix and wedging techniques, and the use of curing lights.

Conclusions:  The amount of teaching of posterior composite resin restorations in undergraduate dental schools in Ireland and the UK has increased since the time of a previous survey in 1997. Composite resin may soon equal or overtake amalgam as the material of choice when restoring posterior cavities in Irish and UK dental schools. There was, however, much variation in the nature and extent of the teaching and the techniques taught.
Hand and nickel‐titanium root canal instrumentation performed by dental students: a micro‐computed tomographic study
Authors: Peru M. , Peru C. , Mannocci F. , Sherriff M. , Buchanan L. S. , Pitt Ford T. R.
Published: January 2006

Abstract  The aim of this study was to evaluate root canals instrumented by dental students using the modified double‐flared technique, nickel‐titanium (NiTi) rotary System GT files and NiTi rotary ProTaper files by micro‐computed tomography (MCT). A total of 36 root canals from 18 mesial roots of mandibular molar teeth were prepared; 12 canals were prepared with the modified double‐flared technique, using K‐flexofiles and Gates‐Glidden burs; 12 canals were prepared using System GT and 12 using ProTaper rotary files. Each root was scanned using MCT preoperatively and postoperatively. At the coronal and mid‐root sections, System GT and ProTaper files produced significantly less enlarged canal cross‐sectional area, volume and perimeter than the modified double‐flared technique (P < 0.05). In the mid‐root sections there was significantly less thinning of the root structure towards the furcation with System GT and ProTaper (P < 0.05). The rotary techniques were both three times faster than the modified double‐flared technique (P < 0.05). Qualitative evaluation of the preparations showed that both ProTaper and System GT were able to prepare root canals with little or no procedural error compared with the modified double‐flared technique. Under the conditions of this study, inexperienced dental students were able to prepare curved root canals with rotary files with greater preservation of tooth structure, low risk of procedural errors and much quicker than with hand instruments.
Cytokeratin expression in oral submucous fibrosis – an immunohistochemical study
Authors: Ranganathan K. , Kavitha R. , Sawant S. S. , Vaidya M. M.
Published: January 2006

Background:  Oral submucous fibrosis (OSF) is a pre‐malignant condition caused by habitual use of areca nut, affecting the oro‐pharynx and characterized by progressive fibrosis. Alteration of cytokeratin (CK) expression has been documented in leukoplakia and oral cancer (OC). However, very little is known of CK alterations in OSF. The present study was carried out to characterize the CK profile in OSF and ascertain if this could be used as a surrogate marker for malignant transformation.

Methods:  Paraffin‐embedded tissues of OSF (n = 50), normal (n = 10) and OC (n = 10) were stained with pancytokeratin (PanCK), high molecular weight cytokeratin (HMWCK), CKs 18, 14, 8, 5, 4 and 1 by immunohistochemistry.

Results:  Significant difference in the CK staining pattern was seen between normal, OSF and cancer. Significant changes in OSF included increased intensity of staining for PanCK and HMWCK, aberrant expression of CK8 and decreased expression of CKs 5 and 14.

Conclusion:  Cytokeratin profile of OSF was significantly different from normals for PanCK, HMWCK, CK8, 5 and 14 suggesting their potential to be used as surrogate markers of malignant transformation. Further studies will help in better defining the nature and clinical implications of these alterations.
Multiple teeth showing invasive cervical resorption – an entity with little known histologic features
Authors: Coyle M. , Toner M. , Barry H.
Published: January 2006

Invasive cervical resorption is a relatively uncommon form of external root resorption, characterized by resorption of the cervical region of the root. There is progressive loss of cementum and dentine with replacement by fibrovascular tissue derived from the periodontal ligament, with deposition of cementum‐like hard tissue. In most cases, a single tooth is involved. We report a case of invasive cervical resorption that resulted in loss of multiple teeth from two different quadrants. The case highlights the diagnostic difficulty that may arise in this uncommon lesion, the pathologic features of which may be mistaken for a fibro‐osseous lesion or a low‐grade sarcoma.
Synovial sarcoma of the mandible
Authors: Tilakaratne W. M.
Published: January 2006

The term synovial sarcoma was first proposed for the histologically well defined entity by Knox in 1936. The name was proposed due to the fact that at least the cases reported in the early part showed some resemblance of the tumour to normal synovial tissue histologically. Thereafter, tumours have been diagnosed from areas without synovial tissue. The diagnosis of monophasic tumours can be difficult and immunostains appear to be a good diagnostic tool in those cases. The occurrence in the mandible is extremely rare. This is a case of synovial sarcoma arising in the condyle involving most of the ramus. The tumour was diagnosed as synovial sarcoma with predominant spindle cell component by correlation of histopathology with immunostains (cytokeratin, epithelial membrane antigen, actin and desmin). The patient has been treated with surgery and radiotherapy.