bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergency Medicine Career Change: Associations with Performances in Medical School and in the First Postgraduate Year and with Indebtedness
Authors: Xu Gang , Hojat Mohammadreza , Veloski J. Jon
Published: August 2010

Objective: Emergency medicine has been identified as the specialty that has gained the most young physicians who have changed their careers. To identify factors that may have contributed to such career changes, the authors compared the characteristics of three groups of physicians trained at their medical school: those who chose and stayed in emergency medicine, those who migrated into emergency medicine from other specialties, and those who moved out of emergency medicine.

Methods: A prospective longitudinal study was conducted. The sample consisted of physicians who chose emergency medicine as their careers at graduation and stayed in the specialty (n= 24), those who migrated from other specialties into emergency medicine (n= 51), and those who moved out of emergency medicine (n= 10). This sample was obtained from a total of 2,173 graduates of Jefferson Medical College between 1978 and 1987. The three groups of physicians were compared according to their academic performances both during medical school and after graduation. The dependent variables were freshman and sophomore grade point averages (GPAs), written clinical examination scores, scores on National Board of Medical Examiners examination (Parts I, II, and III), and residency program directors' ratings. Age and indebtedness at medical school graduation and board certification status also were examined.

Results: Those physicians who stayed in emergency medicine and those who migrated from other specialties into emergency medicine had similar measures of academic performance, but both of these groups had higher academic performance measures and higher board certification rates than did the physicians who moved out of emergency medicine. Those who stayed in emergency medicine had the highest mean debt in the senior year of medical school.

Conclusions: High academic performance and high indebtedness are factors associated with choosing or staying in the specialty of emergency medicine.
An Approach to Emergency Department Photography
Authors: Storrow Alan B. , Stack Lawrence B. , Petersen Phred
Published: August 2010

In the emergency department, photography requires an expedient, portable, adaptable, and relatively simple camera system to take advantage of fleeting opportunities for recording visually educational material. These prerequisites are different from those for traditional medical photography, for which relatively plentiful time and advanced equipment are routinely available. Medical photography departments provide an invaluable service, but are rarely convenient for immediate or spontaneous emergency. department photographs. Although no single system or technique is optimal in all these areas, the authors find certain components and approaches work well. They review photographic equipment, paying attention to speed, ease of use, and quality of output. They also review simple techniques such as film choice, lighting, close‐up photography, standardization, copy work, and radiographs. Attention to these details can help the inexperienced photographer obtain a system and begin to enjoy the rewards of effective photography in the emergency department.
Serum Ethanol Clearance in Intoxicated Children and Adolescents Presenting to the ED
Authors: Simon Harold K. , Cox Jeffrey M. , Sucov Andrew , Linakis James G.
Published: August 2010

Objective: To determine the rate of serum ethanol clearance in 39 children and adolescents who presented intoxicated to one ED.

Methods: All pediatric patients presenting to a university hospital ED, for whom serial ethanol levels had been determined between January 1989 and May 1993, were evaluated. Age, gender, presenting complaint, initial serum glucose concentration, timed serum ethanol concentrations, and rate of serum ethanol clearance were determined retrospectively for all the patients.

Results:39 pediatric patients had had serial serum ethanol concentrations determined. The patients ranged in age from 6 weeks to 17 years (mean 14.6 years). Initial serum ethanol levels ranged from 13.7 to 84.2 mmol/L (63–388 mg/dL) and the mean serum ethanol clearance rate was 4.0 mmol/L/hr (18.6 mg/dL/hr), consistent with clearance rates previously reported for adults.

Conclusion: These data suggest that the rate of serum ethanol clearance in children and adolescents presenting to the ED approaches that previously reported for adults. Clinical diminution of intoxication should not be more rapid for children and adolescents than it is for adults.
Family Abuse and Neglect: A Case‐based Ethics Model
Authors: Tilden Virginia P. , Schmidt Terri A.
Published: August 2010

The ethical dilemma of caring for the patient from a multiproblem family with suspected domestic violence is discussed. An ethical decision making model that organizes patient data and encourages systematic analysis of the case is reviewed to address the responsibility of the emergency physician to intervene and the options available. The analysis explores specific issues related to mandatory reporting laws, discretionary reporting, and factors to be weighed in deciding the best action for protecting various members within a family when abuse is known or suspected.
Infrared Tympanic Thermometry in the Evaluation of Pediatric Acute Otitis Media
Authors: Brennan Daniel F. , Falk Jay L. , Rothrock Steven G. , Kerr Robert B.
Published: August 2010

Objective: The reliability of infrared tympanic thermometry (ITT) in children and the effect of acute otitis media (AOM) on ITT are unsettled. This study assessed the effect of AOM on ITT and the utility of ITT in the diagnosis of AOM.

Methods: 520 consecutive children, aged 6 months to 6 years, presenting to the ED of an urban teaching hospital were eligible for this prospective observational study. Nurses recorded oral or rectal reference temperatures (RefTs) and bilateral ITT temperatures upon presentation. Emergency physicians were blinded to the ITT temperatures. AOM was diagnosed according to published clinical criteria.

Results: Among 520 patients, 108 had unilateral AOM and 78 had bilateral AOM. In patients with unilateral AOM, the infected ears were warmer (I = 100.4 ± 1.8°F) than the uninfected ears (U = 100.3 ± 1.8°F, p = 0.035). However, the disparity in TM temperatures in infected and uninfected ears with unilateral AOM (I ‐ U = 0.2 ± 0.9°F) was similar to the difference between right and left ears in those without AOM (R ‐ L = 0.1 ± 0.8°F, p = 0.60). Compared with patients without AOM, patients with AOM demonstrated no significant elevation of ITT temperatures over RefTs (I ‐ RefT = ‐0.8 ± 1.2°F in AOM; ITT ‐RefT = ‐0.8 ± 1.2°F in non‐AOM; p = 0.94). This study had >99% power to detect a 1.0°F difference for all groups compared.

Conclusions: Infrared tympanic temperatures are not helpful in diagnosing AOM in children. AOM has little direct effect on ITT temperatures.
Acute Pain Management
Authors: Yealy Donald M.
Published: August 2010

Analgesic regimens should be based on sound clinical data and tailored to the individual patient's needs. The combination of specific agents for selected syndromes and traditional analgesics allows safe pain relief to be achieved for most emergency patients.
Women in Academic Emergency Medicine
Authors: Cydulka Rita K. , D'Onofrio Gail , Schneider Sandra , Emerman Charles L. , Sullivan Lisa M. ,   The SAEM Women and Minorities Task Force
Published: August 2010

Abstract. Objective: To evaluate the achievement gof women in academic emergency medicine (EM) relative to men. Methods: This study was a cross‐sectional mail survey of all emergency physicians who were employed at three‐fourths full‐time equivalent or greater at the 105 EM residency programs in the United States from August 1997 to December 1997. The following information was obtained: demographics, training and practice issues, roles and responsibilities in academic EM, percentage of time spent per week in clinical practice, teaching, administrative and research activities, academic productivity, and funding. Results: Of the 1,575 self‐administered questionnaires distributed by the office of the chairs, 1,197 (76%) were returned. Two hundred seventy‐four (23%) of the respondents were women, and 923 (77%) were men. There was a significant difference noted between men and women in all demographic categories. The numbers of respondents who were nonwhite were extremely small in the sample and, therefore, the authors are hesitant to draw any conclusions based on race/ethnicity. There was no difference in training in EM between men and women (82% vs 82%, p = 0.288), but a significantly higher proportion of male respondents were board‐certified in EM (84% vs 76%, p < 0.002). Women in academic EM were less likely to hold major leadership positions, spent a greater percentage of time in clinical and teaching activities, published less in peer‐reviewed journals, and were less likely to achieve senior academic rank in their medical schools. Conclusions: These findings mirror those of most medical specialties: academic achievement of women in academic EM lags behind that of men. The paucity of minority physicians in academic EM didn't permit analysis of their academic achievements.
A Review of Forensic Science Higher Education Programs in the United States: Bachelor’s and Master’s Degrees*
Authors: Tregar Kristen L. , Proni Gloria
Published: August 2010

Abstract:  As the number of forensic science programs offered at higher education institutions rises, and more students express an interest in them, it is important to gain information regarding the offerings in terms of courses, equipment available to students, degree requirements, and other important aspects of the programs. A survey was conducted examining the existing bachelor’s and master’s forensic science programs in the U.S. Of the responding institutions, relatively few were, at the time of the survey, accredited by the forensic science Education Programs Accreditation Commission (FEPAC). In general, the standards of the responding programs vary considerably primarily in terms of their size and subjects coverage. While it is clear that the standards for the forensic science programs investigated are not homogeneous, the majority of the programs provide a strong science curriculum, faculties with advanced degrees, and interesting forensic‐oriented courses.
Do schizophrenics well adapted in the community need neuroleptics?: A DEPOT NEUROLEPTIC WITHDRAWAL STUDY
Authors: Dencker S. J. , Lepp M. , Malm U.
Published: August 2010

Two depot neuroleptics (flupenthixol palmitate and clopemthixol de canoate) used for at least 15 months were withdrawn in 32 schizephrenic outpatients belonging to the most symptom‐free and social cohort of a total patient population. They all had only slight schizophrenic symptoms, were well adapted in the community, and had been free from relapse for at least 2 years before the study. They were assessed by means of rating scales every month during the first six months and then after 9 and 12 months.

After the one‐year trial 26 patients had relapsed. Moreover, after the control period further 4 out of 6 patients relapsed during the following drug‐free year. These results indicate the necessity of a long follow‐up period after withdrawal of depot neuroleptics. Moreover, the results suggest that periodical drug‐free periods of about 3 months are appropriate in symptom‐poor patients during long‐term treatment with long‐acting antipsychotic drugs.
A specific fluorimetric method for assay of drug levels in serum of patients treated with clopenthixol decanoate injections
Authors: Overø K. Fredricson
Published: August 2010

A fluorimetric method is presented for the simultaneous and specific assay in serum of clopenthixol decanoate, clopenthixol and a clopenthixol metabolite, deprived of the ethanol group in the side chain. The sepration is achieved by extractions and thin layer chromatography and fluorescence brought about by treatment with sulphuric acid. The limit of detection in 3 ml serum samples is about 2 ng/ml for clopenthixol and metabolite, and somewhat higher for the ester.

In addition serum data are presented for patients treated with intramuscular injections of 100‐600 mg clopenthixol decanoate in Viscoleor̀ every second week. Relatively stable (maan max./min. ratio about 2; maximum after 3‐7 days) clopenthixol levels were recorded through‐out the dosage interval. Somewhat lower meabolite levels were found. There was no evidence for the presence of clopenthixol decanoate.
Cannabis ‐ 1988
Authors: Hollister Leo E.
Published: August 2010

In this updating review of research on cannabis particular attention has been paid to the increasing number of studies of the disposition of the components of cannabis in man, as well as possible effects on health. Specific binding sites for cannaboids have not been demostrated. Approximately 80 metabolites of tetradrocannabiol (THC) have been discovered, of which 11‐OH‐THC is the main metabolite, but it contributes little to the overall effect when the drug is smoked or given intravenously. The minimu plasma level of THC associted with the psychotropic effect is 25 ng/ml.

Cannabis may produce directly an acute panic reaction, a toxic delirium, and acute paranoid state, or acute mania. Cannabis use may aggrevate schizophrenia, but it is much less certain whether it can lead to sociopathy or even to “amotivational syndrome”. Despite widespred use of cannabis in virtually all parts of the world, no catastrophic effects on health have been noted. Cannabis appears to be relatively safe as compared with current social drugs. It is, however, still too early in the history of the present episode of cannabis use to be sanguine about possible bad effects.
Anorexia Nervosa. Treatment and triggering factors
Authors: Nygaard JofrM Alice
Published: August 2010

Nygaard JA. Anorexia Nervosa. Treatment and triggering factors. Acta Psychiatr Scand Suppl. 361, Vol. 82. 1990: 44–49.

In the period from 1976 to 1983, 84 anorexia nervosa (AN) patients were treated in the Medical and Child Psychiatry Units of the University Hospital of Bergen. Five were men, 79 women. The criteria used for diagnosis are DSM‐III (1) A, B, D and E, but not C. All the patients in this study were treated according to the methods of Bassøe & Eskeland (2) and Bassøe (3) in order to give the patients the necessary insight into the pathophysiology of hunger and to inform them about the symptoms. Those of the patients with personal problems connected with their family or social milieu were given help through therapeutic discussions. However, we stressed that very sick patients should not be put under any pressure to undergo this treatment. I will describe the treatment we employed and the results obtained. It was found to be of great importance that the patients received treatment in the early stages of the condition. Also that the patient, as a part of the prophylaxis of the condition, was informed about the dangers of slimming. A short survey of other methods of treatment found in the literature is given.

My conclusion is hat AN is triggercd by a combination of genetic disposition plus some kind of stress followed by a primary weightloss.
Anorexia Nervosa and Bulimia Nervosa
Authors: Støylen Inge Jarl , Laberg Jon Chr.
Published: August 2010

Støylen IJ, Laberg JC. Anorexia Nervosa and Bulimia Nervosa. Perspectives on etiology and cognitive behavior therapy. Acta Psychiatr Scand Suppl. 361, Vol. 82. 1990: 52–58.

This article gives a brief historical introduction to the field of eating disorders. Anorexia Nervosa (AN) and Bulimia Nervosa (BN) are seen from a sociocultural point of view, and the current emphasis on slimness is regarded as an important factor in the etiology of eating disorders. A short description of the central features of BN is given, and some important explanatory psychological models are described with the emphasis on the cognitive‐behavioral model. Recent controlled treatment studies are cited.
Attention training in the cognitive rehabilitation of schizophrenic patients:a review of efficacy studies
Authors: Suslow T , Schonauer K , Arolt V
Published: August 2010

Objective: To review the literature on effects of attention and cognitive training on attentional functioning in schizophrenic patients.

Method: Relevant efficacy studies were identified by literature searches (in Medline, Current Contents, Psyclit, and Psyndex databases) and through the reference lists of key papers.

Results: Re‐examination of findings from nine methodologically adequate studies using computer‐based or non‐computer‐based training procedures provided inconsistent results. On 16 of 35 outcome measures significant performance improvements were observed from pre‐treatment to post‐treatment but on the majority of the applied measures no performance improvement could be determined. In general, treatment effect sizes but also power of tests were low. For nearly all the outcome measures for which differential training effects were reported there also exist contradictory outcome results.

Conclusion: There is inconclusive evidence that attention training is effective in schizophrenia. Longitudinal efficacy studies are needed in which different aspects of attention are systematically exercised and assessed.
Cognitive‐behavioural intervention in deliberate self‐harm
Authors: Raj. M. Antony Joseph , Kumaraiah V. , Bhide Ajit V.
Published: August 2010

Objective: The objective of the study was to find the efficacy of cognitive behaviour therapy (CBT) in the management of deliberate self‐harm (DSH) patients.

Method: The experimental group (n=20) was given 10 sessions of CBT. CBT included cognitive methods, behavioural methods, problem‐solving skills training and behavioural counselling to significant others. The control group (n=20) was given routine medical treatment. Post‐assessment was done for both groups at the end of 3 months.

Results: The analysis of pre–post‐assessment revealed that only the experimental group showed significant improvement on all the variables, except on impulsivity.

Conclusion: CBT was effective in the management of DSH patients.
Thrombosis associated with physical restraints
Authors: Hem E. , Steen O. , Opjordsmoen S.
Published: August 2010

Objective: Physical restraint is controversial, but still frequently used in psychiatric units. We describe two cases of thromboembolic phenomena, one with a fatal outcome, in association with physical restraint.

Method: The world literature on physical restraint and thrombosis was reviewed by undertaking a search of electronic databases.

Results: To our knowledge, we are the first to report thrombosis associated with physical restraint.

Conclusion: Immobilization and trauma to the legs while restraining a patient are adequate explanations for the occurrence of thrombosis. Special attention should be paid to thrombosis when employing restraints in psychiatric wards. Further systematic research into physical restraints in psychiatry is clearly needed.
Putative clinical subtypes of social phobia:a factor‐analytical study
Authors: Perugi G. , Nassini S. , Maremmani I. , Madaro D. , Toni C. , Simonini E. , Akiskal H. S.
Published: August 2010

Objective: To examine symptomatological subtypes of social phobia (SP) and their relationships with a number of feared situations and avoidant personality disorder (APD).

Method: In 153 out‐patients with SP according to DSM‐III‐R criteria, clinical subtypes were investigated by means of principal component factor analysis of the Liebowitz Social Anxiety Scale (LSAS). We compared the various SP subtypes on the basis of the highest Z‐scores obtained on each LSAS factor.

Results: Five factors (interpersonal anxiety, formal speaking anxiety, stranger‐authority anxiety, eating and drinking while being observed, anxiety of doing something while being observed) emerged, accounting for 64.7% of the total variance. When the dominant LSAS factor groups were compared, the highest values in the numbers of feared situations and the presence of APD were observed in the ‘interpersonal anxiety’ dominant group and the lowest in the ‘anxiety of doing something while being observed’. The ‘interpersonal anxiety’ dominant group was the most likely to present a positive family history for SP and a lifetime comorbidity with mood disorders.

Conclusion: The emerging multidimensional structure of phobia is congruent with, and further enriches, the existing literature.
Validation of psychiatric patients' statements on coercive measures
Authors: Poulsen Henrik Day , Engberg Md Marianne
Published: August 2010

Objective: To investigate the accuracy of psychiatric patients' statements on coercive measures compared with medical file information using empirical methodology, and relating the statements to patients' psychopathology.

Method: One hundred and forty‐three in‐patients were identified consecutively, and interviewed using a structured questionnaire. Psychopathology was measured using BPRS, and social functioning using GAF. Patients' statements about coercion were compared with information in the medical files.

Results: In general, patients stated to have been subjected to more coercion than was evident from the files. In particular, statements about forced medication, earlier involuntary commitments and present legal status showed low accordance with information in the files. Low accordance was related to the severity of psychopathology and being schizophrenic.

Conclusion: The existence of a ‘grey zone’ between patients' and doctors' perception of coercion was confirmed. Knowledge of patients' psychopathology seems essential when considering medical, legal and ethical aspects of the use of coercion.
Quality of Life (QOL) of patients with Gilles de la Tourette's syndrome
Authors: Elstner K. , Selai C. E. , Trimble M. R. , Robertson M. M.
Published: August 2010

Objective:  This is the first study to investigate the Quality of Life (QOL) of patients with Gilles de la Tourette's Syndrome (GTS).

Method:  One hundred and three out‐patients with GTS completed a semi‐structured interview and 90 of these completed questionnaires screening for depression, anxiety and obsessive‐compulsive behaviour. QOL was measured with the SF‐36 and the Quality of Life Assessment Schedule (QOLAS).

Results:  Patients with GTS showed significantly worse QOL than a general population sample. They had better QOL than patients with intractable epilepsy as measured by the QOLAS, although the SF‐36 showed significant differences on the subscales Role Limitation due to physical problems and Social Functioning only. Factors influencing QOL domains were employment status, tic severity, obsessive‐compulsive behaviour, anxiety and depression.

Conclusion:  QOL is impaired in patients with GTS. Measurement of QOL could be used alongside conventional measurements to assess benefit of treatment. We recommend the QOLAS and SF‐36 be used.
Benefits from mianserin augmentation of fluoxetine in patients with major depression non‐responders to fluoxetine alone
Authors: Ferreri M. , Lavergne F. , Berlin I. , Payan C. , Puech A. J.
Published: August 2010

Objective: To assess, in depressed patients, the clinical benefit of mianserin augmentation of fluoxetine or the the benefit of switching treatment from fluoxetine to mianserin.

Method: In a 6‐week double‐blind study we compared the therapeutic efficiency and tolerance of mianserin 60 mg/day (N=34), mianserin 60 mg/day plus fluoxetine 20 mg/day (N=32) and continuing fluoxetine 20 mg/day (N=38) in patients with major depression who did not respond to previous fluoxetine treatment.

Results: Intent‐to‐treat analysis showed that at week 6 the decrease in the Hamilton Depression rating scale score was significantly (P0.03) greater in the mianserin plus fluoxetine group when compared to the fluoxetine group (effect size 0.665). Switching from fluoxetine to mianserin gave intermediate results. Mianserin augmentation of fluoxetine was well tolerated.

Conclusion: Mianserin augmentation of fluoxetine in patients non‐responders to fluoxetine 20 mg/day increases response to treatment and is well tolerated.
Out‐patient behaviour therapy in alcoholism: impact of personality disorders and cognitive impairments
Authors: Wölwer W. , Burtscheidt W. , Redner C. , Schwarz R. , Gaebel W.
Published: August 2010

Objective: We investigated whether alcoholic patients with comorbid personality disorders and those with cognitive impairments would benefit in a different way from different behaviour therapy strategies.

Method: After detoxification, 120 alcoholics were assigned randomly to one of three out‐patient treatment programmes comprising ‘coping skills training’, ‘cognitive behaviour therapy’ or unspecific supportive control therapy. Personality disorders and cognitive impairments were assessed at the beginning of the 6‐month treatment period.

Results: The impact of concomitant personality disorders or cognitive impairments was generally only moderate and mainly independent from treatment condition. However, alcoholic patients relapsing within 6 months after detoxification showed a higher rate of personality disorders (especially antisocial and borderline) and slightly more cognitive deficits (especially in verbal memory and visuomotor functions) than abstainers even before therapy.

Conclusion: The high amount of early relapses and drop‐outs probably hindered larger differentiated treatment effects. Hypotheses will be retested in treatment completers using forthcoming follow‐up data.
Out‐patient behaviour therapy in alcoholism: relapse rates after 6 months
Authors: Burtscheidt W. , Wölwer W. , Schwarz R. , Strauss W. , Löll A. , Lüthcke H. , Redner C. , Gaebel W.
Published: August 2010

Objective: In spite of the increasing interest in out‐patient treatment programmes for alcoholics, there still exist only a few experimental studies on this issue. In this still ongoing study the efficacy of different behaviour therapy strategies is to be examined.

Method: One hundred and twenty patients were assigned randomly to non‐specific supportive therapy or to two forms of behavioural therapy (coping skills training and cognitive therapy). Behavioural treatment comprised 26 weekly sessions; follow‐up examinations will take place every 6 months over 2 years.

Results: Patients undergoing behavioural therapy showed less drop‐outs and significantly higher rates of abstinence compared with supportive treatment. Nevertheless, statistically significant differences between the two behavioural therapy strategies could not be established so far.

Conclusion: Preliminary results demonstrate the feasibility and efficacy of behaviour therapy programmes in the out‐patient treatment of alcoholism. Furthermore, they stress the importance of professional psychiatric and psychotherapeutic engagement in the field of addiction.
The reliability of compliance assessments performed by doctors and patients during neuroleptic treatment: a comparison of compliance ratings
Authors: Kampman Olli , Lehtinen Klaus , Lassila Vesa
Published: August 2010

Objective: To compare compliance assessments made by doctors and patients during neuroleptic drug treatment and to detect any variables explaining the discrepancies between their ratings.

Method: Compliance reports regarding neuroleptic medication were collected from 100 in‐patients and out‐patients and from their doctors. Re‐ratings were performed after 1–2 weeks. Compliance ratings were compared with demographic, treatment and symptom‐related variables and with the Attitudes to Neuroleptic Treatment (ANT) questionnaire using logistic regression analysis.

Results: The doctors' and patients' compliance ratings showed good test–retest reliability (r=0.80, doctors; r=0.81, patients) and concordance (79% of the cases within the limits of ±25%‐units deviation). Variables explaining discrepancies between the ratings included female gender, a low level of education, the diagnosis of mania, a high neuroleptic dose and several items from the ANT scale.

Conclusion: Manic episodes, negative attitudes to neuroleptic medication and a high‐dose treatment increase the risk for deviating views of compliance in the doctor–patient relationship.
Psychiatric morbidity and the presence and absence of angiographic coronary disease in patients with chest pain
Authors: Valkamo M. , Hintikka J. , Niskanen L. , Viinamäki H.
Published: August 2010

Objective:  To assess psychiatric morbidity in coronary angiogram patients.

Method:  A psychiatric assessment of 200 consecutive chest‐pain patients was performed the day before coronary angiography in a double‐blind study design. The sample included 132 men (mean age 57.2 years, SD 9.5) and 68 women (mean age 59.8 years, SD 8.9). A Structured Clinical Interview for DSM‐III‐R was used to obtain psychiatric diagnosis. The 21‐item Beck Depression Inventory, the 20‐item Toronto Alexithymia Scale and a four‐item Life Satisfaction Scale were used to assess mental symptoms. A coronary angiography with obstruction of a coronary artery by more than 50% was considered to indicate angiographic coronary disease.

Results:
 Mental disorders were found in 28% (95% CI 14–41) of the patients with normal angiographic findings (n=47) and in 24% (95% CI 17 – 30) of the patients with angiographic coronary disease (n=153). Furthermore, no difference was found between these two groups in other rating scales assessing mental symptoms even when adjusted for the New York Heart Association class, duration of chest‐pain symptoms or exercise capacity.

Conclusion:  Psychiatric morbidity may not be associated with angiographic findings in patients with chest pain.
Post‐dexamethasone cortisol correlates with severity of depression before and during carbamazepine treatment in women but not men
Authors: Osuch Elizabeth A. , Cora‐Locatelli Gabriela , Frye Mark A. , Huggins Teresa , Kimbrell Timothy A. , Ketter Terence A. , Callahan Ann M. , Post Robert M.
Published: August 2010

Objective:  Previous studies show a state‐dependent relationship between depression and post‐dexamethasone suppression test (DST) cortisol level, as well as differences in DST response with age and gender.

Method:  In this study, 74 research in‐patients with affective disorders were given the DST on placebo and in a subgroup following treatment with carbamazepine. Depression was evaluated twice daily with the Bunney–Hamburg (BH) rating scale. Data were examined for the total subject population, by gender and by menopausal status in women.

Results:
 A robust positive correlation was observed between depression severity and post‐DST cortisol in pre‐ and postmenopausal females, but not in males. This relationship persisted in women when restudied on a stable dose of carbamazepine (n=42).

Conclusion:  The pathophysiological implications of this selective positive relationship between severity of depression and post‐DST cortisol in women, but not men, should be explored further.
Correlates of substance misuse in patients with first‐episode schizophrenia and schizoaffective disorder
Authors: Sevy Serge , Robinson Delbert G. , Holloway Scott , Alvir Jose M. , Woerner Margaret G. , Bilder Robert , Goldman Robert , Lieberman Jeffrey , Kane John
Published: August 2010

Objective: To identify factors associated with substance misuse in first‐episode patients with schizophrenia or schizoaffective disorder.

Method: Twenty‐seven patients with a past or current history of substance misuse were compared with 91 patients with no history of misuse on demographic and psychopathological measures before being treated for their first episode of psychosis, and on cognitive measures after 6 months of treatment.

Results: There were no statistically significant differences between groups for sex, schizophrenia subtype, marital status, education, family history of schizophrenia, course of illness, age of onset, baseline symptoms, time to treatment response, medication side effects, attention span, memory and executive functioning. However, dual diagnosis patients were found to have a higher parental social class, better premorbid cognitive functioning, higher IQ and better language skills.

Conclusion: First‐episode patients with a history of substance misuse have higher intellectual functioning, which may be associated with higher premorbid socioeconomic status and cognitive functioning.
Illicit drug use in patients with psychotic disorders compared with that in the general population: a cross‐sectional study
Authors: Ringen P. A. , Melle I. , Birkenæs A. B. , Engh J. A. , Færden A. , Jónsdóttir H. , Nesvåg R. , Vaskinn A. , Friis S. , Larsen F. , Opjordsmoen S. , Sundet K. , Andreassen O. A.
Published: August 2010

Objective:  Prevalence estimates of illicit drug use in psychotic disorders vary between studies, and only a few studies compared prevalence estimates with those in the general population.

Method:  Cross‐sectional study comparing 148 stable‐phase patients with schizophrenia or bipolar disorder with 329 representative general citizens of Oslo. A total of 849 patients from the same hospital department in the same time period constituted a patient reference group.

Results:  Lifetime illicit drug use was 44% higher (P < 0.001) in study patients than in the general population sample; while lifetime use of amphetamine/cocaine was 160% higher (P < 0.001). No differences were found between user groups for sociodemographic characteristics.

Conclusion:  Patients with psychotic disorders in stable phase had a markedly higher lifetime use of any illicit substance, especially amphetamine/cocaine, than the general population. They also seemed to use drugs more periodically. The same sociodemographic characteristics were associated with increased illicit drug use in both groups.
Periodontal findings in spouses
Authors: Von Troil‐Lindén Birgitta , Torkko Heini , Alaluusua Satu , Wolf Juhani , Jousimies‐Somer Hannele , Asikainen Sirkka
Published: August 2010

Abstract Clinical, radiographic and microbiological examination of periodontal conditions was carried out in 2 groups of married couples to assess similarities between husband and wife. The diseased probands (n=10) exhibited advanced periodontitis and the healthy ones (n=10) were periodontally normal. The clinical examination comprised the assessment of plaque, probing pocket depths, gingival bleeding on probing, suppuration, supragingival and subgingival calculus. The extent and type of alveolar bone loss was determined from panoramic radiographs. Bacterial samples were taken from the 6 deepest and most inflamed periodontal pockets and from stimulated saliva. The samples were cultured for Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Campylobacter rectus and Peptostreptococcus micros. The mean detection frequency of moderately deep pockets (4–5 mm) and deep pockets (6 mm) was significantly higher in the diseased probands than in their spouses. The mean detection frequency of moderately deep pockets was significantly higher in the spouses of the diseased probands than in the spouses of the healthy ones. Deep pockets were found in 6 spouses of the diseased probands, whereas only in 2 spouses of the healthy ones. Both diseased proband and his/her spouse harbored A. actinomycetemcomitans, P. gingivalis, P. intermedia, C. rectus and P. micros in 4, 6, 9, 9 and 4 couples, respectively. Both healthy proband and his/her spouse harbored the pathogens in 0, 1, 9. 5 and 3 couples, respectively. P. gingivalis was found in 7 spouses of the diseased probands, but only in 2 spouses of the healthy ones. The results indicate that spouses of patients with advanced periodontitis may also exhibit frequent recovery of suspected periodontal pathogens and have a worse periodontal status than spouses of periodontally healthy subjects.
Ex vivo studies of polymorphonuclear neutrophils from patients with early‐onset periodontitis
Authors: Mouynet P. , Picot C. , Nicolas P. , Genetet B. , Apiou J. , Genetet N. , Michel J. F.
Published: August 2010

Abstract In this study, we assessed the LFA‐1 (CD18/CD11a) and CR3 (CD18/CD11b) expression on peripheral polymorphonuclear leukocytes (PB‐PMN) and crevicular fluid polymorphonuclear leukocytes (CF‐PMN), by subjects with a healthy periodontium (n=1), gingivitis (n=8). early‐onset periodontitis (n=17) and adult periodontitis (n=8). Using flow cytometry analysis, the %s of CD18, CD11a and CD11b positive cells and the absolute numbers of fluorescent molecules were determined. No significant difference could be found among the 4 groups, for these 2 kinds of parameters, in PB‐PMN or CF‐PMN. However, a great difference could be noted between the results obtained from PB‐PMN and those obtained from CF‐PMN. The %s of positive CF‐PMN were significantly lower than those of PB‐PMN for the 3 sub‐units (p < 0.001). The levels of CD18 and CD11b expressed by CF‐PMN were higher than those expressed by PB‐PMN and the difference was significant for CD11b (p < 0.001). On the contrary, the level of CD11a expressed on CF‐PMN was significantly lower than that expressed by PB‐PMN (p < 0.001). Hence, our current results show that early‐onset periodontitis PMN can be quite normal and this fact is not surprising insofar as, in our study, these cells were perfectly functional and all the subjects were in good health. We concluded that the analysis of the leukocyte adhesion receptors expression on PB‐PMN does not appear useful for helping to establish a differential diagnosis between the different forms of periodontitis. However, the pattern of expression study on CF‐PMN may permit a better comprehension of the local phenomena which are implicated in the defence of the periodontal tissues against oral microorganisms.
Periodontal and systemic findings in children with marginal bone loss in the primary dentition
Authors: Sjödin Bengt , Arnrup Kristina , Matsson Lars , Wranne Lars , Carlsson Jan , Hänström Lennart
Published: August 2010

Abstract In a previous population‐based study of 3896 7–9‐year‐old children living in Sweden, it was found that 32 children (0.8%) exhibited radiographic, periodontal bone loss at 2 proximal surfaces of their deciduous teeth. In the present study, 26 of the 32 children were subjected to additional oral and systemic health examination. 20 other children without any radiographic evidence of bone loss in their primary dentition served as referents. None of the cases or the referents were detected to have any systemic disease. The frequency of bleeding and suppuration on probing, radiographic proximal calculus and probing attachment loss was higher among the cases than the referents. Actinobacillus actinomycetemcomitans was found subgingivally in 14 of the cases but in none of the referents. 11 of 22 cases analysed for presence of serum antibodies against A. actinomycetemcomitans leukotoxin were sero‐positive compared to none of 7 referents available for analysis. Evaluation of the data from each child revealed wide variations in clinical parameters among the children in the case group. In this group, there were children with deep probing depths, probing attachment loss, suppuration on probing, proximal calculus and presence of subgingival A. actinomycetemcomitans, indicating current periodontitis. However, in the case group there were also children without positive signs of inflammatory disease, similar to the children in the reference group. In fact, the findings suggest that less than half of the number of individuals with 2 proximal sites with bone loss had current periodontitis.
Lower protein concentration in GCF from patients with periodontitis: an indicator of host‐specific inflammatory reaction
Authors: Gustafsson A. , Asman B. , Bergstrom K.
Published: August 2010

Abstract To study the local inflammatory reaction associated with gingivitis and periodontitis, the protein concentrations were measured in gingival crevicular fluid (GCF) from 3 types of site: (i) inflamed sites in patients with gingivitis alone; (ii) inflamed sites with or (iii) without tissue destruction in patients with periodontitis. The GCF was sampled with paper strips and the protein concentration was measured with the Bradford protein assay. Higher protein concentrations in GCF were found at inflamed sites in patients with gingivitis alone than at clinically similar sites without tissue destruction in patients with periodontitis. In contrast, the sites with various degrees of disease in the same periodontitis patient showed the same protein concentrations. These discrepancies indicate that the local inflammatory reaction in the gingiva is host‐ and not site‐specific, i.e., the tissue destruction in periodontitis reflects a specific host response.
Psychological mood of regular dental attenders in relation to oral hygiene behaviour and gingival health
Authors: Kurer J.R. B. , Watts T. L. P. , Weinman J. , Gower D. B.
Published: August 2010

Abstract This study examined the relationship between psychological mood, stress and oral hygiene behaviour in a group of 51 regular dental attenders. Subjects brought a saliva sample for cortisol radioimmunoassay. completed the Hospital Anxiety and Depression (HAD) Scale, were assessed for plaque and gingivitis, and were then instructed in toothbrushing. 5 weeks later. 47 subjects were given a full repeat examination. There was a slight reduction in plaque and gingivitis scores, but no change in mood as assessed by HAD Scale and salivary cortisol concentration. Mean anxiety scores were associated with gingivitis level, and mean depression scores with plaque. Neither mood nor cortisol were predictors of subsequent change in plaque or gingivitis.
Plaque formation at healthy and inflamed gingival sites in young individuals
Authors: Ramberg P. , Axelsson P. , Lindhe J.
Published: August 2010

Abstract The present investigation was performed to evaluate the influence of gingivitis on the amount of de novo plaque that forms during a 24‐h period of no oral hygiene. 292 fully dentate subjects participated in the study. The condition of the gingiva and the presence of supragingival plaque were examined at 4 surfaces of each tooth at a baseline examination. Following this examination, the participants were subjected to a comprehensive mechanical tooth cleaning and instructed to refrain from tooth cleaning measures during the subsequent 24 h. The plaque examinations were repeated at the end of the 24‐h period. The results from the clinical trial revealed that during a 24‐h period of no tooth cleaning, subjects with naturally occurring overt gingivitis, in general, formed more plaque than young individuals with healthy gingivae. Furthermore, plaque in all parts of the dentition, formed more frequently on tooth surfaces adjacent to sites with gingivitis than at healthy sites. It was concluded that the condition of the gingiva plays an important role for de novo plaque formation.
Photographic scoring of gingival overgrowth
Authors: Ellis J. S. , Seymour R. A. , Robertson P. , Butler T. J. , Thomason J. M.
Published: August 2010

Background: A wide range of methods have been employed to determine the severity of gingival overgrowth resulting in uncertainty regarding the prevalence of the side‐effect. There is no simple, non‐invasive, objective, blind method for assessing gingival overgrowth.

Aim: This article aims to describe a method which is suitable for use in large‐scale population studies.

Materials and Methods: Photographs were taken of the anterior, buccal gingivae and teeth of 925 patients medicated with calcium channel blockers. In addition, each patient was ascribed a clinical gingival overgrowth score. 100 patients had repeat photographs, and a further 10 patients had alginate impressions taken. The models were scored for severity of gingival overgrowth using a described technique. The slides were scored using a modification of this technique.

Results: When photographic and study model scores were compared, photographic scores were consistently higher, and as a result, a photographic score of 38.6% was considered to represent a significant overgrowth. There was good agreement between clinically determined scores and photographic scores (κ=0.71).

Conclusions: The results indicate that this method is suitable for large‐scale population studies where it also has the advantage of providing a continuous scale of gingival changes for subsequent statistical analysis.
Enamel matrix derivative and low‐level laser therapy in the treatment of intra‐bony defects: a randomized placebo‐controlled clinical trial
Authors: Ozcelik Onur , Cenk Haytac Mehmet , Seydaoglu Gulsah
Published: August 2010

Aim: The aim of this study was to evaluate the immediate post‐operative pain, wound healing and clinical results after the application of an enamel matrix protein derivative (EMD) alone or combined with a low‐level laser therapy (LLLT) for the treatment of deep intra‐bony defects.

Material and Methods: This study was an intra‐individual longitudinal test of 12 months' duration conducted using a blinded, split‐mouth, placebo‐controlled and randomized design. In 22 periodontitis patients, one intra‐bony defect was randomly treated with EMD+LLLT, while EMD alone was applied to the contra‐lateral defect site. LLLT was used both intra‐ and post‐operatively. Clinical measurements were performed by a blinded periodontist at the time of surgery, in the first week and in the first, second, sixth and 12th month. Visual analogue scale (VAS) scores were recorded for pain assesment.

Results: The results have shown that the treatment of intra‐bony defects with EMD alone or EMD+LLLT leads to probing depth reduction and attachment‐level gain. In addition, EMD+LLLT had resulted in less gingival recession (p<0.05), less swelling (p<0.001) and less VAS scores (p<0.02) compared with EMD alone.

Conclusion: This study shows that EMD is an effective, safe and predictable biomaterial for periodontal regeneration and LLLT may improve the effects of EMD by reducing post‐operative complications.
Refuge areas and suture zones in the Pyrenean and Cantabrian regions: geographic variation of the female MPI sex‐linked alleles among oviparous populations of the lizard Lacerta (Zootoca) vivipara
Authors: Guillaume Claude‐P. , Heulin Benoît , Arrayago Maria Jesus , Bea Antonio , Braña Florentino
Published: August 2010

The viviparous lizard Lacerta (Zootoca) vivipara exhibits several alleles of the mannose‐6‐phosphate isomerase (MPI) enzyme that are carried exclusively on the female W sex‐chromosome. Previous studies showed that both the oviparous and viviparous forms of L. (Zootoca) vivipara have these female sex‐linked alleles. We document the existence of geographic variation of these alleles among the oviparous populations of southwestern France and northwestern Spain. Two oviparous subgroups were identified: all females from the eastern and central Pyrenees and most females from Aquitaine and from the northern slope of the western Pyrenees exhibited the fast migrating alleles MPI110 or MPI120, whereas all females from the Cantabric mountains, Spanish Basque country, and from the south slope of the western Pyrenees exhibited the slow migrating allele MPI90. Populations with both fast and slow migrating alleles occurred at some stations in the upper Ossau valley (western Pyrenees) and also at a lowland station of south Aquitaine. The hypothesis that several oviparous forms could have retreated to different places of the Pyreneo‐Iberian refugia during the Quaternary glaciations could explain the conservation or the evolution of the polymorphism of the MPI alleles, and that is consistent with the phylogeographic scenario previously proposed to account for the reproductive and cytogenetical variation observed in this species.