bluuebunny/crossref_metadata_2025_split huggingface dataset:
Das Störungsbild der „Glücksspielsucht“ und seine Behandlung
Authors: Petry J. 
Published: September 2018

ZusammenfassungDie Begriffe „Spiel“, „Glück“ und „Sucht“ als Teile der deutsprachigen Bezeichnung „Glücksspielsucht“ werden definiert. Es erfolgen Hinweise auf die Verbreitung der Glücksspielsucht in der Bevölkerung und die häufigsten Erscheinungsformen. Ein Vulnerabilitätsmodell zur Entstehung der Glücksspielsucht wird vorgestellt. Die abstinenzorientierten Behandlungsmethoden zur Motivierung, Veränderung von Kontrollillusionen und Rückfallprävention werden erläutert. Ansätze zur Behandlung der Selbstwertstörung, Gefühlsdysregulation und Beziehungsstörung werden vorgestellt. Auf differenzielle Behandlungsmaßnahmen für weibliche, ältere, russisch- und französischsprachige Glücksspieler und Patienten mit seltenen komorbiden Störungen (Psychose, ADHS, Drogenabhängigkeit) wird verwiesen. Die Behandlungseffektivität wird im Überblick dargestellt.
Exzessives Computerspielen und Computerspielabhängigkeit im Jugendalter
Authors: Kleimann M. , Mößle T. , Rehbein F. 
Published: September 2018

ZusammenfassungIn diesem Artikel werden die Ergebnisse einer bundesweit repräsentativen Schülerbefragung an 44 610 Schülerinnen und Schülern neunter Klassen vorgestellt, die in den Jahren 2007 und 2008 vom Kriminologischen Forschungsinstitut Niedersachsen (KFN) durchgeführt wurde. Basierend auf einem neu entwickelten Screeninginstrument (KFN-CSAS-II), welches jedem dritten jugendlichen Befragungsteilnehmer (n = 15 168) vorgelegt wurde, werden 3% der Jungen und 0,3% der Mädchen als computerspielabhängig diagnostiziert. Die Daten zeigen, dass sich Computerspielabhängigkeit als klinisch relevantes Phänomen gut von einem ausschließlich zeitlich auffälligen und damit vergleichsweise weniger problematischen Spielverhalten abgrenzen lässt. In einer Validitätsprüfung des Diagnoseinstrumentes ergibt sich für computerspielabhängige Jugendliche eine erhöhte psychosoziale Belastung in Form geringerer Schulleistungen, vermehrten Schulschwänzens, verringerter Schlafzeiten, eingeengtem Freizeiterleben und vermehrter Suizidgedanken. Zusätzlich zeigt sich, dass Spieler bestimmter Computerspiele offenbar in besonderem Maße von Computerspielabhängigkeit betroffen sind. Aus diesen Erkenntnissen leiten sich neben zusätzlichem Forschungsbedarf gesundheitspolitische Folgerungen ab, die am Ende des Artikels diskutiert werden.
Das „Attenuierte Psychose-Syndrom“ in DSM-5
Authors: Klosterkötter J. 
Published: September 2018

Zusammenfassung
Hintergrund: Der Vorschlag, für das erfolgreich herausgearbeitete klinische Hochrisikostadium im Vorfeld psychotischer Erstmanifestation eine eigenständige DSM-5-Diagnosekategorie zu schaffen, hat eine Reihe von strukturellen Fragen aufgeworfen, die für die Weiterentwicklung unserer psychiatrischen Diagnostik von grundsätzlicher Bedeutung sind. Sollten in der Zukunft auch Risikosyndrome in den gültigen Klassifikationssystemen verankert werden, wenn ihre rechtzeitige Feststellung signifikante Vorteile für die Betroffenen und ihre Familien mit sich bringt? Wie kann überhaupt der sich sowohl grundlagenwissenschaftlich als auch versorgungspraktisch abzeichnende Übergang zu einer prädiktiven und präventiven Medizin in der nach wie vor klinisch-nosologisch orientierten psychiatrischen Diagnostik Berücksichtigung finden? Methoden: Der Beitrag stellt zunächst den heutigen Entwicklungsstand der klinischen Hochrisikoforschung auf dem Gebiet der Psychosen dar und erläutert die Transformation später Hochrisikokriterien in das für den Einschluss in DSM-5 vorgeschlagene „Attenuierte Psychosesyndrom“. Ziel: Anschließend werden die Argumente für und gegen die offizielle Anerkennung als Diagnosekategorie, die tatsächlich erfolgte Inklusion des Syndroms in DSM-5 sowohl unter den klinischen Erscheinungsbildern mit weiterem Forschungsbedarf als auch unter den Diagnosen des Schizophreniespektrums sowie die sich hieraus ergebenden Zukunftsperspektiven diskutiert.
Balloon-Anchored CoKatte® for Successfully Delivering Balloons for an Occluded Anomalous Right Coronary Artery
Authors: Hikita Hiroyuki , Hishikari Keiichi , Takahashi Atsushi , Araki Makoto 
Published: September 2018

AbstractPercutaneous coronary intervention (PCI) for anomalous right coronary artery (RCA), originating from the left coronary cusp is challenging, because of the difficulty in engaging the guiding catheter coaxially, and delivering balloons and stents. A 65-year-old man with effort angina underwent PCI for anomalous RCA. This report describes the method we used. Although, delivering the balloon was difficult in short of the guiding catheter's backup force, we finally succeeded by using one more guiding catheter and the balloon-anchored CoKatte®, a novel, straight 4.5-French child catheter, to strengthen the backup force.
Urinary Sodium Loss following Hypertonic Saline Administration Curtails its Superior Osmolar Effect in Comparison to Mannitol in Severe Traumatic Brain Injury: A Secondary Analysis of a Randomized Controlled Trial
Authors: Jagannatha Aniruddha Tekkatte , Sriganesh Kamath , Devi Bhagavatula Indira , Umamaheswara Rao Ganne Sesha 
Published: September 2018

Abstract
Background Mannitol and hypertonic saline (HTS) are used as boluses during episodes of raised intracranial pressure (ICP) in severe traumatic brain injury (TBI). We recently demonstrated that ICP reduction and neurological outcomes are similar with mannitol and HTS in TBI. In the current post hoc analysis, we hypothesized that this lack of difference between mannitol and HTS is due to increased urinary sodium losses after HTS.
Methods In this post hoc analysis of our earlier randomized controlled trial, we analyzed serum and urine osmolarity and sodium levels in 38 patients with severe TBI over 6 days. Equiosmolar boluses of mannitol and HTS were administered whenever ICP increased above 20 mm Hg. Seven hundred sixty samples each of serum sodium, urine sodium, serum osmolarity, and urine osmolarity were analyzed during this period.
Results Three hundred and one and 187 boluses of mannitol and HTS, respectively, were required to maintain ICP below 20 mm Hg. The urinary osmolarity was similar between mannitol and HTS groups (p = 0.63). The urinary sodium excretion was significantly higher in HTS group compared with mannitol group (p = 0.002). Serum sodium and osmolarity values were similar between mannitol and HTS groups (p = 0.16 and 0.31, respectively). There was no difference in the mean ICP between the groups (p = 0.31).
Conclusion Increased urinary sodium loss after HTS contributes to its lack of superiority over mannitol in controlling raised ICP.
A Case of Neonate with Vein of Galen Malformation Refractory to Weaning Attempts from Mechanical Ventilation Managed Successfully with Noninvasive Ventilation
Authors: Kumar Ashutosh , Ajayan Neeraja , Sethuraman Manikandan , Hrishi Ajay Prasad 
Published: September 2018

AbstractWeaning of patients with vein of Galen malformations (VOGM) from mechanical ventilation can be challenging in the postprocedure period due to underlying high-output cardiac failure and the fluid overload caused by the neurointervention procedure. We present the case of a neonate with VOGM who was refractory to multiple weaning attempts from mechanical ventilation and was successfully managed with noninvasive ventilation (NIV). NIV can be safely used as a method of weaning, post mechanical ventilation in this subset of patients. The use of NIV will facilitate successful weaning and reduce the incidence of extubation failure in neonates with VOGM in cardiac failure.
Effect of Prior etching on Bond Strength of Self-Etch adhesive in case of Sensitive Teeth treated with CPP-ACP.
Authors: Chaudhary Tayal Suruchi , Dhillon Jaidev , Tayal Abhishek 
Published: September 2018

Abstract
Introduction: The management of dentinal hypersensitivity involves remineralization by various means, one of which being CPP-ACP paste, followed by restoration. It was speculated that the bond strength of self-etching adhesive was affected following the application of CPP-ACP paste and prior etching with phosphoric acid.
Aims and objectives: To evaluate the tensile bond strength (TBS) of G-Bond (GB, self-etching adhesive) to dentin following the application of CPP-ACP (Tooth Mousse/TM), with and without prior etching.
Materials and method: Freshly extracted forty five permanent molars were collected for the study. All the teeth were ground and polished to expose the flat dentinal surface. The teeth were embedded in the resin in separate molds and were divided into three equal groups of fifteen samples each Group 1: Samples treated with Tooth Mousse for 60 min daily for 7 days and then restored with GB and composite (Filtek Z350, 3M ESPE). Group 2: Samples treated with Tooth Mousse and etched with phosphoric acid prior to restoration with GB and composite. Group3: Samples restored with GB and composite. A split brass mold was placed over the predesigned location and with help of the plasma coated instrument, composite resin was placed. Tensile loading was done using Universal Testing Machine.
Conclusion: TBS of GB was not significantly reduced after CPP-ACP application, but after prior etching the CPP-ACP specimens, the bond strength of GB was significantly reduced.
Denture Stomatitis An Underlying Menace
Authors: Bansal Pardeep , Sharma Akshey , Bhanot Rajesh , Chahal Gagan 
Published: September 2018

AbstractDenture stomatitis is a yeast/fungal infection in the mouth caused by Candida, also known as thrush. It is not a type of infection that can be passed on to others. Denture wearers are the most common group to be affected, along with people who have difficulty in keeping their mouths clean. Diabetics and anyone who takes steroids by mouth or inhalers may also have problems with this condition. Some antibiotics are also responsible for causing thrush. If left untreated, the condition can cause soreness in the mouth and may lead to poorly fitting dentures in the future. So it is important to keep your mouth as clean as possible and rinse after every meal.
Endodontics Generation Next- Microrobotics Category of The Article-Review
Authors: Mittal Sunandan , Kumar Tarun , Mittal Shifali , Sharma Jyotika 
Published: September 2018

AbstractA typical endodontic procedure includes access preparation, root canal preparation and root canal filling. This treatment process is time-consuming and prone to human error. The outcome relies on the clinician's master skills that can be gained only through years of training and practice. In order to improve the quality and reliability of endodontic therapy, an endodontic micro robot is proposed to be built. The objective is to modernize the traditional treatment, moving from a “manual art” to science-based automation. This computer controlled micro machine is mounted on the teeth within patient's mouth. With on-line monitoring and positioning control, the multipurpose micro robot performs automatic treatment procedures, including probing, drilling, filing, cleaning and filling. This article gives an insight to design and applications of the intelligent robotic micro-machine applicable to root canal preparation with on-line monitoring capabilities that will increase the accuracy and efficiency of the treatment.
Neurovascular Anatomy at the “Box Junction”: Considerations in the Anterolateral Thigh Flap
Authors: Stewart Max , Brassett Cecilia , Abood Ahid 
Published: September 2018

Background The anterolateral thigh (ALT) perforator flap is one of the most widely used flaps in reconstructive microsurgery. This study investigated a previously unexplored and clinically relevant aspect of perforator anatomy: the “box junction” (BxJn), the point at which the perforator arises from its source vessel. Negotiating the BxJn can be a challenging and time-consuming step in flap harvest, due to the neurovascular structures in the area which must be protected from injury. However, as the presence and location of these structures have yet to be clearly defined, painstaking exploration is necessary on each occasion. Knowledge of BxJn anatomy could allow surgeons to harvest the ALT flap more rapidly and safely.
Methods We dissected 20 cadaveric thighs and identified perforators to the ALT region and investigated the neurovascular anatomy at their BxJns.
Results In 51 BxJns, two clinically relevant vascular structures were identified: an intramuscular artery arising from the perforator (23, 45% of cases) and a “deep” artery to the underlying muscle arising from the source vessel (29, 57% of cases). We confirmed the consistent presence of motor nerve branches and describe one previously unreported, clinically significant variation, in which the nerve to vastus lateralis crosses the BxJn (12, 24% of cases); 36, 71% of BxJns contained at least one vascular and one neural structure.
Conclusion Our study confirms that the BxJn is a site of potentially complex and challenging neurovascular anatomy for the surgeon. Based on these results, we propose an algorithm to guide inexperienced surgeons in negotiating this area.
Complex Valve Surgery in Elderly Patients: Increasingly Necessary and Surprisingly Feasible
Authors: Saha Shekhar , Varghese Sam , Ahmad Ammar Al , Jebran Ahmad Fawad , Waezi Narges , Niehaus Heidi , Baraki Hassina , Kutschka Ingo 
Published: September 2018

Abstract
Objectives The increasing proportion of elderly patients in cardiac surgery poses additional challenges for the clinical management and leads to a higher operative risk due to multiple comorbidities of these patients. We reviewed the outcome of patients who were 75 years and older and underwent complex multiple valve surgery at our institution.
Methods A retrospective review was performed to identify patients who were 75 years and older and underwent multiple valve surgery between January 2011 and May 2016 at our institution. Patients were assigned to one out of four subgroups: combined aortic and mitral valve surgery (group AM), aortic and tricuspid valve surgery (group AT), mitral and tricuspid valve surgery (group MT), and aortic, mitral, and tricuspid valve surgery (group AMT).
Results A total of 311 patients underwent multiple valve surgery, of whom 119 (38.3%) were 75 years and older (median: 78 [25th–75th quartile: 76–80]). The estimated operative mortality (EuroSCORE II) in the overall cohort was 10.7%. The observed 30-day mortality was 4.2% (7% in group AM, 0% in group AT, 2.2% in group MT, 3.8% in group AMT; p = 0.685). Main complications were reexplorative surgery in 16%, adverse cerebrovascular events in 6.7%, prolonged mechanical ventilation in 10.1%, renal replacement therapy in 15.1%, nosocomial pneumonia in 15.1%, and pacemaker implantation in 18.5%.
Conclusions This study demonstrates the feasibility of complex multiple valve surgery in elderly patients. The observed perioperative mortality was lower than predicted. However, we observed a substantial rate of adverse events; therefore, careful patient selection is required in this high-risk patient population.
Renal Transplantation after Transcatheter Aortic Valve Replacement: Case Report
Authors: Gangadharan Keerthana , Parameswaranunni Reshmibhat , Merzkani Massini , Molmenti Ernesto , Bhaskaran Madhu 
Published: September 2018

AbstractPatients with chronic kidney disease (CKD) have an increased likelihood of developing calcific aortic stenosis (AS). These patients also often suffer from multiple comorbidities, potentially making them high-risk surgical candidates and limiting their treatment options. Transcatheter aortic valve replacement (TAVR) is the recommended therapeutic approach for severe AS in patients who are not suitable candidates for surgical aortic valve replacement (SAVR). TAVR is being increasingly considered as a viable alternative to SAVR. As such, its applications in patients with CKD and other chronic diseases, as well as methods to optimize peri- and postoperative results are of great interest and significance. We present the case of a successful renal transplant procedure, performed within a year following a TAVR, in a 52-year-old man who suffered from multiple comorbidities.
Reversible Visual Involvement in Critical Illness Polyneuropathy
Authors: Mudawi Khalid , Rizk Tamer 
Published: September 2018

AbstractWe hereby describe a 3-year-old boy who developed severe fulminant sepsis with the need of urgent intubation, ventilation, and inotropic support. He was admitted to the pediatric intensive care unit where he was initially ventilated for 10 days. Extubation failed, so he was reventilated for further 10 days. Neuromuscular blocking agents, inotropes, steroids, and broad-spectrum antibiotics, including aminoglycosides, were all used. Weakness of all limbs was noticed on day 7. This was associated with visual disturbances. He was diagnosed as having critical illness polyneuropathy and myopathy (CIP/CIM). His outcome was favorable. This case report highlights the unique combination of CIP/CIM features associated with visual impairment and also suggests that full recovery is possible for this clinical presentation.
Description of an ELANE Mutation in a Girl with Severe Congenital Neutropenia: A Paradigm of Targeted Genetic Screening Based on Clinical Findings
Authors: Damianidou Labrini , Papageorgiou Theodotis , Tragiannidis Athanasios , Haidopoulou Katerina , Giannopoulos Andreas , Hatzipantelis Emmanuel , Gogou Maria 
Published: September 2018

AbstractWe describe the case of a 5-year-old girl with severe congenital neutropenia presenting with recurrent skin and respiratory infections. Sequence analysis of ELANE and HAX1 genes identified a mutation in heterozygous state in exon 2 of the ELANE gene: c.157C > G (p.His53Asp), not previously described in the literature at the exon coding level. Given the autosomal dominant inheritance and the location of the mutation within a “hotspot,” this mutation was considered as clinically relevant. ELANE should be screened in patients with congenital neutropenia of no obvious etiology. A detailed medical history and clinical evaluation can prevent unnecessary investigations allowing for a targeted diagnostic strategy.
Psychotic Disorders in DSM-5
Authors: Carpenter W. T. , Tandon R. 
Published: September 2018

SummaryDSM-5 presents an opportunity to provide greater clarity to constructs involved in classification of psychotic disorders by establishing a meta-structure based on spectra of pathology, giving emphasis to the syndromal nature of current disorders, and to guide ascertainment of psycho-pathology domains to increase understanding of individual cases. There was a need to reduce spurious comorbidity, increase validity, improve reliability, consider possible new disorders, and provide more coherence across chapters in the diagnostic manual. While balancing these objectives, the new information about the nature of these disorders that has been generated since DSM-IV was incorporated into their definition. For example, variations in distinct psychopathological dimensions have been found to better account for the heterogeneity of schizophrenia than traditional subtypes. Resulting changes in DSM-5 include elimination of the classic sub-types of schizophrenia, addition of unique psychopathological dimensions, elimination of special treatment of Schneiderian “first-rank symptoms”, better delineation of schizoaffective disorder, clarification of the nosologic status of catatonia and its consistent treatment across the manual, more precise description of illness course specifiers, and addition of a new category of “attenuated psychosis syndrome” as a condition for further study. The rationale behind and the specific nature of these revisions in the DSM-5 criteria for schizophrenia spectrum and other psychotic disorders are summarized in this article.
Psychiatric remuneration systems in Europe: an overview
Authors: McDaid D. 
Published: September 2018

SummaryNew forms of psychiatric remuneration linked to levels of activity undoubtedly will have an increasing role to play in mental health systems right across Europe. Potentially they can be more efficient and promote choice, but valid concerns have been raised about their impact on the sustainability and nature of psychiatric care. This article looks in particular at recent developments in England and the Netherlands and reflects on how remuneration mechanisms may need to develop further both to improve efficiency and quality within the context of an ever more fragmented and multi-sectoral mental health system. Any introduction of activity- based reimbursement should be introduced gradually. This should be accompanied by investment in adequate information systems to help better understand service utilisation patterns, transitional funding safeguards to reduce the risk of financial instability and incentives/ contractual measures to ensure that services strive to offer services of the highest possible quality that meet the needs of service users.
Update zu Morbus Niemann-Pick Typ C (NPC)
Authors: Mengel E. 
Published: September 2018

ZusammenfassungNPC ist eine neuroviszerale, lysosomale Lipidose. Das klinische Spektrum reicht von einer fatalen, infantilen Form zu adulten Formen mit chronischen Verläufen. Die neurologische Beteiligung bestimmt den Verlauf. Viszerale Befunde wie Ikterus prolongatus, cholestatische Hepatopathie, Splenomegalie können der neurologischen Manifestation um Jahre vorausgehen. Neben der perinatalen schweren Hepatopathie werden 4 neurologische Verlaufsformen – infantil, spätinfantil, juvenil, adult – mit fließenden Übergängen unterschieden. Charakteristisch sind eine gelastische Kataplexie sowie eine vertikalen Sakkadenstörung. Psychiatrische Befunde können auch ein wichtiges Merkmal von NPC sein. Bei juveniler Verlaufsform können häufig Aufmerksamkeits-Defizit, Hyperaktivität und Distanzlosigkeit erfragt werden. Bei adulter Verlaufsform werden regelmäßig psychotische Befunde wie Wahnvorstellungen und visuelle oder akustische Halluzinationen vorgefunden. NPC ist somit auch eine Differentialdiagnose hirnorganischer Psychosen. Seit 2009 steht zur Behandlung des NPC Miglustat zur Verfügung. In kontrollierten Studien konnte der positive Einfluss auf neurologische Zeichen gezeigt werden. Da der frühzeitige Behandlungsbeginn den Therapieerfolg bestimmt, kommt der rechtzeitigen Diagnosestellung auch durch Kinderpsychiater und Psychiater eine entscheidende Bedeutung zu.
Akute vorübergehende psychotische Störungen
Authors: Pillmann F. 
Published: September 2018

ZusammenfassungAkute psychotische Zustandsbilder mit raschem Beginn, dramatischem Erscheinungsbild und günstiger Prognose sind eine klinische Realität. Sie sind aber auch ein Ärgernis, da sie sich schlecht in das Raster der Kraepelin’schen Dichotomie von Dementia praecox/Schizophrenie und affektiven Störungen einfügen. Die Weltgesundheitsorganisation hat sie 1992 mit der ICD-10-Kategorie F23 der „Akuten vorübergehenden Psychosen“ vorläufig als diagnostische Einheit anerkannt, aber auch den offenen Forschungsbedarf konstatiert. Inzwischen haben empirische Untersuchungen viele der Charakteristika der Akuten vorübergehenden Psychosen bestätigt. Es zeigte sich aber auch eine gewisse syndromale Instabilität im longitudinalen Verlauf. Einige Autoren hat dies zu der Forderung geführt, die Diagnose der Akuten vorübergehenden Psychosen wegen mangelnder Stabilität zu verwerfen. Im Folgenden wird begründet, warum die diagnostische Kategorie der Akuten vorübergehenden Psychosen aus nosologisch-theoretischen und klinisch-praktischen Gründen beibehalten werden sollte.