bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebrospinal Fluid ‘Leaks’ and Meningitis following Acoustic Tumor Surgery
Authors: Hughes Gordon B. , Glasscock Michael E. , Hays James W. , Jackson C. Gary , Sismanis Aristides 
Published: January 2017

We reviewed 271 intracanalicular and cerebellopontine angle lesions removed over the past ten years, 237 by the translabyrinthine or combined approach which created a mastoid defect. The patients were divided into three groups with the following results: (1) obliteration of the mastoid defect combined with older wound closure techniques in the first 188 patients produced CSF leakage in 25% and meningitis in 16% of cases; (2) not obliterating the defect intentionally in 16 patients produced CSF leakage in 50% and meningitis in 25% of cases; and (3) obliteration of the defect combined with newer packing and closure techniques in the last 33 patients produced CSF leakage and meningitis in only 6% of cases. Four problem areas were identified: The eustachian tube, middle ear, mastoid defect, and postauricular wound. Of these, obliteration of the mastoid defect was most important in minimizing postoperative CSF wound leakage, CSF rhinorrhea, and meningitis.
Ototoxic and Nephrotoxic Effects of Combined Treatment with cis‐Diamminedichloroplatinum and Kanamycin in the Guinea Pig
Authors: Schweitzer Vanessa G. , Hawkins Joseph E. , Lilly David J. , Litterst Charles J. , Abrams Gerald , Davis Julie A. , Christy Michael 
Published: January 2017

Ototoxic and nephrotoxic potentiation with concomitant cis‐diamminedichloroplatinum, or cis‐platinum II (CSP), and aminoglycoside therapy was investigated in the guinea pig. We evaluated possible potentiation of the toxic effects of CSP and kanamycin compared with CSP alone in the inner ear and kidney and quantitatively localized CSP in the cochlea with gamma emission analysis of 195mPt. Kanamycin‐treated animals demonstrated cytocochleograms and ABR waveforms, absolute latencies, and interwave latencies for waves I, II, and III similar to control animals at our maximum level of acoustic stimulation. CSP treatment produced 60% to 70% mean outer hair cell (OHC) loss in the basal turn of the cochlea, a reduction In ABR waveform and amplitude, and an Increase in latencies of ABR waves I, II, and III. Combined CSP and kanamycin treatment produced 90% to 100% mean OHC loss in all rows of the basal turn of the cochlea, with no discernible ABR waveform corresponding to the region stimulated by a 4500 to 7000 Hz acoustic click. Combined treatment produced the most significant cortical medullary tubular necrosis and interstitial nephritis. Furthermore, this study reports for the first time localization of platinum in the inner ear.
Periodic Alternating Nystagmus
Authors: Dibartolomeo Joseph R. , Yee Robert D. 
Published: January 2017

Horizontal jerk nystagmus is indicative of a disorder involving the vestibular system. Periodic alternating nystagmus is a form of spontaneous nystagmus with a specific pattern. It is identified by the presence of spontaneous nystagmus in the primary direction of gaze, which beats in one direction for 1 or 2 minutes, followed by a null period, and then reappearance of the nystagmus in the opposite direction for a similar length of time. It may be congenital or acquired, and may be seen in association with vestibular‐cerebellar disease or loss of vision. Recent case reports indicate that some forms of periodic alternating nystagmus may respond favorably to baclofen therapy.
A Study of HLA-Linked Genes in a Monosymptomatic Psychotic Disorder in an Indian Bengali Population
Authors: Debnath Monojit , Das Sujit K , Bera Nirmal K , Nayak Chitta R , Chaudhuri Tapas K 
Published: January 2017

Objective: The etiology of delusional disorder is imperfectly understood. Involvement of biological factors has long been suspected. We examined the incidence of class I human leukocyte antigens (HLAs) in patients with delusional disorder to understand the role of HLA genes and explore a possible immunogenetic etiology for delusional disorder. Methods: We used a nested case–control study design. Psychiatric reference data were available for 27 500 patients registered between 1998 and 2003. Initially, we enrolled 150 patients with delusional disorder from the India-born Bengali population, using DSM-IV diagnostic criteria. After longitudinal follow-up, 80 patients were found to have only delusional disorder, while the remaining 70 patients represented different illnesses with paranoid symptoms and were excluded. We performed serological typing on all 150 patients and applied the polymerase chain reaction–based high-resolution molecular typing method to the 80 patients with delusional disorder. Eighty healthy donors of the same ethnic background, matched for age, sex, and other socioeconomic variables, formed the control group. Results: Some of the HLA alleles were associated with delusional disorder, and the gene HLA-A*03 was found to be significantly more frequent. This gene may influence patients' susceptibility to delusional disorder. Conclusion: The study reveals important associations between HLA genes and delusional disorder. This preliminary observation may help our understanding of this disorder's genetic basis.
An Ecologic Study of Parasuicide in Edmonton and Calgary
Authors: Newman Stephen C , Stuart Heather 
Published: January 2017

Objective: From 1986 to 1999, the suicide rate in the Edmonton Regional Health Authority (RHA) was greater than that in the Calgary RHA (mean rate ratio 1.4). We conducted a study to determine whether a similar relation holds for parasuicide, and if so, whether the pattern can be explained at the ecologic level by sociodemographic factors. Methods: The Edmonton and Calgary RHAs provided data on emergency department visits for nonfatal intentional self-injury for 1997. We obtained sociodemographic data from the 1996 national census for the Edmonton and Calgary census metropolitan areas (CMAs) from Statistics Canada's public-use files. In each CMA, which is nearly coterminous with the corresponding RHA, we created 10 geographic areas based on average income. We analyzed the data at the ecologic level, using linear regression and multilevel Poisson regression. Results: The parasuicide rate in the Edmonton CMA was greater than that in the Calgary CMA (rate ratio 1.3). In both CMAs, the parasuicide rate decreased as average income increased. In the final regression models, the only independent variables were average income, CMA, and their interaction term (linear regression model R2 = 0.82). Conclusions: The parasuicide rate in the Edmonton CMA is elevated, compared with that in the Calgary CMA. At the ecologic level, much of the variation in rates can be explained by average income and CMA. The high degree of correlation among the sociodemographic variables suggests that it may not be low income per se that is affecting the parasuicide rate but, rather, the consequences of belonging to a socially disadvantaged stratum of society.
Is Cannabis Use a Contributory Cause of Psychosis?
Authors: Degenhardt Louisa , Hall Wayne 
Published: January 2017

Objective: To assess whether cannabis use in adolescence and young adulthood is a contributory cause of schizophreniform psychosis in that it may precipitate psychosis in vulnerable individuals. Method: We reviewed longitudinal studies of adolescents and young adults that examined the relations between self-reported cannabis use and the risk of diagnosis with a psychosis or of reporting psychotic symptoms. We also reviewed studies that controlled for potential confounders, such as other forms of drug use and personal characteristics that predict an increased risk of psychosis. We assessed evidence for the biological plausibility of a contributory causal relation. Results: Evidence from 6 longitudinal studies in 5 countries shows that regular cannabis use predicts an increased risk of a schizophrenia diagnosis or of reporting symptoms of psychosis. These relations persisted after controlling for confounding variables, such as personal characteristics and other drug use. The relation did not seem to be a result of cannabis use to self-medicate symptoms of psychosis. A contributory causal relation is biologically plausible because psychotic disorders involve disturbances in the dopamine neurotransmitter systems with which the cannabinoid system interacts, as demonstrated by animal studies and one human provocation study. Conclusion: It is most plausible that cannabis use precipitates schizophrenia in individuals who are vulnerable because of a personal or family history of schizophrenia.
What are the Policy Implications of the Evidence on Cannabis and Psychosis?
Authors: Hall Wayne , Degenhardt Louisa 
Published: January 2017

Objective: To explore the implications for mental health services, for health education about the risks of cannabis use, and for public policy toward cannabis use of observational evidence that cannabis use is a contributory cause of psychosis. Method: Using comparative analyses of similar evidence for the harmful effects of alcohol, tobacco, and amphetamine use, we considered the relation between observational evidence and action on cannabis. We examined arguments on the grounds of public health prudence for discouraging cannabis use by young individuals. With the assumption that the relation may be causal, we considered recommendations for policy in mental health services, health education, and public policy toward cannabis. Results: The observational evidence and biological plausibility of the hypothesis that cannabis is a contributory cause of psychosis is at least as strong as evidence for causal relations between heavy alcohol and amphetamine use and psychosis. On public health grounds, there is a good case for discouraging cannabis use among adolescents and young adults. It remains uncertain how best to discourage use and at whom campaigns to reduce cannabis use should be targeted. Conclusions: We should discourage young adults seeking treatment in mental health services from using cannabis and inform them of the probable mental health risks of cannabis use, especially of early and frequent use. We must exercise caution in liberalizing cannabis laws in ways that may increase young individuals' access to cannabis, decrease their age of first use, or increase their frequency of cannabis use. We should consider the feasibility of reducing the availability of high-potency cannabis products.
Going Beyond: An Adventure- and Recreation-Based Group Intervention Promotes Well-Being and Weight Loss in Schizophrenia
Authors: Voruganti Lakshmi NP , Whatham Jeff , Bard Eleanor , Parker Gayle , Babbey Candice , Ryan Janet , Lee Suganya , MacCrimmon Duncan J 
Published: January 2017

Objective: To undertake a preliminary study to assess the feasibility of clinical implementation and evaluate the effectiveness of a novel adventure- and recreation-based group intervention in the rehabilitation of individuals with schizophrenia. Methods: In a 2-year, prospective, case–control study, 23 consecutively referred, clinically stabilized schizophrenia patients received the new intervention over an 8-month period; 31 patients on the wait list, considered the control group, received standard clinical care that included some recreational activities. Symptom severity, self-esteem, self-appraised cognitive abilities, and functioning were documented for both groups with standardized rating scales administered at baseline, on completion of treatment, and at 12 months posttreatment. Results: Treatment adherence was 97%, and there were no dropouts. Patients in the study group showed marginal improvement in perceived cognitive abilities and on domain-specific functioning measures but experienced a significant improvement in their self-esteem and global functioning ( P < 0.05), as well as a weight loss of over 12 lb. Improvement was sustained over 1 year with further occupational and social gains. Conclusion: In the context of overcoming barriers to providing early intervention for youth and preventing metabolic problems among older adults with schizophrenia, adventure- and recreation-based interventions could play a useful complementary role.
Suicide Cases in New Brunswick from April 2002 to May 2003: The Importance of Better Recognizing Substance and Mood Disorder Comorbidity
Authors: Séguin Monique , Lesage Alain , Chawky Nadia , Guy Andrée , Daigle France , Girard Gina , Turecki Gustavo 
Published: January 2017

Objective: To investigate all suicide cases that occurred in New Brunswick in the 14 months spanning April 1, 2002, to May 31, 2003, to determine 6-month and lifetime prevalence rates of psychopathology in the deceased. Method: We used 2 psychological autopsy methods: direct proxy-based interviews and medical chart reviews, together with telephone contacts with informants. Consensus DSM-IV diagnoses were formulated by clinical panels on the basis of the Structured Clinical Interviews I and II for DSM-IV complemented by medical charts. Results: Of the 109 suicide deaths identified by the coroner at the time of the study, we were able to investigate 102. At time of death, 65% of the suicide victims had a mood disorder, 59% had a substance-related disorder, and 42% had concurrent mood and substance-related disorders. The lifetime prevalence of substance-related disorders among these suicide victims was 66%. Finally, 52% of the suicide victims presented with a personality disorder; one-half of these were of the cluster B type. Conclusions: Although treatment of depression has frequently been recognized as the focal point of clinically based suicide-prevention efforts, our results underscore substance-related disorders as a key dimension of completed suicide. Suicide-prevention programs should be designed to address this problem more directly.
Screening for Mental Health Problems among Patients with Substance Use Disorders: Preliminary Findings on the Validation of a Self-Assessment Instrument
Authors: Castel Saulo , Rush Brian , Kennedy Sidney , Fulton Kari , Toneatto Tony 
Published: January 2017

Objectives: We conducted a preliminary study on the validation of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) among patients seeking treatment for substance use disorders (SUDs). Method: We assessed 76 patients with SUDs, using the PDSQ, followed by the Structured Clinical Interview for DSM-IV. Sensitivity, specificity, positive and negative predictive values, and receiver operating characteristic (ROC) curves were calculated. Results: Overall, the psychometric properties identified with the PDSQ in patients with SUDs differed from those found in psychiatric outpatient populations. The ROC curves were calculated for major depressive disorder, posttraumatic stress disorder, and panic disorder. The areas under the curves were 0.86 (95%CI, 0.77 to 0.95; P < 0.001), 0.79 (95%CI, 0.68 to 0.90; P < 0.001), and 0.66 (95%CI, 0.51 to 0.82; P = 0.05), respectively. Conclusion: The use of the PDSQ to screen for other psychiatric disorders in populations with SUDs is promising but requires larger validation studies to provide data on its psychometric properties and inform the choice of cut-off scores for this population.
Functional Mechanisms of Episodic Memory Impairment in Schizophrenia
Authors: Danion Jean-Marie , Huron Caroline , Vidailhet Pierre , Berna Fabrice 
Published: January 2017

Objective: To achieve a better understanding of the functional mechanisms underlying episodic memory dysfunction in schizophrenia, which is a prerequisite for unravelling schizophrenia's neural correlates in neuroimaging studies and, more generally, for developing an integrated approach to the pathophysiology of schizophrenia. It is also crucial for developing cognitive remediation. Method: This paper reviews empirical evidence of episodic memory dysfunction in schizophrenia obtained with reference to various theoretical models of episodic memory. Results: All the studies converge to show a significant impairment of the critical feature of episodic memory: conscious recollection. Schizophrenia is also associated with a defect of autobiographical memory. The episodic memory dysfunction results from a predominant failure of strategic processing at encoding, although an impairment of strategic processing at retrieval cannot be ruled out. The possibility that it is not the execution of the encoding strategies that is defective but, rather, their self-initiation by the patients is plausible. Conclusions: These findings may explain some behavioural abnormalities associated with schizophrenia, notably, inadequate functional outcomes in everyday life. They may also have implications for cognitive remediation and better social and work functioning of patients with schizophrenia.
Acute Treatment of Bipolar Disorder with Adjunctive Risperidone in Outpatients
Authors: Ghaemi S Nassir , Sachs Gary S , Baldassano Claudia F , Truman Christine J 
Published: January 2017

Objective: To test the hypothesis that, although typical neuroleptics are commonly used in the treatment of bipolar disorder, newer atypical antipsychotic agents, like risperidone, may be more effective and better-tolerated. Method: The effectiveness of risperidone was evaluated in 14 outpatients with bipolar disorder, type I, who received risperidone for 6.4 ± 2.7 weeks at 2.75 ± 1.8 mg/day. Results: Nine (64%) patients were much improved based on Clinical Global Impression (CGI) scores, and mean Global Assessment of Functioning (GAF) scores improved from 48.2 ± 4.9 to 58.8 ± 7.3 (t = 4.49, P = 0.0006, paired t test). Treatment was well tolerated, and no patient experienced worsening of mood symptoms while receiving risperidone. Conclusion: This open series suggests risperidone is beneficial in the treatment of outpatients with bipolar disorder.
Potential for Community Relocation among Residents of Alberta's Psychiatric Facilities: A Needs Assessment
Authors: Holley Heather L , Jeffers Betty , Hodges Phyllis 
Published: January 2017

Objective: To identify the proportion of residents in Alberta's psychiatric hospitals who would be relocatable to community-based alternatives to care if appropriate programs were made available. Methods: A survey of a representative sample of residents in all psychiatric hospitals and care centres was undertaken, excluding patients in specialized programs for forensic psychiatry, brain injury, and substance abuse. Results: Findings indicate that 11% of institutionalized patients could be considered good candidates for relocation to community-based alternative care. A further 35% were considered to have potential for relocation provided an intensive and complex array of services was first made available. Conclusion: Results support a phased-in approach to hospital downsizing and the need for considerable transitional funding. Because hospital downsizing is unlikely to save dollars, at least in the short term, reforms must remain guided by humanitarian motivations to improve quality of life for persons with severe and persistent mental illnesses.
Efficacy and Tolerability of Moclobemide in Comparison with Placebo, Tricyclic Antidepressants, and Selective Serotonin Reuptake Inhibitors in Elderly Depressed Patients: A Clinical Overview
Authors: Amrein Roman , Stabl Max , Henauer Stephan , Affolter Eva , Jonkanski Iris 
Published: January 2017

Objective: To review the efficacy and safety of moclobemide in comparison with TCAs(for our purposes, “TCAs” will represent tricyclic and tetracyclic antidepressants, including maprotilin and mianserin) and selective serotonin reuptake inhibitors (SSRIs) in elderly depressed patients. Methods: The efficacy data reviewed were obtained from the following sources: 1) results of published studies in the elderly; 2) data on patients aged ≥ 60 years extracted from all available controlled trials in adults (≥ 18 years) in which moclobemide was compared with TCAs or SSRIs; and 3) the adverse events were extracted for patients aged ≥ 60 years from the safety data base of all available comparative short-term studies with moclobemide versus TCAs, SSRIs, or placebo and of long-term studies with moclobemide. Results: The data show that moclobemide is an effective antidepressant in depressed patients aged ≥ 60 years. The response rate to moclobemide was 50% to 55% in this population. Moclobemide was more effective than placebo and was of similar efficacy to the TCAs and the more recently introduced SSRIs. The tolerability of moclobemide was rated as “very good” or “good” in almost 90% of these patients, which was better than the tolerability of TCAs and similar to that of SSRIs. Patients without any adverse events were more frequently found in the moclobemide group than in those treated with TCAs (P < 0.01) or SSRIs (P < 0.01). Adverse events of the anticholinergic type were more frequent with TCAs than with moclobemide (P < 0.001), and nausea was found 3 times more frequently with SSRIs than with moclobemide (P < 0.01). Conclusions: Moclobemide is an effective and well-tolerated antidepressant for the treatment of elderly depressed patients.
Management of Facial Asymmetry
Authors: Urban Scott D. , Waite Peter D. 
Published: January 2017

Introduction: When satisfactory correction of facial deformities and asymmetries are unobtainable by dental orthopedics alone, maxillomandibular surgery or double-jaw surgery is often indicated. As orthognathic surgery has been refined, it has become evident that some problems are beyond treatment in a single jaw. The purpose of this study was to present a review of the literature on the etiology, clinical assessment procedures, radiographic diagnostic techniques, and surgical treatments for mandibular and facial asymmetry. A photographic case report is also presented. Materials and Methods: Literature review and case report. Results: The indications for bimaxillary surgery are severe deformities untreatable in one jaw, deformities of both jaws, unfavorable movement prone to relapse, and complex 3D movements where single-jaw surgery would be a functional/cosmetic compromise. Conclusions: The most important aspects of maxillomandibular surgery are not the surgery itself but understanding the indications and the treatment plan, and maintaining stable reference during surgery. Combining osteotomies of the maxilla and mandible is complicated and perhaps associated with increased morbidity. However, when indicated, the combined osteotomy offers more surgical options and better results without functional or cosmetic compromises than single-jaw osteotomy.