bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Biopsychosocial Understanding of the Irritable Bowel Syndrome: A Review
Authors: Goldberg Jeremy , Davidson Paul 
Published: January 2017

Objectives: To review and examine the clinical and research literature on irritable bowel syndrome (IBS) with a view to establishing the role that psychiatric factors play in the pathogenesis and treatment of this syndrome. Results: Comorbid psychiatric illness is common with IBS, yet only a small proportion of these patients seek medical attention. Many patients are either satisfied by reassurance or experience symptom relief from medical treatment directed at target symptoms. A small group of patients do not experience much relief, and it is largely this group who come to the psychiatrist's attention. Psychotropic medication is helpful when clinically indicated, and tricyclic antidepressants in small doses (for example, 50 mg) may be helpful for those patients with a pain-predominant pattern of IBS. Psychotherapy (including cognitive, behavioural, relaxation, thermal-biofeedback, insight-oriented therapy, and hypnosis) has been shown to provide relief, although it has often been difficult to differentiate this improvement from a placebo response. Conclusions: The group of patients with “refractory IBS” used a large amount of health care resources in an attempt to find relief to their distress. Further study is needed to gain a better understanding of which component of psychotherapy is most cost-effective and which patients are most likely to benefit. The large group of those who admit to symptoms compatible with IBS but who do not seek medical attention has to a large extent been excluded from most studies. Exploring this group may provide further insight into this perplexing syndrome.
Psychiatric Admissions of Asian Canadians to an Adolescent Inpatient Unit
Authors: Roberts Nasreen , Crockford David 
Published: January 2017

Objective: To compare the psychiatric diagnoses for Asian Canadians admitted to an adolescent inpatient unit with those of their white Canadian peers. Method: A literature review was first completed and then followed by a hospital file review of the Asian Canadians admitted over a 5-year period to the adolescent inpatient psychiatric unit. The data extracted (relating to psychiatric diagnosis, age, length of stay, referral source, family type, and gender) were then compared with a random sample of white Canadians admitted to the same unit during the same 5-year time frame. Results: There were far fewer Asian Canadians admitted than would be expected based on Calgary's demographics. There was equal gender representation among those who were admitted, and they tended to be older and to have a greater preponderance of severe psychiatric symptomatology than their white Canadian peers. Conclusions: This paper adds to previous research in emphasizing that ethnocultural factors play a significant role in the utilization of psychiatric services by immigrant populations.
Disorientation in Chronic Psychiatric Patients
Authors: Gabriel Adel 
Published: January 2017

Objective: To explore the effect of chronic institutionalization on cognitive performance in chronic psychiatric patients with emphasis on age disorientation, a phenomenon that was found in previous research to occur in up to 25% of chronic schizophrenic patients. Method: One hundred and ten chronic psychiatric patients, forming 4 main groups—schizophrenic patients, nonschizophrenic patients, institutionalized, and noninstitutionalized—were examined for age disorientation (inability to give one's chronological age correctly on request), and their Minimental State scores (MMSE) were compared across the 4 groups. Results: Twelve out of 43 patients (26%) who were institutionalized according to our definition were age-disoriented and had significantly lower MMSE scores than the other 3 groups. The chronic, noninstitutionalized schizophrenic group and the other chronic psychiatric patients, whether they were institutionalized or not, were negative for this phenomenon. One of the 12 age-disoriented patients was age delusional, and 5 of the 12 had a total MMSE score consistent with dementia (21 or lower). Conclusion: Age disorientation is a specific phenomenon that characterizes a subgroup of chronically ill and institutionalized schizophrenic patients. It is unlikely that chronicity per se or prolonged hospitalization alone will lead to cognitive impairment.
Breast-Feeding and Postpartum Depression: Is There a Relationship?
Authors: Misri Shaila , Sinclair Dana A , Kuan Annie J 
Published: January 2017

Objective: To study the relationship between breast-feeding cessation and the onset of postpartum depression. Method: The association between breast-feeding and depression was retrospectively examined in an obstetrical outpatient sample of 51 postpartum women who were suffering from major depression and who had stopped breast-feeding. Self-report questionnaire data were obtained from the subjects; the severity of the illness and the clinical course of each subject were evaluated. Results: The majority (39 out of 51; 83%) of the women reported that their depression began before the cessation of breast-feeding, while only 8 patients (17%) stated that their depression was subsequent to breast-feeding cessation. Conclusions: In an outpatient sample of depressed postpartum women, the onset of depression preceded the cessation of breast-feeding. The severity of the illness did not appear to influence breast-feeding persistence significantly.
Building Your Practice with Fillers
Authors: Shippert Ron D. 
Published: January 2017

Introduction: The objectives of this article are to (1) evaluate the popular fillers as practice builders and (2) outline a typical practice builder program for the surgeon. Methods: Information was gained from a search of the literature, 25 years of clinical experience, and interviews as well as a survey of 35 physicians to determine present surgeon techniques. Fillers were graded 1–5 to qualify as an income generator (with 5 being the highest). Results: Autologous fat scores were higher than that of the other fillers, although any filler could be in a practice-builder program. All bioresorbable fillers will need additional fill to obtain the desired results, but fat has an added benefit of some eventual permanence. When more than 5 mL of filler is needed, fat has also has the most reasonable cost. The commercial fillers will cost $93 to $200 per milliliter. Autologous fat, even with the added cost of anesthesia, disposables, and a minor operating room setup, will be more economical for the patient in amounts greater than 5 mL. When the surgeon can charge less for the filler itself, there is more room for a fair professional fee. There are 3 instrument systems available for fat transfer on the market. These systems accomplish different goals; thus, all have their position in the marketplace. These systems include the TissuTrans, the LipiVage, and the Coleman type modified liposuction instruments. The latter includes all micro-cannula-type instruments. Since it has been established that fat trauma during transfer should be minimized, the system and technique that will give the least amount of trauma to the fat cell should be the first choice. Conclusions: There is now a resurgence of interest in autologous fat because of the very high costs of commercial substances. Because of public acceptance and the availability and cost of economical raw goods, autologous fat can be a key filler in a practice-builder program. To have a successful goal-oriented program, one must use lipocyte-friendly instruments and put a great deal of effort into training the staff. The program must be organized, advertised, marketed, and reviewed at specific intervals for improvement. NOTE: When speaking of the best practice-builder filler, it is assumed that the surgeon will follow ethical guidelines in choosing the best filler for the patient, not just the filler that fits his or her program.
Treatment of Extensive Alopecia Combining Scalp Reduction and Punch Grafting in Private Practice
Authors: Frechet Patrick 
Published: January 2017

Use of scalp reduction and punch grafting in the treatment of stages V, VI, or VII extensive alopecia still poses questions which have not yet been completely resolved. Having completed a study I conducted with 100 patients, I can now answer the following questions: What are the evaluation criteria to be used in determining whether a patient may be treated? What is the maximum area of baldness that can be treated? Can one expect redistribution of hair to the entire scalp in these patients? Is there a particular scalp reduction procedure which is more suitable for the treatment of extensive alopecia? Is it desirable to follow a particular chronology when administering this treatment? Are these patients sufficiently motivated to continue treatment fully until its completion? Finally, what questions still remain to be answered?
Laser Surgery in Microgravity
Authors: Caleel Richard T. , Kuo Paul C. , Colvard Michael D. 
Published: January 2017

Human activity in microgravity environments place flight crews at risk to injury that may require surgical triage and care. Current protocols developed to handle surgical care in microgravity are derived from earth-based wound care techniques. Fluid and debris containment, spacecraft environmental contamination, and expediency of wound care in microgravity remain as significant obstacles. For space based surgery, lasers may allow procedures for rapid stabilization of emergency or traumatic injuries, surgical fluid control, hemostasis, and reduce contamination of the aircraft environment. The purpose of this paper is to outline the basic concept of laser surgery in an aviation and microgravity environment using carbon dioxide, neodymium–yttrium—aluminum–garnet (Nd:YAG), KTP, and excimer laser incisions within high altitude, military, aviation, and microgravity environments. “The plans for extending the human presence beyond the limits of Earth into space are: in the 1990s, to establish a permanent presence on the Space Station; in the first decade of the 21st century, to establish an outpost on the lunar surface, and to follow that in the second decade with an expedition to the surface of Mars.” “The demands and potential hazards of space flight require that crew members maintain health and peak proficiency at all times.” “Medical support for space station operations will require new philosophies and new technologies.” “The major considerations in developing such a system … for use in a spacecraft are to provide a sterile environment as well as to prevent contamination of the cabin with blood and other debris while performing the surgery.”
Eyebrow Transplantation: A Simplified Technique
Authors: Chastain G. Lynne , Duplantis Kathryn 
Published: January 2017

Introduction: Single hair grafts to the eyebrow, performed with a simple technique, offer today's cosmetic surgery patient a simple and natural-looking solution for alopecia of the eyebrow due to various causes, ranging from plucking and trauma to systemic and metabolic processes. Methods: We present a technique that requires simple instrumentation and the aid of 1 or 2 well-trained assistants. The procedure has been performed on 2 male and 18 female patients. Results: The procedure has resulted in a 96% graft survival rate, without complications, producing cosmetically pleasing outcomes. Conclusions: A simplified technique for eyebrow transplantation can easily and successfully effect a pleasing and natural look for today's cosmetic surgery patient.
Cardiac Valvular Disease in Asymptomatic Patients Who Have Had Antiobesity Medication
Authors: Shiffman Melvin A. 
Published: January 2017

Introduction: Antiobesity medications have been known to cause pulmonary hypertension and cardiac valvular disease. There is a risk in patients who have taken these medications of sudden hypotension when general anesthesia is induced. This article is a review of the current literature on the subject of valvular disease in asymptomatic patients who have taken antiobesity medications. Materials and Methods: The results of five independent surveys of patients who had been exposed to fenfluramine or dexfenfluramine but who had no obvious history of cardiac disease or cardiac symptoms were reviewed. Results: As detected by echocardiogram evaluation, the presence of significant valvular disease ranged from 30.0% to 38.3%. For patients having less than 3 months or 3 to 5 months of exposure to the drugs, 22% showed evidence of valvular disease. For patients exposed to the drugs for 6 or more months, the percentage showing valvular disease increased to 35%. An audible cardiac murmur was present in 17% of patients. Discussion: The American College of Cardiology issued recommendations that patients who have a history of fenfluramine or dexfenfluramine use undergo a careful cardiovascular physical examination, which should be followed by an echocardiogram in patients with cardiac murmurs or symptoms. The US Department of Health and Human Services Guidelines state that an echocardiogram should be performed on all patients who have taken these drugs.
Clinical Studies Concerning Re-Restoration of Teeth
Authors: Elderton R.J. 
Published: January 2017

Re-restoring teeth is an important component of operative dentistry, and the perceived presence of Re-restoring caries is a major reason for undertaking it. In the absence of a diagnosis of secondary caries, a morphological discrepancy at the margin of a restoration commonly provides the necessary justification for replacement. However, several studies have demonstrated enormous variation among dentists, both in their diagnosis of secondary caries and in the clinical decisions they make regarding whether or not to restore or re-restore. Many of these decisions must have been wrong. Decisions to re-restore teeth have been shown to be particularly idiosyncratic, and some patients apparently become involved in a repeat restoration cycle whereby the more restorations they have, the more re-restorations they receive. The desire by some dentists to replace large numbers of restorations, for reasons other than the presence of disease, shows a fallibility of operative treatment. At the same time it suggests that these dentists have considerable faith in this aspect of dental care. There would appear to be a prima facie case for investigating more deeply the factors involved in the clinical assessment of restorations. It should then be possible to improve the standard of diagnosis and treatment decision-making, especially with respect to the need to re-restore teeth.
Reproducibility and Detection Threshold of Peri-Implant Diagnostics
Authors: Van Steenberghe D. , Quirynen M. 
Published: January 2017

There is an increasing awareness that, for clinical monitoring of oral implants, there is a need for reliable diagnostics and possibly prognostic parameters. Indeed, reports have too often limited results to an inventory of failures, while no mention was made of progressive marginal bone loss or other symptoms of a future failure. Several parameters, such as marginal bone level assessment and/or probing attachment level, give a precision of up to 0.5 mm. Both measurements also seem related. The damping characteristics of the individual implant/bone unit also offer a highly reproducible diagnostic tool. The Periotest® allows for detection of subclinical mobilities, and 95% of repeated measurements fall within a range of one unit on the arbitrary scale. So far, these three parameters offer no prognostic value.
Bacterial-Protein Interactions in the Oral Cavity
Authors: Douglas C.W.I. 
Published: January 2017

Bacteria in the oral cavity must interact with salivary proteins if they are to survive. Such interactions can take several forms, either providing nutrients, a means of adhesion to surfaces, or resulting in aggregation or killing and, therefore, clearance of organisms. Recent work has provided an insight into the mechanisms of some of these bacterial-protein interactions, revealing complexity and diversity. For example, the interaction between a putative Streptococcus mutans adhesin, PI (B, I/II, etc.), and a parotid glycoprotein results in adhesion when it occurs at a surface or aggregation when in solution, and different domains of PI appear to be involved in the two processes. An alternative strategy is employed by Actinomyces viscosus, which interacts, via its type-1 fimbriae, with a proline-rich salivary protein; however, this interaction occurs only when the PRP is adsorbed to a surface. A. viscosus takes advantage of a conformational change in the PRP when it becomes surface-bound, which exposes a cryptic part of the molecule. A third, and intriguing, type of interaction is seen between various streptococci and salivary amylase. This does not result in either adherence or aggregation but provides organisms with the ability to utilize starch breakdown products for metabolism. An understanding of the mechanisms involved in bacterial-protein interactions could conceivably lead to novel methods for controlling specific pathogens, but the systems operating in the mouth are numerous, complex, and diverse.
Mouthrinses
Authors: Adams D. , Addy M. 
Published: January 2017

Mouthrinses have been used for centuries for medicinal and cosmetic purposes, but it is only in recent years that the rationale behind the use of the ingredients has been subject to scientific research and clinical trials. Although Listerine held its position formany years in the vanguard of the anti-plaque agents, the advent of mouthrinses containing chlorhexidine was a major breakthrough in the research for a chemical means to prevent disease. Since that time, and especially in the past ten years, the number of formulations that claim to have anti-plaque, anti-calculus, and anti-caries activity has increased, and much emphasis has been placed on such substances as an adjunct to, or indeed to replace, conventional toothbrushing techniques. This review covers the literature on mouthrinses over the past five years, concentrating more on the anti-plaque, anti-gingivitis, and anti-calculus formulations. In the first section, the methods of conducting clinical trials of mouthrinses are discussed, and a plea is made for a greater degree of standardization of methodology with agreed acceptable levels of clinical benefit. Trials of established mouthrinses are considered, and the advantages and disadvantages of several newer formulations discussed. From the review, it appears that chlorhexidine has no equal in its effects on reduction of plaque and gingivitis, but major drawbacks lie in the taste and stain-producing problems. The pre-brushing rinse, Plax, does not have unqualified success in all trials, though the more recent European formulation may have promise. Newer rinses which inhibit bacterial adhesion to tooth surfaces also appear promising, and it is suggested that more work on combinations of active ingredients is necessary.
Connective Tissue Degradation in Health and Periodontal Disease and the Roles of Matrix Metalloproteinases and Their Natural Inhibitors
Authors: Reynolds J.J. , Hembry R.M. , Meikle M.C. 
Published: January 2017

Connective tissue remodeling is essential for normal growth and development, and many diseases have long been associated with the breakdown of the collagenous matrix of bone, cartilage, and related tissues. Recent work has established that members of the family of matrix metalloproteinases (MMPs) are key enzymes in matrix degradation. They function at neutral pH and can digest synergistically all the matrix macromolecules. Biochemical and cloning studies indicate that there are three major groups, collagenases, gelatinases, and stromelysins. Naturally occurring inhibitors, TIMPs (Tissue Inhibitors of Metallo Proteinases ), are important controlling factors in the actions of MMPs, and tissue destruction in disease processes often correlates with an imbalance of MMPs over TIMPs. The major inhibitor is TIMP-1 (or TIMP), a 30-kDa glycoprotein that is synthesized by most cells. The expression of MMPs and TIMPs by cells is regulated by many cytokines (particularly interleukin-1, IL-1), growth factors, and hormones, some of which are specific to cell type and others that are ubiquitous (e.g.,transforming growth factor β, TGF-P). One way in which pathogenic organisms might mediate tissue degradation in periodontal diseases is through the ability of cell wall antigens to stimulate cytokine production by circulating mononuclear cells. These would then induce MMP synthesis by resident gingival cells, thereby initiating degradative events. Direct in vivo evidence for the source of collagenase and other MMPs in periodontal tissues is limited. By using specific polyclonal antibodies and indirect immunofluorescence, we could demonstrate the presence of collagenase, stromelysin-1, gelatinase A, and TIMP in human gingival biopsy specimens. Their distributions are extremely variable, in both the connective tissue and the epithelium, but the results indicate that host cell production of MMPs may contribute to tissue remodeling in periodontal disease.
Changes in Tumor Volumes and Spatial Locations Relative to Normal Tissues During Cervical Cancer Radiotherapy Assessed by Cone Beam Computed Tomography
Authors: Chen Wenjuan , Bai Penggang , Pan Jianji , Xu Yuanji , Chen Kaiqiang 
Published: January 2017

Purpose: To assess changes in the volumes and spatial locations of tumors and surrounding organs by cone beam computed tomography during treatment for cervical cancer. Materials and Methods: Sixteen patients with cervical cancer had intensity-modulated radiotherapy and off-line cone beam computed tomography during chemotherapy and/or radiation therapy. The gross tumor volume (GTV-T) and clinical target volumes (CTVs) were contoured on the planning computed tomography and weekly cone beam computed tomography image, and changes in volumes and spatial locations were evaluated using the volume difference method and Dice similarity coefficients. Results: The GTV-T was 79.62 cm3 at prior treatment (0f) and then 20.86 cm3 at the end of external-beam chemoradiation. The clinical target volume changed slightly from 672.59 cm3 to 608.26 cm3, and the uterine volume (CTV-T) changed slightly from 83.72 cm3 to 80.23 cm3. There were significant differences in GTV-T and CTV-T among the different groups ( P < .001), but the clinical target volume was not significantly different in volume ( P > .05). The mean percent volume changes ranged from 23.05% to 70.85% for GTV-T, 4.71% to 6.78% for CTV-T, and 5.84% to 9.59% for clinical target volume, and the groups were significantly different ( P < .05). The Dice similarity coefficient of GTV-T decreased during the course of radiation therapy ( P < .001). In addition, there were significant differences in GTV-T among different groups ( P < .001), and changes in GTV-T correlated with the radiotherapy ( P < .001). There was a negative correlation between volume change rate (DV) and Dice similarity coefficient in the GTV-T and organs at risk ( r < 0; P < .05). Conclusion: The volume, volume change rate, and Dice similarity coefficient of GTV-T were all correlated with increase in radiation treatment. Significant variations in tumor regression and spatial location occurred during radiotherapy for cervical cancer. Adaptive radiotherapy approaches are needed to improve the treatment accuracy for cervical cancer.