bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age and Remission of Psychiatric Disorders
Authors: Bland Roger C , Newman Stephen C , Orn Helene 
Published: January 2017

Objective: To examine the relationship between remission of psychiatric disorders and age. Methods: We interviewed 3258 randomly selected adult residents of Edmonton using the Diagnostic Interview Schedule (DIS), which yielded DIS/DSM-III diagnoses. Remission was defined as being free of symptoms of the index lifetime disorder in the year preceding the interview, this being the difference between the lifetime and one-year prevalence. For each age group, the proportion of cases with and without symptoms in the preceding year was calculated. Numbers and proportions of cases were estimated after adjusting to the census population and weighting for household size. Only the more common disorders were examined; any comorbidities were ignored. Results: Drug abuse or dependence, antisocial personality disorder (in both sexes), and alcohol abuse or dependence (in men) all showed remission rates that increased with age. Panic disorder and obsessive–compulsive disorder (OCD) showed a decreased likelihood of remission with increasing age. Major depression and phobias showed little tendency to remission with age. Considering all disorders together, the one-year remission rate for all ages combined was only 33.2%, with a tendency for lower remission rates to be found in those aged 55 to 64. Conclusions: As may be expected, antisocial personality, drug abuse or dependence, and alcohol abuse or dependence tend to show increased remission rates with increasing age. In OCD and panic disorder, the low rates of remission found in all age groups indicate that these disorders produce significant long-term morbidity. For depression, which had an overall remission rate of less than 50%, the stable low rate of remission probably indicates not only the difficulties of treatment but also the low rates at which cases get treated.
Use of Health Services for Anxiety Disorders: A Multisite Study in Quebec
Authors: McCusker Jane , Boulenger Jean-Philippe , Boyer Richard , Bellavance François , Miller Jean-Marc 
Published: January 2017

Objective: We investigated patient characteristics and use of services for anxiety disorders among patients seeking care from participating clinicians at 7 anxiety clinics in Quebec: 3 general hospital clinics, 3 psychologist-run clinics, and one psychiatric hospital clinic. Methods: Persons eligible for the study were those who were visiting the clinics for the first time, had a current diagnosis of an anxiety disorder, and could communicate in French or English. Subjects recruited through advertisements were excluded. Data, collected by a self-administered questionnaire, included demographics, treatment history, use of services for anxiety, and the Beck Anxiety Inventory (BAI). Results: The sample comprised 235 subjects: 146 seen at 3 general hospital clinics, 54 at 3 psychologist-run clinics, and 35 at a psychiatric hospital clinic. There were statistically significant differences by clinic type in the prevalence of specific anxiety diagnoses, BAI score, referral source, antidepressant use, and use of services. High-intensity use (10 or more consultations during the previous year) was reported by 23.4% of the sample for medical services and 19.6% for mental health services. Multiple logistic regression identified variables associated with high-intensity use of medical services (higher BAI score, 1 to 4 years since first sought treatment, and less than 12 years of education) and high-intensity use of mental health services (clinic type, obsessive–compulsive disorder [OCD], and 5 or more years since first sought treatment). Conclusions: The patient populations seen at different types of anxiety clinics differ in several respects, including referral source, previous treatment, and severity of symptoms. Regardless of type of clinic, patients with a longer time since they first sought treatment use more services, particularly mental health services. Those with less education use more medical services than those with greater education.
Reliability of the Manitoba Mental Health Management Information System for Research
Authors: Robinson J Renée , Tataryn Douglas J 
Published: January 2017

Objectives: To determine the accuracy of data contained in Manitoba's Mental Health Management Information System (MHMIS) as compared with client charts and to determine which factors influence completeness and accuracy. Method: Data on diagnosis, open date and close date, demographic information, and contact information were obtained from client charts and compared with data extracted from the MHMIS. Semistructured interviews were conducted with individuals who contribute data to the MHMIS. Results: Data on required demographic variables, primary diagnosis, and open and close dates are highly similar in the 2 sources. The correlation between data sources on the number of client contacts is also good. Conclusion: This study establishes the reliability of MHMIS data. MHMIS data, in combination with hospital abstracts and physician claims data, provide the information needed to serve as a psychiatric case register (PCR) and can be used for psychiatric epidemiology as well as for planning, monitoring, and evaluating mental health services.
Boundary Violations and Departments of Psychiatry
Authors: Garfinkel Paul E , Dorian Barbara , Sadavoy Joel , Bagby R Michael 
Published: January 2017

Objective: To explore a number of issues related to boundary violations in psychiatry, including the relationship between the individual physician and his or her patient and broader issues related to various dilemmas arising in academic departments of psychiatry. Method: Several potentially troublesome scenarios are presented and discussed in the contexts of 1) the doctor–patient relationship, 2) sexual boundary violations, and 3) nonsexual forms of exploitation, such as finances, confidentiality, dual relationships, and relationships with industry. Conclusions: A number of examples of boundary problems involving psychiatrists have been explored, and although some of these behaviours are clearly forbidden and harmful, others are less clear and require careful consideration if the profession is to arrive at a thoughtful consensus.
Risk Assessments for Acute Violence to Third Parties: A Review of the Literature
Authors: Ferris Lorraine E , Sandercock Jane , Hoffman Brian , Silverman Marvin , Barkun Harvey , Carlisle John , Katz Cheryl 
Published: January 2017

Objectives: To provide an overview of risk assessments for acute violence to third parties by combining a clinical and research focus and to offer guidelines to physicians conducting clinical assessments. Method: A computerized literature search of the MEDLINE and PSYCHINFO data bases from 1967 to 1996 was completed using the key words violence, aggression, dangerous behaviour, risk, risk assessment, risk factors, and practice guidelines. The search yielded 116 relevant references, 26 of which were original research articles on risk factor identification. A secondary search, based on the citations from the primary search, yielded an additional 8 general discussion articles. Results: Risk assessments may be conducted using different methods, although all methods should be systematic and comprehensive. Research shows that risk assessments do have validity for use in short-term prediction and that it is possible to develop clinical guidelines in this area. A combined clinical and research approach holds the most promise for improving the accuracy of probability estimates, and most published guides and tools rely on such a combination. Conclusions: Risk assessments are an important and necessary part of the clinical examination. Because this field has sufficiently evolved, there is abundant literature to refer to when determining what constitutes an acceptable assessment for risk of violence to third parties and when it is appropriate to conduct such an examination.
Suicide Attempts among Turkish Psychiatric Patients
Authors: Coşar B , Koçal N , Arikan Z , Işik E 
Published: January 2017

Objectives: The aim of this study was to investigate the sociodemographic characteristics of those who attempt suicide in an Islamic country, the effect of religion on suicide attempts, and the frequency of DSM-III-R diagnoses in suicide attempters referred to the Gazi Medical School Psychiatry Department. Method: Medical records of 185 cases of suicide attempts were reviewed. Results: There was a predominance of single, female subjects. Students, housewives, and employees represented the 3 largest groups. Drug overdose was the most common method of suicide attempt, and the most common DSM-III-R diagnosis was depression. The rate of repetition of suicide attempt was 43.3%. Conclusion: Suicide is one of the major problems among Turkish psychiatric patients, although the Islamic religion strongly disapproves of it.
Seamless Face-Lift with Aptos Thread: The Belo Medical Group Experience
Authors: Belo V. G. , Buse E. B. , Cayetano R. J. , Flores M. A. 
Published: January 2017

Introduction: Aging is manifested on the face as loss of normal volume and contour in all dimensions. The classic methods of face lifting normally leave unsightly scars, especially on Asian skin. In 1999, M. A. Sulamanidze used Aptos thread to lift soft tissue in both the subcutaneous muscular aponeurotic system and in the supraorbital area, restoring the normal contours of the face with excellent results. Aptos threads are polypropelene sutures with dents or cogs along their surface. Here, we present the results of a study using the device introduced by Sulamanidze on patients in the Belo Medical Group. Materials and Methods: Our study group consisted of 257 patients ranging in age from 28 to 73 years. Women made up 91.5% of the population. The population was 98% Asian. From November 2002 to November 2003, surgical procedures using Aptos threads were performed on 257 patients, and 27 patients had additional procedures at the same time. Results: The immediate postoperative period was mostly uneventful. Most cases showed excellent improvement in the ptotic tissues. In 9 cases (3.5% of patients) a “blue pimple” was observed 2–3 weeks postoperatively. These were noted to be thread edges sticking out of the skin and required minimal trimming. In 1 case, the patient developed persistent infection at the puncture site. Wound exploration and removal of implanted thread was performed and antibiotics were shifted to a broader spectrum, which addressed the problem quickly. Five cases (1.9%) required unilateral or bilateral implantation of additional threads. Discussion: The earliest outcome was seen on the operating table. Rehabilitation time was as short as 5–7 days and, if patients comply with elementary recommendations (abstaining from abrupt mimicking and chewing movements, avoiding facial massages for 2–3 weeks), the lifting effect is expected to remain for a considerable length of time. Conclusion: Using the Aptos thread technique was as successful in treating facial ptosis in 257 patients at The Belo Medical Group facility as it was in the Russian study. It proved to be a simple, quick, safe, conservative, and time-saving procedure that did minimal tissue damage and left no visible scars, even on Asian skin.
The Use of Autologous Fat Transplantation to Remedy the Iatrogenic Lipoatrophic Effect of Tissue Expanders
Authors: Roomi Riad 
Published: January 2017

Introduction: Tissue expanders have become a popular modality in plastic and cosmetic surgery. Many victims of burns and severe trauma, premalignant lesions, congenital malformations, unwanted or regretted tattoos over large areas, women undergoing postmastectomy breast reconstruction, or men with extensive male-pattern alopecia may seek treatments that use tissue-expansion techniques. Tissue expansion has been an excellent tool for expanding normal skin to provide good quality, cosmetically appealing, full-thickness skin coverage of defective areas. However, like most treatment modalities, tissue expanders have some undesired pitfalls, sequelae, and complications associated with their use. We used autologous fat transplantation to remedy asymmetrical arm circumference after skin expansion on one arm and report our results in this case report. Case Report and Procedure: The patient is a 16-year-old female who presented with a congenital hairy nevus measuring 6.5 × 5.5 cm in the middle part of the posterolateral aspect of her left arm. Treatment included the use of tissue expanders, followed by excision of the nevus to treat the area. After the treatment, the patient complained that her left arm had become thinner than the right. Circumference of both arms measured at symmetrical points revealed a variance of 3 cm. Autologous fat transplant surgery, with a slight overcorrection that was expected to reduce over time, was offered as a solution. Conclusions: Autologous fat transplantation can be used as an adjunct to tissue expansion to fill the lipo-atrophic defects that may result from tissue expansion. Results: Postoperative follow up revealed sound healing of the wound. Her left arm circumference decreased over the following 6 weeks postoperatively (the overcorrection). The final result was symmetrical arms, both visually and numerically.
Clinical Evaluation of a Device for the Treatment of Cellulite: Triactive
Authors: Boyce Sarah , Pabby Anju , Chuchaltkaren Prapai , Brazzini Benedetta , Goldman Mitchel P. 
Published: January 2017

Introduction: Cellulite has always been a difficult condition for patients and cosmetic physicians to treat. Even if improvement is made in the appearance of cellulite, no machine or topical treatment exists that can provide long-term results in the treatment of cellulite. We evaluated a technique that increases lymphatic drainage and vascular permeation to assist in decreasing the appearance of cellulite. Materials and Methods: Sixteen female patients underwent 12 treatments with a device called Triactive, which has a triple-pronged mechanism of action consisting of low-level suction, diode laser, and contact cooling. We measured results by waist, hip, and thigh circumference as well as elasticity, thermography, and blinded photograph evaluations. Results: We found a small decrease in hip and thigh circumference as well as an increase in elasticity of the treated cellulite. Evaluation of the photographs yielded an overall 21% average improvement in the appearance of cellulite. There was no change in thermography data after treatments. Results were not present at 1 month. Discussion: The Triactive offers a method to temporarily decrease the appearance of cellulite. It appears that treatments must be continued to maintain results. Further study and larger patient groups are needed before this treatment can be recommended above other available treatments.
Facial Rejuvenation with Barbed Sutures: A Retrospective Analysis of Technique and Results
Authors: Haiavy Jacob , Leventhal Marc S. 
Published: January 2017

Introduction: In the last thirty years, various techniques of face-lifting have been developed. Many of these operations require a long recovery. With the increased public awareness of cosmetic surgery, the demand for effective procedures with minimal downtime and quicker recovery is on the rise. We set out to examine a technique of facial rejuvenation with barbed sutures, originally described by Dr M.A. Sulamanidze, and its effectiveness. Materials and Methods: Twenty-seven patients were treated with the APTOS sutures for facial ptosis from May 2002 to October 2003. The patients were followed for 3 to 28 months. The areas treated were the brows, cheeks, jowls and neck. Digital images were taken at each preoperative and postoperative visit. Almost all of the cases (25 of 27) were performed under local anesthesia. The results were evaluated at each postoperative visit by the patients and the surgeons. Results: Two hundred and eighty-two sutures were placed in the 27 patients. The malar area was the most commonly treated (88.9% of patients) section of the face. The brows and jowls were the second most common area of treatment (40.7%). The neck was the least common area of treatment (29.6%). The patients' mean age was 50.9 years. The average follow-up time was 18.6 months. The results were evaluated by the patients and the surgeons based on a subjective rating of improvement when compared to the preoperation pictures in the specific area of treatment. Overall patient improvement rating was highest in the malar region, at 55%, compared to a doctor improvement rating of 40%. Pearson correlation analysis showed that the patient's perceived degree of improvement was directly correlated (P < 0.01) with the patient's overall satisfaction. The most common reason for dissatisfaction was patient disappointment with longevity of results. Complications encountered during the study were suture extrusion, bruising, pain, asymmetry, dimpling of skin, and visible suture tracts. Conclusions: Placement of barbed sutures into the soft tissues of the face for facial lifting is a developing technique. The APTOS lift, as advocated by Dr Sulamanidze, is a limited procedure that is indicated primarily in patients with mild to moderate ptosis who are seeking a subtle improvement in their appearance that is temporary and requires minimal downtime. It is not a replacement for a facelift. When patients are properly informed and educated about the benefits and limitations of this procedure, the chances that they will be satisfied is much higher.
Reconstruction of Gynaecomastia Excision Defect: A Case Report
Authors: Thomas Mohan , D'Silva James Allen , Padubidri Ramesh , Menon Hari 
Published: January 2017

Introduction: Gynaecomastia is a condition of persistent enlargement of the male breast that can be addressed by liposuction alone in many cases. Open surgical excision, which was widely practiced in previous years, can lead to unattractive “saucer” deformity if care is not taken. Here we present a case of similar deformity treated with a dermafat graft giving a satisfactory result. A review of relevant literature is also presented. Materials and Methods: A 28-year-old patient with a saucer-shaped defect after open resection of gynaecomastia was treated with a combination of dermafat graft and fat injection to restore contour. The details of the procedure are presented. Results: Evaluation at 1 month after surgery shows a good result with adequate filling of the defect blending well with surrounding areas and restoration of normal contour. Discussion: Dermafat grafts and fat injections are frequently used for correction of facial defects and volume loss and can be used equally successfully in other parts of the body. Combining the 2 procedures gives better results in properly selected cases.
Treatment of Internal Nasal Valve Collapse with Radiesse (CaHA) Injection Spreader Grafting
Authors: Nyte Christopher P. , Mangubat E. Antonio 
Published: January 2017

Introduction: Nasal obstruction secondary to internal nasal valve (INV) collapse is a well-described condition. Symptoms of INV collapse include chronic nasal congestion, nasal airway obstruction, snoring, and difficulty obtaining restful sleep. The authors report the use of calcium hydroxylapatite (CaHA) injection as a spreader graft to improve nasal airway patency in patients experiencing INV collapse. Materials and Methods: Of 12 patients enrolled in the study, 6 patients completed follow-up and are the subject of this report. They were evaluated and found to have bilateral INV collapse resulting in nasal obstruction. A total of 12 sides were injected with small aliquots of CaHA, also known as Radiesse. Injections were directed into the INV at the junction of the upper lateral cartilage and the dorsal septum until nasal obstruction was relieved and INV angles were visually increased. Biopsy of the CaHA spreader graft was undertaken for histologic evaluation in 1 patient who underwent elective cosmetic rhinoplasty. Each patient completed subjective nasal airway patency questionnaires documenting their degree of perceived nasal obstruction before the CaHA spreader graft and at the 3-month follow-up. Results: All 6 patients experienced immediate subjective relief of their nasal obstruction with the CaHA spreader graft. Immediate posttreatment INV angles were visually widened at rest and during inspiration. At the 3-month follow-up, the improvement in the INV angles remained for all 6 patients. In addition, the subjective nasal airway patency evaluations universally correlated with the observed changes, and high patient satisfaction was preserved. Histologic findings for 1 patient revealed fibrous tissue with few foreign body giant cells. Discussion: Use of CaHA spreader graft injection to relieve nasal obstruction because of INV collapse appears to be a reasonable nonsurgical alternative. Long-term studies are ongoing.
Platelet-Rich Plasma (PRP) Utilized to Promote Greater Graft Volume Retention in Autologous Fat Grafting
Authors: Sadati Kevin S. , Corrado Anthony C. , Alexander Robert W. 
Published: January 2017

Objectives: Autologous fat theoretically provides one of the most ideal mediums for soft-tissue augmentation and reconstruction, although its clinical applications have been marked with skepticism because of its documented unreliable survival. Over the years, numerous unsuccessful efforts have set forth to elucidate modifications in the application process of autologous fat grafts to allow the medium greater clinical predictability. This study aims to investigate the effects of platelet-rich plasma (PRP) on autologous fat grafts when used in conjunction with each other in soft tissue augmentation and reconstruction. Study Design: Retrospective review, over a 30-month period, of consecutive patients with results greater than 6 months in duration. Methods: This study is based on clinical experiences representing 2033 grafts in 448 consecutive patients using PRP additives and in the previous 132 patients who had syringe harvest without use of PRP. All PRP isolates were harvested via the Smart Prep system. Harvest and augmentation techniques are discussed and representative results are presented. Results: Results were based on clinical observations and patient satisfaction. Of the 580 patients in the experimental group, essentially all showed greater graft volume retention over extended time intervals compared with control subjects (nongraft areas). Patients in the PRP-added experimental group displayed less postoperative ecchymosis and edema, which also led to greater patient satisfaction in this group. Conclusion: Adding PRP to autologous fat aids in graft volume retention and survival when used clinically for soft-tissue augmentation and reconstruction.