bluuebunny/crossref_metadata_2025_split huggingface dataset:
The History of the Psychopharmacology of Schizophrenia
Authors: Lehmann Heinz E , Ban Thomas A 
Published: January 2017

Objective: To review the historical development of the psychopharmacological treatment of schizophrenia. Method: A chronological literature review of the clinical practices and theoretical models that have controlled drug treatment of schizophrenia at different times. Results: Effective treatment of schizophrenia was achieved only after the introduction of antipsychotic drugs, in the 1950s, and is still progressing. Conclusion: Close collaboration between basic neuroscience and careful and informed clinical practice are likely to lead to continued progress.
Eating Disorders and Hyperactivity: A Psychobiological Perspective
Authors: Davis Caroline 
Published: January 2017

Objective: To review the eating disorder research investigating the psychobiological connections between self-starvation and high-level exercising, including both animal experimentation and clinical field studies. In recent years it has been proposed that physical activity plays a central role in the pathogenesis and progression of the eating disorders—in particular, anorexia nervosa. Method: A review of research from animal experimentation and from clinical field studies investigating the biological and psychological implications of physical activity and starvation in the pathogenesis of eating disorders. Results: Animal research indicates that physical activity and starvation seem to potentiate one another and that alterations in the serotonergic system may underlie this process. Similar behavioural results have been found in recent clinical studies with eating-disordered patients, which suggests that physical activity plays a more central role in the development and maintenance of the eating disorders than had previously been thought. Conclusions: The emerging picture is that psychosocial factors seem to provide the most compelling factors in the etiology and onset of the disorder, while biological factors—in most cases induced by severe malnutrition and strenuous overexercising—predominate in the maintenance of the disorder.
Past, Present, and Future of Psychiatry: Personal Reflections
Authors: Eisenberg Leon 
Published: January 2017

Objective: To review the past half century of North American psychiatry from personal experience and to gauge its future prospects. Method: An examination of the relevant literature, recollections from a long academic career, and analysis of trends. Results: The pendulum of psychiatric theory continues its swing from its psychological to its biological pole; current economic forces are driving it toward reductionistic biology. The very considerable gains in the npsychosocial and neurobiogical knowledge base of our field will ultimately have a potent yield in patient care once the restrictive controls on its application to service provision are lifted. Conclusion: The future of research in the sciences basic to psychiatry has never been more promising. How rapidly rogress will occur will be a function of the resources society is willing to commit to mental health research. The prognosis for the translation of the new findings to clinical practice will depend on whether professionals can mobilize public support for quality care for the mentally ill.
Boundary Violations and Personality Traits among Psychiatrists
Authors: Garfinkel Paul E , Bagby R Michael , Waring EM , Dorian Barbara 
Published: January 2017

Objective: To demonstrate that sexual abuse of patients by psychiatrists can be due to a variety of contributors, which may include therapists' psychopathic and narcissistic personality styles. Method: Data from a prospective cohort of residents training in psychiatry were examined to evaluate the personality traits of 2 psychiatrists subsequently convicted of boundary violations. Results: The 2 psychiatrists who lost their licenses were identifiable at the beginning of their residency training as individuals with significant character pathology. Conclusions: For some psychiatrists, repetitive sexual abuse of patients represents one aspect of an ongoing pattern of exploitative relationships. The professional and ethical implications of these findings as they relate to early identification for those at risk are considered.
Clinical Profile of Mania in Children and Adolescents from the Indian Subcontinent
Authors: Reddy YC Janardhan , Girimaji Satishchandra , Srinath Shoba 
Published: January 2017

Objectives: To see whether classic DSM-III-R criteria for mania are applicable to Indian youngsters and to examine the clinical presentation of mania in an Indian child and adolescent psychiatric sample. Method: Fifty subjects with a diagnosis of functional psychosis as per the definition in ICD-9 were recruited from the population referred during the study period of approximately one year (n = 840) to the Child and Adolescent Psychiatry (CAP) clinic of the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, South India. The subjects were systematically evaluated using a standardized clinical interview and demographic questionnaire and were classified according to DSM-III-R. The subjects who satisfied DSM-III-R criteria for mania formed the sample for this study. Results: Twenty-one subjects received a diagnosis of mania according to DSM-III-R. The most common symptoms of mania included pressure of speech, irritability, elation, distractibility, increased self-esteem, expansive mood, flight of ideas, and grandiose delusions. No subject had comorbid attention-deficit hyperactivity disorder (ADHD). Additionally, 13 (61%) of the 21 manic subjects had delusions and/or hallucinations. The other common symptoms included psychomotor agitation, reduced sleep, anger, temper tantrums, decreased concentration, disobedience, aggression, and hyperactivity. Conclusions: Mania was diagnosable in Indian children and adolescents using classic DSM-III-R criteria. The clinical profile appears to be generally similar to that seen in adults. ADHD is not a comorbid condition. The presence of aggressive or disruptive behaviours and hyperactivity in childhood- and adolescent-onset mania, however, could lead to a misdiagnosis of attention-deficit hyperactivity disorder/conduct disorder (ADHD/CD). Similarly, the presence of psychotic features could lead to a misdiagnosis of schizophrenia.
An Investigation of Competency to Participate in Legal Proceedings in Canada
Authors: Whittemore Karen E , Ogloff James RP , Roesch Ronald 
Published: January 2017

Objective: To assess fitness to stand trial, competency to plead guilty, and competency to understand Charter cautions to determine if the level of competency varies across these domains. Methods: The Fitness Interview Test-Revised (FIT-R) and the Test of Charter Comprehension (ToCC) were administered to a group of individuals held on remand for fitness evaluations. Additionally, several questions from the FIT-R that address the ability to make a guilty plea were assessed separately and constituted an individual measure of competency to plead guilty (CoP). Results: As predicted, the results indicated that the fact that an individual is competent at one juncture in the criminal proceedings does not mean that the individual necessarily is competent at all other stages of the proceedings. Conclusions: These findings suggest a need for a stage-specific approach to forensic competency assessments, requiring specialized instruments designed to assess the legal issues of competency at the various stages of legal proceedings.
Preliminary Results Using a Magnet-Embedded Compression Garment after Liposuction Surgery
Authors: Dedo Douglas D. , Biemer Theresa A. 
Published: January 2017

Introduction: Magnetic fields have been touted as a cure and method of treatment for a variety of illnesses and medical conditions, and revenues from the sales of health-related magnetic products reportedly add up to billions of dollars. Magnets and the magnetic fields they create are marketed as having no associated risks; however, the medical community questions their benefits, and the Food and Drug Administration has not approved static magnetic fields for the treatment of any medical ailment. Methods and Materials: This study evaluated the postoperative effects of a magnetic garment on patients undergoing liposuction. For each standard postoperative compression garment, one half was fitted with elasticized magnetic neoprene material and the other half with nonmagnetized neoprene. The manufacturer sent the garments to the authors without identifying which sides had the active magnetic strips. Results: Preliminary results of this study showed no statistical difference in bruising, swelling, or postoperative results between the magnetized and the nonmagnetized treated areas. Although theories abound concerning the effects of magnetic field on optimizing the supply of nutrients and oxygen to the magnetic field area, this clinical study did not support any significant difference in the rate of wound healing. However, this study did show that pain and tenderness were markedly reduced on the side covered with the magnetic field. Eight of the 9 patients noted a decrease in pain and discomfort postoperatively on the left side, which was the half of the garment with the magnetized neoprene strips. The greatest reduction in pain was observed in the first 24 hours of treatment with the magnets, and the improvement increased with the passage of time. This study also found a reduction in the amount of analgesics needed by the patients using magnets during the treatment period. Discussion: Magnetic volume is important in delivering a therapeutic effect. Having more volume means that more tissues are experiencing the magnetic field. The neoprene magnetic strength is low in gauss units but high in Maxwell units because of the configuration of the north-south pole orientation described. Conversely, a unipolar magnet with a high magnetic strength delivers a low magnetic volume and is not considered important for therapeutic use. To date, researchers are uncertain whether low-level magnetic fields are hazardous to biological tissues. There has been some concern about safety issues for long-term whole-body exposure, but this may not be applicable to brief exposure to small areas of the body associated with static magnets. The theoretical basis for the physiologic response from static magnets has not been clearly identified. A search and review of the medical literature resulted in a limited number of studies. Few studies have evaluated magnets for relief of chronic pain for disease states and musculoskeletal pain, and even fewer have addressed mechanism of action.
State of the Art in Phalloplasty
Authors: Krakovsky Alexander A. 
Published: January 2017

Introduction: After Sigmund Freud “opened the bedroom door,” significant shifts in social attitudes, behaviors, and institutional regulations concerning male and female body images and the understanding of human sexuality began to occur. Today, male cosmetic genital enhancement surgery, or phalloplasty, has become the subject of recent surgical achievements that are gaining significant popularity in the United States and abroad. Appropriate methodology and surgical techniques have been developed to fulfill the demand in this field of cosmetic surgery. The objective of this study is to review the state of the art in phalloplasty and provide information about the availability of the techniques to the medical community and the public to inform them of surgical treatments that may improve unsatisfactory sexual performance, relationships, intimacy, and love by increasing the size of a man's penis. Material and Methods: Two surgeons performed phalloplasty on 594 patients at multiple surgical facilities over a 2-year period. Phalloplasty procedures include penile lengthening, penile girth enhancement, dual augmentation (combined lengthening and girth enhancement), penile glanular enhancement, scrotal web resection, and reconstruction. The patients' own satisfaction with the results of their surgeries was analyzed by using the Penis Image Assessment Scale Questionnaire. The assessment was based upon questions related to penis size, satisfaction of sexual experiences, and the psychological perspective of patients regarding their penises before and after phalloplasty. Results: Patient scores on the Penis Image Assessment Scale Questionnaire were higher before surgery (almost twice as high) than they were after surgery, showing an increase in patient satisfaction with penis size and performance after enhancement. Seventeen patients required subsequent surgery to treat local infection. Twenty-nine patients experienced localized swelling 3–7 days after surgery. The results showed enormous patient satisfaction with the cosmetic surgical procedures performed. Discussion: Penis size has always symbolized strength, virility, power, and domination in relationships. Although this subject was taboo some years ago, today many men are interested in learning about how phalloplasty may improve their self-confidence, sexual relationships, and female partners' satisfaction. Consequently, phalloplasty has acquired wide acceptance and tremendous popularity.
Decreasing the Recovery Time from Breast Augmentation: Changing the Mind-Set of the Patient, the Technique of the Surgeon, and the Postoperative Care
Authors: Scarlett William L. , Borsand Marvin A. 
Published: January 2017

Introduction: Dr John Tebbetts first described his 24-hour recovery from breast augmentation in Plastic and Reconstructive Surgery in 2002. His original article describes the inframammory approach, using direct visualization, implants ranging in size from 220 to 350 cc, and postoperative exercises. Dr Tebbetts limited the administration of muscle relaxants to the intraoperative period and did not administer narcotics in the postoperative period. Critics of Dr Tebbetts' work have stated that his ability to return patients to normal daily activities in such a short time is, in large part, due to his use of smaller implants. Although other articles have been written on augmentation recovery, the goal of our study was to institute Dr Tebbetts' ideas with our patient population, without limiting the size of the implants used or limiting the procedure to augmentation, and to analyze the results. Materials and Methods: We instructed 100 consecutive primary breast augmentation patients on postoperative exercises, limited the administration of narcotics, immediate postoperative use of ibuprofen, and encouraged the mentality of an earlier return to normal activities. Our patients were administered a survey on postoperative day 7. Results: The overall ability to return to work was 4.0 days after surgery. The use of narcotics was least in the groups where dissection was completed using direct visualization. Ninety-five percent of all patients thought that the postoperative exercises decreased their pain. We did have 5 patients (5%) who developed hematomas requiring evacuation, which was an increase for the practice, but still fell within the national average of 1–6%. Discussion: Our conclusions are that early postoperative arm exercises and encouraged activity, coupled with dissection under direct visualization, does allow for limited use of postoperative narcotics and an earlier return to normal activity. We observed an increase in the number of hematomas, which may suggest that ibuprofen in the immediate postoperative period affects the patients' platelets.
What Five Years of Florida Data Show about Office Surgery Safety
Authors: Coldiron Brett M. 
Published: January 2017

Introduction: In 2000, Florida mandated that all physicians report all adverse events occurring in an office setting to a central collecting agency. The purpose here is to analyze the scope and incidence of adverse events and deaths resulting from office surgical procedures in Florida from 2000 to 2005. Methods and Materials: All reported adverse incidents (eg, the death of a patient or ahospital transfer) occurring after an office procedure as reported to the Florida Agency for Health Care Administration from March 1, 2000, through March 1, 2005, were reviewed. Additional information was gained via telephone follow-up and Internet searches. Results: Of 351 reported office adverse events, 110 occurred in association with an office surgical procedure—25 deaths and 85 hospital transfers. Thirteen complications and 5 deaths were clearly associated with use of intravenous sedation anesthesia or general anesthesia. Two deaths and 11 complications were at the hands of anesthesiologists with an MD or DO credential, 2 deaths were attributable to plastic surgeons using intravenous sedation, and 1 death and 2 hospital transfers were attributable to certified registered nurse anesthetists administering anesthesia. No adverse events were associated with use of dilute local (tumescent) anesthesia. Discussion: Dermatologists are currently under scrutiny by legislative and regulatory bodies because they perform liposuction under tumescent local anesthesia in an office setting. But the data from Florida, presented here and elsewhere, clearly show that dermatologists are not the problem. An extraordinarily high percentage of cosmetic surgery deaths and hospital transfers were attributable to board-certified plastic surgeons. A fair analysis of the data indicates that any restrictions on office procedures should start with the specialty demonstrating the most adverse events. State and/or national legislation establishing reporting systems for adverse events should be supported and should require the reporting of delayed deaths. Restrictions on dilute local (tumescent) anesthesia for liposuction would not reduce adverse events and could increase them if patients are forced into liposuction under deeper anesthesia.
B Mastopexy: Versatility and 5-Year Experience
Authors: Peterson Steven W. , Tobin Howard A. 
Published: January 2017

Introduction: Many women are searching for restoration of a younger outward physical appearance. Mastopexy with or without augmentation may help improve or restore a woman's breast shape at the price of scars on the breast. We describe our experience with the versatility and improved aesthetic result using the B mastopexy technique, which provides a natural-appearing breast contour with less scarring. Materials and Methods: A retrospective review was performed on 40 patients who underwent B-type mastopexy from June 2000 through August 2005. Our technique is described in detail including our approach when simultaneous augmentation is performed. Patients undergoing simultaneous augmentation to give additional fill to the breast typically received an implant size ranging from 240 mL to 300 mL. Results: B mastopexy was performed on 40 patients with simultaneous augmentation performed in 27 patients. There were no complications, and only 1 patient underwent scar revision. All patients were satisfied with final outcome. Conclusion: B mastopexy provides an approach to restoring a naturally appearing breast contour and a more youthful look when augmentation is performed simultaneously. The versatility and limited scar makes this our procedure of choice.
Reduction of Postoperative Nausea and Vomiting through Patient Risk Stratification
Authors: Pippin Gregory W. , Liukkonen John , Garret Michael , Silver William 
Published: January 2017

Objective: To develop a patient risk stratification algorithm that will reduce the incidence of postoperative nausea and vomiting (PONV) in an ambulatory plastic surgery practice by increasing the use of prophylactic medications as the risk of PONV increases. Design: Retrospective review of an ambulatory plastic surgery practice before and after a PONV patient risk stratification algorithm was introduced. A patient risk stratification algorithm was developed based on known causes of PONV. Incidence of patients experiencing PONV before and after the introduction of the patient risk stratification algorithm was compared. Results of the study were analyzed with logistic regression. Results: The rate of PONV was 17.7% before the patient risk stratification algorithm was instituted and 4.47% after. This difference is significant (one-sided P value against no difference in true incidence of PONV = .003). A history of PONV and longer lengths of anesthesia were associated with higher likelihoods of PONV (P = .02 and .0056, respectively), and application of our patient algorithm (ie, membership in the study group as opposed to the control group) was associated with a lower likelihood of PONV (P < .001). Conclusion: Patient risk stratification and a multimodality approach to PONV prophylaxis effectively reduce the rate of PONV in an ambulatory plastic surgery practice.
Superficial Liposuction for Permanent Hair Removal
Authors: Khawaja Hassan Abbas , Shiffman Melvin A. , Hernandez-Perez Enrique , Hernandez-Perez Jose Enrique , Hernandez-Perez Mauricio 
Published: January 2017

Introduction: Superficial liposuction is the most common procedure for facial and body contouring. This article reports the results of a study in which superficial liposuction was utilized for permanent hair removal on the face (sideburn areas), the chin including the submental area, the neck, back, and upper and lower extremities of female and male patients. Possible complications are discussed. Materials and Methods: Thirty patients (25 women and 5 men) between 22 and 65 years of age were included. All patients were of Fitzpatrick skin types III or TV. Results: In 22 patients, 19 women and 3 men, 70–80% complete hair loss was noted by all observers in a single session. Follow-up at 3 months, 6 months, 1 year, and 2 years, showed no hair regrowth in any patient in the hair loss areas. In 8 patients, 6 women and 2 men, 50–60% of hair loss was noted after a single session. Complete hair loss was noted in all cases in the central areas where liposuction of the subcutaneous fat was complete, the direction of the dermal tunnels was superior, and where subsequent inflammation and postoperative hardening were intense. Conclusion: Superficial liposuction for hair removal is a quick method of permanent hair removal in selected patients removing maximum number of hairs in a single session. It is safe in experienced hands.