bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duplex Ultrasound Scanning for Chronic Venous Disease: Recurrent Varicose Veins in the Thigh after Surgery to the Long Saphenous Vein
Authors: Myers K. A. , Zeng G. H. , Ziegenbein R. W. , Matthews P. G. 
Published: January 2017

Objective: To use duplex ultrasound scanning to compare limbs with recurrent and primary varicose veins and to identify connections between deep veins and recurrences. Setting: A non-invasive vascular laboratory in Melbourne, Australia. Patients: A study of 779 limbs with recurrent varicose veins previously treated by ligation or stripping of the long saphenous vein and 1521 limbs with primary varicose veins. Main outcome measures: Connections between deep veins and recurrent varices, reflux in superficial and deep veins, and outward flow in perforators as demonstrated by duplex ultrasonography. Results: Recurrence was due to reflux in the long saphenous territory in 71.8%, short saphenous reflux alone in 14.7% or outward flow in calf perforators without saphenous reflux in 5.2%, while no source was detected in 8.3%. Limbs with recurrent veins in the long saphenous territory were compared with limbs with primary varicose veins; there was more frequent outward flow in thigh perforators (25.2% vs. 16.2%) but no difference for deep reflux (20.7% vs. 17.5%) or outward flow in calf perforators (56.8% vs. 53.1%). The source for recurrence in the long saphenous territory was from a single large connection in the groin in 46.3%, multiple smaller proximal connections in a further 46.3%, or thigh perforators in 7.4%. The destination was to an intact long saphenous vein in 33.7%, major tributaries in 28.7% or to other varices in 37.6%. Limbs known to have been treated by long saphenous ligation alone were compared with those known to be treated by long saphenous ligation and stripping; the source was more likely to be from a single large vein in the groin (60.3% vs. 39.9%) and the destination was more likely to be an intact long saphenous vein or major tributary (75.0% vs. 55.2%). Conclusions: Duplex ultrasound scanning detected the source of recurrent varicose veins in over 90% of patients and demonstrated whether there were single large or multiple smaller connections in the veins affected, and this helps to select the most appropriate treatment. Recurrence after stripping the long saphenous vein was more likely to be due to multiple small connections passing to scattered varices and this may allow more simple treatment by injection sclerotherapy rather than repeat surgery.
Ultrastructure of Evolving Deep Venous Collaterals
Authors: Fredericks R. K. , Raju S. , Klein M. 
Published: January 2017

Objective: To explore the structure of obstructive venous collaterals. Design: A total of 25 rats underwent unilateral ligation of the distal common femoral vein. Bilateral (control and test) vein segments with collaterals were harvested and studied with conventional light microscopy and electron microscopy at 2-week intervals for 10 weeks post-ligation. Results: Obstructive collaterals were quite unlike normal controls throughout the study. Initially, post-obstructive collateral walls showed disorganization of collagen, elastin, smooth muscle cells, and adventitia, while endothelial cells became more rounded and compact. The dense protein subendothelial deposits noted early became organized and moved more deeply into the wall at subsequent study intervals. Minimal motivation of smooth muscle cells, coalescence of elastic lamina, condensation of collagen and some organization of the wall were noted. Conclusion: Inability of deep collaterals to function with normal wall properties is likely to be secondary to the disruption of connective tissue and sustained disorganization of the vein wall noted throughout the evolution of collateral formation.
Duplex Ultrasound Assessment of Neovascularization after Saphenofemoral or Sapheno-Popliteal Junction Ligation
Authors: De Maeseneer M. G. , Ongena K. P. , Van den Brande F. , Van Schil P. E. , De Hert S. G. , Eyskens E. J. 
Published: January 2017

Objective: Evaluation of neovascularization at the saphenous ligation site as a cause of recurrent varicose veins. Design: Prospective duplex study of a single patient group. Setting: Vascular clinic of a University Hospital. Patients: 131 patients (177 limbs) were evaluated 2 and 12 months after varicose vein surgery. Intervention: Clinical assessment and colour duplex scanning of operated limbs. Main outcome measures: Limbs were classified according to the degree of neovascularization: grade 0 = no new communicating vein, grade 1 = new communicating vein with diameter <4 mm, and grade 2 = new communicating vein with diameter >4 mm and pathological reflux. Results: Two months postoperatively, grade 0 was observed in 173 limbs (98%) and grade 1 in four limbs (2%). Twelve months postoperatively, 152 limbs (86%) scored grade 0, 16 limbs (9%) grade 1 and nine limbs (5%) grade 2. Conclusions: After correctly performed previous surgery, neovascularization of varying degree may occur within 1 year, as can be demonstrated on postoperative duplex examination.
Studies on Ponstan (Mefenamic Acid): I. Gastro-Intestinal Blood Loss; II. Absorbtion and Excretion of a New Formulation
Authors: Tali A R , Mistilis S P 
Published: January 2017

Using improved techniques in a study of faecal blood loss no significant change over control level occurred during administration of mefenamic acid 500 mg t.i.d. for six days. This lack of gastro-intestinal bleeding is at variance with earlier findings for this compound. Studies of two mefenamic acid formulations (250 mg capsule and 500 mg filmseal tablet) showed no significant difference in area under blood level curves or in urinary output data, indicating equivalent total absorption. The 500 mg film-coated tablet gave significantly higher serum levels at 0·5 hours, whereas the 250 mg capsule gave significantly higher serum levels at 6 and 8 hours.
Kinetics of Analgesic Response in Man; an Example with Two Non-Steroidal Anti-Inflammatory Analgesic Drugs
Authors: Sacchetti G , Ferrati G C , Parrinello L , Salami A 
Published: January 2017

A double-blind, controlled clinical trial is described in which a total of forty hospital in-patients suffering from severe post-operative pain were randomly allocated to treatment with one of two non-steroidal anti-inflammatory drugs, namely, either indoprofen which has a short half-life (two hours) or naproxen which has a long half-life (thirteen hours). The drugs were administered orally on a single-dose-only basis. The doses used in this way were 300 mg of indoprofen or 250 mg of naproxen. Patients scored the severity of their pain on a five-point scale and these scores were recorded prior to and at fixed time intervals up to eight hours following administration of medication. No significant differences emerged between the two test drugs and the duration of the response was also found to be similar for the two compounds despite their very different plasma half-life values.
Homeless Shelter Users in the Postdeinstitutionalization Era
Authors: Stuart HL , Arboleda-Flórez J 
Published: January 2017

Objective: To describe the psychiatric symptomatology and mental health service needs of homeless shelter users in Calgary, Alberta. Data were collected as part of a broad-based community action initiative designed to reduce the problem of homelessness. Methods: A semistructured interview was conducted with a representative sample of 250 emergency shelter users. Mental health problems were measured through self-reports of 9 psychiatric symptoms known to be related to illnesses prevalent among homeless populations (depression, anxiety, and psychoses). The CAGE alcohol screen was also used. Results: Three-quarters of the sample expressed some symptomatology. About one-third were estimated to have a significant mental health problem. The lifetime prevalence of alcohol abuse was 33.6%. Higher levels of psychiatric symptomatology appeared to relate to a wide range of hardships, personal and public health risks, addictive behaviours, victimization, economic and interpersonal life events, dissatisfaction, and stress. Also, those with significant symptomatology frequently needed mental health care services but often did not know where to access them. Conclusions: The prevalence of mental health and substance abuse problems within homeless populations is significant and associated with considerable hardship as well as personal and public health risks.
Attachment Disorganization and Dissociative Symptoms in Clinically Treated Adolescents
Authors: West Malcolm , Adam Kenneth , Spreng Sheila , Rose Sarah 
Published: January 2017

Objective: To examine the association of unresolved and unclassifiable attachment with dissociative symptomotology in a sample of 133 adolescents in psychiatric treatment. Method: The study compared 69 adolescents who were unresolved and unclassifiable with 64 adolescents who were not unresolved and unclassifiable. Attachment organization was assessed using the Adult Attachment Interview (AAI). Dissociative symptomotology was assessed using a scale derived from the Youth Self Report (YSR) behaviour checklist. Results: A continuing unresolved and unclassifiable response to attachment-related trauma was correlated with dissociative symptomotology for both male and female adolescents. Conclusions: Cognitive disorganization may be an important variable mediating between the effects of earlier traumatic caregiving experiences and later dissociative symptoms.
More Than the Epidemiology of Alzheimer's Disease: Contributions of the Canadian Study of Health and Aging
Authors: Lindsay Joan , Sykes Elizabeth , McDowell Ian , Verreault René , Laurin Danielle 
Published: January 2017

Objective: To highlight contributions to knowledge made by the Canadian Study of Health and Aging (CSHA). Method: The CSHA began in 1991, with follow-ups in 1996 and 2001. It was national in scope, with 18 study centres and a coordinating centre. It included 10 263 participants; of these, 9008 were in the community, and 1255 were in institutions. In each phase, community participants were screened for cognitive impairment, and where appropriate, cognitive status was determined by a detailed clinical examination. Data on possible risk factors for dementia were collected at baseline. Data on caring for people with dementia were collected in each phase. Results: The prevalence of dementia was established at 8% of those aged 65 years and over; incidence (new cases each year) was about 2%. Cognitive impairment not dementia (CIND) was more than twice as common as dementia. Factors affecting the risk of institutionalization, mortality, and the health of caregivers were examined. The costs of dementia were conservatively estimated at $3.9 billion in 1991. Risk factors for Alzheimer's disease (AD) and vascular dementia are presented; it is noteworthy that physical activity appeared to protect against all forms of cognitive decline, particularly for women. Clinical contributions include the development of norms for several neuropsychological tests. Other topics include the health of those with CIND, predicting dementia, medication use, frailty and healthy aging, and urinary incontinence. Conclusion: The CSHA has contributed substantially to knowledge of the epidemiology of dementia, including AD, and to many other topics relevant to seniors' health.
Alzheimer's Disease, Genes, and Environment: The Value of International Studies
Authors: Hendrie Hugh C , Hall Kathleen S , Ogunniyi Adesola , Gao Sujuan 
Published: January 2017

Objective: To describe the construction of a disease model incorporating both genetic and environmental factors in the etiology of Alzheimer's disease (AD), using data generated from the Indianapolis–Ibadan dementia project (I-IDP). Method: The I-IDP is a longitudinal comparative study of the prevalence and incidence of dementia in 2 communities: elderly African Americans living in Indianapolis, Indiana, and Yoruba living in Ibadan, Nigeria. Results: African Americans are more than twice as likely as Yoruba to develop AD. Possible explanations for this finding include genetic factors: the possession of the apolipoprotein E ɛ4 allele does not increase risk for AD among Yoruba but confers a slight increase in AD risk for African Americans. As well, environmental factors may play a role: African Americans have a higher risk of vascular risk factors than do Yoruba. Conclusions: International comparative studies, particularly those involving populations from developing and developed countries, offer a unique opportunity for applying new information regarding population genetics to traditional AD risk factor research.
The Course of Depressive Illness in General Practice
Authors: Limosin Frédéric , Loze Jean-Yves , Zylberman-Bouhassira Myriam , Schmidt Mark E , Perrin Eléna , Rouillon Frédéric 
Published: January 2017

Objective: Depression is reported to be common in primary care settings and to have a high likelihood of relapse during the 4- to 6-month period following initial symptomatic improvement. However, most prospective studies of long-term treatment of depression have been conducted with patients selected for participation in placebo-controlled drug protocols or psychiatric clinics associated with tertiary referral centres. Method: We examined the treatment course and outcome of outpatients with major depressive episode treated in a primary care setting. The general practitioners were free to choose the treatment and its duration. Their only obligation was to assess the therapeutic outcome in terms of efficacy and safety and to perform a final evaluation at the end of the 6-month observation period or, if the patient was treated for a shorter period, at the end of the treatment. Results: Of the 476 patients involved, 308 (64.7%) responded to treatment and remained well, 117 (24.6%) showed no response, and 51 (10.7%) had an early relapse after initial improvement. Among the studied demographic, clinical, and therapeutic factors, the history of recurrent depression was the only variable with a significant effect size in predicting the course of the illness. Conclusion: Patients with recurrent depression were at higher risk of relapse or nonresponse.
Non-Alzheimer's Disease Dementias: Anatomic, Clinical, and Molecular Correlates
Authors: Hou Craig E , Carlin Danielle , Miller Bruce L 
Published: January 2017

Objective: To review the clinical and molecular features of non-Alzheimer's disease (non-AD) dementias, focusing on disorders associated with tau pathology (that is, frontotemporal lobar degeneration [FTLD], corticobasal ganglionic degeneration [CBD], and progressive supranuclear palsy [PSP]) or on disorders with synuclein pathology (that is, dementia with Lewy bodies [DLB] and multisystem atrophy [MSA]). We also discuss the pharmacologic treatment of these disorders. Methods: We report a selective review of the literature on FTLD, CBD, PSP, DLB, and MSA. Results: The non-AD dementias can present with a wide variety of cognitive and behavioural symptoms. Through common clinical features and shared molecular etiologies, neurodegenerative disorders previously thought to be distinct are now classified into tauopathies and synucleinopathies. Conclusions: The unique cognitive and behavioural manifestations of the non-AD dementias can be mistaken for psychiatric disorders. Improved detection of tauopathies and synucleinopathies and their differentiation from AD is possible.
Psychotropic Medication Use in Canada
Authors: Beck Cynthia A , Williams Jeanne VA , Wang Jian Li , Kassam Aliya , El-Guebaly Nady , Currie Shawn R , Maxwell Colleen J , Patten Scott B 
Published: January 2017

Background: Psychotropic medication use can be employed as an indicator of appropriate treatment for mental disorders. The Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2) offers the first opportunity to characterize Canadian psychotropic medication use on a national level within diagnostic groups as assessed by a full version of the Composite International Diagnostic Interview (CIDI). Method: We assessed the prevalence of antidepressant, sedative-hypnotic, mood stabilizer, psychostimulant, and antipsychotic use over 2 days overall and in subgroups defined by CIDI-diagnosed disorders and demographics. We employed sampling weights and bootstrap methods. Results: Overall psychotropic drug utilization was 7.2%. Utilization was higher for women and with increasing age. With any lifetime CIDI-diagnosed disorder assessed in the CCHS 1.2, utilization was 19.3%, whereas without such disorders, it was 4.1%. Selective serotonin reuptake inhibitors (SSRIs) were the most commonly used antidepressants for those with a past-year major depressive episode (17.8%), followed by venlafaxine (7.4%). Among people aged 15 to 19 years, antidepressant use was 1.8% overall and 11.7% among those with past-year depression; SSRIs made up the majority of use. Sedative-hypnotics were used by 3.1% overall, increasing with age to 11.1% over 75 years. Conclusions: International comparison is difficult because of different evaluation methods, but antidepressant use may be higher and antipsychotic use lower in Canada than in recent European and American reports. In light of the relative lack of contemporary evidence for antidepressant efficacy in adolescents, it is likely that antidepressant use among those aged 15 to 19 years will continue to decline. The increased use of sedative-hypnotics with age is of concern, given the associated risk of adverse effects among seniors.
Determinants of Service Use among Young Canadians with Mental Disorders
Authors: Bergeron Emilie , Poirier Léo-Roch , Fournier Louise , Roberge Pasquale , Barrette Geneviève 
Published: January 2017

Objective: To identify the determinants of service use by young Canadians with mental health problems. Methods: Data were drawn from a recent large Canadian mental health survey. The analyses were conducted on a subsample of 1092 Canadians aged 15 to 24 years and identified as presenting a mood disorder, an anxiety disorder, or a substance-related disorder in the 12 months preceding the survey. We classified variables potentially associated with any type of service use for a mental health problem over a 12-month period according to predisposing, enabling, and need factors. We conducted weighted multivariate logistic regressions to determine the association of each factor with service use. Results: In the final model, being female and living alone were the predisposing factors associated with service use. None of the enabling factors predicted help seeking. In regard to the perceived need factors, those who had difficulties with social situations were more likely to use services. Having a mood disorder and (or) having a diagnosed chronic illness were the evaluated need factors associated with service use. Conclusion: Certain groups of young Canadians are less likely to seek help for mental health problems and could be the target of interventions aimed at increasing service use.
Help-Seeking Behaviours of Individuals with Mood Disorders
Authors: Wang JianLi , Patten Scott B , Williams Jeanne VA , Currie Shawn , Beck Cynthia A , Maxwell Colleen J , El-Guebaly Nady 
Published: January 2017

Objectives: This study had the following objectives: 1) to estimate the 12-month prevalence of conventional and unconventional mental health service use by individuals with major depressive disorder (MDD) or mania in the past year, and 2) to identify factors associated with the use of conventional mental health services by individuals with MDD or mania in the past year. Methods: We examined data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). Respondents with MDD ( n = 1563) or manic episodes ( n = 393) in the past 12 months were included in this analysis. Results: An estimated 63.9% of respondents with MDD and 59.0% of those with manic episodes reported having used some type of help in the past 12 months; 52.9% of those with MDD and 49.0% of those with manic episodes used conventional mental health services. Approximately 21% of respondents with either MDD or manic episodes used natural health products specifically for emotional, mental health, and drug or alcohol use problems. Respondents who reported comorbid anxiety disorders and long-term medical conditions were more likely to have used conventional mental health services. Conclusions: Relative to previous Canadian literature, our analysis suggests that the frequency of conventional mental health service use among persons with MDD has not increased significantly in the past decade. Further, the rate of conventional mental health service use by persons with manic episodes is unexpectedly low. These findings may reflect the lack of national initiatives targeting mood disorders in Canada. They have important implications for planning future education, promotion, and research efforts.
Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy Study of Deficits in Hippocampal Structure in Fire Victims with Recent-Onset Posttraumatic Stress Disorder
Authors: Li Lingjiang , Chen Shulin , Liu Jun , Zhang Jinli , He Zhong , Lin Xu 
Published: January 2017

Objective: To explore hippocampal structural abnormalities in fire victims with recent-onset posttraumatic stress disorder (PTSD). Method: We compared 12 patients with recent-onset PTSD diagnosed according to DSM-IV criteria 6 to 8 months after a major fire with 12 individuals without PTSD who were victims of the same fire accident. Voxel-based morphometry (VBM) and magnetic resonance spectroscopy (MRS) were combined to examine hippocampal structural abnormalities in patients with recent-onset PTSD. Results: Results of VBM showed that the grey matter density of the left hippocampus was lower in the group with PTSD than it was in the group without PTSD. Results of MRS showed that the ratio of N-acetyl asparate and creatine in the left hippocampus was significantly lower in patients with PTSD than in control subjects. Conclusion: Patients with recent-onset PTSD had hippocampal structural abnormalities.
Psychiatrists' Documentation of Informed Consent: A Representative Survey
Authors: Schachter Debbie , Kleinman Irwin 
Published: January 2017

Objective: To review psychiatrists' documentation of informed consent and present data on Canadian psychiatrists' attitudes and practices regarding documentation of the informed consent process. Method: We surveyed a stratified random sample of psychiatrists practising in Ontario, using a mailed self-report questionnaire. Results: The response rate was 72%. Among respondents, 63% routinely documented the consent process, with younger respondents reporting more documentation than older ones. Although most respondents (77%) favoured recording the consent process, only 11% felt signed consent forms were necessary. Conclusion: There are differences in the self-reported documentation behaviour of younger and older psychiatrists. Psychiatrists should document the consent process in the clinical record.