bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lithium salts in cluster headache treatment
Authors: Savoldi Faustino , Bono Giorgio , Manzoni Gian Camillo , Micieli Giuseppi , Lanfranchi Marina , Nappi Giuseppe 
Published: July 2017

The short and long-term effects of Lithium carbonate in 90 patients with episodic (68 cases) and chronic (22 cases) cluster headache are reported. The results are discussed in particular in relation to the response of the episodic forms, the development of tolerance, the ability of the substance to modify the natural history of the disease, and the side-effects from long-term treatment. On a évalué l'efficacité thérapeutique de l'administration, à court et à long terme, de lithium carbonate dans 90 patients atteints de formes épisodiques (68 cas) ou chroniques (22 cas) de céphalée en grappe. On discute les résultats en considérant en particulier la réponse des formes épisodiques, le développement des phénomènes de tolérance, la capacité du traitement d'interférer avec l'histoire naturelle de la maladie, l'apparition d'effects collatéraux dans les traitements prolongés. E’ stata valutata l'efficacia terapeutica della somministrazione, a breve e lungo termine, di litio carbonato in 90 pazienti affetti da forme episodiche (68 casi) o croniche (22 casi) di cefalea a grappolo. I risultati sono discussi con particolare riguardo alla risposta delle forme episodiche, allo sviluppo di fenomeni di tolleranza, alla capacità del trattamento di interferire con la storia naturale della malattia, alla comparsa di effetti collaterali in trattamenti prolungati.
Clinical pharmacological aspects of dihydroergotamine timed release: activity on monoamine venospasm
Authors: Franchi Giancarlo , Anselmi Bruno , Bianco Pier Luigi Del , Panconesi Alessandro , Sicuteri Federigo 
Published: July 2017

Using the computerized venotest, it is possible to evaluate both the venospastic activity of the vasoactive monoamines (NA,5-HT, DA) and the effects of the relative agonistic and antagonistic drugs. The ergot-derivatives are 5-HT and NA agonists at low doses, and are 5-HT antagonists at high doses. Dihydroergotamine timed release (DHE-TR) administered orally is capable at 12 hours following the last administration of producing a significant increase of 5-HT and NA venospasm. It is hypothesized that 12 hours after the last administration of DHE-TR, hematic concentrations, corresponding to clinical and therapeutic levels, capable of potentiating the monoamine venospasm still exists. Il est possible évaluer, par le venotest computerisé, soit l'activité venospastique des moamines vasoactives (NA, 5-HT, DA) que l'effect des relatifs médicaments agonistes et antagonistes. Les dérivés de l'ergot en doses moyennes sont agonistes de la 5-HT et de la NA, tandis qu'en doses élevés ils sont antagonistes de la 5-HT. L'administration de la dihydroergotamine à libération programmée (DHE-TR) par os, peut à 12 heures de distance de la dernière administration, prouver une augmentation du venospasme de 5-HT et de NA. On suppose qu'à 12 heures de distance de la dernière administration de DHE-TR, il y a dans le sang une présence de concentrations du médicament relative à celles cliniques-thérapeutiques, qui peut augmenter le venospasme des moamines. Con il venotest computerizzato è possibile valutare sia l'attivita venospastica delle monoamine vasoattive (NA, 5-HT, DA) sia l'effetto dei relativi farmaci agonisti e antagonisti. Gli ergot-derivati a basse dosi sono agonisti della 5-HT e della NA, a dosi alte sono antagonisti della 5-HT. La dihydroergotamina a liberazione programmata (DHE-TR), somministrata per os, è capace, a 12 ore di distanza dall'ultima somministrazione, di produrre un significativo incremento del venospasmo da 5-HT e da NA. Si ipotizza perciò che a 12 ore di distanza dall'ultima somministrazione di DHE-TR siano ancora presenti nel sangue concentrazioni del farmaco, corrispondenti a quelle clinico-terapeutiche, capaci di potenziare il venospasmo delle monoamine.
Psychological peculiarities in children with recurrent primary headache
Authors: Guidetti Vincenzo , Ottaviano Salvatore , Pagliarini Marina , Paolella Anna , Seri Stefano 
Published: July 2017

Thirty-five children with idiopathic headache (average age 10.2 years) were subjected to various examinations and a series of tests (WISC, Bender, Rorschach, Duss, “tree” and “family” tests) on the nature and characteristics of headache with a view to establishing possible psychological peculiarities. The sample was correlated with a random control group of 20 subjects (average age 10.4 years) undergoing all of the above tests except the Rorschach test. This showed a significant decrease in the “digit span” WISC subtest and in the Bender test with respect to normal population, and a drop in “digit span” and in picture completion subtests and in headache length in months. Feelings of being excluded from the family group, insecurity and repressed hostility towards the important figures, were significantly stronger in the headache patients group. Un groupe expérimental de 35 enfants attient de céphalée idiopathic (a.m. 10.2 ans) a été soumis à des recherches sur la nature et les caractéristiques de la céphalée et à une série de tests (WISC, Bender, Rorschach, Duss, Arbre, Famille) pour mettre en évidence les éventuelles particularitées psychologiques. Le groupe expérimental a été comparé à un groupe de contrôle, casuel, formé de 20 sujets (a.m. 10.4 ans) qui ont été soumis, à la même série de tests excepté le test de Rorschach. Les résultats obtenus révèlent un décalage significatif dans le mémoire de seris de chiffres et dans le test de Bender in par rapport à la population normale et encore plus une relation significative entre le décalage de la mémoire de series de chiffres et le completement d'images et encore la durée (mois) de la céphalée. La sensation d'être exclus du noyau familial, l'insicurité et l'obstilité réprimée enverse les figures significatives, sont résultées plus élevées, de façon significative dans le groupe de sujets atteint de céphalée. Un campione di 35 bambini con cefalea essenziale (e.m. 10.2) é stato sottoposto a indagini sulla natura e le caratteristiche della cefalea e ad una batteria di test (WISC, Bender, Rorschach, Duss, Albero, Famiglia) onde evidenziare eventuali peculiarità psicologiche. Il campione é stato comparato ad un gruppo di controllo randomizzato composto di 20 soggetti (e.m. 10.4) cui é stata somministrata la stessa batteria di test ad eccezione del Rorschach. I risultati ottenuti evidenziano una caduta significativa nel sub-test di memoria cifre del WISC, e nel test della Bender in rapporto al controllo; nonché una significativa relazione fra caduta nei sub-test di memoria cifre e completamento figure e durata in mesi della cefalea. Sensazioni di essere esclusi dal nucleo familiare, di insicurezza e ostilità repressa verso le figure significative sono risultati significativamente più elevati nel gruppo dei cefalalgici.
Flunarizine (Sibelium) in the Prophylaxis of Migraine. An Open, Long-Term, Multicenter Trial
Authors: Martínez-Lage J Manuel 
Published: July 2017

Sixty-four Spanish neurological centers participated in a study designed to evaluate the efficacy and safety of flunarizine in migraine. One thousand four hundred and thirty-five outpatients (367 [25.6%] males and 1,068 [74.4%] females) fulfilling the criteria proposed by the International Headache Society for the diagnosis of migraine entered the study. Patients were treated with 10 mg of single-dose flunarizine (Sibelium) alone at bedtime in open fashion for 6 months. At the end of this treatment period, flunarizine was withdrawn, but the follow-up of the patients continued for another 6 months. The evaluation criteria used were a rating scale (the GES) based on frequency, duration, intensity, and characteristics of the attacks as well as a checklist of possible side-effects. This clinical assessment was recorded in detail in the patients' rating notebooks at the start and at the end of the third, sixth, ninth, and twelfth month of the study. A mean decrease of 66.9% in the GES was obtained at the end of the treatment period, which implies a good or excellent result in the prophylaxis of migraine attacks in 69.5% of the patients. This improvement was practically unchanged at the end of the follow-up period. Side-effects were moderate, the most frequent ones being drowsiness and weight gain. Their incidence decreased after the first months of treatment.
Adverse Reactions to St John's Wort
Authors: Parker Vivien , Wong Al bert HC , Boon Heather S , Seeman Mary V 
Published: July 2017

Objective: To re port 2 cases of ad verse re ac tions to St John's wort, a pop u lar herbal treat ment for de pression. Method: We pres ent 2 case his to ries and re view the ex ist ing lit er a ture re gard ing St John's wort. Results: St John's wort may cause se ro to nin syn drome in sen si tive pa tients. In ad di tion, St John's wort may be as so ci ated with hair loss. Conclusions: For clin i cal rea sons, it is im por tant to rec og nize and re port ad verse re ac tions to herbal rem e dies and to doc u ment that these treat ments have side ef fects com men su rate with their po tent ac tion on brain neurochemistry.
Treatment Delays for Involuntary Psychiatric Patients Associated with Reviews of Treatment Capacity
Authors: Kelly Michelle , Dunbar San dra , Gray John E , O'Reilly Rich ard L 
Published: July 2017

Objective: To de ter mine the duration of de lays in treatment initiation when involuntary patients apply for a review of a finding of treatment in capacity and to estimate the cost of keeping patients hospitalized with out treatment in these circumstances. Method: Using a computerized da ta base and writ ten records, we identified all patients at 2 psychiatric hospitals in Ontario who applied for a re view of a finding of treatment in capacity during a 10-yearperiod. We recorded clinical and demographic variables, dates of stopping and starting medication, and dates of review board hearings and out comes. We also noted all cases in which a patient appealed a decision from the re view board to the court. Results: Two hundred and thirty-seven patients made 334 applications to the re view board. The board over turned the physician's finding of incapacity in only 5 (1.5%) applications; 15 appealed the re view board's finding to the courts. None of these appeals were successful. In the absence of an appeal to the courts, the average delay in initiating treatment was 25 days. For patients appealing to the court, the average de lay was 253 days. The cost of hospitalizing un treated patients while their capacity was under legal review was estimated at $3 867 000, of which $1 333 000 could have been saved if treatment had started immediately after the review board confirmed in capacity. Conclusion: We have identified extensive de lays in initiating psychiatric treatment for a number of patients. These de lays are associated with le gal re view of treatment capacity. There are seriousclinical risks and substantial costs as sociated with de lay in treating patients with acute psychiatric illness. Where juris dictions review treatment capacity, we recommend that treatment not be impeded once a re view board has con firmed a clinical finding of in capacity.
Forty Years of Deinstitutionalization of Psychiatric Services in Canada: An Empirical Assessment
Authors: Sealy Patricia , Whitehead Paul C 
Published: July 2017

Objective: To empirically analyze the implementation of the policy of deinstitutionalization of psychiatric services over a 40-year period. Method: We assessed the policy of deinstitutionalization in terms of the following components: 1) population-based psychiatric beds, days of care in psychiatric hospitals (PHs); 2) days of care in psychiatric units in general hospitals (GHs); and 3) per capita expenditures on psychiatric services. Results: There was a rapid closure of beds in PHs in the 1970s and 1980s, but this was associated with an increasing rate of days of care in psychiatric units in GHs (that is, transinstitutionalization). It was not until the 1990s that the overall days of inpatient care began to decrease. Per capita expenditures on community-based psychiatric services increased throughout this period. Conclusions: Standardized rates reveal tremendous variation among the provinces in the timing and intensity of deinstitutionalization.
Acute Day Hospitalization as an Alternative to Inpatient Treatment
Authors: Russell Vincent , Mai François , Busby Keith , Attwood David , Davis Marie , Brown Monica 
Published: July 2017

Objective: This paper describes the administrative process by which the Ottawa General Hospital (OGH) closed 6 beds and used the staff and space resources thus released to set up an acute day hospital (ADH) for the treatment of 8 acutely ill psychiatric patients. Outcome data are presented on the first 160 patients admitted to the ADH. Methods: Demographic and clinical information including diagnostic (DSM-III-R; Global Assessment of Functioning [GAF]) and questionnaire data (Symptom Checklist-90 Revised [SCL-90R]; Beck Depression Inventory [BDI]; State-Trait Anxiety Inventory [STAI]; patient satisfaction) were obtained from 160 ADH patients at admission and discharge. Forty-two of these patients provided follow-up data 3 to 6 months postdischarge. The outcome of ADH patients was compared with that of a retrospectively obtained random sample (n = 100) of inpatients on selected diagnostic and demographic variables. Results: On clinician-rated and self-report clinical scales, ADH patients showed significant clinical improvement reflected in higher GAF scores and less psychological distress, depression, and anxiety at discharge relative to admission. There were no significant group differences in outcome indices except for shorter length of stay in the ADH group compared with inpatients. The ADH group rated the program highly in help received and quality of service. Short-term follow-up showed that gains made during treatment were maintained 3 to 6 months later. Conclusions: These results show that a time-limited day hospital program is clinically effective for acutely ill psychiatric patients and leads to a more efficient use of inpatient resources. We believe that partial hospitalization for the treatment of acute psychiatric disorders may have wide application in psychiatric hospital practice.
Psychogeriatric Consultation Services: Effect and Effectiveness
Authors: Teitelbaum Louise , Cotton Dorothy , Ginsburg M Lynne , Nashed Yousery H 
Published: July 2017

Objectives: To determine the nature of referrals to a psychogeriatric consultation/outreach service, the types of interventions provided, and the effects and effectiveness of the service. Method: The study used a prospective approach in which 67 consecutive patients referred for psychogeriatric assessment were followed up 6 to 8 weeks after the initial assessment and then again 6 months after initial contact. Patients were rated at the time of referral and at follow-up on presence of psychiatric diagnosis, need for institutional care, and placement outcome. Results: Of the 67 patients initially seen, 51 (76%) experienced memory problems and 46 (69%) had depressed mood. Consistent with this finding, 36 (54%) were diagnosed by consultants as having a dementia, and 15 (22%) received a diagnosis of depression. The most frequent recommendations included medication changes in 34 cases (50%) and further assessments in 37 cases (55%). Although information at 6-week follow-up was available for only 58% (n = 38) of the sample, 18 (46%) patients were generally improved. Interestingly, only 12 (31%) of referring physicians indicated that they had followed the advice of the consultants. Cognitive impairment and depressive symptoms were major concerns among referring physicians. The most common recommendation made involved pharmacotherapy. While compliance of family doctors to recommendations made was poor, patients improved over time. Patients requiring inpatient assessment were very old, living alone, experiencing behavioural problems, and not depressed. Conclusions: Psychogeriatric consultations appear most useful in cases where patients are more severely affected and/or are suffering from a greater range of symptoms.
A Young Man with First-Episode Psychosis: Case Presentation and Discussion
Authors: Fallu Angelo , Kopala Lili , Malla Ashok , Thorpe Lilian 
Published: July 2017

Objective: To review and discuss the issues and challenges involved in the treatment of first-episode psychosis in young patients, including choice of appropriate antipsychotic agents and adjunctive medications, dosing regimens, and biopsychosocial interventions. Methods: The case of a young man in his late teens with a history of substance abuse who experienced an acute dystonic reaction to treatment for his first psychotic episode is presented and discussed. Results: Each contributing author provides an evaluation of the intervention strategies presented in the patient's history and factors that influenced the treatment outcomes. Conclusions: The successful management of young patients with psychosis must go beyond the control of positive symptoms. A comprehensive psychosocial and psychoeducational approach combined with a well-tolerated treatment regimen can help the patient achieve positive outcomes.
Correction of Implant Malposition with Capsulorrhaphy: A Retrospective Review and Implementation of Patient Survey
Authors: Haiavy Jacob , Frenzel Clayton A. 
Published: July 2017

Introduction: Aesthetic breast surgery is rapidly evolving and is now the most commonly performed cosmetic surgery; more than 311 000 breast augmentations were performed in 2009. Over the years, the average implant size has increased. It is to be expected that with the increasing number of breast augmentation procedures performed, the rate of implant malposition has increased as well. This problem can be addressed in a systematic way to restore symmetry to the breasts through a surgical procedure consisting of a capsulorrhaphy. Materials and Methods: A retrospective chart review was done from August 2004 through May 2009. All patients who had undergone revisional breast surgery involving capsulorrhaphy were included in the study. Patients were asked to complete a 2-page survey. Intraoperatively, correction of implant malposition involved medial, lateral, and/or inferior capsulorrhaphy. The technique of capsule modification will be described in detail. Results: During the period from August 2004 through May 2009, 30 patients underwent capsulorrhaphy breast surgery for implant malposition. A 2-page survey was completed by 22 of the 30 patients (73%). Average implant size for patients needing capsulorrhaphy surgery was 502.5 mL and 60% were silicone implants. The time from original breast augmentation to revisional surgery was 53.2 months (36.4 months, excluding 2 patient outliers who were >20 years out from their original breast augmentation). The most common problem was inferior or inferolateral implant malposition, which occurred 79% of the time. Bilateral malposition occurred 21% of the time. In all, 91% of patients needed narcotic pain medicine for less than a week, and 59% discontinued narcotic pain medication within 3 days. Patients were taped on average 3.14 weeks. A total of 82% of patients said they had improvement or marked improvement with their current results, and 36% stated that they currently were very symmetric. Follow-up ranged from 3 months to 62 months; mean time from capsulorrhaphy surgery to completion of the patient survey was 22.2 months. In all, 82% of patients stated that if given a choice, they would undergo revisional surgery again. Finally, when asked about overall satisfaction with their experience and results, 86% of patients stated that they were satisfied, 45% were very satisfied, and 14% of patients were unsatisfied. Conclusions: Information collected by the patient survey following our surgical technique shows that the problem of implant malposition following breast augmentation can be addressed and treated by capsulorrhaphy surgery with good aesthetic outcomes and high patient satisfaction. In addition, a recovery with little postoperative discomfort and a decreased need for narcotic pain medicine can be expected. Little information has been published on implant malposition after breast augmentation. More research needs to be dedicated to this common problem.
Immediate Single-Stage Reconstruction of the Breast Utilizing FlexHD and Implant following Skin-Sparing Mastectomy
Authors: Rosenberg Michael , Palaia David , Cahan Anthony , DeChiara Sharon , Arthur Karen , Petro Jane , DeLuca-Pytell Danielle , Spanknebel Kathryn , Magana Rafael , Bonanno Philip 
Published: July 2017

Introduction: Primary reconstruction of the breast is the standard of care for patients undergoing a mastectomy for breast cancer. Surgical techniques involving immediate implant reconstruction following skin-sparing mastectomy can offer improved patient self-image and enhanced aesthetic outcomes compared with other techniques. The use of an acellular dermal matrix (ADM) as a supporting material has been shown to further improve cosmetic results. Here, we describe a technique that allows for primary reconstruction of the breast mound with implant after a skin-sparing mastectomy in a single procedure using a new form of ADM known as FlexHD. Materials and Methods: A total of 50 patients (85 breast reconstructions) over a period of 20 months underwent immediate reconstruction with this method using a silicone gel mammary implant. The surgical approach and complications for each patient were documented. In some patients, biopsies were obtained 2 and 6 months after initial placement of FlexHD (at the time of expander replacement) for pathologic and histologic evaluations. Results: All reconstructions were completed in a single-stage procedure. The technique resulted in positive aesthetic outcomes and patient satisfaction with few complications and low postoperative pain. Infections were more frequently observed following bilateral mastectomy and in patients who had previous radiation therapy or were smokers. Fibroblast migration and neovascularization of the ADM were observed at 2 months with full incorporation into native tissue at 6 months. Conclusions: Our experience suggests that single-stage breast reconstruction with FlexHD is a preferred approach to the primary reconstruction of the breast after mastectomy.
Minimal Invasive Calf Augmentation
Authors: Blugerman Guillermo , Schavelzon Diego , Chomyszyn Anastasia , Galfrascoli Andres , D'Angelo Jorge , Markowsky Andrea , Soto Javier Augusto 
Published: July 2017

Introduction: The calf has become an important aesthetic area since the beginning of the 20th century, when women began to shorten their skirts and when there was more emphasis on the activity of bodybuilding. We believe defects of this area deserve their own classification, and suggest a classification based on defects due to loss of volume or increase of volume. The surgical technique was inspired and adapted from the fasciotomy used during the war for compartment syndrome treatment. In this case report we present our experience in using the minimal invasive vertical fasciotomy technique to treat muscular constitutional hypotrophy. Materials and Methods: The surgical technique is performed in an outpatient setting with tumescent local anesthesia. It is based on the longitudinal section, by a percutaneous approach with minimal access, of the fascia that involves the gastrocnemius muscles. Results: In our group of 82 patients, the results have been satisfactory. Complications were minimal. Results can always be improved with exercise. Conclusions: Fasciotomy at the calf is a simple procedure with minor complications and short operating time that can be done instead of using an implant.