bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘We got the whole story all at once’: physiotherapists’ use of key questions when meeting patients with long‐standing pain
Authors: Afrell Maria , Rudebeck Carl Edvard 
Published: December 2009

Scand J Caring Sci; 2010; 24; 281–289

‘We got the whole story all at once’: physiotherapists’ use of key questions when meeting patients with long‐standing pain Long‐standing musculoskeletal pain has many dimensions. Physiotherapy lacks a tested method of dialogue with which physiotherapists and patients can together explore pain in all its complexity. The present aim was to find out how physiotherapists experienced the influence of systematically prepared key questioning on their relation to, and understanding of, patients with long‐standing pain. A group of six physiotherapists with long experience of pain rehabilitation used such questions in their encounters with their patients. Two periods of work with the questions were followed by discussions in which the physiotherapists shared their experience in a joint focus group. Verbatim transcripts of the discussions constitute the data of the study. A phenomenographic method was used for the analysis. The responses to the key questions gave the physiotherapists an insight into the patient as a person. The questions started a process of change in the patient, and changed the physiotherapist’s relation to her or him. The patient expressed feelings and experience, and this also seemed to encourage a change in chosen coping strategies. This new content of the interaction challenged the physiotherapist’s role, thus raising questions about her professional mandate.
Involvement of Pro‐Nociceptive 5‐HT2A Receptor in the Pathogenesis of Medication‐Overuse Headache
Authors: Supornsilpchai Weera , Le Grand Supang M. , Srikiatkhachorn Anan 
Published: December 2009

(Headache 2010;50:185‐197)Objectives.— To determine the involvement of 5‐HT2A (5‐HT2A) receptor in the process of trigeminal plasticity induced by chronic analgesic exposure and in the process of inflammatory‐induced thermal hyperalgesia.Background.— Derangement in 5‐HT2A serotonin receptor has been reported to implicate in pathogenesis of medication‐overuse headache. No clear explanation concerning the precise roles of these receptors in the process.Methods.— Wistar rats were daily administered with paracetamol (200 mg/kg) for 30 days. On the next day, ketanserin, a 5‐HT2A antagonist, or saline was given prior to cortical spreading depression (CSD) induction. Electrocorticogram, cortical blood flow, Fos and 5‐HT2A‐immunoreactivity in cortex and trigeminal pathway were studied. In the other experiment, complete Freund's adjuvant was injected into the rat hind paw to induce tissue inflammation. Three days later, ketanserin was given and noxious heat was applied to both inflamed and noninflamed paws. The response between 2 sides was compared by measuring paw withdrawal latency.Results.— Chronic paracetamol exposure led to an increase in CSD frequency and CSD‐evoked Fos expression in cerebral cortex indicating the increase in neuronal excitability. Prolonged medication exposure also facilitated trigeminal nociception as evident by an increase in CSD‐evoked Fos expression in trigeminal nucleus caudalis. The expression of 5‐HT2A receptor in cerebral cortex and trigeminal ganglia was enhanced by chronic paracetamol administration. Pretreatment with ketanserin significantly attenuated these effects. The second experiment showed that ketanserin was able to lengthen the paw withdrawal latency in the inflamed side but did not alter nociceptive response in the noninflamed side.Conclusion.— These findings suggest that up‐regulation of pro‐nociceptive 5‐HT2A receptor is an important step in the process of cortical hyper‐excitation and nociceptive facilitation induced by chronic analgesic exposure.
Medication‐Overuse Headache and Personality: A Controlled Study by Means of the MMPI‐2
Authors: Sances Grazia , Galli Federica , Anastasi Serena , Ghiotto Natascia , De Giorgio Giuseppina , Guidetti Vincenzo , Firenze Caterina , Pazzi Stefania , Quartesan Roberto , Gallucci Marcello , Nappi Giuseppe 
Published: December 2009

(Headache 2010;50:198‐209)Objective.— The main aim of this study involves comparing the personality profiles of patients with medication‐overuse headache (MOH) and episodic headaches, in order to elucidate the role of personality characteristics, according to one of the most widely used and validated personality assessment tool: Minnesota Multiphasic Personality Inventory (MMPI‐2).Background.— Many studies have assessed the personality of headache patients by means of MMPI‐2 only using clinical and content scales. In this study the supplementary scales were also used as they evaluate different aspects of personality, particularly broad personality characteristics, generalized emotional distress and behavioral dyscontrol.Methods.— We recruited 219 subjects (151 women and 68 men) who were grouped in the following categories: MOH group (n = 82); episodic headache group (n = 82; 58 migraine aura; 6 migraine with aura; 6 frequent episodic tension‐type headache; 12 migraine+infrequent episodic tension‐type headache) and 1 group of 55 healthy controls. MMPI‐2 was employed. Data were computed with one‐way anova and post hoc analyses.Results.— Medication‐overuse headache and episodic headache patients (EH) showed a very similar pattern, differentiating each other only in the Hypochondriasis (Hs) (P = .007; MOH: mean 14.18 [SD 5.53]; EH: mean 11.93 [SD 5.88] and Health Concerns [HEA]) (P = .005; MOH: mean 14.06 [SD 5.38]; EH: mean 11.81 [SD 5.59]) scales. Surprisingly, no differences were found between the 3 groups in the scales measuring dependence‐related behavior such as Addiction Potential Scale (Aps) and Addiction Admission Scale (Aas). MOH and episodic headache patients scored significantly higher in the so‐called neurotic scales Hs (P < .0001; MOH: mean 14.18 [SD 5.53]; EH: mean 11.93 [SD 5.88]; Controls: mean 5.91 [SD 3.57]), Depression (D) (P < .0001; MOH: mean 26.44 [SD 7.01]; EH: mean 26.09 [SD 5.85]; Controls: mean 21.47 [SD 4.90]), and Hysteria (Hy) (P < .0001; MOH: mean 27.33 [SD 5.51]; EH: mean 26.81 [SD 5.68]; Controls: mean 21.95 [3.85]) and in many other scales such as Paranoia (Pa), Psychasthenia (Pt), Schizophrenia (Sc) while they scored significantly lower on Ego Strength (Es) and Dominance (Do) scales when compared with controls.Conclusions.— Patients with MOH and episodic headache showed very similar patterns, differentiating only in the Hypochondriasis and Health Concerns scales. Surprisingly, there were no significant differences in the scores of the scales measuring dependence‐related behavior. The clinical role of MMPI‐2 in discriminating MOH patients with dependency from drugs is discussed, in order to implement a complete tests' battery for headache patients' assessment.
Triptan Use as a Function of Cardiovascular Risk. A Population‐Based Study
Authors: Bigal Marcelo E. , Golden Wendy , Buse Dawn , Chen Ya‐Ting , Lipton Richard B. 
Published: December 2009

(Headache 2010;50:256‐263)Aim.— To estimate the proportion of individuals with migraine using triptan therapy as a function of their cardiovascular (CV) profile and disease severity.Methods.— As a part of the American Migraine Prevalence and Prevention study, we identified migraineurs representative of the U.S. adult population. Triptan use was estimated as a function of presence of CV disease (CVD), of CV risk factors, and by level of migraine‐related disability.Results.— Our sample consists of 6102 individuals with migraine. Compared with migraineurs without risk factors for CVD, triptans were significantly less likely to be used in individuals with diabetes (11.5% vs 18.3%, OR = 0.6, 95% CI = 0.5‐0.7), hypertension (14.8%, OR = 0.8, 0.7‐0.9) and by smokers (12.9%, OR = 0.7, 0.6‐0.8). Similar findings were seen for individuals with established CVD. As contrasted to individuals without CVD, those with myocardial infarct (8.5% vs 18.5%, OR = 0.4, 0.3‐0.7), stroke (7%, OR = 0.6, 0.3‐0.9) and heart surgery (9.3%, OR = 0.5, 0.4‐0.7) were less likely to use triptans. Use of triptan increased as a function of disability regardless of CVD status or presence of CV risk factors.Conclusion.— Triptan use is lower in those with vs without CV risk, suggesting that doctors and/or patients fear using triptans in individuals at risk to CVD. Furthermore, triptan use in those with established CVD increases with headache‐related disability, suggesting that patients and providers balance risks and benefits. Additional and analytical data are needed on the safety of triptans in the setting of CVD risk. This study has not assessed adequacy of care.
Effect of Surface Conditioning and Taper Angle on the Retention of IPS e.max Press Crowns
Authors: Madina Manal M. A. , Özcan Mutlu , Badawi Manal F. 
Published: December 2009

Abstract Purpose: The objective of this study was to evaluate the retentive strength of single‐unit crowns with 10° and 26° taper angles cemented using two surface conditioning methods. Materials and Methods: Thirty‐two freshly extracted sound human molars were divided into two groups (n = 16) and prepared in a standardized manner with 10° and 26° taper angles. All‐ceramic (IPS e.max Press) single crowns were fabricated for the prepared teeth. The crowns were then subdivided into two groups (n = 8), according to type of surface conditioning for the intaglio surfaces. Half the groups were HF acid etched and silanized, and the other half were conditioned with tribochemical silica coating and silanization. The crowns were cemented using adhesive cement (Panavia F 2.0). Retentive strength was measured in a universal testing machine. Results: No significant difference was found between the mean retention forces for both 10° and 26° taper angles when the crowns were conditioned either with silica coating (613 ± 190 N and 525 ± 90 N, respectively), or with hydrofluoric (HF) acid etching and silanization (550 ± 110 N and 490 ± 130 N for 10° and 26°, respectively) (p= 0.32). Conclusion: Neither the surface conditioning type, nor the taper angle affected the retentive strength of IPS e.max Press single‐unit crowns when cemented adhesively. Since silica coating and silanization did not show significant differences from HF acid gel and silanization, the former can be preferred for conditioning intaglio surfaces of glass ceramic crowns to avoid the use of the hazardous compound HF acid gel chairside.
Intraprocedural Use of Ibutilide to Organize and Guide Ablation of Complex Fractionated Atrial Electrograms: Preliminary Assessment of a Modified Step‐Wise Approach to Ablation of Persistent Atrial Fibrillation
Authors: SINGH SHELDON M. , D’AVILA ANDRE , KIM STEVEN J. , HOUGHTALING CHRISTOPHER , DUKKIPATI SRINIVAS R. , REDDY VIVEK Y. 
Published: December 2009

Ibutilide Guided CFAE Ablation. Introduction: While able to achieve clinical success, the current step‐wise approach to persistent atrial fibrillation (AF) ablation requires considerable “substrate” ablation and frequently mandates multiple procedures to address consequent atrial tachycardias (ATs). An alternative strategy minimizing the amount of ablation while maintaining clinical success would be desirable. We hypothesize that intraprocedural administration of a low‐dose antiarrhythmic drug (AAD) during AF will organize areas of passive activation and not affect areas critical to AF maintenance, thereby potentially minimizing the ablation lesion set.
Methods and Results:
Eleven patients (age = 55 ± 6 years; LA = 48 ± 15 mm; median AF duration = 3 years) with persistent AF undergoing catheter ablation were enrolled in this exploratory prospective observational study. After pulmonary vein (PV) isolation, a mean cycle length (mCL) map was created and areas with mCL <120 ms were considered to represent complex fractionated atrial electrograms (CFAE). Ibutilide (0.25–1.0 mg) was then administered and a second mCL map created. Ablation lesions were placed at CAFE sites identified after ibutilide administration. Activation and/or entrainment mapping was employed to address ATs. The endpoint of ablation was achieving sinus rhythm. The average LA mCL increased (146 vs 165 ms, P = 0.01) and the LA CFAE surface area decreased after ibutilide administration. Additional ablation organized AF to either sinus rhythm or AT in 10/11 (91%) patients. After a median follow up of 455 days, 8 of 11 (72%) patients were free from AF. Three patients underwent a repeat ablation procedure (average 1.27 ablations/patient).
Conclusions:
Ibutilide administration may organize atrial activity and facilitate AF termination during ablation while minimizing the ablation lesion set. (J Cardiovasc Electrophysiol, Vol. 21, pp. 608‐616, June 2010)
On the Use of CartoSound for Left Atrial Navigation
Authors: SCHWARTZMAN DAVID , ZHONG HUA 
Published: December 2009

On the Use of CartoSound for Left Atrial Navigation. Introduction: The utility of “virtual” imaging systems for left atrial (LA) navigation has been hampered by inadequate spatial detail, as well as inaccurate integration of more detailed preoperative images, such as those generated by computed tomography (CT). CartoSound is an intracardiac echocardiography (ICE)‐based technology that promises to ameliorate these problems. Our objective was to examine the capabilities and optimal use of CartoSound, both as a stand‐alone tool and as a facilitator of CT image integration.
Methods and Results:
In 10 patients, CartoSound models of the LA were generated using each of 4 ICE transducer locations: LA, right atrium (RA), coronary sinus (CS), and esophagus (ESO). Each of these models was used to register CT‐derived LA models into the operative workspace. We correlated the comprehensiveness of LA imaging from each transducer location with the quality of the CT registration, as well as the accuracy of mock circumferential antral ablation guided by the CartoSound model alone or by the CT model. The LA transducer location provided the most comprehensive rendering of the LA, which was associated with higher quality CT registration and greater CT‐guided mock ablation accuracy. Mock ablation guided by the CartoSound model alone was at least as accurate as CT, although the models were less intuitive.
Conclusions:
For LA navigation, optimal use of CartoSound may require LA transducer location, which is effective for stand‐alone use and as a facilitator of CT image integration. (J Cardiovasc Electrophysiol, Vol. 21, pp. 656‐664, June 2010)
Significance of Periodontal Risk Assessment in the recurrence of periodontitis and tooth loss
Authors: Matuliene G. , Studer R. , Lang N. P. , Schmidlin K. , Pjetursson B. E. , Salvi G. E. , Brägger U. , Zwahlen M. 
Published: December 2009

Matuliene G, Studer R, Lang NP, Schmidlin K, Pjetursson BE, Salvi GE, Brägger U, Zwahlen M. Significance of Periodontal Risk Assessment on the recurrence of periodontitis and tooth loss. J Clin Periodontol 2010; 37: 191–199. doi: 10.1111/j.1600‐051X.2009.01508.x.AbstractAim: To investigate the association of the Periodontal Risk Assessment (PRA) model categories with periodontitis recurrence and tooth loss during supportive periodontal therapy (SPT) and to explore the role of patient compliance.Material and Methods: In a retrospective cohort, PRA was performed for 160 patients after active periodontal therapy (APT) and after 9.5 ± 4.5 years of SPT. The recurrence of periodontitis and tooth loss were analysed according to the patient's risk profile (low, moderate or high) after APT and compliance with SPT. The association of risk factors with tooth loss and recurrence of periodontitis was investigated using logistic regression analysis.Results: In 18.2% of patients with a low‐risk profile, in 42.2% of patients with a moderate‐risk profile and in 49.2% of patients with a high‐risk profile after APT, periodontitis recurred. During SPT, 1.61 ± 2.8 teeth/patient were lost. High‐risk profile patients lost significantly more teeth (2.59 ± 3.9) than patients with moderate‐ (1.02 ± 1.8) or low‐risk profiles (1.18 ± 1.9) (Kruskal–Wallis test, p=0.0229). Patients with erratic compliance lost significantly (Kruskal–Wallis test, p=0.0067) more teeth (3.11 ± 4.5) than patients compliant with SPT (1.07 ± 1.6).Conclusions: In multivariate logistic regression analysis, a high‐risk patient profile according to the PRA model at the end of APT was associated with recurrence of periodontitis. Another significant factor for recurrence of periodontitis was an SPT duration of more than 10 years.
ORIGINAL ARTICLE: Can Sulfasalazine Prevent Infection‐Mediated Pre‐Term Birth in a Murine Model?
Authors: Nath Carl A. , Ananth Cande V. , Smulian John C. , Peltier Morgan R. 
Published: December 2009

Citation Nath CA, Ananth CV, Smulian JC, Peltier MR. Can sulfasalazine prevent infection‐mediated pre‐term birth in a murine model? Am J Reprod Immunol 2010; 63: 144–149Problem  Sulfasalazine (SASP) blocks activation of nuclear factor‐kappa B (NF‐κB) in gestational tissues in vitro– one of the earliest signals in the inflammatory response. We hypothesized that the administration of SASP would reduce the rate of infection‐mediated pre‐term birth in a murine model.Method of study  CD‐1 mice (n = 40) were assigned on gestational day (gd) 14.5 to 1 of 3 treatments: (1) Sham infection and vehicle; (2) 104 CFU Escherichia coli and vehicle; or (3) 104 CFU E. coli and SASP (150 mg/Kg daily). Mice were observed twice daily and deliveries prior to gd 18.5 were considered pre‐term.Results  Significantly more mice delivered prior to gd 18.5 when infected with 104 CFU E. coli than sham‐infected mice (P < 0.001) and this effect was significantly reduced in mice also treated with SASP (P = 0.002). SASP also tended to increase litter size (P = 0.060) and significantly increased weight of pups born to dams with intrauterine infections (P = 0.001).Conclusion  SASP reduced rates of pre‐term delivery and improved pregnancy outcomes for mice infected with 104 CFU E. coli. This suggests that SASP has the potential to play a role in strategies to prevent pre‐term birth in women.
Between the National and the Global: Exploring Tensions in Canadian Citizenship Education
Authors: Richardson George H. , Abbott Laurence 
Published: December 2009

AbstractOver the last fifteen years, most national public education systems have added some component of ‘global citizenship education’ to their existing civic education curricula. This move to expand the confines of citizenship education has generally been applauded as a way in which schools might better prepare students to understand and address the challenges and possibilities of globalisation. However, a close analysis of curriculum documents in Canada tends to highlight the fact that in terms of civic education, significant ideological tensions exist between global citizenship and national citizenship. In this article, we draw on Canadian civics and social studies curricula from across Canada to examine the different sources of civic tensions between the ‘national’ and the ‘global’.
Britishness in Trafalgar Square: Urban Place and the Construction of National Identity
Authors: Sumartojo Shanti 
Published: December 2009

AbstractThis article argues for the importance of urban public place in exploring how contemporary national identity is constructed. I take Trafalgar Square as my case study, exploring how Britishness was reinvented in two events that took place there in 2005: the celebrations for London's successful Olympic host city bid and the commemorative vigil for the victims of the 7 July London bombings. I contend that during these events, Trafalgar Square contributed to the discourse of national identity in three distinct ways: firstly, as a podium for the promulgation of official messages about the two events; secondly, as a tableau that demonstrated the ‘diversity in unity’ that official messages emphasised; and finally as a physical frame that accessed a version of British history to contextualise the events. More generally, the use of the square helped illuminate some important tensions at the heart of contemporary national identity in Britain, such as the question of multiculturalism and the role of London in the national imagination.
Immunophenotypic distinction between pigmented villonodular synovitis and haemosiderotic synovitis
Authors: Mahendra G , Kliskey K , Athanasou N A 
Published: December 2009

Aim:Haemosiderotic synovitis (HS) is caused by excessive bleeding into a joint. It occurs secondary to a variety of conditions and needs to be distinguished from pigmented villonodular synovitis (PVNS) for the purposes of treatment. The histopathological distinction between these conditions, particularly in biopsy specimens, can be problematic.Methods:Immunophenotypic findings in 20 cases of PVNS and 20 cases of HS were analysed using monoclonal antibodies against proliferation (Ki-67), apoptosis (bcl2), macrophage (CD14, CD68, HLA-DR) and osteoclast (CD51) antigens.Results:Macrophages in PVNS and HS expressed CD14 and HLA-DR. The giant cells in PVNS, but not those in HS, expressed CD51 and were negative for CD14 and HLA-DR, indicating that these cells had an osteoclast phenotype. Considerably more CD51-expressing mononuclear cells were noted in PVNS compared with HS. The Ki-67 proliferation index was higher in PVNS than in HS.Conclusions:The findings indicate that there are immunophenotypic differences in giant cells between PVNS and HS, and that expression of CD51 and a high Ki-67 index effectively distinguishes between these two conditions.
Ascribing intentions in clinical decision-making
Authors: Jansen L A , Fogel J S 
Published: December 2009

Background:The intentions of clinicians are widely considered to be relevant to the ethical assessment of their actions. A better understanding of the psychological factors that influence the ascription of intentions in clinical practice is important for improving the self-understanding of clinical decision-making and, ultimately, the ethics of clinical care. Drawing on empirical research on intentionality that has been done in other contexts, this is the first study to test whether the “asymmetric effect” of intention ascription is exhibited by respondents when presented with clinical decision-making scenarios.Objective:To assess how individuals attribute intentions to clinical actors in clinical decision-making scenarios.Methods:A total of 149 first and second year medical students was randomly assigned to two groups (group A, group B). Subjects in each group read two scenarios and submitted anonymous responses to questions regarding each scenario.Results:The asymmetric effect was strongly exhibited by the responses given to scenario 2, but it was not exhibited by the responses given to scenario 1.Conclusion:The present study provided evidence for the view that people’s ascription of intentions to others is influenced by their previous evaluative judgement of the conduct in question.