bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Transmission of Trauma across Generations: Identification with Parental Trauma in Children of Holocaust Survivors
Authors: Rowland-Klein Dani , Dunlop Rosemary 
Published: January 2008

Objective: This study examines the phenomenology of intergenerational transmission of trauma with the aim of elucidating the interactional process of transmission within an object relations framework. Method: The method consisted of systematic textual analysis of semi-structured interviews with six Jewish women born after the war who were children of concentration camp interned Holocaust survivors. Results: Four superordinate themes were identified: heightened awareness of parents' Holocaust survivor status, parenting style, overidentification with parents' experiences and transmission of fear and mistrust. These were found despite the variation in parental communication. Conclusions: The data suggest that unconscious processes are at least partially involved in the transmission of trauma. A form of projective identification is proposed as an explanatory mechanism which brings together diverse aspects of the observed phenomena: projection by the parent of Holocaust-related feelings and anxieties into the child; introjection by the child as if she herself had experienced the concentration camps; and return of this input by the child in the form of compliant and solicitous behaviour associated with enmeshment and individuation problems. Further research may establish these phenomena as a particular form of Secondary Traumatic Stress Disorder.
Lunar Cycles and Violent Behaviour
Authors: Owen Cathy , Tarantello Concetta , Jones Michael , Tennant Christopher 
Published: January 2008

Objective: It is commonly believed that the full moon exerts an influence on violence and aggression in psychiatric settings. The literature to date is contentious. This study used a robust methodology to examine the hypothesis that there was an increased frequency of violent and aggressive behaviour among hospitalised psychiatric clients at the time of the full moon. Method: Prospective data were collected in five inpatient psychiatric settings across the Northern Sydney Area Health Service. Morrison's hierarchy of violence and aggression was used to rate behaviour. Lunar phases were clearly defined and Poisson regression used to examine relationships between lunar phase and violence. Extraneous temporal variation was considered. Results: No significant relationship was found between total violence and aggression or level of violence and aggression and any phase of the moon. Conclusion: Future research could profitably examine the implications of a belief in the lunar effect among health workers in the face of evidence that no relationship exists between violence, aggression and the lunar cycle.
The Role of SPECT Scanning in a Neuropsychiatry Unit
Authors: Velakoulis Dennis , Lloyd John H. 
Published: January 2008

Objectives: Single photon emission computerised tomography (SPECT) studies allow the assessment of cerebral blood flow and have been increasingly used as a clinical tool in neurology and neuropsychiatry. This paper examines the contribution of SPECT to the clinical management of patients with neuropsychiatric disorders, in particular patients with atypical or early onset dementia. Method: All patients admitted to an eight-bed neuropsychiatry unit in a general hospital setting who had undergone SPECT scanning over a 15–month period were reviewed. Information was collected on clinical diagnosis, neuropsychological testing, structural neuroimaging and SPECT. Results: SPECT abnormalities were present in 88% of patients. The pattern of SPECT abnormality was concordant with structural neuroimaging in 65% of patients and concordant with neuropsychological testing in 82% of patients. The sensitivity and specificity of SPECT was 89%/79% for Alzheimer's disease and 56%/79% for frontotemporal dementias. Conclusions: SPECT results must be interpreted in the context of other clinical and diagnostic assessments. In no single case was the clinical diagnosis made solely on the basis of a SPECT result. SPECT was of maximum clinical use in the diagnosis of frontotemporal dementias and in confirming the diagnosis of Alzheimer's dementia. SPECT was valuable in Lewy body dementia, vascular dementia and head injury. Its clinical utility in other psychiatric disorders remains unclear.
Psychiatry in Transition: Outcomes of Mental Health Policy Shift in Italy
Authors: Barbato Angelo 
Published: January 2008

Objective: To assess the outcomes of changes in mental health policy introduced in Italy in 1978. Methods: Data on psychiatric services, before and after the policy change, are presented. Effects of change are evaluated through indicators related to four issues: transfer of care, criminalisation of the mentally ill, suicides, and homelessness. Results: Admissions of new patients to mental hospitals have been stopped and the size of the mental hospital population is now very low (26 per 100 000 population). Psychiatric care has been shifted to community services including general hospital psychiatric units. There has been an overall reduction of psychiatric hospitalisation. However, the provision of residential facilities is inadequate and community services are unevenly distributed across the country. Few negative effects of changing patterns of care have been reported, although the low quality of data limits the validity of such a conclusion. Outcome of care in areas where the full range of community services is available has been rated as satisfactory. Conclusions: Although care of the mentally ill has been shifted to community services, we lack hard data on the social and clinical outcome of communty care at the nation-wide level. Long-term monitoring and evaluation of community services is a high priority in Italy.
From sealing wax to bone wax: predecessors to Horsley's development
Authors: Gupta Gaurav , Prestigiacomo Charles J. 
Published: January 2008

Object
Writers of neurosurgical history have traditionally maintained that the initial use of cranial bone wax for hemostasis in humans was developed and promoted by Sir Victor Horsley, the father of British neurosurgery. A thorough literature review, however, suggests that the use of bone wax for cranial bone hemostasis had its roots more than 50 years before Dr. Horsley's description in 1892. In this study the authors review the sources addressing this issue and establish due credit to the surgeons using bone wax for cranial bone hemostasis before Horsley.

Methods
Primary and secondary general surgery and neurosurgery literature from 1850 to the present was comprehensively reviewed. The key words used in the literature searchers were “bone wax,” “sealing wax,” “cranial surgery,” “Victor Horsley,” “hemostasis,” and “bone hemostasis.”

Results
Although Dr. Horsley's description in 1892 clearly delineates the necessary formula for creating a soft, malleable, nonbrittle wax that would easily promote hemostasis, the literature suggests that sealing wax was commonly used as early as 1850 for hemostasis in cranial bones. Even though there is documentation that Magendie (1783–1855) used wax to occlude venous sinuses in animals, detailed documentation of the constituents are not available. Evidence reveals that surgeons like Henri Ferdinand Dolbeau (1840–1877), professor of external pathology and the surgical clinic (1868–1872) at the Paris hospitals, used bone wax in 1864 for the extirpation of a frontal osteoma/exostoses of the frontal sinus.

Conclusions
The use of bone wax in cranial surgery was described by Henri Ferdinand Dolbeau, 50 years prior to Sir Victor Horsley's report in 1892. Nonetheless, it was Horsley who advocated and popularized its use in neurological surgery as an additional tool in the hemostatic and surgical armamentarium.
A technique for endoscopic pituitary tumor removal
Authors: Cusimano Michael D. , Fenton Ronald S. 
Published: January 2008

A number of milestones have marked the development of transsphenoidal pituitary tumor resection this century. The introduction of headlamp illumination, followed by the use of the operating microscope and fluoroscopy have allowed neurosurgeons to perform this surgery in a safe and highly effective manner.
With the aid of a case report, we describe the incorporation of endoscopic techniques in pituitary tumor resection. The technique described is minimally invasive, avoiding septal dissection and allowing unsurpassed, unobstructed, and panoramic visualization of the region of interest to the surgeon and operative team.
Quantitative, crossover, double-blind trial paradigm for patient screening for chronic intraspinal narcotic administration
Authors: Levy Robert M. 
Published: January 2008

Careful preoperative screening of candidates for indwelling drug administration systems for the relief of intractable pain can help to exclude patients who will not benefit from this technology and predict efficacy in others. Unfortunately, bias on the part of both the treating physician and the patient can inappropriately skew the results of subjective or improperly controlled trials and lead to the implantation of drug administration systems in patients who will not benefit from chronic intrathecal narcotic administration.
The author and his coworkers have designed a quantitative, crossover, double-blind paradigm for screening patients who might otherwise be deemed eligible for chronic intraspinal narcotic administration. This paradigm has been used 31 times in 30 patients; based on the outcome of this testing, 22 patients (73%) underwent implantation of chronic infusion systems. Sixteen (80%) of 20 patients with pain related to cancer underwent pump implantation, whereas only six (60%) of the 10 patients with pain of nonmalignant origin were so treated. Sixteen of the patients (72%) have reported good to excellent relief after pump implantation; this includes 12 (75%) of the 16 patients with pain related to cancer and four (66%) of the six patients with pain of nonmalignant origin.
This screening paradigm thus appears to be both reliable and easily applied and promises to be of assistance in the selection of patients appropriate for this mode of therapy.
Prediction of posterior fossa tumor type in children by means of magnetic resonance image properties, spectroscopy, and neural networks
Authors: Arle Jeffrey E. , Morriss Craig , Wang Zhiyue J. , Zimmerman Robert A. , Phillips Peter G. , Sutton Leslie N. 
Published: January 2008

Recent studies have explored characteristics of brain tumors by means of magnetic resonance spectroscopy (MRS) to increase diagnostic accuracy and improve understanding of tumor biology. In this study, a computer-based neural network was developed to combine MRS data (ratios of N-acetyl-aspartate, choline, and creatine) with 10 characteristics of tumor tissue obtained from magnetic resonance (MR) studies, as well as tumor size and the patient's age and sex, in hopes of further improving diagnostic accuracy.
Data were obtained in 33 children presenting with posterior fossa tumors. The cases were analyzed by a neuroradiologist, who then predicted the tumor type from among three categories (primitive neuroectodermal tumor, astrocytoma, or ependymoma/other) based only on the data obtained via MR imaging. These predictions were compared with those made by neural networks that had analyzed different combinations of the data. The neuroradiologist correctly predicted the tumor type in 73% of the cases, whereas four neural networks using different datasets as inputs were 58 to 95% correct. The neural network that used only the three spectroscopy ratios had the least predictive ability. With the addition of data including MR imaging characteristics, age, sex, and tumor size, the network's accuracy improved to 72%, consistent with the predictions of the neuroradiologist who was using the same information. Use of only the analog data (leaving out information obtained from MR imaging), resulted in 88% accuracy. A network that used all of the data was able to identify 95% of the tumors correctly. It is concluded that a neural network provided with imaging data, spectroscopic data, and a limited amount of clinical information can predict pediatric posterior fossa tumor type with remarkable accuracy.
Optimized magnetic resonance image-guided stereotaxis: a technique with validation based on the anterior commissure-posterior commissure line
Authors: diPierro Charles G. , Francel Paul C. , Jackson Theodore R. , Kamiryo Toshifumi , Laws Edward R. 
Published: January 2008

Some of the earliest successful frame-based stereotactic interventions directed toward the thalamus and basal ganglia depended on identifying the anterior commissure (AC) and posterior commissure (PC) in a sagittal venticulogram and defining the intercommissural line that connects them in the midsagittal plane. The AC-PC line became the essential landmark for the localization of neuroanatomical targets in the basal ganglia and diencephalon and for relating them to stereotactic atlases.
Stereotactic functional neurosurgery has come to rely increasingly on magnetic resonance (MR) imaging guidance, and methods for accurately determining the AC-PC line on MR imaging are being developed. Our technique uses MR sequences that minimize geometric distortion and registration error, thereby maximizing accuracy in AC-PC line determinations from axially displayed MR data. The techniques are based on our experience with the Leksell G-frame, but can be generalized to other MR imaging-based stereotactic systems.
This methodology has been used in a series of 62 stereotactic procedures in 47 adults (55 pallidotomies and seven thalamotomies) with preliminary results equivalent or superior to results reported using microelectrode recordings. The measurements of the AC-PC line reported here compare favorably with those based on ventriculography and computerized tomography previously reported. The methodology reported here is critical in maintaining the accuracy and utility of MR imaging as its role in modern stereotaxy expands. Accurate parameters such as these aid in ensuring the safety, efficacy, and reproducibility of MR-guided stereotactic procedures.
Characterization of cerebral hemodynamic phases following severe head trauma: hypoperfusion, hyperemia, and vasospasm
Authors: Martin Neil A. , Patwardhan Ravish V. , Alexander Michael J. , Africk Cynthia Zane , Lee Jae Hong , Shalmon Ehud , Hovda David A. , Becker Donald P. 
Published: January 2008

The extent and timing of posttraumatic cerebral hemodynamic disturbances have significant implications for the monitoring and treatment of patients with head injury. This prospective study of cerebral blood flow (CBF) (measured using 133Xe clearance) and transcranial Doppler (TCD) measurements in 125 patients with severe head trauma has defined three distinct hemodynamic phases during the first 2 weeks after injury. The phases are further characterized by measurements of cerebral arteriovenous oxygen difference (AVDO2) and cerebral metabolic rate of oxygen (CMRO2). Phase I (hypoperfusion phase) occurs on the day of injury (Day 0) and is defined by a low CBF15 calculated from cerebral clearance curves integrated to 15 minutes (mean CBF15 32.3 ± 2 ml/100 g/minute), normal middle cerebral artery (MCA) velocity (mean VMCA 56.7 ± 2.9 cm/second), normal hemispheric index (mean HI 1.67 ± 0.11), and normal AVDO2 (mean AVDO2 5.4 ± 0.5 vol%). The CMRO2 is approximately 50% of normal (mean CMRO2 1.77 ± 0.18 ml/100 g/minute) during this phase and remains depressed during the second and third phases. In Phase II (hyperemia phase, Days 1-3), CBF increases (46.8 ± 3 ml/100 g/minute), AVDO2 falls (3.8 ± 0.1 vol%), VMCA velocity rises (86 ± 3.7 cm/second), and the HI remains less than 3 (2.41 ± 0.1). In Phase III (vasospasm phase, Days 4-15), there is a fall in CBF (35.7 ± 3.8 ml/100 g/minute), a further increase in VMCA (96.7 ± 6.3 cm/second), and a pronounced rise in the HI (2.87 ± 0.22).
This is the first study in which CBF, metabolic, and TCD measurements are combined to define the characteristics and time courses of, and to suggest etiological factors for, the distinct cerebral hemodynamic phases that occur after severe craniocerebral trauma. This research is consistent with and builds on the findings of previous investigations and may provide a useful temporal framework for the organization of existing knowledge regarding posttraumatic cerebrovascular and metabolic pathophysiology.
Intravenous insulin-like growth factor-I (IGF-I) in moderate-to-severe head injury: a Phase II safety and efficacy trial
Authors: Hatton Jimmi , Rapp Robert P. , Kudsk Kenneth A. , Brown Rex O. , Luer Mark S. , Bukar Julie G. , Chen Sharon A. , McClain Craig J. , Gesundheit Neil , Dempsey Robert J. , Young Byron 
Published: January 2008

The purpose of this study was to determine the effect of insulin-like growth factor-I (IGF-I) on the catabolic state and clinical outcome of head-injured patients. Thirty-three patients between the ages of 18 and 59 years with isolated traumatic head injury and Glasgow Coma Scale (GCS) scores of 4 to 10 were randomized to one of two groups. All patients received standard neurosurgical intensive care plus aggressive nutritional support; the patients in the treatment group also received intravenous therapy with continuous IGF-I (0.01 mg/kg/hour).
During the 14-day dosing period, the control patients lost weight, whereas treated patients gained weight despite a significantly higher measured energy expenditure and lower caloric intake (p = 0.02). Daily glucose concentrations and nitrogen outputs were greater in control patients (p = 0.03) throughout the study period. During Week 1, only treated patients achieved positive nitrogen balance. Fifteen of 17 treated and 13 of 16 control patients survived the 1st week. No deaths occurred in patients whose serum IGF-I concentrations were higher than 350 ng/ml. Dichotomized Glasgow Outcome Scale scores for patients with baseline GCS scores of 5 to 7 improved from poor to good for eight of 12 treated patients but for only three of 11 control patients (p = 0.06). Eight of 11 treated patients with serum IGF-I concentrations that were at least 350 ng/ml achieved moderate-to-good outcome scores at 6 months, compared to only one of five patients with lower concentrations (p < 0.05). These findings indicate that pharmacological concentrations of IGF-I may improve clinical outcome and nitrogen utilization in patients with moderate-to-severe head injury.
The anatomy of the Berrettini branch: implications for endoscopic carpal tunnel release
Authors: Kolic Zlatko , Micovic Vladimir , Zamolo Gordana , Golubovic Vesna , Uravic Miljenko , Stancic Marin F. 
Published: January 2008

Hand dissections were performed in 100 fresh cadaver palms to determine the frequency with which superficial palmar communication between the median and ulnar nerves occurs and to what extent it might incur iatrogenic injury during endoscopic carpal tunnel release.
Superficial palmar communication between the median and ulnar nerves was present in 81% of the dissected hands. Superficial palmar communication, also known as the Berrettini branch, has been classified into four distinct types by Ferrari and Gilbert. Thirty hands were classified as Group 1 (communication in an oblique course from the ulnar to the median nerve), 16 hands were classified as Group 2 (communication parallel to the distal margin of the transverse carpal ligament), and 35 hands were classified as Group 3 (communication in an oblique course from the ulnar nerve to the third common digital nerve, originating below the distal margin of the transverse carpal ligament). No hand fit the Group 4 classification (atypical communication).
These findings led the authors to conclude that changing the course of an incision in the distal part of the carpal ligament radially from the ulnar side a few millimeters is strongly recommended. Sensory branch iatrogenic injury can be avoided by using this technical alteration, in light of the fact that superficial palmar communication between the median and ulnar nerves may be the more likely anatomical finding.
The transfacet pedicle-sparing approach for thoracic disc removal: cadaveric morphometric analysis and preliminary clinical experience
Authors: Stillerman Charles B. , Chen Thomas C. , Day J. Diaz , Couldwell William T. , Weiss Martin H. 
Published: January 2008

A number of operative techniques have been described for the treatment of herniated thoracic discs. The transfacet pedicle-sparing approach allows for complete disc removal with limited spinal column disruption and soft-tissue dissection. Fifteen cadaveric spinal columns were used for evaluation of exposure, development of thoracic microdiscectomy instrumentation, and establishment of morphometric measurements. This approach was used to remove eight thoracic discs in six patients. Levels of herniation ranged from T-7 through T-11. Preoperatively, all patients had moderate to severe axial pain, and three (50%) of the six had radicular pain. Myelopathy was present in four (67%) of the six patients. Through a 4-cm opening, the ipsilateral paraspinal muscles were reflected, and a partial facetectomy was performed. The disc was then removed using specially designed microscopic instrumentation. Postoperatively, the radiculopathy resolved in all patients. Axial pain and myelopathy were completely resolved or significantly improved in all patients.
The minimal amount of bone resection and muscle dissection involved in the operation allows for: 1) decreased operative time and blood loss; 2) diminished perioperative pain; 3) shorter hospitalization time and faster return to premorbid activity; 4) avoidance of closed chest tube drainage; and 5) preservation of the integrity of the facet-pedicle complex, with potential for improvement in outcome related to axial pain. This technique appears best suited for the removal of all centrolateral discs, although it has been used successfully for treating a disc occupying nearly the entire ventral canal. The initial experience suggests that this approach may be used to safely remove appropriately selected thoracic disc herniations with good results.
Efficacy of pedicle screw fixation in the treatment of spinal instability and failed back surgery: a 5-year review
Authors: Masferrer Roberto , Gomez Carlos H. , Karahalios Dean G. , Sonntag Volker K. H. 
Published: January 2008

Object
The goal of this study was to review retrospectively the outcome of 95 patients with various disorders leading to instability of the thoracolumbar and lumbar spine who were treated consecutively via a posterior surgical approach with pedicle screw fixation in which the Texas Scottish Rite Hospital system was used.

Methods
All cases were managed according to the same protocol. Follow-up review averaged 29.6 months. Radiographic evidence of osseous union and the patient's current status were analyzed. Four screws were malpositioned, and there were two dural lacerations of a nerve root and one pedicle fracture. Deep wound infections developed in five patients (5.2%) and three patients had postoperative radicular pain. In one case, the rods disengaged from the screws; in four cases, hardware was removed but there were no broken screws. Neurological deficits improved in 85% of the patients and no patient was worse neurologically after surgery. The rate of osseous union was 96.8%. Three patients developed pseudarthrosis, one of whom was asymptomatic. Back pain improved in 80 patients (85%). A solid bone fusion, however, was not necessarily associated with decreased back pain.

Conclusions
These results support the use of pedicle screw fixation as an effective and safe procedure for fusion of the thoracolumbar and lumbar spine and support the finding that complications can be minimal when a meticulous surgical technique is used. The proper selection of patients for surgery is probably the most important factor associated with good outcomes.