bluuebunny/crossref_metadata_2025_split huggingface dataset:
Venlafaxine and paroxetine in treatment-resistant depression
Authors: Poirier M.-F. , Boyer P. 
Published: October 2008

BackgroundAbout one-third of patients fail to respond to initial antidepressant therapy, which suggests a need for more effective drugs.AimsTo compare the efficacy and safety of venlafaxine and paroxetine in 122 patients with non-chronic treatment-resistant depression.MethodIn-patients or out-patients satisfying DSM – III – R criteria for major depression in evolution for less than eight months, having a baseline HAM–D score 18 and a HAM – D Item 3 score < 3 were eligible. Patients were required to have a history of resistance to two previous antidepressant treatments and a CGI improvement score of 3 at the beginning of treatment. Doses were adjusted to 200–300 mg/day for venlafaxine and 30–40 mg/day for paroxetine.ResultsFor the observed-case analysis, the response rate was 51.9% for venlafaxine and 32.7% for paroxetine (P=0.044), and a remission was achieved in 42.3% of venlafaxine-treated and 20.0% of paroxetine-treated patients (P=0.01). The incidence of adverse effects was comparable between treatment groups.ConclusionsVenlafaxine showed some evidence of superiority to paroxetine in this difficult-to-treat patient population.
Reducedin vivobinding to the serotonin transporter in the cerebral cortex of MDMA (‘ecstasy’) users
Authors: Semple David M. , Ebmeier Klaus P. , Glabus Michael F. , O'Carroll Ronan E. , Johnstone Eve C. 
Published: October 2008

BackgroundThe use of MDMA (‘ecstasy’) is common among young people in Western countries. Animal models of MDMA toxicity suggest a loss of serotonergic neurons, and potentially implicate it in the development of significant psychiatric morbidity in humans.AimsTo test whether long-term use of MDMA can produce abnormalities in cerebral serotonin, but not dopamine, transporter binding measured by single photon emission computed tomography (SPECT)MethodTen male regular ecstasy users and 10 well-matched controls recruited from the same community sources participated in SPECT with the serotonin transporter (SEPT) ligand [123I]-CIT. Dopamine transporter binding was determined from scans acquired 23 hours after injection of the tracer.ResultsEcstasy users showed a cortical reduction of SERT binding, particularly prominent in primary sensory-motor cortex, with normal dopamine transporter binding in lenticular nuclei.ConclusionsThis cross-sectional association study provides suggestive evidence for specific, at least temporary, serotonergic neurotoxicity of MDMA in humans.
Psychological autopsy study of suicides by people aged under 35
Authors: Appleby Louis , Cooper Jayne , Amos Tim , Faragher Brian 
Published: October 2008

BackgroundIn the past two decades the suicide rate in young people has risen in the UK and other countries.AimsTo identify the characteristics of people aged under 35 who commit suicide.MethodPsychological autopsy study with case–control design. Cases were 84 suicides and probable suicides (open verdicts). Controls were 64 age- and gender-matched non-suicides obtained through the general practices of the matched cases. Main variables: social, including employment status, marital status and living circumstances; life events and interpersonal difficulties; clinical, including current psychiatric disorder, alcohol and drug misuse, previous self-harm and personality disorder.ResultsA large number of highly significant social, interpersonal and clinical differences between suicides and controls was found. Factor analysis identified two groups of variables within each of the social, interpersonal and clinical domains which were independently linked to suicide, corresponding to: acute, severe mental disorder and chronic disorder of behaviour; rootlessness and social withdrawal; chronic and recent interpersonal problems.ConclusionsA broad prevention strategy is needed to reverse the recent rise in the suicide rate in young people.
Route of discharge for special (high-security) hospital patients with personality disorder
Authors: Davison Sophie , Jamieson Elizabeth , Taylor Pamela J. 
Published: October 2008

BackgroundA considerable proportion of patients with personality disorder are discharged directly to the community from special (high-security) hospitals.AimsTo examine whether patients with personality disorder discharged directly to the community are more likely to be re-convicted than those transferred to psychiatric hospitals of lesser security.MethodRe-conviction data for a f ive-to nine-year follow-up were collected for a four-year (1988–1991) special hospital discharge cohort of patients with personality disorder.ResultsIndividuals discharged directly to the community were not significantly more likely to be re-convicted than those transferred to less secure psychiatric hospitals. However, patients discharged to the community without formal conditions of supervision were more likely to be re-convicted than those discharged to the community with conditions or those transferred to other psychiatric hospitals.ConclusionsFormal supervision after discharge may be more important than actual destination in influencing the likelihood of re-conviction.
Suicide in young people
Authors: Hawtdn Keith , Houston Kelly , Shepperd Rosie 
Published: October 2008

BackgroundSuicide rates in youngmales in the UK have risen markedly in recent years.AimsTo investigate the characteristics of a series of consecutive suicides in under-25-year-olds.MethodWe studied coroners' inquest notes, general practitioners' records and psychiatric case notes of 174 individuals (148 males and 26 females) whose deaths received a verdict of suicide or an open or accidental verdict (excluding traffic accidents) where the circumstances strongly suggested suicide.ResultsMore individuals were of lower social class and unemployed than in the local population. Hanging and carbon monoxide poisoning were the most frequent methods of suicide, and co-proxamol was the drug most often used in overdoses. Previous self-harm had occurred in 44.8%, nearly half of these having carried out multiple episodes and 80% having self-harmed within the previous year. Little support was found for an earlier finding of increasing frequency of general practitioner visits shortly before death. Only 22.4% of individuals were in the care of psychiatric services.ConclusionsDiverse strategies are required to prevent suicide in the very young.
A Jamaican psychiatrist evaluates diagnoses at a London psychiatric hospital
Authors: Hickling F. W. , McKenzie K. , Mullen R. , Murray R. 
Published: October 2008

BackgroundAuthors have suggested that the high rate of schizophrenia reported for African–Caribbeans living in the UK is due to misdiagnosis by British psychiatrists.AimsTo compare the diagnoses made by a Black Jamaican psychiatrist with those of White British psychiatrists.MethodAll in-patients on four wards at the Maudsley hospital were approached for the study; 66 participated: 24 White, 29 Black African–Caribbeans and 13 Blacks from other countries of origin. F. W. H., a Black Jamaican psychiatrist, conducted his standard clinical assessment and performed the Present State Examination (PSE) on these patients. His diagnoses were compared with the case note diagnoses made by British psychiatrists, and with the PSE CATEGO diagnoses.ResultsOf 29 African and African–Caribbean patients diagnosed with schizophrenia, the diagnoses of the British and the Jamaican psychiatrists agreed in 16 instances (55%) and disagreed in 13 (45%). Hence, interrater reliability was poor (κ=0.45). PSE CATEGO diagnosed a higher proportion of subjects as having schizophrenia than the Jamaican psychiatrist did (χ2=3.74, P=0.052)ConclusionsAgreement between the Jamaican psychiatrist and his UK counterparts about which patients had schizophrenia was poor. PSE CATEGO may overestimate rates of schizophrenia.
Community-based case–control study of depression in older people
Authors: Copeland J. R. M. , Chen Ruoling , Dewey Michael , McCracken C. F. M. , Gilmore Chris , Larkin B. , Wilson K. C. M. 
Published: October 2008

BackgroundRisk factors of depression in later life, particularly for sub-cases and for psychotic and neurotic types of depression, are unclear.AimsTo identify such risk factors.MethodOver 5200 older people ($65 years), randomly selected from Liverpool, were interviewed using the Geriatric Mental State (GMS)and the Minimum Data Set (MDS). The computer-assisted diagnosis AGECAT identified 483 cases and 575 sub-cases of depression and 2451 with no mental problems. Logistic regression was employed to examine factors relevant to caseness.ResultsIn multiple logistical regression, odds ratios (ORs) were significantly high for being female (2.04, 95% CI 1.56–2.69), widowed (2.00, 1.18–3.39), having alcohol problems (4.37, 1.40–2.94), physical disablement (2.03, 1.40–2.94), physical illness (1.98,.1.25–3.15), taking medications to calm down (10.04, 6.41 −15.71), and dissatisfaction with life (moderate 4.54, 3.50–5.90; more severe 29.00, 16.00–52.59). Good social networks reduced the ORs. If sub-cases were included as controls, the statistical significance was reduced.ConclusionsAge was not associated with depression in later life whereas gender, physical disablement and dissatisfaction with life were. The sub-cases shared many risk factors with cases, suggesting that prevention may need to be attempted at an early stage.
Natural history of pharmacotherapy of older depressed community residents
Authors: Wilson K. C. M. , Copeland J. R. M. , Taylor S. , Donoghue J. 
Published: October 2008

BackgroundDepression in older people is common and has a high mortality, but effective treatments exist.AimsTo describe drug prescribing in older community residents in relation to depression status.MethodThe MRC–ALPHA community cohort aged 65 and over were interviewed using the Geriatric Mental State examination drug data collected at index interview and at two and four years.ResultsAntidepressants were used by 10.9% of the depressed population. Benzodiazepines were used frequently. Of the antidepressant users, 59.6% took low-dose antidepressants for two years, had a poor outcome and few drug changes.ConclusionsTrends of increasing antidepressant use have cost implications for primary care groups. Benzodiazepines may be mis-prescribed for treatment of depressive symptoms. Antidepressant users have poor outcome and follow-up.
Violence, homicide and suicide: Strong correlation and wide variation across districts
Authors: Kennedy H. G. , Iveson R. C. Y. , Hill O. 
Published: October 2008

BackgroundThe clinical assessment and management of the risk of violence and suicide by people with mental illness may have to focus on environmental as well as individual factors.AimsTo investigate possible associations between violence, homicide and suicide rates, population density and indices of deprivation, with particular reference to inner-city boroughs.MethodCoroners' statistics in London for homicide and suicide were obtained, with police-reported homicide and violence rates as a validity check. Correlations were made between these data and population density, the Jarman under-privileged areas score, and the Mental Illness Needs Index for each of the 32 London boroughs.ResultsHomicide rates had a 14.3-fold range, suicide a 4.4-fold range and interpersonal violence a 6.6-fold range. The variables under study were strongly correlated with each other. Rates were highest in boroughs with high population density and deprivation scores. The associations persisted when covarying for deprivation, age structure or population density.ConclusionsBecause violence, homicide and suicide are so closely correlated, they are likely to be valid indices of the differences between adjacent boroughs; this has implications for the delivery of preventive and mental health services and for clinical management of risk.
‘Obsessions' in children with autism or Asperger syndrome
Authors: Baron-Cohen Simon , Wheelwright Sally 
Published: October 2008

BackgroundWe report a survey of the content of obsessions in children with autism spectrum conditions. We use the term obsessions' narrowly, to indicate strong, repetitive interests. We predicted that obsessions would not cluster randomly, but rather would occur significantly more often in the domain of ‘folk physics' (an interest in how things work), and significantly less often in the domain of ‘folk psychology’ (an interest in how people work). These predictions were tested relative to a control group of 33 children with Tourette syndrome.AimsTo examine the content of autistic obsessions, and to test the theory that these reflect an evolved cognitive style of good folk physics alongside impaired folk psychology.MethodNinety-two parents returned a questionnaire designed to determine the subject of their child's obsessional interests. The results were analysed in terms of core domains of cognition.ResultsBoth predictions were confirmed.ConclusionsThese results suggest that impaired folk psychology and superior folk physics are part of the cognitive phenotype of autism. A content-free theory of obsessions is inadequate.
Randomized Phase II Trial Comparing Amrubicin With Topotecan in Patients With Previously Treated Small-Cell Lung Cancer: North Japan Lung Cancer Study Group Trial 0402
Authors: Inoue Akira , Sugawara Shunichi , Yamazaki Koichi , Maemondo Makoto , Suzuki Toshiro , Gomi Kazunori , Takanashi Shingo , Inoue Chieko , Inage Minoru , Yokouchi Hiroshi , Watanabe Hiroshi , Tsukamoto Toumei , Saijo Yasuo , Ishimoto Osamu , Hommura Fumihiro , Nukiwa Toshihiro 
Published: October 2008

Purpose Amrubicin, a new anthracycline agent, and topotecan are both active for previously treated small-cell lung cancer (SCLC). No comparative study of these agents has been reported. This randomized phase II study was conducted to select amrubicin or topotecan for future evaluation. Patients and Methods Patients with SCLC previously treated with platinum-containing chemotherapy were randomly assigned to receive amrubicin (40 mg/m2 on days 1 through 3) or topotecan (1.0 mg/m2 on days 1 through 5). Patients were stratified by Eastern Cooperative Oncology Group performance status (0, 1, or 2) and type of relapse (chemotherapy sensitive or refractory). The primary end point was overall response rate (ORR), and secondary end points were progression-free survival (PFS), overall survival, and toxicity profile. Results From February 2004 to July 2007, 60 patients were enrolled, and 59 patients (36 patients with sensitive and 23 patients with refractory relapse) were assessable for efficacy and safety evaluation. Neutropenia was severe, and one treatment-related death owing to infection was observed in the amrubicin arm. ORRs were 38% (95% CI, 20% to 56%) for the amrubicin arm and 13% (95% CI, 1% to 25%) for the topotecan arm. In sensitive relapse, ORRs were 53% for the amrubicin arm and 21% for the topotecan arm. In refractory relapse, ORRs were 17% for the amrubicin arm and 0% for the topotecan arm. Median PFS was 3.5 months for patients in the amrubicin arm and 2.2 months for patients in the topotecan arm. Multivariate analysis revealed that amrubicin has more influence than topotecan on overall survival. Conclusion Amrubicin may be superior to topotecan with acceptable toxicity for previously treated patients with SCLC. Further evaluation of amrubicin for relapsed SCLC is warranted.
Getting adequate information across to colorectal cancer screening subjects can be difficult
Authors: van Rijn A F , van Rossum L G M , Deutekom M , Laheij R J F , Bossuyt P M M , Fockens P , Dekker E , Jansen J B M J 
Published: October 2008

Objectives Participation in screening should be the outcome of an informed decision. We evaluated whether invitees in the first Dutch colorectal cancer (CRC) screening programme were adequately informed after having received a detailed information leaflet. Methods A total of 20,623 subjects aged 50–75 years were invited to the fecal occult blood test (FOBT) screening programme. All received a detailed information leaflet by mail between May 2006 and January 2007. After two weeks, a reminder letter was sent to all invitees, accompanied by a survey on CRC and screening. Results The survey was completed by 9594 invitees (47%). Almost all responders (99%) found the leaflet clear and readable. Almost all indicated that CRC can be treated better if found early (99%). Only 20% of the responders answered all knowledge-related answers correctly. Almost half of the responders (47%) believed that a negative FOBT excludes the presence of CRC. Older age and having a positive family member for CRC were correctly identified as risk factors by 80%. Conclusion This study demonstrates that although an information leaflet was reported as being clear and readable, the information provided in it was not always understood well. This suggests that other educational options should be investigated in order to improve general knowledge of CRC in screening invitees.
Is there utility in the transtheoretical model?
Authors: Armitage Christopher J. 
Published: October 2008

Objectives The transtheoretical model is arguably the dominant model of health behaviour change, having received unprecedented research attention, yet it has simultaneously attracted exceptional criticism. However, the criticisms have been directed almost exclusively at the stages of change, just one of fourteen components of the transtheoretical model, which may have diverted attention away from more fruitful avenues of research based on the model.Design and methods Narrative review.Results The evidence would suggest some flaws in the concept of stages of change as currently articulated in the transtheoretical model. On a conceptual level, even studies incorporating the five stages of change point to a model that better fits Gollwitzer (1993) and Heckhausen's (1991) idea of a motivational phase followed by a volitional phase. Potentially the processes of change components of the transtheoretical model may actually prove the most useful, yet have been under‐researched, at least experimentally. Three studies that successfully utilise the processes of change to reduce alcohol consumption, encourage smoking cessation and increase physical activity are described.Conclusions Elements of the transtheoretical model offer promise in developing effective health behaviour change interventions, but the question arises as to whether extracting these elements undermines completely the idea of a transtheoretical model.
Geodata-based probabilistic risk assessment and management of pesticides in germany: a conceptual framework
Authors: Schulz Ralf , Stehle Sebastian , Elsaesser David , Matezki Steffen , Müller Alexandra , Neumann Michael , Ohliger Renja , Wogram Jörn , Zenker Katharina 
Published: October 2008

Abstract
The procedure for the risk assessment of pesticides in Germany is currently further developed from a deterministic to a geodata-based probabilistic risk assessment (GeoPRA) approach. As the initial step, the exposure assessment for spray drift in permanent crops, such as vineyards, fruit orchards, and hops, is considered. In our concept, geoinformation tools are used to predict distribution functions for exposure concentrations based mainly on spatial information regarding the neighbourhood of crops and surface waters. A total number of 23 factors affecting the drift into surface waters were assessed and suggestions for their inclusion into the approach developed. The main objectives are to base the exposure estimation on a realistic representation of local landscape characteristics and on empirical results for the impact of each feature on the drift deposition. A framework for the identification of high-risk sites (active management areas [AMAs]) based on protection goals and ecological considerations was developed in order to implement suitable risk mitigation measures. The inclusion of active mitigation measures at sites with identified and verified risk is considered a central and important part of the overall assessment strategy. The suggested GeoPRA procedure itself is comprised of the following 4 steps, including elements of the extensive preliminary work conducted so far: 1) nationwide risk assessment, preferably based only on geodata-based factors; 2) identification of AMAs, including the spatial extension of contamination, the level of contamination, and the tolerable effect levels; 3) refined exposure assessment, using aerial photographs and field surveys; and 4) mitigation measures, with a focus on landscape-level active mitigation measures leading to effective risk reductions. The suggested GeoPRA procedure offers the possibility to actively involve the farming community in the process of pesticide management. Overall, the new procedure will aim at increased flexibility of pesticide application regulations and a high level of protection of surface waters.
Infection and Bronchiolitis Obliterans Among Native American Lung Transplant Recipients
Authors: Dosanjh Amrita , Koziol James 
Published: October 2008

Background:
Alaska Native and Native American populations (AN/NA) are prone to respiratory tract infections, due to genetic
predisposition and environmental factors. Since community acquired respiratory tract infections are associated with higher rates of bronchiolitis
obliterans syndrome (BOS), it was hypothesized that AN/NA lung transplant recipients may experience a higher rate of BOS.

Methods:
The UNOS database was searched from 1995-2005 to identify adult AN/NA patients undergoing lung transplantation in the
U.S. Among 11,103 patients, 33 AN/NA (13M/20F) patients were identified for further analysis. Among this population rates of: i) initial
hospital stay, ii) first year hospitalizations, iii) hospitalization for infection, iv) subsequent BOS in years 1-5, were compared. Statistical
analysis was performed using the fisher exact test, and a p value of <0.05 was considered significant.

Results:
AN/NA recipients did not have a higher incidence of BOS in years 1-5 following lung transplantation. They did have a higher
rate of first year complications, reflected by higher hospitalization rates. AN/NA patients had a higher rate of first year hospitalizations
for non-CMV infection (p < 0.03).

Conclusions:
AN/NA patients despite being at risk for community acquired respiratory infections did not have a higher rate of transplantation
BOS in subsequent years.
Initial Results of the S3-Humerus Plate
Authors: Gille J , Schulz A.P , Queitsch Ch , Paech A , Jürgens Ch 
Published: October 2008

Fractures of the humeral head account for 5% of all fractures and incidence increases with age. Depending on fracture form and patients age a wide variety of therapeutical options exist. Stable fractures can be treated conservatively, while the majority of unstable and displaced fractures require surgical treatment. Many different surgical options are available; open reduction and internal fixation are widely preferred. The S3 Proximal Humerus Plate is a contoured plate to match the complex shape of the proximal humerus. It is designed to be positioned distal to the greater tuberosity preventing subacromial impingement.Between august 1 and 30, 2007, 5 patients meeting the inclusion criteria (that is primary operative stabilization within 7 days after trauma in a standardized way and minimal follow up period of 3 month) with acute fractures of the proximal humerus were treated with S3 Proximal Humerus Plate. Follow up was performed using the Constant Score. The mean age was 59.0 years. According to the Neer classification fractures were rated as Neer 2,3 and 4. A mean Constant score of 72.3 (57-86) points was obtained.We did not observe any complications like humeral head necroses, loss of reduction, deep infection or breakage of the plate.