bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender and Schizophrenia: Association of Age at Onset with Antecedent, Clinical and Outcome Features
Authors: Gureje Oye , Bamidele Rotimi W. 
Published: January 2008

Objective: There is evidence that gender and age at onset may have a bearing on schizophrenia. The extent to which this differential age at onset influences the clinical features of schizophrenia and its outcome in males and females is not clear. Method: One hundred and twenty outpatients with DSM-III-R schizophrenia were studied to determine the association of antecedent, historical, clinical and 13–year outcome features with age at onset in females (n = 64) and in males (n = 56). Results: Males were significantly younger at illness onset but were not otherwise different from females in antecedent features of illness. For males, age at onset bore little relationship to outcome after 13 years. Females with early onset of illness were more likely to have experienced obstetric complications, to evidence poorer premor-bid functioning, and to have a worse clinical, social and functional outcome than females with late onset. Conclusions: Even though females may have a more benign illness than males, among females, those with early age at onset may be characterised by neurodevel-opmental deviance and worse illness outcome.
Psychiatric Disorder in HIV Infection
Authors: Kelly Brian , Raphael Beverley , Judd Fiona , Perdices Michael , Kernutt Graeme , Burrows Graham D. , Burnett Paul C. , Dunne Michael 
Published: January 2008

Objective: This study aimed to investigate rates of psychiatric disorder in human immunodeficiency virus (HIV) infection, in an Australian sample of homosexual and bisexual men. Method: A cross-sectional study of a total of 65 HIV sero-negative (HIV-) and 164 HIV sero-positive men (HIVt) (79 CDC stage 1 1/1 11 and 85 CDC stage IV) was conducted in three centres. Lifetime and current prevalence rates of psychiatric disorder were evaluated using the Diagnostic Interview Schedule Version lllR (DIS-IIIR). Results: Elevated current and lifetime rates of major depression were detected in both HIV negative and HIV positive homosexual/bisexual men. Lifetime rates of alcohol abuseldependence were significantly elevated in HIV positive men (CDC group IV) when compared with HIV negative men. Among the HIV positive group the majority of psychiatric disorders detected were preceded by a pre-HIV diagnosis of psychiatric disorder. Major depression represented the disorder most likely to have first onset after HIV infection diagnosis. Conclusions: Lifetime rates of major depression were elevated in this sample of HIV-negative and HIV-positive men, In the HIV-positive men, psychiatric disorder was significantly associated with the presence of lifetime psychiatric disorder prior to HIV infection diagnosis, The findings indicate the importance of evaluation of psychiatric history prior to HIV infection and the clinical significance of depressive syndromes in this population.
Temporal Variation in Parasuicide among Singaporean Chinese
Authors: Ho Brian K.W. , Kua E. H. , Hong Clarice 
Published: January 2008

Objective: The aim of this study was to determine whether there is any temporal variation in the incidence of parasuicide within the Chinese community and, if possible, to correlate the findings with prevailing cultural and social influences. Method: All patients of Chinese origin referred to a teaching hospital in Singapore between 1990 and 1994 were included in the study. The cases were divided by sex and aggregated for the month and day of the week in which the parasuicides occurred. Results: Cases of parasuicide peaked on Mondays, while the lowest incidences occurred on Saturdays. The peak months were June, August and September with a trough in December and January. Conclusions: The findings may not be amenable to any single explanation but the peak months coincided with the month of the Hungry Ghosts, which is believed to be a particularly inauspicious period, while the trough occurred during a festive period. Similarly, looking at the student population, the peaks coincided with the examination period. It appears that social and cultural factors play a significant role in the temporal variation in parasuicide in Singapore.
Dissociative Identity Disorder: An Australian Series
Authors: Middleton Warwick , Butler Jeremy 
Published: January 2008

Objective: Series of patients fulfilling diagnostic criteria for Dissociative Identity Disorder (DID), otherwise known as multiple personality disorder, have particularly been reported on in North America and increasingly in other countries. The present study investigated the trauma and past treatment histories, symptom profiles and dissociative phenomenology of 62 patients fulfilling diagnostic criteria for DID seen in Brisbane (Queensland, Australia). Method: From 1992, systematic assessments, including the Dissociative Experience Scale and the Dissociative Disorders Interview Schedule, were performed with a personal series of 57 patients with DID seen by one of the authors (WM) and five patients seen by the second author (JB). Results: The histories of childhood trauma, the clinical profiles and dissociative indices of these patients closely approximate those described in series reported in other countries. Conclusions: Patients fulfilling diagnostic criteria for DID are regularly seen in Australian inpatient and outpatient settings. The dissociative symptomatology of the patients examined in the present study represents a significant component of a complex syndrome associated with a history of severe ongoing developmental trauma dating from early childhood.
Delirium in Hospital: Does it Increase Length of Stay?
Authors: Stevens Lee E. , de Moore Gregory M. , Simpson Judy M. 
Published: January 2008

Objective: To determine the effect of delirium, as a comorbid diagnosis in hospitalised patients, on patient length of stay (LOS). Method: Prospective study comparing LOS of delirious patients with controls matched by age, gender, principal diagnosis and date of admission. Medical and surgical inpatients of Westmead Hospital with delirium were identified from a Consultation Liaison (CL) psychiatry database and were matched with controls from the hospital medical records. Results: Delirious patient LOS was found to be significantly longer (2.2-fold; 95% confidence interval 1.5-3.3) than matched controls. Conclusions: Delirium, as a comorbid diagnosis in general hospital patients, is associated with an increased use of resources. Its early diagnosis may limit this and morbidity.
Sport Psychiatry
Authors: Macleod A. D. 
Published: January 2008

Objective: The aim of this article is to provide an overview of the literature on psychiatry for elite athletes. Method: Relevant literature was presented to the general psychiatrist. Results: The prevalence of drug misuse, eating disorders and brain injury in elite and professional athletes is stressed. The uniquely troublesome adverse effects of psychopharmacology in this group of subjects is commented upon. Conclusions: Elite athletes may require competent and informed psychiatric opinion and management.
Development of a Consumer Advocacy Program
Authors: O'donnell Maryanne , Proberts Miriam , Parker Gordon 
Published: January 2008

Objective: The aim of the present paper was to describe the development of a consumer advocacy program within the Eastern Suburbs of Sydney (NSW, Australia). Methods: The program was developed within the context of a research project that investigated the effect on outcome of client-focused approaches to community case management for clients with schizophrenia and bipolar disorder. Results: While the development of the advocacy program was limited by the constraints imposed by the research methodology, the study provided the opportunity to delineate the process involved and identify key components that need to be incorporated into future advocacy programs. Conclusions: The main guidelines determined were that consumer participation in service delivery needs to be flexible, consumer driven, have broad-based support, ready access to supervision and debriefing, ongoing training and clear job descriptions. Given adequate support, autonomy and funding, consumer advocates can provide a much needed resource for their fellow consumers.
Defining the Role of the Consultant Psychiatrist in a Public Mental Health Service
Authors: Boyce Philip , Tobin Margaret 
Published: January 2008

Objective: The aim of this paper is to clarify elements of the role of a psychiatrist working in the public sector. Method: The relevant literature was examined to help clarify some of the reasons psychiatrists have been leaving the public sector and to help define the key roles of a psychiatrist working in the public sector. Results: Two principal roles for the consultant psychiatrist in the public sector are identified: the psychiatrist as a clinician and the psychiatrist as a manager. The management role is contrasted with the role as an administrator and important differences between these roles are identified. The management role includes planning, advocacy and managing human resources. The importance of professional development in the career path for the newly qualified psychiatrist is discussed. Conclusions: The role of the psychiatrist in public sector psychiatry is a challenging and exciting one. Psychiatrists will start to return to the public sector when they recognise this new role for the consultant psychiatrist. This will be to the advantage of public sector psychiatry in general and to the job satisfaction of psychiatrists. The key features of the clinical role are the demonstration of sophisticated clinical skills, providing clinical leadership via supervision, being accountable for patient care and providing consultant opinion on complex clinical problems.
Clinical features of temporal tip epidural hematomas
Authors: Yanagawa Youichi , Sakamoto Toshihisa , Okada Yoshiaki 
Published: January 2008

Object
The purpose of this paper was to clarify the clinical features of temporal tip epidural hematomas (EDHs).

Methods
A retrospective chart review was conducted for 53 patients who had suffered an EDH. They were divided into two groups, those whose hematoma occurred in the temporal tip (23 patients) and others (30 patients). The following variables were analyzed: age, sex, Glasgow Coma Scale score, systolic blood pressure on admission, Injury Severity Score, incidence of hematomas in intracerebral regions, location of skull fracture, incidence of cranial nerve injury, type of operation, and Glasgow Outcome Scale (GOS) score at 3 months postinjury.

Results
A greater incidence of zygomatic arch or lateral orbital cavity fracture was found in the “temporal tip” group than in the “other” group. There was a greater incidence of cranial nerve injury in the temporal tip (26.0%) than in the other group (6.6%; p < 0.05). Surgery to treat the EDH was more frequently performed in the other group (36.6%) than in the temporal tip group (two patients, 8.6%; p = 0.01). There were no significant differences between the groups in terms of the GOS score.

Conclusions
A temporal tip hematoma is not a rare injury among patients with EDHs. This hematoma tends to be induced by lateral orbital cavity and/or zygomatic arch fractures. It tends to be associated with cranial nerve injury, but it rarely requires an operation. The outcome of patients with this hematoma depends on the associated intracerebral lesions, thus indicating it to be similar to an EDH in other places.
Toward improving the therapeutic ratio in stereotactic radiosurgery: selective modulation of the radiation responses of both normal tissues and tumor
Authors: Hopewell John W. , Millar William T. , Ang K. Kian 
Published: January 2008

✓A review of the radiobiological factors that influence the response of the brain to radiation is provided in relation to stereotactic radiosurgery (SRS). The prospects for intervention after radiation treatment to selectively modulate the expression of late central nervous system (CNS) injury is considered, as well as an account of recent interest in the use of radiation enhancers to selectively increase the response of tumors to radiation.
Brain necrosis in humans, after conventional irradiation, indicates that the risk of necrosis increases rapidly after an equivalent single dose of 12 or 13 Gy. When single-dose treatments are extended due to 60Co decay or planned extension of treatment times, account should be taken of the effects of the repair of sublethal radiation damage to DNA on the efficacy of treatment. Both repair capacity and repair kinetics will also influence tumor control, but parameters to quantify this effect have not yet been established.
The volume of CNS tissue that has been irradiated affects the tissue response, but this effect is only significant for volumes less than 0.05 cm3. The gain obtained from irradiation of small volumes is reduced, however, when focal irradiation is given within a wider field of irradiation.
Based on a vascular hypothesis explaining the pathogenesis of late CNS damage, approaches designed to selectively modulate the frequency of late CNS damage have been validated. Given the high intrinsic radioresistance of some tumors, as opposed to the presence of hypoxia, an interest has developed in the use of selective radiation enhancers in the treatment of tumors. The compound presently available has proved to be disappointing clinically due to toxicity at effective doses, when repeated administration is required. However, when given at high single doses it is less toxic and may be more effective. Less toxic radiation enhancers need to be developed.
Recovery of low-frequency sensorineural hearing loss following resection of a greater superficial petrosal nerve schwannoma
Authors: Sade Burak , Lee Joung H. 
Published: January 2008

✓Facial nerve schwannomas can occur anywhere from the internal auditory canal to the parotid gland. Schwannomas arising from the greater superficial petrosal nerve are exceedingly rare.
The authors report the case of a 63-year-old woman who presented with a selective low-frequency hearing loss of 3 weeks' duration. Neurological examination demonstrated a House–Brackmann Grade II facial paresis and asymmetrical hearing loss on the left side. Audiometric evaluation showed a significant loss of low-frequency hearing with a speech reception threshold (SRT) of 30 dB and a speech discrimination score (SDS) of 88% on the left side. Magnetic resonance imaging revealed a 2.4-cm enhancing left middle fossa mass. Near-complete resection was performed via a left temporal craniotomy. The tumor was located in the Glasscock triangle and had invaded the petrous bone overlying the cochlea. A very small piece of the tumor over the cochlea was left in order to preserve hearing. A postoperative audiogram showed significant improvement in the patient's hearing, with an SRT of 20 dB and an SDS of 100%. The histological findings were consistent with schwannoma.
The patient experienced postoperative improvement of hearing function despite cochlear involvement, which has previously been reported as an unfavorable factor for postoperative hearing outcome in facial nerve schwannomas.
Trigeminocardiac Reflex
Authors: Schaller Bernhard J. 
Published: January 2008

Object
Surgical manipulation of the fifth cranial nerve during its intra-or extracranial course may lead to bradycardia or even asystole as well as arterial hypotension, a phenomenon described as the trigeminocardiac reflex (TCR). The authors studied the impact of this reflex on postoperative auditory function in patients undergoing vestibular schwannoma (VS) surgery.

Methods
One hundred patients scheduled for VS surgery were studied prospectively for parameters influencing the postoperative auditory function. The evaluation included sex, age, pre-and postoperative auditory function, preoperative mean arterial blood pressure, preoperative medical diseases or medication (for example, antiarrhythmia drugs), tumor size and localization, and the intraoperative occurrence of the TCR.
The TCR, which occurred in 11% of the patients, influenced the postoperative hearing function in the patients with Hannover Class T3 and T4 VSs.
With an overall hearing preservation of 47%, 11.1% of the patients in the TCR group and 51.4% of those in the non-TCR group experienced preserved hearing function postoperatively. In cases involving larger tumors (Hannover Class T3 and T4), an intraoperative TCR was associated with a significantly worse postoperative hearing function during VS surgery (p = 0.005).

Conclusions
The hypotension following TCR is a negative prognostic factor for hearing preservation in patients undergoing VS surgery. Patients' knowledge of this can be increased pre-and postoperatively. Further study of this phenomenon will advance the understanding of the underlying mechanisms and may help to improve hearing preservation by controlling the occurrence of the TCR.
World's first magnetic resonance imaging/x-ray/operating room suite: a significant milestone in the improvement of neurosurgical diagnosis and treatment
Authors: Matsumae Mitsunori , Koizumi Jun , Fukuyama Haruo , Ishizaka Hideo , Mizokami Yoshihito , Baba Tanefumi , Atsumi Hideki , Tsugu Atsushi , Oda Shinri , Tanaka Yutaka , Osada Takahiro , Imai Masaaki , Ishiguro Tomoko , Yamamoto Minako , Tominaga Jiro , Shimoda Masami , Imai Yutaka 
Published: January 2008

Object
In February 2006, the magnetic resonance/x-ray/operating room (MRXO) suite opened at the authors' institution. This is the first hybrid neurosurgical procedure suite to combine magnetic resonance (MR) imaging, computed tomography (CT), and angiography within a neurosurgical operating room (OR). In the present paper the authors describe the concept of the MRXO as well as their first 10 months of experience using this suite, and discuss its advantages and limitations.

Methods
In the MRXO suite, the combined OR and angiography (OR–angiography) station is located in the middle of the suite, and the MR imaging and CT scanning stations are each installed in an adjoining bay connected to the OR–angiography station by shielded sliding doors. The surgical, MR imaging, angiography, and CT tables are positioned in order of use. The patient lies on a fully MR imaging– and radiography-compatible mobile patient tabletop that is used to move the patient quickly and safely among the tables in the imaging and operating components of the MRXO suite.

Results
The authors performed all interventional procedures safely. The specially designed operating tabletop of the MRXO suite reduced the limitations on neurosurgeons during standard neurosurgical procedures. This hybrid suite helps to provide high-quality intraoperative imaging, greatly reducing the risk of unexpected events during the procedure.

Conclusions
The MRXO suite, which combines OR and imaging equipment, represents a significant milestone in the improvement of neurosurgical diagnosis and treatment and other interventional procedures. Another advantage of the MRXO suite is its cost-effectiveness, which is partly due to its streamlined imaging procedure.
Assessment of brain aneurysms by using high-resolution magnetic resonance angiography after endovascular coil delivery
Authors: Wong John H. , Mitha Alim P. , Willson Morgan , Hudon Mark E. , Sevick Robert J. , Frayne Richard 
Published: January 2008

Object
Digital subtraction (DS) angiography is the current gold standard of assessing intracranial aneurysms after coil placement. Magnetic resonance (MR) angiography offers a noninvasive, low-risk alternative, but its accuracy in delineating coil-treated aneurysms remains uncertain. The objective of this study, therefore, is to compare a high-resolution MR angiography protocol relative to DS angiography for the evaluation of coil-treated aneurysms.

Methods
In 2003, the authors initiated a prospective protocol of following up patients with coil-treated brain aneurysms using both 1.5-tesla gadolinium-enhanced MR angiography and biplanar DS angiography. Using acquired images, the subject aneurysm was independently scored for degree of remnant identified (complete obliteration, residual neck, or residual aneurysm) and the surgeon's ability to visualize the parent vessel (excellent, fair, or poor).

Results
Thirty-seven patients with 42 coil-treated aneurysms were enrolled for a total of 44 paired MR angiography–DS angiography tests (median 9 days between tests). An excellent correlation was found between DS and MR angiography for assessing any residual aneurysm, but not for visualizing the parent vessel (κ = 0.86 for residual aneurysm and 0.10 for parent vessel visualization). Paramagnetic artifact from the coil mass was minimal, and in some cases MR angiography identified contrast permeation into the coil mass not revealed by DS angiography. An intravascular microstent typically impeded proper visualization of the parent vessel on MR angiography.

Conclusions
Magnetic resonance angiography is a noninvasive and safe means of follow-up review for patients with coil-treated brain aneurysms. Compared with DS angiography, MR angiography accurately delineates residual aneurysm necks and parent vessel patency (in the absence of a stent), and offers superior visualization of contrast filling within the coil mass. Use of MR angiography may obviate the need for routine diagnostic DS angiography in select patients.
Incidence and pattern of direct blunt neurovascular injury associated with trauma to the skull base
Authors: Feiz-Erfan Iman , Horn Eric M. , Theodore Nicholas , Zabramski Joseph M. , Klopfenstein Jeffrey D. , Lekovic Gregory P. , Albuquerque Felipe C. , Partovi Shahram , Goslar Pamela W. , Petersen Scott R. 
Published: January 2008

Object
Skull base fractures are often associated with potentially devastating injuries to major neural arteries in the head and neck, but the incidence and pattern of this association are unknown.

Methods
Between April and September 2002, 1738 Level 1 trauma patients were admitted to St. Joseph's Hospital and Medical Center in Phoenix, Arizona. Among them, a skull base fracture was diagnosed in 78 patients following computed tomography (CT) scans. Seven patients had no neurovascular imaging performed and were excluded. Altogether, 71 patients who received a diagnosis of skull base fractures after CT and who also underwent a neurovascular imaging study were included (54 men and 17 women, mean age 29 years, range 1–83 years). Patients underwent CT angiography, magnetic resonance angiography, or digital subtraction angiography of the head and craniovertebral junction, or combinations thereof.

Results
Nine neurovascular injuries were identified in six (8.5%) of the 71 patients. Fractures of the clivus were very likely to be associated with neurovascular injury (p < 0.001). A high risk of neurovascular injury showed a strong tendency to be associated with fractures of the sella turcica–sphenoid sinus complex (p = 0.07).

Conclusions
The risk of associated blunt neurovascular injury appears to be significant in Level 1 trauma patients in whom a diagnosis of skull base fracture has been made using CT. The incidence of neurovascular trauma is particularly high in patients with clival fractures. The authors recommend neurovascular imaging for Level 1 trauma patients with a high-risk fracture pattern of the central skull base to rule out cerebrovascular injuries.