A 5-year follow-up study of suicide attempts

We reviewed 59 hips in 44 children with slipped capital femoral epiphysis (SCFE), all treated by in situ pinning. The average clinical and radiographic follow-up was 11.4 years. Fifty-three hips (90%) were rated as either excellent or good. Osteonecrosis or chondrolysis developed in five patients. Postoperative remodeling was noted, not only by a process of local resorption and apposition of bone, but also by correction of the disturbed anatomic axes, in proportion to the severity of the slip, together with global thickening of the femoral neck. We believe that the good long-term results after in situ pinning are the consequence of this important remodeling process.     

Ulcerative colitis is as common in Crete as in northern Europe: a 5-year prospective study

A DNA ligase-encoding gene (Ca CDC9) was cloned from Candida albicans by complementation of an ime-1 mutation in Saccharomyces cerevisiae. In this system, IME1 function was assayed using a S. cerevisiae strain with a ime2-promoter-lacZ gene fusion such that following transformation with a C. albicans genomic library, the presence of positive clones was indicated upon the addition of X-gal to sporulation media. Transforming fragments were subcloned in pGEM7 and sequenced. Sequence homology with several ATP-dependent DNA ligases from viruses, fission yeast, human, baker yeast and bacteria was observed.     

A longitudinal study of pain sensitivity and blood pressure in adolescent boys: Results from a 5-year follow-up.

A growing literature has observed a significant reduction in pain sensitivity among hypertensive animals and humans. It is uncertain whether a reduced sensitivity to pain can be observed in normotensive individuals who go on to develop high blood pressure. Blood pressure (BP) was reassessed in one hundred fifteen 19-year-old boys initially tested at age 14, when they were also presented with a pain stimulus (mechanical finger pressure). Hierarchical regression analyses indicated that information regarding pain tolerance improved prediction of changes in systolic and diastolic blood pressure beyond that afforded by differences in BP at age 14, parental history of hypertension, and body mass index. These analyses suggest that pain sensitivity may be associated with physiological processes involved in the development of sustained high blood pressure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A 5-year multicenter study on implant-supported single crown restorations

A site-specific endonuclease SscL1 I preparation has been isolated and purified to near homogeneity from the strain Staphylococcus sp. L1 without admixtures of other nuclease activity. DNA cleavage proceeds according to the scheme: 5'-G down arrow ANTC-3' 3'-CTNA up arrow G-5', and thus the isolated enzyme is an isoschizomer of restriction endonuclease HinfI and belongs to the second class of restriction endonucleases. SscL1 I works over a broad range of temperature and pH. The enzyme is characterized by high stability during storage.     

A prospective 4- to 5-year study of DSM-III-R hypochondriasis

BACKGROUND: Although hypochondriasis is generally thought to be a chronic and stable condition with a relatively low remission rate, this disorder remains understudied. METHODS: This is a 4- to 5-year prospective case-control study of DSM-III-R hypochondriasis. Medical outpatients meeting DSM diagnostic criteria for hypochondriasis completed an extensive research battery assessing hypochondriacal symptoms, medical and psychiatric comorbidity, functional status and role impairment, and medical care. A comparison group of nonhypochondriacal patients from the same setting underwent the same battery. Four to 5 years later, both cohorts were re-interviewed. RESULTS: One hundred twenty hypochondriacal and 133 nonhypochondriacal comparison patients were originally studied. Follow-up was obtained on 73.5% (n = 186) of all patients. At follow-up, the hypochondriacal sample was significantly (P<.001) less hypochondriacal and had less somatization (P<.001) and disability than at inception, but 63.5% (n = 54) still met DSM-III-R diagnostic criteria. When compared with the comparison group using repeated measures multivariate analysis of variance, these changes remained statistically significant (P<.0001). Changes in medical and psychiatric comorbidity did not differ between the 2 groups. When hypochondriacal patients who did and did not meet diagnostic criteria at follow-up were compared, the latter had significantly less disease conviction (P<.05) and somatization (P<.01) at inception, and their incidence of major medical illness during the follow-up period was significantly (P<.05) greater. CONCLUSIONS: Hypochondriacal patients show a considerable decline in symptoms and improvement in role functioning over 4 to 5 years but two thirds of them still meet diagnostic criteria. Hypochondriasis, therefore, carries a very substantial, long-term burden of morbidity, functional impairment, and personal distress.     

Understanding persistence in bulimia nervosa: A 5-year naturalistic study.

Bulimia nervosa shows a marked tendency to persist, suggesting that powerful maintaining mechanisms operate. Using data from a prospective, 5-year, study of the natural course of 102 people with bulimia nervosa, the authors sought to identify predictors of persistence and to test specific hypotheses derived from the cognitive-behavioral theory of the persistence of bulimia nervosa. The results of both sets of analyses were consistent with the theory, with the degree of overevaluation of shape and weight and a history of childhood obesity predicting a persistent course. There was also support for the central prediction of the cognitive-behavioral theory. These findings suggest that the mechanisms specified by the theory influence its longer term natural course. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual function in patients with disseminated sclerosis. A 5-year follow-up study

Sexual dysfunction is known to occur in multiple sclerosis (MS). The purpose of the study is to describe the change in sexual function and symptoms in a five year follow-up study. Forty-nine patients (27 females, 22 males) with definite MS were interviewed and examined. The number of patients with sexual dysfunction increased significantly (p = 0.004) and involved females and males equally. Males usually had one or two symptoms, while females frequently had two or more symptoms. It is concluded that the risk of sexual dysfunction increases over time. Further studies concerning treatment possibilities are needed.     

Cognitive predictors of achievement growth in mathematics: A 5-year longitudinal study.

The study's goal was to identify the beginning of 1st grade quantitative competencies that predict mathematics achievement start point and growth through 5th grade. Measures of number, counting, and arithmetic competencies were administered in early 1st grade and used to predict mathematics achievement through 5th (n = 177), while controlling for intelligence, working memory, and processing speed. Multilevel models revealed intelligence and processing speed, and the central executive component of working memory predicted achievement or achievement growth in mathematics and, as a contrast domain, word reading. The phonological loop was uniquely predictive of word reading and the visuospatial sketch pad of mathematics. Early fluency in processing and manipulating numerical set size and Arabic numerals, accurate use of sophisticated counting procedures for solving addition problems, and accuracy in making placements on a mathematical number line were uniquely predictive of mathematics achievement. Use of memory-based processes to solve addition problems predicted mathematics and reading achievement but in different ways. The results identify the early quantitative competencies that uniquely contribute to mathematics learning. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A 5-year in vitro and in vivo study of the biodegradation of polylactide plates

PURPOSE: The purpose of this study was to investigate the long-term tissue response and duration of degradation of self-reinforced poly-L-lactide (SR-PLLA) multilayer plates in vivo. MATERIALS AND METHODS: Mandibular osteotomies in sheep were fixed with SR-PLLA multilayer plates. The animals were followed for 1, 2, 3, 4, and 5 years, after which histologic studies were performed. RESULTS: The foreign-body reaction was mainly mild, and the osteotomies were well united. After 5 years in vivo, the material was almost completely resorbed, but small particles of polymer could still be detected at the implantation site. SR-PLLA plates were also incubated in vitro for 5 years. The material degraded considerably faster in vivo than in vitro. Molecular weight, melting temperature, and crystallinity of the plates remained at a constant level after 2 years in vitro, indicating very slow degradation of the oligomeric (molecular weight [Mw], 3500 daltons), highly crystalline (heat of fusion, 70 J/g), PLLA residue solely as a result of hydrolysis. Although the plates became increasingly fragile as they degraded, they retained their macroscopic form until the end of the 5-year follow-up. Loss of mass of the plates was 52%+/-8% after 5 years of incubation in vitro. CONCLUSIONS: Although the long degradation period may seem to be a minor drawback to the use of such plates, it does not appear to affect the healing process.     

Prognosis and progress: A 5-year study of 48 schizophrenic men.

48 patients diagnosed as schizophrenic were rated by the Phillips Scale of premorbid adjustment 5 years ago. Important subcultural variables, which were related to the prognostic scores became apparent. In this study the reliability of the Phillips Prognostic Rating Scale as an instrument of prognosis and the subcultural variables were examined. For this purpose 3 categories were used: (a) In Group, which contained those men who had not been out of the hospital during the intervening 5 years nor were being considered for discharge or trial visit. (b) Half-way Group, which included those men who had been discharged and returned or who were either now or had been on trial visit. (c) Out Group, or those patients who had been discharged for over 12 mo. and whose readmission appeared unlikely. The results are positive and (the In Group has a higher mean score than the other groups) support the thesis that premorbid adjustment is an indicator of prognosis in schizophrenia. In this particular Kentucky hospital population important subcultural variables along a rural-urban dimension and the importance of marital status are emphasized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric symptoms in male cannabis users not using other illicit drugs

PURPOSE: To examine the ultrastructure of clear corneal incisions (CCIs) performed with diamond keratomes and steel blades as well as the corneal trauma after implantation of a foldable intraocular lens (IOL) through two incision widths. SETTING: University Eye Clinic and Institute of Histology and Embryology II, University of Vienna, Austria. METHODS: Twenty-four human cadaver eyes without prior ocular surgery were obtained from the University Eye Bank, Vienna. Single-plane CCIs were performed with 3.0 and 3.2 mm Alcon steel blades and with a 3.0 mm Huco diamond keratome. The AMO PhacoFlex II lens was implanted with a Fine II folder. During the entire procedure, the eye pressure was kept between 26 and 30 mm Hg by infusing balanced salt solution into the anterior chamber. Specimens were prepared for light microscopy, transmission electron microscopy, and scanning electron microscopy according to standard procedures. RESULTS: The diamond keratome produced cleaner cuts than the steel blade. After IOL implantation, 3.0 mm steel blade incisions exhibited extensions at their lateral ends. Within these extensions, the collagen lamellae were displaced and torn. This was not true with 3.2 mm tunnels. Because of the thickness of a 3.0 mm diamond keratome, the extent of corneal trauma was between that found with 3.0 and 3.2 mm steel keratome tunnels. CONCLUSIONS: Implantation of the SI-30 through 3.0 mm CCIs produced by the steel blade led to more severe corneal trauma than implantation through 3.2 mm steel blade incisions or 3.0 mm diamond keratome incisions. Thus, IOL implantation through incisions that are too small intensifies corneal trauma.     

Incidence of transient ischemic attacks in Dijon, France. A 5-year community-based study

Partial obstruction of the left ureter was created in newborn rats. Unobstruction was performed after 2 or 7 days. The investigations were carried out at 9 weeks of age--under slight hydropenia to institute an element of stress. Unobstruction was successful. On the unobstructed side, there were nevertheless impairments as compared to controls: urine osmolality (-32%), free water reabsorption (-44%), potassium excretion (-34%), renal blood flow (-36%) and glomerular filtration (-36%). On the intact contralateral side, tubular changes were the only signs of an attempt to compensate. Thus, consistent renal damage remained despite a very early unobstruction. Furthermore, the changes were similar to those we observed during long-term permanent obstruction. The injury seems to be established within a very short time and imitates the probable development seen in the affected fetus: after start of production, the urine is confronted by the preformed obstruction at the pyeloureteral junction. A high-pressure-prone system is built up and is not reversed, until the pelvis has become dilated and thus capable to buffer urinary flow peaks. Thereafter, no further deterioration occurs except in specific conditions. If clinically applicable, these observations implicate that there is no advantage with surgical intervention, even when performed early in fetal life, and there is no need for swift intervention, as the damage does not progress after its establishment. Most of the cases probably do not require surgery at all, unless pain, obvious functional impairment or urinary tract infection supervene.     

A 5-year study of change in the relationship between well-being and job performance.

Recent research, primarily cross sectional in nature, has established a link between psychological well-being and job performance ratings. Such findings suggest that organizations can improve their overall effectiveness by increasing worker well-being, but they provide little guidance as how these increases can be achieved. One means would be to select only those individuals with high well-being scores. However in addition to various ethical concerns, this approach could also be limited if the association between these two variables deteriorates as the time between the measurement increases. This possibility was examined in a 5-year longitudinal study. Consistent with the expectation of diminishing association, it was found that the well-being–performance relationship is influenced by the interval between assessment of well-being and assessment of performance. When well-being was measured at the same time as performance, or as long as a year before, the two were associated. When well-being was assessed 4.5 or 5 years before job performance, the relationship was no longer significant. Practical implications of these findings for both the individual and the organization are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Repetition of overdose: a retrospective 5-year study

This study investigated the number, timing and disposal (admission or discharge) of patients repeating an overdose who attended the accident and emergency department of a district general hospital during a 5-year period. There was a total of 1958 overdoses by 1597 individuals over the 5-year period. Overdoses were repeated by 12% (n = 191) of patients and accounted for 552 of the total overdoses (representing 361 repeats). First repeats were found to occur more frequently in the 3 months following the original overdose for 43% of patients, 70% of repetitions occurring within a year. The distribution of first repeats showed a similar pattern for males and females. During the 5-year period 49% of all repetitions occurred within 3 months. Almost one-fifth of repeaters were discharged, irrespective of whether it was the patient's 'index' (first overdose within the study period) or a repeat overdose. Within the repeater population, 31% of overdoses occurred on a Friday, Saturday and on, or immediately prior to, a Bank Holiday. Since there was no on-site psychiatric service available at such times, those patients had to wait until the next working day for assessment. The study recommends that all overdose patients should receive psychiatric assessment, and therefore on-site psychiatric services should be available for accident and emergency patients.     

Predictors and consequences of childhood depressive symptoms: A 5-year longitudinal study.

A 5-yr longitudinal study investigated the interrelationships among children's experience of depressive symptoms, negative life events, explanatory style, and helplessness behaviors in social and achievement situations. The results revealed that early in childhood, negative events, but not explanatory style, predicted depressive symptoms; later in childhood, a pessimistic explanatory style emerged as a significant predictor of depressive symptoms, alone and in conjunction with negative events. When children suffered periods of depression, their explanatory styles not only deteriorated but remained pessimistic even after their depression subsided, presumably putting them at risk for future episodes of depression. Some children seem repeatedly prone to depressive symptoms over periods of at least 2 yrs. Depressed children consistently showed helpless behaviors in social and achievement settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting marital dissolution: A 5-year prospective longitudinal study of newlywed couples.

Examined how well marital dissolution was predicted by husbands' and wives' personal demographic scores, couple demographic scores, husbands' and wives' individual-differences scores, husbands' and wives' interdependence scores, and the size of the discrepancy between spouses' individual-differences scores as well as their interdependence scores. Over 5 annual assessments, 222 newlywed couples remained together and 64 dissolved their marriages. Variables from each of the 4 sets of scores reliably discriminated between stable and unstable couples. For a subsample of couples on whom multiple assessments were available, husbands and wives who would dissolve their marriage showed a greater decline in interdependence scores and had greater increases in discrepancies on interdependence variables than did husbands and wives from stable couples who were assessed at comparable times. Marital dissolution is discussed in terms of interrelated distal and proximal risk factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived control and intellectual functioning in the elderly: A 5-year longitudinal study.

We examined whether control beliefs are related to individual differences in intellectual aging by administering a battery of intellectual tests and perceived control scales to 63 elderly adults in 1981 and in 1986. Over the 5 years there were no changes in generalized control or intellectual performance, but there were changes in intellectual control beliefs. Specifically, the participants reported an increased dependence on others to carry out cognitive tasks. The cross-occasion stability correlations were relatively high, although there was some evidence for individual differences in change, especially for the control variables. Surprisingly, those with higher levels of education were more likely to show decreases in perceived intellectual control. Health was a significant antecedent of individual changes in vocabulary performance and intellectual control. The results also indicated that fluid intelligence was a significant predictor of changes in intellectual control beliefs, but control beliefs did not affect performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of outcome in neurotic disorder: a 5-year prospective study

BACKGROUND: There have been no previous studies of the outcome of different neurotic disorders in which a prospective group with original randomization to treatment have been followed up over a long period. Such studies are important in identifying the factors associated with good and poor outcome. METHODS: A 5-year follow-up assessment was made of a cohort of 210 psychiatric out-patients seen in general practice psychiatric clinics with a DSM-III diagnosis of generalized anxiety disorder (71), panic disorder (74) or dysthymic disorder (65) and randomized to drug treatment, cognitive and behaviour therapy, and self-help. A total of 182 of the patients (87%) were assessed after 5 years by examination of hospital and GP records using a standardized procedure and outcome determined with a four-point outcome scale. RESULTS: One hundred and seven (60%) of the patients had a favourable outcome but the remainder continued to be handicapped either intermittently or continuously throughout the 5-year period. Analysis of the value of initial data in predicting outcome using polychotomous step-wise logistic regression revealed that five variables were significant predictors of poor prognosis: older age; recurrent episodes; the presence of personality disorder at entry; general neurotic syndrome at entry; and symptom severity after 10 weeks. The initial DSM diagnosis and original treatment given, together with ten other variables, were of no predictive value. CONCLUSIONS: The long-term outcome of neurotic disorder is better predicted by age, personality and recency of onset than by other clinical variables with the exception of initial response to treatment.     

The economic costs of alcohol, tobacco and illicit drugs in Canada, 1992

AIMS, DESIGN AND SETTING: The economic costs of alcohol, tobacco and illicit drugs in Canadian society in 1992 are estimated utilizing a cost-of-illness framework and recently developed international guidelines. MEASUREMENTS: For causes of disease or death (using ICD-9 categories), pooled relative risk estimates from meta-analyses are combined with prevalence data by age, gender and province to derive the proportion attributable to alcohol, tobacco and/or illicit drugs. The resulting estimates of attributable deaths and hospitalizations are used to calculate associated health care, law enforcement, productivity and other costs. The results are compared wit other studies, and sensitivity analyses are conducted on alternative measures of alcohol consumption, alternative discount rates for productivity costs and the use of diagnostic-specific hospitalization costs. FINDINGS: The misuse of alcohol, tobacco and illicit drugs cost more than $18.4 billion in Canada in 1992, representing $649 per capita or 2.7% of GDP. Alcohol accounts for approximately $7.52 billion in costs, including $4.14 billion for lost productivity, $1.36 billion for law enforcement and $1.30 billion in direct health care costs. Tobacco accounts for approximately $9.56 billion in costs, including $6.82 billion for lost productivity and $2.68 billion for direct health costs. The economic of illicit drugs are estimated at $1.4 billion. CONCLUSIONS: Substance abuse exacts a considerable toll to Canadian society in terms of illness, injury, death and economic costs.