A three-dimensional airway assessment for the treatment of snoring and/or sleep apnea with jaw repositioning intraoral appliances: a case study

The purpose of this snoring/sleep apnea study was to assess the role of 3-D magnetic resonance imaging (MRI) of the airway correlated to jaw reposturing/intraoral appliance design. A clinical case is presented utilizing this technology, integrating a diagnostic baseline and follow-up sleep study/ polysomnograph. The baseline polysomnography, prior to jaw repositioning appliance design, indicated a respiratory disturbance index (RDI) of 21.5 hypopnea/apneas per hour. The follow-up sleep study, with use of an intraoral repositioning appliance, showed a 3.9 per hour RDI, an 82% RDI reduction/improvement. Magnetic resonance TMJ and airway images were done. The MRI enhanced airway assessment computer software program analyzed the 3-dimensional volume and cross sectional area changes from hard/soft palate junction to epiglottis. Imaged were the oropharynx nasopharynx and hypopharynx regional anatomy. The baseline, without mandibular positioning device, showed a total airway volume of 5,801.31 cubic mm, whereas with the mandibular positioning device in place, the total airway volume was increased to 8,657.22 cubic mm or a total increased volume of 32%. The largest improvement site in the airway was the mid-soft palatal uvula/nasopharynx region, with base of tongue moving forward. Along with traditional polysomnography, 3-dimensional MRI airway imaging should be considered as a diagnostic procedure in assessing sleep apnea patients. The necessity of a combined medical/dental team approach is emphasized.     

Need and demand for dental treatment. A comparison between an evaluation based on an epidemiologic study of 35-, 50-, and 65-year-olds and performed dental treatment of matched age groups

The aim of this study was to compare the results of the level of treatment need as judged from a sample drawn from the general population aged 35, 50, and 65 years with treatments performed in 1992 and 1993 of patients of matched ages. Both the sample and the patients lived in V?sterbotten in the northern part of Sweden. In all three age groups there was a significantly higher frequency of restorative treatment performed than the professionally assessed need in the epidemiologic sample. In all ages examined, treatment aimed at rehabilitation of temporomandibular disorders was performed statistically significantly (p < 0.001) less frequently than the evaluated need in the population. A similar result was found for dentures among 65-year-olds. The results may reflect dental care paradigms favoring operations on single teeth rather than treatments aimed at functional rehabilitation on a broader sense.     

Stress fracture of the humerus in a weight lifter

Hog cholera virus (HoCV) 5' terminus of the ALD and GPE(-) strains were analyzed by using rapid amplification of cDNA end method (5'RACE). An additional nine nucleotides were found at the 5' termini of genomic RNA in the ALD and GPE(-) strains of HoCV. These nine nucleotides were also conserved in BVDV and were suggested to form a hairpin structure at the 5' terminus by computer-assisted analysis. It seems possible that the secondary structure and/or the 5' terminus sequence has a significant role in the HoCV virus genome.     

A comparison of a token economy with standard inpatient treatment.

Used the Nurses Observation Scale for Inpatient Evaluation (NOSIE-30) to evaluate a token economy ward at a large psychiatric hospital in comparison with 3 nontoken wards in the same unit. The token economy appeared to be more effective in generating a broad range of behavior changes, including both an increase in positive behaviors and a decrease in negative behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A further investigation of the filled-duration illusion with a comparison between children and adults.

This study investigated the filled duration illusion in children in comparison to adults, using a temporal bisection task with two ranges of anchor durations (1 vs. 4s and 2 vs. 8s). The results revealed a marked filled duration effect when filled and empty durations were presented in the same session (within-subjects condition), with the filled durations being judged to be longer than the empty durations in all age groups. However, the magnitude of this effect appeared to be larger in the children than in the adults. Furthermore, the filled duration effect decreased with the longest duration stimuli, and apparent reversals of this effect were observed with the empty durations being judged longer. In the between-subjects experiment, the filled duration effect disappeared in all age groups. However, in the children, the variability in the temporal judgment appeared to be greater for the empty than for the filled durations, thus indicating a lower sensitivity to empty durations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hot flashes and panic attacks: A comparison of symptomatology, neurobiology, treatment, and a role for cognition.

Despite decades of research, the causal mechanisms of hot flashes are not adequately understood, and a biopsychosocial perspective on hot flashes remains underdeveloped. This article explores overlooked parallels between hot flashes and panic attacks within 5 areas: course and symptomatology, physiological indicators, neurocircuitry and biochemical mechanisms, pharmacotherapy, and psychological treatment, noting both similarities and important differences between the 2 events. An integrative conceptual model is presented that identifies key ways in which psychological factors may influence the experience of hot flashes, with clinical implications and areas of future research. This model yields readily testable hypotheses and may provide a template for exploring the role of cognition in the frequency and severity of hot flashes and, in turn, a basis for the development of nonpharmacological treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapeutic orientations: A comparison of conceptualizations, interventions, and treatment plan costs.

Delineated patterns of conceptualization and intervention for 4 psychotherapeutic orientations (psychodynamic, cognitive-behavioral, family systems, and eclectic) and then determined how these patterns related to treatment plan costs. 43 therapists with 1 of the 4 orientations responded to 2 case vignettes that each contained a psychosocial history and portions of a 3rd therapy session for a fictitious patient. Ss were asked to (a) conceptualize about information given by the patient, (b) verbally intervene with the patient, and (c) recommend a treatment plan consisting of types (modality/setting) and amounts (session/days) of treatment. Conceptualization and intervention responses were rated by 3 clinical raters using a psychotherapy judgment rating scale. As predicted, psychodynamic therapists recommended significantly more costly treatment plans. Conceptualization and intervention categories given more focus by the psychodynamic group correlated positively with treatment plan costs, and those categories given more focus by the other therapeutic groups correlated negatively with costs. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

cAMP, an activator of protein kinase A, suppresses the expression of sonic hedgehog

In Drosophila, it has been shown that protein kinase A and hedgehog have antagonistic actions during the formation of imaginal disks. In vertebrate skin, sonic hedgehog is expressed specifically in the feather bud epithelia. using an in vitro explant culture model we showed that dibutyryl cAMP, a protein kinase A (PKA) activator, suppresses the expression of Sonic hedgehog, (Shh) and continuous feather growth. The results suggest that Shh and PKA also have antagonistic action during vertebrate skin morphogenesis.     

Assessment of the taste interaction between two qualitatively similar-tasting substances: A comparison between comparison rules.

The taste interaction between sucrose and fructose was assessed by using three different comparison procedures: the summated response comparison, the factorial plot comparison, and the equimolar comparison rule. The perceived sweetness intensities were obtained on a ratio scale by using a functional measurement approach in combination with a two-stimulus procedure. The conclusions obtained from each of the three comparison rules were identical. The taste interaction between sucrose and fructose could be explained to a large extent, but not completely, by the apparent taste "interactions" within sucrose and fructose as single substances. It is argued that the apparent taste interaction within a large number of single sugars and between two of these sugars in a mixture is somewhat synergistic at low sweetness levels, additive at intermediate sweetness levels, and suppressive at high sweetness levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward an alcohol treatment entry model: a comparison of problem drinkers in the general population and in treatment

Building on a model used in the health services literature, this article examines differences among problem drinkers in treatment and in the general population to understand treatment utilization further. Discriminant function analysis showed significant differences between treated and untreated groups for men and women. For women, lifetime general treatment history, ethnicity, and employment were major contributors to the model; for men, the most important variables were social consequences, treatment history, and employment. For women, only the domain of individual predisposing variables provided a unique contribution to the model (p < 0.01). For men, the individual predisposing (p < 0.001), need (p < 0.001), and enabling (p < 0.01) domains did so. Findings indicate important differences in the factors that influence treatment entry for women and men.     

A comparison of bibliotherapy and group therapy in the treatment of panic disorder.

Investigated 2 methods of disseminating a cognitive-behavioral intervention for panic disorder (PD). 36 Ss who met diagnostic criteria for PD were randomly assigned to 1 of 3 conditions: bibliotherapy (BT), group therapy (GT), or a waiting-list control (WL) condition. Results show that both the BT and GT treatments were more effective than the WL condition in reducing frequency of panic attacks, severity of physical panic symptoms, catastrophic cognitions, agoraphobic avoidance, and depression and that the BT and GT treatments were more effective in increasing self-efficacy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison between emergency diagnostic and treatment unit and inpatient care in the management of acute asthma

BACKGROUND: Emergency diagnostic and treatment units (EDTUs) may provide an alternative to hospitalization for patients with reversible diseases, such as asthma, who fail to adequately respond to emergency department therapy. OBJECTIVE: To evaluate the medical and cost-effectiveness, patient satisfaction, and quality of life of patients receiving EDTU care for acute asthma compared with inpatient care. METHODS: A prospective, randomized clinical trial performed at 2 urban public hospitals enrolled patients with acute asthma (age range, 18-55 years) not meeting discharge criteria after 3 hours of emergency department therapy. Patients were treated with inhaled adrenergic agonists and steroids in an EDTU for up to 9 hours after randomization or with routine therapy in a hospital ward. Patients were followed up for 8 weeks. MAIN OUTCOME MEASURES: Discharge rate from the EDTU, length of stay, relapse rates, days missed from work or school, days incapacitated during waking hours, symptom-free days and nights, nocturnal awakenings, direct medical costs, patients satisfaction, and patient quality of life. RESULTS: The study consisted of 222 patients with asthma. Sixty-five patients (59%) treated in an EDTU were discharged home; the remainder were admitted to the hospital. There were no differences during the follow-up period in relapse rates (P = .74) or in any other morbidities between the EDTU and inpatient groups. There were significant differences in the length of stay, patient satisfaction, and quality of life favoring EDTU care. The mean (+/-SD) cost per patient in the EDTU group was $1202.79 +/- $1343.96, compared with $2247.32 +/- $1110.18 for the control group (P < .001). CONCLUSIONS: Treatment of selected patients with asthma in an EDTU results in the safe discharge of most such patients. This study suggests that quality gains and cost-effective measures can be achieved by the use of such units.     

A comparison between ipsative and normative ratings of personality.

This is a report of results of 2 studies in which ipsative ratings, treated normatively, were correlated with corresponding normative ratings in a test of the functional equivalence of the 2 forms of measurement. "Both analyses showed an almost complete equivalence between the 2 methods. A possible reason for this relationship was discussed and some of the advantages of the ipsative approach presented." The opinion that a number of current rating and assessment procedures bear revision in light of these findings was offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)