Acute aortic dissection: association with patent ductus arteriosus

The Cuban recombinant vaccine against the hepatitis B virus was applied to a group of individuals over 65 from a geriatric home in Havana City. Dose of 20 ìg were administered within a scheme from 0.1 to 6 months in order to study its immunogenicity, which was evaluated at 2, 7, and 12 months after the first dose. 47.1% of protective titres and geometrical mean of 6.04 UI/L were obtained after 60 days. 100% of seroconversion (UI/L) and seroprotection (10 UI/L) and geometric mean of 136.93 UI/L were obtained when the immune response was evaluated on the 7th month. Finally, after a year, seroconversion and seroprotection were also of 100%, and the geometric mean was of 204.61 UI/L. It was proved the high immunogenic power of this vaccine, which makes it recommendable to protect this age group from the hepatitis B virus.     

Video-assisted thoracoscopic surgery (VATS). Endoscopic thoracoplasty technique

STUDY DESIGN: The study of two patients whose rib deformity was treated using a new endoscopic thoracoplasty technique is reported. OBJECTIVES: To report a new endoscopic thoracoplasty technique for the treatment of rib deformities associated with idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Thoracoplasty has traditionally been performed as an open procedure, often necessitating additional incisions and/or tissue dissection. METHODS: Two children with significant rib humps associated with idiopathic scoliosis were treated with a new endoscopic thoracoplasty technique. RESULTS: Both children showed dramatic cosmetic improvement of their rib deformity. CONCLUSIONS: The indications for the use of video-assisted thoracoscopic surgery in the treatment of pediatric spinal deformity are expanding. We have extended our video-assisted thoracoscopic surgery repertoire to include endoscopic thoracoplasty for treatment of rib deformities associated with idiopathic scoliosis. The technique for endoscopic thoracoplasty is discussed, and illustrative cases are presented.     

Effectiveness of cotherapists versus single therapists and immediate versus delayed treatment in behavioral marital therapy.

Evaluated the overall effectiveness of behavioral marital therapy (BMT) in aiding distressed couples, and explored the relative effectiveness of (a) cotherapists vs single therapists and (b) immediate treatment vs delayed treatment, which resulted from placing couples on a waiting list. 30 maritally distressed couples (aged 19–59 yrs) were randomly assigned to 1 of 6 treatment conditions, with 5 couples per condition: (a) immediate treatment by Therapist A; (b) immediate treatment by Therapist B; (c) immediate treatment by Therapists A and B as a cotherapy team; (d) delayed treatment by Therapist A; (e) delayed treatment by Therapist B; or (f) delayed treatment by Therapists A and B as a cotherapy team. Ss were administered a battery of tests that included the Marital Adjustment Test and Areas-of-Change Questionnaire. Results indicate that BMT was more effective than no treatment on both self-report measures and 1 of 2 behavioral measures, thus affirming the overall effectiveness of the treatment. A cotherapy team and single therapists were equally effective in producing treatment changes. In addition, overall there were no significant differences between couples receiving therapy immediately and couples treated after a 10-wk waiting period. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When do health care decisions discriminate against persons with disabilities?

Recent interpretations of laws prohibiting discrimination against persons with disabilities indicate that these laws will play a greater role in health care decision making than previously anticipated. This article employs lessons from other areas of antidiscrimination law to examine these developments and to provide a framework for making health care decisions that are consistent with these new legal interpretations. This article addresses decisions in individual cases, treatment policies adopted by health care providers, and coverage programs of third-party payers, both public and private.     

Excuse theory: A test of the self-protective role of attributions.

Tested the hypothesis that individuals use consensus-raising, distinctiveness-raising, and consistency-lowering attributional explanations as strategies to excuse their poor performance on an ego-involving task. It was also predicted that such excuse-making tactics occurring after failure feedback, in comparison with those occurring after success feedback, lead to (1) decreased negative emotions when individuals anticipate that their excuse attempts will not be closely scrutinized by an informed or all-knowing audience, and (2) increased negative emotions when individuals anticipate that an evaluative audience has access to their private cognitions and feelings about their poor performance. 96 male undergraduate students were given high or low scores on a purported intelligence test and were administered a mood questionnaire and either items from Rotter's Internal–External Locus of Control Scale (control condition) or an excuse questionnaire (excuse condition). Results support the use of distinctiveness-raising and consistency-lowering, but not consensus-raising, attributional explanations. In addition, the predicted effects of excuse making on emotional state were generally obtained; that is, without the scrutiny of the all-knowing audience, the excuse making lessened negative affect after failure, whereas under the scrutiny of an all-knowing audience, excuse making served to increase negative affect. Results are discussed in terms of the circumstances under which excuse behaviors are construed as self-protective or self-defeating. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

CSF testosterone and 5-HIAA correlate with different types of aggressive behaviors

We studied the potential roles of testosterone and serotonin in various forms of aggressive and violent behaviors by measuring each biochemical and behaviour in free-ranging adolescent male nonhuman primates. Our results showed that (1) CSF free testosterone concentrations were positively correlated with overall aggressiveness, but not with measures of impulsivity. (2) CSF 5-HIAA concentrations were negatively correlated with impulsive behavior, and severe, unrestrained aggression, but not with overall rates of aggression. High rates of impulsive behavior were positively correlated with severe, unrestrained aggression, but not overall rates of aggression. (3) Dimensional analyses showed that while subjects with low CSF 5-HIAA exhibited high rates of aggression, high CSF testosterone further augmented rates and intensity of aggression in subjects with low CSF 5-HIAA. We conclude that high CSF free testosterone concentrations are associated with competitive aggression, while low CSF 5-HIAA concentrations are associated with severe aggression which results from impaired impulse control, and perseverance.     

Narcissistic issues in therapists: Diagnostic and treatment considerations.

Examines narcissistic issues with which therapists are likely to struggle, including extreme audience sensitivity, pathological parentification, perfectionism, and impostor feelings. It is suggested that many therapists were, as children, raised by narcissistic parents, and these children learned to respond to parental needs at the expense of their own development. Unresolved narcissistic issues may contribute to therapist burnout as well as to a tendency to vicariously gratify needs through one's clients. An object relations approach to treatment emphasizes resolving dependency conflicts and developing more resilient self-esteem. Clients are provided insight through interpretations and a corrective interpersonal experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hyphenated history: Osgood-Schlatter disease

The dental technician must have an accurate impression of gingival contour, in order to apply porcelain correctly to a metal-ceramic restoration. This article describes a technique for making an accurate model of the soft tissues around a restoration. The technique involves taking a transfer impression and making a soft tissue model.