Individualized versus standardized therapy: A comparative evaluation with obsessive-compulsive patients

The aim of this study was to investigate whether individualized tailor-made behavioural treatment based upon a problem analysis of each case was more effective than a standardized behavioural treatment protocol. Twenty-two obsessive-compulsive patients were randomly assigned to two treatment conditions: (1) tailor-made cognitive behavioural therapy and (2) standardized exposure in vivo therapy. Treatment in both conditions led to significant improvements on obsessive-compulsive targets and on the Maudsley Obsessional-Compulsive Inventory. Improvement generalized to general levels of psychopathology, depressed mood and social anxiety. Contrary to expectations the individualized treatment was not more effective than the standardized exposure therapy.     

Nonsurgical closure of oroantral communications with a biodegradable polyurethane foam: A pilot study in rabbits.

PURPOSE: Surgical closure of oroantral communications (OACs) has several disadvantages. An animal study was performed to test whether OACs can be closed nonsurgically with a biodegradable polyurethane (PU) foam. MATERIALS AND METHODS: In 6 rabbits, an OAC was created on both sides of the maxilla. Three rabbits were used to evaluate the animal model by applying a surgical treatment on 1 side and by leaving the other defects untreated. In the 3 other rabbits, OACs were closed with PU foam. Wound healing was evaluated clinically and histologically. RESULTS: The surgically treated defects healed without complications. The untreated defects showed complicated and delayed healing. Healing of the foam-treated OACs was dependent on the type of foam that was used. CONCLUSIONS: The rabbit is a suitable animal model for OAC investigations. It is possible to close an OAC with a biodegradable PU foam. Further research is needed to show the most suitable composition of the PU for this purpose.     

Reflex sympathetic dystrophy of the left hand and motor impairments of the unaffected right hand: impaired central motor processing?

OBJECTIVE: To test whether central motor processing can be impaired in chronic reflex sympathetic dystrophy (RSD). DESIGN: Experimental 2-group analysis. SETTING: Tertiary care center in the Netherlands. PARTICIPANTS: Five patients with stage 3 RSD of the left forearm, free of symptoms and complaints in the right forearm; and 10 healthy control subjects. INTERVENTION: On a digitizer, RSD patients and controls had to draw 3 sequences of graphemes of different complexity with their (unaffected) dominant right hand. The drawing tracks were segmented in time periods between points of velocity minima of the pen tip. MAIN OUTCOME MEASURES: Mean velocity, coefficients of variation of both length and movement time per segment, and mean intersegmental pausing time were calculated for each sequence. RESULTS: A repeated-measures analysis of variance by using the multivariate method yielded a 35% lower mean velocity (F(1,13) = 5.83, P =.031), a 110% larger segment length variability (F(1,13) = 9.72, P =.008) and a 60% larger variability of movement time per segment (F(1,13) = 5.78, P =.032) in RSD patients. No group difference was found for intersegmental pausing time or any interaction effect with the type of task. CONCLUSION: Patients with chronic RSD have a normal ability to preprogram sequential movements of their unaffected hand; but with impaired temporospatial coding and movement execution. We concluded that cortical mechanisms may be involved in motor impairments in patients with chronic RSD.     

Minimal displacement of novel self-anchoring catheters suitable for temporary prostate implants.

Catheters were developed that can be fixed in the prostate gland by self-expanding parts for use in PDR brachytherapy. Daily CT-scans were made to investigate the magnitude of catheter displacement. The mean absolute displacement during the 3 day treatment was 1.2 mm. The resulting minor alterations in dose-volume parameters were of no clinical importance.     

Astigmatism and visual recovery after phacoemulsification and conventional extracapsular cataract extraction

In this study we wanted to investigate the post-operative astigmatism and visual acuity after phacoemulsification and conventional extracapsular cataract surgery. Patients operated between April and June 1993 (n=150) were retrospectively analyzed. The patients were examined prior to surgery and at day 1, at day 10, and in week 6 post-operatively. The difference between the post-operative log mean visual acuity in the Phaco group and in the CECCE group was significant after 1 and 10 days, however it was not significant (p=0.191) after 6 weeks. The mean astigmatism was significantly less in the Phaco group than in the CECCE group during the whole post-operative check-up period. This study suggests that Phaco results in a lower post-operative astigmatism and an earlier visual rehabilitation compared to the CECCE technique.Abbreviations Phaco Phacoemulsification - CECCE Conventional extracapsular cataract extraction     

Xanthogranulomatous pyelonephritis: Comparison of extent using computed tomography and magnetic resonance imaging in one case

In a case of diffuse xanthogranulomatous pyelonephritis, computed tomography (CT) and magnetic resonance (MR) were used. The MR proved to be more precise in the preoperative evaluation of inflammatory extension to the spleen and into the abdominal wall. The CT was more accurate in excluding spread to the colon.     

Cortisol moderates the relationship between testosterone and aggression in delinquent male adolescents.

BACKGROUND: In animals, strong evidence exists for an association between testosterone and aggression. In humans, and particularly in children and adolescents, findings have been less consistent. Previous research has suggested that this may partly be due to moderating effects of other factors, e.g., hormones. This study aims to investigate the moderating effect of cortisol on the relationship between testosterone and subtypes of aggression in delinquent male adolescents. METHODS: Participants were 103 boys (mean age 13.7) referred to a delinquency diversion program. Testosterone and cortisol levels were determined from saliva samples collected during resting conditions and related to self-report scores on overt and covert aggression. RESULTS: Linear regression analyses revealed a significant interaction between cortisol and testosterone in relation to overt aggression, with a significant positive relationship between testosterone and overt aggression in subjects with low cortisol levels but not in subjects with high cortisol levels. Using the same model for covert aggression, no significant effects of testosterone, cortisol, or testosterone x cortisol interaction were found. CONCLUSIONS: These results indicate a moderating effect of cortisol on the relationship between testosterone and overt aggression in delinquent male adolescents. Implications and directions for future research are discussed.     

Ewing's sarcoma of bone: Oncologic and functional results

This paper describes 29 patients with Ewing's sarcoma of bone treated between 1975 and 1990 at the University of Nijmegen Hospital, Nijmegen, The Netherlands. Osteomyelitis was the primary diagnosis in 24%. Treatment consisted of chemotherapy in combination with surgery and/or radiotherapy. Nine patients received radiotherapy only; five of them died of disease. Five patients underwent an intralesional excision; four of them died of disease. Twelve patients underwent a wide excision; there is no evidence of disease in any of them. Three patients underwent a radical disarticulation; all died of disease. The disease-free survival at 1.5 years was 66%. This figure at 5 years was 55%. After wide excision and reconstruction in tumors of expendable, femoral or radial bones good functional results were obtained in all cases. © 1995 Wiley-Liss, Inc.