Aortoduodenal fistula in the acute trauma setting: case report.
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Abdominal Injuries↗
Biomedical subjects
Barry Simon
Publications and source records attributed to Barry Simon.
Psychoanalytic patients in the U.S., Canada, and Australia: II. A DSM-III-R validation study.
A study was conducted to validate our previous work on the DSM-III-R disorders diagnosed in patients in psychoanalysis in the U.S., Canada, and Australia and to determine which specific mood, anxiety, and personality disorders were the most common in these patients. The earlier study consisted of three surveys of psychoanalytic practice that together obtained data on 1,718 patients, through extensive mail surveys to analysts in the three countries. In the validation study, 206 patients were diagnosed using a different technique. Analysts similar in important respects to those who participated in the original surveys rated patients diagnostically before and after DSM-III-R training. After training, no significant changes appeared in the rates for any of the specific mood disorders. For the thirty disorders examined, training effects decreased the identification of the generalized anxiety disorder, and increased the identification of three personality disorders: avoidant, dependent, and personality disorder not otherwise specified. Thus, analysts slightly underdiagnosed the number of personality disorders, and some "anxious" patients appear to have qualified for personality disorders. Some limitations of the DSM-III-R notion of narcissistic personality are discussed, as are the importance and stability of the self-defeating (masochistic) personality disorder. The most common Axis I disorder in psychoanalytic patients was dysthymia, followed by major depression, recurrent. This study reinforces the findings of the original three surveys. Minor corrections were developed to adjust the original three surveys.
Adult↗
Psychoanalytic patients in the U.S., CANADA, and Australia: I. DSM-III-R disorders, indications, previous treatment, medications, and length of treatment.
To determine the demographics, DSM-III-R disorders diagnosed, indications used in recommending psychoanalysis, previous treatment histories, use of medication, and length of treatment in patients in psychoanalysis in the U.S., Canada, and Australia, a mail survey of practice was sent to every other active member of the American Psychoanalytic Association and every member of the Australian Psychoanalytical Society. This supplemented an earlier survey sent to all Ontario psychoanalysts. The response rates were 40.1 % (n = 342) for the U.S., 67.2% (n = 117) for Canada, and 73.9% (n = 51) for Australia. Respondents supplied data on 1,718 patients. The employment rate for patients increases as analysis progresses (p < .0001). The mean number of concurrent categories of disorders (Axis I, Axis II, and Disorders First Evident in Childhood) per patient at the start of treatment is 5.01 (SD = 3.66; median = 4; mode = 3). There are no statistically significant differences across countries. Mood, anxiety, sexual dysfunction, and personality disorders are most common. American Psychiatric Association / American Psychoanalytic Association peer review criteria for indicating psychoanalysis are followed for 86.5% of patients. Over 80% of patients in all three countries had undergone previous treatments prior to analysis. In the U.S., 18.2% of analysands are on concurrent psychoactive medication; in Australia, 9.6%. The mean length of analyses conducted in the U.S. is 5.7 years, in Australia 6.6, and in Canada 4.8. Psychoanalytic patients in all three countries have similar rates of DSM-III-R psychopathology, and many indications of chronicity.
Adult↗
Sensory responses from loading of implants: a pilot study.
PURPOSE: Osseointegrated implants lack a periodontal ligament. Nevertheless, masticatory function in subjects with implant-supported restorations appears similar to function in those with natural dentition. It is not clear how the neurophysiologic mechanisms that modulate jaw movement are associated with osseointegrated implants. This study examined the output from the inferior alveolar nerve during implant loading. MATERIALS AND METHODS: In 3 dogs, 3 premolars were extracted in the mandible and 2 endosseous titanium implants were placed, allowed to osseointegrate for 3 months, and loaded with vibration force at the threshold response for tooth vibration, at 2x threshold, and at 3x threshold. Neurophysiologic recordings were made from the inferior alveolar nerve during loading of both implants and the adjacent molar and canine. The response magnitude in action potentials in the 50- ms poststimulus period and latency of inferior alveolar afferents in milliseconds were compared following implant loading. RESULTS: Detectable inferior alveolar nerve responses were recorded following loading from both the implants and the teeth at 2x and 3x threshold. However, the response magnitude of teeth (canine, 2.38 +/- 0.18 at 2x, 2.78 +/- 0.2 at 3x; molar, 2.2 +/- 0.16 at 2x, 2.5 +/- 0.21 at 3x) was twice that of the implants (anterior, 1.3 +/- 0.12 at 2x, 1.68 +/- 0.13 at 3x; posterior, 0.8 +/- 0.1 at 2x, 1.53 +/- 0.15 at 3x). The differences in response magnitude between the teeth and implants were significant (P < .05). The latency of response was similar. DISCUSSION: Management of the occlusion for implant-supported restorations has been empirically developed. An underlying assumption has been that implant-guided jaw function lacks significant proprioception to modulate mastication and related jaw movements. This animal study provides preliminary evidence that force application to implants does elicit a proprioceptive response. CONCLUSION: Loading of implants does elicit a sensory response that can be observed in the inferior alveolar nerve. The implications are that during occlusal function, information from regions associated with the implant can provide knowledge that could potentially modulate jaw activity in a manner similar to natural teeth.
Action Potentials↗