The potential use of artificial intelligence in the therapy of borderline personality disorder.

This paper explores the possibility of AI-based addendum therapy for borderline personality disorder, its potential advantages and limitations. Identity disturbance in this condition is strongly connected to self-narratives, which manifest excessive incoherence, causal gaps, dysfunctional beliefs, and diminished self-attributions of agency. Different types of therapy aim at boosting self-knowledge through self-narratives in BPD.

The dipeptidyl peptidase IV (CD26, EC 3.4.14.5) inhibitor vildagliptin is a potent antihyperalgesic in rats by promoting endomorphin-2 generation in the spinal cord.

We have reported previously that the dipeptidyl peptidase IV inhibitor Ile-Pro-Ile had an antihyperalgesic action in rats when given intrathecally in the carrageenan-induced hyperalgesia, as detected by the Randall-Selitto test. Vildagliptin, a non-peptide inhibitor of the same enzyme, which is already on the market as an "euglycemic" agent in diabetics, has a slightly more potent and more sustained antihyperalgesic effect in the same test when given by the same route. The action of 3nmol/rat vildagliptin could be antagonized by subcutaneous naltrexone (0.

Intrathecally injected Ile-Pro-Ile, an inhibitor of membrane ectoenzyme dipeptidyl peptidase IV, is antihyperalgesic in rats by switching the enzyme from hydrolase to synthase functional mode to generate endomorphin 2.

We have found recently that membrane-bound dipeptidyl peptidase IV (DPP-IV) generated extracellularly immunoreactive endomorphin-2 from Tyr-Pro precursor in a depolarisation-sensitive manner in rat isolated L4,5 dorsal root ganglia when the enzyme was switched to synthase mode by the hydrolase inhibitor Ile-Pro-Ile. Presently, we induced hyperalgesia in rats by injecting carrageenan into the right hindpaw and measured the reduction in nociceptive threshold (hyperalgesia) to pressure (Randall-Selitto test). The hyperalgesia, peaking at 180 min after injection, was fully reversed by intrathecal administration of 30 nmol/rat Ile-Pro-Ile.

Hypercoagulability after trauma: hemostatic changes and relationship to venous thromboembolism.

Background: Major trauma induces a hypercoagulable state, which is frequently complicated by pathological thrombosis. However the sequential changes in coagulation markers and their relationship to clinical thrombosis have been poorly characterized.

Methods: We measured several markers of in vivo coagulation and fibrinolysis and their regulation serially for 2 weeks after multi-system trauma in a prospective cohort of patients who received no anticoagulant prophylaxis.

Waiting for hip revision surgery: the impact on patient disability.

Objective: Increased wait times for total joint arthroplasty (TJA) are a concern nationally and provincially. Additionally, the number of patients requiring revision of their initial TJA is increasing. The purpose of this study was to evaluate the wait times and impact of waiting for revision TJA.

Minimising blood loss and transfusion requirements in hepatic resection.

Background: Substantial blood loss and the requirement for blood transfusion remain major considerations for hepatic surgeons. We analysed the impact of a systematic protocol aimed at reducing intraoperative blood loss and homologous blood (HB) transfusion associated with hepatic resection.

Methods: Prospective clinical data were collected from 151 elective liver resections performed during the period between 1980 and 1999.

The effect of low-complexity patients on emergency department waiting times.

Study Objective: The extent to which patients presenting to emergency departments (EDs) with minor conditions contribute to delays and crowding is controversial. To test this question, we study the effect of low-complexity ED patients on the waiting times of other patients.

Methods: We obtained administrative records on all ED visits to Ontario hospitals from April 2002 to March 2003.

A randomized controlled trial of the effect of dietary soy and flaxseed muffins on quality of life and hot flashes during menopause.

Objective: To compare the effects of daily ingestion of soy flour (S), ground flaxseed (F), or wheat flour (W) muffins, on quality of life and hot flash frequency and severity in postmenopausal women.

Design: This was a double-blind, randomized, controlled, intention-to-treat trial. Ninety-nine women, 1 to 8 years after menopause, ingested muffins with 25 g of flaxseed (50 mg of lignans), 25 g of soy (42 mg of isoflavones), or wheat (control) daily for 16 weeks.

Effect of nurse-directed hypertension treatment among First Nations people with existing hypertension and diabetes mellitus: the Diabetes Risk Evaluation and Microalbuminuria (DREAM 3) randomized controlled trial.

Background: First Nations people with diabetes mellitus and hypertension are at greater risk of renal and cardiovascular complications than are non-native patients because of barriers to health care services. We conducted this randomized controlled trial to assess whether a community-based treatment strategy implemented by home care nurses would be effective in controlling hypertension in First Nations people with existing hypertension and type 2 diabetes.

Methods: We compared 2 community-based strategies for controlling hypertension in First Nations people with existing hypertension and diabetes.

Physiotherapy coupled with dextroamphetamine for rehabilitation after hemiparetic stroke: a randomized, double-blind, placebo-controlled trial.

Background And Purpose: Hemiparesis is the commonest disabling deficit caused by stroke. In animals, dextroamphetamine (AMPH) paired with training enhances motor recovery, but its clinical efficacy is uncertain.

Methods: In a randomized, double-blind, placebo-controlled trial, 71 stroke patients were stratified by hemiparesis severity and randomly assigned to 10 sessions of physiotherapy coupled with either 10 mg AMPH or placebo.

Impact of job and marital strain on ambulatory blood pressure results from the double exposure study.

Background: Psychosocial stressors such as job strain and marital stress have been associated with a sustained increase in blood pressure (BP).

Methods: We evaluated whether job strain and marital cohesion were associated with ambulatory BP in workers with normal or untreated elevated BP using baseline data from the Double Exposure study. The study population included 248 male and female volunteers who were nonmedicated, employed, and living with a significant other, all for a minimum of 6 months.

Expectant management of postdural puncture headache increases hospital length of stay and emergency room visits.

Purpose: This retrospective cohort study examined hospital length of stay (LOS) and emergency room (ER) visits in parturients diagnosed with postdural puncture headache (PDPH) following recognized dural puncture (DP). All cases were managed expectantly. Outcomes were compared with matched controls with uneventful labour epidurals.

Mild cognitive impairment: an operational definition and its conversion rate to Alzheimer's disease.

Objective: Because of discrepant findings regarding the accuracy of mild cognitive impairment (MCI) in predicting Alzheimer's disease (AD), further study of this construct and conversion rates is essential before use in clinical settings. We aimed to develop an operational definition of MCI consistent with criteria proposed by the Mayo Alzheimer's Disease Center, and to examine its conversion rate to AD.

Methods: Patients were identified from an inception cohort of patients with at least a 3-month history of memory problems, and referred to a 2-year university teaching hospital investigation by primary care physicians.

Verbal fluency patterns in two subgroups of patients with Alzheimer's disease.

Previous research has identified two subgroups of patients with Alzheimer's disease (AD) based on performance discrepancies on semantic and visual-constructional measures: Left AD (LAD) and Right AD (RAD). In this study, verbal fluency performances (Animal Fluency [AF] and Letter Fluency [FAS]) of these two subgroups were examined. It was hypothesized that LAD patients would perform worse on AF compared to FAS, due to an underlying breakdown of left-hemisphere semantic networks.

Epidural catheter penetration of human dural tissue: in vitro investigation.

Background: Factors contributing to subarachnoid catheter passage after epidural placement are not well understood. This study explored mechanisms that might explain its occurrence.

Methods: Human cadaveric dura was mounted on a model and pressurized to physiologic levels.

Carpal tunnel syndrome: cross-sectional and outcome study in Ontario workers.

Purpose: To carry out an analytic cross-sectional study of Ontario workers with carpal tunnel syndrome (CTS) and to assess workers' symptoms, functional disabilities, recreational difficulties, and work capability 4 years after treatment of their CTS.

Methods: Data were obtained by review of Ontario Workers Safety and Insurance Board (WSIB) files and by completion of self-assessment questionnaires. Inclusion criteria included all workers registered with the Ontario WSIB who were off work with newly diagnosed carpal tunnel syndrome in 1996.

Linear width of the medial temporal lobe can discriminate Alzheimer's disease from normal aging: the Sunnybrook dementia study.

To discriminate Alzheimer's disease (AD) from healthy controls, the thinnest medial temporal lobe (tMTL) width on 3D-MRI was measured according to a newly developed method at the inter-collicular sulcus (ICS) level with scans aligned to the long axis of the hippocampus in 22 mild, 27 moderate probable AD patients and 41 healthy controls. For comparison, MTL width replicating the technique of Jobst et al. (jMTL) as well as hippocampal and parahippocampal volumes, were also measured.

Impact of antidepressant side effects on adolescent quality of life.

Objective: This study examines the relative impact of antidepressant side effects on adolescents with a history of major depression.

Methods: We used Q-sort methodology to capture the opinions of adolescents with a history of depression (n = 22), adults with a history of depression (n = 20), healthy adolescents (n = 20), and clinicians (n = 18) on the impact of 40 common antidepressant side effects. We asked subjects to force rank the side effects, judging each side effect on its relative impact on their daily lives.

Long-term pulmonary function abnormalities and survival after allogeneic marrow transplantation.

We studied long-term pulmonary function testing (PFT) in a retrospective cohort of 6-month survivors of allogeneic marrow transplant (BMT) between 1980 and 1997. Of 593 patients, 73, 71 and 65% had adequate data to assess for obstruction, restriction and diffusion impairments respectively. Over 5 years, mean declines in 1-s forced expiratory volume/forced vital capacity (FEV1/FVC), total lung capacity (TLC) and diffusion were 4, 7 and 17%, respectively.

Dural tissue trauma and cerebrospinal fluid leak after epidural needle puncture: effect of needle design, angle, and bevel orientation.

Background: The effects of epidural needle design, angle, and bevel orientation on cerebrospinal fluid leak after puncture have not been reported. The impact of these factors on leak rate was examined using a dural sac model. Dural trauma was examined using scanning electron microscopy.

Classifying failed hip arthroplasty: generalizability of reliability and validity.

Interrater reliability and validity of a radiographic severity classification was evaluated in 81 patients having revision hip arthroplasty. Severity was rated separately on the femoral and acetabular sides using a five-level scale ranging from no significant loss of bone stock to uncontained loss of bone stock and discontinuity. Three academic orthopaedic surgeons rated preoperative anteroposterior radiographs taken within 6 weeks of surgery.

The Toronto outcome measure for craniofacial prosthetics: a condition-specific quality-of-life instrument.

Purpose: The objective was to develop a patient-based outcome measure of condition-specific quality of life that would minimize measurement error related to the instrument when used with patients requiring extraoral craniofacial prostheses.

Materials And Methods: An item pool of potential questionnaire items covered 10 clinical/technical and social/psychologic domains. They sought how frequently the issue in the item affected patients and how important the problem in the item was.

Marital support, spousal contact and the course of mild hypertension.

Objective And Methods: To define marital support (MS) and its correlates in a sample of mild hypertensives where marital adjustment (by Dyadic Adjustment Scale, DAS) was related to 3-year left ventricular mass, a secondary analysis was performed on 103 men and women who underwent 24-h ambulatory BP (ABP) monitoring, M-mode echocardiography and completed psychosocial questionnaires at baseline and 3 years.

Results: MS, defined as the presence of both marital satisfaction and cohesion (upper quartiles of DAS subscales) at baseline, predicted 3-year left ventricular mass (P=.007), which decreased 8% in the MS group and increased 6.