17 results on '"William Fisher"'
Search Results
2. Patient Perspectives on Deep Brain Stimulation Clinical Research in Early Stage Parkinson’s Disease
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Adria K. Martig, Mallory L. Hacker, Lauren E. Heusinkveld, Christina Tamargo, Lauren McLaughlin, Madelyn K Bollig, William Fisher, Maxim Turchan, and David Charles
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Male ,medicine.medical_specialty ,Deep brain stimulation ,Parkinson's disease ,Deep Brain Stimulation ,medicine.medical_treatment ,Disease ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Double-Blind Method ,medicine ,Humans ,Longitudinal Studies ,030212 general & internal medicine ,Stage (cooking) ,Aged ,Medical treatment ,business.industry ,Parkinson Disease ,Middle Aged ,Patient Acceptance of Health Care ,medicine.disease ,Patient preference ,Clinical research ,Physical therapy ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
The FDA has approved a multicenter, double-blind, Phase III, pivotal trial testing deep brain stimulation (DBS) in 280 people with very early stage Parkinson's disease (PD; IDE#G050016). In partnership with The Michael J. Fox Foundation for Parkinson's Research, we conducted a survey to investigate motivating factors, barriers, and gender differences among potentially eligible patients for participation in a trial testing DBS in early PD compared to standard medical treatment. The majority of survey respondents (72%) indicated they would consider learning more about participating. Early PD patients are therefore likely to consider enrolling in trials of invasive therapies that may slow symptom progression and help future patients. more...
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- 2017
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Catalog
3. Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty
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Stéphane Pelet, Paul Y. Kim, Susan R. Kahn, Michael J. Kovacs, Etienne Belzile, Steve Doucette, Pascal-André Vendittoli, John Murnaghan, Chris Theriault, Michael J. Dunbar, Mark Crowther, Marc Carrier, Steven J. MacDonald, William Fisher, Philip S. Wells, Peter L. Gross, Abongnwen Abianui, Susan Pleasance, Wade Gofton, Sean Dolan, Eric Bohm, David J. Zukor, David R. Anderson, Doug Coyle, Michael E. Forsythe, Pantelis Andreou, and Marc A. Rodger more...
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Arthroplasty, Replacement, Hip ,Hemorrhage ,030204 cardiovascular system & hematology ,Vte prophylaxis ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Randomized controlled trial ,Double-Blind Method ,Rivaroxaban ,law ,Risk Factors ,medicine ,Humans ,Arthroplasty, Replacement, Knee ,Aged ,030222 orthopedics ,Aspirin ,business.industry ,General Medicine ,Venous Thromboembolism ,Middle Aged ,medicine.disease ,Thrombosis ,Arthroplasty ,3. Good health ,Surgery ,Pulmonary embolism ,Clinical trial ,business ,Platelet Aggregation Inhibitors ,medicine.drug ,Factor Xa Inhibitors - Abstract
Clinical trials and meta-analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge.We performed a multicenter, double-blind, randomized, controlled trial involving patients who were undergoing total hip or knee arthroplasty. All the patients received once-daily oral rivaroxaban (10 mg) until postoperative day 5 and then were randomly assigned to continue rivaroxaban or switch to aspirin (81 mg daily) for an additional 9 days after total knee arthroplasty or for 30 days after total hip arthroplasty. Patients were followed for 90 days for symptomatic venous thromboembolism (the primary effectiveness outcome) and bleeding complications, including major or clinically relevant nonmajor bleeding (the primary safety outcome).A total of 3424 patients (1804 undergoing total hip arthroplasty and 1620 undergoing total knee arthroplasty) were enrolled in the trial. Venous thromboembolism occurred in 11 of 1707 patients (0.64%) in the aspirin group and in 12 of 1717 patients (0.70%) in the rivaroxaban group (difference, 0.06 percentage points; 95% confidence interval [CI], -0.55 to 0.66; P0.001 for noninferiority and P=0.84 for superiority). Major bleeding complications occurred in 8 patients (0.47%) in the aspirin group and in 5 (0.29%) in the rivaroxaban group (difference, 0.18 percentage points; 95% CI, -0.65 to 0.29; P=0.42). Clinically important bleeding occurred in 22 patients (1.29%) in the aspirin group and in 17 (0.99%) in the rivaroxaban group (difference, 0.30 percentage points; 95% CI, -1.07 to 0.47; P=0.43).Among patients who received 5 days of rivaroxaban prophylaxis after total hip or total knee arthroplasty, extended prophylaxis with aspirin was not significantly different from rivaroxaban in the prevention of symptomatic venous thromboembolism. (Funded by the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT01720108 .). more...
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- 2018
4. Hypnotic Relaxation Therapy for Reduction of Hot Flashes in Postmenopausal Women:Examination of Cortisol as a Potential Mediator
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Janet S. Carpenter, Gary R. Elkins, Aimee K. Johnson, Vicki Patterson, Cassie Kendrick, William Fisher, and Jim Sliwinski
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Complementary and Manual Therapy ,medicine.medical_specialty ,Evening ,Hydrocortisone ,genetic structures ,medicine.drug_class ,Relaxation Therapy ,Hypnotic ,Mediator ,Breast cancer ,Internal medicine ,medicine ,Humans ,Saliva ,Salivary cortisol ,Postmenopausal women ,business.industry ,Galvanic Skin Response ,Middle Aged ,medicine.disease ,eye diseases ,Clinical Psychology ,Endocrinology ,Hot Flashes ,Biomarker (medicine) ,Female ,sense organs ,business ,Biomarkers ,Hypnosis - Abstract
Hypnotic relaxation therapy (HRT) has been shown to reduce hot flashes in postmenopausal women and breast cancer survivors. While the biological mechanism by which HRT reduces hot flashes is unknown, it has been speculated that reduction of stress mediates the intervention’s effectiveness. The purpose of the present study was to examine the effect of HRT on a known biomarker of stress (cortisol) and changes in cortisol as a mediator. Sixty-two postmenopausal women received hypnotic relaxation therapy for hot flashes and completed measures of hot flashes in addition to providing cortisol samples at baseline and endpoint. HRT resulted in significantly decreased early evening salivary cortisol concentrations. However, changes in salivary cortisol concentrations did not mediate the effects of HRT. more...
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- 2014
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5. Risk factors, pathophysiology, and treatment of hot flashes in cancer
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Julie L. Otte, Janet S. Carpenter, Menggang Yu, William Fisher, Gary R. Elkins, Aimee K. Johnson, and Debra S. Burns
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Complementary Therapies ,Adrenergic Antagonists ,medicine.medical_specialty ,Palliative care ,medicine.medical_treatment ,Stellate Ganglion ,Cholinergic Antagonists ,Article ,Quality of life ,Risk Factors ,Hot flash ,Neoplasms ,Internal medicine ,Humans ,Medicine ,Cognitive Behavioral Therapy ,business.industry ,Cancer ,Vitamins ,Hematology ,medicine.disease ,Antidepressive Agents ,Surgery ,Menopause ,Cognitive behavioral therapy ,Mood ,Oncology ,Hot Flashes ,Cognitive therapy ,Anticonvulsants ,medicine.symptom ,business ,Autonomic Nerve Block ,Body Temperature Regulation ,Phytotherapy - Abstract
Hot flashes are prevalent and severe symptoms that can interfere with mood, sleep, and quality of life for women and men with cancer. The purpose of this article is to review existing literature on the risk factors, pathophysiology, and treatment of hot flashes in individuals with cancer. Electronic searches were conducted to identify relevant English-language literature published through June 15, 2012. Results indicated that risk factors for hot flashes in cancer include patient-related factors (eg, age, race/ethnicity, educational level, smoking history, cardiovascular risk including body mass index, and genetics) and disease-related factors (eg, cancer diagnosis and dose/type of treatment). In addition, although the pathophysiology of hot flashes has remained elusive, these symptoms are likely attributable to disruptions in thermoregulation and neurochemicals. Therapies that have been offered or tested fall into 4 broad categories: pharmacological, nutraceutical, surgical, and complementary/behavioral strategies. The evidence base for this broad range of therapies varies, with some treatments not yet having been fully tested or showing equivocal results. The evidence base surrounding all therapies is evaluated to enhance hot flash treatment decision-making by clinicians and patients. more...
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- 2013
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6. Cognitive Hypnotherapy for Pain Management
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Gary R. Elkins, Aimee K. Johnson, and William Fisher
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medicine.medical_specialty ,Hypnosis ,Psychotherapist ,Psychological intervention ,Pain ,Disease ,Relaxation Therapy ,Chest pain ,Fibromyalgia ,Health care ,medicine ,Humans ,Pain Management ,Randomized Controlled Trials as Topic ,Cognitive Behavioral Therapy ,business.industry ,Chronic pain ,Cognition ,General Medicine ,medicine.disease ,Complementary and alternative medicine ,Chronic Disease ,Physical therapy ,medicine.symptom ,business - Abstract
Pain is a serious health care problem and there is growing evidence to support the use of hypnosis and cognitive-behavioral interventions for pain management. This article reviews clinical techniques and methods of cognitive hypnotherapy for pain management. Current research with emphasis given to randomized, controlled trials is presented and the efficacy of hypnotherapy for pain management is discussed. Evidence for cognitive hypnotherapy in the treatment in chronic pain, cancer, osteoarthritis, sickle cell disease, temporomandibular disorder, fibromyalgia, non-cardiac chest pain, and disability related chronic pains are identified. Implications for clinical practice and research are discussed in light of the accumulating evidence in support of the efficacy and effectiveness of cognitive hypnotherapy for pain management. more...
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- 2012
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7. Hot Flashes: Phenomenology and Measurement
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William Fisher and Rebecca C. Thurston
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Race ethnicity ,030219 obstetrics & reproductive medicine ,genetic structures ,business.industry ,Treatment options ,medicine.disease ,Menopause ,03 medical and health sciences ,0302 clinical medicine ,Hot flash ,medicine ,sense organs ,030212 general & internal medicine ,medicine.symptom ,business ,Skin conductance ,Clinical psychology ,Reproductive health - Abstract
Hot flashes are a highly prevalent symptom experienced by women transitioning through menopause, as well as by men and women undergoing certain cancer-related treatments. Though many individuals do not find these symptoms troublesome, others suffer from severe and frequent symptoms and related decrements in sleep, psychological well-being, sexual health and overall quality of life. In order to develop a better understanding of the etiology and treatment options for hot flashes, accurate measurement is vital. This chapter provides an overview of hot flash measurement both physiologic, and via self-report measures. It critically evaluates the four categories of hot flash measurement tools: symptom scales based on retrospective reporting over weeks and months, daily diaries completed by end of day, daily diaries completed at the time of the hot flash, and physiologic measures of hot flashes. Further, the impact of psychological/emotional influences, ethnic differences, and body mass on hot flash reporting is discussed. Finally, this chapter provides recommendations for the future development and refinement of hot flash reporting tools and suggestions for best-practice hot flash measurement methodology. more...
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- 2016
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8. A double-blind, randomized controlled trial of the prevention of clinically important venous thromboembolism after isolated lower leg fractures
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Rita, Selby, William H, Geerts, Hans J, Kreder, Mark A, Crowther, Lisa, Kaus, Faith, Sealey, and William, Fisher
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Adult ,Dalteparin ,Male ,medicine.medical_specialty ,Deep vein ,Venography ,Ankle Fractures ,Asymptomatic ,law.invention ,Double blind ,Fractures, Bone ,Randomized controlled trial ,Double-Blind Method ,law ,medicine ,Humans ,Orthopedics and Sports Medicine ,Clinical significance ,Aged ,Ultrasonography ,medicine.diagnostic_test ,business.industry ,Anticoagulants ,General Medicine ,Venous Thromboembolism ,Middle Aged ,medicine.disease ,Thrombosis ,Surgery ,Tibial Fractures ,medicine.anatomical_structure ,Fibula ,cardiovascular system ,Female ,medicine.symptom ,business ,Venous thromboembolism ,Leg Injuries - Abstract
Among patients with isolated below-knee fractures, previous studies have detected asymptomatic deep vein thrombosis in 10%-40% using contrast venography. However, the clinical relevance of these thrombi is unknown; there is considerable uncertainty about the risk: benefit of routine thromboprophylaxis and clinical practice guidelines differ in their recommendations.In this multicenter, double-blind trial, 265 patients with isolated lower leg fractures requiring surgery were randomized to subcutaneous dalteparin 5000 units or matching placebo once daily for 2 weeks with bilateral Doppler ultrasound (DUS) of the proximal leg veins on postoperative day 14±2 and 3-month follow-up. The primary effectiveness outcome was clinically important venous thromboembolism (CIVTE), defined as the composite of symptomatic venous thromboembolism within 3 months after surgery and asymptomatic proximal deep vein thrombosis on DUS. The primary safety outcome was major bleeding.Two hundred fifty-eight patients (97%) were included in the primary outcome analysis for effectiveness (130: dalteparin; 128: placebo). Incidence of CIVTE in the dalteparin and placebo groups was 1.5% and 2.3%, respectively (absolute risk reduction, 0.8%; 95% confidence interval, -2.0 to 3.0). There were no fatal pulmonary emboli or major bleeding.The overall incidence of CIVTE after surgically repaired, isolated tibia, fibula, and ankle fractures was low (1.9%; 95% confidence interval, 0.7-4.7), with no observed differences between dalteparin and placebo either for CIVTE or safety. Recruitment was stopped at the first interim analysis. This study also demonstrates the substantial discrepancy in venous thromboembolism rates between trials that use venographic outcomes compared with more clinically relevant outcomes.Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. more...
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- 2015
9. Emergency contraception
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Sheila Dunn, Édith Guilbert, Margaret Burnett, Anjali Aggarwal, Jeanne Bernardin, Virginia Clark, Victoria Davis, Jeffrey Dempster, William Fisher, Karen MacKinnon, Rosana Pellizzari, Viola Polomeno, Maegan Rutherford, Jeanelle Sabourin, Vyta Senikas, and Marie-Soleil Wagner more...
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Health Knowledge, Attitudes, Practice ,Time Factors ,Practice setting ,business.industry ,medicine.medical_treatment ,Contraindications ,Obstetrics and Gynecology ,Levonorgestrel ,medicine.disease ,Intrauterine Devices, Copper ,Clinical Practice ,Action (philosophy) ,Pregnancy ,Medicine ,Humans ,Emergency contraception ,Female ,Medical emergency ,business ,Contraception, Postcoital - Abstract
To review current knowledge about emergency contraception (EC), including available options, their modes of action, efficacy, safety, and the effective provision of EC within a practice setting.The combined estradiol-levonorgestrel (Yuzpe regimen) and the levonorgestrel-only regimen, as well as post-coital use of copper intrauterine devices, are reviewed.Efficacy in terms of reduction in risk of pregnancy, safety, and side effects of methods for EC and the effect of the means of access to EC on its appropriate use and the use of consistent contraception.Studies published in English between January 1998 and March 2010 were retrieved though searches of Medline and the Cochrane Database, using appropriate key words (emergency contraception, post-coital contraception, emergency contraceptive pills, post-coital copper IUD). Clinical guidelines and position papers developed by health or family planning organizations were also reviewed.The studies reviewed were classified according to criteria described by the Canadian Task Force on Preventive Health Care, and the recommendations for practice were ranked according to this classification (Table 1).These guidelines are intended to help reduce unintended pregnancies by increasing awareness and appropriate use of EC.The Society of Obstetricians and Gynaecologists of Canada. Summary Statements 1. Hormonal emergency contraception may be effective if used up to 5 days after unprotected intercourse. (II-2) 2. The earlier hormonal emergency contraception is used, the more effective it is. (II-2) 3. A copper IUD can be effective emergency contraception if used within 7 days after intercourse. (II-2) 4. Levonorgestrel emergency contraception regimens are more effective and cause fewer side effects than the Yuzpe regimen. (I) 5. Levonorgestrel emergency contraception single dose (1.5 mg) and the 2-dose levonorgestrel regimen (0.75 mg 12 hours apart) have similar efficacy with no difference in side effects. (I) 6. Of the hormonal emergency contraception regimens available in Canada, levonorgestrel-only is the drug of choice. (I) 7. A pregnancy that results from failure of emergency contraception need not be terminated (I) Recommendations 1. Emergency contraception should be used as soon as possible after unprotected sexual intercourse. (II-2A) 2. Emergency contraception should be offered to women if unprotected intercourse has occurred within the time it is known to be effective (5 days for hormonal methods and up to 7 days for a copper IUD). (II-2B) 3. Women should be evaluated for pregnancy if menses have not begun within 21 days following emergency contraception treatment. (III-A) 4. During physician visits for periodic health examinations or reproductive health concerns, any woman in the reproductive age group who has not been sterilized may be counselled about emergency contraception in advance with detailed information about how and when to use it. (III-C). more...
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- 2012
10. Semuloparin for thromboprophylaxis in patients receiving chemotherapy for cancer
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Giancarlo, Agnelli, Daniel J, George, Ajay K, Kakkar, William, Fisher, Michael R, Lassen, Patrick, Mismetti, Patrick, Mouret, Umesh, Chaudhari, Francesca, Lawson, Alexander G G, Turpie, and V, Armenio more...
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Adult ,medicine.medical_specialty ,Bevacizumab ,medicine.medical_treatment ,Antineoplastic Agents ,Hemorrhage ,Kaplan-Meier Estimate ,Double-Blind Method ,Fibrinolytic Agents ,Risk Factors ,Multicenter trial ,Neoplasms ,medicine ,Humans ,Fibrinopeptide A ,Chemotherapy ,business.industry ,Incidence ,Cancer ,General Medicine ,Venous Thromboembolism ,Heparin, Low-Molecular-Weight ,medicine.disease ,Thrombosis ,Chemotherapy regimen ,Surgery ,Pulmonary embolism ,Semuloparin ,business ,medicine.drug - Abstract
Patients receiving chemotherapy for cancer are at increased risk for venous thromboembolism. Limited data support the clinical benefit of antithrombotic prophylaxis.In this double-blind, multicenter trial, we evaluated the efficacy and safety of the ultra-low-molecular-weight heparin semuloparin for prevention of venous thromboembolism in patients receiving chemotherapy for cancer. Patients with metastatic or locally advanced solid tumors who were beginning to receive a course of chemotherapy were randomly assigned to receive subcutaneous semuloparin, 20 mg once daily, or placebo until there was a change of chemotherapy regimen. The primary efficacy outcome was the composite of any symptomatic deep-vein thrombosis, any nonfatal pulmonary embolism, and death related to venous thromboembolism. Clinically relevant bleeding (major and nonmajor) was the main safety outcome.The median treatment duration was 3.5 months. Venous thromboembolism occurred in 20 of 1608 patients (1.2%) receiving semuloparin, as compared with 55 of 1604 (3.4%) receiving placebo (hazard ratio, 0.36; 95% confidence interval [CI], 0.21 to 0.60; P0.001), with consistent efficacy among subgroups defined according to the origin and stage of cancer and the baseline risk of venous thromboembolism. The incidence of clinically relevant bleeding was 2.8% and 2.0% in the semuloparin and placebo groups, respectively (hazard ratio, 1.40; 95% CI, 0.89 to 2.21). Major bleeding occurred in 19 of 1589 patients (1.2%) receiving semuloparin and 18 of 1583 (1.1%) receiving placebo (hazard ratio, 1.05; 95% CI, 0.55 to 1.99). Incidences of all other adverse events were similar in the two study groups.Semuloparin reduces the incidence of thromboembolic events in patients receiving chemotherapy for cancer, with no apparent increase in major bleeding. (Funded by Sanofi; ClinicalTrials.gov number, NCT00694382.). more...
- Published
- 2012
11. Assessment and Treatment of Comorbid Substance Abuse in Individuals with Schizophrenia
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Douglas M. Ziedonis and William Fisher
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Substance abuse ,Psychiatry and Mental health ,medicine.medical_specialty ,business.industry ,Schizophrenia (object-oriented programming) ,medicine ,medicine.disease ,Psychiatry ,business - Abstract
The Epidemiological Catchment Area study found that 47% of individuals with schizophrenia have or have had an alcohol or illicit drug use disorder during their lifetime.
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- 1994
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12. Event-related potentials in impulsively aggressive juveniles: a retrospective chart-review study
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Dan Matthews, Natalie A. Ceballos, William Fisher, and Larry Fisher
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Male ,medicine.medical_specialty ,Impulse control disorder ,Adolescent ,Poison control ,Audiology ,Impulsivity ,Developmental psychology ,Event-related potential ,Injury prevention ,medicine ,Reaction Time ,Humans ,Clinical significance ,Child ,Biological Psychiatry ,Retrospective Studies ,Aggression ,Cognition ,Electroencephalography ,medicine.disease ,Psychiatry and Mental health ,Impulsive Behavior ,Evoked Potentials, Visual ,Female ,medicine.symptom ,Psychology ,Photic Stimulation - Abstract
The assessment, treatment and management of aggressive youth represent a major clinical challenge facing pediatric mental health professionals today. Although a number of studies have examined physiological differences among aggressive patients vs. controls, the current literature lacks a comprehensive examination of the electroencephalographic activity of impulsively aggressive juveniles. The current study was designed to fill this void in the literature via a retrospective chart review of 80 male and female juveniles undergoing inpatient treatment for pathologically impulsive aggression. Clinical reports for mid- and late-latency event-related potentials (ERPs) were examined to determine their correlations with aggression characteristics, as well as any differential predictive utility of hemispheric differences and auditory vs. visual potentials. Results indicated that decrements of mid-latency potentials and ERPs evoked by auditory stimuli (vs. late-latency components and visual ERPs) were more highly predictive of aggressive behavior. No significant hemispheric differences were noted. Taken together, these results have theoretical significance for the etiology of impulsive aggression, and perhaps also clinical relevance for the treatment of this condition. more...
- Published
- 2010
13. Rhinological manifestations of Paget's disease of bone (osteitis deformans)
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Edward William Fisher
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musculoskeletal diseases ,Rhinology ,medicine.medical_specialty ,Bone disease ,Nose Neoplasms ,Malignancy ,Nose Diseases ,otorhinolaryngologic diseases ,medicine ,Humans ,Nose ,Aged ,Osteosarcoma ,business.industry ,Osteomyelitis ,Osteitis Deformans ,Middle Aged ,medicine.disease ,Surgery ,Paget's disease of bone ,medicine.anatomical_structure ,Otorhinolaryngology ,Maxilla ,Female ,Oral Surgery ,business - Abstract
Summary Two cases of Paget's disease of bone are presented in which nasal symptoms were prominent. The clinical and radiographic features of Paget's disease of the maxilla and ethmoids are described. Medical and surgical treatment is discussed with the recommendation that surgery is kept to a minimum and covered by prophylactic antibiotics to prevent osteomyelitis. Sudden enlargement of the involved bones should raise the suspicion of malignancy. more...
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- 1990
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14. Contraception d’urgence
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Sheila Dunn, Édith Guilbert, Margaret Burnett, Anjali Aggarwal, Jeanne Bernardin, Virginia Clark, Victoria Davis, Jeffrey Dempster, William Fisher, Karen MacKinnon, Rosana Pellizzari, Viola Polomeno, Maegan Rutherford, Jeanelle Sabourin, Vyta Senikas, and Marie-Soleil Wagner more...
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business.industry ,medicine.medical_treatment ,medicine ,Obstetrics and Gynecology ,Emergency contraception ,Medical emergency ,medicine.disease ,business - Published
- 2012
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15. ASSESSING ADHERENCE TO USE OF HIP PROTECTORS: AUTOMATED MONITORING IS FEASIBLE
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Julie Stocks, Susan Kurrle, Keri Lockwood, William Fisher, Frederieke G. Schaafsma, Chanelle Oen, Susan Quine, Bronwyn Cook, and Ian D. Cameron
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medicine.medical_specialty ,Text mining ,business.industry ,Medicine ,Medical emergency ,Geriatrics and Gerontology ,business ,medicine.disease ,Surgery - Published
- 2011
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16. Thermal Epiglottitis From Smoking a Home Rolled Cigarette
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Rami Zebian, William Fisher, Saadia A. Faiz, Labib Debiane, and George Nassif
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Epiglottitis ,business.industry ,Emergency medicine ,medicine ,Cardiology and Cardiovascular Medicine ,Critical Care and Intensive Care Medicine ,medicine.disease ,business - Published
- 2012
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17. Hypnosis for hot flashes among postmenopausal women study: A study protocol of an ongoing randomized clinical trial
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William Fisher, Gary R. Elkins, and Aimee K. Johnson
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medicine.medical_specialty ,Hydrocortisone ,Visual analogue scale ,Hospital Anxiety and Depression Scale ,law.invention ,Pittsburgh Sleep Quality Index ,03 medical and health sciences ,Study Protocol ,0302 clinical medicine ,Randomized controlled trial ,Clinical Protocols ,law ,Hot flash ,medicine ,Humans ,030212 general & internal medicine ,business.industry ,lcsh:Other systems of medicine ,General Medicine ,Center for Epidemiologic Studies Depression Scale ,Middle Aged ,lcsh:RZ201-999 ,medicine.disease ,3. Good health ,Menopause ,Postmenopause ,Complementary and alternative medicine ,030220 oncology & carcinogenesis ,Hot Flashes ,Physical therapy ,Anxiety ,Female ,medicine.symptom ,business ,Hypnosis ,Follow-Up Studies - Abstract
Background Hot flashes are a highly prevalent problem associated with menopause and breast cancer treatments. The recent findings from the Women's Health Initiative have important implications for the significance of a non-hormonal, mind-body intervention for hot flashes in breast cancer survivors. Women who take hormone therapy long-term may have a 1.2 to 2.0 fold increased risk of developing breast cancer. In addition, it is now known that hormone therapy with estrogen and progestin is associated with increased risk of cardiovascular disease and stroke. Currently there are limited options to hormone replacement therapy as non-hormonal pharmacological agents are associated with only modest activity and many adverse side effects. Because of this there is a need for more alternative, non-hormonal therapies. Hypnosis is a mind-body intervention that has been shown to reduce self-reported hot flashes by up to 68% among breast cancer survivors, however, the use of hypnosis for hot flashes among post-menopausal women has not been adequately explored and the efficacy of hypnosis in reducing physiologically measured hot flashes has not yet been determined. Methods/design A sample of 180 post-menopausal women will be randomly assigned to either a 5-session Hypnosis Intervention or 5-session structured-attention control with 12 week follow-up. The present study will compare hypnosis to a structured-attention control in reducing hot flashes (perceived and physiologically monitored) in post-menopausal women in a randomized clinical trial. Outcomes will be hot flashes (self-report daily diaries; physiological monitoring; Hot Flash Related Daily Interference Scale), anxiety (State-Trait Anxiety Inventory; Hospital Anxiety and Depression Scale (HADS); anxiety visual analog scale (VAS rating); depression (Center for Epidemiologic Studies Depression Scale), sexual functioning (Sexual Activity Questionnaire), sleep quality (Pittsburgh Sleep Quality Index) and cortisol. Discussion This study will be the first full scale test of hypnosis for hot flashes; one of the first studies to examine both perceived impact and physiologically measured impact of a mind-body intervention for hot flashes using state-of-the-art 24 hour ambulatory physiological monitoring; the first study to examine the effect of hypnosis for hot flashes on cortisol; and the first investigation of the role of cognitive expectancies in treatment of hot flashes in comparison to a Structured-Attention Control. Trial Registration This clinical trial has been registered with ClinicalTrials.gov, a service of the U.S. National Institutes of Health, ClinicalTrials.gov Identifier: NCT01293695. more...
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