OBJECTIVE: We investigated the efficacy and tolerability of paliperidone extended-release (ER) tablets in patients with first-episode psychosis (n=75). METHODS: This was an 8-week, open-label, multicenter trial. The primary outcome variable was scores on the Positive and Negative Syndrome Scale (PANSS); secondary measures included the Scale for the Assessment of Negative Symptoms (SANS), the Cognitive Assessment Interview (CAI), and the Global Assessment of Functioning (GAF). To assess safety, we measured drug-related adverse events, weight, lipid-related variables, and prolactin and administered the Simpson–Angus Rating Scale (SARS), the Abnormal Involuntary Movement Scale (AIMS), the Barnes Akathisia Scale (BAS), the Arizona Sexual Experiences Scale (ASEX), and the Udvalg for Kliniske Undersogelser side effect rating scale (UKU). RESULTS: The administration of paliperidone ER resulted in significant improvement in the PANSS, SANS, CAI, and GAF scores (p<0.001) over time. This improvement was evident as early as 1 week. The most frequent adverse events were akathisia, somnolence, anxiety, and sedation, which were well tolerated. Modest increases in weight and lipid profiles were also noted. Prolactin levels were substantially increased at the endpoint in both male and female patients. CONCLUSION: These results indicate that paliperidone ER is effective and is characterized by good tolerability in the treatment of positive and negative symptoms and cognitive functioning in first-episode psychosis.
Abnormal Involuntary Movement Scale ; Anxiety ; Arizona ; Female ; Humans ; Male ; Multicenter Studies as Topic* ; Paliperidone Palmitate* ; Prolactin ; Psychomotor Agitation ; Psychotic Disorders* ; Tablets

BACKGROUND AND PURPOSE: The purpose of this study was to estimate the incidence and prevalence of epilepsy among an elderly and poor population in the United States. METHODS: Arizona Medicaid claims data from January 1, 2008 to December 31, 2010 were used for this analysis. Subjects who were aged > or =65 years and were continuously enrolled in any Arizona Medicaid health plans (eligible to patients with low income) for > or =12 months between January 1, 2008 and December 31, 2009 were considered eligible for inclusion in the study cohort. In addition to meeting the aforementioned criteria, incident and prevalent cases must have had epilepsy-related healthcare claims. Furthermore, incident cases were required to have a 1-year "clean" period immediately preceding the index date. Negative binomial and logistic regression models were used to assess the factors associated with epilepsy incidence and prevalence. RESULTS: The estimated epilepsy incidence and prevalence for this population in 2009 were 7.9 and 19.3 per 1,000 person-years, respectively. The incidence and prevalence rates were significantly higher for patients with comorbid conditions that were potential risk factors for epilepsy and were of younger age than for their non-comorbid and older counterparts (p<0.05). The prevalence rates were significantly higher for non-Hispanic Blacks and male beneficiaries than for non-Hispanic Whites and female beneficiaries, respectively (p<0.05). CONCLUSIONS: This patient population had higher epilepsy incidence and prevalence compared with the general US population. These differences may be at least in part attributable to their low socioeconomic status.
African Continental Ancestry Group ; Aged* ; Arizona ; Cohort Studies ; Delivery of Health Care ; Epilepsy* ; Female ; Humans ; Incidence* ; Logistic Models ; Male ; Medicaid ; Poverty* ; Prevalence* ; Risk Factors ; Social Class ; United States*

PURPOSE: This study was performed in order to identify the relationships among self-care behavior, health conservation, and cardiovascular risk factors and to examine the influence of self-care behavior and health conservation on cardiovascular risk factors among Korean elders with diabetes mellitus. METHODS: The participants were 105 elders with diabetes mellitus using senior welfare centers and elderly leisure houses in Daegu. Data were collected through interviews during the period from April to May in 2014. Self-care behavior was measured with Kim's (1997) Self-care Behavior Scale, health conservation with Sung's (2005) Health Conservation Scale, and cardiovascular risk factors with the Arizona Heart Institute Cardiovascular Risk Factor Questionnaire. Collected data were analyzed through one-way ANOVA, independent t-test, Pearson's correlation, and stepwise multiple regression using the SPSS/WIN 19.0 program. RESULTS: A negative correlation was found between self-care behavior and cardiovascular risk factors, and between health conservation and cardiovascular risk factors. Self-care behavior explained 6% and health conservation did 49% of variance in elderly diabetes mellitus patients' cardiovascular risk. CONCLUSION: The results indicate that, in order to reduce cardiovascular risk factors among Korean elders with diabetes mellitus, we need nursing interventions for increasing health conservation and self-care behavior.
Aged* ; Arizona ; Daegu ; Diabetes Mellitus* ; Health Behavior ; Heart ; Humans ; Leisure Activities ; Nursing ; Risk Factors* ; Self Care* ; Surveys and Questionnaires

BACKGROUND: The importance of communication between patients and physicians has been proven in many previous studies. The authors analyzed the effect of interview skill education through videotapes which recorded students' interviews with real patients in the outpatient department of family medicine. METHODS: This study was conducted with all students who chose the elective course of family medicine and one randomly selected student every week from an 'infectious internal medicine' class at Dongguk University Ilsan Hospital during the period from December 2008 to March 2011. All students performed a preliminary examination of a new patient at the outpatient department of family medicine. All consultations were videotaped. Feedback to the student was given on the same day by viewing the videotape together. After feedback, all students performed another preliminary examination of one new patient at the department of family medicine the same week. Three family medicine residents scored all videotapes using 10-item interview skill checklists. Many parts of the checklists were modified using the Arizona Clinical Interview Rating Scales. RESULTS: Thirty-three students participated. Of 10 items, nine showed increased scores after feedback. There was a significant change in four items after feedback: 'type of question' (before 2.36 +/- 0.60, after 2.73 +/- 0.72), 'timeline' (before 2.82 +/- 0.68, after 3.18 +/- 0.73), 'positive verbal reinforcement' (before 2.24 +/- 0.56, after 2.61 +/- 0.90), and the total score (before 21.70 +/- 2.62, after 23.39 +/- 3.13) (P < 0.05). CONCLUSION: Giving feedback to medical school students on medical interview skills using videotapes of students' preliminary consultations with real patients in outpatient settings, was effective in improving the interview areas of 'type of question,' 'timeline,' 'positive verbal reinforcement,' and the total interview scores.
Arizona ; Checklist ; Humans ; Outpatients ; Referral and Consultation ; Schools, Medical ; Videotape Recording

The aim of the present study was to retrospectively identify sexual dysfunction changes in the patients under mirtazapine-augmented serotonin reuptake inhibito (SSRI) treatment. The study comprised medical records of 20 outpatients, under mirtazapine-augmented SSRI treatment for their major depressive disorder, who had been selected among the patients that had developed sexual dysfunction to previous treatment as monotherapy, with SSRI for at least six weeks. These drugs were maintained and mirtazapine were added (15-45 mg/day). There was a significant difference in scores between baseline and week 4 or week 8 on the both Hamilton Depression Rating and Arizona Sexual Experience Scale. According to Clinical Global Impression-Improvement, 68.4% of the patients were responders. The use of low-dose mirtazapine as an add-on treatment to SSRIs appears to be an effective and well-tolerated augmenttaion for sexual dysfunction caused by SSRIs.
Arizona ; Depression ; Depressive Disorder, Major ; Humans ; Medical Records ; Mianserin ; Outpatients ; Retrospective Studies ; Serotonin

OBJECTIVE: Antidepressants used to treat depression are frequently associated with sexual dysfunction. Sexual side effects affect the patient's quality of life and, in long-term treatment, can lead to non-compliance and relapse. However, studies covering many antidepressants with differing mechanisms of action were scarce. The present study assessed and compared the incidence of sexual dysfunction among different antidepressants in a naturalistic setting. METHODS: Participants were married patients diagnosed with depression, per DSM-IV diagnostic criteria, who had been taking antidepressants for more than 1 month. We assessed the participants via the Arizona Sexual Experiences Scale (ASEX), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI), and assessed their demographic variables, types and dosages of antidepressants, and duration of antidepressant use via their medical records. RESULTS: One hundred and one patients (46 male, 55 female, age 42.2+/-7 years) completed the instruments. Thirteen were taking fluoxetine (mean dose 21.3+/-8.5 mg/day), 24 were taking paroxetine (mean dose 20.4+/-7.2 mg/day), 20 taking citalopram (mean dose 22.1+/-6.5 mg/day), 22, venlafaxine (mean dose 115.7+/-53.2 mg/day) and 22, mirtazapine (mean dose 18+/-8.7 mg/day). Mean ages, sex ratios, and BDI and STAI scores did not differ significantly across antidepressants. A substantial number of participants (46.5%, n=47) experienced sexual dysfunction. The prevalence of sexual dysfunction differed across drugs: citalopram 60% (n=12), venlafaxine 54.5% (n=12), paroxetine 54.2% (n=13), fluoxetine 46.2% (n=6), and mirtazapine 18.2% (n=4). Regression analyses revealed the significant factors for sexual dysfunction were being female, total scores on the BDI and SAI, and type of antidepressant (F=4.92, p<0.0001). Of the antidepressants, the mirtarzapine group's total ASEX score was significantly lower than the scores of the citalopram, fluoxetine, and paroxetine groups. CONCLUSION: The incidence of sexual dysfunction was substantially high during antidepressant treatment. The incidence of sexual dysfunction differed among antidepressants having different mechanisms of action. Our study suggests the need for clinicians to consider the impact of pharmacotherapy on patients' sexual functioning in the course of treatment with antidepressants.
Antidepressive Agents ; Anxiety ; Arizona ; Citalopram ; Cyclohexanols ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Fluoxetine ; Humans ; Incidence ; Male ; Mianserin ; Paroxetine ; Prevalence ; Quality of Life ; Recurrence ; Sex Ratio ; Venlafaxine Hydrochloride

PURPOSE: Recently, the Recon Challenge at the 2009 ISMRM workshop on Data Sampling and Image Reconstruction at Sedona, Arizona was held to evaluate feasibility of highly accelerated acquisition of time resolved contrast enhanced MR angiography. This paper provides the step-by-step description of the winning results of k-t FOCUSS in this competition. MATERIALS AND METHODS: In previous works, we proved that k-t FOCUSS algorithm successfully solves the compressed sensing problem even for less sparse cardiac cine applications. Therefore, using k-t FOCUSS, very accurate time resolved contrast enhanced MR angiography can be reconstructed. Accelerated radial trajectory data were synthetized from X-ray cerebral angiography images and provided by the organizing committee, and radiologists double blindly evaluated each reconstruction result with respect to the ground-truth data. RESULTS: The reconstructed results at various acceleration factors demonstrate that each components of compressed sensing, such as sparsifying transform and incoherent sampling patterns, etc can have profound effects on the final reconstruction results. CONCLUSION: From reconstructed results, we see that the compressed sensing dynamic MR imaging algorithm, k-t FOCUSS enables high resolution time resolved contrast enhanced MR angiography.
Acceleration ; Angiography ; Arizona ; Cerebral Angiography ; Image Processing, Computer-Assisted ; Principal Component Analysis

PURPOSE: Recently, the Recon Challenge at the 2009 ISMRM workshop on Data Sampling and Image Reconstruction at Sedona, Arizona was held to evaluate feasibility of highly accelerated acquisition of time resolved contrast enhanced MR angiography. This paper provides the step-by-step description of the winning results of k-t FOCUSS in this competition. MATERIALS AND METHODS: In previous works, we proved that k-t FOCUSS algorithm successfully solves the compressed sensing problem even for less sparse cardiac cine applications. Therefore, using k-t FOCUSS, very accurate time resolved contrast enhanced MR angiography can be reconstructed. Accelerated radial trajectory data were synthetized from X-ray cerebral angiography images and provided by the organizing committee, and radiologists double blindly evaluated each reconstruction result with respect to the ground-truth data. RESULTS: The reconstructed results at various acceleration factors demonstrate that each components of compressed sensing, such as sparsifying transform and incoherent sampling patterns, etc can have profound effects on the final reconstruction results. CONCLUSION: From reconstructed results, we see that the compressed sensing dynamic MR imaging algorithm, k-t FOCUSS enables high resolution time resolved contrast enhanced MR angiography.
Acceleration ; Angiography ; Arizona ; Cerebral Angiography ; Image Processing, Computer-Assisted ; Principal Component Analysis

OBJECTIVEInjuries are common and important problem in Tehran, capital of Iran. Although therapeutic centers are not essentially established following the constructional principles of developed countries, the present opportunities and equipments have to be used properly. We should recognize and reduce the deficits based on the global standards. This study deliberates the trauma resources and capacities in university hospitals of Tehran based on Arizona trauma center standards, which are suitable for the assessment of trauma centers.

METHODSForty-one university hospitals in Tehran were evaluated for their conformity with "Arizona trauma center standards" in 2008. A structured interview was arranged with the "Educational Supervisor" of all hospitals regarding their institutional organization, departments, clinical capabilities, clinical qualifications, facilities and resources, rehabilitation services, performance improvement, continuing education, prevention, research and additional requirements for pediatric trauma patients. Relative frequencies and percentages were calculated and Student's t test was used to compare the mean values.

RESULTSForty-one hospitals had the average of 77.7 (50.7%) standards from 153 Arizona trauma center standards and these standards were present in 97.5 out of 153 (63.7%) in 17 general hospitals. Based on the subgroups of the standards, 64.8% items of hospital resources and capabilities were considered as a subgroup with the maximum criteria, and 17.7% items of research section as another subgroup with the minimum standards.

CONCLUSIONSOn the basis of our findings, no hospital meet all the Arizona trauma center standards completely. The hospitals as trauma centers at different levels must be promoted to manage trauma patients desirably.

Arizona ; Hospitals, University ; standards ; Humans ; Iran ; Trauma Centers ; standards

AIMCluster analysis was conducted on data from 5,169 United States (U.S.) Arizona children, age's 5-59-months with the goal of delineating patterns of caries in the primary dentition of pre-school children without a priori pattern definitions.

METHODOLOGYCluster analyses were conducted using all data for children ages 0-4 years in aggregate: (1) for all subjects, and (2) for subjects without crowned restored teeth. Each of these two sets of analyses consisted of 8 differently specified cluster analyses as a validation procedure.

RESULTSThe caries patterns identified from the clustering analysis are: (1) smooth surfaces (other than the maxillary incisor), (2) maxillary incisor, (3) occlusal surfaces of first molars, and (4) pit and fissure surfaces of second molars.

CONCLUSIONThe cluster analysis findings were consistent with results produced by multidimensional scaling. These cross-validated patterns may represent resulting disease conditions from different risks or the timing of various risk factor exposures. As such, the patterns may be useful case definitions for caries risk factor investigations in children under 60 months of age.

Arizona ; epidemiology ; Caregivers ; education ; Child, Preschool ; Cluster Analysis ; Cohort Studies ; Dental Caries ; epidemiology ; Dental Enamel ; pathology ; Dental Fissures ; epidemiology ; Educational Status ; Ethnic Groups ; statistics & numerical data ; Female ; Humans ; Incisor ; pathology ; Infant ; Male ; Mandible ; Maxilla ; Molar ; pathology ; Tooth, Deciduous ; pathology