Outcomes among patients treated for gastric adenocarcinoma during the last decade.

OBJECTIVES: To evaluate the outcomes among patients treated for gastric adenocarcinoma in a referral hospital, and to identify possible trends during the last decade. METHODS: All patients evaluated for gastric adenocarcinoma during the period 1999-2009 were included. RESULTS: Of 397 patients, 52% were curatively resected. Crude 5-year survival for the first 6 years period was 38.7% (CI 29.5-47.9), for the last 5 years, 49.2% (CI 38.8-59.6). Time period (P = 0.013), age (P < 0.001) and disease stage (P < 0.001), were significant predictors of long-term survival rates. Among curatively resected, in-hospital mortality was reduced from 8.5% in the first period to 2.0% in the last one (P = 0.037). There was a significant increase in the use of primary stents from the first to the last period (P = 0.006), paralleled by a significant reduction in the number of explorative laparotomies or bypass procedures (P < 0.001). CONCLUSIONS: During the last decade, long-term survival rates improved among patients curatively resected for gastric adenocarcinoma, and in-hospital mortality was substantially reduced. For patients in a non-curative situation, there was a significant shift from explorative laparotomies or bypass procedures to primary use of stents.

Validation of the Dental Fear Scale and the Dental Belief Survey in a Norwegian sample.

The aim of this study was to validate the Kleinknecht's Dental Fear Scale and the Getz's Dental Belief Survey in a Norwegian sample by 1) testing their ability to discriminate between fearful (n = 151) and regular (n = 160) patients, and 2) correlating them. Both instruments were highly reliable (Cronbach's alpha > 0.90). Between 81% and 95% of the fearful and regular patients were correctly assigned to their appropriate groups with both instruments. It may thus be concluded that both instruments are valid. Also, the correlation between the instruments was 0.68, indicating that they to a large extent seem to measure the same concept. The most important predictor items for both instruments were related to avoidance of dental treatment.

Prediction of individual vulnerability to stress-induced gastric ulcerations in rats: a factor analysis of selected behavioral and biological indices.

Fifty rats were subjected seriatim to 6 different test tasks (open-field, startle, drug-induced sterotypy, oral finickiness, defensive burying, and memory for aversive event). This yielded 12 test-specific plus 2 general biobehavioral measures (growth and defecation). These 14 measures were subjected to factor analysis to determine if these measured tapped a common construct of "emotionality." The data yielded a 4-factor structure of Finickiness, Defensiveness, Startle-Sensitivity, and Dopaminergic-Sensitivity that accounted for 62% of the variance. Then, all rats were subjected to restraint-in-water stress to induce gastric ulcerations. Multivariate techniques tested if there was a factor or factor-structure that could predict individual differences in vulnerability to the stress-induced gastric ulcerations. Only the Dopaminergic-Sensitivity factor predicted ulcerogenic vulnerability, and its predictive power resided substantially in the latency to initiate stereotypic gnawing induced by apomorphine. This single test score correlated with amount of ulcer (r = +0.52), accounting for 25% of the variance in ulcer, suggesting that 1. prescreening rats on this variable could be a tool for reducing intrastrain experimental variance in future studies of treatments that modulate ulcerogenicity, and 2. the dopaminergic system may be intimately involved in the causal path of ulcerogenicity.

Psychological variables and patient acceptance of complete dentures.

Psychological variables and tests used in general psychology have been used in the prediction of patient acceptance of dentures. However, a survey of the dental literature indicates that with the possible exception of a 'focused interview' on self-image, none of these methods are of clinical value, either for practical reasons or because their ability to predict denture acceptance is negligible. In the present study 74 individuals with newly made dentures were interviewed with a focused interview and 16 additional questions. No correlations of practical importance between these psychological variables and denture acceptance were found, indicating that useful indicators of patient acceptance of dentures will have to be designed for the prosthodontic problem specifically.

Social variables and patient acceptance of complete dentures. A study of patients attending a dental school.

It has been suggested that the social conditions under which patients live may influence their acceptance of dentures. In this paper a sample of 74 complete-denture wearers has been interviewed with regard to several social variables. These variables include the patients' marital status, occupation, interests, social activities, economy, housing conditions, relationship to neighbors, and other people's opinion of their new dentures. The last factor appeared to influence denture acceptance strongly. The other social variables tested showed no significant or only minimal effects in this respect.

Some attitudes towards edentulousness, complete dentures, and cooperation with the dentist. A study of denture patients attending a dental school.

Our purpose was to study some patient attitudes related to edentulousness and aspects of the personal relationship between patient and dentist. Seventy-four edentulous patients at a dental school, all experienced denture wearers, were interviewed before the insertion of new complete dentures. Half of them felt bitter and sad about the loss of their teeth. This attitude was found significantly more frequently in women than men. More than 3/4 were quite willing to talk to others about having dentures. Almost as many, however, refused to appear in front of others without their dentures. Nearly 70% seemed to have accepted their dentures as a part of themselves. More than 80% of the patients expressed that satisfaction with new dentures may be influenced by the personal relationship between patient and dentist. A similar proportion expressed that satisfaction with dentures may be influenced by their own cooperation. There seemed to be less agreement about how they should cooperate and also what the responsibilities of the dentist were. None of these patient attitudes or opinions were significantly related to acceptance of new dentures.

Patient motives and fulfillment of motives in renewal of complete dentures.

Seventy-four edentulous patients were interviewed concerning their opinion of their old dentures, motives for renewing them, and requirements for new ones. After an initial period of adaptation they were asked questions relating to their experience with the new dentures. More than 80% of the patients claimed to have functional motives for renewing their old dentures. A similar proportion had functional requirements with regard to the new ones. Less than 30% claimed to have any esthetic motives. Examination of the data, however, suggests that the esthetic factor may be underrecorded. The patient motives, as recorded, were only weakly correlated to the overall acceptance of new dentures. More than 90% found their new dentures as expected or better than expected.

Multivariate analysis of the septal syndrome.

Since recent reviews of the behavioural effects of septal lesions agree that more than one explanatory concept is required, a multivariate analysis of the septal syndrome has been made. A total of 127 rats have been tested 73 with septal lesions and 54 controls. The rats were tested in a standard test battery consisting of a residential maze, spontaneous alternation, spatial learning, approach/avoidance conflict and one-way active avoidance. Factor analyses reveal a complex change in the factor structure after septal lesions. None of the previous explanations of septal functions receives unequivocal support. The findings do not exclude the possibility that septal lesions interfere with a few general behaviour mechanisms or perhaps only one. However, if so, this factor does not explain as much of the variance as expected. Situational or test-dependent factors play a greater role in the variance. This is interpreted as an indication of insufficiency in the theoretical structure, or in conventional test designs.