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Biomedical subjects

Martin Voracek

Publications and source records attributed to Martin Voracek.

At least 55 records · Page 3Linked to original sources
PubMed2004

Neoadjuvant radiochemotherapy of oral cavity and oropharyngeal cancer: evaluation of tumor response by CT differs from histopathologic response assessment in a significant fraction of patients.

BACKGROUND: Our aim was to compare and assess the predictive value of CT and histopathologic grading of tumor regression at primary tumor sites in patients with squamous cell carcinoma of the oral cavity and oropharynx after neoadjuvant (preoperative) radiochemotherapy (RCT). METHODS: We investigated 55 patients with carcinomas of the oral cavity and oropharynx who underwent RCT before curative surgery. Two blinded observers measured RCT-induced reduction of tumor volume in pretherapeutic and posttherapeutic CT scans. Volume changes were compared with histopathologic findings obtained at surgery. RESULTS: Histopathologic response evaluation revealed 31 complete remissions, 12 cases of partial response, and 12 nonresponders. We performed a logistic regression analysis to evaluate whether measured volume reduction could predict the likelihood of belonging to a certain response group. Taken together, we found 35 correct, 12 false-negative, and seven false-positive predictions. CONCLUSIONS: The extent of remission as assessed by CT scans 4 to 5 weeks after completion of neoadjuvant RCT leads to false predictions in a significant percentage of patients.

Adult↗
PubMed2004

A dose-response relationship between imitational suicides and newspaper distribution.

Although the Werther effect is well known, up to now a correlation between the differential distribution of particular media reports and subsequent imitational suicides could not be found. This study investigates a celebrity suicide by gun in Austria, which led to extensive reports in the largest Austrian newspaper, whose distribution shows substantial regional differences. The numbers of suicides by firearm in the 3 weeks after the reporting showed an increase over the 3 weeks prior. Regional analysis revealed a strong correlation of suicides by firearm and distribution of the newspaper (log odds ratios; r(9) = .62; p = .04, one-tailed). This dose-response effect explains 40% of the variability of changes. These results underline the influence of media reports on suicidal behavior.

Journal Article↗
PubMed2004

Effects of music therapy for children and adolescents with psychopathology: a meta-analysis.

BACKGROUND: The objectives of this review were to examine the overall efficacy of music therapy for children and adolescents with psychopathology, and to examine how the size of the effect of music therapy is influenced by the type of pathology, client's age, music therapy approach, and type of outcome. METHOD: Eleven studies were included for analysis, which resulted in a total of 188 subjects for the meta-analysis. Effect sizes from these studies were combined, with weighting for sample size, and their distribution was examined. RESULTS: After exclusion of an extreme positive outlying value, the analysis revealed that music therapy has a medium to large positive effect (ES =.61) on clinically relevant outcomes that was statistically highly significant (p <.001) and statistically homogeneous. No evidence of a publication bias was identified. Effects tended to be greater for behavioural and developmental disorders than for emotional disorders; greater for eclectic, psychodynamic, and humanistic approaches than for behavioural models; and greater for behavioural and developmental outcomes than for social skills and self-concept. CONCLUSIONS: Implications for clinical practice and research are discussed.

Adolescent↗
PubMed2004

Seasonality of suicide in Eastern Europe: a rejoinder to Lester and Moksony .

Seasonality of suicide in Hungary decreased from the 1980s to the 1990s, supporting the 2003 conclusion of Lester and Moksony. However, it was the strongest ever to be documented with contemporary suicide data, supporting the conjecture of Voracek, et al. (2002) that seasonality of suicide remains high in Eastern Europe. A new hypothesis regarding the co-occurrence of high incidence and strong seasonality of suicide is presented.

Europe, Eastern↗
PubMed2004

Suicide rate and blood groups: an ecological study of 39 nations.

Across 29 European and 10 non-European nations, contemporary suicide rates for men and women were negatively correlated with national proportions of people with Type O blood, thus replicating and extending findings of Lester (1987) and Lester and Kondrichin (2004).

Adult↗
PubMed2004

Variation in European suicide rates is better accounted for by latitude and longitude than by national percentage of Finno-Ugrians and Type O blood: a rebuttal of Lester and Kondrichin (2004).

The variation in contemporary suicide rates for men and women across 20 European nations is, in terms of shared variance, better accounted for by latitude and longitude than by national percentage of Finno-Ugrians and Type O blood, thus supporting the conclusion of Voracek, et al. in 2003 and refuting the supposition of Lester and Kondrichin of 2004. Discussion focuses on possible bases of this finding and on research problems pertaining to relations between suicide and blood type.

ABO Blood-Group System↗
PubMed2003

Suicide and general elections in Austria: do preceding regional suicide rate differentials foreshadow subsequent voting behavior swings?

BACKGROUND: Suicide-epidemiological research on short-term effects of elections on national/regional suicide and parasuicide incidence has yielded contradictory evidence. Reversing the cause-effect relationship of this line of research we investigated whether preceding regional suicide rates are related to subsequent election results. METHODS: For Austria's 121 districts, we regressed averaged standardized suicide rates for the preceding period (1988-1994) on political parties' subsequent electoral gains/losses (1999-to-1995) while controlling for a set of 12 domain-relevant psychosocial/economic indices. RESULTS: Stepwise weighted multiple regression led to a significant model. The 1999-to-1995 electoral gains/losses of two opposition parties, together with the population variation caused by migration balance and by births/deaths balance, accounted for a substantial part (30%) of the variability in preceding district-level suicide rates. Various other social indices failed to contribute further substantial increments to this model. CONCLUSIONS: This finding suggests that variations in preceding regional suicide incidence might be mirrored in subsequent changes in voting behavior. A speculative post hoc explanation for the finding is offered: on a community level, suicide's aftermath might produce socially and politically alienated survivors of suicide who co-shape swings towards opposition parties in subsequent general elections. The finding calls for more research on suicide's long-term aftermath. LIMITATIONS: Within-country replicability and cross-national generalizability await further investigation. At present, the factor/mechanism accounting for this finding is neither well-established nor has been directly tested.

Adult↗
PubMed2003

Videofluoroscopy of swallowing abnormalities in 22 symptomatic patients after cardiovascular surgery.

OBJECTIVE: The aim of this study was to evaluate the types of swallowing abnormalities that occur in symptomatic patients who have undergone cardiovascular surgery. MATERIALS AND METHODS: From 1994 to 2001, 22 patients (17 males and five females; age range, 4-89 years; mean age, 64 years) who had swallowing abnormalities after cardiovascular surgery were referred for a videofluoroscopic swallowing study. Each study was analyzed for functional abnormalities of the tongue, soft palate, epiglottis, hyoid and larynx, pharynx, upper esophageal sphincter, and esophagus. Also, the performance of transesophageal echocardiography, long-term intubation, or both was noted. RESULTS: Swallowing abnormalities were present in 18 patients (81.8%) (range, one to eight functional abnormalities; mean, 3.9 functional abnormalities). The distribution of abnormalities across the functional units statistically significantly deviated (chi(2) = 14.4; df = 6; p = 0.025) from uniform distribution, with abnormalities most commonly involving the hyoid and larynx (13 patients [59.1%]) and the pharynx (10 patients [45.5%]). Aspiration was found in 13 patients (59.1%) (predeglutitive, n = 1; intradeglutitive, n = 4; postdeglutitive, n = 3; and mixed, n = 5). In the 14 patients (63.6%) who underwent transesophageal echocardiography, long-term intubation, or both, we frequently found incomplete tilting of the epiglottis, pharyngeal weakness, and postdeglutitive aspiration. CONCLUSION: Most patients with swallowing problems after cardiovascular surgery present with multiple abnormalities that most commonly affect the hyoid and larynx and the pharynx and result predominantly in intra- or postdeglutitive aspiration. The performance of transesophageal echocardiography and long-term intubation may influence the types of swallowing abnormalities.

Adolescent↗
PubMed2003

The Finno-Ugrian suicide hypothesis: variation in European suicide rates by latitude and longitude.

The marked variation regarding the suicide rate in 34 European countries is well described by regressing the national suicide rate on the capital cities' latitudes and on an interaction term of squared latitude multiplied with longitude. The interaction term explains 40.8% and 29.1% of men's and women's suicide rate, respectively, and latitude explains a further significant increment of 10.9% and 10.6% variance of men's and women's suicide rate, respectively. This regression model quantifies the Finno-Ugrian suicide hypothesis of Kondrichin and of Marusic and Farmer. The European countries highest in suicide rate constitute a contiguous, J-shaped belt, spanning from Finland to Austria. This area maps onto the second principal component identified for European gene distribution, representing ancestral adaptation to cold climates and the Uralic language dispersion. Thus, population differences in genetic risk factors may account for the spatial pattern in European suicide rates.

Acclimatization↗
PubMed2002

Suicide risk-related knowledge and attitudes of general practitioners.

BACKGROUND: Those attempting or committing suicide very often contact their general practitioner (GP) in the weeks before the suicidal act. Therefore, the ability of GPs to detect and treat suicidality is of major importance for suicide prevention. OBJECTIVES: This study investigated the knowledge, attitudes, experiences, and potential problems GPs have in dealing with persons at risk of committing suicide in Vienna, a city well known for having a rather high suicide rate. METHODS: A 41-item questionnaire was developed and mailed to a random sample of 200 Viennese GPs who practice under the health insurance system. RESULTS: GPs' knowledge on suicidality and its management is sufficient, as is their awareness of risk groups, particularly regarding the suicide risk of depressed persons. However, there is a marked underestimation of the suicide risk of alcoholics and an overestimation of the risk of physicians. GPs also found it difficult to assess suicide risk, and they generally did not receive enough training in suicide prevention and were interested in further training. CONCLUSIONS: The results indicate a high general knowledge on suicidality, and a rather liberal attitude towards the issue, but they also reveal deficits and a need for further training.

Adult↗
PubMed2002

Evaluation of computer-based area and volume measurement from coronal computed tomography scans in isolated blowout fractures of the orbital floor.

PURPOSE: In this retrospective study, we evaluated isolated blowout fractures of the orbital floor by region-of-interest measurements from coronal computed tomography (CT) scans and their relationship to ophthalmologic findings. PATIENTS AND METHODS: Fracture area and volume of displaced tissue of blowout fractures in 38 patients were measured from coronal CT scans. Measurement was performed by identifying distances (for area calculation) of the fracture and identifying areas (for volume calculation) of the displaced tissue in each CT slice. The calculated data were then compared with the amount of enophthalmos, presence of diplopia, and limitation of ocular motility. RESULTS: Orbital floor area (mean +/- SD) was 5.72 +/- 1.07 cm(2); fracture area, 2.63 +/- 1.20 cm(2); and the volume of displaced tissue, 1.15 +/- 0.91 mL. The average proportion of the fracture within the orbital floor was 45.3 +/- 17.6%. Fracture area and volume of displaced tissue were significantly positively correlated with enophthalmos and diplopia and not correlated with the limitation of ocular motility. For enophthalmos of 2 mm or greater, mean fracture area (mean +/- SD) was 4.08 +/- 1.09 cm(2) and volume of displaced tissue was 1.89 +/- 1.19 mL; for less than 2-mm enophthalmos, 1.98 +/- 0.83 cm(2) and 0.83 +/- 0.58 mL, respectively. Enophthalmos of 2 mm can be expected with 3.38 cm(2) of fracture area and 1.62 mL of displaced tissue. CONCLUSIONS: Region-of-interest measurement from coronal CT scan has an application in the assessment of patients with pure blowout fractures of the orbital floor and adds useful information in posttraumatic evaluation of orbital fractures.

Adolescent↗
PubMed2002

2D- and 3D-based measurements of orbital floor fractures from CT scans.

OBJECTIVE: Two methods for area and volume calculation of the orbit were evaluated following blow-out fractures of the orbital floor using computed tomography (CT) scans. MATERIAL AND METHODS: Isolated blow-out fractures of the orbital floor in human cadavers were simulated by fracturing the orbital floor and placing a defined volume of silicone within each defect. The area of fracture and the volume of silicone simulating herniated periorbital tissue were evaluated in 16 orbits by the use of a three-dimensional (3D) CT-based software package (Analyze((R)); Mayo Clinic, Rochester, MN, USA) and software based on two-dimensional (2D) coronal CT scans. Both methods were compared with direct anatomical measurements and evaluated with Lin's concordance coefficient (rho(c)). RESULTS: Between-method concordance of area and volume calculation were rho(c)=0.962, and 0.872 for the 3D-CT-based method, and 0.981 and 0.952 for the 2D-CT method, respectively. The time allocated for measurement was significantly longer for the 3D-CT than for the 2D-CT method (p<0.001). CONCLUSION: Calculations of blow-out fractures of the orbital floor by 3D-CT and 2D-CT method are accurate for assessing the area of fracture and the volume of herniated tissue. Lesser processing time and simple usage favour the 2D-CT-based calculation method.

Cadaver↗
PubMed2002

Three-dimensional histomorphometric analysis of distraction osteogenesis using an implanted device for mandibular lengthening in sheep.

The aim of this study was to lengthen the sheep mandible with a fully buried device and to quantitatively analyze the tissue regenerate in the distraction gap by means of two-dimensional and three-dimensional histomorphometry. A custom-made device for continuous distraction was used in five adult sheep and fixed with three bicortical screws on either side of an osteotomy, anterior to the premolar region of the mandible. A cable-connected power and control unit was implanted in the neck region. After a 5-day latency period, distraction was activated every 2 hours and advanced at a rate of 1.01 mm per day. The distraction period was planned for 14 days, but because of stability problems and cable breakage, the actual distraction period ranged from 2 to 17 days, resulting in gap distances from 1.7 to 17.1 mm (mean, 0.95 mm/day). Osteogenesis was followed by radiographic imaging, and after a 6-week consolidation period, the harvested mandibles were serially sectioned for histologic and two-dimensional histomorphometric analysis, with three-dimensional reconstruction. Histologic examination of the specimens demonstrated predominantly membranous bone formation with remodeling bridging the distraction gap mainly in the periosteal region of the lingual side. In addition, cartilaginous areas and chondral bone formation were observed where the bridging appeared incomplete. Because of device fixation on the buccal side of the mandible, the preservation of the lingual periosteum seemed to play the major role for sufficient bone repair in the distraction gap. Cartilage within the distraction gap suggests fixation instability in this animal model.

Animals↗